Objective To discuss the efficacy of sufentanil combined with propofol in iv anesthesia during laparoscopic cholecystectomy.Methods Totally 182 patients received laparoscopic cholecystectomy.They were divided into two groups according to odd or even number of hospitalization.The control group (81 cases) were given remifentani combined with propofol for iv anesthesia.The observation group (101 cases) were given sufentanil combined with propofol for iv anesthesia.The anesthetic effect of sufentanil combined with propofol for iv anesthesia during laparoscopic cholecystectomy was evaluated by breathing recovery time,opening time,extubation time,VAS scores after 1,6,12 h,and complications during anesthesia.Results Breathing recovery time,opening time,and extubation time of observation group were longer than those of control group (P ＜ 0.05).The VAS scores after 1,6,and 12 h of observation group were lower than those of the control group (P ＜ 0.05).During anesthesia,the proportion of restlessness in observation group was lower than that in control group (P ＜ 0.05).The complication rate of observation group was lower than that of control group (P ＜ 0.05).Conclusion Sufentani combined with propofol has a good anesthetic effect on patients receiving laparoscopic cholecystectomy with mild postoperative pain and less restlessness.It is worthy of clinical use.

Combined Modality Therapy ; Humans ; Stomach Neoplasms ; therapy

Objective To investigate the renal protection of Chinese cobra venoms (CCV) and its mechanism in renal ischemia/reperfusion (I/R). Methods Thirty-two rats were divided into four groups. 0.1% CCV was separately infused into abdominal cavity at 0.5 h, 24 h before reperfusion in group Ⅰ and Ⅱ . Group Ⅲ suffered from kidney I/R was served as pathological control. Group Ⅳ was sham operation group. BUN and Scr were measured before ischemia and 24 h after reperfusion. Complement C3 was observed at 0, 0.5, 2, 24 h after reperfusion. The kidney samples were examined by HE stain under light microscopy. Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin in situ nick-end labeling(TUNEL). Results Significant histological damage, apoptosis of tubular cell and impaired renal function were found in group Ⅰ and Ⅲ.The above indexes decreased to a less extend in group Ⅱ (P

Acute and chronic graft rejection are the major factors leading to graft non-function.There is an active expression of chemokines early after transplantation.They recruit T cells and antigen presenting cells selectively to the graft, leading to inflammatory reaction and finally to graft non-function.Accordingly,monitoring the expression status of chemokines and their receptors regularly may help to the diagnose rejection.To determine one or more chemokines or their receptors as the new targets for anti-rejection therapy will be of great clinical significance.This review focuses on the research progression in the above areas.

Oxyfedrine (Oxy ) exhibited inhibitory effect on washed rabbit platelet aggregation and MDA production induced by thrombin (4 U /ml) . The concentration of Oxy causing 50% inhibition of platelet aggregation induced by thrombin was 254 ?mol/L . Up to 2 nig/ml, acetysalicylic acid (ASA) could not antagonize platelet aggregation induced by thrombin 。 However, ASA 50 ?g/ml reduced the generation of MDA markedly. These results suggest that anti-aggregation of Oxy may be related to inhibition of PAF formation and the effect of Oxy on MDA generation may be due to the inhibition of arachi-donic acid release.

0.05) during follow-up angiography. Conclusion Pullback atherectomy is an effective method of plaque removal for coronary artery disease with optimal short-term angiographic results, and large cutter and eccentric lesion seem to come with good immediate and follow-up angiographic results.

Objective　To analyze the epidemiological characteristics of hepatitis B in Hainan from 2015 to 2021, and to predict the incidence trends among different populations, so as to provide a scientific basis for the prevention and control of hepatitis B based on the epidemiological characteristics and prediction. Methods　Descriptive epidemiological characteristics of hepatitis B in Hainan were analyzed, and the incidence of hepatitis B among different populations in Hainan was studied based on the grey prediction model and polynomial model. The optimal model was selected by the principle of least absolute mean relative error, and future incidences were predicted. Results　The reported incidence of hepatitis B in Hainan Province from 2015 to 2019 basically showed an annual upward trend, but a decreasing trend was observed in 2020. From 2017 to 2021, the reported incidence rates in the age groups of 0-<15 and 15-<30 showed a declining trend, while the incidence of the age groups of 60-<75 and ≥75 years old basically stabilized in Hainan. The annual average number and annual incidence of the population aged 30-<45 and 45-<60 were both higher. The male-to-female sex ratio of the annual average reported incidence of hepatitis B was approximately 2:1. Among the various occupations, the incidence was mainly among farmers, with an annual average proportion of hepatitis B of 43.06%. Regional disparities in the number of reported annual hepatitis B cases were found, with 5 cities decreasing year by year, 1 city increasing first and then decreasing, 2 cities being stable and other cities increasing year by year. The predicted incidence rates for 2022-2024 years were 127.43/100 000, 116.05/100 000, and 102.09/100 000, respectively. Conclusions　In recent years, the incidence of hepatitis B among people under 30 years old in Hainan Province has shown a decreasing trend, indicating that policies such as hepatitis B vaccine included in the immunization program for children in Hainan have a good effect on the prevention and control of hepatitis B. Therefore, it is necessary to focus on strengthening the prevention and control of the high incidence rate in the age groups and gender. The existence of regional differences in the incidence of Hepatitis B suggests that comprehensive prevention and control measures should be continued to strengthen in areas where the incidence is increasing year by year, such as knowledge and health promotion of hepatitis B prevention and control, screening treatment, and vaccinatio.

AIM:To investigate the serum antibody of aquaporin 4 ( AQP4 - Ab ) in positive expression rate and the significance in patients with neuritis.
●METHODS: A total of 98 cases ( 128 eyes ) of patients with optic neuritis were studied to detect the patient′s serum AQP4-Ab positive rate of antinuclear antibodies ( ANAs) from Jan. 2012 to Dec. 2015 in ophthalmology center of our hospital. According to the expression of AQP4 - Ab group, the best corrected visual acuity between the two groups, peripapillary nerve fiber layer thickness (pRNFL), the volume of the macula, macular RNFL ( mRNFL ) , macular core layer volume ( mlNL ) measurement were compared.
●RESULTS:Ninety-eight patients (128 eyes) with optic neuritis cases diagnosed through examination revealed AQP4-Ab positive in 22 patients ( 22%) , negative in 76 patients ( 78%) , ANAs positive in 21 patients ( 21%) , negative 77 patients ( 79%) . Optic neuritis patients with serum AQP4 - Ab positive rate and ANAs positive significant correlation ( r = 0. 707, P < 0. 05 ). After examination revealed AQP4-Ab patients and negative-positive patients with best corrected visual acuity difference was not statistically significance (P>0. 05). After inspection found pRNFL, macular volume measured value AQP4 - Ab positive patients were significantly less than the negative patients, the differences were statistically significant (P<0. 05). AQP4-Ab positive patients and negative patients the mRNFL, mlNL measured values were not significantly different (P>0. 05).
●CONCLUSION:AQP4-Ab and ANAs expression in optic neuritis patients is a significant correlation. AQP4-Ab positive patients with optic neuritis pRNFL thinning of macular volume are decreased compared with negative patients.

Objective To investigate the distribution and drug resistance of pathogenic bacteria in children with urinary tract infection.Methods All data were analyzed retrospectively.Middle segment urine samples from 573 outpatients and inpatients in children were collec-ted,cultured and identified for pathogenic bacteria by the way of ATB apparatus during Jan.2005-Dec.2007,and the drug resistance of positively cultured bacteria was tested with disc agar diffusion method.Extended spectrum ?-lactamases(ESBLs) were determined by phenotypic comfirmatory test according to the criteria of National Committee for Clinical Laboratory(NCCLS),and the identifications of methicillin-resistant staphylococcus aureus(MRS) and high level aminoglycoside resistance(HLAR) were carried out by the methods recommended from NCCLS too.Results Four hundred and eighty-two pathogenic strains were isolated from urine culture of children during 3 years,in which 385 strains(79.9%) were gram-negative(G-) and 97 strains(20.1%) were gram-positve(G+).The primary G-bacterium was Escherichia coli which accounted for 41.1%(198 strains),and the primary G+ bacterium was Enterococcus which accounted for 14.7%(71 strains).All the strains of Escherichia coli and klebsiella pneumoniae were sensitive to imipenem.Their resistance rates to sulperazone,amikacin and nitrofurantoin were less than 9.7%,while the rates to piperacillin,ceftazidime,ciprofloxacin and trimethoprim-sulfamethoxazole were more than 50%.ESBLs-producing strains accounted for 59.2% in Escherichia coli and 52.7% in klebsiella pneumoniae.Pseudomonas aeruginosa showed high multi-drug resistance.All the Enterococcus strains were sensitive to vancomycin.The resistance rate to nitrofurantoin was less than 8.1%.The detection rate of HLAR was 26.1%.All the Staphylococcus strains were sensitive to vancomycin.The resistance rate to nitrofurantoin and rifampicin were less than 22.4%.The detection rate of MRS was 52.7%.Conclusions The primary pathogenic bacterium in children with urinary tract infection is G-bacteria.The Escherichia coli is the first,the Enterococcus is the second and the klebsiella pneu-moniae is the third.All the pathogenic strains show high drug resistance to antibiotics in common use,therefore,clinicians should attach importance to the results from bacteria culture and susceptibility test,in order to obtian reference for accurate clinical diagnosis and rational use of antibiotics.

Clinical practice is an important period to train student's skills in pediatric surgical learning,but it is confronted with difficult condition under the new doctor-patient relationship.How to resolve these difficulties is the key to carry on teaching successfully.Aaccording to the students' interests and the knowledge structure characteristics,teachers should cultivate their professionalism,train their communication skills,extend their thinking ability with appropriate use of teaching aid to increase the teaching interests and develop self-learning ability.