Objective To compare the duration of neuromuscular blockade in laparoscopic and open surgical approaches following a single bolus dose of rocuronium or cisatracurium.Methods One hundred female patients underwent either laparoscopic or open gynaecological surgery were randomly and equally divided into OR group (rocuronium administered in open surgery),OC group (cisatracurium administered in open surgery),LR group (rocuronium administered in laparoscopic surgery) and LC group (cisatracurium administered in laparoscopic surgery).Anaesthesia was induced with sufentanil of 0.5 μg/kg and propofol of 2 mg/kg,and neuromuscular blockade was induced with rocuronium of 0.9 mg/kg or cisatracurium of 0.15 mg/kg,intravenously.Then adductor pollicis trainof-four responses following ulnar nerve stimulation were monitored with mechanomyography.We recorded the duration of the first twitch (T1) occurrence after the injection of rocuronium or cisatracurium,and the duration from T1 recovered to 5 ％ and 25 ％ of baseline.Results The mean time from the end of injection of rocuronium until spontaneous recovery to T1,and to recovery to 5％and 25％ of baseline,was significantly prolonged in LR group [(44.8 ± 10.7) min,(52.8 ± 11.2) min and (62.6 ± 13.5) min] compared with OR group [(36.2 ± 4.0) min,(41.8 ± 6.8) min and (49.5 ±7.5) min] (P all＜0.05) On the other hand,there was no significant difference on the duration of neuromuscular blockade between LC group and OC group.Conclusions Neuromuscular blockade may be prolonged following a single bolus dose of rocuronium given during laparoscopic procedures,which should be on the alert,and assess neuromuscular function to ensure safe recovery.

Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.

To investigate the mechanism of inhibitory effect of a novel bFGF antagonist peptide isolated from the phage display random heptapeptide library on cell proliferation induced by basic fibroblast growth factor. The effect of P7 on cell morphology was observed under an inverted microscope. Flow cytometry was applied to analyze the effect of P7 on cell cycle progress of bFGF-stimulated cells. The effect of P7 on bFGF-induced activation of MEK and Erk1/2 in MAPK pathway was detected by Western blotting. The results showed that no significant cell morphology change was observed in the range of detected concentrations of P7. Cell cycle analysis showed that P7 decreased S-phase cell population and arrested cell cycle at the G0/G1 phase of bFGF-stimulated cells. The results of MAP kinase activation assay indicated that P7 decreased bFGF-induced MEK and Erk1/2 phosphorylation in a dose-dependent manner. P7 inhibited proliferation of bFGF-stimulated Balb/c 3T3 cells possibly via cell cycle arrest at the G0/G1 phase and down-regulation of signal molecular activation in MAPK pathway.

Objective To observe the clinical effect of edaravone combined with fibrinolysin for treating acute cerebral infarc-tion .Methods 80 cases of acute cerebral infarction were randomly divided into the two groups .The treatment group(40 cases) was treated by edaravone injection 30mg plus normal saline 100 mL by intravenous drip ,twice daily ,fibrinolysin injection 100 U plus 5%glucose injection 250 mL by intravenous drip on 1 d ,subsequently 200U plus 5% glucose 250 mL by intravenous drip from the next day ,for 14 d;the control group(40 cases ) used fibrinolysin alone ,the dose and usage were same to the treatment group .The neuro-logical impairment scale scores(NIHSS) were monitored before and after treatment in the two groups .Results The NIHSS scores and Barthel index on 7 ,14 ,30 ,90 d after treatment in the treatment group were superior to those in the control group (P<0 .05) ,no statistical difference before treatment between the two group existed .Conclusion Edaravone combined with fibrinolysin has better effect for treating acute cerebral infarction .

Objecive To explore the significance of RECK expression in breast cancer .Methods Im-munohistochemical staining was used to analyze RECK expression levels in patients with breast cancer .We com-pared these data with the clinicopathological features of these patients .Rseults Breast cancer patients with nega-tive RECK expression had significantly lower DFS and 5-year survival rates than patients with positive RECK expression.In addition,for node-negative breast cancer ,negative RECK expression indicated markedly unfavor -able survival rate than positive arm .Multivariate analysis further confirmed that RECK expression was an inde -pendent prognostic factor for patients with breast cancer .Conclusion The loss of RECK expression indicates un-favorable survival rate for patients with breast cancer .RECK expression is a new ,important risk factor for recur-rence in breast cancer .

It was proposed that the items incurrent testing itemsdatabase should be classified , ranked , amal-gamated or disintegrated , the testing items and their names should be standardized , and the link between current testing itemsdatabase and new standards should be established according to the new standards by taking their problems into consideration, such as non-standard link, repetition of a same item, non-standard names of testing item and method, in order to improve the effectiveness of main testing methods, lay a foundation for the verifica-tion, and provide reference for the link between new and old items in other provinces.

OBJECTIVE: To discuss the safe approach to exposure of the recurrent laryngeal nerve (RLN) in thyroid second operation. METHOD: The data of 153 patients with thyroid second operation were analyzed retrospectively to compare the effectiveness of superior and inferior approach in the exposure of RLN. RESULT: A total of 177 RLNs were exposed in 153 cases. Among those 39 RLNs were exposed by superior approach, 34 by inferior approach after failure of superior approach, and 104 by inferior approach. CONCLUSION In thyroid second operation, inferior approach is a safe and efficient method to expose RLN. Trachea and esophagus are the most important anatomical landmarks to look for the left RLN. Innominate artery and common carotid artery are the most important anatomical landmarks to look for right RLN.
Carotid Artery, Common ; Esophagus ; Humans ; Recurrent Laryngeal Nerve ; surgery ; Reoperation ; Retrospective Studies ; Thyroid Gland ; surgery ; Trachea

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

Fanconi anemia (FA) is an autosomal recessive inherited disease and the most common hereditary bone marrow failure syndrome, which can lead to bone marrow failure, increased risk of cancer, and developmental abnormalities. FANCD2 is a member of the FA gene family and has become the focal point of FA signaling. Research has found that FANCD2 plays an important role in the occurrence and development of tumors and can participate in regulating ferroptosis as a related gene. This article reviews the mechanism of action of FANCD2 and its research progress in tumors, in order to provide new directions and ideas for the diagnosis and treatment of diseases.

Objective To observe the efficacy of ultrasound-guided erector spinae plane (ESP) block on intraoperative and postoperative analgesia in patients undergoing chronic empyema. Methods Sixty patients scheduled for elective decortication of pleural fibreboard under video-assisted thoracoscopic, 35 males and 25 females, aged 30-70 years, falling into ASA physical status Ⅰ or Ⅱ, were randomized into 2 groups: ESP block combined with general anesthesia group (group E) and only general anesthesia group (group G). Patients in group E received ESP block before general anesthesia, while patients in group G received general anesthesia only. All patients received patient controlled intravenous analgesia (PCIA). The thoracic paravertebral space were recorded using ultrasound. Dermatomes of sensory block on midclavicular line were recorded at 20 min after ESP block. The amount of remifentanil, duration of stay in post-anesthesia care unit, the frequency of PCIA pressing, the pain analog scale (VAS) scores during rest and movement at 1, 4, 12, 24, 48 h after operation were recorded. Results Twenty-four patients in group E showed unclear thoracic paravertebral space, dermatomes of sensory block at 20 min after ESP block were 4.9 ± 1.0 on midclavicular line. The consumption of remifentanil and duration of stay in post-anesthesia care unit and the frequency of PCIA pressing in group E were significantly less than that in group G (P ＜ 0.05). The VAS scores at 1, 4, 12, 24 h in group E were lower than those of group G (P ＜ 0.05). Conclusion The ultrasound-guided erector spinae plane block were safe and effective for patients undergoing chronic empyema, and provided satisfactory intraoperative and postoperative analgesia.