Objective To investigate the efficacy of preemptive analgesia with parecoxib sodium combined with local infiltration anesthesia with ropivacaine for postoperative pain after laparoscopic cholecystectomy.Methods One hundred and fifty ASA Ⅰ or Ⅱ patients,aged 41-63 yr,weighing 55-87 kg,scheduled for laparoscopic cholecystectomy under the general anesthesia,were randomly divided into 3 groups (n=50 each): parecoxib sodium+0.9％ normal saline (group A),parecoxib sodium + 0.5％ ropivacaine (group B) and parecoxib sodium + 0.75 ％ ropivacaine (group C).Parecoxib sodium 40 mg was injected intravenously 30 min before induction of anesthesia.Anesthesia was induced and maintained with remifentanil and propofol given by TCI.Immediately before skin closure,0.9％ normal saline 12 ml was given in group A,and 0.5％ and 0.75％ ropivacaine 12 ml were injected for local infiltration anesthesia in groups B and C,respectively.VAS scores were maintained ≤ 3after operation.When VAS scores ＞ 3,pethidine 75 mg was injected intramuscularly.Ramsay sedation scores were recorded at the end of operation and 2,4,8,12 and 24 h after operation.The side effects (nausea and vomiting,allergy,respiratory depression,etc.),requirement for pethidine,algesic sites (incisional pain,upper abdominal pain,referred pain in right shoulder),and condition of the wound healing were all recorded within 24 h after opcration.Results Compared with group A,Ramsay sedation scores,the incidence of nausea and vomiting,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in groups B and C (P ＜ 0.05 or 0.01).Compared with group B,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in group C (P ＜ 0.05 or 0.01).There was no significant difference in Ramsay sedation scores between groups B and C (P ＞ 0.05).There was no significant difference in the condition of the wound healing,upper abdominal pain and referred pain in right shoulder between groups A,B and C (P ＞ 0.05).Conclusion For the patients scheduled for laparoscopic cholecystectomy,local infiltration anesthesia with ropivacaine can improve the efficacy of preemptive analgesia with parecoxib sodium,and it provides better postoperative analgesia when 0.75 ％ ropivacaine is used.

Preeminent Doctors Education and Training Plan has put forward an urgent request to reform the five-year clinical undergraduate medical talent training mode and strengthen the professional spirit cultivation for medical students. As a pilot project, our college continuously explored the professional spirit cultivation mode for medical students in preeminent physician class and has almost established the three-dimensional mode of whole process, joint participation, multi approach and stressing practice.

Objective To study the vascular endothelial growth factor(VEGF) expression and secretion of mesenchymal stem cells(MSCs) of rabbit transfected with pcDNA3-VEGF165 expression plasmid in order to construct a kind of tissue engineering artificial skull with more blood supply.Methods By gene reconstruction method,the VEGF165 gene was cloned into eukaryotic expression plasmid pcDNA3 and recombined eukaryotic expression plasmid pcDNA3-VEGF165 was constructed;By lipofectamine transfection method,pcDNA3-VEGF165 expression plasmid was transfected into MSCs of rabbit;By RT-PCR and Western blotting methods,the VEGF mRNA expression and VEGF protein secretion in the MSCs were detected.Results Recombined eukaryotic expression plasmid pcDNA3-VEGF165 was confirmed to be true by double enzyme digestion,two strips came to appear in 5400 bp and 600 bp of gelose electrophoresis and their sizes accorded with pcDNA3 plasmid and VEGF165 accordingly;Primarily cultured and subcultured MSCs of rabbit were successfully performed and the MSCs storehouse of rabbit was established,primary MSCs presented lymphoid form at first and then the morphology of them became circulara,polygonal or irregular forms,they were more and more like fibroblastic cells after subcultured cultivation.The expressions of VEGF mRNA and VEGF protein in the MSCs were found after transiently transfection by RT-PCR and Western blotting methods.Conclusion Recombined eukaryotic expression plasmid pcDNA3VEGF165 can be transfected into MSCs of rabbit effectively by lipofectamine and the VEGF expression can be detected in the MSCs after transfection.

0.05).Conclusion The increasing of IL-15 in peripheral blood after MP infection may play a role in bronchitic asthma pathogenesis.

Objective To investigate the biological properties of human amniotic mesenchymal stem cells (hAMSCs) which were preconditioned with phosphodiesterase-5 inhibitor (Vardenfil). Methods hAMSCs were in vitro isolated and cultured, hAMSCs were pre-treated with vardenfil in final concentration of 10 μmol/L. The morphology of Vard-hAMSCs was observed, and the immunological characteristics, proliferative capacity, and ability of anti-oxidative damage of hAMSCs and Vard-hAMSCs were analyzed by flow cytometry. Double labeling immunofluorescent staining was used to count the differences of differential potential between neural cells of hAMSCs and Vard-hAMSCs. Results (1)Flow cytometry revealed that both hAMSCs and Vard-hAMSCs positively expressed CD90、CD105 and CD73, and negatively expressed CD34、CD45、CD11b and HLA-DR. The SPF and PI in Vard-hAMSCs group were (0.57 ± 0.40)% and (2.20 ± 1.60)% respectively, there was no statistical significance compared with hAMSCs group; (2)After 4 hours treated by H2O2, the apoptosis rate in Vard-hAMSCs group were (7.67 ± 0.82)%,which were markedly lower than that in the hAMSCs group and specific blocker group; (3)Under the same induction condition, positive rates of MAP-2 and GFAP in Vard-hAMSCs group were (49.8 ± 6.42)%and (55.2 ± 6.10)% respectively detected by double labeling immunofluorescent staining, which were significantly higher than the control group. Conclusion The strategy that hAMSCs are treated with vandenfil can enrich the ability of anti-oxidative damage and the differential potential for neural cells in a certain time, and the morphology, immunological characteristics, proliferative capacity of Vard-hAMSCs have no significant change. It suggests that pre-treatment with vandenfil may provide a optimized experimental strategey for hAMSCs which were used to treat nervous system disease.

Objective:To retrospectively analyze the routine clinical laboratory parameters for hepatocellular carcinoma,in an attempt to search for parameters for diagnosis of hepatocellular carcinoma(HCC).Methods:The pre-operation clinical labo- ratory data,such as tumor makers,and serological biochemical indices,hepatitis B virus(HBV)infection markers,and HBV DNA titers,were collected from 828 patients who were pathologically diagnosed as having HCC;then the correlation between these data with tumor size and the pathological grades of HCC was analyzed.Results:It was found that 97.9% of the 828 pa- tients were infected with HBV and 70.9% of them were accompanied by liver fibrosis.We also found that the tumor size was correlated with albumin(ALB),globulin(GLB),A/G,aspartate aminotransferase(AST),ratio of aspartate to alanine amin- otransferase(AST/ALT),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),alpha-L-fucosidase(AFU),al- pha-fetoprotein(AFP)and tumor grades;meanwhile,the pathological grades of tumor was correlated to prealbumin(PALB), GGT and tumor size(all P

Adult ; Benzene ; Biomarkers, Tumor ; blood ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Serum ; chemistry

A total of 183 patients of ectopic pregnancy due to tubal factors were divided into the methotrexate (MTX),conservative surgery and salpingectomy groups.The dose of gonadotropin,counts of harvested oocytes and high-quality embryos and pregnancy rate were compared among three groups to analyze the differences of in vitro fertilization and embryo transfer (IVF-ET).And the above parameters showed no significant differences (P ＞0.05 ).The clinical pregnancy rate of the conservative group was higher than the other two groups.And the difference was statistically significant compared with salpingectomy ( P ＜ 0.05 ).It suggested that the treatments of ectopic pregnancy had some effects on the outcome of IVF-ET.The pregnancy rate was slightly higher in the conservative surgery group.

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.

Background The alteration of dominance eye is associated with visual quality in patients with age-related cataract or after cataract-surgery.However,the study on the relationship of dominance eye shift with vision following cataract-surgery is lack.Objective This study was to observe the influence of age-related cataract and cataract surgery on ocular dominance in the elderly.Methods A serial cases-observational study was designed.Eighty-seven patients with age-related cataract were collected from December 2011 to April 2012 in Affiliated Eye Hospital of Wenzhou Medical University,and phacoemulsification combined with intraocular lens (IOL) implantation was performed in all the patients.The patients were grouped into binocular vision difference (best corrected distance vision) ≥2 lines group (42 patients) and ≤ 1 line group (45 patients) on the standard logarithmic visual acuity chart.The frequency and shift of dominant eye were determined by card-hole method or thumb method before operation and 1 day,1 week,1 month and 3 months after operation.The difference in the frequencies of dominant eye between before and after operation was analyzed with MecNmar test.Results The median of best corrected distance vision (LogMAR) was 0.40 (0.00-1.40) in preoperation and 0.00 (-0.08-0.30) in postoperation,with significant difference between them (Z=-9.481,P =0.000).In the binocular vision difference ≥ 2 lines group,the dominant eyes were 24 in the right eyes and 18 in the left eyes.The milder cataractous eyes were identified as dominant eyes in 33 (78.57％) patients and heavier cataractous eyes were determined as dominant eyes in 9 (21.43％) patients before operation.However,the right eye was evidenced as dominant eye in 31 patients and the left eye was in 11 patients after operation.In the 42 patients,dominant eye shifted from the left eyes to the right eyes in 10 patients and from the right eyes to the left eyes in 3 patients,and 4 patients presented an unstable change binocularly.In 45 patients of the binocular vision difference ≤ 1 line group,the dominant eyes were the right eyes in 27 patients and the left eyes in 18 eyes in preoperation ; while after operation,dominant eye altered form the left eyes to the right eyes in 3 patients and form the right eyes to the left eyes in 1 patient,and unstable change occurred in 5 patients.There were no significant differences in the frequency of dominant eyes between before and after operation both the two groups (group A:P =0.092 ; group B:P =0.727).Conclusions Age-related cataract impact on eye dominance.Dominance eye may occur alteration binocularly following cataract surgery,which is one of causes of visual discomfort.