Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group (local anesthesia combined with physiological saline) and observation group (using local anesthesia drugs with dexmedetomidine).The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups (P<0.05).The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group (P<0.05).The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group (P<0.05) sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group (P<0.05).There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.

Objective To obtain effective siRNA fragment of HOXA10 gene and verify its function,to supply experimental evidence for tumor prevention and curation by RNAi targeting to HOXA10 gene.Methods Three pairs of small interfering RNA targeting to the different sites of HOXA10 were designed and introduced into A549.The mRNA expression of HOXA10 of A549 was detected by semi-quantitative RT-PCR,the cell proliferation was assayed by MTT,the apoptosis was measured by flow cytometry.The most effective siRNA assay was screened and was tested the relationship between it and proliferation and apoptosis.Results The mRNA of HOXA10 was inhibited by three siRNAs in A549 cells,among which siRNA1 gave the strongest inhibiting of HOXA10 by ODR was (20.190±1.698) ％.The inhibitory rate of cell proliferation was (69.793±2.092) ％ and the apoptosis rate was (29.593±2.670) ％.Conclusion siRNA1 can specifically degrade HOXA10 mRNA and inhibit the proliferation of A549 cell and promote its apoptosis.

Objective To explore the impact of nucleos(t)ide analogue antiviral therapy on anxiety and depression of patients with chronic hepatitis B (CHB),and analyze the related factors.Methods Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,120 CHB patients were investigated with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The demography data of patients were collected.Serum levels of alanine transaminase (ALT) and hepatitis B virus (HBV) DNA and other biochemical indicators were measured regularly.Results Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,both the mean scores of SAS and SDS became lower gradually (F=12.661 and 22.395,respectively;both P＜0.01).The percentage of patients with SAS and SDS scores more than 50 were 5.8％,4.2％,1.7％ and 13.3％,7.5％,5.0％,respectively.After 2 years of therapy,the anxiety improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 69.0％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =22.325,P＜0.01).Meanwhile,after 2 years of therapy,the depression improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 77.4％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =32.179,P＜0.01).Multiple factors Logistic regression analysis indicated that the odds ratios (OR) of improvement of anxiety and depression in patients with HBV DNA＜1000 copy/mL were 7.751 (95％ CI:3.026-19.853) and 15.069(95％ CI:5.309-42.770),respectively,compared with those with HBV DNA≥1000 copy/mL; and OR of improvement of depression in patients with ALT≤40 U/L waa 4.103 (95％ CI: 1.376 - 12.238).Conclusions Nucleos(t) ide analogue antiviral therapy could improve the anxiety and depression of CHB patients.The HBV DNA negativity is the independent impact factor of improvement of anxiety and depression in CHB the patients.

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

Objective To explore the effect of neonatal exposure to different doses of Bisphenol A (BPA)on the hypothalamic -pituitary -testis axis in toddler and adolescent male rats.Methods Neonatal male Sprague -Daw-ley rats were randomly divided into 5 groups through random digital table method:control group,vehicle group,low -dose BPA [25 μg/(kg · d)]group,medium -dose BPA [50 μg/(kg · d)]group and high -dose BPA [250μg/(kg·d)]group.The rats were subcutaneously injected with respective agents on postnatal days 1 -7 (PND 1 -7).Pups were sacrificed on PND 22 and PND 50.The hypothalamus and testis were taken and weighed.The hypotha-lamic Kiss -1 mRNA and the testis androgen receptor (AR)mRNA were tested by using real -time fluorescence quan-titative and the levels of serum luteinizing hormone (LH),follicle stimulating hormone (FSH),testosterone (T)were tested by using radio immunity method,and inhibin B was measured by using enzyme linked immunosorbent assay. Results Compared with the controls,the level of serum FSH [(1 .610 0 ±0.693 2)IU /L,(1 .574 3 ±0.675 0)IU /L vs (2.362 9 ±0.580 3)IU /L](F =3.314,P =0.026),LH [(3.876 3 ±0.908 0)IU /L,(3.603 8 ±1 .350 2)IU /L vs (5.302 5 ±0.768 4)IU /L](F =3.1 39,P =0.027)and T [(0.383 8 ±0.1 77 8)μg/L,(0.442 5 ±0.21 4 1 )μg/L vs (0.782 5 ±0.282 1 )μg/L](F =5.1 06,P <0.01 )of medium and high -dose BPA groups,were decreased in PND 22,and the organ coefficient of testis [(0.952 90 ±0.049 1 5)%,(0.969 20 ±0.045 82)% vs (1 .022 80 ± 0.01 1 08)%](F =1 0.326,P <0.01 )and serum T [(1 .758 6 ±0.369 6)μg/L,(1 .71 8 8 ±0.395 7)μg/L vs (3.357 5 ±0.749 8)μg/L](F =1 3.799,P =0.01 2)were significantly decreased in PND 50.In high -dose BPA group of PND 22,the expression of hypothalamic Kiss -1 mRNA (0.068 80 ±0.01 1 79)was increased compared with the other groups (F =272.1 25,P <0.01 ),while in PND 50,compared with control group,the Kiss -1 mRNA (0.002 00 ±0.000 25,0.001 90 ±0.000 48 vs 0.001 40 ±0.000 1 7)of medium -and high -dose BPA groups was decreased(F =1 91 .826,P <0.01 ).Conclusions Neonatal exposure to the medium and high -dose BPA may impair the function of testis in toddler and adolescent male rats,and affect the hypothalamus -pituitary -testis axis.Neonatal exposure to the low -dose BPA does not have a significant influence on the hypothalamus -pituitary -testis axis.

Objective To explore the composition principles of prescriptions for simple obesity based on the analysis of medical literature issued in recently 30 years about Chinese medicine for simple obesity. Methods We collected literature of Chinese medicine in treating simple obesity from VIP, CNKI, Wanfang, CBM and CMCC/CMCI databases, and screened out the formulas for simple obesity to establish a formula database. And then the medication rules were figured out with the Traditional Chinese medicine Inheritance Support System version 2.5 (TCMISS 2.5) software. Results A total of 57 formulas were screened out. And the top 10 herbs with highest occurrence frequency in the prescriptions were Poria, Rhizoma Atractylodis Macrocephalae, Rhizoma Alismatis, Radix et Rhizoma Rhei, Fructus Crataegi, Radix Astragali, Radix Glycyrrhizae, Folium Nelumbinis, Pericarpium Citri Reticulatae and Semen Cassiae. After data mining, we got 13 high-frequency herb-pair combinations and 31 core combinations, and 8 new prescriptions were extracted. Conclusion The research has achieved the quantitative description of the relationship between the Chinese medicines, the extraction of the core combinations and the discovery of new Chinese medicine prescriptions for simple obesity. The results will provide references for the development of new Chinese medicines for the treatment of simple obesity .

Objective:The present study was aimed to evaluate the nutritional risk using nutritional risk screening 2002 (NRS2002) score and to investigate the impact of nutrition support on clinical outcome in hospitalized patients.Methods:Six hundred and ninety four hospitalized patients were recruited.NRS 2002 was applied to evaluate the nutritional risk of patients.Meanwhile,the effect of nutrition support on complication rate was evaluated between different types of patients.Results:14.0％ of patients had malnutrition and the incidence of nutritional risk was 27.5％.Patients with nutritional risk had a higher complication rate (P ＜0.01).Totally,22.0％ (153/694) patients received nutrition support,including 81.7％ patients with nutritional risk and 18.3％ patients without nutritional risk.Patients with nutritional risk benefited from nutrition support,as shown by lower complication rate and shorter length of hospital stay.In patients with nutritional risk,complication rate was lower in enteral fed patients compared to parenteral fed patients.Conclusion:With nutritional risk screening,patients' nutritional status can be evaluated and appropriate nutrition support can be performed.Compared to those without nutritional risk,patients with nutritional risk will benefit more from nutrition support,as indicated by lower complication rate and reduced length of hospital stay.

Objective To explore the influence factors on hepatitis B virus (HBV) relapse after nucleos(t)ide analogues (NA) withdrawal in the chronic hepatitis B (CHB) patients who met NA cessation criteria. Methods Eighty-one consecutive CHB patients were treated with NA, 38 with lamivudine (LAM), 25 with adefovir dipivoxil (ADV), 12 with entecavir (ETV), 6 with LAM +ADV. Among recruited patients, 40 were hepatitis B virus e antigen (HBeAg) positive, 41 were HBeAg negative, 67 of them were initial treatment, 14 were retreatment due to resistance to NA at baseline. The treatment was discontinued after meeting China therapeutic end-point criteria. HBV DNA, HBV serological markers, alanine aminotransferase (ALT) were measured respectively at baseline, every month before virological response, every 3 months after virological response, every month within first 6 months and every 2 months over 6 months after drugs withdrawal. Twelve probable influence factors on relapse which were sex, age, HBV family history, baseline HBV DNA,baseline HBeAg status, baseline ALT, virological response time, total duration of treatment, duration of additional treatment, the level of hepatitis B virus surface antigen (HBsAg) at cessation therapy,initial treatment or retreatment, drug category were analyzed with univariate, multivariate Cox regression modle and stratified analysis. The cumulative relapse was calculated by the Kaplan-Meier method. Results A total of 36 patients (44. 4%) relapsed within 1 year. Initial treatment or retreatment, HBV family history, virological response time, the level of HBsAg at cessation therapy were independent risk factors. The relapse rate of retreatment was higher than that of initial treatment (78.6% vs 37. 3% , χ2 = 7. 983, P = 0. 005) , those of patients with HBV family history higher than without family history (64. 5% vs 15.0%, χ2 =12. 096,P = 0.002), those of patients obtained virological response within 3 months lower than after 3 months(34. 0% vs 64. 3% , χ2 =6. 823,P=0. 009) , those of patients with HBsAg≤150 μg/L at cessation therapy lower than >150 μg/L(27. 6% vs 53. 8%, χ2=5. 199,P=0. 023). Conclusions Retreatment, HBV family history, later virological response and higher HBsAg level at cessation therapy are risk factors of relapse after NA withdrawal. Such patients should be treated with prolonged duration after meeting end-point criteria to strengthen the efficacy.

Objective To evaluate the efficacy and drug resistance profiles of nucleosides (NA) retreatment in NA experienced chronic hepatitis B (CHB) patients. Methods Totally 104 NA experienced CHB subjects were enrolled in this study.All these subjects had received at least 3 months NA monotherapy and stopped the treatment,and then received NA retreatment for at least one year.The subjects were divided into three groups according to the following criteria:reached the therapy endpoint of China guideline when they stopped NA-naive treatment (group A,n =39); did not reach the therapy endpoint when they stopped NA-naive treatment but hepatitis B virus (HBV) DNA＜1.0× 103 copy/mL (group B,n=33); and with HBV DNA＞1.0× 103 copy/mL (group C,n=32).The efficacy and drug resistance profiles of retreatment were compared among three groups. The effects of baseline alanine aminotransferase (ALT) levels,HBV DNA levels and HBeAg titers on the retreatment efficacies were analyzed. The mutations of HBV P gene were detected by nested polymerase chain reaction (PCR) and direct sequencing.The data were analyzd by Wilcoxon test and x2 test.Results The time to ALT normalization in patients with baseline ALT＜ 1.3 × upper limit normal (ULN) was shorter than that in patients with ALT≥1.3×ULN (2 months vs 4 months; Z=2.281,P=0.023).The time to virological response in patients with baseline HBV DNA＜5 lg copy/mL was shorter than that in patients with HBV DNA≥5 lg copy/mL (1 month vs 2 months; Z=2.054,P =0.040). The time to virological response and ALT normalization in baseline HBeAg negative were both shorter than those in patients with baseline HBeAg positive patents ( 1 month vs 3 months and 2 months vs 4.5 months,respectively; Z=2.580 and 2.304,respectively; both P＜0.05). The subjects in group A achieved virological response and HBeAg seroconversion after retreatment earlier compared to previous NA-naive therapy ([1.61 ± 1.76] months vs [3.48±4.066]months and [3.38 ± 3.34] months vs [9.92-11.22] months,respectively; Z=-2.854 and-1.094,respectively; both P＜0.05).The cumulative HBeAg seroconversion rate in group A was higher compared to those in group B and group C (80.0％ vs 36.8％ and 37.5％,respectively; x2 =4.368 and 5.100,respectively; both P＜0.05).Thirteen patients developed clinical resistance and four of them developed genotypic resistance proved by PCR direct sequencing.Among the patients retreated with the same regimen as previous in the C group,the cumulative resistance rate was highest compared to group A and B (44％ vs 9％ and 0,respectively; x2 =5.019 and 6.588,respectively;both P＜0.05).No resistance was detected in the 14 patients retreated with combined NA treatment without cross resistance.Conclusions For NA experienced CHB patients who fulfill the indication of antiviral therapy,the retreatment should be started as earlier as possible. Retreatment with NA combination without cross resistance can prevent (reduce) the risk of developing drug resistance.

Objective To investigate the treatment results for different regions of posterior cruciate ligament ganglion cyst by surgery.Methods From January 2011 to September 2016,17 patients with posterior cruciate ligament ganglion cysts of the knee were involved in this study.5 cases were located on the femoral side of the ligament (upper 1/3),8 cases were in the middle,and 4 cases were located in the tibia side (lower 1/3),15 cases were operated and 2 were not.A total of 13 cases in the upper 2/3 of the ligament were resected by the anterior two approaches through arthroscopy.two of which were resected by the posterior capsule.2 cases of the tibial lateral cysts were resected by posterior approach.Lysholm scoring system was used to evaluate the knee function before and after operation,and Glasgow curative effect system was used to evaluate the final follow-up results.Results A follow-up 6-24 months in an average of (12.6 ± 3.2) months shows no sign of recurrence at the last follow-up,all patients had no complications such as infection,ligament relaxation,et al.Lysholm score was improved from 57.5 ± 5.2 preoperatively to 92.5 ± 3.6 postoperatively,and the statistical difference is very significant (P ＜ 0.05).And curative effect was evaluated well by Glasgow system.Conclusions Arthroscopic surgery is an effective measure in the treatment of postior cruciate ligament (PCL) ganglion cysts.The upper part of the ligament can be resolved through the anterior approach,and the lower part should be followed by the posterior approach,and if necessary,open the way to handle the external part of the joint.