Objective To investigate the pharmacodynamics of remifentanil required to prevent laryngeal mask airway (LMA) insertion response in patients anesthetized with propofol by TCI. Methods Thirty-six ASA Ⅰor Ⅱ patients aged 18-59 yr with body mass index ＜ 30 kg/m2 undergoing elective breast operation were enrolled in the study. Propofol was administered by TCI at an effect-site concentration of 4.0 μg/ml. When the patients lost conciousness, TCI of remifentanil was started. The initial target plasma concentration of remifentanil was set at 2.9 ng/ml, and the ratio of two consecutive effect-site concentrations was 1.2. LMA was inserted at 3 min after the target effect-site concentration and the plasma concentration achieved the balance. Criteria of successful insertion were defined as Muzi score≤2 and the increase in MAP and HR≤ 15% of the baseline values within 3 min after insertion. EC50 was determined by modified Dixon's up-and-down sequential trial and the 95 % confidence interval was calculated. Results The EC50 of remifentanil was 2.75 ng/ml. The 95% confidence interval was 2.51-3.01 ng/ml. Conclusion The EC50 of remifentanil for suppression of cardiovascular response to LMA insertion is 2.75 ng/ml in patients anesthetized with propofol by TCI.

Objective:To investigate varied electromyographic types in the patients with hemimasticatory spasm(HMS).Methods:Surface electromyography was recorded to study electromyographic features of 16 cases with HMS.Results:Spasm was found in mandibular rest position in 2 cases and in tooth contact position in 14 cases.During the involuntary spasm of the 14 cases, motor unit potential could be classified into three types:continuous(8 cases), rhythmic(3 cases) and irregular(3 cases).Conclusion:The electromyographic feature of hemimasticatory spasm is characterized by continuous motor unit potential discharge. The spasm is mostly triggered by tooth contact.

Objective:To investigate the effect and mechanism of donor-Ag specific T cell vaccination on inducing specific immune tolerance of allogenic liver transplantation and the mechanism of immune privilege of liver transplantation .Methods:CBA mice were recipients,B6 mice were donors,T cell vaccination (TCV) were made from the attenuated spleen cells of CBA mice ,which were stimulated by Con A and were challenged with the spleen cells of B 6 mice.There are 3 groups in this experiment:Transplant control group:Orthotopic liver transplantation ( OLT) were performed with the recipients of CBA mice and donors of B 6 mice;Flt3-L treating group:OLT were performed with the recipients of CBA mice and donors of B 6 mice treated with Flt3-L;TCV group:OLT were performed with the recipients of CBA mice inoculated with TCV and donors of B 6 mice treated with Flt3-L.Median survival time (MST) of liver grafts was recorded, IL-4, IL-10 and IFN-γin peripheral blood were tested after transplantation in each group .One-way mixed lymphocyte reaction ( MLR) were carried out with effectors of spleen cells from CBA mice and stimulator of spleen cells from B 6 mice at the 5th day after transplantation.The apoptosis of liver graft infiltrating cells (GICs) were analyzed by flow cytometric analysis at the 5th day after transplantation.Results: Flt3-L treating donor activated allogenic acute rejecting reaction , TCV vaccinating recipient before and after transplantation significantly depressed the acute immune rejecting reaction mediated by Flt 3-L.The liver grafts were accepted by recipient without the presence of Flt 3-L.The cytokines test show that the serum value of IL-4 and IL-10 were increased in Transplant control group and TCV group ,but decreased in Flt3-L treating group.The value of IFN-γwas increased in Flt3-L treating.

ObjectiveTo investigate the effects of ligustrazine on renal tubulointerstitial injury in adriamycin nephrosis rats and its mechanism.MethodsForty male Sprague-Dawley rats were randomly divided into sham-operation group,model group,ligustrazine group and Benazepril group.The rat nephropathy model was established by adriamycin injection and unilateral nephrectomy.The 24-hour urinary protein excretion at the start,2nd,4th,6th weekends was analyzed.All rats were sacrificed at the 6th weekend,and then the renal function and the tubulointerstitial pathological injury were examined.Immunohistochemistry was used to measure the expression of ET-1.ResultsThe 24-hour urinary protein excretion [ (30.07 ±2.12) mg/24 h,(201.83 ± 8.63 ) mg/24 h,( 470.70 ± 58.79 ) mg/24 h ] ( at the 2th,4th,6th weekend),blood urea nitrogen[ BUN( 20.20 ± 2.65 ) mmol/L],serum creatinine[ Scr ( 86.79 ± 2.20 ) μmol/L),tubulointerstitial pathological injury (4.38 ± 0.26) and the expression of ET-1 ( 126.92 ± 3.63 )in model group were significantly higher than those in sham-operation group [ ( 6.75 ± 2.07 ) mg/24 h,( 8.28 ± 0.71 ) mg/24h,( 25.37 ± 4.30) mg/24 h,( 8.93 ± 1.05 ) mmol/L,(49.00 ± 5.34 ) μmol/L,1.06 ± 0.19,32.09 ± 3.71,P ＜ 0.01 ].Compared with model group,the 24-hour urinary protein excretion [ ( 176.93 ± 9.20)mg/24 h,( 270.45 ± 60.21 ) mg/24 h) ( at the 4th,6th weekend),BUN [ ( 13.75 ± 2.60 ) mmol/L ],Scr [ ( 62.49 ±3.29)μmol/ L ],Renal tubulointerstitial pathological injury (2.78 ± 0.10) and the expression of ET-1(57.44 ± 4.98 ) were significantly decreased in ligustrazine group( P ＜ 0.01 ).ConclusionsLigustrazine can downregulate the expression of ET-1 and decreased urinary protein excretion,leading to reduce tubulointerstitial inflammation and fibrosis.

Objective To analyze radiological features of rare tumor of breast.Methods To analyze retrospectively radiological features of 11 cases with rare tumor, all cases were confirmed by operation or pathology. Results Among the 11 cases ,1 case was non Hodgkin lymphoma(NHL). 1 case was malignant pleomorphic adenoma. 1 case was primary squamous cell carcinoma of breast. 1 case was osteosarcoma.2 cases were lobate cystadenosarcoma. 5 cases were hamartomas.Osteosarcoma shows bone tissues in the mass. Malignant pleomorphic adenoma shows more big mass with leaning-edge and abnormal vessel.Lobate cystadenosarcoma is a low-degree malignant tumor with long history, shows big mass, cleaning-edge and big calcification in it, there was a vitellary membracnce around the mass, usually no metastasis to armpit .Hamartoma’s density is highly uneven, the area of high density likes island. Primary squamous cell carcinoma of breast and NHL have no specific X-ray features.Conclusion Rare breast tumors have no specific radiological featare.Qualitative diagnosis needs sythetical analysis.

Objective: To compere OQL of recruits of armed police in south area fore-and-aft the basic military training.Methods: The WHOQOL-BREF Scale was used to investigate 539 recruits before the training and at the end of the 3rd month of the basic military training.Results: The score of physiological,psychological,social,and environmental domain of the OQL of recruits before the basic military training were68.90?13.36,65.65?14.28,67.16?16.71,61.06?14.23,The score of physiological,psychological,social,and environmental domain of the OQL of recruits before the basic military training were 71.52?12.16,70.34?14.78,74.10?22.00,66.07?14.36,the differences were salient.Conclution:The Basic Military Training can improve the OQL of recruits of armed police in south area.The improvement are bear on the education of adapting and improved training.

Objective To observe the therapeutic efficacy of auricular point sticking in preventing pain after perianal abscess surgery.Method Sixty patients going to receive radical perianal abscess surgery admitted by the First Affiliated Hospitalof Guangzhou University of Chinese Medicine between December of 2015 and February of 2016 were enrolled and randomized into an ordinary group and an auricular point sticking group. Pain was scored at different time points after the surgery and the use of analgesics was also recorded.Result There were significant inter-group differences in comparing the pain intensity from 6 h after the surgery till 7:30 on the next day of the surgery (P<0.05);the between-group differences in comparing the Visual Analogue Scale (VAS) scores from the 2nd day till the 7th day despite of the dressing change time were unstable(P>0.05,P<0.05); the differences in pain intensity at the dressing change were statistical significant (P<0.05).Conclusion Auricular point sticking can effectively treat mild-moderate pain in the early stage after perianal abscess surgery at non-dressing-change time, and it can also produce a satisfactory effect in preventing moderate-severe pain at dressing change after perianal abscess surgery.

Background Diabetes is one of the risk factors that leads to corneal neuropathy.Silent signal regulatory factor 1 (Sirt1) plays an important role in glucose metabolism,lipid metabolism,regulation of insulin secretion and is closely related to the nervous system disease.The relationship between Sirt1 and diabetic corneal neuropathy is not fully understood.Objective This study was to detect the expression of Sirtl in cornea and trigeminal ganglion with type 1 diabetes model mice and explore the association of Sirt1 expression with diabetic corneal neuropathy.Methods Eight C57BL/6-Ins2Akita/J male mice and eight wild-type C57BL/6 male mice in the same litter were selected as type 1 diabetes model group and control group,respectively.The mice of two groups were sacrificed in overdose anesthesia method at 12-month old.Histological examination of cornea and trigeminal ganglion was performed using hematoxylin and eosin staining.Expression and localization of Sift1 protein in cornea and trigeminal ganglion were detected using immunohistochemistry.Western blot assay and fluorescine quantitative PCR were respectively used to quantitatively analyze the expression of Sirt1 protein and Sirt1 mRNA.Results Trigeminal ganglion cells were uneven in size and shape with the loosened cellular arrangement and disorder neurofibrosis alignment,and the corneal epithelial cells were less in the C57BL/6-Ins2Akita/J mice,but the trigeminal ganglion cells and corneal epithelial cells were normal in wild-type C57BL/6 mice.Immunochemisty exhibited that Sirtl protein was expressed mainly in corneal epithelium and the expression of Sirtl protein was stronger in the C57BL/6 mice than that in C57BL/6-Ins2Akita/J mice.Fluorescine quantitative PCR assay showed that the gray scale value of Sirt1 mRNA in cornea in C57BL/6-Ins2Akita/J mice was lower than that of the wild-type C57BL/6 mice(0.56±0.03 vs.0.98±0.13) with significant difference (t =5.853,P =0.010).Western blot showed that the expression of Sirt1 protein in cornea was lower in C57BL/6-Ins2Akita/J mice than that of the wild-type C57BL/6 mice(0.78±0.017 vs.1.300±0.012) with significant difference(t =33.140,P =0.001).However,no significant differences were seen in the gray scale value of Sirt1 mRNA(2.45±0.18 vs.2.51±0.22) (t=0.587,P=0.599) and protein level(1.100±0.015 vs.1.110±0.017) (t =0.430,P=0.709) in trigeminal ganglion tissues between C57BL/6-Ins2Akita/J mice and wide-type C57BL/6 mice.Conclusions The corneal nerve and structure is abnormal in 12-month-old C57BL/6-Ins2Akita/J mouse.Sirt1 is involved in the pathogenesis of diabetic keratoneuropathy,suggesting that it may be a potential target.

Objective To observe the role of the health education model in pain self- efficacy for patients with cancer pain. Methods Sixty- four patients suffering from cancer pain were enrolled into the study and self- contrast experiment was made on each patient. The health education model was set up and health education for each patient with cancer pain was implemented. The pain, self- efficacy, cancer pain knowledge before and after the intervention were observed by Numerical Rating Scale (NRS),Chronic Pain Self- efficacy Scale(CPSS) and Cancer Pain Knowledge Questionnaire. Results NRS score were (5.38 ±0.19) points and (1.05 ± 0.11) points before and after the intervention, and there was significant difference (t =25.288, P = 0.000). Before intervention, pain management self- efficacy, physical function self- efficacy, symptom coping self- efficacy of CPSS scores were (10.38 ±0.37) , (20.97±0.81) , (16.86 ± 0.49) points, while after the intervention, the scores were (19.31± 0.30) , (33.25 ± 0.60) , (29.75 ±0.51) points, there were significant differences ( t = -33.225, -18.236, -18.235, all P = 0.000). Before and after the intervention, the answer rate of Cancer Pain Knowledge Questionnaire was 50.00%(32/64) and 87.50%(56/64), there was significant difference( χ2=20.51, P < 0.01). Conclusions To set up the health education model and implement health education for each patient with cancer pain can improve the patient′s pain management and enhance self-efficacy.

BACKGROUND:Denis B thoracolumbar burst fractures are common spinal injury and may be involved in the upper end plate injury. Fracture reduction and pedicle screw fixation are used to repair above injury. This scheme can effectively achieve the aim of correcting deformity, but the trabecular bone after crushing cannot be fuly recovered. OBJECTIVE:To observe the repair effect of fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body on Denis B thoracolumbar burst fracture, and compare with fracture reduction and pedicle screw fixation alone. METHODS:Clinical data of 70 cases of Denis B thoracolumbar burst fractures, who were treated in the Department of Orthopedics, Zhangjiagang Aoyang Hospital from January 2012 to December 2014, were retrospectively analyzed. According to repair scheme, they were equaly divided into two groups. Patients in the control group received fracture reduction and pedicle screw fixation. Patients in the observation group received fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body. Oswsetry Disability Index, height of anterior border of injured vertebral body, lower back pain visual analogue scale and vertebral kyphosis Cobb’s angle were compared and observed between the two groups before repair, 1 week, 3 and 6 months after repair. RESULTS AND CONCLUSION:No significant difference in Visual Analogue Scale was detected at 1 week, 3 and 6 months after repair between the observation and control groups (P > 0.05). Oswsetry Disability Index was significantly lower in the observation group than in the control group (P < 0.05). No significant difference in the height of anterior border of injured vertebral body was detected between the observation and control groups (P > 0.05). Cobb’s angle was significantly lower in the observation group than in the control group (P < 0.05). These findings suggest that fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body obtained good repair effects on Denis B thoracolumbar burst fracture, not only effectively corrected Cobb’s angle and the height of anterior border of injured vertebral body, but also helped to restore normal spinal loads by filing bone in the injured vertebral body.