Objective To explore the level of autophagy induced by oxygen glucose deprivation/reperfusion(OGD/R) injury in L02 cell.Methods L02 cells were cultured to establish the model of OGD/R injury and simulate clinical hepatic ischemia-reperfusion injury.The L02 cells were randomly divided into 5 groups : normal control group, oxygen-glucose deprivation 6 h/reperfusion 1,3,6,12 h group (OGD 6 h/R 1,3,6,12 h).Then observe the form changes of the L02 cells by optical microscope.The appreciation of the company's relative L02 cells was detected by MTT.The expression of autophagy related proteins such as Beclin-1, LC3 and p62 were evaluated by Western blot.Results Compared with the normal control group, the form damaged and the cells proliferation activity of L02 cells in the OGD/R group were gradually increased in a time-dependent manner.Compared with the normal control group, autophagy related proteins LC3 , Beclin-1 were increased at OGD 6 h/R 1 h.The expression of LC3 was gradually increased as the time went on and was increased gradually at OGD 6 h/R 6 h, reached a peak at OGD 6 h/R 12 h(P<0.01).The expression of Beclin-1 was gradually increased as the time went on and was increased gradually at OGD 6 h/R 6 h and OGD 6 h/R 12 h (P<0.01).The expression of p62 had no obvious change at OGD 6 h/R 1 h and OGD 6 h/R 3 h, began to increase sharply at OGD 6 h/R 6 h and reached a peak at OGD 6 h/R 12 h(P<0.01).Conclusion Our data suggests that oxygen-glucose deprivation/reperfusion may increase the level of autophagy and lead to autophagic cell death in L02 cell.

Objective To assess the clinical application value of single-source dual energy CT(SSDE),by measuring the multi-slice CT(MSCT) and single-source dual energy CT(SSDE) lower limb fractures image noise and contrast noise ratio(CNR),comparing the difference in the radiation dosage.Methods 39 cases of lower extremity fractures by clinical diagnosis were included in the study.Preoperation or postoperation the patients underwent MSCT scans,postoperation or postoperative follow-up SSDE CT scans were conducted,two sets of images were achieved.We measured and compared conventional CT group with 130 key energy spectrum group (prior studies showed the elimination of metal artifacts,images,subjective scoring the highest photon energy level) no significant artifacts cancellous bone area,compared the image background noise and contrast noise ratio (CNR),and radiation dosage,using paired sample t-test.Results Two sets of data for the same patient before and after surgery or after review of images,which body mass index (BMI) was negligible.The CTDIvol value of the conventional MSCT was (7.94 ± 1.69) mGy,the dual-energy CT was (7.04 ± 0.97) mGy,with significant difference (t =2.71,P ＜ 0.05) ; The image noise of the conventional MSCT was (44.36 ± 15.66) Hu,the dual-energy CT was (15.04 ± 8.23) Hu,with significant difference (t =15.26,P ＜ 0.05) ; The CNR of the conventional MSCT was (3.96 ± 1.78),the dual-energy CT was (4.62 ± 2.80),with significant difference (t =-2.14,P ＜ 0.05).Conclusion Compared with conventional MSCT,single source dual-energy CT imaging provides improved image CNR,obviously eliminate metal artifacts,to better show the complex structure for lower limb fracture surgery,and reduction in radiation dosage.

Objective To evaluate the effect of propofol on autophagy during oxygen-glucose deprivation and restoration (OGD/R) in human liver cells.Methods Human hepatic HL-7702 cells at the logarithmic growth phase were seeded into culture plates and randomly divided into 3 groups (n =12 each) using a random number table:control group (group C),OGD/R group,and propofol + OGD/R group (group P+OGD/R).The cells were cultured in normal culture medium in group C.In OGD/R and P+OGD/R groups,the cells were subjected to O2-glucose deprivation for 6 h followed by restoration of O2-glucose supply for 12 h.Propofol with a final concentration of 50 mmol/L was added at 10 min before oxygen-glucose deprivation.The cell viability was detected by MTT assay.The expression of autophagy-related proteins such as microtubule-associated protein light chain 3 (LC3) and Beclin-1 was evaluated by Western blot.Immunofluorescence was used to determine the number and distribution of autophagosomes.Results Compared with group C,the cell viability was significantly decreased,the expression of LC3 and Beclin-1 was significantly up-regulated (P＜0.05),and the number of autophagosomes was significantly increased in OGD/R and P+OGD/R groups.Compared with group OGD/R,the cell viability was significantly increased,the expression of LC3 and Beclin-1 was significantly down-regulated (P＜0.05),and the number of autophagosomes was significantly decreased in group P+OGD/R.Conclusion The mechanism by which propofol reduces OGD/R injury is probably related to inhibition of autophagy in human liver cells.

Objective:To explore the effect of different nasal packing methods on the comfort of patients after operation.Methods:From January to August 2020, 216 patients with chronic sinusitis who were admitted to the Otolaryngology Head and Neck Surgery of Beijing Tongren Hospital by convenience sampling were selected as the research object. All patients underwent functional endoscopic sinus surgery under general anesthesia. According to the different nasal packing materials, the patients were divided into the nasopore packing group (132 cases) and the silicone drainage tube packing group (84 cases) . The patients were investigated with the Visual Analogue Scale (VAS) one day before operation and four hours after operation.Results:After functional endoscopic sinus surgery, the score of facial pain in the silicone drainage tube packing group was higher than that in the nasopore packing group, and the score for nasal congestion was lower than that in the nasopore packing group, with statistically significant differences ( P<0.05) . There were no significant differences in postoperative runny nose, hyposmia, headache, ear stuffiness and overall discomfort scores between the two groups ( P>0.05) . Conclusions:Attention should be paid to postoperative headache, hyposmia, and general discomfort in chronic sinusitis patients undergoing functional endoscopic sinus surgery and nasal packing. The head and face pain in patients with postoperative nasal packing with silicone drainage tube should be paid attention to, and the drainage tube should be kept unobstructed. Patients with nasopore packing should be focused on postoperative nasal congestion symptoms.

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Objective:To investigate the effect of tranexamic acid on perioperative hemorrhage of cranioplasty for craniosynostosis.Methods:A retrospective analysis was performed on the clinical data of children who received cranial remodeling from the Children’s Hospital of Fudan University from February 2015 to October 2018. The patients were divided into two groups: tranexamic acid treatment group (TXA group) and no tranexamic acid treatment group (control group). The average intraoperative blood loss, the average amount of blood transfusion, postoperative average amount of blood transfusion, average drainage volume, and changes of postoperative hemoglobin and blood coagulation function were observed. The measurement data were described by M ( Q1, Q3) and analyzed with Mann-Whitney U test. Results:A total of 41 patients were included in this study. There were 26 patients in TXA group, 18 males and 8 females, aged 9.5 (7.0, 38.8) months; in the control group, there were 15 patients, 10 males and 5 females, aged 9.2 (6.6, 18.3) months. The results showed that there was no significant difference in preoperative hemoglobin level between the two groups ( P>0.05). The hemoglobin level of TXA group was higher than that of control group immediately after operation and 24 h and 72 h after operation ( P<0.05). Total intraoperative blood loss and blood loss per kilogram of body weight in TXA group were lower than those in control group [150.0 (57.5, 225.0) ml vs. 200.0(80.0, 300.0) ml, P<0.05; 13.6(6.8, 18.5) ml/kg vs. 15.8(7.0, 27.0) ml/kg, P<0.01]. The amount of intraoperative transfusion volume per kilogram of body weight in TXA group was less than that in control group [15.0(8.8, 17.7) ml/kg vs.17.1 (13.0, 23.3) ml/kg, P<0.05]. There were no significant differences between the two groups in postoperative total transfusion volume, transfusion volume per kilogram of body weight, total drainage volume and drainage volume per kilogram of body weight ( P>0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen between the two groups before and after surgery ( P<0.05). Conclusion:TXA can reduce the amount of blood loss and blood transfusion in craniosynostosis in children.

Objective:To summarize the surgery effect of tongue volume reduction for macroglossia patients with Beckwith-Wiedemann syndrome (BWS).Methods:The clinical data of children diagnosed as BWS based on clinic symptoms and gene tests, who received operation in Department of Plastic Surgery, Children’s Hospital of Fudan University from July 2012 to December 2019 were analyzed retrospectively. All the patients underwent dorsal tongue bell-shaped resection and ventral V-shaped resection. By pulling tongue tip, the tongue body was cut and dissected along the marking line followed by suturing the muscle layer of the central part of the tongue tissue. Intermittent mattress suture of the dorsal and ventral mucous wounds of the tongue. After operation, all patients kept the trachea intubation and were transferred to PICU for further treatment and received early nasal feeding. The short-term postoperative complications, and long-term follow-up of the tongue body shape and clinical symptoms were recorded.The clinical effect was evaluated by onesurgeon and the parents.The effect was graded into four levels: dissatisifaction, average, satisifaction and great satisifaction.Results:A total of 61 children were included in this study, including 30 males and 31 females, with an average age of 8.5 months. The length of the tongue exposed outside at the resting state was 1.34-2.62 cm, with a median of 1.87 cm. Symmetric hypertrophy was found in 52 cases (85.2%), lateral hypertrophy in 9 cases (14.8%). There were 3 cases with respiratory obstruction (4.9%), 35 cases with salivation (57.4%), 4 cases suffering difficulty of feeding and dysphagia (6.6%). All children underwent the operation successfully, and the average operation time was 35.8 min. Among the short-term complications, there were 3 ventral wounds dehiscence, none of which needed sutured again. By prolonging nasal feeding time, the wounds were all healed in the secondary stage. Respiratory obstruction occurred in 1 patient after operation, and the symptoms were relieved after tongue retraction. The mean follow-up time was 3.3 years (2 months to 7 years), and 1 patient was inadequately corrected and good condition was got after second aryoperation. The remaining children obtained satisfactory resting tongue position and appearance, and the postoperative clinical symptoms were improved. In the long-term follow-up, the comprehensive evaluation results of the resting tongue position and clinical symptoms of the children by surgeon and parents were satisfied in 10 cases (16.4%), very satisfied in 50 cases (82.0%), and average in 1 case (insufficient correction after the first operation).Conclusions:Central resection and volume reduction of tongue body is a simple, effective and safe surgical technique in children with giant tongue diagnosed as BWS.

Objective:To investigate the effect of tranexamic acid on perioperative hemorrhage of cranioplasty for craniosynostosis.Methods:A retrospective analysis was performed on the clinical data of children who received cranial remodeling from the Children’s Hospital of Fudan University from February 2015 to October 2018. The patients were divided into two groups: tranexamic acid treatment group (TXA group) and no tranexamic acid treatment group (control group). The average intraoperative blood loss, the average amount of blood transfusion, postoperative average amount of blood transfusion, average drainage volume, and changes of postoperative hemoglobin and blood coagulation function were observed. The measurement data were described by M ( Q1, Q3) and analyzed with Mann-Whitney U test. Results:A total of 41 patients were included in this study. There were 26 patients in TXA group, 18 males and 8 females, aged 9.5 (7.0, 38.8) months; in the control group, there were 15 patients, 10 males and 5 females, aged 9.2 (6.6, 18.3) months. The results showed that there was no significant difference in preoperative hemoglobin level between the two groups ( P>0.05). The hemoglobin level of TXA group was higher than that of control group immediately after operation and 24 h and 72 h after operation ( P<0.05). Total intraoperative blood loss and blood loss per kilogram of body weight in TXA group were lower than those in control group [150.0 (57.5, 225.0) ml vs. 200.0(80.0, 300.0) ml, P<0.05; 13.6(6.8, 18.5) ml/kg vs. 15.8(7.0, 27.0) ml/kg, P<0.01]. The amount of intraoperative transfusion volume per kilogram of body weight in TXA group was less than that in control group [15.0(8.8, 17.7) ml/kg vs.17.1 (13.0, 23.3) ml/kg, P<0.05]. There were no significant differences between the two groups in postoperative total transfusion volume, transfusion volume per kilogram of body weight, total drainage volume and drainage volume per kilogram of body weight ( P>0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen between the two groups before and after surgery ( P<0.05). Conclusion:TXA can reduce the amount of blood loss and blood transfusion in craniosynostosis in children.

Objective To investigate the effects of postoperative semi-reclining position in early stage on the comfort degree of patients with endoscopic sinus surgery under general anesthesia. Methods Totally 106 cases of patients with endoscopic sinus surgery under general anesthesia were selected from the ENT&HN Surgery Department of Beijing Tongren Hospital during September 2014 to May 2015. The patients were randomly divided into the control group (n=54) and the experimental group (n=52). Patients in the control group adopted traditional clinostatism after surgery,while patients in the experimental group adopted early semi-reclining position after surgery. Four hours after surgery,patients' comfort degree with discomfort visual analogue score (VAS) were evaluated,and the incidence of neck-shoulder soreness and waist soreness of patients was compared between two groups. Results In the experimental group,the total discomfort VAS score of patients was 3.00 (2.00~5.00),which was lower than VAS score 4.00 (3.00~6.00) in the control group (Z=-2.270,P<0.05). In the experimental group,the incidence of shoulder-soreness was 0,and the incidence of waist soreness was 3.85%,and they were all lower than those in the control group (16.67%,11.11%) (χ2= 9.471,5.666;P<0.05). Conclusions Early semi-reclining position can effectively reduce the postoperative headache,ear fullness and general discomfort of patients with endoscopic sinus surgery,reduce the occurrence of shoulder-neck soreness and waist soreness of patients,and improve patients' comfort.

Objective:To explore the effect of enhanced recovery after surgery (ERAS) nursing in patients with chronic sinusitis during the perioperative period.Methods:From July 2019 to January 2021, 106 patients with chronic sinusitis admitted to the Otolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the control group (52 cases) and the observation group (54 cases) . The control group was given routine nursing, and the observation group was given ERAS nursing on this basis. The preoperative discomfort (thirst and hunger) scores, postoperative discomfort (shoulder, neck and low back discomfort) incidence, perioperative anxiety, comfort, and discharge satisfaction were compared between the two groups.Results:The preoperative thirst and hunger scores of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The postoperative incidence of shoulder, neck and low back discomfort, and discharge anxiety scores of the observation group were lower than those of the control group, and the scores of comfort and discharge satisfaction were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Perioperative ERAS nursing in patients with chronic sinusitis can reduce preoperative thirst, hunger and postoperative discomfort in the shoulder, neck, and lower back, improve patients' perioperative anxiety, comfort and discharge satisfaction, and promote patients' rapid recovery.