Objective To evaluate the impact of epidural anesthesia with levobupivacaine combined with general anesthesia on colon surgery. Methods Sixty patients undergoing elective radical procedure for colon carcinoma were randomLy divided into four groups: saline group (group S), 0.125% levobupivacaine group (group L1), 0.25% levobupivacaine group (group L2), and 0.5% levobupivacaine group (group L3). Group S received normal saline of 10 mL epidurally and then infusion of 5 mL·h-1 until the procedure was finished; groups L1, L2, and L3 received levobupivacaine instead. Anesthetic induction was performed after epidural puncture. Mean blood pressure and heart rate were recorded at 8 time points including 5 min after entering into the operation room, 1 min after intubation, skin incision, abdominal exploration, 1 h after skin incision, completion of operation, extubation, and leaving PACU; meanwhile blood glucose and cortisol were detected, anesthesia time, time to PACU stay, bleeding, transfusion volume, adverse reaction, and doses of propofol, remifentanil, ephedrine, and fentanyl were noted. Results Time to PACU stay was longer in S group than in other 3 groups. Doses of remifentanil and fentanyl were larger in L1 group than in L2 group and L3 group. Ephedrine dose in L3 group was larger than in other 3 groups. Blood sugar in L1 group was higher than L2 group and L3 group. Cortisol in S group was higher than in other 3 group. Cortisol in L1 group was higher than in L3 group. The number of patients with hypotension was greater in L3 group than other 3 groups. Conclusions Continue epidural infusion of 0.25%levobupivacaine can reduce stress response and opioid uses, shorten PACU stay, whereas it does not increase use of ephedrine.

The leaves of Scindapsus aureum were frozen at\|19℃ for 5 mins after sprayed with 91?g/mL Ampicillin and 91?g/mL streptomycin sulfate mixture solution,After 15 days the results showed that frozen spot number of the leaves treated with water reduced by 75% compared with those of CK,but thethickness unchanged.The frozen spots began with the border of the leaves.The frozen spots of the group treated with antibiotic mixture solution didn't appear until 5 mins later,and the number of the frozen spots reduced by 95% after 8 mins of freezing.They covered the border of the leaves.This indicated that the antibiotic mixture solulion can obviously reduce the freeze injury to the leaves.

Objective To evaluate the efficacy of anesthesia with different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery.Methods Ninety ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 45-80 kg,undergoing abdominal surgery,were randomly assigned into 3 groups ( n =30 each):control group (group C ),dexmedetomidine 0.25 μg· kg-1 · h-1 group ( group D1 ) and dexmedetomidine 0.50 μg· kg-1·h-1 group (group D2 ).Dexmedetomidine was infused at a rate of 0.25 μg·kg-1 ·h-1 and 0.50 μg·kg-1 ·h-1 in groups D1 and D2 respectively until extubation after a loading dose of 0.5 μg/kg over 15 min.In group C,normal saline was infused intravenously at a rate of 10 ml/h.Anesthesia was induced with TCI of propofol with the target plasma concentration (Cp) of 1.0 μg/ml,iv injection of cisatracurium 0.2 mg/kg and TCI of remifentanil with Cp of 3 ng/ml.The patients were tracheal intubated and mechanically ventilated.PETCO2 was maintained 35-40 mm Hg and SpO2 was maintained ≥95％.Anesthesia was maintained with TCI of remifentanil with the target Cp of 5 ng/ml,iv infusion of cisatracurium 0.1 mg· kg-1 · h-1 and TCI of propofol.The target Cp of propofol was increased to maintain Narcotrend index of 37-46.The amount of remifentanil,cisatracurium and propofol consumed,extubation time and eye-opening time,complications during operation and during recovery from anesthesia were recorded.Results There was no significant difference in the amount of remifentanil and cisatracurium consumed and extubation time among the three groups ( P ＞ 0.05).Compared with group C,the eye-opening time was significantly prolonged,the incidence of hypertension and tachycardia during operation,and restlessness,vomitting,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in groups D1 and D2,and the amount of propofol consumed was significantly decreased in group D2 (P ＜ 0.05).Compared with group D1,the eye-opening time was significantly prolonged,the incidence of hypertension during operation,and restlessness,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in group D2 ( P ＜ 0.05).Conclusion When combined with propofol and remifentanil,dexmedetomidine infused at a rate of 0.50 μg·kg-1 · h-1 can provide satisfactory efficacy for abdominal surgery.

Objective To describe the MRI features of vanishing white matter disease (VWM).Methods Ten patients diagnosed as VWM between 2008-2013 were enrolled,with the mean age of(40 ±23)months.The clinical materials and MR images of them were reviewed retrospectively.The findings of MRI were analyzed by two experienced neuroradiologists in this study,including the location (cerebrum,cerebellum,brainstem,corpus callosum and internal/external capsule),size and signal intensity of the lesions,as well as the presence of cystic degeneration,cerebrum atrophy and the abnormal signal of the basal nuclei.Results MRI of brain typically showed extensive abnormal signal in the cerebral central white matter (10/10) and the focal lesion in subcortical white matter (9/10).The involvement of U-fibers was present in 7 cases.Cystic degeneration of the affected white matter was found in 7 cases.Abnormal signal also appeared in the white matter of posterior limb of the internal capsule (8/10),the external capsule (7/10),the inner rim (the callosal-septal interface) of the corpus callosum (8/10).The lesions of the thalamus and globus pallidus were detected in 2 cases.The white matter of the brainstem and cerebellum were involved in 6 and 7 cases respectively.Conclusion VWM typically shows a diffuse and symmetrical abnormal signal in the cerebral white matter with cystic degeneration on MRI,which is usually diagnostic.

OBJECTIVE: To study the expression of IgE in recur repeatedly children otitis media with effusion (OME), and the relativity of IgE between adenoid and middle ear effusion. METHOD: Thirty-five cases diagnosed of OME in our department, were enrolled in the research. Thirty-one adenoidal hypertrophy cases were selected as control group. Obtained middle ear effusion and adenoid samples from experimental group, and obtained adenoid samples from control group. All adenoid samples were taken for tissue homogenate. Determination all samples of concentration of IgE by ELISA. SPSS 18.0 statistical software was used for all relevant data processing and analysis. RESULT: Compared the IgE content between experimental group and control group with adenoid samples, IgE content increased significantly in experimental group (P < 0.05), and IgE in experimental group of middle ear effusion samples were also increased (P < 0.05). The content of IgE in the experimental group of middle ear effusion and adenoid assumed straight-line correlation, in negative correlation (r = 0.580, P < 0.05). CONCLUSION The occurrence of OME is related to immune factors. Adenoidal hypertrophy may lead to local immunity enhancement, may cause middle ear cavity immune system abnormality, give rise to recur repeatedly with OME and procrastinate does not recover.
Adenoids ; immunology ; metabolism ; Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Ear, Middle ; immunology ; metabolism ; Female ; Humans ; Immunoglobulin E ; metabolism ; Male ; Otitis Media with Effusion ; immunology ; metabolism

Objective To study the relationship between phosphodiesterase 4D (PDE4D) gene rs966221 single nucleotide polymorphisms (SNPs) and ischemic stroke (IS) in Guangxi Zhuang population.Methods One hundred and one IS patients from Guangxi Zhuang Autonomous Region served as IS pgroup and 104 healthy subjects undergoing physical ecamination served as control group in this study.Their PDE4D gene rs966221 SNPs were detected by SNaPshot technique.The genotypes and frequencies of alleles were compared between the two groups and the relationship between PDE4D gene rs966221 SNPs and IS was analyzed.Results No significant difference was found in the GG,GA,AA genotypes and in the frequencies of G and A alleles between the two groups (0.99％ vs 3.85％,29.70％ vs 21.15％,69.31％ vs 75.00％,P＞0.05;15.84％ vs 14.42％,84.16％ vs 85.58％,P＞0.05).Univariate and multivariate logistic regression analysis showed that the PDE4D gene rs966221 SNPs were not related with the risk of IS in dominant AA vs GG+GA,recessive GG vs AA+GA and additive GG vs AA genetic models (P＞0.05).Conclusion The PDE4D gene rs966221 SNPs are not related with IS in Guangxi Zhuang population.

Objective To summarize complications and nursing measures of patients with coronary angiography and stent implantation.Methods 62 patients with coronary angiography and stent implantation were retrospectively analyzed.Results There were 8 patients with bleed-ing,1 patients with chest pain,1 patient with heart dysfunction,2 patients with hypotension,2 patients with chest tightness,2 patients with secondary epilepsy,3 patients with digestive tract symptoms.After careful nursing,all the patients recovered.Conclusion Deep understanding of clinical material of patients before operation,preoperative education,close intraoperative monitor-ing of condition changes,close cooperation and observation and nursing of complications after the operation could improve the success rate of operation and rehabilitation of patients,so it is of great significance in clinic.

Objective To summarize complications and nursing measures of patients with coronary angiography and stent implantation.Methods 62 patients with coronary angiography and stent implantation were retrospectively analyzed.Results There were 8 patients with bleed-ing,1 patients with chest pain,1 patient with heart dysfunction,2 patients with hypotension,2 patients with chest tightness,2 patients with secondary epilepsy,3 patients with digestive tract symptoms.After careful nursing,all the patients recovered.Conclusion Deep understanding of clinical material of patients before operation,preoperative education,close intraoperative monitor-ing of condition changes,close cooperation and observation and nursing of complications after the operation could improve the success rate of operation and rehabilitation of patients,so it is of great significance in clinic.

Objective:To investigate the characteristics of anorectal dynamics in elderly patients with functional defecation disorders(FDD), and to provide a basis for their diagnosis, treatment and prevention.Methods:In this retrospective study, 226 patients with FDD receiving 3D high-resolution anorectal manometry were divided into an elderly group(93 cases)and a non-elderly group(133 cases). Results from anorectal manometry parameters were compared and analysis of patterns of anorectal pressure changes in elderly participants based on sex, the Bristol stool classification and clinical symptoms was conducted.Results:The resting anal pressure, rectal pressure and anal relaxation rate were lower( t=-3.407, -2.051, Z=2.548, P=0.001, 0.040, 0.011)and the volume of first sensation was higher( t=1.998, P=0.047)in the elderly group than in the non-elderly group.The maximum anal squeezing pressure, residual anal pressure and maximum tolerated volume were higher( t=4.589, 4.730, 2.025, all P<0.05), whereas the anal relaxation rate and anorectal pressure gradient were lower in elderly men than in elderly women( Z=4.059, t=-3.714, P<0.001 for both). Regarding the types of FDD, both the elderly group and the non-elderly group were dominated with type Ⅱ defecation disorder, with more men than women having type Ⅱ defecation disorder in the elderly group( χ2=10.343, P=0.001). In cases of paradoxical sphincter contraction during simulated defecation, the incidence in the elderly group was 80.65%(75/93), which was higher than 68.42%(91/133)in the non-elderly group( χ2=4.194, P=0.041). The volume of first sensation, volume of first defecation sensation, and maximum tolerated volume of patients in the elderly group without the urge to defecate were(59.86±23.84)ml, (96.76±34.61)ml, and(144.32±30.57)ml, respectively, higher than those of patients with the urge to defecate(46.79±17.20)ml, (75.26±28.75)ml, and(120.00±40.28)ml( t=-2.241, -2.493, -2.891, P=0.027, 0.014, 0.005). The rectal pressure(26.52±16.08)mmHg of patients with defecation dyssynergia was lower than that of patients without defecation dyssynergia(39.91±8.82)mmHg(1 mmHg=0.133 kPa)( t=-3.128, P=0.002), while the resting anal pressure of patients with defecation dyssynergia(90.60±28.44)mmHg was higher than that of patients without defecation dyssynergia(73.65±27.10)mmHg( t=-2.201, P=0.030). The resting anal pressure and maximum anal squeezing pressure in patients with anal blockage sensation[(87.11±24.64)mmHg, (149.28±48.29)mmHg]were higher than those in patients without anal blockage sensation[(72.43±20.02)mmHg, (121.76±26.35)mmHg]( t=2.954、3.066, P=0.004、0.003). There was no significant difference in values from parameters of anorectal dynamics between patients with different Bristol stool types, with and without incomplete defecation or with different degrees of abdominal distension(all P>0.05). Conclusions:Anorectal dynamics in patients with FDD are characterized by paradoxical anal sphincter movements, but older patients with FDD are mainly characterized by inadequate rectal propulsion, pelvic floor muscle dysfunction and reduced rectal sensitivity.

To explore the pharmacogenomic markers that affect the platinum-based chemotherapy response in non-small-cell lung carcinoma (NSCLC), we performed a two-cohort of genome-wide association studies (GWAS), including 34 for WES-based and 433 for microarray-based analyses, as well as two independent validation cohorts. After integrating the results of two studies, the genetic variations related to the platinum-based chemotherapy response were further determined by fine-mapping in 838 samples, and their potential functional impact were investigated by eQTL analysis and in vitro cell experiments. We found that a total of 68 variations were significant at P < 1 × 10^-3 in cohort 1 discovery stage, of which 3 SNPs were verified in 262 independent samples. A total of 541 SNPs were significant at P < 1 × 10^-4 in cohort 2 discovery stage, of which 8 SNPs were verified in 347 independent samples. Comparing the validated SNPs in two GWAS, ADCY1 gene was verified in both independent studies. The results of fine-mapping showed that the G allele carriers of ADCY1 rs2280496 and C allele carriers of rs189178649 were more likely to be resistant to platinum-based chemotherapy. In conclusion, our study found that rs2280496 and rs189178649 in ADCY1 gene were associated the sensitivity of platinum-based chemotherapy in NSCLC patients.