Objective To study the effect of preemptive analgesia with tramadol on ovarian cancer patients with stress reaction.Methods 80 cases with ovarian cancer undergoing elective surgery under general anesthesia were divided into the observation group and the control group according to the computer randomly generated control table,40 cases in each group.Patients in the observation group with PECA were pumped into tramadol after anesthesia induction,while the control group was in the same conditions of pumping tramadol after operation.Patients were all treated with intravenous patient -controlled analgesia with sufentanil after waking up.The blood concentrations of cortisol (COR),adrenal cortical hormone (ACTH),angiotensin Ⅱ (AT Ⅱ)were determined by radioimmunoassay, and the blood concentrations C reactive protein (CRP)was determined by immune turbidity method.The adverse reactions and the VAS score of patients after 2h,6h,12h,24h,48h were recorded.Results The COR,ACTH,AT Ⅱ, CRP concentrations of the two groups had no significant differences (all P >0.05)before operation.After each time point,COR[(208.5 ±31.6)ng/mL vs (446.3 ±19.8)ng/mL],ACTH[(35.7 ±8.2)pg/mL vs (63.5 ±9.1)pg/mL],AT Ⅱ[(46.8 ±10.9)pg/mL vs (75.9 ±12.5)pg/mL],CRP[(3.9 ±0.7)mg/mL vs (40.5 ±2.9)mg/mL] concentrations were significantly higher than those of pre -operation (all P <0.05 );The concentration of COR [(446.3 ±19.8)ng/mL vs (570.8 ±67.2)ng/mL],ACTH (63.5 ±9.1)pg/mL vs (85.2 ±12.5)pg/mL),AT Ⅱ[(75.9 ±12.5)pg/mL vs (108.5 ±18.1)pg/mL]and CRP[(40.5 ±2.9)mg/mL vs (51.8 ±8.5)mg/mL]in the observation group was significantly lower than those in the control group (all P <0.05);After operation,the VAS scores of rest (2.4 ±0.7)and cough (3.4 ±1.0)in the observation group were significantly lower than those in the control group in 2h (t =5.812,P =0.017;t =14.606,P =0.044);At rest,the other time point of the two groups of VAS scores had no significant difference (P >0.05);At the time of coughing,the two groups were significantly differ-ent only at the 6h[(2.5 ±0.6)vs (3.1 ±0.8)]and 12h[(2.1 ±0.6)vs (2.9 ±0.4)]time point (t =13.406, P =0.012;t =12.625,P =0.025).Conclusion Preemptive analgesia with tramadol and sufentanil for postoperative analgesia can effectively reduce the radical resection of postoperative pain and the stress reaction after surgery.It is a safe and effective analgesic method.

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

Periostin is preferentially expressed in the periosteum, which covers a large majority of bones.Periostin has been reported to promote osteoblast proliferation, adhesion, and differentiation, involving bone repair process, response to mechanical stimulation and parathyroid hormone (PTH), regulating bone development/ remodeling and bone strength.Circulating periostin may serve as a candidate of biological markers for bone metabolism.

AIM To investigate the effects of several 5-hydroxytryptamine(5-HT) subtype receptor antagonists on late slow excitatory postsynaptic potential(LS-EPSP) of the neurons of guinea pig inferior mesenteric ganglion(IMG). METHODS Intracellular recordings were made from neurons of the isolated guinea pig IMG. RESULTS Cyproheptadine and BRL 24924 suppressed LS-EPSP of 5-HT sensitive neurons reversibly, while mianserin, MDL 72222 and spiperone showed no significant effect. Continuous superfusion of IMG with MCPP suppressed LS-EPSP of 5-HT sensitive neurons by 5-HT 1P receptor desensitizated. CONCLUSION LS-EPSP of 5-HT sensitive neuron is mediated by 5-HT 1P subtype receptor.

Objective To compare the clinical characteristics of cirrhosis with or without portal vein thrombosis(PVT),and to analyze the therapeutic effect of transjugular intrahepatic portosystemic shunt(TIPS)in treating cirrhosis with or without PVT.Methods The clinical data of 193 patients with cirrhosis complicated by gastrointestinal bleeding,who received TIPS from October 2018 to October 2022,were retrospectively analyzed.According to the presence or absence of PVT before TIPS,the patients were divided into non-PVT group(n=118)and PVT group(n=75).After TIPS,the patients were followed up at one,3,6 months and every 6 months thereafter.The effect of PVT on the clinical characteristics of cirrhosis patients and on the therapeutic efficacy after TIPS were analyzed.Results The success rate of TIPS was 100％in both groups.The proportion of carrying out splenectomy or partial splenic artery embolization(PSE)in PVT group was 26.7％(20/75),which was obviously higher than 13.6％(16/118)in non-PVT group,the difference between the two groups was statistically significant(x2=5.192,P=0.023).In PVT group the preoperative Child-Pugh score,the model of end-stage liver disease(MELD)score and serum sodium model of end-stage liver disease(MELD-Na+)score were(8.1±1.9)points,(9.2±8.0)pointsand(9.2±8.0)points respectively,which in non-PVT group were(7.4±1.9)points,(7.7±5.8)points and(7.7±5.8)points respectively,the differences between the two groups were statistically significant(all P＜0.05).The incidence of overt hepatic encephalopathy in PVT group was 33.3％(25/75),which was strikingly higher than 19.5％(23/118)in non-PVT group,the difference between the two groups was statistically significant(P=0.030).No statistically significant differences in postoperative survival rate,rebleeding rate and stent dysfunction rate existed between the two groups(all P＞0.05).Conclusion For the treatment of cirrhotic patients with PVT complicated by gastrointestinal bleeding,TIPS is clinically safe and effective.In cirrhotic patients with PVT,the worse the liver function is,the higher the incidence of overt hepatic encephalopathy after TIPS will be.

AlM: To compare the duration of 0.25% ropivacaine used for sciatic nerve block between type 2 diabetic patients and non-diabetic patients, and to explore the factors affecting the duration of nerve block. METHODS: Sixty eight patients with unilateral lateral malleolus fracture who were to be treated with open reduction and internal fixation were selected from January 2021 to January 2022, aged 20-80 years old, ASA I-III, including 28 diabetic patients and 40 non-diabetic patients. All patients were given 0.25% ropivacaine 20 mL to the superior popliteal sciatic nerve under the guidance of ultrasound. The onset and duration of sensory block were evaluated by blunt needle stimulation. The onset and duration of motor block were evaluated by dorsiflexion and plantar flexion of the operated foot. The interval between the end of the operation and the patientls first request for analgesia was taken as the duration of nerve block analgesia. RESULTS: Compared with non-diabetic patients, the duration of sciatic nerve sensation, motor block and analgesia in diabetic patients were prolonged (P < 0.05). There was no significant difference in the onset time of sciatic nerve sensation and motor block between the two groups (P > 0.05). Linear regression analysis showed that diabetes mellitus, duration of diabetes mellitus, fasting blood glucose and glycosylated hemoglobin were factors affecting the duration of nerve block, and fasting blood glucose was not related to the duration of analgesia. CONCLUSlON: 0.25% ropivacaine can prolong the duration of sciatic nerve block in diabetic patients. The duration of diabetes, diabetes, fasting blood glucose and glycosylated hemoglobin are positively correlated with the duration of block.

Objective To compare and analyze the clinical characteristics and efficacy of transjugular intrahepatic portosystemic shunt(TIPS)in the treatment of liver cirrhosis with different portal vein thrombosis(PVT)grades.Methods A retrospective analysis was performed on 75 patients with liver cirrhosis and gastrointestinal bleeding who received TIPS.According to the Yerdel scale of PVT,the patients were divided into type Ⅰ(34 cases),type Ⅱ(25 cases)and type Ⅲ(16 cases).The patients were followed up 1,3,6 months after TIPS and every 6 months thereafter to compare the clinical data and the efficacy of TIPS in three types of PVT patients.Results The success rate of TIPS in three types of patients was 100％.There were differences in platelet to lymphocyte ratio(PLR)and proportion of different Child-Pugh grades among the three types of patients(P＜0.05).After TIPS,portal vein pressure was decreased compared with that before TIPS(P＜0.001).However,there were no significant differences in postoperative survival rate,rebleeding rate,over hepatic encephalopathy rate,stent dysfunction rate,thrombus complete recanalization rate and thrombus recurrence rate(P＞0.05).Conclusion The success rate of TIPS in three types of patients is higher,and the portal vein pressure is decreased significantly after TIPS,but there are no significant differences in the postoperative efficacy.Although the implementation of TIPS in cirrhotic PVT patients is challenging,it is still worth the effort to reshape the portal vein for the benefit of patients.