Testicular proteoglycan 1 ( SPOCK1 ) , a kind of extracellular matrix glycoprotein, can inhibit the activity of cathepsin and promotes the combination of low affinity for calcium.SPOCK1 is essential to the de-velopment of mammals.It not only regulates cell,and the interactions between cells and matrix are also related to cell migration and proliferation.Currently,SPOCK1is confirmed that expression can promote the occurrence and development of tumor,suggesting it could be a new anti-tumor target.This article is to review SPOCK1 molecular structure,biological function and its relationship with tumor.

Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing gynecological laparoscopic surgery. Methods Eighty ASA Ⅰ or Ⅱ patients, aged 40-64 yr,weighing 50-70 kg, undergoing elective gynecological laparoscopic surgery, were randomized into 2 groups ( n = 40 each): LMA Supreme group (group S) and LMA ProSeal group (group P). Mallampati test was performed before operation in both groups. The patients were classified as Ⅰ or Ⅱ . LMA Supreme and LMA ProSeal were inserted in group S and P respectively after induction of anesthesia with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 3 μg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA. The number of attempt, success rate, LMA placement time, success rate of gastric tube placement, cuff volume, peak airway pressure, and airway seal pressure, BP, HR, ECG, SpO2, PET CO2 and complications were recorded. The duration of surgery and pneumoperitoneum, and emergence time were also recorded. The fiberoptic bronchoscope scores were assessed after successful LMA placement. Results There were no significant differences in the duration of operation and pneumoperitoneum, emergence time between the two groups (P ＞ 0.05). The BP, HR,SpO2, PET CO2 and peak pressure were within the normal range during operation in both groups. The first attempt success rates of LMA placement and gastric tube placement were significantly higher, the LMA placement time was significantly shorter, and the fiberoptic bronchoscopic scores were significantly higher in group S than in group P ( P ＜ 0.05). Conclusion LMA Supreme is helpful for ventilation during operation with less complications and can be used effectively for gynecological laparoscopic surgery.

BACKGROUND: Although the Incidence of irritation, abrasion and rupture of the extensor tendon at the dorsal carpal side of the distal radius caused by internal fixation with volar locking plate is not high, these complications seriously affect the quality of life of the patients. OBJECTIVE: To summarize the latest progress of intraoperative fluoroscopy in the treatment of distal radius fracture with volar locking plate. METHODS: Using the English key words "volar locking plate, distal radius fracture, radiological method", the authors retrieved PubMed for 160 relevant studies published from 2000 to 2019. Using the Chinese key words "fluoroscopy, distal radius fracture, volar plate", the authors searched Wanfang database for 7 relevant studies published from 2000 to 2019. This paper reviewed the literature of intraoperative fluoroscopy in the treatment of distal radius fracture with volar locking plate. RESULTS AND CONCLUSION: (1) There are various methods of intraoperative fluoroscopy during volar locking plate fixation for distal radius fracture, such as standard anteroposterior view, lateral view, carpal canal method, skyline, dorsal tangent view and radial groove view. (2) The above common methods still have some limitations in detecting the problem of posterior screw penetration in volar locking plate fixation. The complications such as irritation, abrasion and rupture of the extensor tendon of the dorsal wrist still occur, and the problems brought by the secondary and multiple operations to the patients' life and economy should also be paid attention to. (3) More appropriate intraoperative detection methods should be found, in order to reduce the incidence of complications caused by the internal fixation of the posterior screw with the locking plate on the palmar side.

Objective To observe the clinical effects of budesonide inhalation combined with psychotherapy on patients with chronic obstructive pulmonary disease.Methods 90 cases diagnosed with chronic obstructive pulmonary disease from January 2014 to June 2015 were randomly divided into two groups, 45 cases in each group.The control group received budesonide inhalation, and observation group received psychotherapy on the basis of control group.The serum airway remodeling indexes, sputum inflammatory indicators and blood gas indexes were compared between two groups .Results After two weeks’ treatment, the serum basic fibroblast growth factor (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in observation group were significantly lower than those in control group (P <0.05), the sputum interleukin-8 (IL-8), IL-18 and tumor necrosis factor-α(TNF-α) in observation group were significantly lower than those in control group (P<0.05), PaO2in observation group was higher and PaCO2was lower than those in control group (P <0.05).There was no significant difference in pH value between two groups (P <0.05). Conclusion Budesonide inhalation combined with psychotherapy has a good effect on patients with chronic obstructive pulmonary disease, which is better than that of budesonide alone.

Objective To determine the median effective dose (ED50) of 0.375 ％ ropivacaine for ultrasound-guided subgluteus approach to the sciatic nerve block in the elderly patients.Methods Thirty ASA Ⅰ-Ⅲ patients of both sexes,aged 65-85 yr,scheduled for foot or ankle surgery under the sciatic nerve block,were enrolled in this study.The patients were placed in the Sim's position and received the sciatic nerve block using the posterior subgluteus approach guided by ultrasound.The initial dose of 0.375％ ropivacaine was 14.5 ml in the first patient and the ratio between the 2 successive doses was 1.2.The ED50 and 95 ％ confidence interval of ropivacaine were calculated by up-and-down technique.Results The ED50 and 95％ confidence interval of 0.375％ ropivacaine resulting in complete block of the sciatic nerve by using the ultrasound-guided subgluteus approach were 13.4 and 11.5-16.2 ml,respectively.Conclusion The ED50 of 0.375 ％ ropivacaine for ultrasound-guided subgluteus approach to the sciatic nerve block is 13.4 ml in the elderly patients.

Objective To investigate the influence of different head and neck positions on airway sealing pressure (OLP) with i-gel laryngeal mask airway (LMA) in patients undergoing elective surgery under general anesthesia with mechanical ventilation.Methods Thirty ASA Ⅰ or Ⅱ patients of both sexes aged 32-64 yr with a body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were studied.Size 4 i-gel LMA was placed blindly after induction of anesthesia and connected to anesthetic circuit.The criteria for successful placement were easy inflation with small leak,peak inspiratory pressure (PPeak) within normal range and normal PETCO2 wave form.Fiberoptic bronchoscopy was performed to check the position of LMA.OLP,expiratory tidal volume ( VTE ),PPeak and efficiency of mechanical ventilation were measured in different head and neck positions.OLP was measured by gradually increasing airway pressure until PPeak was reached.The measurement was stopped when there was large leak or OLP ＞ 35 cm H2 O.The efficacy of ventilation was evaluated by manually inflating the lungs (perfect:easy inflation,no audible leak; satisfactory:easy inflation,small leak; poor:difficult inflation,large leak).Results Flexion of the head significantly increased OLP and PPeak and decreased VTE,while hyperextension significantly decreased OLP and PPeak and increased VTE as compared with middle position of the head.Lung ventilation was less satisfactory when the head was flexed.Turning the head to either side did not affect ventilation.Conclusion Flexion of the head should be avoided when i-gel LMA is used during anesthesia.

Objective　To analyze the clinical features, etiological examination, laboratory examination, imaging examination, and treatment of patients with diabetes combined with Klebsiella pneumoniae liver abscess (KPLA), and to provide a reference for clinical work. Methods　The clinical data of patients with diabetes combined with KPLA in the First People's Hospital of Neijiang City from 2021 to 2022 were retrospectively analyzed. Results　Among the 12 patients with diabetes combined with KPLA, there were 8 males and 4 females, aged 47-74 years old. Five cases were combined with biliary tract diseases, 3 cases were combined with syphilis, and 2 cases were combined with hepatitis B.The main clinical manifestations included fever (12 cases), anorexia (10 cases), stomachache (6 cases), dizziness (2 cases), weakness (3 cases), cough and sputum (2 cases), disturbance of consciousness (2 cases), and visual impairment (1 case). Laboratory test results showed an increase in the percentage of neutrophils, glycosylated hemoglobin, transaminase, C-reactive protein, and procalcitonin, as well as a decrease in platelets and albumin. Abdominal CT findings were predominantly unilateral lesions, mostly found in the right liver, mainly manifested as mass, flaky, and nodular shadows. Two patients presented with invasive syndromes, 2 cases had lung abscesses, and 1 case had concomitant endophthalmitis and meningitis. The etiological examination of 12 patients with Klebsiella pneumoniae showed that they were all sensitive bacteria. After actively controlling blood glucose, effectively using antibiotics, and performing liver puncture and drainage, 11 cases improved, while 1 case was left with permanent blindness. Conclusions　The clinical features of diabetes combined with KPLA are atypical and easy to misdiagnose, thus early imaging and etiological examination should be performed. Aggressive glucose control, and selection of sensitive antimicrobial drugs based on drug sensitivity tests combined with liver abscess puncture and drainage can help to improve the prognosis.

Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18F-FDG PET/CT features of 72 patients with tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F-FDG. The degree of 18F-FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P>0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65,T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69,T/NT=0.57±0.27, t=2.243 and 5.045,both P<0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases.

With the rise of magnetic therapy, biological effects of magnetic field have gotten more and more attention in recent years. Based on literatures both at home and abroad, this article summarized research status of biological effects of static magnetic field on whole level, tissue-organ level, cellular level and molecular level of living organisms. We found that conclusions and results of researches varied with different purposes and experiment methods, demonstrating that researches on dose-response relationship and safety of static magnetic field were necessary.

Objective To investigate midkine (MK) level in serum of patients with esophageal squamous cell carcinoma (ESCC) before and after operation,detect the expression of MK protein in tissues and analyze its relationship with the malignant biological behavior of ESCC.Methods The MK levels in serum were detected by enzyme-linked immunosorbent assay in 30 healthy cases and 55 patients with ESCC when the day before operation and the tenth-day after operation.Then the expression of MK protein in 55 patients surgically removed ESCC were detected by immunohistochemistry using monoclonal antibodies against human MK.Results The average optical density of MK in serum of ESCC patients before operation was 0.1006±0.0624,0.0455±0.0155 in normal control group,0.0752±0.0267 in postoperative control group (t =6.203,P ＜ 0.001).The MK levels in serum of ESCC patients before operation were significantly higher than those after operation (t =4.357,P ＜ 0.001) and those in healthy controls (P ＜ 0.05).The expression of MK protein was no statistically significant correlation with tumor size (x2 =0.131),TNM stage (x2 =0.315) and lymph node metastasis (x2 =0.282) in ESCC (all P ＞ 0.05).But significant correlation was noted between the expression of MK protein and the vasculature involving of the cutting edge (x2 =4.223),degree of cellular differentiation (x2 =10.326),invasive extent of the carcinoma (x2 =20.556) (all P ＜ 0.05).Conclusion MK is overexpressed in ESCC patient' s serum and tissue.The high level of preoperative serum MK is caused by the tumor.