Objective To evaluate the effects of ABO blood group factors on perioperative coagulation in patients following epidural anesthesia.Methods One hundred and twenty ASA I or Ⅱ patients,aged 30-50 yr,weighing 50-75 kg,scheduled for elective operations expected to cause small volume of blood loss during operation under epidural anesthesia,were divided into 4 groups according to the blood group (n =30 each):blood group A group (A group),blood group B group (B group),blood group AB group (AB group) and blood group O group (O group).Blood samples were taken from the central vein before anesthesia (baseline,T1),at 30 min after beginning of operation (T2),at the end of operation (T3),and at 1,8 and 24 h after operation (T4-6) for determination of prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib) concentration,thrombin time (TT),prothrombin activity (PTA),hematocrit (Hct),and platelet (Plt) count.Results The parameters of coagulation were within the normal range at T1-6 in each group.Compared with the baseline value at T1,Fib concentration was significantly decreased,and PT,TT and APTT were increased at T2-6 in O group (P ＜0.05),however,no significant change in all parameters was found at T2-6 in the other three groups (P ＞ 0.05).Fib concentration was significantly lower,and PT,APTT and TT were longer at T1-6 in O group than in A,B and AB groups (P ＜ 0.05 or 0.01).Conclusion Although perioperative coagulation is in the normal range under epidural anesthesia in patients of different ABO blood groups,the coagulation is decreased in patients of blood group O as compared with the other blood groups.

Objective To investigate the effect of methylprednisolone pretreatment on cardiopulmonary bypass(CPB)-induced intestinal barrier injury in patients undergoing cardiac surgery.Methods Ninety NYHA Ⅰor Ⅱ patients,aged 30-50 yr,weighing 50-75 kg,scheduled for elective cardiac surgery with CPB,were randomly divided into 3 gnoups(n =30 each):control group without CPB(group Ⅰ),control group with CPB(group Ⅱ)and administration of methylprednisolone before CPB group(group Ⅲ).Anesthesia was induced with midszolam,fentanyl,etomidate and rocuronium and maintained with intravenous infusion of propofol and intermittent iv boluses of fentanyl and rocuronium.The patients were mechanically ventilated after tracheal intubation.In group Ⅲ,methylprednisolone 10 mg/kg was injected intravenously before operation and CPB.While in groups Ⅰ and Ⅱ,the equal volume of normal saline was injected instead.The blood samples were taken from the central vein before induetion of anesthesia(T1),before CPB(T2),at 30 min after the beginning of CPB(T3),at 30 rin afier the end of CPB(T4)and at 120 min after operation(T5)for determination of the plasma endotoxin concentration.Infection was recorded within 7 days after operation.Results The plasma endotoxin concentrations at T1 were within the normal range in all groups,without significant difference among the three gnoups(P ＞0.05).The plasma endotoxin concentration at T3-5 and incidence of postoperative infection in group Ⅲ were significantly lower than those in group Ⅱ,while higher than those in group Ⅰ(P ＜ 0.05).Conclusion Methylprednisolone pretreatment can reduce CPB-induced impairment of the intestinal harrier function in patients undergoing cardiac surgery.

Objective To evaluate the efficacy of ultrasound-guided sacral block in the obese patients by comparing it with the traditional positioning method.Methods Sixty obese patients,aged 25-50 yr,weighing 56-80 kg,with body mass index ≥ 30 kg/m2,scheduled for elective anorectal surgery,were randomly divided into 2 groups (n =30 each) using a random number table:ultrasound-guided sacral block group (group U) and traditional positioning method group (group T).The sacral canal puncture point was located via either ultrasonic or traditional positioning method.After successful puncture,1％ lidocaine 20 ml was injected.The number of patients in whom puncture was successful at first attempt and the number of patients in whom the time for puncture ≤ 1 min were recorded.The adverse reactions were observed.The efficacy of sacral block was evaluated.Results Compared with group T,the success rate of puncture at first attempt was significantly increased (P ＜ 0.05),and no significant changes were found in the number of patients in whom the time for puncture ≤ 1 min or efffcacy of sacral block in group U (P ＞ 0.05).No adverse reactions were found in the two groups.Conclusion Ultrasound-guided sacral block can raise the success rate of puncture at first attempt and provide similar efficacy of block in the obese patients when compared with the traditional positioning method,and thus has significant clinical value.

A sensitive colorimetric method for the detection of copper ions (Cu2+) was developed based on the surface modification of silver/platinum nanoclusters (Ag/Pt NCs) and regulation of peroxidase-like activity. It was found that 3-mercaptopropionic acid (MPA) could inhibit the catalytic ability of Ag/Pt NCs; however, it lost the inhibition toward catalytic ability of Ag/Pt NCs after oxidized by oxygen through the catalysis of Cu2+. On the basis of this, a colorimetric method was developed for the detection of Cu2+ through measuring the colorimetric signal variation of the TMB-H2O2 reaction. This method exhibited high sensitivity and selectivity toward Cu2+ over a panel of other metal ions. The linear range was 10-100 nmol/L and the detection limit was 5.0 nmol/L (3σ). The above method was also applied to detect real water samples and spiked samples, and the results demonstrated that this method was simple with low cost.

ObjectiveTo observe the clinical effect of Kangxiuke apozem in the treatment of severe bum shock.Methods40 patients of severe burn shock were randomly divided into a treatment group and a control group,with 20 patients in each group.All the patients were treated by the same route of counter-shock therapy,and the treatment group was additionally given Kangxiuke apozem (nasal feeding,qd,150 ml/d).Level of blood lactic acid,heart rate and urinary volume were evaluated by time.Main shock symptoms,including restlessness,hydrodipsia,perspiration and coldness,were observed.ResultsThe treatment group was significantly superior to the control group in the amelioration of blood lactic acid,heart rate and urinary volume ( t =10.485、3.219、7.429,P＜ 0.01 ).The symptomatic extinction of restlessness,hydrodipsia,perspiration and coldness in the extremities in the treatment group were significantly superior to those in the control group (x2=10.16、7.37、5.63、4.29,P＜0.05).ConclusionAt the same time of routine counter-shock therapy,thereby prompt burn patients to smoothly go through shock period and decreas late complications.

Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

Objective To analyze the prognosis and risk factors for antineutrophil cytoplasmic antibody?associated vasculitis (AAV) patients on maintaining dialysis. Methods AAV patients on maintaining peritoneal dialysis (PD) or hemodialysis (HD) in First Affiliated Hospital Zhejiang University from June 2007 to June 2015 were included, and were followed up until death, kidney transplant, changed dialysis modalities or January 31, 2016. Patients were divided into PD group and HD group for comparison. Their survival rates and risk factors were analyzed by Kaplan?Meier analysis and COX regression model respectively. Results A total of 123 cases were chosen, with a median duration of dialysis for 854 (388, 1573) days, and with 88 cases (71.5%) on HD and 35 cases (28.5%) on PD. Fifty?two patients (42.3%) were more than 65 years old. At the median follow?up time of 36 months, 39 patients (31.7%) died. The main causes of death were cardiovascular events (30.8%) and infection (23.1%). COX regression analysis showed that patients older than 65 years old (HR=3.289, P=0.001), with cardiovascular disease (HR=3.241, P=0.003) and interstitial pneumonia (HR=2.173, P=0.048) at the dialysis onset were independent risk factors affecting survival. Conclusions Factors including age (older than 65 years), pre?dialysis cardiovascular disease and interstitial pneumonia were independent risk factors affecting survival of AAV patients on maintaining dialysis, then infections and cardiovascular events were the main causes of death.

Objective To investigate the target genes in RYBP-mediated leukemia cell apoptosis by high-flux sequencing. Methods The HL-60 cell line with knockdown of RYBP was set up. MRNA and microRNA sequencing was conducted by the next-generation sequencing technology. Result MRNAs and miRNAs were dys-regulated in HL-60 cell line with knockdown of RYBP. The results of KEGG analysis indicated that the down-regu-lated genes were associated with cancer transcription regulation and amino acid metabolism. SPI1 and miR-214-3p were shown downregulated after knockdown of RYBP. Conclusion The target genes in RYBP-mediated leukemia cell apoptosis include BBC3,BAI1,SESN2 ,CCNG2,JAK3,STAT4,SPI1,BCL6,CD11b and hsa-miR-214-3p.

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

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