Objective To evaluate the efficacy of coenzyme Q10 in preventing propofol infusion syndrome in rats.Methods Thirty pathogen-free healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-280 g,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),propofol group (group P) and coenzyme Q10 group (group CoQ10).Normal saline was infused intravenously in group C.In group P,1％ propofol in medium-and long-chain triglyceride emulsion injection was infused intravenously.In group CoQ10,CoQ10 100 mg/kg was administrated by intragastric gavage,and 1 h later propofol was infused intravenously.The infusion rate was 20mg·kg-1 ·h-1 within the first6hand40mg· kg-1 · h-1fortherest6h,and the total time was 12hin the three groups.Immediately after the start of administration (To),and at 6 and 12 h after the start of administration (T1,2),blood samples 2 ml were taken from the common carotid artery,with 0.5 ml for blood gas analysis and 1.5 ml for determination of the levels of serum aspartate aminotransferase (AST),alanine aminotransferase (ALT),creatine kinase (CK),creatine kinase isoenzyme-MB (CK-MB),cardiac troponin Ⅰ (cTnⅠ),blood urea nitrogen (BUN) and creatinine (Cr).After blood sampling,the rats were sacrificed,and myocardial tissues were obtained for pathological examination.Results Compared with group C,the serum AST,ALT,CK,CK-MB and cTnⅠ levels were significantly increased at T1,2 (P＜0.05),no significant changes were found in serum BUN and Cr levels (P＞0.05),the pathological changes of myocardium were aggravated in P and CoQ10 groups.Compared with group P,the serum AST,ALT,CK,CK-MB and cTnⅠ levels were significantly decreased at T1,2 (P＜0.05),no significant changes were found in serum BUN and Cr levels (P＞0.05),and the pathological changes of myocardium were significantly attenuated in group CoQ10.Conclusion Coenzyme Q10 can effectively prevent the development of propofol infusion syndrome in rats.

Objective To explore the effects of dexmedetomidine on peripheral blood T lymphocyte proliferation and T lymphocyte subsets of juvenile rats with splenectomy.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 130-150 g,aged six weeks were enrolled in this study.Half of the rats received splenectomy to make an immunosuppressive model,then they were randomly divided into 2 groups (n=6 each): splenectomy+normal saline group (group SN) and splenectomy+dexmedetomidine group(group SD).The another half of the rats without splenectomy were randomly divided into 2 groups: normal saline group(group S) and dexmedetomidine group(group D).After one week of normal feeding,normal saline 10 ml/kg was injected intraperitoneally (ip) in groups S and SN,dexmedetomidine 50 μg/kg was injected ip in groups D and SD respectively.Two hours after the injection,blood samples were collected.MTT was utilized to examine the peripheral blood T lymphocyte proliferative capability.T lymphocyte subsets CD4+,CD8+ were determined by flow cytometry.CD4+/CD8+ was calculated.Results Compared with group S,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio were significantly decreased in group SN (P<0.05);T lymphocyte proliferative capability in group D was decreased (P<0.05),but no significant changes was found in the percentages CD4+,CD8+ and CD4+/CD8+ ratio.Compared with the group D,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio in group SD were significantly decreased (P<0.05).Compared with the group SN,T lymphocyte proliferative capability in group SD was significantly decreased (P<0.05).Conclusion Cellular immune function of juvenile rats with or without splenectomy is suppressed by dexmedetomidine,and the suppressive function is more severe in splenectomy rats than that in normal juvenile rats.

Objective To analyze the expression of Galectin-3 in thyroid follicular tumors and its clinical significance in differential diagnosis between benign and malignant thyroid follicular tumor.Methods The expression of Galectin-3 in 120 cases of thyroid follicular carcinoma and 80 cases of thyroid follicular adenoma was detected by immunohistochemical technique.Results The expression rate of Galectin-3 in thyroid follicular carcinoma was significantly higher than that in follicular adenoma(84％ vs 19％,P ＜ 0.01).Strong positive expression of Galectin-3 was found in 40％ cases of thyroid follicular carcinoma and no case of thyroid follicular adenoma.Conclusions The expression of Galectin-3 can be regarded as an important parameter for differential diagnosis between benign and malignant thyroid follicular tumor.

Objective To explore the clinicopathologic characteristics and treatment of medullary thyroid carcinoma(MTC).Methods The data of 42 cases of MTC admitted to Fujian Medical University Provincial Clinical College from Jan 1995 to Feb 2010 were retrospectively analyzed.Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.Results Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.The lymph node metastasis rate was 76.19％ (32/42).The central lymph node metastasis rate was 61.90％ (26/42).All the 42 cases were followed up for 1 to 502 months with 102 months as the median.35 cases(83.33％)were followed up for more than 5 years and the 5-year overall survival rate was 85.71％ (30/35).Death occurred in 5 cases.Conclusions The lymph node metastasis rate of MTC is high.The treatment should be based on the principle of radical resection.Total thyroidectomy should be recommended to treat primary tumor.Lymph node dissection should be as thorough as possible.Central compartment neck dissection should be done in all cases.

Objective:To investigate the effect of nerve block anesthesia on hemodynamics in elderly patients undergoing unilateral lower limb trauma surgery.Methods:From February 2017 to June 2019, 100 elderly patients with unilateral lower extremity trauma admitted in our hospital were selected in this study.According to different anesthesia methods, the patients were divided into two groups, with 50 cases in each group.Group B was given light specific gravity subarachnoid anesthesia, while group A received nerve block anesthesia.The anesthesia effect, hemodynamic parameter changes, complications and incidence of adverse reactions between the two groups were compared.Results:The total effective rate of group A was 98.00%(49/50), which was significantly higher than that of group B[86.00%(31/50)], the difference between the two groups was statistically significant(χ 2=16.973, P<0.05). Before anesthesia, there were no statistically significant differences in diastolic blood pressure, heart rate and blood oxygen saturation between the two groups(all P>0.05). At 15 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (70.32±3.42)mmHg, (86.28±2.42)times/min, (139.03±2.63)%, respectively, which in group B were (70.26±1.66)mmHg, (86.73±1.63)times/min, (140.97±1.84)%, respectively.At 30 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (68.73±2.11)mmHg, (85.26±0.52)times/min, (136.18±3.89)%, respectively, which in group B were (70.98±1.92)mmHg, (87.24±2.31)times/min, (140.39±0.77)%, respectively.At 60 minutes after anesthesia, the diastolic blood pressure, heart rate, blood oxygen saturation in group A were (67.34±3.25)mmHg, (86.26±1.31)times/min, (134.89±2.37)%, respectively, which in group B were (71.01±3.12)mmHg, (87.39±1.32)times/min, (140.99±1.64)%, respectively.The differences between the two groups were statistically significant( t=11.315, 10.924, 10.599, t=13.411, 8.226, 9.779, t=9.057, 8.497, 10.131, all P<0.05). The incidence of complications and adverse reactions in group A was 2.00%(2/50), which was significantly lower than that in group B[18.00%(9/50)], the difference between the two groups was statistically significant(χ 2=16.913, P<0.05). Conclusion:Nerve block anesthesia is effective in elderly patients with unilateral lower limb trauma surgery, which can effectively stabilize the hemodynamics and reduce the incidence of complications and adverse reactions.

Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.

The incidence and mortality of esophageal cancer are high, with strong invasiveness and poor prognosis. In China, the number of morbidity and death accounts for about half of the world. The cause of the disease has not yet been clarified, and it is known to be related to many factors such as chronic damage to the upper digestive tract caused by poor diet and lifestyle, heredity and environment. With the continuous advancement of molecular biology technology, metagenomics and high-throughput sequencing began to be used as non-culture methods instead of traditional culture methods for micro-ecological analysis, and is becoming a research hotspot. Many studies have shown that the disturbance of upper digestive tract microecology may be one of the causes of esophageal cancer, which affects the occurrence and development of esophageal cancer through complex interactions with the body and various mechanisms. This paper reviews the research progress, which is of great significance to further clarify the value of upper gastrointestinal microecology in the pathogenesis, diagnosis and treatment of esophageal cancer.

Objective:To evaluate the safety of thymic surgery in patients aged 65 years and over.Methods:A total of 696 patients who underwent thymectomy/thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from November 2011 to March 2022 were collected and divided into two groups according to the age of 65 years old.The preoperative course of disease, MG stage, dosage of pyridostigmine bromide, American College of Anesthesiologists(ASA)score, surgical method, intraoperative bleeding, postoperative drainage, postoperative complications, Clavien-dindo score(CDC), and myasthenic crisis were recorded and statistically analyzed.Results:A total of 696 patients were enrolled, including 364 males and 332 females, aged 15~86 years, with an average age of 49.1 years.There were 309 patients with thymoma, 565 patients with MG, and 178 patients with both.There were 124 cases in the elderly group(≥65 years old)and 572 cases in the non-elderly group(<65 years old). The incidence of thymoma was higher in the elderly group(54.8 % versus 42.1 %, χ2=6.664, P=0.010), while the incidence of MG was lower(67.7 % versus 84.1 %, χ2=17.827, P<0.001). The ASA score of the elderly group was higher than that of the non-elderly group( χ2=52.372, P=0.000), and the preoperative ventilation function FEV1 and FEV1/FVC were also significantly lower than those of the non-elderly group( z=8.187, 4.580, P=0.000 for all). The drainage volume in the first 3 days after operation and postoperative drainage tube time in the elderly group were significantly higher than those in the non-elderly group( P=0.018, P=0.003). The incidence of postoperative myasthenia crisis in the elderly group was higher than that in the non-elderly group( P=0.034). There was no significant difference in the incidence of postoperative complications between the two groups, but after Clavien-dindo classification, the score of the elderly group was higher than that of the non-elderly group( P=0.003). Although the ASA score and Clavien-dindo score of the elderly group were both higher than those of the non-elderly group, there was no correlation between the two. Conclusions:Although the preoperative ASA score and pulmonary function of elderly patients were poorer than those in the non-elderly group, while the incidence of postoperative myasthenia crisis was higher, and the incidence of postoperative complications was not higher, the Clavien-dindo classification, however, was higher in elderly patients than that of the non-elderly group.After careful preoperative evaluation and strengthening perioperative management, most elderly patients can receive thymus surgery safely with acceptable risks.

Objective    To analyze the effect of microecological preparation on digestive tract complications and nutritional status after esophageal cancer surgery. Methods    A total of 146 patients with esophageal cancer admitted to the Department of Thoracic Surgery, Renmin Hospital of Wuhan University from October 2017 to June 2019 were selected. There were 91 males and 55 females, aged 65 (61.9±8.2) years. They were randomly divided into two groups (an observation group and a control group, n=73 in each group) according to whether microecological preparation was given when they could take food one week after the surgery. Nutritional status and the incidence of gastrointestinal complications including anorexia, acid reflux, nausea, vomiting and diarrhea (≥3 times per day) in the first month after operation were compared between the two groups. Results    The incidence of anorexia, nausea, diarrhea (≥3 times per day), anastomotic fistula and stenosis in the observation group was lower and the index of nutritional status was higher than those in the control group within one month after the operation (all P<0.05). There was no statistically significant difference in acid reflux, vomiting, lung infection and incision infection between the two groups (all P>0.05). Conclusion    Microecological preparation can regulate gastrointestinal microecological balance, improve nutritional status, reduce the incidence of gastrointestinal complications and accelerate the postoperative rehabilitation.

Objective    To construct a prognostic model of esophageal squamous cell carcinoma (ESCC) based on immune checkpoint-related genes and explore the potential relationship between these genes and the tumor microenvironment (TME). Methods     The transcriptome sequencing data and clinical information of immune checkpoint genes of samples from GSE53625 in GEO database were collected. The difference of gene expression between ESCC and normal paracancerous tissues was evaluated, and the drug sensitivity of differentially expressed genes in ESCC was analyzed. We then constructed a risk model based on survival-related genes and explored the prognostic characteristics, enriched pathway, immune checkpoints, immune score, immune cell infiltration, and potentially sensitive drugs of different risk groups. Results    A total of 358 samples from 179 patients were enrolled, including 179 ESCC samples and 179 corresponding paracancerous tissues. There were 33 males and 146 females, including 80 patients≤60 years and 99 patients>60 years. 39 immune checkpoint genes were differentially expressed in ESCC, including 14 low expression genes and 25 high expression genes. Drug sensitivity analysis of 8 highly expressed genes (TNFRSF8, CTLA4, TNFRSF4, CD276, TNFSF4, IDO1, CD80, TNFRSF18) showed that many compounds were sensitive to these immunotherapy targets. A risk model based on three prognostic genes (NRP1, ICOSLG, HHLA2) was constructed by the least absolute shrinkage and selection operator analysis. It was found that the overall survival time of the high-risk group was significantly lower than that of the low-risk group (P<0.001). Similar results were obtained in different ESCC subtypes. The risk score based on the immune checkpoint gene was identified as an independent prognostic factor for ESCC. Different risk groups had unique enriched pathways, immune cell infiltration, TME, and sensitive drugs. Conclusion     A prognostic model based on immune checkpoint gene is established, which can accurately stratify ESCC and provide potential sensitive drugs for ESCC with different risks, thus providing a possibility for personalized treatment of ESCC.