Objective:To study the long-term inhibitory effect of external stent on atherosclerosis of autologous vein graft in hypercholesterolemic rabbit and the possible mechanism.Methods:Hypercholesterolemic model was established in 15 rabbits and their bilateral jugular veins were anastomosed with bilateral carotid arteries.One jugular vein graft was stented with a polytetrafluoroethylene tube(external stent group)and the other receiving no stenting served as control(unstent group).Ultrasound was used to evaluate the haemodynamics 12 weeks after operation.The grafts were harvested to examine the thickness and area of intima and media,the deposition of lipid in the vessel wall,and the distribution of VCAM-1 positive cells.Scanning electron microscope(SEM)was used to evaluate the regeneration of endothelium.Results:Ultrasound results showed that the stent group was laminar blood flow and the control group had vortex flow.The thickness and areas of intima and media were significantly lower in the stent group than in the control group(P

OBJECTIVE:To probe into an inventory method of high efficiency and quality for PIVAS.METHODS:Data processing and calculation were carried out using Excel based on the information system of PIVAS.RESULTS & CONCLUSIONS:Digital inventory greatly improves the efficiency and quality of inventory.Under the condition of same workload and same number of staff,working time of digital inventory is 60% less than that of traditional inventory.And consistent rate between material and account is increased by 5%.

Objective To investigate the clinical curative effect of Milligan‐Morgan and Ligasure blood vessels closed system for conducting mixed hemorrhoidectomy under local anesthesia .Methods 68 inpatients with mixed hemorrhoid in the general sur‐gery department of our hospital from April 2009 to April 2012 were selected and randomly divided into the Ligasure group (observa‐tion group ,34 cases) and the Milligan‐Morgan group (control group ,34 cases) .The operation adopted the local infiltration anesthe‐sia .The postoperative followed up lasted for 6‐36 months .The operation time ,intraoperative blood loss ,total hospitalization cost , postoperative hospital stay time ,postoperative pain degree and the postoperative complications were compared between the two groups .Results The average operation time in the control group and the observation group was (32 .35 ± 10 .24)min and (20 .29 ± 7 .88) min(P=0 .000) ,the average intraoperative blood loss was (29 .71 ± 14 .67)mL and (4 .97 ± 2 .89) mL(P=0 .000) ,the aver‐age postoperative pain score was (5 .88 ± 1 .12) points and (3 .47 ± 0 .83) points(P=0 .000) ,the average postoperative hospital stay time was (7 .97 ± 2 .55) d and (2 .29 ± 1 .17) d(P=0 .000) ,and the average hospitalization expense was (1 541 .32 ± 205 .91) Yuan and (2 872 .32 ± 652 .30) Yuan ,respectively ,the differences between the two groups were statistically significant (P=0 .000) .Dur‐ing the hospitalization period and follow‐up ,the anal exudation rate and the average postoperative pain score in the control group were higher than those in the observation group(P=0 .000) ,the occurrence rate of other complications had no statistically signifi‐cant differences between the two groups .Conclusion The Ligasure operation mode has less intraoperative blood loss ,shorter opera‐tion time and shorter postoperative hospital stay time .

Objective To investigate the relationship between apoptosis in epidermal keratinocytes and efficacy of epidermal grafting. Methods Epidermal specimens were obtained from donor sites and depigmented area of 44 patients with vitiligo receiving epidermal grafting. The apoptosis in keratinocytes was determined by terminal deoxynucleotidyl transferase end-labeling (TUNEL) assay, and the expressions of caspase 3, 8, 9 as well as bcl-2 and P53 were evaluated by immunohistochemistry. Results As TUNEL assay showed, the number of apoptotic keratinocytes in epidermis from depigmented area differed significantly from that from donor sites.The expressions of caspase 3, 8 and 9 were mainly located in the membrane and cytoplasm of keratinocytes,and positive keratinocytes were predominately distributed in the middle and lower layer of the epidermis. Of the 44 patients, 19, 15 and 16 were positive for the expressions of caspase 3, 8 and 9 in the depigmented epidermis,respectively, and 9, 5 and 4 for those in the donor epidermis, respectively. P53 was expressed in neither donor epidermis nor depigmented epidermis, while Bcl-2 was weakly positive in donor epidermis and negative in depigmented epidermis. The number of apoptotic keratinocytes was higher in donor epidermis from patients failing to respond to the transplantation than in that from patients successfully treated by transplantation (15.83 ± 2.69 vs.9.24 ± 1.80, t = 10.96, P < 0.01 ). Conclusions There is an obvious apoptosis in keratinocytes from depigmented epidermis of patients with vitiligo, together with an increase in the expression of caspase 3, 8 and 9. The apoptosis in keratinocytes may be related to the efficacy of epidermal transplantation.

Background and purpose: In recent years indirubin-3'-monoxime has been found to be capable of inhibiting some cell proliferation in vitro and in vivo studies, but human colon cancer HT-29 cells, therefore the purpose in this paper was to study the effect of indirubin-3'-monoxime on proliferation and apoptosis of HT-29 cells and its associated mechanism. Methods: HT-29 cells were treated with indirubin-3'-monoxime. The proliferative status of cells was measured by methabenzthiazuron (MTT) assay, flow cytometry (FCM) was used to measure the apoptosis rate. RT-PCR was used to measure the transcription of apoptosis suppressor gene bcl-2, survivin and apoptosis promoting gene Bar. Results: Indimbin-3'-monoxime inhibited growth of HT-29 cells in a dose-dependent and time-dependent manner (F=11.25, P<0.01). The apoptosis rate increased after the treatment by indirubin-3'-monoxime at 10 μmol/L. There were significant differences between different time groups (F=195.25, P<0.01). The transcription of survivin (F=78.75, P<0.01) and Bax (F=87.61, P<0.01) mRNA in HT-29 cells were increased; the transcription of bcl-2 was significantly decreased (F=95.82, P<0.01). Conclusion: Indirubin-3'-monoxime has obviously inhibited proliferation and induce apoptosis of colon cancer HT-29 cells, its mechanism may be related to decrease the bcl-2/Bax ratio.

Objective To investigate the clinical value of high frequency ultrasonography with E-flow imaging in the evaluation of fingertip's microcirculation changes in patients with systemic sclerosis(SSc).Methods Twenty-four SSc patients and 29 healthy subjects were involved.High frequency ultrasonography with E-flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of left and right middle finger.Peak systolic velocity (PSV),end diastolic velocity (EDV),mean velocity(MV),vascular resistance index (RI) and pulsatility index(PI) of digital palmar propria arteries,nail bed arteries and finger ventral arteries were measured.Results In control group,rich blood supply was revealed within the fingertips.Digital palmar propria arteries,nail bed arteries and finger ventral arteries and their small branches were displayed clearly and continuously by E-flow imaging.While in SSc patients,the definition and continuity of fingertip's small vascular flow images were not as good as that in the control group,with the distribution of blood flow markedly reduced.compared with the control group,PSV,EDV and MV of digital palmar propria arteries,nail bed arteries,finger ventral arteries were decreased in SSc group(P＜0.01),but both RI and PI were increased(P＜0.05).There were no statistically significant differences between left and right fingertip's arteries index in normal control group (P＞0.05).But PSV,EDV and MV of left digital palmar propria arteries in SSc group were higher than that of the right(P＜0.05),whose differences bear statistic significance.Conclusions High frequency ultrasonography with E-flow imaging is sensitive and reliable to reflect fingertip's microcirculation changes and provide a new method to assess microvascular changes in SSc patients.

AIM:To investigate the specific anti-tumor effects of mature dendritic cells ( DCs) transfected with amplified mucin 1 ( MUC1) mRNA in vitro.METHODS:DCs separated and purified from the peripheral blood mononu-clear cells were induced in vitro and then identified by flow cytometry .pcDNA3.1(+)-MUC1 plasmid was constructed and was able to transcribe MUC1 mRNA in vitro.The MUC1 mRNA was transfected into DCs by electroporation .MUC1-trans-fected DCs were used to induce T cells to be cytotoxic T-lymphocytes .Quantitative real-time PCR was performed to assess MUC1 mRNA expression in transfected DCs .The proliferation of T cells was examined by MTT assay .The proportion of CD8 +cells in the T cells was determined by flow cytometry and the specific cytotoxicity was measured by LDH assay .The secretion of IFN-γwas detected by ELISA .RESULTS: The marker gene expression in the DCs transfected with MUC 1 mRNA was significantly increased compared with control group , peaking at 24 h.The transfection group showed the higher capacity to stimulate the proliferation of T cells compared with control group when the ratio of DCs to T cells was 1∶10.The proportion of CD8 +cells in transfection group was higher than that in control group .The lethal effect of special cytotoxic T-lymphocytes on target cells in transfection group was stronger than that in control group .The level of IFN-γin the cell su-pernatant of transfection group was higher than that in control group .CONCLUSION:DCs plus MUC1 mRNA by electri-cal transfection induces specific anti-tumor effects , which provides an experiment evidence of using MUC 1 as a target for immunotherapeutic strategy against non-small cell lung cancer .

Objective To study the impact of preoperative nutritional support on the clinical outcomes in patients with malnutrition who underwent transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma.Methods 46 patients with malnutrition underwent TACE after operation for primary liver cancer were randomly divided into the experimental group (n =23) and the control group (n =23).The patients in the experimental group received preoperative nutritional support,but patients in the control group did not receive preoperative nutrition support.The preoperative and postoperative nutritional status,the incidences of postoperative complication,the liver function,the lengths of hospital stay,the costs of nutrition support and the costs of hospitalization were compared between the two groups.Results On the day before the operation,on postoperative day 1,day 7,and one month,the levels of serum albumin,and on the postoperative day 7 and one month,the levels of pre-albumin were significantly higher in the experimental group than in the control group,and the differences were significantly different [(38.4 ± 1.5) g/L vs.(32.8±0.8) g/L,(37.6±1.3) g/Lvs.(31.4±0.9) g/L,(39.0±1.6) g/L vs.(32.0±0.7) g/L,(39.8±2.2) g/L vs.(33.0±2.0) g/L,respectively,P＜0.05],[(160.0±14.6) mg/L vs.(131.0 ± 16.5) mg/L,(163.0 ± 17.7) mg/L vs.(135.0 ± 17.1) mg/L,respectively,P ＜0.05].The incidences of complication were significantly lower in the experimental group than that of the control group (52.2％ vs.91.3％,P ＜0.05).The length of hospital stay in the experimental group was shorter than that of the control group [(19.9 ± 2.0) d vs.(24.8 ± 2.7) d,P ＜ 0.05].The cost in the experimental group was significantly lower than that in the control group [(20 108.9 ± 1 142.4) yuan vs.(23 174.1 ± 1 128.5) yuan,P ＜ 0.05].The cost in nutrition support in the experimental group was similar to that of the control group (P ＞ 0.05).Conclusions Preoperative nutritional support was helpful in reducing the incidence of postoperative complications,in shortening the length of hospital stay and in reducing medical costs.Nutritional support improved the nutritional status of the patients with primary hepatocellular carcinoma after surgery and TACE.

Objective To investigate the clinical effect of Mudan Granules combined with pentoxifylline in the treatment of type 2 diabetes mellitus (T2DM) with early renal disease and analyze its impact on the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway. Methods A total of 164 patients with T2DM and early renal disease admitted to the Second People's Hospital of Hunan Province between May 2022 and October 2023 were enrolled and randomly divided into observation group(n=82) and control group (n=82) using a random number table in a 1-to-1 ratio. The control group received pentoxifylline treatment, while the observation group received Mudan granules combined with pentoxifylline. The clinical effects and changes in renal function indicators[serum creatinine (SCr), urea nitrogen, urinary albumin-to-creatinine ratio (UACR)], TLR4/NF-κB signaling pathway indicators (TLR4, MyD88, NF-κB mRNA), and inflammation and oxidative stress indicators [C-reactive protein (CRP), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), total antioxidant capacity (TAC), and transforming growth factor β1 (TGF-β1)] before and after treatment were compared between the two groups. Results The total effective rate in the observation group was 97.56%, which was higher than 89.02% in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of SCr, urea nitrogen, and UACR in both groups decreased compared with those before treatment, and the levels of these indicators in the observation group were lower than those in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of TLR4, MyD88, and NF-κB mRNA in both groups decreased compared with those before treatment, and the levels of these indicators in the observation group were lower than those in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of GSH-PX and TAC in both groups increased, while the levels of CRP, MDA, and TGF-β1 decreased compared with those before treatment. The levels of GSH-PX and TAC in the observation group were higher than those in the control group, while the levels of CRP and MDA were lower (P<0.05). Conclusion Mudan Granules combined with pentoxifylline in the treatment of T2DM with early renal disease can improve renal function to a certain extent, regulate the TLR4/NF-κB signaling pathway, and reduce inflammation and oxidative stress responses, which is beneficial for disease control.

Objective:To evaluate the effective dose, efficacy and safety of remimazolam for induction of general anesthesia in super-elderly patients.Methods:Trial Ⅰ American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex, aged ≥80 yr, with body mass index of 18-25 kg/m 2, undergoing elective surgery with general anesthesia in the Zhejiang Provincial People′s Hospital from January to March 2022, were selected. Remimazolam 0.12 mg/kg or propofol 0.8 mg/kg was intravenously injected in the first patient, and the dose of remimazolam or propofol in the next patient was determined by using the modified Dixon′s up-and-down method. The difference between the two successive doses was 0.01 mg/kg for remimazolam and 0.05 mg/kg for propofol. A positive response was defined as achieving an anesthesia depth (BIS value ≤ 65) within 5 min of administration. If the response was positive, the next patient received a lower dose, or conversely if negative, a higher dose was given in the next patient. The 50% effective dose (ED 50) and 90% effective dose (ED 90) of remifentanil and propofol and their 95% confidence intervals ( CIs) were calculated by Probit method. Trial Ⅱ One hundred and forty-six American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ elderly patients of either sex, aged ≥80 yr, with a body mass index of 18-25 mg/kg, scheduled for elective surgery with general anesthesia from April to October 2023 in Zhejiang Provincial People′s Hospital, were selected and divided into 2 groups ( n=73 each) by using a random number table method: remimazolam group (R group) and propofol group (P group). R group was induced with intravenous remimazolam ED 90 and P group was induced with intravenous propofol ED 90, and the injection time was both 30 s. If the BIS value was still greater than 65 at 5 min after administration, remimazolam 0.05 mg/kg was intravenously added each time in R group and propofol 0.5 mg/kg was intravenously added each time in P group until the patient′s BIS value ≤65. The success of anesthesia induction, time for successful induction of anesthesia and rescue sedation were recorded. The occurrence of intraoperative injection pain, hypertension, hypotension, bradycardia, hypoxemia, intraoperative awareness and postoperative delirium, nausea and vomiting was also recorded. Results:Trial Ⅰ The ED 50 (95% CI) of remimazolam was 0.148 (0.139-0.157) mg/kg, and the ED 90 (95% CI) was 0.160 (0.153-0.202) mg/kg; the ED 50 (95% CI) of propofol was 0.824 (0.726-0.983) mg/kg, and the ED 90 (95% CI) was 0.916 (0.860-2.472) mg/kg. Trial Ⅱ Compared with group P, the time for successful induction of anesthesia was significantly prolonged, the incidence of intraoperative injection pain and hypotension was decreased ( P<0.05), and no significant change was found in the success rate of anesthesia induction, rate of rescue sedation, intraoperative hypertension, bradycardia, hypoxemia, postoperative delirium, and nausea and vomiting in group R ( P>0.05). Conclusions:The ED 50 and ED 90 of remimazolam for induction of general anesthesia are 0.148 and 0.160 mg/kg, respectively, in super-elderly patients. Compared to propofol, remimazolam has a slightly longer onset time, but it is safer when used for induction of general anesthesia in super-elderly patients.