Objective To explore the effects of dexmedetomidine on recovery quality of hypertension patients under general anesthesia,so as to provide reference for its clinical application.Methods 31 patients who underwent abdominal surgery were chosen as study subjects.They were randomly divided into observation group(15 patients) and control group(16 patients) according to the digital table.At the time of 15 min before the end of surgery,the patients in the observation group were injected with dexmedetomidine of 0.5g/kg,and the patients in the control group were injected with the same volume of normal saline instead in 15 min.At the time of before anesthesia(T0),before injection(T1),3 min after injection (T2),just before extubation(T3),1 min(T4),5 min(T5),15 min(T6) after extubation,the hemodynamic parameters,the sedation scores at the time of T5 and T6,and the occurrence of cough during extubation were recorded and compared between the two groups.Results During operation and extubation,the levels of SBP,DBP,HR and their fluctuations in the observation group were lower than those in the control group.At the time of T5 and T6,the sedation scores in the observation were lower than those in the control group.The mean rank and scores of the two groups [at the time of T5 were [(12.2±24.6) and (19.5±24.6),respectively,Z=2.27,P=0.022].The mean rank and scores of the two groups at the time of T6 were T6[(12.3±24.7) and (19.5±24.7),respectively,Z=2.25,P=0.024].During the time of extubation,the occurrence of cough in the observation group was lower than that in the control group.The mean rank of the cough score in the observation group and the control group was[(12.2±24.1) and (19.5±24.1),Z=2.33,P=0.020].Conclusion Small dose of dexmedetomidine can reduce the incidences of intraoperative cerebral vascular accident risk,improve the quality of general anesthesia recovery in hypertension patients,and thus should be recommend in clinical application.

Objective To study the clinical significance of the proinflammatory cytokines and anti-inflammatory cytokines in acute pancreatitis with systemic inflammatory response syndrome. MethodsIn this study, 13 cases of mild acute pancreatitis (MAP), and 19 cases of severe acute pancreatitis(SAP) were recruited to evaluate acute physiology and chronic health evaluation (APACHEⅡ) on post admission day 1,3,5,7 and Balthazar CT criteria on post admission day 1,7. Values of serum IL-6?IL-8?IL-10?IL-12 were measured. ResultsThe scores of APACHEⅡ and Balthazar CT criteria were lower in the MAP patients than those in the SAP patients(5.6?2.1 and 1.5?0.6 vs. 13.6?4.3 and 6.3?1.5, all P

Objective To explore the clinical efficacy of posterior component separation (PCS) with Sublay mesh repair for complex abdominal incisional hernia.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients with complex abdominal incisional hernia who were admitted to the Beijing Chao-Yang Hospital of Capital Medical University from July 2016 to March 2017 were collected.Patients intraoperatively received PCS with Sublay mesh repair.Observation indicators:(1) intra-and post-operative situations:defect area of incisional hernia,operation time,volume of intraoperative blood loss,time of postoperative drainage-tube removal,postoperative complications and duration of postoperative hospital stay;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect recurrence of hernia and mesh-related complications up to July 2017.Outpatient examination was done once at postoperative month 1,3 and 6 and telephone interview was done at 1 year postoperatively.Measurement data with normal distribution were represented as x±s and measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative situations:30 patients received successful PCS with Sublay mesh repair for complex abdominal incisional hernia.Defect area of incisional hernia,operation time,volume of intraoperative blood loss and time of postoperative drainage tube removal were respectively (222± 124)cm2,100 minutes (range,40-235 minutes),80 mL (range,50-200 mL) and 5 days (range,2-15 days).Of 7 patients with postoperative complications,3 were complicated with shallow surgical site infection,including 1 with wound healing by vacuum sealing drainage and 2 with delayed healing by debridement and drainage;2 with postoperative seroma were improved by aspiration and local pressurization after 1 months;1 with fat liquefaction of abdominal incision was improved by symptomatic treatment;1 with postoperative active hemorrhage was confirmed with arteriolar hemorrhage of muscular layer and then received hemostasis by ligation.Time of postoperative hospital stay of 30 patients was 15 days (range,10-57 days).(2) Follow-up situation:30 patients were followed up for (7± 3) months,without occurrences of hernia recurrence,intestinal fistula and mesh-related complications.Conclusion PCS with Sublay mesh repair for complex abdominal incisional hernia is safe and feasible,with good clinical efficacies.

Objective To examine the reliability and validity of the Chinese version of Moral Distress Scale for nurses.Methods Cross-cultural adaptation process was applied to translate and develop the Chinese version of Moral Distress Scale for nurses.238 nurses were selected to answer the scale to evaluate the reliability and validity of the scale.Results Content validity index of the Chinese version of Moral Distress Scale for nurses was 0.909.Construct validity of validity analysis:exploratory factor analysis of the items identified that the scale had 4 factors,explaining 54.583％ of the total variance.Reliability analysis:The Cronbach' α coefficients for the MDS-R dimensions were 0.846、0.724、0.738 and 0.566,and 0.879 for the total scale.The test-retest reliability coefficient for MDS-R was 0.802.Conclusions The Chinese version of Moral Distress Scale-Revised for nurses has good reliability and validity in the measurement of Chinese nurses.

8 oocytes) according to the number of oocytes collected in one ovary. On day of human chorionic gonadotrophin injection, PSV, EDV, PI, RI, S/D of ovarian stromal artery in the ovarian were detected and perifollicular vascularity were graded with color Doppler ultrasonography. Results Not only PSV and EDV of stromal artery but also perifollicular vascularity in low-response group was significantly lower than that of normal-response and high-response groups. PSV and EDV of ovarian stromal artery and perifollicular vascularity were highly interrelated with ovarian response. Conclusions The increase of PSV and EDV of ovarian stromal artery and perifollicular vascilarity indicate the improvement of perfusion in ovary and ovarian response.

Objective To investigate the incidence of subclinical hypothyroidism (SCH) during the third trimester of pregnancy and its effects on pregnancy outcomes and neonatal hypothyroidism.Methods A total of 10 695 women in the third trimester of pregnancy (28-42 weeks of gestation) who labored from January 1,to December 31,2012 in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University were enrolled.The levels of thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) of the mothers were quantified by electrochemical immunoassay.The time-resolved fluorescence immunoassay was used to detect neonatal thyroid hormone levels.Using t test or x2test,the incidence of adverse pregnancy outcomes was compared between SCH group and euthyroid group and between SCH women with positive (n=40) or negative TPOAb (n=176).Results The incidence of SCH was 2.02％ (216/10 695) and the positive rate of TPOAb in SCH women was 18.5％ (40/216).No neonatal thyroid dysfunction was found.According to the age matched,222 cases were randomly selected as controls from 7 757 euthyroid women.Compared with the controls,SCH women had a higher incidence of premature rupture of membranes [28.7％ (62/216) vs 14.9％ (33/222),x2=12.34],anemia [11.6％ (25/216) vs 4.1％ (9/222),x2=8.65],pregnancy-induced hypertension [9.7％ (21/216) vs 4.5％ (10/222),x2=4.53],premature labor [8.8％ (19/216) vs 3.6％ (8/222),x2=5.10] and intrahepatic cholestasis of pregnancy [8.3％(18/216) vs 2.3％ (5/222),x2=8.14] (all P＜0.05).The overall incidence of adverse pregnancy outcomes was also higher in SCH group than in the controls [69.4％ (150/216) vs 49.5％ (110/222),x2=17.96,P＜0.01].The incidence of fetal growth restriction and still birth in SCH mothers with positive TPOAb was higher than in those with negative TPOAb [7.5％ (3/40) vs 0.0％ (0/176),x2=13.32,P＜0.01; 2.5％ (1/40) vs 0.0％ (0/176),x2=4.40,P＜0.05],but there was no significant difference in the overall incidence of adverse pregnancy outcomes compared with TPOAb-negative mothers [65.0％ (26/40) vs 70.5％ (124/176),x2=0.46,P=0.50].Conclusions SCH diagnosed in the third trimester may lead to adverse pregnancy outcomes.Early screening for thyroid dysfunction is necessary.

AIM: To study the role of liver in immune regulation in experimental endotoxemia. METHODS: 17 castrated male goats were subjected to simultaneously installing catheters in jugular, hepatic and portal veins by surgery. Four days later, lipopolysaccharide (LPS) was infused in term of three groups as followings: In group ①, LPS of 20 EU (endotoxin unit, EU)?kg -1 was infused into portal vein; In group ②, LPS of 20 EU?kg -1 was infused into jugular vein and LPS of 1 500 EU?kg -1 infused into jugular vein in group ③. Before and after infusion, blood samples were collected from the three veins through the catheters for 8 h. The plasma levels of TNF-? were measured by RIA. RESULTS: In group ①, the plasma TNF-? levels of hepatic and portal vein rose to peak value at 5 h, but that of the jugular vein did not changed. In group ②, the plasma TNF-? levels in hepatic vein rose to peak value at 3 h. The TNF-? levels of jugular vein rose to peak value at 1 h and the one in portal vein enhanced continuously between 0-8 h. In group ③, the plasma TNF-? levels in jugular, hepatic and portal vein rose to significant peaks at 1 h simultaneously. CONCLUSION: During experimental endotoxemia,liver showed different dynamic characteristics in TNF-? secretion according to the pathway and doses of LPS delivery. [

Objective To explore the interaction between hepatitis B virus(HBV) X protein and cytochrome C oxidase Ⅲ (COXⅢ).Methods Mating experiment and in vitro binding assays were utilized tO verify the interaction between HBV X protein and COX Ⅲ in vivo and in vitro respectively in yeast cells.Coimmunoprecipitation was employed to demonstrated the binding between these tWOproteins in mammalian cells.Results In mating experiment,the resulting diploids containing both pAS2-1-X and pACT2-COX Ⅲ plasmids turned blue in the β-gal assay,the result of Western blot displayed a positive reactive strap which indicated X protein could interact directly with COX Ⅲ in vitro binding assays.Interaction between these two proteins in mammalian cells was further confirmed by coimmunoprecipitation,as a protein strap about 17 000 was detected in Western blot.Conclusions It is speculated the specific interaction may exist between HBV X protein and COX Ⅲ in both prokaryotie and mammalian cells.X protein may impair the mitochondrial respiration chain and energy metabolism through its association with COX Ⅲ.

Objective To compare contrast-enhanced ultrasound and conventional ultrasound in determining artery stenosis of varying degrees of accuracy. Methods Using conventional ultrasound and contrast-enhanced ultrasound renal artery stenosis was diagnosed.And the renal artery diameter stenosis were measured the extent to which digital subtraction angiography (DSA) as the standard diagnostic accuracy of two methods to determine the rate. Results 50 patients were diagnosed as renal artery stenosis with DSA,21 patients stenosis rate 30%-49%,23 patients stenosis rate 50%-75%,6 patients stenosis rate ＞75%.diagnose accordance rate 78%(38/50)with conventional color doppler and 92% (46/50) with contrast-enchanced ultrasound.The difference was statistically significant (P＜0.05＝. ConclusionUsing ultrasound imaging of the renal artery stenosis to determine the degree had higher accuracy than the conventional ultrasonic testing method,was suitable for clinical application.

Laparoscopic surgery develops fast in China in recent years,and it is widely applied in different fields in the digestive surgery and satisfactory results are achieved.However,uniformed training,technique standard and quality control standard are missing in the education of laparoscopic surgery in China.Fundamentals of laparoscopic surgery (FLS) program is developed by the Society of American Gastrointestinal and Endoscopic Surgeons in 2004.It is composed of congenital assessment and manual skills assessment.Twelve surgeons from China have taken FLS examination in April of 2014,and they introduced the content,features of FLS examination,some thoughts and inspirations on the training of laparoscopic surgery in China in this article.