Objective To observe the feasibility of combining dezocine with fentanyl in the application of single integral high in‐tensity focused ultrasound(HIFU)ablation of uterine fibroids .Methods One hundred and sixty patients with uterine fibroids trea‐ted by HIFU under conscious sedation were randomly divided into 2 groups(n=80):group A with treatment combined fentanyl and midazolam and group B treated with combined dezocine ,fentanyl and midazolam .Analgesic effect was evaluated with visual analog scale (VAS) .Variation of patients′vital signs (blood pressure ,heart rate ,electrocardiogram ,oxygen saturation) ,pain scores ,com‐fort scores ,sedation scores ,analgesic consumption and side effects were recorded before treatment (T0 ) ,during drug delivery (T1 ) , at the beginning of the treatment(T2 ) ,30 minutes after drug delivery (T3 ) ,at the end of the treatment(T4 ) ,2 hours after treatment (T5 ) ,4 hours after treatment (T6 ) ,8 hours after treatment (T7 )and 24 hours after treatment(T8 ) .Results Both groups showed reliable analgesic effects and vital signs of each time point were stable .VAS scores and Ramsay scores of group A were higher than those of group B ,but there was no statistical difference (P>0 .05) .Three patients in group A showed dysuria and relieved after symptomatic treatment .No respiratory depression occurred in both groups .But compared to group A ,the incidence of the analgesic side effects of group B was significantly lower and patients satisfaction was significantly higher(P<0 .05) .Conclusion The analge‐sic effects of dezocine combined with fentanyl are reliable in HIFU ablation of uterine fibroids with fewer side effects ,and could be worthy to be promoted in clinical use .

Object To extract and purify a novel fibrinolytic enzyme from Perinereis aibuhitensis Grube Methods The enzyme was precipitated from the extract by ammonium sulfate, dialyzed, chromatographed on Sephadex G 100 column, and then purified by polyacrylamide gel electrophoresis Its fibrinolytic activity was assessed with fibrin plate method Results The purified enzyme showed an isoelectric point (PI) around 4 5 as tested by gel isoelectric focusing It consisted of two polypeptide chains with molecular weights around 33 000 u and 14 400 u, respectively Conclusion This was a novel fibrinolytic enzyme discovered from P aibuhitensis for the first time

Aim To explore the protective roles of lic-ochalcone A ( LA) on mice with cigarette smoke-medi-ated acute lung injury and the related mechanisms. Methods In vivo: Mice were exposed to cigarette smoke ( CS) to establish acute lung injury model. The bronchoalveolar lavage fluid ( BALF ) was conducted for cell counting. The mRNA and protein expression of keratinocyte-derived chemokine ( KC ) , tumor necrosis factor alpha ( TNF-α) , interleukin 1β ( IL-1β) and matrix metalloproteinases ( MMP)-9 in lungs were de-termined. The myeloperoxidase ( MPO ) , superoxide dismutase ( SOD ) activities and glutathione ( GSH ) levels in lungs were quantified. The paraffin sections of lungs were prepared and stained with HE. In vitro:Human lung epithelial cells (BEAS-2B) were exposed to cigarette smoke extract ( CSE ) , which induced cell injury. The releases of interleukin 8 (IL-8) and MMP-9 were assessed. The phosphorylation of mitogen-acti-vated protein kinases ( MAPKs, including ERK1/2, p38 and JNK ) and nuclear factor-κB ( NF-κB ) p65 protein were analyzed by Western blot. Results In vi-vo: The accumulation of inflammatory cells was lower in LA groups than that in model group. In comparison with normal control group, the mRNA and protein lev-els of KC, TNF-α, IL-1βand MMP-9 were significant-ly increased in model group. Following treatment with LA, the above indicators were significantly decreased as compared to model group. In the CS-exposed mice, the MPO activity in lungs was significantly increased, meanwhile the SOD activity and GSH level were signif-icantly decreased compared with the air-exposed ani-mals. CS-induced activity of MPO was significantly in-hibited, which were accompanied by increases in SOD and GSH levels by LA. In vitro: CSE-induced mRNA levels of IL-8 and MMP-9 were significantly inhibited by LA at 2 . 5 and 5 μmol · L-1 . The CSE-induced phosphorylation of ERK1/2 and nucleus NF-κB p65 protein expression were prevented by pretreatment with LA. Conclusions LA has protective effects on CS-ex-posed acute lung injury in mice by preventing CS-in-duced pulmonary inflammation, oxidative stress and protease rise. The exploration of the mechanisms sug-gests that LA exerts protective effects via suppressing ERK1/2/NF-κB pathways.

The professional identity and the influencing factors were surveyed among 110 resident physicians of general practice standardized training program in the First Affiliated Hospital of Xi'an Medical College with a self-designed questionnaire,and 100 valid questionnaires were received.The average score of professional identity was (66.10 ± 13.644),and the six dimensions ranked from high to low:professional behavior,professional efficacy,professional cognition,professional emotion,professional value and professional commitment.There were significant differences in the scores of professional identity among general practitioners with different monthly income(F=2.947,P=0.037).The survey indicates that the professional identity of the resident physicians of general practice standardized training program is generally low and the income is an important influencing factor.

Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P＜0.05).The 3-year cumulative survival rate of high sNGAL group(77.2％) was significantly lower than that of low sNGAL group(96.5％),and the 3-year incidence of cardiovascular events (37.9％) was significantly higher than that of low sNGAL group (9.8％) (P＜ 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P＜0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P＜ 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P＜0.05),((HR=1.976 and 1.588,95％ CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.

Objective:To investigate the association of serum magnesium with cardiovascular disease (CVD) and all-cause mortality in peritoneal dialysis patients.Methods:A retrospective study was performed in patients who initiated peritoneal dialysis from January 1, 2013 to July 31, 2019 in the Shaoxing People's Hospital. According to the standard of serum magnesium, the patients were divided into control group (Mg≥0.7 mmol/L) and low-magnesium group (Mg<0.7 mmol/L). The differences in baseline biochemical variables, comorbidities, medications, and clinical outcomes between the two groups were compared. Logistic regression was used to analyze the related factors of hypomagnesemia. Kaplan-Meier survival analysis and Fine-Gray model were used to compare the difference in cumulative survival rate between the two groups. Cox regression model and competitive risk model were used to analyze the risk factors of all-cause mortality and CVD mortality.Results:A total of 381 peritoneal dialysis patients were enrolled in this study. Among them, 321 patients were in control group and 60 patients in low-magnesium group. The total median follow-up time was 27(15, 43) months. There were significant differences in serum albumin, magnesium, phosphorus, intact parathyroid hormone, low-density lipoprotein chloesterol, high sensitivity C-reactive protein and 4-hour dialysate-to-plasma creatinine (4 h D/Pcr) between the two groups. CVD was the main cause of death in patients on peritoneal dialysis. Multivariate logistic regression analysis showed that hypoalbuminemia ( OR=0.901, 95% CI 0.831-0.976, P=0.011), hypophosphatemia ( OR=0.217, 95% CI 0.080-0.591, P=0.003), higher hsCRP ( OR=1.276, 95% CI 1.066-1.528, P=0.008), and higher 4 h D/Pcr ( OR=1.395, 95% CI 1.014-1.919, P=0.041) were independent risk factors for patients with hypomagnesemia. Kaplan-Meier survival curve analysis showed the cumulative survival rate of patients in low-magnesium group was significantly lower than that of control group (Log-rank χ2=5.388, P=0.020). Fine-Gray model analysis showed the cumulative CVD survival rate of low-magnesium group was significantly lower than that of control group ( Gray=6.915, P=0.009). Multivariate-corrected Cox regression model and competitive risk model analysis showed that higher serum magnesium level was a protective factor for all-cause mortality and CVD mortality when serum magnesium was used as a continuous variable ( HR=0.137, 95% CI 0.020-0.946, P=0.044; SHR=0.037, 95% CI 0.002-0.636, P=0.023, respectively). Hypomagnesemia was an independent risk factor for all-cause mortality and CVD mortality when serum magnesium was used as categorical variable ( HR=1.864, 95% CI 1.044-3.328, P=0.035; SHR=2.117, 95% CI 1.147-3.679, P=0.029, respectively). Conclusions:Hypomagnesemia is susceptible to peritoneal dialysis patients with hypoalbuminemia, hypophosphatemia, higher hsCRP and higher peritoneal transport characteristics. Hypomagnesemia is an independent risk factor for CVD mortality and all-cause mortality in peritoneal dialysis patients.