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 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 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 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.

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.

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 explore the magnetic properties of permanent magnet wafers commonly used in magnetotherapy to provide a basis for the scientific and rational use of sources of magnetism.Methods A magnetometer was used to measure the magnetic induction intensities of the N and S polar centers of eight groups of magnet wafers (axial magnetization) with nominal magnetic induction intensities of 6 mT, 10 mT, 20 mT, 30 mT, 60 mT,100 mT, 200 mT and 350 mT.Results There were some differences between the nominal values and the measured mean magnetic induction intensities. In a few groups the differences were close to 20％. There were also differences within the same group. The magnetic induction intensities of the two polar surfaces were not always equal for the same magnet, and there were large differences among individual magnets.Conclusions The intensities of magnetic sources must be measured before use to ensure the consistency of magnetic induction intensities in therapeutic applications.

Objective To evaluate the efficacy of fiberoptic bronchoscope (FOB)-guided tracheal intubation with laryngeal mask airway i-gel (LMA i-gel) in patients undergoing cervical spine surgery. Methods Forty ASA Ⅰ or Ⅱ patients, aged 36-62 yr, weighing 57-78 kg, scheduled for cervical spine surgery under general anesthesia, were randomly divided into 2 groups (n = 20 each): FOB-guided tracheal intubation with oropharynx ventilation tube group (group O) and FOB-guided tracheal intubation with LMA i-gel (group I). Anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 2-3 μg/kg and rocuronium 0.9 mg/kg. The intubation time, fiberoptic bronchoscope score, the number of successful intubation, hypertension, tachycardia and hypoxemia were recorded. All the patients were followed up postoperatively for adverse effects like sore throat or hoarseness, etc. Results The rate of successful LMA i-gel placement at first attempt was 100%, placement time was (10 + 3) s, and the rate of successful intubation in the two groups was 100%. The intubation time was significantly shorter, the rate of successful intubation at first attempt and fiberoptic bronchoscope score were significantly higher in group I than in group O (P ＜ 0.05). Hypertension, tachycardia and hypoxemia were not found in the two groups. There was no significant difference in the incidence of adverse effects between the two groups (P ＞0.05). Conclusion FOB-guided tracheal intubation with LMA i-gel can provide adequate ventilation during operation, improve the success rate of FOB-guided intubation and shorten the intubation time in patients undergoing cervical spine surgery.

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.