Objective To evaluate the optimum ratio of medicine dosage for dexmedetomidine mixed with sufentanil used for patient?controlled intravenous analgesia ( PCIA) after Nuss procedure in pedi?atric patients with pectus excavatum. Methods Sixty pediatric patients diagnosed with pectus excavatum, aged 5-12 yr, weighing 18-50 kg, of ASA physical statusⅠorⅡ, scheduled for elective Nuss procedure under general anesthesia, were randomly divided into 3 equal groups using a random number table:different ratios of medicine dosage while dexmedetomidine was added to sufentanil groups ( SD1-3 groups) . Postopera?tive analgesia was as follows: group SD1 received sufentanil 1 μg∕kg + dexmedetomidine 2 μg∕kg; group SD2 received sufentanil 1 μg∕kg + dexmedetomidine 3 μg∕kg; group SD3 received sufentanil 1 μg∕kg +dexmedetomidine 4 μg∕kg. A mixture of tropisetron 0?1 mg∕kg and dexamethasone 0?1 mg∕kg ( in 100 ml of normal saline) was added in each group. The PCA pump was programmed to deliver 0?5 ml with a lockout interval of 15 min and background infusion at 2 ml∕h. The PCA pump was connected immediately after the end of operation, and sufentanil with a dosage of 0?1μg∕kg was used as a rescue analgesic within 48 h post?operatively. The VAS score was maintained below 4. The requirement for rescue analgesics was recorded. The Ramsay sedation scores was recorded at 4, 8, 12, 24 and 48 h postoperatively, and the occurrence of adverse reactions such as nausea and vomiting, bradycardia, over?sedation, respiratory depression, agitation and shivering was recorded within 48 h after surgery. Results No pediatric patients developed nausea and vomiting, respiratory depression, bradycardia, over?sedation, and shivering. No pediatric patients required rescue analgesics in SD2 and SD3 groups. Compared with group SD1 , the requirement for rescue analgesics and incidence of agitation were significantly decreased, and Ramsay sedation scores were increased at 4 and 8 h after operation in SD2 and SD3 groups. Ramsay sedation scores were significantly higher at 4 h after oper?ation in SD3 group than in SD2 group. Conclusion Dexmedetomidine 3 μg∕kg mixed with sufentanil 1μg∕kg is the optimum ratio of medicine dosage when used for PCIA after Nuss procedure in pediatric patients with pectus excavatum.

Objective To verify the antiviral effects of Siji Kangbingdu mixture (SJKBDM) against coxsackievirus A16 (CoxA16).Methods Vero cells and 5-day-old suckling mice, injected with 75/50 and 1×106 TCID50 CoxA16, were used as evaluation models.The preventive influences of SJKBDM against CoxA16 in Vero cells were assessed in the models.The effects of SJKBDM on the mortality, survival time, change rate of body weight, and clinical symptom scores of suckling mice were observed.Results ①The half maximal inhibitory concentration of SJKBDM on Vero cells was 9.59 mg·mL-1.②Toxic effects were not observed from 32.3 g·kg-1 single dose or continuous intraperitoneal injectin of SJKBDM in suckling BALB/c mice.③The SJKBDM had significant inhibitory effect against CoxA16 virus.Doses higher than 1.22 mg·mL-1 could significantly improve the Vero cell survival rate, and the SJKBDM inhibition of 75/50 TCID50 CoxA16 induced pathological changes in Vero cells.④The SJKBDM significantly improved clinical symptoms of mice with CoxA16 viral infection, especially with crude drug doses of higher than 1.62 g·kg-1.The survival rate and other indicators were comparable or slightly higher compared with ribavirin, and the clinical score was higher than that of ribavirin.Conclusion The SJKBDM has significant inhibitory effect on CoxA16 cell proliferation, significantly decreases death rate, and improves clinical symptoms of mice infected with CoxA16 virus.

Objective To study the distribution status and clinical significance of human papillomavirus(HPV) infection geno‐types in condyloma acuminate(CA) tissues of vulva ,vagina and cervix .Methods The gene‐chips combined with polymerase chain reaction (PCR) technology were utilized for detecting 23 kinds of HPV genotypes in tissue specimens from 63 cases of vulval CA , 61 cases of vaginal CA and 65 cases of cervical CA .Their clinical pathological data were analyzed .Results In 63 cases of vulval CA ,56 cases were HPV positive with the HPV infection rate of 88 .89% (56/63) ,in 61 cases of vaginal CA ,55 cases were HPV positive with the HPV infection rate of 90 .16% (55/61) ,and in 65 cases of cervical CA ,62 cases were HPV positive with the HPV infection rate of 95 .39% (62/65) .Conclusion HPV infection is closely related to the CA pathgenesis in vulva ,vagina and cervix . HPV6 and HPV 11 are main stream genotypes ,in which vulval CA is most common .The gene‐chips combined with PCR technology is a method suitable for HPV typing diagnosis ,and has the characteristics of good sensitivity and high specificity ,which has an im‐portant significance for clinical diagnosis ,treatment and vaccine study of CA in femal vulva ,vagina and cervix .

Objectives To investigate preparation of gemcitabine albumin nanoparticles, and its property of slow-release, the cytotoxic effect on pancreatic cancer cells (PANC1) in vitro, for improving the effect of regional intra-arterial infusion chemotherapy in pancreatic cancer with new medicament in the future. Methods The gemcitabine albumin nanoparticles were prepared with bovine serum albumin and gemcitabine with the desolvation-crosslink method, the concentration of gemcitabine was detected by high performance liquid chromatography (HPLC). The cytotoxic effect on pancreatic cancer cells in vitro were detected with MTT colorimetric assay. Results The mean diameter of gemcitabine albumin nanoparticles was (156.2±2.2) nm, and Zeta potential was (-20.4±1.41)mV, drug loading was 10.8%, drug release time in virto was 3 hours respectively. Gemcitabine albumin nanoparticles (0.01～50 μg/ml) had a 31%～44% inhibitory rate on PANC1 cell, which was similar to the inhibitory rate of same concentration of gemcitabine (26%～47%). Conclusions The new preparation of gemcitabine albumin nanoparticles had obvious drug slow-release effect, which may help improve the effect of regional intra-arterial infusion chemotherapy for pancreatic cancer.

Objective:To investigate the role of miR-483-5p in adrenocortical cancer (ACC) and its possible mechanism.Methods:Quantitative real-time polymerase chain reaction was conducted to estimate the expression of miR-483-5p and CDK15 in ACC tissues and cell lines. The effects of miR-483-5p on proliferation were determined in vitro using CCK-8 proliferation assays, the changes of invasion of ACC cells were examined by Transwell. The molecular mechanism underlying the relevance between miR-483-5p and CDK15 was confirmed by luciferase assay and rescue assays.Results:We found a relatively higher miR-483-5p (2.36±1.02 vs 1.09±0.43) and lower CDK15 (0.57±0.26 vs 1.06±0.32) expression in ACC specimens and cell lines. CDK15 was verified as a direct target of miR-483-5p by luciferase assay. over-expression of miR-483-5p promoted proliferation (24 h: 0.26±0.03 vs 0.23±0.04, 48 h: 0.56±0.05 vs 0.41±0.03, 72 h: 0.73±0.04 vs 0.59±0.03) and invasion (95.78±4.66 vs 23.89±2.52) by down-regulating CDK15 expression.Conclusion:miR-483-5p plays a tumorigenesis role in ACC progression by down-regulating CDK15 expression, which may lead to a novel insight to the potential biomarker and novel therapeutic strategies for ACC.

To address the problems of the low accuracy of pathological classification caused by the large size of pathological data and the high cost of labeling,a pathological classification algorithm for oral cancer is designed based on multi-instance network and two-level attention module,which takes losses at the instance level and image block level into account.A retrospective analysis is conducted on 186 cases of oral cancer(126 cases of squamous cell carcinoma and 60 cases of adenocarcinoma)in the Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Wannan Medical College,and the digital pathological sections are divided into training set,verification set and test set.The foreground and background segmentations are performed on the pathological image,and the noise is removed from the background.ResNet50 is used to extract features from the segmented pathological images,and the features are input into the first-level attention network to obtain the attention score and loss based on image block.Then,the image blocks are sorted according to the attention score,and the reset labels are input into the second-level attention network to obtain the loss based on the instance level.The loss of the two-level attention is taken as the total loss of the model,and the prediction result is obtained by training the final network.The experimental results show that the multi-instance network using two-level attention achieves an accuracy of 78.95%and AUC of 0.8430,demonstrating superior performance than the baseline models.

Objective:To investigate the effect and molecular mechanism of hesperadin in inducing ferroptosis in chronic myeloid leukemia cell line K562 cells.Methods:The effects of hesperadin on the viability, proliferation, and migration of K562 cells were detected though CCK8, EDU-594, and Transwell assays, and the apoptotic rate of K562 cells was detected by flow cytometry. In addition, C11-BODIPY and FerroOrange were utilized to detect intracellular lipid peroxidation and Fe 2+ levels. Meanwhile, the expression levels of ferroptosis-associated protein solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) in cells were detected through Western blot. Lipid peroxidation and Fe 2+ levels were also detected after transfection of cells with SLC7A11 overexpression plasmid. Results:Hesperadin decreased cell viability in a dose-dependent manner with IC 50 of 0.544 μmol/L. Hesperadin concentrations of 0.4 and 0.8 μmol/L were selected for follow-up experiments. EDU-594, Transwell, and flow cytometry showed significantly decreased proliferation and migration rate of K562 cells after 0.4 and 0.8 μmol/L hesperadin treatment for 24 h, and the apoptosis rate was significantly increased compared with the control group ( P<0.05). Western blot indicated a downregulated expression of the antiapoptotic protein Bcl-2 and an elevated expression of proapoptotic proteins Bax and Caspase-3. Moreover, hesperadin increased intracellular lipid peroxidation and Fe 2+ levels compared with the control treatment ( P<0.05). The combination of ferroptosis inhibitor (Fer-1) and hesperadin could reverse the effect of hesperadin on K562 cells. The mRNA and protein levels of ferroptosis-related genes SLC7A11 and GPX4 were significantly decreased in the 0.8 μmol/L hesperadin-treated group ( P<0.05). SLC7A11 overexpression can inhibit hesperadin effect and alleviate ferroptosis. Conclusion:Hesperadin can promote ferroptosis in K562 cells by regulating the SLC7A11/GPX4 axis.

Objective To study the efficacy of two different modes of surgical intervention for the treatment of hypertensive intracerebral hemorrhage (HICH):YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction versus conventional craniectomy plus hematoma evacuation.Methods Medical records of 23 patients with HICH treated from December 2012 to February 2017 were retrospectively analyzed.The differences in demographics,length of operation time,costs and length of hospital stay,Glasgow Outcome Scale scores and 3-month follow-up results were compared between the YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction in 12 patients and conventional craniectomy plus hematoma evacuation in 11 patients.Results There were no significant differences in the gender (male 58.33％ vs.63.64％,femal 41.67％ vs.36.36％),age (65.5±11.8 years vs.56.8±10.1 years),preoperative GCS (6.83±3.93 vs.5.82±3.40),intracranial hematoma volume (50.52±23.07 mL vs.68.77±11.18 mL) and length of hospital stay (15.58±14.72 days vs.22.45±18.37 days) (P＞0.05);There were statistically significant differences in length of operation time (0.73±0.21 h vs.3.92±0.67 h) and hospitalization costs (45 230.50±36 566.88 yuan of RMB vs.79 857.90±34 916.48 yuan of RMB) between two groups (P＜0.05);Follow-up 3 months,there were no significant differences in rate of good recovery 33.3％ vs.18.1％,severe disability rate (25.0％ vs.27.3％) and mortality rate (41.7％ vs.54.6％) between two groups (P＞0.05).Conclusions The minimally invasive YL-1 type hematoma aspiration procedure with bio-enzyme liquefaction as a minimally invasive surgery may be superior to conventional craniectomy for treating HICH because it can offer shorter operation time,more accurate hematoma localization,lower risk of injury,and lower hospitalization costs.In particular,the procedure is suitable for elderly,frail,and poor general condition patients.It can also be applied as emergency treatment for HICH.

With the continued development of molecular biology technologies,circulating tumor DNA (ctDNA)has shown certain value in the diagnosis and treatment of malignant tumors. The emergence of next generation sequencing technology makes ctDNA detection more accurate and rapid. ctDNA plays a certain role in the early diagnosis,disease monitoring,therapeutic evaluation and medication guide of ovarian cancer by vir-tue of its safety and non-invasiveness. The application of ctDNA detection is insufficient at present,but with the continuous development of sequencing technology,ctDNA will play increasingly important roles in the diagno-sis,personalized treatment and prognosis evaluation of ovarian cancer.

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.