Objective:To study the effects of transverse abdominis plane block (TAPB) combined with dexmedetomidine on the recovery quality after general anesthesia in cesarean section.Methods:From June 2019 to October 2020, 120 cases of cesarean section in Changsha Maternal and Child Health Hospital were randomly divided into dexmedetomidine group (Group D), transversus abdominis plane block group (group T), transversus abdominis plane block combined with dexmedetomidine (Group TD) and control group (Group C). Before anesthesia induction, local infiltration of 1% lidocaine was performed at the incision of all parturients. Propofol and rocuronium were used for induction under general anesthesia. After delivery of fetus, sufentanil and midazolam were injected intravenously, and propofol was pumped to maintain anesthesia. At the same time, dexmedetomidine was pumped into group D and TD, and normal saline was pumped into group T and C. After the posterior sheath of rectus abdominis was sutured in T group and TD group, two epidural anesthesia catheters were placed to the fascia of transverse abdominis on both sides, and 10 ml of 0.33% ropivacaine was injected respectively. The parturients were sent to postanesthesia care unit (PACU) after the operation. The time from the end of operation to the extubation of tracheal tube, heart rate (HR) and mean arterial pressure (MAP) before operation (T 1), after induction (T 2), after operation (T 3), at the time of extubation (T 4), 10 minutes after extubation (T 5) and at the time of leaving PACU (T 6) were recorded. Steward's wake-up score at T 4, T 5 and T 6, agitation during extubation (Sedation Agitation Scale, SAS score), PACU stay time and pain visual analogue scale (VAS) were recorded. Results:There was no difference in HR and MAP between the four groups at T 1, T 2, and T 3 ( P>0.05), while HR and MAP in group C at T 4, T 5 and T 6 were higher than those in the other three groups ( P<0.05). There was no significant difference in Steward′s wake-up score among the four groups ( P>0.05). The SAS score [(4.0±0.4)point], the time from the end of operation to extubation [(10.1±1.5)min] and stay time of PACU [(21±4.2)min] were the lowest in group TD than those in the other three groups ( P<0.05); the VAS score in group TD [(0.5±0.5)point] and group T [(1.1±0.4)point] were lower than that in group D [(4.1±0.3)point] and group C [(5.3±0.5)point] ( P<0.05). Conclusions:The application of general anesthesia combined with TAPB and dexmedetomidine in cesarean section may improve the quality of anesthesia recovery.

Objective: To investigate the inhibitory effect of gypenosides on proliferation of human uterine cervical cancer HeLa cells in vitro, and to explore its possible mechanism. Methods: The HeLa cells were treated with different concentrations of gypenosides (low-dose group, 4.5 μg/mL; middle-dose group, 45 μg/mL; high-dose group, 450 μg/mL). The cells treated with 0.9% sodium chloride solution was designed as a control group. The inhibitory effect of gypenosides on the proliferation of HeLa cells was detected by MTT assay and BrdU (5-bromo-2-deoxyuridine) incorporation experiment. The effect of gypenosides on apoptosis of HeLa cells was detected by FCM (flow cytometry). The expression levels of Bcl-2, Bax, ERK1/2 (extracellular regulated protein kinase 1/2), p-ERK1/2 (phospho-ERK1/2), MEK1/2 (mitogen-activated protein kinase kinase) and p-MEK1/2 were detected by Western blotting. Results: The survival rate of HeLa cells was decreased significantly after treatment with gypenosides (45 μg/mL) at 24 h (P < 0.01). The survival rate of HeLa cells was decreased significantly after treatment with gypenosides (4.5 μg/mL) at 48 h (P < 0.01). The inhibitory effect of gypenosides (450 μg/mL) on the cell proliferation was confirmed by BrdU incorporation experiment. The apoptotic rate of HeLa cells was increased significantly after treatment with different concentrations of gypenosides. Gypenosides could down-regulate the expression levels of Bcl-2 and p-ERK1/2 and up-regulate the expression level of Bax. Conclusion: Gypenosides can significantly inhibit the proliferation of cervical cancer HeLa cells and also markedly induce the apoptosis. This effect may related to the up-regulation of Bax expression and down-regulation of Bcl-2 and p-ERK1/2 expressions. Copyright © 2013 by TUMOR.

Objective To study the transduction dynamics, location of PTD-OD-HA fusion protein and its interaction with Bcr-Abl oncoprotein in K562 cell lines, and explore the influence of PTD-OD-HA fusion protein on oligomerization and tyrosine kinase activity of Bcr-Abl. Methods PTD-OD-HA fusion protein was labeled with FITC and co-cultured with K562 cells. The transduction efficiency of labeled PTD-OD-HA at different doses and time intervals was observed under fluorescence microscope. The location of labeled PTD-OD-HA fusion protein in K562 cells was detected by confocal microscopy. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was confirmed by coimmunoprecipitation. The phosphorylation of Bcr-Abl oncoprotein was detected by Western blotting. Results PTD-OD-HA fusion protein labeled with FITC was transduced into K562 cells in a dose- and time-dependent manner. PTD-OD-HA fusion protein was located in the cytoplasm of K562 cells and was consistent with the location of Bcr-Abl oncoprotein. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was proved in K562 cells. This interaction could interrupt the homologous oligomerization of Bcr-Abl oncoprotein and reduce the phosphorylation of Bcr-Abl oncoprotein. Conclusion PTD-OD-HA fusion protein could be transduced into K562 cells efficiently, inhibit the oligomerization and reduce the phosphorylation of Bcr-Abl oncoprotein.

Radical resection is one of the important factors for improving the prognosis of patients with resectable carcinoma of head of the pancreas,carcinoma of the distal bile duct and periampullary carcinoma.In order to proceed with a R0 resection,there are many types of pancreaticoduodenectomy (PD) for pancreatic,biliary and periampullary carcinoma such as PD with lymphadenectomy.In this report,we described a PD with extended retroperitoneal lymphadenectomy (D2 +) for the adenocarcinoma of the distal bile duct.The case presented underscores the feasibility and safety of PD with D2 + lymphadenectomy.

[Summary] This paper reported a patient suffering from hemorrhage after percutaneous liver biopsy treated by contrast enhanced ultrasound-guided percutaneous injection of thrombin in June 2015.Firstly,we performed contrast-enhanced ultrasound examination to find the position of active bleeding.And then,percutaneous injection of thrombin was performed under the guidance of ultrasonography.The active bleeding was stopped successfully.

Objective To observe the effect of Ginkgo Biloba Extract Injection on urinary albumin excretion rate in patients with diabetic nephropathy (DN). Methods A total of 90 patients with DN were divided into two groups: group A was micro-urinary-albumin group; group B was multiple-urinary-albumin group. Both groups were treated with routine therapy plus Ginkgo biloba extract injection (at a dose of 15ml) q.d. for 4 consecutive weeks. The urinary albumin excretion rate was compared between the two groups before and after treatment. Results As compared with the group B, urinary albumin excretion rate was significantly lowered in the group A (P＜0.01). Conclusion Ginkgo Biloba Extract Injection had effects in lowering microalbumin in urine and therapeutic effect for patients with early DN.

Objective To investigate the relationship between the changes of serum total bilirubin(TBil) and hybrid muscle crea-tine kinase isozyme(CK-MB),and its clinical implication in neonates with hypoxic-ischemic encephalopathy (HIE). Methods The levels of TBil and CK - MB were measured in 49 neonates with HIE (15 mild cases, 20 moderate cases and 14 serious cases), and 31 normal neonates on the first day and the fourth day after birth. Results The levels of TBil on the first day after birth were significantly higher than those in normal neonates;the levels of TBil were correlated with the severity of HIE(P

With the developments of endoscopic and interventional techniques, the role of surgical treatment in some diseases is gradually replaced by endoscopic or interventional treatment.The word surgery may not preserve only for surgeons, therefore it is redefined.According to different interventional pathways, digestive surgery can be divided into two categories, although both are with similar surgical essentials as resection and repair. Serosa surgery is traditional surgery,characterized for its pathway from skin to visceral serosa and cavity, either by open or laparoscopic platform. Mucosa surgery performs endoscopic operations from natural orifice then mucosa surface.The intercrossing or merging of different disciplines is an inevitable trend for modern medical science, traditional disciplines may be replaced by disease-centered medical model combined with multiple disciplines and techniques.Facing challenges, digestive surgeons should be confidential and inclusive;facing competitions, digestive surgeons should be brave enough for innovation and cooperation, and always regard patients' interest as his first priority.A universal norm for various disciplines should be set up on the practice of evidencebased medicine;surgeons in different specialties should learn from each other, and reinforcing comple-mentary advantages from each other;creating a novel disease-centered multidisciplinary heahhcare model on the basis of fusion of different disciplines is the development direction of digestive surgery.

Objective To characterize the CT features of peripheral small lung cancers of fast growthing and to correlate such features with pathological findings.Methods 12 peripheral small lung cancers(