Objective To investigate the effect of different duration skeletal muscle denervation on acetylcholine receptor activity in rats.Methods Fourteen Balb/c mice weighing 18-22 g were used in this study.The denervation model was established by excising sciatic nerve.Two rats were chosen before(T0 ) and at days 1,4,7,14,21 and 28 after excising sciatic nerve (T1～6),and flexor digitorum brevis of the hindfoot was acutely isolated Skeletal muscle cells were isolated ( five cells in each rat),the acetylcholine currents were recorded using whole-cell patch-clamo technique.Extracellular fluid containing 30 μmol/L acetylcholine was first applied to skeletal muscle cells for 10 s,acetylcholine currents (11)were recorded,then the ceils were washed out using extracellularfluid.Skeletal muscle cells were balanced using extracellular fluid containing 0,0.1,1,10,30,100,1000,3000,or 10 000 nmol/L atracurium for 3 min respectively,then perfused using extracellular fluid containing 30 μmol/L acetylcholine and differents concentrations of atracurium mentioned above for 10 s respectively,and acetylcholine currents were recorded,then the cells were washed out,and 30 μmol/L acetylcholine was perfused again and currents(I2 ) were recorded.The mean value of I1 and I2 was taken as control current,and inhibitory percentage of control current was calculated,and the inhibition concentrations for the half-maximal response (IC50) of atracurium were determined by nonlinear regression analysis.Results Compared with T0,IC50 significantly increased at T1～6 ( P ＜ 0.05).IC50 was increased gradually at T1～3 ( P ＜ 0.05).Compared with T3,IC50 was decreased at T4～6 ( P ＜ 0.05).IC50 was decreased gradually at T4～6 ( P ＜ 0.05 ).Conclusion Skeletal muscle denervation can inhibite acetylcholine receptor activity,which is relate to the denervation time.

Objective To investigate the incidence of postoperative intubation-related complications and the need for measurement and adjustment of cuff-pressure of endotracheal tube. Methods Five hundred and nine patients of either sex undergoing elective surgery under general anesthesia with tracheal intubation were divided into 2 groups: control group (group C)and cuff-pressure measured group (group CPM). Operation time and duration of endotracheal tube were recorded. Twenty patients with the duration of endotracheal tube 120-180 min in each group were selected. Their tracheal mucous membrane was examined by fiberoptic bronchoscopy at the time of withdrawal of endotracheal tube. Postoperative complications including cough and bloody sputum were also recorded at 24 h after extubation. Results The two groups were comparable with respect to age, sex, operation time and the duration of endotracheal tube. The incidence of sore throat and bloody sputum was significantly higher in group C than in CPM group. The incidence of sore throat and bloody sputum was significantly increased as the duration of endotracheal tube was prolonged in control group while in CPM group only the incidence of sore throat was increased. Varying degrees of injuries to tracheal mucous membrane were observed with fiberoptic bronchoscope.The injuries were more serious in group C than in CPM group. Conclusion Measurement of intracuff pressure is helpful for reducing the tracheal intubation-related complications.

Objective:To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach.Methods:A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data.Results:All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%).Conclusion:The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients

Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.