Objective:To evaluate the efficacy of dexmedetomidine-scalp nerve block (SNB) combined with general anesthesia in the patients with acute traumatic brain injury (TBI) undergoing craniotomy.Methods:In this randomized controlled trial, 74 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex with acute TBI, aged 30-78 yr, with body mass index of 18-30 kg/m 2, underwent craniotomy for hematoma evacuation combined with decompressive craniectomy at the Traditional Chinese Medicine Hospital of Kunshan from January to December 2024, of the Glasgow Coma Scale score 8-12, were selected and divided into 2 groups ( n=37 each) using a random number table method: dexmedetomidine combined with ultrasound-guided SNB group (DS group) and ultrasound-guided SNB group (S group). Before anesthesia, dexmedetomidine was infused as a loading dose of 1 μg/kg over 10 min followed by an infusion of 0.3 μg·kg -1·h -1 until the end of operation. Ultrasound-guided SNB was performed after completion of intubation in both groups. The consumption of intraoperative fentanyl, propofol and remifentanil and the usage of vasoactive drugs were recorded. Before surgery (T 0), at 1 h after the start of surgery (T 1) and at the end of surgery (T 2), blood samples from the jugular bulbar and radial artery were collected, the jugular venous oxygen saturation was recorded, the arteriovenous oxygen content and cerebral oxygen uptake rate were calculated, and the occurrence of postoperative complications was also recorded. Results:Compared with group S, the consumption of fentanyl, propofol and remifentanil was significantly reduced, the usage rate of vasoactive drugs was decreased, the arteriovenous oxygen content and cerebral oxygen uptake rate were decreased at T 1 and T 2, the jugular venous oxygen saturation was increased, and the incidence of postoperative agitation was decreased in group DS ( P<0.05). Conclusions:Dexmedetomidine-SNB combined with general anesthesia can optimize the analgesic effect, improve cerebral oxygen supply and demand, reduce the occurrence of postoperative agitation when used in patients with acute TBI undergoing craniotomy.

Objective:To evaluate the efficacy of dexmedetomidine-scalp nerve block (SNB) combined with general anesthesia in the patients with acute traumatic brain injury (TBI) undergoing craniotomy.Methods:In this randomized controlled trial, 74 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex with acute TBI, aged 30-78 yr, with body mass index of 18-30 kg/m 2, underwent craniotomy for hematoma evacuation combined with decompressive craniectomy at the Traditional Chinese Medicine Hospital of Kunshan from January to December 2024, of the Glasgow Coma Scale score 8-12, were selected and divided into 2 groups ( n=37 each) using a random number table method: dexmedetomidine combined with ultrasound-guided SNB group (DS group) and ultrasound-guided SNB group (S group). Before anesthesia, dexmedetomidine was infused as a loading dose of 1 μg/kg over 10 min followed by an infusion of 0.3 μg·kg -1·h -1 until the end of operation. Ultrasound-guided SNB was performed after completion of intubation in both groups. The consumption of intraoperative fentanyl, propofol and remifentanil and the usage of vasoactive drugs were recorded. Before surgery (T 0), at 1 h after the start of surgery (T 1) and at the end of surgery (T 2), blood samples from the jugular bulbar and radial artery were collected, the jugular venous oxygen saturation was recorded, the arteriovenous oxygen content and cerebral oxygen uptake rate were calculated, and the occurrence of postoperative complications was also recorded. Results:Compared with group S, the consumption of fentanyl, propofol and remifentanil was significantly reduced, the usage rate of vasoactive drugs was decreased, the arteriovenous oxygen content and cerebral oxygen uptake rate were decreased at T 1 and T 2, the jugular venous oxygen saturation was increased, and the incidence of postoperative agitation was decreased in group DS ( P<0.05). Conclusions:Dexmedetomidine-SNB combined with general anesthesia can optimize the analgesic effect, improve cerebral oxygen supply and demand, reduce the occurrence of postoperative agitation when used in patients with acute TBI undergoing craniotomy.

Bluetongue virus(BTV)is classified as a category Ⅱ animal epidemic disease in China,infecting multiple species and posing significant threats to the ruminant breeding industry.There are 29 serotypes of BTV,with BTV16 being one of the major serotypes currently prevalent in Chi-na.Bluetongue virus infection mainly manifests as a latent infection,making the establishment of ELISA assays crucial for epidemiological detection.In this study;the expression of the BTV16 VP2 protein was achieved using a prokaryotic expression system,and polyclonal antibodies were pre-pared using BALB/c mice.An indirect ELISA assay using VP2 protein as the encapsulated antigen was established and optimized.Clinical samples from the Guangxi Zhuang Autonomous Region were tested and analyzed for compliance with commercial kits.The results showed that the BTV16 VP2 protein was successfully expressed and purified,and the prepared polyclonal antibody exhibi-ted good immunogenicity.The ELISA assay had good specificity,with no cross-reactivity against ruminant diseases such as AKAV,FMDV and GETV.The critical values for negativity and positivity were determined to be 0.314,and the coefficients of variation(Cv)between batches and within batches were both less than 5％,indicating good reproducibility.The ELISA assay revealed a positive rate of 92.4％for 79 samples from the Guangxi Zhuang Autonomous Region,with a compliance rate of 98.7％when compared to the commercialized kit.In conclusion,this study suc-cessfully established an indirect ELISA method for BTV16,facilitating the detection of bovine clin-ical samples.

Bluetongue virus(BTV)is classified as a category Ⅱ animal epidemic disease in China,infecting multiple species and posing significant threats to the ruminant breeding industry.There are 29 serotypes of BTV,with BTV16 being one of the major serotypes currently prevalent in Chi-na.Bluetongue virus infection mainly manifests as a latent infection,making the establishment of ELISA assays crucial for epidemiological detection.In this study;the expression of the BTV16 VP2 protein was achieved using a prokaryotic expression system,and polyclonal antibodies were pre-pared using BALB/c mice.An indirect ELISA assay using VP2 protein as the encapsulated antigen was established and optimized.Clinical samples from the Guangxi Zhuang Autonomous Region were tested and analyzed for compliance with commercial kits.The results showed that the BTV16 VP2 protein was successfully expressed and purified,and the prepared polyclonal antibody exhibi-ted good immunogenicity.The ELISA assay had good specificity,with no cross-reactivity against ruminant diseases such as AKAV,FMDV and GETV.The critical values for negativity and positivity were determined to be 0.314,and the coefficients of variation(Cv)between batches and within batches were both less than 5％,indicating good reproducibility.The ELISA assay revealed a positive rate of 92.4％for 79 samples from the Guangxi Zhuang Autonomous Region,with a compliance rate of 98.7％when compared to the commercialized kit.In conclusion,this study suc-cessfully established an indirect ELISA method for BTV16,facilitating the detection of bovine clin-ical samples.

Objective:To investigate the therapeutic effects of finger pressing on Hegu acupoint on nausea and to find an optimal method to reduce nausea in first-time complete denture wearers. Methods:Forty-one first-time complete denture wearers who received treatment between June 2016 and December 2019 in Huxi Hospital Affiliated to Jining Medical University were included in this study. They were randomly divided into observation group ( n = 21) and control group ( n = 20). The observation group received finger pressing on Hegu acupoint for 3 minutes before complete denture wearing and before three meals. The control group received self-adaptive therapy. After 3, 7 and 14 days of wearing complete denture, the number of wearers without nausea, the number of wearers with normal swallowing function, and the number of wearers with masticatory efficiency were recorded in each group. Efficacy was compared between two groups. Results:After 3 and 7 days of wearing complete denture, the percentage of complete denture wearers without nausea was 85.71% (18/21) and 95.24% (20/21), respectively, which were significantly higher than those in the control group [45.00% (9/20), 65.00% (13/20), χ2 = 5.58, 4.19, both P < 0.05 ]. After 14 days of wearing complete denture, there was no significant difference in number of wearers without nausea between observation and control groups ( P > 0.05). After 3 days of wearing complete denture, there was significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups [57.14% (12/21) vs. 15.00% (3/20), χ2 = 8.16, P < 0.01). After 7 and 14 days of wearing complete denture, there was no significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups (both P > 0.05). After 3 and 7 days of wearing complete denture, masticatory efficiency in the observation group was (42.03 ± 5.02)% and (50.34 ± 5.05)%, which were significantly higher than those in the control group [(37.00 ± 4.00)%, (47.13 ± 4.03)%, t = 3.51, 1.65, both P < 0.05]. After 14 days of wearing complete denture, there was no significant difference in masticatory efficiency between the two groups ( P > 0.05). Conclusion:Finger pressing on Hegu acupoint has good clinical effects on alleviating nausea in complete denture wearers and can shorten the adjustment time to first time wearing complete denture.

Objective:To investigate the significance of MLH1 protein expression and MLH1 gene methylation rate between metastatic solid pseudopapillary tumor of pancreas (SPT) and non-metastatic SPT, and to explore the correlation between MLH1 gene methylation and SPT metastasis.Methods:Twelve metastatic SPT patients admitted to Peking University People's Hospital, Rizhao Central Hospital and Chaoyang Central Hospital of Liaoning Province from January 2009 to May 2022 were studied retrospectively, including 3 males and 9 females, with a median age of 47 years old, ranging from 21 to 73 years old. Thirty non-metastatic SPT patients with clear diagnosis, clear medical history and complete follow-up data from pathological database of Peking University People's Hospital from January 2009 to May 2017 were selected as the control group, including 12 males and 18 females, with a median age of 42 years old, ranging from 34 to 69 years old. Clinical data such as gender, age and pathological data were collected. Immunohistochemical expression of MLH1 protein and methylation of MLH1 gene were detected by pathological paraffins.Results:There was no significant difference in general data between the two groups (all P>0.05). Among the 12 metastatic SPT patients, 4 cases metastasized to liver, 2 to spleen, 2 to lung, 2 to lymph nodes, 1 to mediastinum, and 1 to sacrum. Compared with the non-metastatic tissue, the MLH1 protein deletion in metastatic pancreatic lesions (metastatic SPT-P) and metastatic lesions (metastatic SPT-M) were increased [both 33.3%(4/12)], and the difference was statistically significant (both Chi square=5.00, both P=0.041). Compared with 0 (0/30) MLH1 gene methylation rate in non-metastatic SPT tissues, the methylation rate of MLH1 gene in metastatic SPT-M and metastatic SPT-P tissues [both 30% (3/10)] were higher, with statistical significance (both Chi square=0.96, both P=0.032). Conclusion:Compared with non-metastatic SPT, the loss rate of MLH1 protein expression and MLH1 gene methylation are increased in metastatic SPT. MLH1 methylation may occur before metastasis, which can be used as a predictor of SPT metastasis.

Objective: To investigate the effect of macrophage-capping protein (CapG) on migration and proliferation of human gastric cancer cell line.Methods: Real-time PCR method was used to detect the expression of CapG gene in four gastric cancer cell lines, and AGS cells with low expression and transfection were selected as the research objects.Specific primers were designed for CapG and recombinant plasmids synthesized.A lentivirus packaging system which could express CapG was constructed, and a cell line stably expressing CapG was established by infecting human gastric cancer cell line AGS cells.The effect of overexpression of CapG gene on the growth and proliferation of AGS cells was analyzed by CCK8 assay.Cells cratch and Transwell assay were used to analyze the effect of overexpression of CapG gene on AGS cell migration.Results: After the overexpression of CapG, the growth rate of AGS cells was slightly lower than that of the control group, but there was no significant difference between the two groups (t=2.424, P=0.073).Scratch test showed that the average narrowing distance of the scratches in the CapG experimental group was significantly reduced compared with the control group, the average narrowing distance of the CapG experimental group and the control group was 336.99 μm and 45.54 μm, the difference was statistically significant (t=14.97, P=0.004).The average number of cell penetra-ting membrane in the CapG experimental group and the eGFP control group was 176 and 70, the number of the cells in the CapG experimental group was significantly higher than that of the control group (t=40.00, P<0.001).Conclusion: The overexpression of CapG gene has no significant effect on the growth and proliferation of AGS cells of gastric cancer cell line.Overexpression of CapG gene can promote the migration of AGS cells of gastric cancer cell lines.

Objective To explore the clinical significance of typical reflux symptoms in the diagnosis of gastroesophageal reflux disease (GERD).Methods Consecutive patients older than 16 years,who initially visited department of gastroenterology at clinic of Peking University Third Hospital from May 9,2012 to Dec 31,2012,were required to complete a self-reported GERD questionnaire.Upper endoscopy was performed in some selected patients.Results A total of 18 987 patients were enrolled with a response rate of 91.5％.The prevalence of symptom-defined GERD was 13.6％ (2 579/18 987).A total of 4 357 (22.9％) patients underwent the upper endoscopy,and the diagnostic rates of reflux esophagitis,Barrett's esophagus,peptic ulcer disease,and upper gastrointestinal malignancy were 13.1％ (572/4 357),1.8％ (78/4 357),10.5％ (456/4 357),and 1.7％ (75/4 357),respectively.The incidence of reflux esophagitis was 22.7％ (216/951) in patients with reflux symptoms and 10.5％ (356/3 406) (P ＜0.001) in patients without reflux symptoms,2.7％ (26/951) and 1.5 ％ (52/3 406),respectively (P =0.013) for Barrett's esophagus; 6.8％ (65/951) and 11.5％ (391/3 406),respectively (P＜0.001) for peptic ulcer disease; 1.7％ (16/951) and 1.7％ (59/3 406),respectively (P =0.917) for upper gastrointestinal malignancy.Conclusions GERD is one of the major diseases at gastroenterology clinic.Typical reflux symptoms suggest a diagnosis of GERD.But some patients with peptic ulcer disease or upper gastrointestinal malignancy can also present typical reflux symptoms.Upper endoscopy is valuable to avoid the misdiagnosis of other disorders.

Objective To evaluate the risk factors for prognosis in liver cirrhotic patients with acute esophageal variceal bleeding (EVB). Methods Retrospective analysis was carried out in patients with liver cirrhosis,who were admitted to the hospital for EVB between January 2000 and December 2006 . All patients were follow-up to August 31st, 2009. The death of the patients was identified as the end of the study. The vital signs and results of laboratory tests were recorded when patients were admitted to the hospital. Child-Pugh score/grade, model for end stage liver disease (MELD) score and Rockall score were calculated. Results Ninty-five cases (66 males and 29 females) were enrolled in the study. Among them, 60 cases died and 35 cases survived for (42. 61±33.21) months (ranged from 2 days to 114 months). Univariate Cox regression analysis showed that age, male, Child-Pugh score/grade, MELD score, Rockall score, white blood cell counts and active hepatitis B were risk factors for death in liver cirrhotic patients with EVB (P＜0.05), while high level of hemoglobin and high hematocrit, endoscopic variceal sclerosis therapy or surgical treatment were protective factors (P＜0.05). Multivariate Cox regression analysis revealed that Child-Pugh grade (RR= 4. 997,95%CI:2. 787～8. 960, P＜0.01),Rockall score (RR= 1. 284,95%CI:1. 062～1. 553,P=0. 010), high counts of white blood cells (RR= 1. 072,95%CI: 1. 001 ～ 1. 148, P= 0. 046) were risk factors for prognosis of liver cirrhotic patients with EVB. Conclusion It is demonstrated that Child-Pugh grade,Rockall score and high counts of white blood cells are risk factors for prognosis of liver cirrhotic patients with EVB.