Objective To investigate the proper anesthetic administration schemes in pediatric patients undergoing surgery of transcatheter ventricular septal defect closure .Methods A total of 120 pediatric patients with congenital heart diseases of ventricu-lar septal defect ,aged 3-9 years old with ASA physiological status Ⅰ or Ⅱ ,undergoing surgery of transcatheter ventricular septal defect closure were randomly divided into 4 groups with 30 each :ketamine group( K group) ,propofol group( P group) ,ketamine associate with propofol ( KP group) ,sevoflurane group( S group) .Spontaneous respiration were maintained in K ,P ,PK groups ,but mechanical ventilation was adopted after endotracheal tube intubation in S group .The values of MAP ,HR ,SpO2 ,RR were recorded at the following time points :before anesthesia ,incision immediate ,procedure in heart ,completion of operation ,and 30min after oper-ation .awaking time and adverse reactions were recorded .Results Anesthesia and operation were carried out successfully in all pa-tients .Awaking time in P group and KP group markedly shorter than K group (P<0 .01) .The incidence rate of adverse reactions such as cough ,asphyxia and body motion in pediatric patients by mechanical ventilation and sevoflurane inhaled markedly less than other groups(P<0 .01) .Conclusion It is safe that pediatric patients received mechanical ventilation and sevoflurane inhaled after endotracheal intubation undergoing surgery of transcatheter ventricular septal defect closure .

Objective To compare the effects of tracheal intubation (TI) and laryngeal mask (LM) during general anesthesia (GA) induction on the α 1-band of quantitative pharmaco-electroencephalography (QPEEG).Methods Fortypatients undergoing GA were randomly divided into two groups:group T included 20 patients who received TI and group L included 20 who received a LM.Parameters like heart rate (HR),mean arterial pressure (MAP),and QPEEG were recorded before anesthesia induction (T0),after induction (T1),and after intubating the cannula or LM (T2).Using power-spectrum analysis,we calculated the power percentage of the α 1-band of QPEEG.Results The HR,MAP,and power percentage of the α 1-band in most areas of the brain were lower at T1 than at T0 (P ＜ 0.05) in both groups.Moreover,the HR,MAP,and α 1-band power percentage were higher at T2 than at T1 (P ＜ 0.05) in group T,whereas they showed no significant change at T2 (P ＞ 0.05) in group L.Conclusion TI is stronger than LM for stimulating the circulatory system.Moreover,TI may cause an increase in the power percentage of the α 1-band of QPEEG.This finding suggests that the α1-band power percentage of QPEEG can be an effective means of monitoring stimulation.

Objective To compare the difference region of interest volume (ROI) calculation method between Pinnacle and Eclipse treatment planning system. Methods To acquire CT image with 3 of slice thickness (1 mm, 3 mm, and 5 mm). Delineate 1, 2 and 5 slices square and circle contours in Pinnacle treatment planning system. Meanwhile 15 cases that include 5 cases with head neck tumor, 5 with thorax tumor and 5 with abdomen tumor were selected. Those image and ROI were transfer to Eclipse treatment plan system by DICOM RT protocol . The ROI volume was compared between two TPS . Results For ROI with small volume, the volume difference between TPS was obvious (for small volume ROI have 12 times difference, for big volume ROI almost same). The volume difference between TPS was influenced by many factors. The number of ROI slice and the magnitude of ROI was related with the difference between TPS (R2 = 1. 000, P = 0. 000). The CT thickness (R2 = 0. 200, P = 0. 972 ) and the shape of ROI ( R2 =0. 200, P = 0. 089) were not significant factors. The center of ROI on different axis was not affect the volume calculation in Pinnacle, which cause 3% different in Eclipse. The CT thickness was proportional to the ROI volume ( Pinnacle R2 = 0. 548, P = 0. 011; Eclipse R2 = 0. 502, P = 0. 027 ). In clinical case, optic chiasm and Len averagely have more than 35% volume difference between those two TPS. Conclusions We should pay more attention about the difference volume calculation algorithm between Pinnacle and Eclipse,especially when transfer small volume ROI to another TPS, which may have significant difference.

Objective To observe the effect of transcutanous acupoint electrical stimulation(TAES)and dexmedetomidine on postoperative cogni?tive dysfunction in female patients underwent laparoscopic surgery. Methods Nighty patients scheduled for laparoscopic surgery were recruited in this study and randomly divided into control group(group C,n=30),TAES group(group T,n=30)and dexmedetomidine group(group D,n=30). In group T,patients received TAES treatment 30 min before the anesthesia until the end of the surgery at Neiguan(PC 6)and Zusanli(ST 36). The frequency was 2/100 Hz. In group D,patients were intravenously administrated with dexmedetomidine(0.5μg/kg)before the induction. All the patients were given routine general anesthesia. Drugs induced were sulfentanyl,etomidate and cisatracurium. Sevoflurane was given to main?tain the bispectral index(BIS)between 40 and 55. The time of extubation and in PACU was recorded. The serum S100βlevel was assessed at pre?operation(T0),the end of operation(T1)and 24 h after operation(T2). Mini?mental state examination(MMSE)was adopted to evaluate and re?cord the changes in cognitive function 1 day before operation and 24 h after operation. Results The incidence rate of POCD in group T and group D were lower than that in group C(all P<0.05). The level of S100βin group T and group D was lower than those in group C at T1 and T2 separately (all P<0.05). The time of extubation and time in PACU in group D were longer than those in group C and group T(all P<0.05),and the incidence of bradycadia in group D was higher than that in the other groups(all P<0.05). Conclusion TAES and dexmedetomidine reduce the incidence of cognitive dysfunction,decrease the release of S100βprotein. However,dexmedetomidine increases bradycadia,and prolongs extubation time and stay time in PACU. Hence,TAES deserve to be recommended practically.

Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non?small cell lung cancer ( NSCLC) . Methods Sixty?six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image?guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum?based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short?term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty?four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The objective response rate for thoracic lesions was 70%. The follow?up rate was 97%. The 1?, 2?, and 3?year overall survival ( OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months;the 1?, 2?, and 3?year progression?free survival ( PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2?3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3?4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short?term outcome and long?term survival, with tolerable adverse effects.

Objective To compare the effects of different doses of sufentanil on theα1?band of quantitative pharmaco?electroencephalography (QPEEG)during the induction of general anesthesia by tracheal intubation(TI). Methods Forty selected patients under general anesthesia were randomly divided into two groups,with 20 patients per group. Patients in group Ⅰ were administered 0.2μg/kg sufentanil,whereas patients in group Ⅱ were administered 0.3μg/kg sufentanil. Subsequently,the patients were administered 2 mg/kg propofol and 0.15 mg/kg cisatracurium. HR,MAP,and QPEEG were recorded before induction(T0),after induction(T1),and after insertion of the cannula(T2). Using the method of power spectrum analysis,theα1?band power percentage of QPEEG was calculated. Results In comparison with T0,the values of HR,MAP,andα1?band power percentage in most areas of the brain were both decreased at T1(P<0.05). Furthermore,in comparison with T1,the parameters were increased in group Ⅰ at T2(P<0.05),but no significant changes were observed in group Ⅱ (P>0.05). Conclusion The administration of 0.3μg/kg sufentanil during anesthesia induction can effectively depress the cardiovascular response to TI and stabilize theα1?band power per?centage. This suggests that theα1?band power percentage of QPEEG can be an effective means to monitor the depth of sedation.

Objective To survey the satisfaction degree of the postgraduates in professional degree with The Joining Together of Double-Track education model in the current stage of professional degree graduate education and standardized training of residents in China. Methods According to various factors, such as the current situation of postgraduates in medical universities, we sought the opinions of relevant experts to design questionnaire. Meanwhile, to enhance the reliability of the questionnaire and the survey, we chose the postgraduates of Shengjing Hospital of China Medical University first to do the pre-survey, and according to the feedback, we adjusted part of the aspects, thus formed a formal questionnaire, which included the satisfaction with training of clinical practice ability, training of research ability, and tutors' assessment etc. Finally, the Chinese New Youth Forum online released the questionnaires, selecting the postgraduates in professional degree who were participating in, or had participated in the completion of the standardized training as the participants, which took place between March 2016 and May 2016. SPSS 16.0 was used for statistical analysis. The evaluation results of different majors were tested by Kruskal-Wallis rank sum test. Results According to the results of the survey, the aspects in the clinical resident standard-ized training that the 1000 postgraduates were more satisfied with were as follows: training time [42.8%(n=428)], training center [41.8% (n=418)], training of clinical practice ability [41.6% (n=416)], tutors [40.2%(n=402)], economic income [38.8%(n=388)], department arrangements [38.4% (n=384)], training of research ability [37.5%(n=375)]. There is a significant difference in the satisfaction degree of different pro-fessional graduate students in theJoining Together of Double-Trackeducation model (P<0.05). ConclusionThe Joining Together of Double-Track education model should be compatible with the training objectives of postgraduates in professional degree. Much more attention should be paid to the post-graduates, satisfac-tion degree with the clinical resident standardized training, as well as the requirements during the training period, improve the evaluation of graduate students' ability of scientific research, econo-mic income and so on, so as to improve the training system for the postgraduates.

Comparative pharmacokinetic (PK) analysis is often carried out throughout the entire period of drug development, the common approach for the assessment of pharmacokinetics between different treatments requires that the individual PK parameters, which employs estimation of 90% confidence intervals for the ratio of average parameters, such as AUC and Cmax, these 90% confidence intervals then need to be compared with the pre-specified equivalent interval, and last we determine whether the two treatments are equivalent. Unfortunately in many clinical circumstances, some or even all of the individuals can only be sparsely sampled, making the individual evaluation difficult by the conventional non-compartmental analysis. In such cases, nonlinear mixed effect model (NONMEM) could be applied to analyze the sparse data. In this article, we simulated a sparsely sampling design trial based on the dense sampling data from a truly comparative PK study. The sparse data were analyzed with NONMEM method, and the original dense data were analyzed with non-compartment analysis. Although the trial design and analysis methods are different, the 90% confidence intervals for the ratio of PK parameters based on 1000 Bootstrap are very similar, indicated that the analysis based on NONMEM is a reliable method to treat with the sparse data in the comparative pharmacokinetic study.

Objective To study TMSG-1 and Cyclin D1 expressions in esophageal squamous cell carcinoma (ESCC) and their relevance to the clinicopathological data and prognosis. Methods Immunohistochemistry S-P method was used to examine the expressions of TMSG-1 and Cyclin D1 in pathological specimens of 136 cases of ESCC and 13 cases of normal esophageal mucosa. Contrast study among immunohistochemistry, clinicopathological data and prognosis was also analyzed. Results (1)The positive expression rates of TMSG-1 and Cyclin D1 in ESCC were 52.2% and 65.4%, respectively. The expressions of TMSG-1 and Cyclin D1 in ESCC were significantly higher than that in normal esophageal mucosa (P<0.05). (2)The expressions of TMSG-1 and Cyclin D1 were all related to clinical stage , differentiation degree and lymph node metastasis (P < 0.05). (3)The expression of TMSG-1 was negatively correlated to the expression of Cyclin D1 in ESCC (r=-0.386,P=0.000). (4)The expression levels of TMSG-1 and Cyclin D1 were independent risk factors in patients with ESCC (P < 0.05). Conclusions The abnormal expressions of TMSG-1 and Cyclin D1 may cooperatively play a role in initiation and development of ESCC. Co-examination of TMSG-1 and Cyclin D1 expressions in primary tumors may be useful for predicting prognosis of ESCC.

Objective To explore the treatment of multifocal lower extremity arteriosclerosis oblitera-tions. Methods From March 2014 to September 2014, combined procedures were performed on 30 lower limbs in 30 patients with multifocal lower extremity arteriosclerosis obliterations for revascularization. All the patients underwent endovascular , 20 of whom received endarterectomy , 10 received artery emboloctomy , and 8 received profundaplasty. The rates of technical success and clinical success were observed. The patients were followed up for 6-12 months to observe the total patency rate and rate of limb reservation. Results The technical success rate was 100%. The perioperative complication rate was 30% (9/30). 29 limbs gained improvement with differ-ent degree and the clinical success rate was 96.67% (29/30). The ankle-brachial index elevated 0.37 ± 0.19 on average (P < 0.001). Primary patency rate was 90% and 73% at 6 and 12 months, and 12-month limb reserva-tion rate was 97.67%. Conclusions The combined procedures for complex lower extremity arteriosclerosis oblit-erations have a higher short- to mid-term patency rate and limb reservation rate.