Objective To investigate the relationship between acute cerebral infarction(CI)and matrix metalloproteinase-9(MMP-9)serum level and polymorphism(C-1562T)in Han population.Methods One hundred and one patients with acute CI from the department of neurology of Taizhou Hospital were included and 114 healthy persons were selected from physical examination as the control group.Serum MMP-9 level was measured by enzyme-linked immunosorbent assay(ELISA).At the same time.genotype was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)for the common C-1562T functional promoter polymorphism of the MMP-9 gene.The serum MMP-9 level and genotype frequencies of the MMP-9 gene between the patients and the control group were analyzed.Results The genotype frequencies of the MMP-9 gene C-1562T polymorphism of the two groups were in Hardy-Weinberg equilibrium.The results of individual polymorphisms analysis showed that the frequencies of CT and TT genotypes in the C-1562T polyporphismin were of no significant difference between the patients group with CI(13.9%)and the control group(13.2%).The frequencies of-1562T allele was of no statistical difference between the CI group(6.9%)and the control group(7.5%).But serum levels of MMP-9 in CI patients group((138.9±121.8)ng/ml)were significantly higher than in the control group((18.4±4.6)ng/ml,t=9.93,P=0.00).Conclusions Serum level of MMP-9 obviously is increased after ischemic stroke in 48 hours.But genetic polymorphism in MMP-9 promoter(C-1562T)has no definite relationship with MMP-9 genetic expression and CI in the Han population of China.Therefore,the relationship between genetic polymorphism in MMP-9 promoter(C-1562T)and ischemic stroke needs further investigation.

Objective To investigate the sedative effect of different doses of buccal dexmedeto-midine premedication during peri-anesthesia in pediatric patients undergoing tonsillectomy and/or ade-noidectomy.Methods Eighty pediatric patients undergoing tonsillectomy and/or adenoidectomy in department of otorhinolaryngology,54 males and 26 females,aged 4-12 years,ASA Ⅰ or Ⅱ,from June,2014 through May,201 6 were enrolled,n =20 in each group.Children were randomly assigned to receive buccal dexmedetomidine 0 μg/kg (group A),1 μg/kg (group B),2 μg/kg (group C)and 4μg/kg (group D)60 min before transporting to operating room.Sedation score (OAA/S scale)was monitored before and after administering buccal dexmedetomidine.Time of post-operative first spon-taneous respiration,opening eyes,extubation,anxiety score (SAS scale),as well as OAA/S scale, pain intensity (FLACC),and adverse events 60 min after surgery were recorded.Results Compared with group A and group B,markedly superior OAA/S within 60 min after administering buccal dexmedeto-midine in group C and group D were observed (P < 0.05 ).Compared with group A and group B,the OAA/S score 5 min after extubation was lower in group D.FLACC scores within 30 and 60 min after extu-bation in group D were lower than those in group A.Group D showed obviously prolonged time of post-op-erative first spontaneous respiration,opening eyes and extubation compared with the other groups (P <0.05).All the rates of adverse events were similar.Conclusion 2 or 4 μg/kg premedecation of buccal dexmedetomidine 60 min before transporting to operating room can effectively and safely sedate pediatric pa-tients when entered operating room,improve parental separation,mask and sevoflurane acceptance,as well as decrease the stress induced by intubation and post-operative pain.

Objective To evaluate the effect of anti-microbia-l coated central venous catheter (CVC),compared with routine CVC,on catheter-associated deep venous thrombosis (CADVT). Methods A total of 1 359 patients,aged 26-82 years,ASA physical status Ⅰ-Ⅲ,undergoing internal jugular,axillary-subclavian,or femoral vein CVC catheterization during January to June of 2017,were retrospectively reviewed.The patients were divided into intoanti-microbial-coated CVC group (group A)and routine CVC group (group B).Gender,age,ASA class,pre-operative risk of thrombus (Caprini score),CVC site,surgical site,ultrasound-guided catheterization,and anticoagu-lation therapy,CADVT and the degree,as well as the other adverse events were recorded.Results A total of 938 patients were successfully matched.There were 323 (34.4%)articipants diagnosed with CADVT with bedside point-of-care ultrasound,in which 172 cases (36.7%)in group A and 151 (32.2%)in group B.There was no statistical significance of CADVT and the degree between the two groups.The subgroup analysis results indicated that the patients using anti-microbial-coated CVC with high risk of thrombus (Caprini score ≥ 5 points)(OR 1.34,95% C I 1.01-1.78),undergoing catheterization according to anatomical landmark (OR 1.69,95% C I 1.04-2.74),and not-receiving anticoagulation therapy (OR 1.39,95% C I 1.01-1.92)had an increased risk of CADVT compared with those using routine CVC.A significantly decreased incidence of catheter-associated infection in group A was observed compared with group B (0.9% vs 4.1%,P<0.05).Conclusion Anti-micro-bial-coated CVC does not increase the incidence of CADVT.

Background: Diabetes is a risk factor for postoperative complications. Previous meta-analyses have shown that elevated glycated hemoglobin (HbA1c) levels are associated with postoperative complications in various surgical populations. However, this is the first meta-analysis to investigate the association between preoperative HbA1c levels and postoperative complications in patients undergoing elective major abdominal surgery. Methods: PRISMA guidelines were adhered to for this study. Six databases were searched up to April 1, 2020. Primary studies investigating the effect of HbA1c levels on postoperative complications after elective major abdominal surgery were included. Risk of bias and quality of evidence assessments were performed. Data were pooled using a random effects model. Meta-regression was performed to evaluate different HbA1c cut-off values. Results: Twelve observational studies (25,036 patients) were included. Most studies received a ‘good’ and ‘moderate quality’ score using the NOS and GRADE, respectively. Patients with a high HbA1c had a greater risk of anastomotic leaks (odds ratio [OR]: 2.80, 95% CI [1.63, 4.83], P < 0.001), wound infections (OR: 1.21, 95% CI [1.08, 1.36], P = 0.001), major complications defined as Clavien-Dindo [CD] 3–5 (OR: 2.16, 95% CI [1.54, 3.01], P < 0.001), and overall complications defined as CD 1–5 (OR: 2.12, 95% CI [1.48, 3.04], P < 0.001). Conclusions An HbA1c between 6% and 7% is associated with higher risks of anastomotic leaks, wound infections, major complications, and overall postoperative complications. Therefore, guidelines with an HbA1c threshold > 7% may be putting pre-optimized patients at risk. Future randomized controlled trials are needed to explore causation before policy changes are made.