Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group (local anesthesia combined with physiological saline) and observation group (using local anesthesia drugs with dexmedetomidine).The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups (P<0.05).The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group (P<0.05).The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group (P<0.05) sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group (P<0.05).There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.

Objective To analyze the risk factors impeding early extubation after off-pump coronary artery bypass grafting (OPCAB) in Chinese patients, so that to identify the applicable patients for "fast track recovery". Methods Clinical data of 680 consecutive patients who had received OPCAB were analyzed retrospectively. The patients were divided into two groups according to the time of extubation (group Ⅰ,n=333, extubation was performed within 12 h postoperation; group Ⅱ,n=347, extubation failed in 12 h). Univariate and multivariate analyses were used to determine risk factors prolonging mechanical ventilation. Results Univariate analyses showed significant difference between the two groups in the percentages of patients over 70 years [25% (84/333) vs 39% (136/347), ?2=15.148, P=0.000], with history of stroke [14% (46/333) vs 22% (75/347), ?2=7.068, P=0.008], with LVEF70 (OR=2.003), LVEF70, severe coronary artery lesion, emergency operation, and poor cardiac function are risk factors impeding early extubation. "Fast track recovery" protocol is applicable to young patients who have good cardiac function without left main lesion and do not need IABP during perioperative period.

Objective To explore the association of apoB gene polymorphisms with dyslipidemia and lipid levels in Xinjiang Shihezi Han Chinese. Methods 150 dyslipidemia patients and 150 normal pople were involved in this study. EcoRI and XbaI polymorphisms of apolipoprotein B was analyzed by PCR-restriction fragment length polymorphism. The levels of plasma total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apoAI and apoB were determined. Results The frequency of E + E -/E - E - genotype and E-Allele(37.3% and 19% ) in dyslipidemia group was significantly higher than that in controls( 12. 7% and 6. 3% ). The levels of TC, TG and LDL-C in the E +E -/E - E - gene type were significantly higher than those of the E + E + gene type in each group ( P ＜0. 01 ). The frequency of X + X -/X + X + genotype and X + Allele( 20. 7% and 1 1% ) in dyslipidemia group was significantly higher than that in controls (8% and 4% ). The levels ofTC, TG, LDL-C and apoB in the X + X -/X + X + gene type patients were significantly higher than those in the X - X - gene type patients in every group ( P ＜ 0. 05 ). Conclusion The EcoRI and XbaI polymorphism of ApoB gene was related to dyslipidemia in population of Xinjiang Shihezi Han Chinese, and the E - and X + Allele may be the genetic risk factors for dyslipidemia.

Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy, concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.
Antineoplastic Combined Chemotherapy Protocols ; Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy

In this study, we investigated the feasibility of using autologous vein graft and platelet-derived growth factors to bridge transected cavernous nerve in a rat model. A short defect in the bilateral cavernous nerve was created and repaired with vein graft from the right jugular vein or vein graft plus platelet-derived growth factors. The 32 rats were divided into four groups, namely Group 1 - no repair as a negative control, Group 2 - vein graft alone, Group 3 - vein graft plus platelet-derived growth factors, and Group 4 - sham operation as a positive control. We evaluated nerve regeneration and functional recovery using retrograde tracing study with FluoroGold, Toluidine blue staining of cavernous nerve, and the intracavernous pressure at 3 months. Three months after surgery, rich FluoroGold-positive cells were observed in the sham and vein graft plus platelet-derived growth factors group, but very few were found in the no repair group. The number of myelinated axons of regenerated cavernous nerve and intracavernous pressure were increased obviously in the two vein graft groups, especially in the vein graft plus platelet-derived growth factors group. These findings confirm the feasibility of using autologous vein as guides for cavernous nerve regeneration, and the regeneration can be further enhanced when the vein is filled with platelet-derived growth factors.

Objective To discuss the clinical effects of treatment of femoral intertrochanteric fracture by DHS internal fixation. Methods 42 cases with femoral intertrochanteric fracture were treated by DHS internal fixation. According to AO classification, there were 16 cases of type A1,14 A2,and 12 A3. Results 36 patients were followed up for 6 to 18 months, with an average of 10 months. Their results were satisfactory. Conclusion Treatment of femoral intertrochanteric fractures with DHS internal fixation is an effective method.

AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.METHODS: Totally 161 age-related cataract patients (196 eyes) were assigned randomly to phacoemulsification by torsional mode(Group A) or conventional ultrasound mode (Group B) in our hospital from January 2012 to December 2014.The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE) were recorded.Postoperative outcomes and the change of the best corrected visual acuity(BCVA),corneal edema degree(CED),central corneal thickness(CCT) and endothelial cell count were also recorded and compared.RESULTS: For grade Ⅰ,Ⅱ,Ⅲ and Ⅳ nuclear density,the mean UST and mean CDE were significantly lower in Group A.The average BCVA of Group A was better than Group B at 1 and 7d after surgery.But at 30d postoperative,there was no statistical difference between these two groups(P>0.05).The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively.This difference was no longer found significantly at 30d after surgery(P>0.05).At 7 and 30d postoperative,the endothelial cells in Group B were lower than in Group A.CONCLUSION: By reducing the effective UST and CDE intraoperatively,the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells,and patients get better prognosis.But the damage to cornea by torsional mode phacoemulsification isn`t fundamentally solved.

AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome ( AIDS) patients.
METHODS:The study based on the data analysis of 38 human immunodeficiency virus ( HIV ) positive patients ( 64 eyes ) . According to CD4 count and whether cytomegalovirus retinitis ( CMVR) happened, the patients were divided into 3 groups. Group A included 16 patients (32 eyes), in which CD4 count was < 50cells/μL and CMVR did not happen. Group B included 10 patients ( 20 eyes), in which CD4 count was>50cells/μL and CMVR did not happen. Group C included 12 patients (12 eyes), in which CD4 count was < 50cells/μL and CMVR just happened. Group D included 10 healthy people ( 20 eyes ) , as normal control group. By using optical coherence tomography ( OCT ) , thickness of retina along with a 1mm diameter circle centered on macular was evaluated.
RESULTS:The mean foveal thicknesses in groups A, B, C and D were 254. 03±15. 63μm, 263. 11±17. 12μm, 304. 50±50. 62μm and 257. 64±8. 54μm in order. Compared with foveal thickness in each group, there were significant differences in general (F=12. 933, P=0. 000). The mean foveal thickness in groups CMVR increased, which was of significant difference (P= 0. 000), compared with other groups.
CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Objective: To study the role of basic fibroblast growth factor (bFGF) during human tooth germ development.Method: bFGF expression was exmined with immmunohistochemical technique in bud stage,cap stage and bell stage of human tooth germ from aborted embryo of 7,8,10 and 14 weeks.Results: At the bud stage of human tooth development, bFGF was expressed in most dental epithelium cells,and few condensed mesenchymal cells.At the cap stage ,bFGF was weakly expressed.At the bell stage,bFGF was strongly expressed in the inner enamel epithelium layer and dental papillary cells near inner enamel epithelia,weakly in the stellate reticulum.Conclusion:During human tooth development,bFGF plays an important role in the proliferation and differentiation of dental epithelium.