Objective To investigate the effect of different time administration of parecoxib sodium on the postoperative analgesic efficacy in patients undergoing thoracic surgery. Methods This was a prospective,randomized, double-blind, placebo-controlled study. Sixty ASA Ⅰ orⅡ patients aged 17-83 yr undergoing pulmonary lobectomy were randomly allocated to one of 3 groups (n=20 each):A, B and C groups. Group A received normal saline 2 ml at 30 min before skin incision and the end of operation. Group B received iv parecoxib sodium 40 mg at 30 min before skin incision and normal saline 2 ml at 30 min before the end of operation. Group C received normal saline 2 ml at 30 min before skin incision and iv parecoxib sodium 40 mg at 30 min before the end of operation. All the patients received patient-controlled intravenous analgesia with morphine and VAS score was maintained≤3. The patients were followed up after operation.The morphine consumption, patients' global evaluation of the postoperative analgesia (0-100, 0=worst pain, 100=no pain), nausea and vomiting, body temperature , volume o chest drainage, hepatic, renal and blood coagulation function were recorded. Results Compared with group A, the morphine consumption was significantly reduced, the patient' s satisfaction score increased and body temperature decreased in B and C groups(P＜0.05 or 0.01). There was no significant difference in the morphine consumption, patient's satisfaction score and body temperature between B and C groups(P＞0.05). No significant difference was found in the parameters of hepatic, renal and blood coagulation function, volume of chest drainage and incidence of nausea and vomiting among the three groups(P＞0.05).Conclusion When postoperative analgesia is assisted with iv parecoxib sodium 40 mg given at 30 min before skin incision or at 30 min beforethe end of operation,the efficacy is similar,and both can improve the postoperative analgesic efficacy of morphine and reduce fever after operation in patients undergoing thoracic surgery.

Objective To explore the feasibility and safety of fentanyl, sufentanil or remifentanil combined with target-controlled infusion (TCI) of propofol for sedation in the elderly undergoing colonoscopy. Methods In this prospective randomized study, 60 patients undergoing colonoscopy and propofol TCI were randomly assigned to group F (fentanyl), group S (sufentanil) and group R (remifentanil)(each n=20). Patients in group F received a single bolus of fentanyl, while those in group S and group R received TCI sufentanil and remifentanil separately. The blood pressure, heart rate, blood oxygen content and Bispectral index (BIS) were monitored, and all the complications were recorded. Results All patients were adequately sedated. There were no significant differences in general conditions, hemodynamics changes, sedation depth and adverse event among the three groups (all P＞0.05). Time for recovery was longer in group F [(21.3±4.6) min] than in group S [(19.9±3.3) min] and group R [(15.9±1.8) min, P＜0.05]. Conclusions For the elderly undergoing colonoscopy, sedation with fentanyl, sufentanil or remifentanil combined with propofol TCI is feasible and safe. It is more excellent for the remifentanil group at shorter discharge time.

The effedt of ligustrum lucidum(LL)and acanthopanax senticosus(AS)on T cells was observed by Ea rosette formation and lymphocyte stimulation test with diff- erent experimental conditions.Both of the two drugs can promote the response of lymphocyte to PHA,but can not stimulate al one lymphocytes to proliferate.LL can raise EaRFC% of lymphocyte and accelerate the restoration of the EaRFC% of trypsin-treated lymphocytes,but AS not.AS can antagonize the inhibition of hydr- ocortisone,but LL not,In this paper,the mechanisms of the action of the two drugs were discussed.

Objective To investigate the effects of substrate stiffness on the proliferation of human umbilical vein endothelial cells ( HUVEC) during dengue virus infection.Methods Polyacrylamide gels were prepared for cell culture [(0±4) kPa].The proliferation of HUVEC cultured on substrates with differ-ent stiffness was determined by using 3-(4,5-diethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfo-phenyl)-2H-etrazolium,inner salt ( MTS) assay.The cycle and apoptosis of HUVEC were determined by flow cytometry analysis.Dengue virus serotype 2 (DENV-2) strains were propagated and identified by con-ventional assays.The HUVEC were infected with DENV-2 strains at a MOI of 10 and cultured on traditional plastic and hydrogel substrates, respectively.The levels of nitric oxide (NO) and endothelin-1 (ET-1) were detected by nitric acid reductase assay and double antibody sandwich ELISA.Results Young′s modulus E value of the hydrogels was (3030 ±0.44) Pa.The proliferation of HUVEC and the expression of NO and ET-1 were enhanced along the increased substrate stiffness.However, no significant differences with the cell cycle and apoptosis were observed between cells cultured on different substrates.Conclusion The stiffness of substrates affected not only the proliferation of HUVEC, but also the release of cytokines during DENV-2 infection.The development of dengue fever was associated with the decreased secretion of vascular active substances as a result of blood vessel injury.The establishment of hydrogel substrates as the model of vascu-lar basement membranes might provide a new way for the in vitro investigation of the pathogenesis of DENV infection.

Objective:To investigate the possibility of miR-125b in serum as a novel tumor marker for primary hepatocellular car-cinoma (HCC) and the diagnosis value of combined detection of miR-125b and alpha-fetoprotein (AFP) for HCC. Methods:We detected serum miR-125b expression of 65 cases of HCC patients and 30 cases of healthy controls by real-time quantitative PCR. Moreover, we analyzed the significance of miR-125b and explored the relationship between miR-125b and clinical pathological factors. Results:The level of miRNA-125b was down regulated in serum of HCC patients compared with healthy controls which showed significant differences (P<0.05). Furthermore, the expression of miRNA-125b has no distinct correlation with sex, age, HbsAg, AFP, ALT andα-GGT, which had no significant differences (P>0.05). The expression level of miRNA-125b correlated the difference with liver Cirrhosis, tumor size and tumor node metastasis (TNM) stages, which were considered significant differences (P<0.05). The receiver operating characteristic (ROC) curve analysis of serum miR-125b for the diagnosis of HCC yielded AUC of 0.917(95%CI:0.851~0.960, P<0.001)with 85.9%sensitivity and 93.5%specificity. The ROC curve analysis of combined miR-125b and AFP for HCC detection yielded AUC of 0.951(95%CI:0.894~0.982, P<0.001)with 92.9%sensitivity and 93.5%specificity. The ROC curve analysis of serum miR-125b as biomarkers for the group (AFP<20μg/L) of HCC yielded AUC of 0.889(95%CI:0.776~0.957, P<0.001)with 84.0%sensitivity and 87.1%specificity. Conclusion:Serum miRNA-125b combined with AFP has considerable clinical value for the early diagnosis of primary HCC.

Objective: To investigate the effects of lidocaine on impairment of learning and memory function and cholinergic system caused by cerebral microsphere embolism in rats. Methods: Healthy male Wister rats were randomly divided into the following groups. (1) Control group. (2) 600 microsphere group and 900 microsphere group, in which 600 or 900 microspheres were injected into the right internal carotid artery, respectively. (3) 600 treatment group and 900 treatment group, in which 600 or 900 microspheres were injected into the right internal carotid artery, respectively, and lidocaine was given. Water maze tasks were tested for 5 consecutive days from the 7th postoperative day. The rats were then decapitated and regions of cerebral cortex, hippocampus, and striatum were selected. The activities of choline acetyltransferase and cholinesterase and the binding activity of muscarinic receptor were determined. Results: (1) The latency periods were significantly longer in the 900 microsphere group than in the control group and in the 600 microsphere group. (2) The percentages of effective search strategy were significantly lower in the 600 and 900 microsphere groups than in the control group. They were significantly higher in the 600 and 900 treatment groups than in the corresponding microsphere groups. (3) The activities of choline acetyltransferase of cerebral cortex were significantly lower in the 900 microsphere and two treatment groups than in the control group. They were also significantly lower in the 600 and 900 treatment groups than in the corresponding microsphere groups. Those of striatum were all significantly lower in the microsphere and treatment groups than in the control group. (4) The activities of cholinesterase of cerebral cortex were significantly lower in the 900 microsphere group than in the control and 600 microsphere groups. They were significantly higher in the 900 treatment group than in the 900 microsphere group. Those of hippocampus were all significantly lower in the microsphere and treatment groups than in the control group. (5) The binding activities of muscarinic receptor of cerebral cortex were significantly lower in the 900 microsphere and two treatment groups than in the control group. They were also significantly lower in the two treatment groups than in the corresponding microsphere groups. Those of hippocampus and striatum were all significantly lower in the microsphere and treatment groups then in the control group. They were also significantly lower in the 600 or 900 treatment group than in the corresponding microsphere group. Conclusion: Cerebral microsphere embolism caused significant and quantity-dependent impairment of learning and memory function and cholinergic system in rats. Lidocaine alleviated learning and memory dysfunction caused by cerebral microsphere embolism, but further inhibited the parameters of central cholinergic system.

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel used in patients undergoing laparoscopic gynecological surgery. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 21-64 yr, weighing 4590 kg, undergoing elective laparoscopic gynecological surgery, were randomized into 2 groups ( n = 30 each):LMA i-gel group (group Ⅰ) and LMA Supreme group (group S) . Mallampatti test was performed before operation in both groups. Anesthesia was induced with target-controlled infusion of propofol (target plasma concentration 2.5-4.0 μg/ml) and remifentanil (target plasma concentration 3-6 ng/ml) . After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA i-gel and LMA Supreme were inserted in I and S groups respectively. A gastric tube was inserted through the drain tube of the LMA. In group S the air was injected into the cuff to make intracuff pressure reach 60 cm H2O after successful LMA insertion. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of hemodynamics and ventilation, and complications (sore throat, odynopliagia,hoarseness) were recorded. The fiberoptic laryngoscopy scores were assessed after successful LMA placement. The anesthesia time and recovery time were also recorded. Results There was no significant difference in the anesthesia time, recovery time, LMA placement time, fiberoptic bronchoscopy scores and the parameters of hemodynamics and ventilation between the two group. The success rates of LMA and gastric tube placement were 100% in both groups. The airway sealing pressure was significantly higher, while the incidence of sore throat and odynopliagia was significantly lower in group I than in group S. Conclusion LMA i-gel provides adequate ventilation during operation with fewer complications and can be used effectively for gynecological laparoscopic surgery.

Objective To evaluate the parametric features of image textures on 18F-FDG PET/CT for the differentiation between malignant and benign pulmonary nodules and compare the diagnostic performance of these parameters with SUVmax.Methods 18F-FDG PET/CT images of 170 patients (102 males,68 females,age range:29-81 (mean 59)years) with pulmonary nodules were retrospectively evaluated.Eightynine pulmonary nodules (230 slices) were malignant and 81 (193 slices) were benign.The pulmonary nodules were contoured on CT images and mapped to the co-registered PET images.Thirteen parameters of textural features were extracted and SUVmax was measured.Logistic regression analysis was used to identify the significant texture parameters and create a regression model.The efficacy of the textural features and SUVmax to distinguish between malignant and benign pulmonary nodules was evaluated by ROC curve analysis.The textural features of squamous cell carcinoma and adenocarcinoma were compared via the Mann-Whitney u test.The sensitivity and specificity of the textural features and SUVmax for the differential diagnosis were compared with x2 test.Results Logistic regression model identified 4 textural features (skewness (β =1.7058),kurtosis (β =-1.0989),angular second moment (ASM,3 =-4.4140) and strength (β =0.5626) ; all P ＜ 0.05) to have significant correlation with the malignancy of lung nodules.The AUC of ROC curve was 0.775 (95％ CI0.732-0.819; P＜0.001) with the sensitivity of 89.6％ (206/230) and specificity of 50.8％ (98/193).ASM and strength had statistically significant differences between squamous cell carcinoma and adenocarcinoma [ASM:0.0303 (95％ CI 0.0392-0.0724) vs 0.0594 (95％ CI 0.0721-0.0947) ; strength:2.4714 (95％ CI 2.4632-4.1050) vs 1.5945 (95％ CI 1.9003-2.4652) ; u =3082.0 and 3115.0,both P＜0.01].The AUC of SUVmax-based diagnosis was 0.757 (95％ CI 0.711-0.802 ; P ＜ 0.001) with the sensitivity of 80.9 ％ (186/230) and specificity of 50.3 ％ (97/193) at a cut-off value of 2.5.The sensitivity of the textural features was superior to SUVmax in differentiating malignant from benign pulmonary nodules (x2 =6.903,P ＜ 0.01).Conclusions Image textural parametric features extracted from 18 F-FDG PET/CT are more sensitive to differentiate between malignant and benign pulmonary nodules compared to SUVmax.They might also be useful to discriminate between different pathological types of lung cancers.

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