Objective To investigate the analgesic efficacy of ultrasound guided transversus abdominis plane block and to compare the efficacy of posterior approach and medial approach of ultrasound guided transversus abdominis plane block (TAPB) in providing postoperative analgesia after children laparoscopic groin surgery.Methods Eligible children 2 ～ 4 years old (n =60),American society of anesthesiologists (ASA) I,undergoing elective laparoscopic unilateral groin surgery were randomly assigned into posterior approach group (Group P),medial approach group (Group M) and control group (Group C).Many parameters were measured and recorded during the study,including funk sedation scores,intraoperative circulation monitoring at time points of T1 (before induction),T2 (skin incision) and T3 (skin closure),length of surgery,the time from post anesthesia care unit (PACU) arrival to the first obtainable pain score,length of PACU stay,modified-children's hospital of eastern ontario pain scale(m-CHEOPS),pediatric anesthesia emergence delirium (PAED) scores,number of children with sufentanil administered in PACU,number of people occurred nausea and vomiting,and satisfaction of parents.Results There were no statistically significant difference in general characteristics,basic emotion score,duration of surgery,the time from PACU arrival to first obtainable score,haemodynamic parameter at T1 and satisfaction of parents among groups P,M,and C.However,the m-CHEOPS scores at the time points of first obtainable,10 min,the number of children received sufentanil administration,PAED scores and haemodynamic parameter at T2 and T3 were significantly lower in groups P and M than in group C.There were no significant difference in parameters mentioned above between groups P and M.Conclusions Ultrasound guided transversus abdominis plane block could provide efficient and secure postoperative analgesia for children undergoing laparoscopic groin surgery.Both posterior approach and medial approach are ideal options.

Nitric oxide (NO) is the most important known endogenous vasodilator factor. The competitive inhibitor asymmetric dimethylarginine (ADMA) of endothelial nitric oxide synthase (NOS) inhibits NO synthesis, which makes NO/NOS pathway to be obstructed and the reduction of NO synthesis. The studies in recent years have suggested that ADMA is as-sociated with the occurrence and development of diabetes with cerebrovascular disease. It has provided new insights into further clarifying the mechanism of the disease.

Objective To investigate the mechanism of the fluorouracil(FU)drug resistance and to prove deeply the role of serum dihydropyrimidine dehydrogenase(DPD)activity in patients with gastric cancer resistance to FU with the level of cell culture. Methods The peripheral blood was collected from 45 patients with advanced gastric cancer before chemotherapy to detect the activity of DPD by high performance liquid chromatography(HPLC).The patients were divided into two groups(high activity group and low activity group)according to the results. The FU drug inhibitory rate of gastric cancer cell cultured in vitro were tested with MTT to compare the effects of the two groups. Result The FU drug inhibitory rate of gastric cancer cell cultured in vitro was obviously lower in high activity group than that in low activity group,(47.6±±4.0)%,(53.7±8.0)%respectively. Conclusion The activity of serum DPD may be simple and convenient indicators in predicting the resistance to FU.

Objective: To study the antioxidative and hepatoprotective activities of low molecular fucoidan oligosaccharides(LMFO) from Laminaria japonica in mice.Methods: Mice were pretreated with LMFO(50?100?150 mg/kg ig respectively, 10 days),and then 0.2 % CCl 4 10 ml/kg ig and D-GalN(600 mg/kg)+LPS(lipopolysaccharide,1 ?g/kg) ig respectively in two model groups to induce liver injury. Liver injury was assessed by quantifying activities of plasma GPT, SOD, GSH-Px and MDA content.Results: The increase of plasma GPT activity was significantly inhibited by LMFO in two liver injury models, suggesting that LMFO had good protective effect on the hepatocytes. LMFO had good antioxidative effect in mice with liver injury induced by CCl 4 and D-GalN+LPS as indicated by decreased MDA content and increased activities of plasma SOD and GSH-Px. Conclusion: LMFO is protective against CCl 4-induced and D-GalN+ LPS induced liver injury in mice and its effect may be due to its antioxidative activities in vivo.

Objective To investigate the application value of low dose high pitch dual source CT angiography technique in diagno-sis of acute aortic dissection.Methods 21 cases of critically ill patients with suspected aortic dissection underwent total aortic angiog-raphy without using ECG by adopting the second generation dual source CT Flash Technology (pitch 3 .2 ,1 0 0 kV and 1 0 0 mAs), using a lower contrast dose (60 mL).Results All subjects accepted as low as possible radiation doses and iodine intake;at the same time,accurate information including aortic intimal tear position,intimal flap,true and false lumen,and lesions involving the range vessel signs and anatomic relationship were received,2 cases of Stanford type A,type B 1 9 cases (2 cases of aortic rupture).Average scan time 2.6 s,average effective radiation dose cm 270 mGy·cm.Conclusion High quality images by using high pitch dual source CT low dose angiography with lower contrast dose provide safe,reliable,real-time screening method for critically ill patients with aor-tic dissection caused by systemic severe compound injury.

Objective: To observe the expression of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) in non-small cell lung cancer(NSCLC), and to discuss its clinical significance. Methods: The expression of EGFR and VEGF was detected in 82 NSCLC and 20 non-malignant pulmonary samples by immunohistochemical method. The expression of EGFR and VEGF in NSCLC patients with various pathological characteristics was observed and the correlation between them was analyzed. Results: The positive rates of EGFR and VEGF in 82 NSCLC samples were obviously higher than those in the 20 non-malignant samples(53.66% vs 0 for EGFR, 62.20% vs 25% for VEGF, both P<0.05). The expression of EGFR in NSCLC samples was significantly correlated with the sex of patients, pathological types of cancer (squamous-cell carcinoma vs adenocarcinoma), presence of lymph node metastasis, and TNM stages(P<0.05). The expression of VEGF in NSCLC was correlated with lymph node metastasis and TNM stages (P<0.05). It was also noticed that higher expression of EGFR or VEGF was associated with poor prognosis of patients (P<0.05). The expression of EGFR was correlated with VEGF expression in pulmonary tissues of NSCLC patients(rs = 0.314, P<0.05). Conclusion: EGFR and VEGF are over-expressed in NSCLC tissues and the 2 are correlated with each other, which may serve as predicator for prognosis and a therapeutic target of NSCLC patients.

Objective:To investigate the effect of homocysteine (Hcy) on peripheral vascular plaque formation in patients with type 2 diabetes mellitus (T2DM) combine subclinical hypothyroidism (SCH), and to provide guidance for clinical medication and prognosis judgement.Methods:A total of 125 patients with type 2 diabetes admitted to the NO.3201 Hospital from 2018 Jan to Dec 2019 were selected. 125 patients with type 2 diabetes mellitus were divided into T2DM without plaque group (40 cases), plaque group (23 cases), T2DM with SCH without plaque group (25 cases) and plaque group (37 cases) according to thyroid function and whether they had peripheral vascular plaque. Data were collected to analyze the influencing factors of peripheral vascular disease.Results:(1) The incidence of vascular plaque in T2DM group and T2DM with SCH group was 36.5%(23/63) and 59.7%(37/62), respectively, with significant difference ( P<0.05). (2) There were significant differences in serum thyroid stimulating hormone (TSH), apolipoprotein A (ApoA), triglyceride (TG) and Hcy between T2DM group and T2DM with SCH group ( P<0.05); there was significant difference in low-density lipoprotein (LDL-C) and Hcy between T2DM groups with or without plaque ( P<0.05); there were significant differences in ApoA and Hcy between T2DM with SCH group with or without plaque ( P<0.05). (3) Logistic regression analysis showed that Hcy was the risk factors for the occurrence of vascular plaque in T2DM and T2DM with SCH group ( OR=1.640, 2.695, P<0.05). (4) Receiver operating characteristic (ROC) curve showed that the area under the curve of Hcy in T2DM group was 0.842 and Youden index was 15.75 μmol/L; The Hcy's area under ROC curve was 0.945 and Youden index was 12.9 μmol/L in T2DM with SCH. Conclusions:Hcy is closely related to the presence of peripheral vascular plaque in T2DM patients with subclinical hypothyroidism. The detection of blood Hcy level can provide new ideas for early diagnosis and treatment of peripheral vascular lesions in T2DM patients with SCH.

A case of traumatic delayed meningo-encephalocele suffered orbital fracture, but bony defects in frontal sinus had not been found on CT scanning. We treated the patient with surgery of intranasal endoscopy and repaired the skull base defect successfully during the first attempt. There was no recurrence in 10 months followed up. The leak site may not correlate with imaging in traumatic delayed meningo-encephalocele by comparing operative findings with the imaging estimate and endoscopy. Therefore, endoscopical approaching is effective in seeking and treatment.
Encephalocele ; complications ; Endoscopy ; Exophthalmos ; etiology ; Frontal Sinus ; pathology ; Humans ; Orbital Fractures ; pathology ; Recurrence ; Tomography, X-Ray Computed

Adenoid hypertrophy is a disease that mostly occurs among children of 3-5 years old. It is caused by repeated inflammation and infection of nasopharynx and its adjoin parts, or the adenoid itself, which will finally leads to pathological hyperplasia of adenoid. With so much information we have acquired about this disease, its specific mechanism remains unknown. In recent years, some researches have indicated that adenoid hypertrophy may have something to do with extra-gastroesophageal reflux, in which pepsin plays a very important role, and pepsin will do a series of pathological damages to the upper airway as it reaches the upper respiratory tract. Based on relative domestic and foreign literature, this paper attempts to make a review about the relationship between gastroesophageal reflux and adenoid hypertrophy.
Adenoids ; pathology ; Child ; Gastroesophageal Reflux ; complications ; Humans ; Hypertrophy ; complications ; Nasopharynx ; pathology ; Pepsin A ; metabolism