0.05).Motor block with ropivacaine was recorded earlier than that with bupivacaine(P0.05).Conclusion Ropivacaine is superior to bupivacaine in postoperative analgesia and in motor recovery in children undergoing subabdominal surgery.

Object To investigate the isomer transition reaction of ferulic acid and the existing form of ferulic acid in Ligusticum chuanxiong Hort. and Angelica sinensis (Oliv.) Diels. Methods HPLC and HPLC-MS were used to confirm the isomer transition of ferulic acid. Results The trans-ferulic acid was translated into cis-ferulic acid partly when its solution was deposited under some routine conditions,and the trans- and cis-ferulic acids could coexist in the Chinese medicinal materials,L. chuanxiong and A. sinensis. Conclusion The trans-ferulic acid is stable thermodynamicly,but could be translated into cis-ferulic acid partly and slowly.

Objective To investigate the ultrastructural characteristics of amelanotic melanocytes (AMMCs). Methods Individual hair follicles from normal human scalp were digested with collagenase type V, then washed in phosphate buffer saline. Hair-follicle cell suspensions were prepared by trypsin and cultured in a medium suitable for melanocyte growth. The keratinocytes were removed by differential trypsinization. Geneticin (100?g/mL) was used to eliminate contaminating fibroblasts. After 3 passages the cells were trypsinized, washed in phosphate buffer saline, and finally processed for transmission electron microscopy. Results Under transmission electron microscope, the cultured cells were round or oval-shaped with a single large nucleus and double-layered karyotheca. Abundant euchromosome but sparse heterochromosome was observed within the nucleus. There were various organelles in the cytoplasm, including mitochondria, rough endoplasmic reticulum (RER), ribosomes and abundant melanosomes of nearly uniform size. The electronic density granules distributed in a concentric pattern in most of the melanosomes. Colgi complexes were inconspicuous in the cells. Conclusions Compared to epidermal melanocytes, AMMCs from human hair follicles have different ultrastructural characteristics which implies their functional immaturity. AMMCs may serve as the depot for mature melanocytes.

Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.

Objective To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age.Methods Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017.909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively.According to the age,of the 909 TOLAC cases,237 were the advanced age group,and 672 cases were the low age group.The maternal and neonatal outcomes between the two groups were compared.Results The percentage of TOLAC in women with advanced age was 32.4％ (237/731),and VBAC rate was 88.2％ (209/237).The percentage of TOLAC in younger women was 36.2％ (672/1 856),and VBAC rate was 82.4％ (554/672).The difference of the TOLAC rate between the two groups was not significant (P＞0.05),and the VBAC rate of the advanced age group was higher than the low age group (P＜0.05).In the comparison of the two groups,the proportion of bachelor degree or above(55.7％,132/ 237),the prepregnancy BMI (22.4±3.0) kg/m2,pregnant interval time (68.5±38.3) months,the proportion of gestational hypertension (8.4％,20/237),the proportion of gestational diabetes(34.6％,82/237) and the rate of the neonatal ICU admission (18.1％,43/237) in the advanced age group were higher than those of the low age group (P＜0.05),respectively.And there were no significant differences in the rate of postpartum hemorrhage,the rate of postpartum hemorrhage≥1 500 ml,the rate of postpartum transfusion,puerperal morbidity,neonatal birth weight,neonatal 5 min Apgar score＜7 score,umbilical artery blood pH＜7.0,neonatal tracheal intubation and respiratory distress syndrome (all P＞0.05).In all TOLAC cases,the rate of uterine rupture was 0.11％(1/909) and there was no maternal and neonatal death.Conclusion VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

Objective: To explore the application safety for off-label using of rotational atherectomy. Methods: A total of 112 patients received rotational atherectomy in our hospital from 2010-01 to 2015-12 were enrolled in this study. There were 9 off-label indications for using of rotational atherectomy which included vein grafts, massive thrombotic burden, unprotected left main coronary artery disease, culprit lesions of acute myocardial infarction, severe coronary dissection, signiifcant impaired left ventricular function (LVEF<30%), severe three-vessel coronary disease, diffuse long coronary lesions (≥25mm) and angulation lesions (≥45°). The patients were divided into 2 groups: Off-label group, the patients with ≥ 1 above mentioned indication(s),n=67 (59.8%) and On-label group, the patients without any indication,n=45 (40.2%). Rotational atherectomy related complication rates were compared between 2 groups including slow lfow/no lfow, stuck of rotablator, coronary artery perforation, guide wire fracture and in-hospital MACE as urgent CABG, acute in-stent thrombosis and cardiac death. Results:①The most common complication was slow lfow/no lfow and its occurrence rates were similar between 2 groups (4.5%vs 8.9%),P>0.05.②Off-label group had 1 patient with stuck of rotablator (1.5% vs 0%) and 1 cardiac death (1.5% vs 0%), both P>0.05; On-label group had 1 patient with acute in-stent thrombosis (2.2% vs 0%),P>0.05. Conclusion: Off-label using of rotational atherectomy did not increase the incidence of slow lfow/no lfow in relevant patients, other severe complications and in-hospital MACE occurrence were also rare.

Objective To investigate the clinical efficacy of a period of joint fusion and plate internal fixation for four parts calcaneal fractures.Methods The clinical data of 53 patients with four parts calcaneal fractures from January 2009 to January 2013 were analyzed retrospectively.Twenty-two patients were performed a period of joint fusion (joint fusion group),31 patients were performed plate internal fixation (plate internal fixation group).The Bohler angle and Gissane corner before and after operation,operation time and bleeding,the Maryland foot function score between two groups were compared.Results Compared with before operation,the Bohler angle and Gissane corner in plate internal fixation group and joint fusion group were improved significantly after operation (34.6° ± 4.2° vs.5.7° ± 2.4°,125.4° ± 8.2° vs.87.2° ± 6.8°,32.8° ± 3.9° vs.5.4° ± 2.7°,127.6° ± 7.8° vs.86.9° ± 6.7°),and there were significant differences (P ＜0.05),but the Bohler angle and Gissane corner before and after operation between two groups had no significant difference (P ＞ 0.05).The operation time and bleeding were (52.1 ± 5.1) min,(50.0 ± 10.2) ml in plate internal fixation group and (70.3 ± 5.2) min,(105.0 ± 20.5) ml in joint fusion group,and there were significant differences between two groups (P ＜ 0.05).The fineness rate of Maryland foot function at 6 months follow-up between two groups had no significant difference (P ＞ 0.05).Conclusions The plate internal fixation and joint fusion is therapeutic equivalence in treatment of four parts calcaneal fractures.Due to the small surgical trauma and less bleeding of plate internal fixation,it may be preferred in the treatment of four parts calcaneal fractures.

To explore the effects of different doses of puerarin on proliferation of cultured vascular endothelial cells in vitro.

Objective To investigate the safety and short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified coronary long lesions. Methods From Jan 1, 2011 to May 31, 2016, 109 cases with 114 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stenting in Peking University People's Hospital were included. They were divided into diffuse lesion group ( lesion ≥25 mm, 68 cases, 72 lesions ) and focal lesion group (lesion ﹤25 mm,41 cases, 42 lesions). All patients were followed up in hospital. Procedure parameters, procedural complications ( dissection, perforation, slow flow/no flow and procedural related myocardial infarction),procedural success and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and stent thrombosis) were analyzed. Results The procedural success rate was 98. 5%(67/68) in diffuse lesion group and 100% ( 41/41 ) in focal lesion group ( P=0. 453 ) . Complication rates did not differ between the two groups (41. 2% and 34. 1%, P=0. 673). Major adverse cardiovascular events rates were 41. 2% and 31. 7%, P =0. 484. Conclusions Treating coronary lesions ≥25 mm in length with rotational atherectomy followed by drug-eluting stenting does not impact the short-term outcome when treating carefully and correctly . Procedural success rate and in-hospital outcome is satisfactory.

Objective To explore the effectiveness and safety of branch protection technique with provisional stenting strategy in coronary bifurcation lesions by utilizing jailed balloon protection technique after pre-dilation in branch with cutting balloon. Methods 32 patients undergone jailed balloon protection technique after pre-dilation in branch with cutting balloon during January, 2015 to May, 2016 in Peking University of People's Hospital were enrolled consecutively in our study. 32 patients were involved including a total of 32 bifurcation lesions which were medina type 1,1,1 (n = 25, 78. 1% ), Medine type 0,1,1 (n =5,15. 6% ) and Medine type 1,0,1 (n = 2, 6. 3% ). For side branch diameter ≥2. 5 mm, the diameter ratio of cutting balloon to side branch was 1: 1. The angiography success rate after using branch protection during main branch stent implantation, perioperative complications and major adverse cardiac events were observed. Results ( 1 ) The angiography success rate of branch protection was 100% . ( 2 ) No perioperative complications and major adverse cardiac events were observed. Conclusions Side branches were effectively protected in provisional stenting strategy by applying jailed balloon protection technique after pre-dilation using branch cutting balloon.