Objective To compare analgesic efficacy of intravenous postoperative and preemptive analgesia with flurbiprofen axetil combined with small dose of morphine and with morphine alone. Methods One hundred and twenty patients were randomly divided into four groups: group A,morphine 30 mg +0.9% NaCl for postoperative analgesia,n=30;group B,morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30;group C,flurbiprofen axetil 100 mg + morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30;group D,flurbiprofen axetil 100 mg before operation + morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30.The drugs in each group were diluted to 100 mL and infused by a pump at a rate of 2 mL/h with a patient-controlled analgesia(PCA)bolus of 2 mL after a loading dose of 5 mL.The visual analogue scale(VAS),demanding times for PCA and incidence of side effects were recorded during the period of postoperative 24 h. Results The VAS of group B at 3 h after operation was significantly higher than those of the other three groups(P

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population with serious influence to their ability of living independently.Epidemiological researches have revealed various risk factors of AMD,some of which are not controllable such as age,heredity and race ;while others are modifiable such as lifestyle,eye conditions and other systemic diseases.However,the awareness of AMD risk factors is alarmingly low in public.Meanwhile,the understanding of AMD risk factors among ophthalmologists is also unsatisfactory.Therefore,the risk factors of AMD are reviewed here in order to improve the understanding of the ophthalmologists and better guide the clinical management of AMD.

Objective To evaluate the effect of nitrous oxide(N2O) on the cuff pressure of ProSeal laryngeal mask airway(PLMA) in pediatric anesthesia. Methods Thirty-two pediatic patients were enrolled and divided into two groups randomly.PLMA cuffs were inflated with air(Group A) or 50% N2O/oxyen(Group N) to 20 mmHg as initial pressure.The intracuff pressure was monitored during anesthesia with 50% N2O in oxygen. Results Intracuff pressure increased to(40.6?9.3) mmHg in Group A and slightly decreased in Group N.Deflation volume in Group A was much more than that in Group N[(4.4?2.3) mL vs(2.6?1.0) mL,P

Objective To investigate the effects of magnesium isoglycyrrhizinate on liver function of patients with gastrointestinal cancer following chemotherapy.Methods From Apr.2012 to Dec.2015,a total of 168 cases of patients with gastrointestinal cancer following chemotherapy were enrolled,and were randomly divided into observation group(84 cases) and control group(84 cases).Each of the two groups was divided into A group(42 cases) and B group(42 cases) according to the treatment methods.Patients of observation group(including observation A group and observation B group) were treated with magnesium isoglycyrrhizinate,while patients of control group(including control A group and control B group) were treated with glutathione.Patients of A group(including observation A group and control A group) were treated with FOLFOX4 regimen,while patients of B group(including observation B group and control B group) were treated with XELOX regimen.The incidence of abnormal liver function and changes of the levels of liver function of each group were analyzed and compared.Results After the appropriate treatment,the abnormal rate of liver function of observation group were significantly lower than control group(P<0.05).After treatment,levels of liver function parameters in observation group and control group were all significantly increased(P<0.05),and those in control group were higher than observation group(P<0.05).After treatment,levels of liver function parameters in observation A group and control A group were all significantly increased(P<0.05),and those in control A group were higher than observation A group(P<0.05).After treatment,levels of liver function parameters in observation B group and control B group were all significantly increased(P<0.05),and those in control B group were higher than observation B group(P<0.05).Conclusion Magnesium isoglycyrrhizinate could be with protection effects on liver function of patients with gastrointestinal cancer following chemotherapy,which might be worthy of promotion.

Background Uveal effusion syndrome is uncommon in clinic.To understand the clinical characteristics of uveal effusion syndrome is helpful for rescuing visual acuity of patient.Objective This study was to discuss the diagnosis,classification and surgical outcome of uveal effusion syndrome.Methods This was a descriptive study.The clinical data of 14 eys from 10 patients with uveal effusion syndrome,ineluding ophthalmologic examination,B-scan sonography,ultrasound biomicroscopy (UBM),fundus fluorescence angiography (FFA),indocyanine green angiography (ICGA),surgical treatment and prognosis,were retrospectively analyzed.The follow-up period was 6 months.Results The fundus findings of all impacted eyes showed bullous-shape retinal detachment (RD).B-scan sonography revealed retinal and choroidal detachment.A annular peripheral ciliochoroidal detachment was observed in the cases under the UBM.FFA exhibited leopard spots without any leakage from choroid into the subretinal space.ICGA demonstrated diffusely choroidal granular hyperfluorescence in the very early phase,which presented with an increasing intensity as time lapse until the late phase.Full-thickness sclerectomy was performed on 4 eyes of 2 patients and subscleral sclerectomy was performed in 1 eye of 1 patient,achieving a retinal anatomic reattachment after surgery.All of the patients finished the fellow-up.No recurrence of RD was seen during the followup duration.Conclusions Comprehensive preoperative evaluation,including ophthalmologic ultrasonography,MRI and CT,is crucial for accurate classification of uveal effusion syndrome and determine of proper management strategy.

Insulin-like growth factors (IGF), regulated by their receptors and binding proteins, play a pivotal role in human cell proliferation, differentiation and apoptosis. Increasing evidence has revealed that IGF system is involved in the genesis and progress of various malignancies including lung cancer. Recent studies in regard to IGF axis expression in the lung cancer cell lines, pulmonary tissue samples and blood circulation of lung cancer patients have shown that the IGF axis may contribute to the transformation and progression of lung cancer. Several researches have shown that a number of drugs targeting the IGF receptor are being investigated in clinical trials and suggest a potential therapeutic efficacy. This article reviews the updates and progress in the research of IGF axis in lung cancer.

Objective To evaluate the feasibility and outcome of laparoscopic cholecystectomy as a overnight procedure in China.Methods The data of 59 consecutive patients who had undergone outpatient laparoscopic cholecystectomy between Januaiy 2013 and January 2015.All the patients were operated in the morning hours and discharged during 24 hours after operation.They were contacted by telephone 3 days subsequent to surgery and were seen in the outpatient unit 7 days after.Results Fifty-nine laparoscopic cholecystectomies were performed.No Conversion to open surgery case.The average operation time was 25 minutes,and restore semi-liquid diet 6 hours after the operation All the 59 patients were discharged during 24 hours after operations.None of the patients had an emergency readmission.None of the patients had complications 7 days after discharged.The average payment was 8 240 yuan.Conclusion These results suggest that laparoscopic cholecystectomy can be routinely performed as a overnight procedure.

Objective Intercellular adhesion molecule-1 (ICAM-1) plays an important role in mediating pulmonary infiltration of neutrophils .The aim of the study was to observe the expression of ICAM-1 and its potential regulators MK 2/HuR in pulmonary micro-vascular endothelial cells ( PMVEC ) in mice with acute respiratory distress syndrome ( ARDS) induced by lipopolysaccharide ( LPS) . Methods Ten 6-8 weeks old healthy C57BL/6 mice were randomly divided into an LPS and a control group of equal number , the former injected intraperitoneally with LPS diluted in 100 μL PBS while the latter with PBS only , both at 5 mg per kg of the body weight .At 24 hours after injection , all the mice were sacrificed .Real-time PCR was used to determine the mRNA expressions of HuR and ICAM-1 in the PMVECs, Western bolt employed to detect the protein expressions of MK2, HuR and ICAM-1, and flow cytometry adopted to measure the ICAM-1 expression on the surface of the PMVECs and pulmonary infiltration of neutrophils . Results The W/D ratio in the lung tissue of the mice was significantly lower in the LPS than in the control group (3.61 ±0.28 vs 6.16 ±0.40, P<0.05), while the rate of neutrophil infiltration markedly higher in the former than in the latter ([13.92 ±3.23]%vs [3.24 ±1.24]%, P<0.05).The mRNA and protein expressions of ICAM-1 in the PMVECs were significantly elevated in the LPS group as compared with that in the control (P<0.05), and so was the mRNA expression of HuR (P<0.05).No remarkable changes were observed in the expressions of total MK 2 and HuR proteins, but phosphorylated MK2 (p-MK2) and cytoplasmic HuR were increased in the LPS-stimulated mice. Conclusion Specific blockage or reduction of the HuR expression in PMVECs may lower the expression of ICAM-1, reduce neutrophil infiltration , and lessen pathophysiological changes in mice with ARDS .

OBJECTIVE:To prepare paeonol-HP-β-cyclodextrin (PAE-HP-β-CD) inclusion compound and to optimize its pre-scription technology. METHODS:PAE-HP-β-CD was prepared by freeze drying method and validated. Using inclusion rate as in-dex,main drug-accessory ratio,inclusion time,inclusion temperature and stirring speed as factors,the preparation technology was optimized by central composite design-response surface methodology. RESULTS:Prepared PAE-HP-β-CD underwent phase transfor-mation. The optimal inclusion technology was as follows as main drug-accessory ratio of 3.39∶1,inclusion temperature of 50 ℃, inclusion time of 3.2 h, stirring speed of 350 r/min. Relative error between measured value (87.46%) and predicted value (89.12%) of inclusion rate was 1.86%(n=6). CONCLUSIONS:PAE-HP-β-CD inclusion compound is prepared successfully, and its prescription technology is stable and feasible.

Objective To explore the clinical efficacy of laparoscopic transabdominal preperitoneal (TAPP) hernia repair and risk factors affecting postoperative complications.Methods The retrospective casecontrol study was conducted.The clinical data of 595 patients who received laparoscopic TAPP hernia repair in the First Affiliated Hospital of Soochow University from February 2008 to August 2016 was collected.Operations were performed by the same doctors' team.Observation indicators:(1) surgical situations;(2) postoperative situations;(3) follow-up situations;(4) risk factors affecting complications after laparoscopic TAPP hernia repair.Follow-up using outpatient examination and telephone interview was performed to detect the recovery time of non-restricted activity,postoperative complications and hernia recurrence up to February 2017.Measurement data with normal distribution were represented as (x)±s.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model.Results (1) Surgical situations:595 patients underwent laparoscopic TAPP hernia repair using the heavy meshes.Overall operation time and overall volume of blood loss were (55±25) minutes and (7±5)mL,including operation time of (50±20)minutes in 502 unilateral hernias and operation time of (81 ± 29)minutes in 93 bilateral hernias.Of 595 patients,34 had incarcerated hernia,the contents of hernia:greater omentum,small intestine and sigmoid colon were detected in 21,11 and 2 patients,respectively,with an incarcerated time of 2-21 hours;4 with incarcerated hernia induced small intestinal necrosis received laparoscopy-assisted small intestinal resection ± anastomosis,1 with sigmoid colon necrosis received necrotic sigmoid canal resection ± sigmoidostomy and 29 received repair after the contents restoration of hernia.Operation time and volume of intraoperative blood loss in 34 patients with incarcerated hernia were (84 ± 39)minutes and (12±6) mL.Thirteen of 595 patients (10 with indirect hernia and 3 with direct hernia) had recurrent hernia,and operation time and volume of intraoperative blood loss were (75±-26)minutes and (10± 5)mL.(2) Postoperative situations:time to initial exsufflation of 595 patients was (19± 12)hours.Of 595 patients,590 took fluid diet at 6 hours postoperatively and 5 undergoing enterectomy took fluid diet at 24 hours postoperatively.The pain score at 1 day postoperatively and duration of hospital stay were respectively 2.5± 1.4 and (2.1± 1.9)days.(3) Follow-up situations:of 595 patients,593 recovered non-restricted activity at 2 weeks postoperatively and 2 didn't recover non-restricted activity at 2 weeks postoperatively.Of 595 patients,542 were followed up for 6-60 months,with a median time of 31 months.Fifty-seven,25,13 and 1 patients were respectively complicated with seroma,surgical pain,urinary retention and enteroparalysis,they were improved by symptomatic treatment,and the same patient can have multiple complications.There were no severe complications which needed surgical intervention,such as vascular injury,damnify of intestinal canal and poke hole hernia.Of 2 patients with recurrence of hernia,1 with right indirect hernia had recurrence of direct hernia and then received Lichtenstein tension-free hernia repair,and 1 received treatment in other hospital.(4) Risk factors affecting complications after laparoscopic TAPP hernia repair:results of univariate analysis showed that age,diameter of hernia sac,incarcerated hernia,recurrent hernia,operation time and volume of intraoperative blood loss were related factors affecting complications after laparoscopic TAPP hernia repair (x2 =6.657,55.296,44.305,5.253,117.461,100.722,P＜0.05).Results of multivariate analysis showed that diameter of hernia sac ≥ 4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL were independent risk factors affecting complications after laparoscopic TAPP hernia repair (OR =3.610,11.315,12.401,7.346,95％ confidence interval:2.009-6.486,3.579-35.772,5.408-28.437,3.739-14.434,P＜ 0.05).Conclusion Laparoscopic TAPP approach for inguinal hernia is safe and effective,and diameter of hernia sac ≥4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL are independent risk factors affecting complications after laparoscopic TAPP hernia repair.