Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.

Objective:To explore the clinical application values of contrast-enhanced ultrasound in the diagnosis and classification of portal vein tumor thrombosis (PVTT)by comparing with enhanced CT.Methods:43 patients with PVTT confirmed by clinic and pathology were selected, and the accuracy rates of the diagnosis and clinic classification of contrast-enhanced ultrasound and enhanced CT were compared. Results:The characteristic of PVTT in contrast-enhanced ultrasound was“quick in fast out”;88.4% (38/43)of PVTT were hyper-enhancement in the arterial phase, 81.4% (35/43 ) of PVTT were hypo-enhancement in the vein phase, and all tumor thrombosis showed hypo-enhancement in the delay phase. The diagnostic accuracy rate of contrast-enhanced ultrasound in PVTT was 100%,and the accuracy rate of enhanced CT was 97.7% (42/43).The classification accuracy rate of contrast-enhanced ultrasonic was 95.3% (41/43),and the accuracy rate of enhanced CT was 93.0% (40/43 );there was no statistically significant difference between two methods (P > 0.05 ). Conclusion:Dynamiccontrast-enhanced ultrasonography can display the blood perfusion characteristics of PVTT, and displays the actual infiltrating tumor thrombosis. Ultrasonic imaging and enhanced CT in the qualitative diagnosis of PVTT and clinical classification have a good consistency.Contrast-enhanced ultrasound can be used as an important imaging method to evaluate the PVTT before treatment.

Objective To construct a prokaryotic plasmid expressing the recombinant protein of enterohemorrhagic Escherichia coli(EHEC) effector NleB1 and to prepare the polyclonal antibody of mouse anti-NleB1.Methods The nleB1 (990 bp) gene was amplified from the genome EHEC O157∶H7 and cloned into the expression plasmid pET24a to construct the recombinant plasmid pET24a-nleB1 that was transformed into E.coli BL21(DE3).After induction with isopropylthio-gelactoside( IPTG) , the His-tag fusion proteins were purified by Ni+affinity chromatography and gel slices.The polyclonal antibody was prepared by immunizing BALB/c mice with purified recombinant proteins and analyzed by Western blotting and ELISA.Results The pET24a-nleB1 recombinant plasmid was successfully constructed, the fusion protein was ex-pressed and purified,and the polyclonal antibody was obtained by immunizing mice with purified fusion protein.Western blotting and ELISA staining demonstrated that the polyclonal antibody was successfully obtained.Conclusion The prepara-tion of the polyclonal antibody against EHEC O157∶H7 NleB1 will be of help for further studies on the function of NleB1 protein.

Objective To examine the values of Regional Homogeneity (ReHo) in first-episode, treatment-naive patients with major depressive disorder before and after antidepressant treatment in order to explore the neural mechanism of antidepressants. Methods Twenty-five first-episode, treatment-naive patients with major depressive disorder, which met with DSM-IV diagnosis criteria underwent fMRI resting-state scans before and after 8-week antidepressant treat-ment. Paired Samples T-test was used to analysis the differences between two groups. Results The ReHo in the patient group after treatment were significantly decreased in the right medial frontal gyrus, left inferior parietal lobule, left middle temporal gyrus, left insula, right precuneus, left cingulate gyrus and posterior lobe of the cerebellum , while significantly in-creased in the right medial frontal gyrus, left medial frontal gyrus, right inferior parietal lobule, left postcentral gyrus and right middle temporal gyrus compared with before treatment. Conclusions E xtensive abnormal activity within the default mode network in the resting-state may be involved in the neuropathophylogical substrate of depression and the abnormal activity can be partly reversed by antidepressant treatment, suggesting that regional homogeneity can be used to dynamical-ly evaluate the effect of antidepressant treatment.

OBJECTIVETo establish rat C6 brain-tumor models and find a simple reliable index to judge tumor volume.

METHODSC6 cell suspension (10 microl) containing 10 g/L agarose and 1 x 10(6) cells was injected into the right caudate nucleus of the rat brain by a stereotaxic method. After implantation, rats were observed and given MRI scans. Rats were perfused with paraformaldehyde trans-aorta at the 10th, 15th, 20th and 25th day and before natural death. All brains, lungs, spinal cords and tumors were sectioned and inspected. Tumor-containing samples were prepared histologically by hematoxylin and eosin (HE) stains.

RESULTSFifty implanted rats had 100% yield of intracerebral growth, with distant metastasis of 0% to 4%.

CONCLUSIONA rat C6 brain-tumor model was successfully established. Rat survival time is correlated with tumor volume and may be useful as an index of tumor size.

Animals ; Brain Neoplasms ; pathology ; Disease Models, Animal ; Glioma ; pathology ; Magnetic Resonance Imaging ; Rats

OBJECTIVETo observe the effects of inhaled Chuankezhi injection (CKZ) on airway inflammation in a mouse model of asthma and dilation of isolated guinea-pig airway smooth muscle in vitro, which can provide pharmacodynamic evidence for CKZ treating acute attack of asthma.

METHODBALB/c mice were sensitized with ovalbumin (OVA) on Days 1, 15, and then were inhaled with OVA aerosol on Days 22-28. The sensitized mice were administered with inhalation of aerosolized CKZ injection (0.2, 0.4, 0.8 mL x kg(-1), bid), or intraperitoneal injection of CKZ (0.4 mL x kg(-1), bid), dexamethsone (0.5 mg x kg(-1) x d(-1)) and saline (control) on Days 22-28. Airway inflammation was evaluated by counting cells in bronchoalveolar lavage fluid (BALF) and by lung histology. The influences of CKZ on the dilation of tracheal smooth muscle in guinea-pig and the contraction induced by carbamylcholine (CCH)/histamine in vitro were also observed.

RESULTIn vivo, OVA-sensitized mice developed a significant airway inflammatory response that was significant inhibited by inhalation of CKZ (0.8 mL x kg(-1), bid), and intraperitoneal injection of CKZ (0.4 mL x kg(-1), bid) and dexamethasone (0.5 mg x kg(-1) x d(-1)). in vitro, CKZ did not dilate tracheal smooth muscles in guinea-pigs, and did not attenuate the contraction induced by carbamylcholine (CCH)/histamine.

CONCLUSIONCKZ can modulate airway inflammation in asthma, but has no dilation effect on the tracheal smooth muscle in guinea-pig in vitro. These results demonstrate that inhaled CKZ is not a preferred administration.

Animals ; Asthma ; drug therapy ; immunology ; Bronchoalveolar Lavage Fluid ; immunology ; Cells, Cultured ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Female ; Guinea Pigs ; Humans ; Injections ; Lung ; drug effects ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Muscle, Smooth ; drug effects ; immunology ; Respiratory System ; Trachea ; cytology ; drug effects ; immunology

Objective: To establish and optimize the HPLC fingerprints of Angelica sinensis medicinal material and determine the ligustilide content to improve the quality standard for Angelica sinensis and improve the quality control level of Chinese angelica medici-nal material and preparations. Methods: A method for the determination of ligustilide was optimized by HPLC. The column was eluted on an Agilent ZORBAX SB C18(250 mm×4. 6 mm, 5 μm) column with acetonitrile-water (60 ∶ 40) as the mobile phase. The flow rate was 1. 0 ml·min-1, the detection wavelength was 326 nm, and the column temperature was at 35 ℃. The HPLC fingerprints of 13 batches of Angelica sinensis from different origins and methodological investigations were established and validated to set up an HPLC fingerprinting evaluation method for Angelica sinensis. Acetonitrile-0. 1% formic acid was used as the mobile phase with gradient elu-tion. The flow rate was 1. 0 ml·min-1, the detection wavelength was 280nm, and the column temperature was at 25℃. Results: The results showed that under the above HPLC conditions, ligustilide had good linearity within the range of 0. 032 3-0. 645 5 mg·ml-1(r=0. 999 9), and the average recovery was 100. 5% (RSD=1. 61% ,n=6). The quality fraction of ligustilide in Angelica sinensis was 0. 885 6%-2. 382 2% . Through the establishment of HPLC fingerprints of Angelica sinensis, the characteristic profiles with better peak shape and degree of separation and 18 common peaks with better resolution were obtained. The similarities of the 13 batches of angelica were all between 0. 9 and 1. 0. Conclusion: According to the methodological investigation, the HPLC fingerprints and ligustilide con-tent determination method of Angelica sinensis are simple, reliable, stable and feasible.

Objective To explore the technique and significance of intraoperative neuromonitoring (IONM) for scarless in the neck endoscopic thyroidectomy (SET) via breast approach.Methods From Apr.2015 to Oct.2015,101 consecutive patients undergoing SET with IONM were included.During the operation,patients received radical resection of the thyroid cancer by Wang's seven-step method.The lymph nodes in the central area were dissected and Wang's multi-functional separation forceps were implemented for recurrent laryngeal nerve (RLN) positioning,monitoring and protection.Also,time required for RLN positioning and exposure,postoperative transient and permanent RLN damage incidence were calculated to assess the feasibility of IONM under SET.Results Among 101 patients,130 RLNs in total were exposed.The average time required for RLN positioning under IONM was (3.26 ± 1.08)min,with round-nerve management time of (13.95 ± 4.58)min.Nerve signal change happened in 16.9％(22/130) patients.Positive predictive value was 13.6％ and negative predictive value was 100％.The overall accuracy rate was 85.4％.Conclusion IONM during SET is feasible,and can be helpful for the localization and functional protection of RLN and was useful to predict vocal cord paralysis.

Objective:To compare the surgical outcomes between scarless endoscopic thyroidectomy-lateral neck dissection (SET-LND) and open LND for papillary thyroid cancer (PTC) with lymph node metastasis and to share the experience in the prevention and treatment of lymphatic leakage after LND.Methods:Totally 90 PTC patients (25 males) who underwent LND in the Second Affiliated Hospital of Zhejiang University School of Medicine from Jan. 2021 to Aug. 2022 were retrospectively enrolled, with an average age of (28.06±4.89) years. They were divided into the SET-LND group ( n=50) and the open LND group ( n=40). The intraoperative blood loss, operation time, drainage volume on the first and the second days, postoperative lymphatic leakage, tumor (T), and node (N) were observed. The categorical variable data were compared between groups by χ 2 test, and the continuous variable data confirming normal distribution were compared between groups by independent sample t-test. Results:The operation time of the SET-LND group was (284.00±74.65) min, significantly longer than that of the open LND group (145.38±43.26) min ( t=-10.42, P<0.001). The intraoperative blood loss ( t=-1.309, P=0.194), postoperative hospital stay ( t=-0.136, P=0.892), drainage volume on the first day ( t=-1.074, P=0.286), and drainage volume on the second day ( t=-1.595, P=0.114), postoperative lymphatic leakage ( χ2=0.001, P=0.989), T ( t=0.367, P=0.714), N ( t=-1.614, P=0.110) were not significantly different between the two groups. Conclusion:Two surgical methods of LND have similar therapeutic effects and no significant difference was observed in the incidence of postoperative lymphatic leakage between the two groups.

Objective:To investigate the application of post-mortem tissue sampling under ultrasonography guidance in the autopsy of COVID-19 cases.Methods:Ultrasound-guided post-mortem tissue sampling of heart, lungs, liver, kidneys, and spleen were performed in 24 confirmed COVID-19 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from Feb 20 to Mar 28, 2020. Seventeen males and seven females aged 39-91(66.6±10.6) years old were enrolled. The total time required for each post-mortem sampling was recorded, and the size of the samples collected from each organ was measured. The success rate of ultrasound-guided post-mortem tissue sampling for each organ was calculated.Results:Ultrasound images could clearly show the needle path and enabled accurate placement of the needle within the target organs, including heart, lung, liver, kidney, and spleen. The total time required for sampling was about 32-54 (39.8±5.7)min. The lengths of heart, lung, liver, kidney, and spleen tissues collected by ultrasound-guided sampling were 10(8, 14)mm, 13(12, 15)mm, 14(13, 15)mm, 13(11, 15)mm, 14(13, 15)mm, respectively. The success rates of heart, lung, liver, kidney, and spleen tissue sampling under ultrasound guidance were 87.5% (21/24), 91.7%(44/48), 100%(24/24), 89.6%(43/48) and 83.3%(20/24), respectively.Conclusions:Post-mortem sampling under ultrasonography guidance may be a rapid and reliable method for collecting of heart, lung, liver, kidney, and spleen tissues in the autopsy of COVID-19 cases.