Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.

Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P<0.05). The incidence of mild CRBD in LB group was significantly lower than that in C, L and B group:10%(2/20) vs. 45%(9/20), 35%(7/20) and 40% (8/20), and there were statistical differences (P<0.05). There were no statistical differences in dosage of fentanyl among the 4 groups (P>0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.

Objective To compare the influences of general anesthesia and intra spinal anesthesia on circulation, respiration, body temperature and anesthesia-related complications in patients undergoing percutaneous nephrolithotomy (PCNL), and assess the effectiveness and safety of both anesthesia. Methods Forty ASA Ⅰ - Ⅱ patients elective for PCNL surgery were divided into two groups by random digits table with 20 cases each:group Ⅰ (endotracheal general anesthesia) and group Ⅱ (intra spinal anesthesia). The temperature, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) values and postoperative shivering, nausea, vomiting, back discomfort and the incidence of sore throat were observed and recorded. Results The anesthesia was stable, there were no changes in MAP, HR at different time in group Ⅰ . The anesthesia in group Ⅱ was effective, MAP at 15 min after anesthesia,and HR,MAP after lithotomy position and prone position were obviously changed in group Ⅱ compared with those before anesthesia and group Ⅰ (P ＜ 0.05 ). The temperature at 30,60,90, 120 min after anesthesia decreased compared with that before anesthesia in two groups (P ＜ 0.05 ), and the temperature at 30,60 min after anesthesia in group Ⅰ [(35.8 ±0.6), (34.8 ± 0.5)℃] was lower than that in group Ⅱ [(36.2 ± 0.6),(35.6 ± 0.5)℃](P＜ 0.05).During recovery,complications such as shivering, nausea,sore throat, back discomfort occurred to some extent, of which the incidence of shivering was the highest. Conclusion Both of two anesthesia are applicable to PCNL. When intra spinal anesthesia is used,the life indicators of patients need to be observed and general anesthesia is preferable for the obesity,less physical and the old with poorly compensatory function.

Objective To find an easy to do testing method to diagnose CJD in the early stage.Methods The values of NSE and S 100 protein in the serum and CSF of 10 cases of CJD, 10 cases of non CJD dementia and 10 cases of healthy control were measured by ELISA and sandwich ELISA.while the expression of PrP gene of CJD patients being detected.Results The values of NSE and S 100 protein in the serum and CSF of CJD patients were higher than those of non CJD dementia(all P

Objective:Helicobacter pylori is one of the human pathogens causing gastric ulcers and cancers.A key virulence factor of H.pylori is the Cag pathogenicity island,which encodes a type IV secretion system.HP0525 is an essential component of the Cag system and acts as an inner membrane associated ATPase.To construct recombinant plasmid containing hp0525 gene of Helicobacter pylori(H.pylori)NCTC 11637,and analysis of sequence nucleic acid,express it in E.coli BL21 and study the influence of the HP0525 protein on proliferation of SGC-7901 cells.Methods:H.pylor hp0525 gene was amplified from the genome DNA by PCR,then operated T-A cloning and sequenced.The hp0525gene fragment was inserted directionally into vector pMD18-T to construct recombinant clones of hp0525 and was sequenced.The recombinant plasmid was transformed into E.coli BL21for expressing under induction of IPTG.Purify the expressed protein by Ni2+-NTA column chromatography.Expressed product was analyzed by Western blot and MALDI-TOF.Added the purified protein into SGC-7901 cells,the effect of cell proliferation in SGC-7901 cells induced by the recombinant protein was observed by MTT.Results:A 993 base pairs long hp0525 gene,which encodes a product of 330 amino acid,was obtained using PCR method and was cloned into pMD18-T vector successfully.The sequence analysis for hp0525 showed that it shares 97%~99% homology with other strains in Gene bank.SDS-PAGE showed a protein band with a relative molecular weight of 36 000,which was consistent with the expectation.The expressed product reached a purity of 97% after Ni2+-NTA column chromatography.The protein after dialyzed and annealed,was co-cultured with SGC-7901 cells,The protien of different concentration co-cultured with SGC-7901 cells for different times,found that the protein in low concentration stimulates proliferation of cells,to achieve some concentration,it inhibits proliferation of cells along with multiplication of the concentration of the protein;The protein inhibits proliferation of cells relay on the extension of time and concentration.Conclusion:It is indicated that the correct hp0525 gene was obtained and expressed in E.coli BL21.High purified protein was obtained by Ni2+-NTA column chromatography,the protein can inhibits proliferation of SGC-7901cells,and T-ATPase activity which posed a basis for further researching on its biological function.

Objective To analyze the mammographic findings of triple-negative breast cancer [TNBC,which is estrogen receptor (ER) negative,progesterone receptor (PR) negative,and human epidermal growth factor receptor 2 ( HER2 ) negative ] and triple-positive breast cancer ( TPBC,which is ER positive,PR positive,and HER2 positive ),and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings.MethodsThe immunohistochemistry results of 631 cases with breast cancers were reviewed,including 117 cases of TNBC and 44 cases of TPBC.All of the patients took mammography at initial diagnosis.We retrospectively evaluated the visibility,morphology,distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC,and compared them with those of TPBC.The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test.ResultsThe visibility rate of TNBC and TPBC on mammography were 88.0％(103/117) and 90.9％ (40/44),and the difference between them was insignificant ( x2 =0.055,P ＞0.05).TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (x2 =6.860,P＜0.01 ),and the mean diameter of the mass of TNBC [ ( 2.6 ± 1.4 ) cm ] was larger than that of TPBC [(2.0 ± 0.6) cm](t =2.087,P ＜ 0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC ( 24/40 ) ( x2 =7.423,P ＜ 0.01 ).Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers.The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t =2.759,P ＜0.01).Infiltrating ductal carcinoma was the main pathologic type of both groups.Basal-like breast cancer accounted for 49％ (57/117 ) of TNBC while none happened in TPBC.ConclusionsTNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications.These mammographic features might be useful in diagnosing triple negative breast cancer.

Objective:To evaluate the effect of washing red cell suspension before transfusion in the prevention of hyperkalemia in children undergoing scoliosis orthomorphia.Methods:Thirty-two children who had underwent scoliosis orthomorphia from January 2018 to December 2019 in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University, were selected. The children were divided into experiment group and control group by random digits table method with 16 cases each. In experiment group, the red cell suspension was washed by cell-saver before transfusion; in control group, the red cell suspension was infused routinely. Potassium concentration before operation, before blood transfusion, after blood transfusion and after operation was detected. The operation time, autologous blood transfusion, urine output, bleeding volume, allogeneic blood transfusion volume, intake and output, intraoperative blood potassium>5.0 mmol/L and blood transfusion related adverse reactions were recorded.Results:There were no statistical differences in operation time, autologous blood transfusion, urine output, bleeding volume, allogeneic blood transfusion volume, intake and output between 2 groups ( P>0.05). There was no statistical difference in blood potassium before operation and before blood transfusion between 2 groups ( P>0.05). In control group, the blood potassium after blood transfusion and after operation was significantly higher than that before blood transfusion: (4.5 ± 0.7) and (3.9 ± 0.3) mmol/L vs. (3.7 ± 0.2) mmol/L, and there was statistical difference ( P<0.05); in experiment group, the blood potassium after blood transfusion was significantly higher than before blood transfusion: (3.9 ± 0.2) mmol/L vs. (3.8 ± 0.2) mmol/L, and there was statistical difference ( P<0.05); the blood potassium after blood transfusion in experiment group was significantly lower than that in control group, and there was statistical difference ( P<0.01); there was no statistical difference in blood potassium postoperative between 2 groups ( P>0.05). In control group, 3 cases had transient blood potassium>5.0 mmol/L, and 1 case had blood potassium>6.7 mmol/L and cardiac arrest occurred during the operation; there was no blood potassium>5.0 mmol/L in experiment group. No blood transfusion related adverse reactions occurred in 2 groups. Conclusions:The method of washing red cell suspension before transfusion used in pediatric scoliosis orthomorphia can significantly reduce blood potassium after blood transfusion and effectively avoid the occurrence of hyperkalemia during the operation.