OBJECTIVETo explore the feasibility and safety of dexmedetomidine combined with remifentanil for lower eyelid blepharoplasty.

METHODS50 patients undergoing lower eyelid blepharoplasty ASA I - II were randomly divided into 2 groups (25 in each group) as observation group and control group. Dexmedetomidine (0.3 microg x kg(-1) x h(-1)) and remifentanil (0.05 microg x kg(-1) x min(-1)) were used in observation group. Local anesthesia by lidocaine (1%) combined with midazolam (0.04 mg/kg) intravenous sedation were used in control group. HR, mean arterial pressure (MAP), heart rate (HR), breathing rate (RR), pulse oxygen saturation (SpO2) change were monitored and recorded before and after the administration of the drug, as well as at the beginning of operation, during the operation, at the end of the operation, and 5 minutes after the operation. Patients sedation degree was evaluated by Ramsay. Operation time, recovery time, the incidence of adverse reactions, the satisfaction of patients and doctors were also recorded.

RESULTSPatients had no obvious difference of intraoperative MAP, RR, SpO2, operation time and postoperative recovery time between the two groups (P > 0.05). Compared with control group, HR during the operation were decreased significantly [(64.2 +/- 8.2) bpm, P < 0.05] in observation group. In control group, there were 18 cases of patients with agitation, but they endured the operation anyway. In observation group, 24 cases of patients underwent operation without agitation. The satisfaction of patients and the operation doctors (96%) in observation group were markedly higher than that in control group (P < 0.05).

CONCLUSIONDexmedetomidine combined with remifentanil is practical and safe. The effect of reducing HR should be noticed.

Adult ; Blepharoplasty ; Dexmedetomidine ; therapeutic use ; Double-Blind Method ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Piperidines ; therapeutic use

Objective To investigate the pathological changes of myocardium in diabetic rats and the effect of aspirin, perindopril, prednisone on the pathological changes of myocardium in type 1 diabetic rats. Methods Thirty SD rats were randomly divided into the following groups: ( 1 ) diabetes mellitus (DM)group ( n = 20): treated with intraperitoneal injection of streptozocin (STZ) 60 mg/kg at one time, diluted in sodium citrate buffer. (2) normal control group (n = 10): intraperitoneal injection of sodium citrate buffer. The blood glucose and the weight were measured regularly for 8 weeks. The 20 diabetic model rats were randomly divided into four groups (n = 5 individually), from the 4th day, the rats were given normal saline dissolved aspirin, perindopril, prednisone gavage respectively, and the normal control group and diabetic group were given an equal volume of saline daily gavage. After 8 weeks, the pathological changes in the cardiac muscle tissue were observed under light microscope and electron microscope. Results Three days after the injection of STZ, the blood glucose in the DM group was higher than 16. 7 mmol/L,20 rats were all modeling successfully. The model rats suffered from polydipsia, polyphagia, polyuria and weight loss significantly. HE staining showed diabetic myocardial cell swell, hypertrophy, degeneration and significant nuclear enlargement; the myocardial fiber fractured,dissolved, contraction wavy and disorganized fibre infiltrated by inflammatory cells. Under electron microscope, diabetic myocardial muscle fibers arranged irregularly, fractured and dissolved; the glycogen between the muscle fiber accumulated, mitochondria swelled, most of the ridges in mitochondria were not clear, cell plate widened. Compared with the diabetic group, the above-mentioned pathological changes reduced in the drug intervention group,and the changes in perindopril group was most significant. Conclusion Injection of STZ 60 mg/kg could successfully induce diabetic in rats and held stable blood glucose level. After 8 weeks, diabetes could cause servere damages in myocardium in the rats, but aspirin, perindopril, prednisone could reduce the cardiomyopathy in diabetic rats,in which perindopril had more positive effect.

Objective To study the characteristics,operative timing,repair methods for iatrogenic bile duct injury caused by laparoscopic cholecystectomy.Methods Clinical data of 30 cases of iatrogenic bile duct injury found during or after laparoscopic cholecystectomy were studied retrospectively.Results There were type Ⅱ 1 bile duct injury in 9 patients,type Ⅱ 2 in 4 patients,type Ⅱ 3 in 2 patients,and type Ⅱ 4 in 15 patient.17 cases underwent immediate repair,13 cases did early repair.All cases followed up from 5 months to 10 years,the follow-up rate was 83.3％.1 case with end-to-end anastomosis and biliary stent underwent Roux-en-Y choledochojejunostomy for biliary stenosis 13 months postoperatively,4 cases underwent secondary Roux-en-Y choledochojejunostomy because of obstructive jaundice and the cicatricial anastomotic orifice stenosis one to one and half years after primary repairs.The remaining cases were doing well up to the end of the follow-up.Conclusion Most iatrogenic bile duct injury after laparoscopic cholecystectomy were high in position,while Roux-en-Y choledochojejunostomy is the mainstay of repair.

Objective To investigate the significance of calcification in thyroid node for diagnosis of thyroid carcinoma.Method Retrospective analysis of 107 thyroid nodules' pre-operative ultrasonic and postoperative pathologic results.Results Total ultrasonic thyroid calcification ratio was 27.1%(29/107),which in benign samples was lower than Ihat in malignant samples(17.2%vs 70.0%,P＜0.01).Micro-calci-fication ratio in benign samples Was lower than thai:in malignanl samples(8.0%vs 50.0%,P＜0.01).Conclusion The ralio of thyroid carcinoma with calcification is higher,so the detection of thyroid carcinoma,especially micro-single-calcification should be significant.

Objective To analyze medication rules of TCM treatment for primary hepatic carcinoma in recent ten years;To provide references for clinical medication. Methods Literature about primary hepatic carcinoma in CNKI, VIP and Wanfang database from January 2005 to September 2015 was searched by computers to carry out statistical analysis of medicine classification and frequency of usage. Results Through screening, 131 articles were included, covering 131 compound TCM prescriptions, 228 kinds of medicine, and 1416 times of frequency of usage. Medicines with relatively high frequency were tonifying deficiency medicine 430 times (30.37%), damp-clearing medicine 233 times (16.45%), medicine for invigorating blood circulation and eliminating stasis (12.99%). Medicines with relatively high frequency were Atractylodis Macrocephalae Rhizoma 64 times (4.52%), Poria 62 times (4.38%), Glycyrrhizae Radix et Rhizoma 52 times (3.67%), Bupleuri Radix 49 times (3.46%), Paeoniae Radix Alba 45 times (3.18%), Astragali Radix 44 times (3.22%), Curcumae Rhizoma 43 times (3.04%), and Artemisiae Scopariae Herba 41 times (2.90%). Conclusion This study summarizes the medicine classification and frequency of usage of TCM treatment for primary hepatic carcinoma in recent ten years, which can provide data support for clinical treatment.

Objective To develop a fluorescence signal activatable multifunctional molecular probe with theranostics function through combining ultrasmall gold nanorods(UGNRs) with fluorescein,and to evaluate its therapeutic effect on photothermal therapy (PTT) in breast cancer cells.Methods The UGNRs were synthesized by the one-pot seedless method,then the functionalized modification of UGNRs were conducted using cysteamine.Finally,the activatable ultrasmall gold nanorods (AUGNRs) were synthesized by amide condensation of —NH2 of cysteamine and —COOH of carboxylated fluorescein CyS.The cell uptake ability and GSH-mediated imaging ability of AUGNRs were studied using breast cancer 4T1 cells.4T1 cells co-cultured with AUGNRs were irradiated with 808 nm excitation light,and the PTT effects were assessed by MTT colorimetric staining and calcein-AM/PI staining.Results The AUGNRs were synthesized successfully,which could be uptaken by 4T1 cells quickly and efficiently,and could achieve intracellular glutathione (GSH) triggered fluorescence recovery.No obvious cytotoxicity of AUGNRs to 4T1 cells was observed in the co-cultivation.Moreover,obvious PTT effects could be induced by 808 nm laser,which could effectively kill 4T1 cancer cells.Conclusion The fluorescence signals of AUGNRs can be induced by intracellular GSH,and tumor cell destruction can be achieved by 808 laser-excitated PTT effects.

Objective:To study the effects of FcγRIIb gene modified dendritic cells on liver function and rejection after orthotopic liver transplantation in rats.Methods:The recombinant lentivirus expression vector TRE-FcγRIIb containing Lewis rat FcγRIIb gene was constructed by gene cloning technique. TRE-FcγRIIb expression virus and TET-on regulatory virus were packaged and co-infected with immature dendritic cells derived from DA rat bone marrow. The expression of FcγRIIb was detected. Donor rats DA and recipient Lewis were paired according to body weight and then randomly divided into three groups. The control group (group A) did not receive any pretreatment. The Lewis rats in group B were treated with cyclosporin A on the 2nd day after liver TX. Immature dendritic cells derived from bone marrow of DA rats were injected intravenously one day before liver TX in FcγRIIb gene modified immature dendritic cells (1×10 6 cells)group (group C). Blood and liver tissue were biopsied 7 days after operation to detect liver function and pathological changes. Results:The abnormal liver function in FcγRIIb gene modified immature dendritic cells group (group C) was significantly lower than that of control group 7 days after operation ( P<0.05), and the liver pathological rejection of FcγRIIb gene modified immature dendritic cells group (group C) was significantly lower than that of control group 7 days after operation ( P<0.05). The average survival days of rats in the control group was 12.8 days; the average survival days of rats in the cyclosporin A group was 65.3 days; the average survival days of rats in the FcγRIIb gene-modified immature dendritic cell group was 58.5 days. Conclusion:FcγRIIb gene modified immature dendritic cells can ameliorate liver dysfunction and acute liver rejection after orthotopic liver transplantation.

Objective To investigate the effect of mild hyperthermia on chemoresistance of gemcitabine in the pancreatic cancer cell line PANC1.Methods The PANC1 cell was treated with gemcitabine ( 1 μmol/L) for 1 h,then was heated at 37℃,42℃ and 45℃ for 1 hour,and was cultured for 0 h,24 h,48 h.Cell growth was analyzed by CCK-8 assay.Cell apoptosis was analyzed by Annexin Vfluorescein isothiocyanate ( FITC)/propidium iodide (PI) staining.Results The proliferation of cells at 42℃ and 45℃ for 24 h and 48 h were significantly lower than that at 37℃ (0.96 ± 0.05,0.88 ± 0.03vs 1.05 ±0.02;1.28 ±0.04,0.94 ±0.04vs 1.49 ±0.09;t =4.367,25.120,P ＜0.05).The proliferation of cells at 45℃ was significantly lower than that at 42℃ (t =3.348,11.732,P ＜0.05).The cell apoptosis rates at 37℃,42℃,45℃ after 48 h were (7.125 ±0.064)％,(9.985 ±0.615)％,(14.845 ± 1.987)％,the difference among the 3 groups was statistically significant (t =10.320,9.832,4.575,P ＜0.05).Conclusions Mild hyperthermia can reduce chemoresistance of gencitabine in pancreatic cancer cell PANC1.

Objective To explore the clinical features and treatment of upper gastrointestinal bleeding with rare etiologies.Methods A total of 45 cases with rare etiologies was selected from a group of 1200 patients with upper gastrointestinal bleeding admitted from January 2012 to December 2015.Results The incidence of gastric stromal tumor (24.4％) and Dieulafoy's lesion (20.0％) was the highest.Among rare etiologies of upper gastrointestinal bleeding were Mallory-Weiss syndrome (17.8％) and stomal ulcer and hemorrhage of efferent loops after subtotal gastrectomy (17.8％),as well as left-side portal hypertension (6.7％),liver cirrhosis complicated with variceal bleeding in the descending part of the duodenum (2.1％),esophageal hematoma (2.1％),esophageal mucosa avulsion (2.1％),P-J syndrome (2.1％),duodenal adenocarcinoma (2.1％),and cutaneous malignant melanoma with duodenal metastasis (2.1％).Conclusions Gastroscopy in early stages played a role in etiologies identification,while etiological treatments could substantially reduce recurrent bleeding rate,thus enhanced cure rate.Analysis on rare etiologies promoted the medical understanding,with clinical diagnosis and treatment improved.

Objective To investigate the effects of Siwu decoction on the learning and memory abilities in mice with blood deficiency and the related mechanism.Methods The mice were randomly divided into five groups:normal control group,model control group,high-,medium-,and low-dose group of Siwu decoction.Blood deficiency mouse model was established by continuously cuttingtailand bleedingin model control group,high-,medium-,and low-dose group of Siwu decoction.The mice in high-,medium-,and low-dose group were intragastrically administrated with Siwu decoction of 2.5,5.0,10.0 g·kg-1 for 14 days,respectively.The erythrocyte counts (RBC),hemoglobin (HGB),red blood cell hematocrit (HCT) were detected before modeling,7 and 14 days after administration.The spatial learning and memory abilities were assessed using the T maze test.The spontaneous activities were assessed using locomotors activity detector.The levels of erythropoietin (EPO) content in serum and acetylcholinesterase (AChE) in hippocampal tissue were detected by enzyme-linked immunousorbent assay.Results 5.0 and 10.0 g·kg-1Siwu decoction could increase RBC,HGB,HCT on the 7th and 14th day,2.5 g.kg-1Siwu decoction could increase RBC,HCT on 14th day,and each dosage of Siwu decoction could significantly increase the spontaneous activities of model mice with blood deficiency on the 7th and 14th day as compared with model control group (P ＜0.05 or P ＜0.01).Compared with model control group,the number of errorsin T Maze test were decreased significantly in high-,medium-,and low-dose groups (P ＜ 0.01).And the Siwu decoction had a tendency to reduce the hippocampal AChE levels,but when compared with the model control group there were no statistical differences (P ＞ 0.05).Conclusion Siwu decoction is benefit formemory and spatial learning in mice with blood deficiency,which may be related with higher serun EPO and lower hippocampal AChE expression.