Objective To compare the efficacy of tramadol for patient-controlled intravenous versus provicial epidural analgesia (PCIA vs PCEA) and their effects on the T-lymphocyte subsets and natural killer (NK) cells during postoperative period in patients undergoing gynecological operation for tumor. Methods Thirty-nine ASA Ⅰ-Ⅱ patients aged 18-83 yr undergoing elective surgery for ovarian cancer or uterine cancer or myoma were randomly divided into two groups : PCIA group (n = 21) and PCEA group ( n = 18). Premedication consisted of intramuscular atropine 0.5 mg and phenobarbital 0.1 g. Operation was performed under epidural anesthesia. Epidural catheter was inserted at T12 -L1 approximately 3-4 cm into epidural space cephalad. The patients received a test dose of 2% lidocaine 5 ml. The first dose was 2% lidocaine 10-12 ml followed by 0.5% bupivacaine 5 ml every 45-60 min. Tramadol 100 mg was given iv in PCIA group or epidurally in PCEA group 15 min before the end of surgery. 100 ml of PCIA solution contained tramadol 800 mg (16 ml), haloperidol 5 mg (1 ml) and normal saline 83 ml and 100 ml of PCEA solution contained tramadol 400 mg (8 ml), haloperidol 5 mg (1 ml) and NS 91 ml. The PCA pump was set to deliver a background infusion at 2 ml?h-1 and a bolus dose 0.5 ml with lock-out interval of 15 min. Analgesia was assessed using VAS. Venous blood samples were taken for determination of T-lymphocyte subset (CD3+ , CD4+ , CD8+) and NK cell counts by flow cytometry the day before surgery and on 1st and 2nd postoperative day. Results The postoperative analgesia was satisfactory in both groups, and there was no significant difference in VAS scores between the two groups. No vomiting and respiratory depression were observed in both groups. The NK cell counts decreased significantly on the 1 st and 2nd postoperative day as compared with the preoperative value (P

Objective: To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors, so as to provide evidences for reducing stress and relieving job burnout. Methods: The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to June 2019, to understand the existence of stress and job burnout in surgical residents, and analyze the linear correlation between each dimension of stressors and each dimension of burnout. There were 132 males and 13 females, who were (26.62±1.45) years old, ranged from 22 to 30 years. SPSS19.0 software was used for statistical analysis. The measurement data of normal distribution were expressed as Mean±SD Counting data were expressed by frequency and constituent ratio. Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout. Results: The total score of surgical resident stress was 2.51±0.57. The scores of social factors and workload were higher in each dimension 3.02±0.58 and 3.00±0.62, respectively. The burnout survey showed that 7 residents (4.8%) had severe burnout. In the dimension of emotional exhaustion, there were 14 residents with severe burnout. In the dimension of cynicism, there were 21 residents (14.5%) had severe burnout. In the dimension of reduced personal accomplishment, there were 19 residents (13.1%) of mild burnout and 17 residents (11.7%) of severe burnout. Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated. In particular, emotional exhaustion and workload (r=0.411, P<0.05), reduced personal accomplishment and social factors (r=0.429, P<0.05) had a relatively large correlation coefficient. Conclusions The stress and burnout of surgical residents were at a high level. In order to reduce the stress and relieve the burnout, it is necessary to strengthen the residents′ self-management and improve the social support system.

Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.