Objective To investigate the impact of the COX-2 specific inhibitor parecoxib on postoperative serum cytokines and early cognitive function in the elderly patients undergoing knee replacement.Methods Seventy-two elderly patients undergoing knee replacement were divided into a control group (group Ⅰ)and parecoxib group (group Ⅱ).MMSE score were compared at preoperative 1 d and postoperative 1 d,3 d,7 d.Before induction of anesthesia (T1 ),postoperative 6 h (T2 ),1 d (T3 ),3 d (T4 ),7 d (T5 ),the serum IL-1β,IL-6 concentrations were measured,meanwhile the serum S-100βwere measured in T2 .Results At postop-erative 1 d,3 d,the MMSE score in group Ⅰ was significantly lower compared with the preoperative (P <0.05).IL-6 in T2 ,IL-1βin T3 increased in both group.In group Ⅱ,three days later,the exaltation of plasma inflammatory factors returned to the preopera-tive level,but this process last untill T5 in group Ⅰ.The plasma concentration of IL-6 in T2 ,T3 ,T4 and IL-1βin T3 ,T4 in group Ⅰwere higher than group II (P <0.05).At T2 ,the serum S-100βin group Ⅰ was (1 625 ± 364)pg/mL higher than group Ⅱ(1 263 ±174)pg/mL(P <0.05).Conclusion The protective effection of COX-2-specific inhibitor parecoxib upon postoperative cognitive decline in elderly patients undergoing orthopedic surgery may be related to inhibition of peripheral cytokine release.

Objective To investigate the protective effect of NS398,a specific cyclooxygenase-2 inhibitor,on microglial activation-mediated neuronal damage.Methods The microglia of neonatal SD rat were isolated and cultured in the medium containing 1 μg/ml of LPS.The morphological changes of microglial were observed.The IL-1β and TNF-α levels were detected by Western blot in LPS group (group L) and control group (group C).The hippocampal neurons of neonatal SD rats were cultured in the control medium (group C),LPS-activated microglial conditioned medium (group L) and LPS-activated microglial conditioned medium with NS398 (group N),respectively.The survival rate of neurons were detected by MTT.The respiration of hippocampus neurons was determined by detecting the ratio of lactic acid/pyruvic acid.Results LPS-induced microglial activation was characterized by the morphological change and increased secretion of IL-1β and TNF-α.The survival rate of neurons cultured by microglia activated conditioned medium was 64.37％,while the group N was 80.25％ (P＜0.01).In group L,the ratio of lactic acid/pyruvic acid (27.34±8.53) was significantly higher than that of group N (20.32±6.05,P＜0.01) and group C (14.95±4.72,P＜0.01).Conclusion NS398,a specific cyclooxygenase-2 inhibitor,has a protective effect on rat hippocampus neuron damaged by activated microglia.

Objective To investigate the role of intercellular adhesion molecule-1(ICAM-1)in Isoflurane against hepatic ischemia-reperfusion(I/R)injury in vivo.Methods Thirty-two female SD rats were randomly divided into 4 groups:sham-operation group(A),I/R group(B),Isoflurane group(C),I/R+ Isoflurane group(D).Groups A and C were be used as controls.In groups B and C,the hepatic hilar vessels distributing to the left and median lobes were clamped to induce partial hepatic ischemia(70%).Reperfusion was done 60 min after hepatic ischemia.The animals were killed 3 h after reperfusion,then the specimens of liver tissues and blood were obtained.ALT and AST in blood serum were detected as liver damage markers.The histological examination of liver tissues was done by hematoxylin and eosin staining.The levels of ICAM-1 protein in the hepatic tissues were detected by immunohistochemistry.Results After hepatic ischemia-reperfusion,the ICAM-1 protein expression in the hepatic tissues increased;ALT and AST increased;Reperfusion induced severe liver damage.Isoflurane significantly inhibited the ICAM-1 expression.Conclusion The degree of hepatic ischemia-reperfusion injury is closely associated with the expression level of ICAM-1.Isoflurane abates liver ischemia-reperfusion injury and inhibits the ICAM-1 expression.

Objective To observe the preventive efficacy and safety of dexmedetomidine with parecoxib sodium on the patients with postoperative hyperalgesia induced by remifentanil. Methods A total of 100 female patients undergoing elective surgery under general anesthesia were as-signed into four groups according to the table of random number:the control group (group C),the parecoxib sodium group (group P),the dexmedetomidine group (group D)and the parecoxib sodium combined with the dexmedetomidine group (group DP).The vital signs were monitored and the total intravenous anesthesia was performed.All the patients were give intravenous injection of 0.2μg·kg-1 ·min-1 remifentanil and 4-12 mg·kg-1 ·h-1 propofol to maintain the anesthesia.Patients in group P were given 40 mg parecoxib sodium 30 minutes before the end of the operation.Patients in group D were give intravenous injection of 0.6μg·kg-1 ·min-1 dexmedetomidine consistently till 30 min before the end of the operation.Patients in group DP were given 0.6 μg·kg-1 ·min-1 till 30 min before the end of the operation and were given 40 mg parecoxib sodium.The VAS scores were re-corded at 1,2,6,12,24 hours.The cases of agitation,rigors,nausea and vomiting and increasing of analgesics were recorded.Results The postoperative VAS scores in group P,group D and group DP were significantly lower than group C(P <0.05).The postoperative VAS scores in group DP were significantly lower in group P and group D (P<0.05).Cases of agitation and rigors in group D and group DP were less than group C(P <0.05).The increasing of analgesics in group DP was much higher than other groups(P<0.05).Conclusion After induced,patients were given intravenous in-jection of 0.6 μg·kg-1 ·min-1 dexmedetoniding consistently till 30 min before the end of the opera-tion were given 40 mg parecoxib sodium can effectively prevent hyperalgesia after remifentanil anes-thesia without significant increase in revival time and obtain a better sedation.

Purpose To analyze and summarize morphological characteristics, the immune phenotype, diagnosis and differential diag-nosis, clinical features and prognosis of epithelioid angiomyolipomas retrospectively, to deepen understanding of EAML and improve the diagnostic accuracy. Methods The pathological morphology was observed and immunohistochemistry of phenotypic characteristics were analyzed in 7 cases of epithelioid angiomyolipomas. Results Seven cases of epithelioid angiomyolipomas had similar morphology:larger tumor cells, ovoid, fusiform or polygonal, with abundant and eosinophilic cytoplasm, a big nucleus of different size with obvious nucleoli, polynuclear and gaint tumor cells, with a few mitotic figures. The tumor cells arranged in nests or sheets, cuff-shaped around the blood vessels. Immunohistochemistry showed that the tumor cells were positive for HMB-45, Melan-A, vimentin and SMA, but negative for EMA, CK, and CD10. All of them underwent radical surgery or surgical resection, and were followed up for 3~56 months after operation. 6 cases were alive, without recurrence and metastasis, while 1 case died of gastrointestinal stromal sarcomas 3 months later. Conclusion Epithelioid angiomyolipomas belong to mesenchymal tumors with malignant potential, pathological morphology would be easily misdiagnosed as malignant tumors. Immunohistochemistry plays an important role in the differential diagnosis. Surgical treatment is the main method at present, with possibility of recurrence or metastasis.

The central corneal thickness (CCT) in age 48 years or less of Chinese was characterized and its relationship with gender, age, refraction and intraocular pressure (IOP) was investigated. Right eyes of 1669 participants were included in this study (880 men, 52.7% and 789 women, 47.3%). Mean age of the samples was 23.8 +/- 5.9 years. After the examination of corneal topography and refraction, Goldman applanation tonometry was carried out by one physician. Tonometric values were the mean of three consecutive readings. Subsequently, another physician carried out ultrasonic pachymetry with the DGH 2000 AP ultrasonic pachymeter. Six measurements were made at the center of the cornea of each eye. The mean value was used for analysis. The results showed that mean CCT of male participants was 551.33 +/- 34.62 microm, 5.79 microm more than that of female participants. Linear regression analyses revealed that CCT was negatively related with age only in female and no association was found between refractive status and CCT. IOP was positively related to CCT, and there was a difference in IOP of 1.5 mmHg (1 mmHg = 0.133 kPa) per 100 microm difference in CCT. Ocular hypertension group was prone to have thicker cornea than average. The results indicated that in adult Chinese CCT tended to decrease with aging in female only. IOP measured by Goldmann tonometry was positively related with CCT so that CCT should be measured along with IOP.
Age Factors ; China ; Cornea/*anatomy & histology ; Corneal Topography ; Intraocular Pressure ; Reference Values ; Sex Factors ; Tonometry, Ocular

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Obiective To set up a method of scaffold evaluation using human cell line as seed cells and screen appropriate scaffold for live tissue engineering, Methods HepG2 cells were plated onto biodegradable polymer scaffolds: PLGA, 3% chitosan (3%CS) and 2% silk fibroin (2%SF), and cultured in vitro. The growth, distribution and function of HepG2 cells in the scaffolds were evaluated using MTT assay, H.E. staining, and urea assay kit. Results HepG2 cells plated on the three scaffolds maintained a proliferative state. In contrast, the cells on the 2%SF proliferated strongly, while the cells on the PLGA and chitin proliferated poorly. Histological examination showed that HepG2 cells distributed evenly on the 2%SF scaffold with a high amount, while few cells could be found on the PLGA and ehitin at day 7. Cell function assay showed that HepG2 cells on the 2%SF and PLGA exhibited slower decrease of urea synthesis compared to HepG2 cells on the chitosan. Conclusion The three scaffolds have good biocompatibility. In contrast, 2%SF scaffold is more appropriate for liver tissue engineering. This method may be used for scale screening of scaffolds for liver tissue engineering.

Objective To get minimally invasive and cosmetic effect,minimal incision was used in thyroid surgery.Methods By using MPBS series instruments,thyroid surgeries were performed through anterior cervical tiny incision approach.Results 164 cases of subtotal theroidectomy and 78 cases of thyroid individual lobe resection were performed.The length of incision were(2.0 ± 0.5)cm,and the duration of operation time were(40 ± 10)min.the volume of blood loss were(30 ± 10)ml.There was no conversion to traditional open operation.After 3 years follow-up,short and long term complications were not found.Conclusions Minimally incision thyroid surgery has advantages of less trauma,cosmetic effect and does not compromise the safety.The disadvantages of this method is limited operative field and inconvenience for operation,which need to be further improved.

Objective: To analyze three events of severe fever with thrombocytopenia syndrome （SFTS） among family members by exposure risk matrix, so as to provide reference for SFTS prevention and control. Methods : The field investigation and clinical data of seven confirmed cases with SFTS reported in Linhai from 2014 to 2016 were collected. Exposure risk matrix was used to list the risk of exposure two weeks before the onset, such as the environment, duration of activity and protection, and evaluate the possible routes of transmission. Results: The first event involved three sisters. Two of them had plucked tea together on a hill, and the possibility of infection through tick bites were 60% and 75%, respectively. Another sister was more likely to be infected by ticks in her residence after visiting her sister （no physical contact with the sick sister）, with a possibility of 74%. The second event involved two cases （mother and son）. They were more likely to be infected by ticks in the current residential area, and the possibility were 100% and 80%, respectively. The third event involved two cases （husband and wife）. The wife had 60% possibility of being infected by the ticks on the hill she picked arbutus, and 40% by the ticks in her residence. The husband was most likely to be infected through contacting with body fluids or blood of his wife （44%）, then through the ticks on the hill he picked arbutus （33%）. Conclusion Among seven cases with SFTS reported in Linhai from 2014 to 2016, six cases have more than 50% possibility of being infected by tick bites; one case has higher possibility of being infected by contacting with body fluids or blood of a patient, but tick bites could not be ruled out.