Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .

OBJECTIVE To discuss the quality management of the recycled medical instrument.METHODS We executed the routine of recycled instrument seriously during our daily work,and gave strict measures during quality management such as callback,washing,classification,packaging,sterilization,handout,and inspection.RESULTS The recycled medical instrument had been used and managed for more than one year and the clinical work was ensured in progress smoothly and achieved satisfied results.CONCLUSIONS Actualizing the measure of quality control,perfecting the method of management and improving quality control could assure the safe and efficient use of recycled medical instrument and reach the standard of controlling hospital infection,and advancing medical nursing level.

Objective To explore the effects of dexmedetomidine on peripheral blood T lymphocyte proliferation and T lymphocyte subsets of juvenile rats with splenectomy.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 130-150 g,aged six weeks were enrolled in this study.Half of the rats received splenectomy to make an immunosuppressive model,then they were randomly divided into 2 groups (n=6 each): splenectomy+normal saline group (group SN) and splenectomy+dexmedetomidine group(group SD).The another half of the rats without splenectomy were randomly divided into 2 groups: normal saline group(group S) and dexmedetomidine group(group D).After one week of normal feeding,normal saline 10 ml/kg was injected intraperitoneally (ip) in groups S and SN,dexmedetomidine 50 μg/kg was injected ip in groups D and SD respectively.Two hours after the injection,blood samples were collected.MTT was utilized to examine the peripheral blood T lymphocyte proliferative capability.T lymphocyte subsets CD4+,CD8+ were determined by flow cytometry.CD4+/CD8+ was calculated.Results Compared with group S,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio were significantly decreased in group SN (P<0.05);T lymphocyte proliferative capability in group D was decreased (P<0.05),but no significant changes was found in the percentages CD4+,CD8+ and CD4+/CD8+ ratio.Compared with the group D,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio in group SD were significantly decreased (P<0.05).Compared with the group SN,T lymphocyte proliferative capability in group SD was significantly decreased (P<0.05).Conclusion Cellular immune function of juvenile rats with or without splenectomy is suppressed by dexmedetomidine,and the suppressive function is more severe in splenectomy rats than that in normal juvenile rats.

Objective To analyze the expression of Galectin-3 in thyroid follicular tumors and its clinical significance in differential diagnosis between benign and malignant thyroid follicular tumor.Methods The expression of Galectin-3 in 120 cases of thyroid follicular carcinoma and 80 cases of thyroid follicular adenoma was detected by immunohistochemical technique.Results The expression rate of Galectin-3 in thyroid follicular carcinoma was significantly higher than that in follicular adenoma(84％ vs 19％,P ＜ 0.01).Strong positive expression of Galectin-3 was found in 40％ cases of thyroid follicular carcinoma and no case of thyroid follicular adenoma.Conclusions The expression of Galectin-3 can be regarded as an important parameter for differential diagnosis between benign and malignant thyroid follicular tumor.

Objective To explore the clinicopathologic characteristics and treatment of medullary thyroid carcinoma(MTC).Methods The data of 42 cases of MTC admitted to Fujian Medical University Provincial Clinical College from Jan 1995 to Feb 2010 were retrospectively analyzed.Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.Results Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.The lymph node metastasis rate was 76.19％ (32/42).The central lymph node metastasis rate was 61.90％ (26/42).All the 42 cases were followed up for 1 to 502 months with 102 months as the median.35 cases(83.33％)were followed up for more than 5 years and the 5-year overall survival rate was 85.71％ (30/35).Death occurred in 5 cases.Conclusions The lymph node metastasis rate of MTC is high.The treatment should be based on the principle of radical resection.Total thyroidectomy should be recommended to treat primary tumor.Lymph node dissection should be as thorough as possible.Central compartment neck dissection should be done in all cases.

Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.

As an emerging artificial intelligence （AI）， the text-to-video large model Sora possesses powerful functions that previous AI did not have. In the medical field， medical staff can use the Sora model to achieve efficient medical education， patient health consultation， medical research， and other activities. Studying the innovative application scenarios， ethical issues， and governance paths of the current Sora model is of great significance for utilizing the new AI technology to promote and improve medical experience and quality， as well as to grasp the future development direction of AI in the field of healthcare.

Objective    To analyze the effect of microecological preparation on digestive tract complications and nutritional status after esophageal cancer surgery. Methods    A total of 146 patients with esophageal cancer admitted to the Department of Thoracic Surgery, Renmin Hospital of Wuhan University from October 2017 to June 2019 were selected. There were 91 males and 55 females, aged 65 (61.9±8.2) years. They were randomly divided into two groups (an observation group and a control group, n=73 in each group) according to whether microecological preparation was given when they could take food one week after the surgery. Nutritional status and the incidence of gastrointestinal complications including anorexia, acid reflux, nausea, vomiting and diarrhea (≥3 times per day) in the first month after operation were compared between the two groups. Results    The incidence of anorexia, nausea, diarrhea (≥3 times per day), anastomotic fistula and stenosis in the observation group was lower and the index of nutritional status was higher than those in the control group within one month after the operation (all P<0.05). There was no statistically significant difference in acid reflux, vomiting, lung infection and incision infection between the two groups (all P>0.05). Conclusion    Microecological preparation can regulate gastrointestinal microecological balance, improve nutritional status, reduce the incidence of gastrointestinal complications and accelerate the postoperative rehabilitation.

Objective To investigate the current situation of occupational health of radiation workers in Zhejiang Province, China, and to provide a theoretical basis for the improvement of standards and management systems for occupational health examinations of radiation workers. Methods Data of occupational health examination cases were collected from occupational health examination institutions, including basic information, type of physical examination (pre-job, on-job, off-job), and health examination results. The differences in occupational health examination results among different groups were analyzed, and the factors influencing occupational health of radiation workers were analyzed using a logistic regression model. Results A total of 5668 cases were collected, with 86% of the participants being male and 14% being female. Compared with the pre-job group, the on-job group showed an increased abnormal rate of triiodothyronine and the off-job group demonstrated an increased abnormal rate of leukocyte count (P < 0.05). Compared with the industrial group, the nuclear fuel group showed decreased abnormal rates of thyroid structure and thyroxine and an increased abnormal rate of triiodothyronine, and the medical group demonstrated an increased abnormal rate of thyroid structure (P < 0.05). The abnormal rates of thyroid structure and white blood cell count increased with the increase of working age (P < 0.05). The abnormal rates of white blood cell count, thyroid structure, triiodothyronine, and thyroid stimulating hormone were higher in female radiation workers than in male radiation workers (P < 0.05). Sex (female), radiation work history, and age were the risk factors affecting the occupational health of radiation workers (P < 0.05). Conclusion The occupational health status of radiological workers in Zhejiang Province needs to be further improved, and the occupational health management of radiological workers should be strengthened.

Objective To investigate the current situation of occupational health of radiation workers in Zhejiang Province, China, and to provide a theoretical basis for the improvement of standards and management systems for occupational health examinations of radiation workers. Methods Data of occupational health examination cases were collected from occupational health examination institutions, including basic information, type of physical examination (pre-job, on-job, off-job), and health examination results. The differences in occupational health examination results among different groups were analyzed, and the factors influencing occupational health of radiation workers were analyzed using a logistic regression model. Results A total of 5668 cases were collected, with 86% of the participants being male and 14% being female. Compared with the pre-job group, the on-job group showed an increased abnormal rate of triiodothyronine and the off-job group demonstrated an increased abnormal rate of leukocyte count (P < 0.05). Compared with the industrial group, the nuclear fuel group showed decreased abnormal rates of thyroid structure and thyroxine and an increased abnormal rate of triiodothyronine, and the medical group demonstrated an increased abnormal rate of thyroid structure (P < 0.05). The abnormal rates of thyroid structure and white blood cell count increased with the increase of working age (P < 0.05). The abnormal rates of white blood cell count, thyroid structure, triiodothyronine, and thyroid stimulating hormone were higher in female radiation workers than in male radiation workers (P < 0.05). Sex (female), radiation work history, and age were the risk factors affecting the occupational health of radiation workers (P < 0.05). Conclusion The occupational health status of radiological workers in Zhejiang Province needs to be further improved, and the occupational health management of radiological workers should be strengthened.