Enhanced recovery after surgery (ERAS)is a new concept of accelerating the recovery of patients through a series of multi-mode strategies based on evidence-based medicine date in perioperative period. The perioperative fluid therapy is an important part of ERAS, including three phases of preoperative、intraoperative and postoperative. Its aim is to maintain the circulation volume to ensure circulation stability and effective perfusion of tissues, to avoid tissue ischemia and hypoxia, and to reduce surgical stress, maintain internal environment stability, reduce postoperative respiratory and circulatory complications, thus accelerating recovery. Fluid therapy has been controversial, Goal-directed Fluid Therapy is a recognized method.This article reviews the latest advances in preoperative, intraoperative and postoperative fluid therapy on the guidance of ERAS and its influence on postoperative outcomes.

OBJECTIVE:To study the affinity of penehyclidine optical isomers to muscarinic(M)receptor subtypes,and pro-vide reference for revealing the action targets and efficacy selectivity of penehyclidine. METHODS:Homology modeling,molecu-lar docking and other molecular simulation technologies were used to analyze and predict the binding energy of 4 optical isomers to M receptor subtypes and judge its affinity by comparing the binding energy of different optical isomers R1 (3R,2′R),R2 (3R, 2′S),S1(3S,2′R),S2(3S,2′S)with M receptor subtypes M1-M5. RESULTS:All the 4 optical isomers can dock into the ac-tive sites of M receptor subtypes,and different optical isomers showed great differences in the molecular docking with different M receptor subtypes. Penehyclidine isomers showed larger binding energy to M3,the binding energy of 4 optical isomers ranged in 5736.519-5907.143 kcal/mol. The binding energy of R1 to M1 was 1190.041 kcal/mol;while those of other optical isomers to each receptor subtype were lower or negative. CONCLUSIONS:R1 shows the affinity to M1 receptor. And all the 4 optical isomer show the affinity to M3.

BACKGROUNDTo explore the feasibility of detection of aberrant methylaion of p16 and death-associated protein kinase gene as biological markers for the diagnosis of non-small cell lung cancer (NSCLC) patients.

METHODSThe methylation of p16 and death-associated protein kinase gene in serum and primary NSCLC tumors from 30 NSCLC patients was detected by using methylation-specific PCR methods.

RESULTSAberrant methylation of at least one gene was detected in 18 of 30 (60.0%) in NSCLC tumor tissues. In these primary tumors with methylation, 9 of 18 (50.0%) samples also was detected abnormal methylation in the matched serum samples, but not in any paired normal lung tissue and healthy control subjects.

CONCLUSIONSDetection of aberrant methylation in the serum of NSCLC patients may have implications for early diagnosis of NSCLC.