Advances in ophthalmic surgery,together with achieving greater patient safety,have changed the requirements,methods and choice of regional anaesthesia of the eyes.So far,there still lacks of an absolutely safe ophthalmic regional block method,and the intraoperative anesthesia method depends on the needs of the surgeon and the expectations and the cooperation of the patients.The majority of ophthalmic procedures can be performed under regional anesthesia,but the proximity of important structures,such as the blood vessels,optic nerve and the brainstem,leads to increased risks associated with these blocks.The most serious one of these complications is brainstem anesthesia.An clear and full understanding of these complications,which may sometimes be life-threatening,is thus vital to the anesthesia practitioner.Procedural improvements include a close evaluation of the precise anatomy of the region,with particular attention to injection sites,depth of injection,position of the eyeball,and techniques to avoid nerve damage and accidental injection into surrounding structures,including blood vessels,eyeball and cerebrospinal fluid.To emphasize the importance of the prevention,recognition and management of these complications,which includes the extremely serious complication of brainstem anesthesia.

Objective To assess the effective of helicobacter pylori in gallbladder malignant disease ,cholelithiasis ,cholecysti‐tis .Methods The literature about helicobacter pylori and gallbladder disease were collected in EMbase ,Pubmed ,VIP and CBM from inception to May ,2015 .Two reviewers independently screened the literature according to the inclusion and exclusion criteria , extracted the data ,and assessed the quality ,and then the meta‐analysis were performed by using Stata11 software .Results A total of 24 case control study were included .The results of meta‐analysis showed that ,helicobacter pylori had a higher incidence rate in gallbladder maliganant disease and cholelithiasis(OR=5 .31 ,95% CI:2 .34 -12 .05 ,P= 0 .000)and (OR=1 .84 ,95% CI:1 .13-2 .98 ,P=0 .014) compared with control group .Also it have influence on cholecystitis (OR= 9 .92 ,95% CI:4 .04 -24 .39 ,P=0 .000) .Conclusion Helicobacter pylori is a risk factor of inducing cholelithiasis and gallbladder malignancy disease ,cholecystitis .

Objective To study the growth inhibition of human hepatoma cells tranfected with type Ⅱ insulin like growth factor receptor (IGF ⅡR) antisense gene. Methods We constructed the recombinant eucaryotic expression plasmids of IGF ⅡR sense and antisense genes, which were transfected into SMMC 7721 human hepatoma cell line using calcium phosphate coprecipitation, and selected in DMEM supplemented with 500 ?g/ml G418(Geneticin) for 2～3 weeks. Then the total number of colonies formed was counted. The effect of IGF ⅡR antisense gene transfection on endogenous IGF ⅡR mRNA levels was examined by Northern blot, and the growth rate and the ability of the transfected cells to form colonies in soft agar medium were also examined. Results The hepatoma cells transfected with IGF ⅡR antisense gene exhibited significant reduction in endogenous IGF ⅡR messenger RNA(mRNA) levels and loss of their ability for anchorage independent growth in soft agar. The IGF ⅡR antisense gene supressed the formation of colonies of SMMC 7721 cells resistant to G418 without alteration on cell growth curve. Conclusion The IGF ⅡR antisense gene expression effectively blocks IGF Ⅱ to IGF ⅡR autocrine and/or paracrine signal transduction pathway and reverses certain aspects of the cell malignant phenotype.

Objective To explore the application of ultrasound-guided femoral and sciatic nerve blocks combined with general anesthesia in lower limb fracture surgery.Methods Sixty four patients who received orthopaedics surgerywere randomly divided into two groups including combined group(n =32),control group (n =32).Control group was given general anesthesia alone,combined group was givengeneral anesthesia combined with ultrasound-guided femoral and sciatic nerve blocks.The intraoperative hemodynamic state at different time,anesthetic dosage,and agitation after waking upbetween two groups were compared.Results Compared with T1 moment,HR and MAP at T2 moment in both groups were significantly decreased (P ＜ 0.05),while all these indicators at T3-T5 moment had no significant difference compared with the T1 moment in combined group (P ＞ 0.05),while the difference was significant in control group (P ＜ 0.05).Compared with control group,combined group had less intraoperative propofoland fentanyl dosage during the surgery,shorter awakening timeand extubation time,and the difference had statistical significance (P ＜ 0.05).The incidence of agitation after waking up and degree of agitation was significantly decreased in combined group than that in control group (P ＜ 0.05).Conclusion Ultrasound-guided nerve blockade combined with general anesthesia for lower limb fracture surgery,canmaintain the stability of intraoperative hemodynamics,reduce the dosage of analgesic drugs,and promote early awakening and extubation.

Objective To compare the predictive power of model for end-stage liver disease(MELD) and Child-Turcotte-Pugh(CTP) on the cirrhotic patients who underwent transjugular intrahepatic portosystemic shunt(TIPS).Methods A total of 110 patients(98 males and 12 females) undergoing TIPS from January 2004 to March 2008 in our hospital were analyzed.Data of all patients were analyzed retrospectively.The main statistical tests included: Kaplan-Merier analysis to compare survival respectively,and the area of receiver operating characteristics(ROC) to compare the performance of the 2 models for predicting 3-month,1-year,and 2-year mortality.Results The survival rate rate of the patients whose MELD score under 15 showed significantly higher than the patients above MELD score 15.The area of ROC that predicting survival was 0.866 and 0.863 at 3 months,0.755 and 0.739 at 1-year,0.729 and 0.750 at 2-years respectively for the MELD and the CTP score.Conclusion Both MELD and CTP score can predict short-term survival accuracy,but poor in long-term.However,the MELD has overcome the shortcomings of CTP,and may be worth using in clinical.

Objective To investigate the effect of IVIG on pre-existing anti-HLA-A2 Ab levels and graft skin survival.Methods C57BL/6 wild type mice were sensitized to HLA-A2 by intraperitoneal injec-tion (IP) of HLA-A2 TgN mouse spleen cells (C57BL/6-TgN [HLA-2.1]1Enge SC) expressing human HLA-A2 at day 0, week 3 and 4.Sensitized mice were respectively treated with human IVIG , albumin, gly-cine, or PBS for 5 days during week 7.Skin transplantation from TgN mice to C57BL/6 wild type mice was performed at week 10 .Efficacy of IVIG DES was assessed by measuring anti-HLA Ab levels by ELISA pre-/post-Rx and graft skin survival was monitored daily post-Tx.Results Changes of HLA-A2-IgG levels:IgG HLA-A2 class I Ab levels in all groups predictably increased from baseline following spleen cell IP and peaked at week 4 ( P <0.01 ) , indicating sensitization .IVIG-treated mice showed significantly lower IgG Ab levels vs.albumin, glycine and PBS-treated at week 9 post-desensitization ( P <0.01).IgG quickly increased to extremely high levels in all groups following skin transplantation ( P <0.01 ) .Graft skin sur-vival between Rx-groups were similar with all rejecting at about 7 days post-transplantation ( P >0.05 ) . Conclusion However, IVIG alone does not inhibit anti-HLA class I Ab production after skin transplanta-tion or prolong SG survival , indicating combination of IVIG with other immunosuppressant or more optimal protocol for desensitization might show more efficacy and should be under explored .

Objective primary hospitals at the county level in xiaogan City 17 years for the production of scientific papers in qualitative and quantitative statistical analysis,summary of research progress and existing problems in county hospitals,and provides references for research management in local hospitals.Methods Wanfang medicine network included in 1998-2014 year published Xiaogan city 7 county hospital as the object;All biomedical scientific papers published as the first author to statistical analysis.Results 7 County Hospital of xiaogan City 17-year total output articles 1909,General journals 1273articles(66.68％ per cent),Core journal 636 papers (33.31％ per cent).Hanchuan city people's Hospital total the largest number of papers;total 544 articles (28.50％ total),yingcheng hospital quality highest core journal papers and the highest proportion;total 186 (proportion of the total core thesis 29.25 ％),minimum quantity and quality of outputs anlu city people's Hospital,only 15 articles in periodicals of General The core journals and 2 papers (0.89％ of the total number of accounts for the paper,core paper accounted for 0.31％ of the total).On the whole 2006-2009 published papers began to gradually slow growth,The number 2010-2014 entered the stage of rapid growth,but the core papers for slow growth.Conclusions xiaogan city grass-roots scientific articles in recent years in county hospitals are generally presented a trend of rapid growth,but the quality of growth is relatively slow,output quantity and quality distribution imbalances between hospitals.

Objective To explore the feaibility of laparoscopic hepatectomy(LH) for hepatolithiasis.Methods Eight patients with hepatolithiasis were treated by laparoscopic cholecystectomy(LC) and common bile duct exploration(LCBDE) and LH.Laparoscopic resection of left lateral lobe of liver was performed in 7 cases,and left hemihepatectomy in 1 case.Results Procedures were all successful with operation time of(285.00?37.42) minutes,and bleeding volume(306.25?29.73)mL.The postoperative hospital stay was(7.88?1.36) days.No complications occurred.No residual stone was found in any patient.Conclusions LH was safe and effective for hepatolithiasis,and gives better results when combined with choledoscopic stone removal.

Objective To examine the effects of different doses of midazelam on ED50 of emulsified isoflurane and to determine the type of interaction between them for hypnosis by isobelographic analysis in rats. Methods One hundred and twenty-five adult male SD rats weighing 240-300 g were randomized into 5 groups (n=25 each): group Ⅰmidazolam (M); group Ⅱ emulsified isnflurane (Ⅰ); group Ⅲ ,Ⅳ ,Ⅴ, 1/4, 1/2 and 3/4 ED50 of midazelam for hypnosis + emulsified isoflurane (MI1 , MI2, MI3). Up-and-down sequential experiment was used to determine ED50of midazolam and emulsified isoflurane for loss of righting reflex in group Ⅰ -Ⅴ . The intial dose of midazolm was 17.3 mg/kg in group M. The initial doses of emulsified isoflurane (120 mg/ml) were 0.55 (in group Ⅰ, 0.22 (MI1), 0.19 (MI2) and 0.12 ml/kg (MI3) respectively. In group MI1-3 midazolam was injected over 15 seconds and after an interval of 2.5 min emulsified isoflurane was injected over 10 s. ED50 was calculated using Dixon-Mood method. Isebolographic and algebraic analyses were used to determine the type of interaction between midazolam and emulsified isoflurane. Results The five groups were comparable with respect to M/F sex ratio and body weight. The Edso of midazolam was 26.0 mg/kg in group M. Midazolam 6.5, 13.0 and 19.5 mg/kg were given in group MI1 , MI2 and MI3 respectively. The ED50 of emulsified isoflurane was 0.67 (ingroup Ⅰ), 0.30 (MI1), 0.22 (MI2) and 0.18 ml/kg (MI3) respectively. The isobolographic analysis indicated that with increasing doses of midazolam, the Edw of emulsified isoflurane decreased progressively in a non-linear fashion. The isobolographic and algebraic analyses demonstrated that the interaction between midazolam and emulsified isoflurane was synergistic for hypnosis. Conclusion The hypnosis is synergistic when midazolam 6.5,13 mg/kg are combined with emulsified isoflurane and additive when midazolam 19.5 mg/kg is combined with emulsified isoflurane.

AIM: To explore the effect of HBV transfection on apoptosis induced by TWEAK and the regulatory effect of IFN-γ on the apoptosis process.METHODS: BEL-7402-pCDNA3/1.1HBV hepatoma cell line was used as cell model in this experiment, in which BEL-7402 was stably transfected with pCDNA3/1.1HBV and its corresponding empty vector BEL-7402-pCDNA3 was used as control. The effect of HBV transfection on TNF-like weak inducer of apoptosis(TWEAK) induced hepatoma cell apoptosis was determined by CCK-8. The apoptosis before and after HBV transfection induced by TWEAK and the effect of IFN-γ on apoptosis induced by TWEAK in HBV transfected hepatoma cells were detected by TUNEL and caspase 3 activity detection kit.RESULTS: BEL-7402-pCDNA3/1.1HBV and BEL-7402-pCDNA3 hepatoma cell line were successfully established and identified. Cell viability of hepatoma cells was increased after HBV transfection. The apoptosis rate was much higher after HBV transfection compared to the empty vector control and empty cell control. The apoptosis rate induced by TWEAK was much higher in BEL-7402-pCDNA3/1.1HBV cells when exposed to IFN-γ.CONCLUSION: After HBV infection, TWEAK might be involved in the clearance of HBV infected hepatocyte by apoptosis and inflammatory factor such as IFN-γ.