Objective:To compare the effect of different plane block under general anesthesia combined with ultrasound guidance in laparoscopic radical gastrectomy for gastric cancer.Methods:A total of 160 patients with gastric cancer admitted to the Quzhou Hospital Affiliated to Wenzhou Medical University from June 2022 to September 2023 were selected and divided into control group and observation group by random number table method, with 80 cases in each group. All participants underwent general anesthesia. On this basis, the control group combined with ultrasonic-guided vertical spinal plane block (ESPB). The observation group was combined with ultrasound-guided quadratus lumbar block (QLB). The hemodynamics, stress response, pain degree, postoperative recovery time, adverse events and quality of recovery from anesthesia were compared between the two groups.Results:The mean arterial pressure (MAP) level at the time of skin incision (T 1) and lesion resection (T 2) in observation group was lower than that in control group, and the heart rate (HR) at the time of T 1, T 2 and after surgery (T 3) was lower than that in control group (all P<0.05). The levels of cortisol (Cor) and interleukin-6 (IL-6) in the observation group were lower than those in control group after anesthesia induction, 10 min after skin resection, 24 h after surgery (all P<0.05). The scores of Visual Analogue Scale (VAS) at rest and exercise at 2, 6, 12, 24 and 48 h in the observation group were lower than those in the control group (all P<0.05). The time of awakening, getting out of bed and anal exhaust in the observation group was shorter than that in the control group (all P<0.05). There was no significant difference in the incidence of adverse events between the observation group and the control group [11.25%(9/80) vs 16.25%(13/80), P>0.05]. The scores and total scores of 40-item Quality of Recovery Score (QoR-40) in the observation group were higher than those in the control group (all P<0.05). Conclusions:Compared with ultrasound-guided ESPB combined with general anesthesia, the application of ultrasound-guided QLB combined with general anesthesia in laparoscopic radical gastrectomy for gastric cancer can achieve better perioperative analgesia effect, which is conducive to stabilizing the hemodynamics of patients and alleviating the stress response of the body, and the postoperative recovery time of patients is shorter, which can improve the quality of anesthesia recovery of patients.

Objective:To compare the effect of different plane block under general anesthesia combined with ultrasound guidance in laparoscopic radical gastrectomy for gastric cancer.Methods:A total of 160 patients with gastric cancer admitted to the Quzhou Hospital Affiliated to Wenzhou Medical University from June 2022 to September 2023 were selected and divided into control group and observation group by random number table method, with 80 cases in each group. All participants underwent general anesthesia. On this basis, the control group combined with ultrasonic-guided vertical spinal plane block (ESPB). The observation group was combined with ultrasound-guided quadratus lumbar block (QLB). The hemodynamics, stress response, pain degree, postoperative recovery time, adverse events and quality of recovery from anesthesia were compared between the two groups.Results:The mean arterial pressure (MAP) level at the time of skin incision (T 1) and lesion resection (T 2) in observation group was lower than that in control group, and the heart rate (HR) at the time of T 1, T 2 and after surgery (T 3) was lower than that in control group (all P<0.05). The levels of cortisol (Cor) and interleukin-6 (IL-6) in the observation group were lower than those in control group after anesthesia induction, 10 min after skin resection, 24 h after surgery (all P<0.05). The scores of Visual Analogue Scale (VAS) at rest and exercise at 2, 6, 12, 24 and 48 h in the observation group were lower than those in the control group (all P<0.05). The time of awakening, getting out of bed and anal exhaust in the observation group was shorter than that in the control group (all P<0.05). There was no significant difference in the incidence of adverse events between the observation group and the control group [11.25%(9/80) vs 16.25%(13/80), P>0.05]. The scores and total scores of 40-item Quality of Recovery Score (QoR-40) in the observation group were higher than those in the control group (all P<0.05). Conclusions:Compared with ultrasound-guided ESPB combined with general anesthesia, the application of ultrasound-guided QLB combined with general anesthesia in laparoscopic radical gastrectomy for gastric cancer can achieve better perioperative analgesia effect, which is conducive to stabilizing the hemodynamics of patients and alleviating the stress response of the body, and the postoperative recovery time of patients is shorter, which can improve the quality of anesthesia recovery of patients.

ObjectiveTo investigate the prevalence of polycystic ovary syndrome （PCOS） among female college students at a university in Fuzhou City， Jiangxi Province， and to facilitate early detection and intervention of PCOS. MethodsUsing a stratified sampling method， a total of 450 female freshmen were randomly selected for PCOS screening. A self-designed questionnaire was used for data collection， covering menstrual status， high androgen signs， lifestyle， dietary habits， and awareness of PCOS. Sample t test and χ² test were used to compare the basic information and dietary habits between PCOS and non-PCOS cases. The correlation between various indicators and the prevalence of PCOS was analyzed by a logistic regression model. ResultsA total of 12 PCOS cases were identified， with a prevalence rate of 2.99%. PCOS cases exhibited statistically significant differences compared to non-PCOS cases in terms of waist-to-hip ratio， waist circumference， abdominal obesity， the proportion of overweight or obese individuals， and a preference for sweet food （all P<0.05）. Multivariate logistic regression analysis revealed a significant correlation between preference for sweet food and the occurrence of PCOS （OR=4.858， 95%CI=1.199‒19.675，P=0.027）， as well as a significant correlation with PCOS accompanied by abdominal obesity （OR=7.083， 95%CI=0.773‒64.937， P=0.048）. Among the female college students surveyed， 37.90% had never heard of PCOS， 51.62% were only familiar with the name of the disease， and 10.47% had attempted to search for PCOS-related information. ConclusionThe prevalence of PCOS among female college students should not be overlooked and unhealthy dietary habits may be a crucial factor contributing to the occurrence of PCOS during this period. Early screening for PCOS during puberty is crucial.

OBJECTIVE：To investigate the effects of dexmedetomidine on regional cerebral oxygen saturation and cerebral function in patients undergoing intracranial aneurysm embolization. METHODS ：Totally 44 patients undergoing intracranial aneurysm embolization in the First Affiliated Hospital of Hunan University of TCM during Jun. 2017-Aug. 2019 were collected and randomly divided into group D （22 cases）and group C （22 cases）. Ten minutes before anesthesia induction ，group D was given intravenous injection of Dexmedetomidine hydrochloride injection 1 μg/kg；group C was given buffered normal saline 20 μL. Both groups were induced with Propofol emulsion injection+Midazolam injection+Fentanyl citrate injection+Cisatracurium besylate for injection. During the operation ，group D was given Dexmedetomidine hydrochloride injection 0.5 μg（/ kg·h）+Fentanyl citrate injection+Benzsulfosum atracurium for injection+Propofol emulsion injection to maintain anesthesia ；group C was continuously pumped with buffered normal saline 0.5 μg（/ kg·h）+Fentanyl citrate injection + Benzsulfosum aratracurium for injection Propofol emulsion injection to maintain anesthesia. Before anesthesia induction （T0）， immediately after anesthesia。induction （T1）， 1 min after tracheal intubation （T2）， immediately after operation finished （T3），immediately afte extubation（T4），the mean arterial pressure（MAP），heart rate 中国药房 2021年第32卷第7期 China Pharmacy 2021Vol. 32 No. 7 ·865· （HR），regional cerebral oxygen satur ation（rSO2）were observed in 2 groups. The levels of neuron specific enolase （NSE）and S100 β protein in serum were measured at T1，T3，6 h after operation （T6）. The recovery time ，intraoperative blood loss ， nitroglycerin amount and the occurrence of ADR were recorded. RESULTS ：MAP and HR of group D at T 2-T4 were significantly lower than those at T 0；MAP and HR of group C at T 2-T4 were significantly higher than those at T 0；the group D were significantly lower than the group C at the same period （P＜0.05）；there was no statistical significance in rSO 2 between 2 groups at T 0-T4（P＞ 0.05）. The levels of serum NSE and S 100β protein in 2 groups at T 3 were significantly higher than at T 1；those in 2 groups at T 6 were significantly lower than at T 3，but those of group D were significantly lower than the group C at T 3（P＜0.05）；there was no statistical significance in the levels of serum NSE or S 100β protein between 2 groups at T 1（P＞0.05）. The recovery time of anesthesia，the amount of nitroglycerin ，the incidence of tachycardia ，nausea and vomiting ，restlessness，shivering and cough in group D were significantly shorter or lower than group C （P＜0.05）；there was no statistical significance in the intraoperative blood loss between 2 groups（P＞0.05）. CONCLUSIONS ：Dexmedetomidine can maintain the hemodynamic stability of patients with intracranial aneurysm embolization during the perioperative period ，has little effect on rSO 2 and brain function ，and has good safety.

Objective To investigate the difference between histopathological changes of brain white matter in low-density lipoprotein receptor (LDLR) homozygous mutation rats with hypercholesterolemia and wild-type rats.Methods Thirty LDLR-/-rats and 28 wild-type rats were selected.Plasma cholesterol levels were measured by enzyme-linked immunosorbent assay at 15,18 and 26 weeks old respectively.The axonal structure of the corpus callosum area was observed by transmission electron microscopy.The myelin basic protein (MBP) of the corpus callosum area was quantitatively analyzed by Western blotting.In addition,at 26 weeks old,the myelin sheaths were stained by fast blue staining.The expression level of MBP in white matter was further detected by immunofluorescence staining,and the morphological changes of glial cells were observed.Results Compared with the wild-type rats,the plasma cholesterol concentration in LDLR-/-rats increased significantly,and it could be as high as 3.3 times at 26 weeks.The results of electron microscopy showed that the LDLR-/-rats had axonal injury at 15 weeks and aggravated gradually over time.At 26 weeks,Western blot analysis of the LDLR-/-rats showed that the MBP expression level of the corpus callosum area decreased significantly.Fast blue staining showed loosening of nerve fibers,diffuse vacuole formation,and myelinated nerve fiber loss in the corpus callosum area.In addition,it was also found that the number of oligodendrocytes in LDLR-/-rats was significantly reduced,and large numbers of astrocytes and microglia were activated.Conclusions LDLR-/-rats will have spontaneous hypercholesterolemia.Axonal injury,demyelination,decreased oligodendrocytes,as well as the abnormal activation of astrocytes and microglia are present in the early adult brain white matter area.

Objective To explore the clinical effect of Tongluo-Ningxue decoction for hematuria from IgA nephropathy. Methods A total of 60 patients with IgA nephropathy in the hospital between July 2015 and August 2016 were randomly divided into two groups, with 30 cases in each group. The control group was treated with western medicine (Benazepril Hydrochloride plus dipyridamole), whereas the observation group took Tongluo-Ningxue decoction for treatment. The clinical efficacy, clinical symptom score, biochemical index and humoral immune index in the two groups were compared. Results The effective rate was 86.7％ (26/30) in the observation group, and 63.3％ (19/30) in the control group, with the difference between the two groups being statistically significant (χ2=4.356, P=0.037). After treatment, the scores of fatigue and weakness (0.7 ± 0.1 vs. 1.4 ± 0.2, t=18.954), soreness and weakness of waist and knees (0.7 ± 0.1 vs. 1.4 ± 0.2, t=21.071), swollen sore throat (0.6 ± 0.1 vs. 1.4 ± 0.2, t=20.723), and hot flashes and night-time sweating (0.6 ± 01 vs. 1.5 ± 0.2, t=20.732) in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the 24h UP (0.53 ± 0.12 g vs. 0.74 ± 0.15 g, t=5.988), RBC (16.84 ± 5.38 vs. 21.42 ± 9.73, t=2.256), SCr (56.34 ± 7.21 μmol/L vs. 61.27 ± 8.45 μmol/L, t=2.431), and IgA (2.35 ± 0.43 g/L vs. 2.62 ± 0.45 g/L, t=2.376) in the observation group were significantly lower than those in the control group (P<0.05). Conclusions The Tongluo-Ningxue decoction can improve the biochemical indicators, enhance immunity, improve renalfunction and relieve clinical symptoms, and therefore, it is worthwhile for the clinical application.

Objective To investigate the correlations of P2Y1 and ITGB3 single nucleotide polymorphisms (SNP) with aspirin resistance (AR) in patients with large atherosclerotic stroke (LAA) in a Chinese Han population.Methods Patients with first-ever LAA from Anhui stroke registration system were enrolled.Thrombus elasticity diagram was used to detect the platelet function.TaqMan technology was used to detect the P2Y1 and ITGB3 genotypes.Results A total of 206 patients with LAA were enrolled.Thirty-one patients (15.0％) had AR and 175 (85.0％) were aspirin sensitive (AS).The frequency of P2Y1 rs701265 G allele in the AR group was significantly higher than that in the AS group (43.5％ vs.26.9％;x2 =7.074,P=0.008).The frequency of P2Y1 rs701265 AA genotype in the AR group was significantly lower than that in the AS group (32.3％ vs.53.7％;x2 =4.850,P=0.028).There were no significant significances in the frequencies of P2Y1 rs1065776 and ITGB3 rs5918 alleles and genotypes between the AR group and the AS group.Multivariate logistic regression analysis showed that P2Y1 rs701265 G allele was an independent risk factor for AR in patients with LAA (odds ratio 2.186,95％ confidence interval 1.190-4.016;P=0.012).Conclusion The P2Y1 rs701265 polymorphism is associated with AR in Chinese Han patients with LAA,while the P2Y1 rs1065776 and ITGB3 rs5918 polymorphisms are not.

Objective To explore the impacts of NPHP1 knockdown on the phenotype of Madin-Darby canine kidney (MDCK) cells. Methods The expression of NPHP1 in MDCK cells was knockdown by siRNA interference. Cells were divided into normal control group, negative control group and siRNA group. The cellular morphology and migration were observed by light microscope. The mRNA expressions and activities of matrix metalloproteinases 2 and 9 (MMP2 and MMP9) were detected by real time PCR and gelatin zymography. The mRNA and protein expressions of E-cadherin, β-catenin, zonula occluden-1 (ZO-1), ZO-1-associated nucleic acid binding protein (ZONAB) and α-smooth muscle actin (α-SMA) were analyzed by real time PCR, Western blotting and immunocytochemistry. Results Compared with those in normal control group, in siRNA group the mRNA expressions of E-cadherin, β-catenin and ZO-1 decreased, and MMP9, MMP2, α-SMA and ZONAB increased after interfering NPHP124 h (all P<0.05); the protein expressions of E-cadherin,β-catenin and ZO-1 decreased and ZONAB and α-SMA increased after 48 h (all P<0.05), and MDCK cells became elongated with enhanced migration capacity; siRNA cells had decreased expressions of E-cadherin and β-catenin on the membrane, but increased expression of ZONAB in cytoplasm and nucleoplasm after 72 h, and α-SMA was also observed in some interfered cells. Conclusions NPHP1 knockdown induces epithelial-mesenchymal transition in MDCK cells, and ZO-1/ZONAB signaling pathway was activated. These changes may associate with renal interstitial fibrosis of Nephronophthisis type I.

Objective: To investigate the changes in the composition of intestinal microbiota in mice with acute liver failure and identify characteristic bacteria, and to provide a basis for the diagnosis and treatment of acute liver failure with intestinal microbiota disorders. Methods: A total of 30 specific pathogen-free male BALB/c mice were used in this study, including 25 mice in the model group and 5 mice in the control group. An acute liver failure model was induced by D-galactosamine. Microbial DNA was extracted from intestinal contents in different segments of the lower digestive tract (ileum and colon) and feces and then were amplified using PCR. The regions of 16S V3-V4 were subjected to high-throughput sequencing, followed by bioinformatics analyses, including OTU hierarchical clustering, species annotation, alpha-diversity analysis, and LEfSe (LDA Effect Size) analysis. Comparison of continuous data was made using t-test, while comparison of categorical data was made using χ2 test. Results: A total of 10 mice survived in the two groups, with 80% mortality rate in the model group. The alpha-diversity analysis revealed increased bacterial diversity and abundance in the ileum, increased bacterial diversity and reduced bacterial abundance in the colon, and reduced bacterial diversity and insignificantly changed bacterial abundance in feces in the model group compared with the control group. Based on the optimized classification level, significantly reduced abundance of Clostridiaceae (44.95% ± 19.28% vs 7.51% ± 16.57%, P = 0.011) in the ileum, whereas significantly increased abundance of Rikenellaceae (1.08% ± 1.01% vs 4.18% ± 2.39%, P = 0.028), S24-7 (4.75% ± 4.87% vs 22.77% ± 13.05%, P = 0.020), and F16 (0.24% ± 0.28% vs 2.18% ± 1.61%, P = 0.029) in the colon were found in model group compared with the control group. The LEfSe analysis demonstrated that there were significant differences in Staphylococcaceae and S24-7 between the two groups, and S24-7 could be defined as the characteristic bacteria. Conclusion Intestinal microbiota disorders, especially the excessive growth of microbes in the ileum, are observed in mice with acute liver failure. Moreover, acute liver failure may be closely associated with the excessive growth of S24-7.

Objective There is little research on the relationship of gene polymorphism of CYP2C19 and clopidogrel response after percutaneous transluminal angioplasty and stenting ( PTAS) in patients with ischemic cerebrovascular disease.The study aimed to investigate the relationship between gene polymorphism and high on-treatment platelet reactivity ( HTPR ) after PTAS and 6 months of regular dual antiplatelet administration in patients. Methods A total of 145 Chinese patients treated with PTAS in our de-partment from January 2011 to March 2014 were enrolled in this study.According to the gene sequencing, patients were divided into wild-type group(CYP2C19*1/*1,69 cases) and mutation group(heterozygous mutation CYP2C19*1/*2 and homozygous mutation CYP2C19*2/*2, 76 cases).Patients received a 100mg/d aspirin and 75mg/d clopidogrel maintenance dose (MD) as dual anti-platelet therapy after PTAS.The clopidogrel inhibition effect was measured by thrombelastography ( TEG) system 6 months after PTAS. Routine cerebral artery digital subtraction angiography was applied to evaluate whether there was restenosis in stent and logistic regres-sion analysis was used to analyze the influential factors of HTPR after PTAS and clopidogrel adminstration. Results After 6 months'regular administration of clopidogrel after PTAS, the platelet adenosine diphosphate ( ADP ) receptor inhibition rates in wild-type group, heterozygous mutation and homozygous mutation group were respectively (58.43 ±21.98)%, (47.80 ±22.93)%, (37.53 ± 21.84)%.The platelet ADP receptor inhibition rate was significantly decreased compared with wild-type group(P=0.001).Carriers of at least one CYP2C19 loss-of-function ( LOF) allele had a higher frequency of clopidogrel HTPR (35.5% vs17.4 % for patients with and without LOF alleles, respectively;P=0.014) .Using multivariate logistic regression analysis, the carriage of CYP2C19 LOF alleles was an independent predictor of the post-procedure HTPR (OR=2.356, 95% CI:1.053-5.272, P=0.037).The rate of ISR was remarkably higher in patients with at least one CYP2C19*2 alleles compared with wild-type patients(11.8%vs 1.4%, P=0.019) . Conclusion In patients with ischemic cerebrovascular disease, the CYP2C19 LOF allele had significant impact on post-procedure clopidogrel HTPR and the prognosis of ISR after PTAS.