Objective To compare the effects of flurbiprofen axetil and fentanyl of postoperative analgesia on T-lymphocytes subtypes in patients undergoing esophagectomy.Methods Forty patients undergoing esophagectomy were randomly divided into two groups(20 cases each):group C (group fentanyl) was given fentanyl 20μg/kg plus tropisetron 5 mg diluted to 100 ml via PCIA after surgery,group F (group flurbiprofen-fentanyl) was administrated flurbiprofen axetil 50 mg at 30 min before the end of surgery,fentanyl 10μg/kg and flurbiprofen axetil 100 mg plus tropisetron 5 mg diluted 100 ml was administrated via PCIA after surgery.The PCIA rate was 2 ml/h,bolus 0.5ml,lock time 15 min.The VAS score was recorded at 12,24,48 h after surgery.Blood samples 2 ml were obtained from peripheral vein for determination of CD3+,CD4+,CD8+ and CD4+/CD8+ at 30 min before surgery(T0),24 h(T1)and 72 h(T2)after surgery.Results Patients in two groups did not show any significant difference in the VAS scores(P＞0.05).At T1 CD3+,CD4+ T-lymphoeytes were significantly lower than those at T0 in two groups(P＜0.05).At T2,CD3+,CD4+ T-lymphocytes in group F were significantly higher than those in group C(P＜0.05).In group C,CD3+,CD4+ T-lymphocytes at T2 were significantly decreased than those at T0(P＜0.05).CD8+ T-lymphocytes Was no significantly changed in two groups and at each time point determined (P＞0.05).Conclusion Postoperative analgesia by using flurbiprofen axetil and fentanyl can diminish the using dose of postoperative opioid drug,and it can'improve patient's cellular immune function.

Objective To summarize the experience of the prevention and treatment of iatrogenic hypo-parathyroidism in total thyroidectomy .Methods 377 patients received total thyroidectomy performed by the Thy-roid Professional Group of Hepatobiliary Surgery Department of the Third Affiliated Hospital of Soochow University from Jan.2010 to Dec.2012.Their clinical date were retrospectively analyzed .Results There was no perma-nent postoperative hypoparathyroidism .The incidence of temporary hypoparathyroidism was 13.79%( 52/377 ) . The occurrence of transient hypocalcemia was 10.61%( 40/377 ) .Conclusions Iatrogenic hypoparathyroidism can be prevented by intraoperative in situ protection of parathyroid glands and their blood supply using fine cap -sule anatomy method .Postoperative improvement of microcirculation and calcium supplement also help prevent postoperative hypoparathyroidism .

Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.

Objective To observe the effectiveness and expenses of the AMI patients with facilitated PCI,and to search for a new pattern for them.Methods 81 AMI patients were divided into 2 groups.One group accepted facilitated PCI(n=42) and the other group took routine PCI(n= 39).We compared the successful rate,death rate,left ventricular function between the two groups in infusing the infarction related artery(IRA).Results The successful rate of facilitated PCI group is 41/42,while routine PCI group is 31/39.There was no dead patient in facilitated PCI group,but six patients died in the routine PCI group.The EF in facilitated PCI group was(53.8?6.7)% and in routine PCI group it was(50.2?5.2)%.Conclusion Facilitated PCI is a safer and more efficient method than routine PCI,which will be worthy of further research to treat AMI.

Objective To compare the cardiac function effect of right ventricular septum(RVS) pacing with that of right ventricular apex(RVA) pacing.Methods One hundred and six patients with indication of dual chamber pacemaker implantation were divide into two groups randomly.In each patient,influence of different pacing site to LVEF and pacing parameter were examined and left ventricular eject fractions were compared.Results All patients' operation were successful,LVEF of RVS group compared with that of RVA showed a significant difference.Conclusion The cardiac function are significantly different between right ventricular septum pacing group and right ventricular apex group.

Objective To investigate the feasibility and methodology of active fixation lead on patients under right ventricular outflow tract septum(RVOTS) pacing.Methods Fifty DDD pacemaker patients were enrolled 31 male,23 female,50~86 years old,mean age 67.7?8.6.Ventricular active fixation lead was implanted in the right ventricular apex(RVA) and RVOTS successively and pacing parameter was tested.Results The success rate of RVOTS active fixation lead implantation was 98.15%.Mean lead threshold was 0.73?0.12 V.Pacing QRS duration show a significant difference between RVOTS pacing and RVA pacing,130.45?18.24 and 153.11?20.10,respectively(P

Objective To analyze the transformation situation of the tuberculosis (TB) diagnosis and treatment mode in 18 coun-ties(cities) of Guangxi and to explore the countermeasure for perfecting the TB control service system in Guangxi .Methods The self-designed questionnaire was adopted to retrospectively investigate the transformation situation of the TB diagnosis and treatment mode in 18 counties(cities) .Results In the 18 counties(cities) ,there were 8 counties(cities) ,accounted for 44 .4% ,with the trans-formation reason of the qualification was not completed in the original agency;there were 16 counties (cities ) ,accounted for 88 .9% ,with issuing the formal documents and arranging relevant work by the local health bureau before the transformation ;the number of full-time TB staff was reduced in 14 counties(cities) ,accounted for 77 .8% ,after the transformation ;there were 8 coun-ties(cities) ,accounted for 44 .4% ,set up the independent TB outpatient in the designated hospital ;there were 4 counties(cities) ,ac-counted for 22 .2% ,received the evaluation of very goodandgoodfor the TB control work after the transformation .Conclusion The health administrative department should actively promote the counties (cities) without the completed medical qualification to transform the TB diagnosis and treatment mode and coordinate the related works to carry out smoothly .

Objective To explore the activity of thioredoxin reductase (TrxR) in chronic myeloid leukemia cell line K562 and the anti-leukemia effect of BBSKE (a novel inhibitor of TrxR) in vitro. Methods The activity of TrxR on K562 cell lineage and fresh bone marrow cell from healthy adult was analyzed by insulin reduction assay. The inhibition of proliferation was measured by CCK-8 assay. The anti-leukemia effect of BBSKE was detected by laser scanning confocal microscope,agarose gel electrophoresis and flow cytometry with Annexin V -FITC/PI staining. Results TrxR activity of K562 cell lineage was significantly higher than that of normal bone marrow mononuclear cells. The apoptosis of K562 cells could be induced at concentrations of 10 μmol/L BBSKE after treated for 24 hours. The typical DNA ladder bans were observed by agarose gel electrophoresis. The apoptotic rates of K562 cells were (10.28±2.74) %. Application of 10 μmol/L BBSKE for 48 hours could also induce apoptosis of fresh bone marrow cell from chronic myeloid leukemia patients, and the apoptotic rates were (5.70±0.48) %. Conclusion TrxR activity in chronic myeloid leukemia cells was significantly higher than that of normal cells. BBSKE inhibits the TrxR activity and the proliferation of K562 by inducing apoptosis.It might be a potential medication for chronic myeloid leukemia.

Objective To analyze the clinical features,treatment methods,and prognostic factors for early primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.Methods A retrospective analysis was performed on the clinical data,treatment outcomes,and survival of 32 patients with early pulmonary MALT lymphoma from March 2001 to September 2013.The median age of those patients was 56 years.Twenty-three patients had stage ⅠE disease and nine had stage Ⅱ E disease.According to the marginal zone B-cell lymphoma prognostic index (MZLPI),twenty-three patients were scored as 0 and nine as 1.Nine patients received radiotherapy,eight patients underwent surgery alone,three patients underwent surgery plus chemotherapy,and twelve patients received chemotherapy alone.The Kaplan-Meier method was adapted for calculating the OS,PFS and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The 5-year sample size was 22.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 84.5％ and 73.2％,respectively.Radiotherapy yielded an overall response rate of 100％,including a complete response rate of 66.7％ and a partial response rate of 33.3％.The univariate analysis showed that non-radiotherapy treatment was a prognostic factor for poor PFS.The patients treated with radiotherapy had significantly higher 5-year PFS rates than those treated without radiotherapy (100％ vs.63.0％,P=0.029),while there was no significant difference in 5-year OS rate between these two groups (100％ vs.78.8％,P=0.129).Age older than 60 years,an ECOG score of 2,and an MZLPI score of 1 were prognostic factors for poor PFS (P=0.041,0.018,and 0.044) and OS (P=0.001,0.001,and 0.003).Conclusions The prognostic factors for early pulmonary MALT lymphoma include age,ECOG score,and MZLPI score.Low-dose involved-field radiotherapy (24-30 Gy) can improve local control and survival.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2/antioxidant responsive element (Nrt2/ARE) signaling pathway inthe reduction of myocardial ischemia-reperfusion (I/R) injury by propofol in rats.Methods Sixty adult male Sprague-Dawley rats,weighing 200-240 g,were randomly divided into 5 groups (n =12 each) using a random number table:sham operation group (S group),I/R group,propofol group (P group),propofol + Nrf2 vehicle-plasmid group (PNV group) and propofol + Nrf2 siRNA plasmid group (PNS group).The animals were anesthetized with inhalation of 2％ isoflurane,tracheally intubated and mechanically ventilated.Myocardial I/R was produced by 5 min occlusion of left anterior descending branch of coronary artery followed by 60 min reperfusion.In P,PNV and PNS groups,isoflurane inhalation was stopped after successful intubation and propofol was infused via the caudal vein at 6 mg· kg-1 · h-1 until 30 of reperfusion.At 30 min of propofol infusion,Nrf2 vehicle-plasmid 10 μg (100 μl) was injected intramyocardially before myocardial ischemia in group PNV,and Nrf2 siRNA 10 μg (100 μl) was injected intramyocardially before myocardial ischemia in group PNS.The animals were sacrificed at 60 min of reperfusion and myocardial specimens were taken for determination of the infarct size,apoptosis index,and the expression of Nrf2 and heme oxygenase-1 (HO-1).Results Compared with group S,the infarct size and apoptosis index were significantly increased,and the expression of Nrf2 and HO-1 was up-regulated in I/R and P groups.Compared with group I/R,the infarct size and apoptosis index were significantly decreased,and the expression of Nrf2 and HO-1 was up-regulated in group P.Compared with group P,no significant changes were found in the infarct size,apoptosis index and expression of Nrf2 and HO-1 in group PNV,and the infarct size and apoptosis index were significantly increased,and the expression of Nrf2 and HO-1 was down-regulated in group PNS.Conclusion Nrf2/ARE signaling pathway is involved in the reduction of myocardial I/R injury by propofol in rats.