Enhanced recovery after surgery (ERAS) emphasizes applicating a series of sophisticated measures with the synergy effect of optimized combination to minimize various physical and mental stress reaction.The aim of ERAS is to accelerate postoperative recovery,shorten duration of hospital stay and hospital expenses,improve postoperative life quality of patients.ERAS includes minimally invasive surgery,anesthetic management,reasonable postoperative management,among which anesthetic management is very important.

Objective To discuss the diagnosis value of ultrasonography in hepatorrhexis. Methods The contrast of ultrasonography for 120 cases of hepatorrhexis with operative exploration was made. Results All of the 120 patients were examined with ultrasonography, fragmentation of liver parenchyma in 55 cases, dehiscence of liver parenchyma in 38 cases, liver subcapsular hematoma in 12 cases, and spontaneous rupture of liver cancer in 7 cases. All of the 120 patients were confirmed hepatorrhexis with laparotomy. The positive diagnostic rate of ultrasonography in the hepatorrhexis was 93.3%.Conclusion Ultrasonography is valuable for diagnosing hepatorrhexis and it is one of the important diagnostic approaches.

Objective Increased serum uric acid level is associated with type 2 diabetes (T2DM) through the mechanism of oxidative stress.As the rate-limiting enzyme in the degradation of purines in humans,xanthine oxidoreductase (XOR)catalyzes the final two reactions of purine catabolism,oxidizing hypoxanthine to xanthine,and xanthine to uric acid.The aim of this study is to investigate the association between serum XOR activity and T2DM.Methods A total of 270 patients with T2DM and 140 age-and-gender-matched health controls were enrolled in the study.The clinical examinations such as weight and height were conducted in the morning after an overnight fast.Serum XOR activity and other biochemical parameters like triglyceride,total cholesterol,high density lipoprotein cholesterol,fasting plasma glucose and uric acid levels were measured.Results Serum XOR activity was significantly elevated in T2DM patients compared with that in the controls (31.2 ± 8.91 vs 4.6 ± 0.91 U/L,P ＜0.01).Serum XOR activity was significantly elevated in T2DM patients complicated with lower extremity arterial disease compared to that in patients without lower extremity arterial disease (42.1 ± 8.43 vs 23.7 ± 5.31 U/L,P ＜ 0.01).Conclusion High XOR activity plays an important role in onset and development of T2DM.

Objective To construct eukaryotic expression vector of antisense MBD1 gene fragment and to provide a tool for studying MBD1 gene function. Methods PCR primers were designed according to the coding sequence of MBD1 gene. Xba I and Kpn I recognition sequences and cutting sites were added to the 5' end of the sense and antisense primer respectively. The 342 bp specific PCR fragment was obtained from the cDNA of biliary tract carcinoma cell line QBC-939 using RT-PCR, the purified PCR fragment was then inserted reversely into the multiple cloning site of eukaryotic expression vector pcDNA3. 1 ( + ). The constructed recombinant plasmid was identified by PCR confirmation, Xba I and Kpn I double enzyme digestion and DNA sequencing. Results The 322 bp specific DNA band was obtained by PCR, Xba I and Kpn I double digestion produced a 327 bp and a 5. 4 kb DNA band which represent the inserted target gene fragment and the vector respectively. The sequencing result confirmed that the sequence of inserted fragment was correct. Conclusion The eukaryotic expression vector of antisense MBD1 gene fragment was constructed successfully by using gene cloning technique. It will be a useful tool for studying MBD1 gene function in DNA methylation and tumorigenesis.

BACKGROUND:To improve the survival rate of transplanted hematopoietic stem cells, dynamic monitoring of plasma content of human cytomegalovirus (HCMV) and rapid screening of early active HCMV infection in hematopoietic stem celltranplantation recipients, thus to guide the clinical medication, is preferred. OBJECTIVE:To evaluate the usefulness of fluorescence quantitative PCR assay for early detection of HCMV activation after hematopoietic stem celltransplantation. METHODS:Real-time fluorescence quantitative PCR assay was applied for HCMV monitoring in 656 blood samples from 41 hematopoietic stem celltranplantation recipients and 60 control blood samples. RESULTS AND CONCLUSION:In 656 blood samples, 96 samples were positive, and the HCMV DNA copies ranged from 5.0×102 to 1.0×107 IU/mL. Timely initiation of therapy resulted in the rapid clearance of DNA-viraemia but it recurrenced in short time by drug-resistent. Two cases from 12 postive recipients died from HCMV infection. The quantitative detection of HCMV DNA by real-time PCR is a rapid method for monitoring HCMV infection and the early diagnosis in patients after hematopoietic stem celltransplantation.

[Objective]To discuss the surgical treatment,the proper application,and the respective effect of the therapy of burst fracture in the posterior marginal vertebral bone block and the thoraco-lumbar vertebra.[Method]Thirty-eight patients with thoraco-lumbar burst fracture induced by high energy injury were hospitalized from July 2002 to June 2006.Through the were assessed application of section and ORIF(open reduction internal fixation),decompression of vertebral canal by bone grafting and fusion,the clinical effect of therapy by rechecking the postoperative thoracic-lumbar function and radiographic information.[Result]All the 38 patients were followed up for 12-18 months(average 14.4 months).The fracture were all healed and lumbar pain disappeared,the vertebral height restored,and well-fused.According to Frankel ranking,the neurological function recovered,with the degree varying from 1 to 3.[Conclusion]It's a good method to apply the open and reduction,decompression of spinal canal with bone grafting and fusion operation.This kind of operation can get perfect treating effect by providing good fixation and reducing the complications.

[Objective]To investigate the relationship between neurogenic pulmonary edema(NPE)and the changes of substance P in serum and bronchoatveolar lavage fluid(BALF)in acute spinal cord injured rats during isoflurane inhalation.[Method]Thirty male SD rats with body weight of 300-330g were randomly divided into 3 groups:1.5% isoflurane group,chloral hydrate group and sham operation group,ten in each group.Epidural balloon compression of the T8 spinal cord was performed.Alt animals were sacrificed 10 min after being compressed.The content of substance P and protein concentration in serum and BALF were measured.Then the lung permeability index(LPI)was calculated.[Result]The content of substance P in serum and BALF in 1.5% isofiurane group was higher than that in chloral hydrate group(P0.05).[Conclusion]1.5% isofturane can stimulate the release of substance P to take part in the development of neurogenic pulmonary edema in rats.

BACKGROUND:At present, the confrontation of CAD/CAM systems and the lost wax casting method for marginal adaptation has been widely concerned, but the results are controversial. OBJECTIVE:To compare the marginal adaptation of single cobalt-chromium PFM crowns produced by 3 Shape CAD/CAM systems and the lost wax casting method. METHODS: A maxilary first premolar was prepared according to the standards. 50 resin-generation models were created by bi-color silicone rubber method and randomly divided into two groups: CAD/CAM group (A1-A25) and cast group (B1-B25). Al the models were cast in plaster. In CAD/CAM group, the digital impressions were obtained by optical scanning, then designed through computer and cut directly by NC miling machine. In cast group, metal ceramic crowns were made by the lost wax casting method. When crowns were al seated on the working dies, the marginal gaps were copied with light silicone rubber and then embedded with occlusal silicone rubber. The thickness of crown marginal gap was measured with a stereo microscope. RESULTS AND CONCLUSION:The average vertical clearance was (34.67±7.48)μm of CAD/CAM group, while (53.70±9.64)μm of the cast group; the difference was statisticaly significant between two groups (P < 0.05). The average level clearance was (37.61±7.63)μm of CAD/CAM group, while (53.02±10.65)μm of the cast group, and the difference was statisticaly significant between two groups (P < 0.05). Experimental findings suggest that, the marginal adaptation of single cobalt-chromium PFM crowns cast produced by 3 Shape CAD/CAM systems is clinical acceptable (< 120μm), and CAD/CAM systems of metal casting is obviously better than the lost wax casting in building metal based crowns with adaptable margin.

Objective To observe the reactivity of spinal cord transection (SCT) rat abdominal aorta to ?-AR agonists and the infuence of propofol on vascular reactivity, so as to explore the mechanism of autunomic dysreflxia. Methods The rats were divided into sham-operated group and SCT group. 4 weeks after transection of the fourth thoracic spinal cord, the rats were killed, then abdominal aorta rings were adopted to assay their sensitivity to noradrenaline, phenylephrine, clonidine and propofol in isolated organ perfusion system. Results Compared with the rats in sham-operated group, the abdominal aorta reactivity of SCT rats to noradrenaline and clonidine was significantly higher (P

Objective To observe the clinical curative effect of Zoladex combined with Sanjie analgesic capsule in treatment of endometriosis.Methods 80 patients with endometriosis treated in our hospital from January 2016 to December 2016 were randomly divided into two groups,with 40 cases in each group.The study group was given Zoladex needle and Sanjiezhentong capsule treatment;The control group were given Sanjie Zhentong capsule.Prostaglandin F2a(PCF2a), CA125, visual analogue scale(VAS), clinical efficacy and adverse reactions were compared between the two groups.Results After treatment, the PCF2a and CA125 in the study group were significantly higher than those in the control group, the difference was statistically significant(t=4.167, t=3.533, P<0.05).There was no significant difference in VAS score between the two groups(t=0.961, P>0.05).The total effective rate of the study group was 90%, and the control group was 75%, the difference was statistically significant(x2=5.741, P<0.05)., there were 4 cases of adverse reactions(10%)in the study group,and 10 cases in the control group(25%), the difference was statistically significant(x2=7.792, P<0.05).Conclusion Zoladex needle combined with Sanjiezhentong capsule, can effectively relieve the pain caused by endometriosis, reduce adverse reaction, improve the clinical efficacy, suitable for use in clinical research.