Objective:To investigate the analgesic effect of nalbuphine combined with sufentanil on elderly patients with colorectal cancer after laparoscopic surgery.Methods:From January 2017 to December 2019, 106 elderly patients with colorectal cancer underwent laparoscopic surgery in Jiangshan People's Hospital were divided into observation group (53 cases) and control group (53 cases) according to the random digital table method.The control group was given sufentanil analgesia, and the observation group was given nalbuphine analgesia on the basis of the control group.The recovery time and catheter extubation time, pain visual analogue score (VAS) scores at 3, 12 and 24 hours after operation, changes of stress response before and 24h after operation, and adverse reactions were compared between the two groups.Results:The recovery time [(9.87±1.42)min] and catheter extubation time [(13.24±3.51)min] in the observation group were shorter than those in the control group [(17.34±2.98)min and (21.83±5.62)min] ( t=16.474, 9.438, all P<0.05). The postoperative 12h VAS score[(1.63±0.19)points] and 24h VAS score[(1.06±0.13)points] in the observation group were lower than those in the control group [(2.37±0.27)points and (1.83±0.32)points] ( t=16.318, 16.230, all P<0.05). The serum levels of Cor [(234.18±19.98)μg/L] and NE [(1.59±0.21)mmol/L] in the observation group were lower than those in the control group [(287.24±14.26)μg/L and (1.97±0.16)mmol/L] ( t=15.737, 10.479, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusion:Nalbuphine combined with sufentanil has good analgesic effect on elderly patients with colorectal cancer after laparoscopic surgery, and can reduce the postoperative stress response.

Objective: To investigate the effect and underlying mechanism of Long non-coding RNAurothelial carcinoma associated 1 (lncRNA UCA1) on proliferation, invasion and migration of non-small cell lung cancer (NSCLC) A549 cells. Methods: NSCLS A549 cells were cultured and transfected with lentivirus; RT-PCR was employed to detect the levels of UCA1 in A549 cells. The relationship between UCA1 and miR-185-5p was validated by luciferase reporter assays. Cell viability ofA549 cells was measured by MTT. Cell invasion and migration were determined by Transwell and Wound healing assay, respectively; and western blotting was performed for measuring the levels of Wnt1/β-catenin pathway-related proteins. Results: sh-UCA1 significantly decreased UCA1 expression and increased miR-185-5p expression in A549 cells (all P<0.05). miR-185 inhibitor attenuated the promotion effect of sh-UCA1 on miR-1855p (P<0.05). UCA1 could significantly down-regulate miR-185-5p expression in A549 cells (P<0.05), which was reversed by miR-185 mimic (P<0.05). Luciferase reporter assay validated the binding site on UCA1 to link miR-185-5p. sh-UCA1 significantly inhibited cell proliferation, invasion and migration ofA549 cells (all P<0.05), and also decreased the protein levels of Wnt1, β-catenin and TCF-4 notably (all P<0.05); however, miR-185 inhibitor attenuated such inhibitory effects of sh-UCA1 (P<0.05). Conclusion: UCA1 could promote proliferation, invasion and migration of A549 cells through targeting miR-185-5p, and the mechanisms might be related with activation of Wnt1/β-catenin pathway.

BACKGROUND:Studies have found that Notch pathway and Bmi-1 gene both have the ability to regulate stem cel self-renew. Functional dysfunction of the both may have a great relationship with tumorigenesis. OBJECTIVE:To investigate the expression and clinical significance of Notch1 and Bmi-1 protein in lung tissue. METHODS:Eighty-seven lung cancer tissue samples (lung cancer group) and forty pathologicaly confirmed normal lung tissue samples (normal group) were obtained from related surgeries and included as research objects. The protein expression of Notch1 and Bmi-1 in specimens of these two groups was measured by immunohistochemistry SP method. The relationship between Notch1 and Bmi-1 protein expression and clinicopathological features of lung cancer patients was analyzed. RESULTS AND CONCLUSION: The positive rate of Notch1, Bmi-1 protein expression was respectively 61% and 47%, which was significantly higher in the lung cancer group than that in the normal group (P < 0.05). In the lung cancer group, Notch1 protein expression was significantly positively correlated with Bmi-1 protein expression (r=0.567,P < 0.001). There were no significant differences in Notch1 and Bmi-1 protein expression rates between different genders and different pathological types of patients (P < 0.05). The Notch1 and Bmi-1 protein positive expression rates in poorly-differentiated, TNM stage III-IV lung cancer patients with lymph node metastasis were significantly higher than those in wel- and moderately-differentiated, TNM stage I-II lung cancer patients without lymph node metastasis (P < 0.05). These results demonstrate that Notch1 and Bmi-1 protein may have certain relationship with the occurrence and development of lung cancer.

Objective To investigate the effect of three kinds of skin external use in the prevention and treatment of radiation dermatitis in patients with nasopharyngeal carcinoma. Methods 120 patients with nasopharyngeal carcinoma who were treated form August 2014 to October 2015 were divided into three groups by random number table method, namely, aloe vera gel group, triethanolamine cream group, radiation treatment of skin protectants (lifuning) group. Except for different medications among the groups, the other conditions remained relatively consistent. 3 groups were compared in the radiotherapy classification, area, local pain score, and topical drug costs during the radiotherapy and the radiation dose when radiation dermatitis occurred the first time. Results Three kinds of skin external use had a preventive effect, but the effect was different. Three groups′ patients with radiation dermatitis incidence was 100%, but occurred at different levels. Aloe vera gel cream group and triethanolamine group were mainly for gradeⅡradiation dermatitis, grade IV radiation dermatitis occurred in 2 cases and 4 cases, lifuning group were mainly for grade Ⅰ and grade Ⅱ radiation dermatitis, grade Ⅲ radiation dermatitis only occurred 2 cases, noⅣgrade radiation dermatitis occurred. Comparison among the three groups, the difference was statistically significant (H=8.758,P<0.05). 3 groups of patients after treatment all suffered pain, 12 patients in triethanolamine cream group , 7 patients in lifuning group , only 2 cases in aloe vera gel group (H=8.586,P<0.05). The average cost of skin external used in 3 groups was different, triethanolamine cream group was 546.0 yuan, lifuning group was 458.2 yuan, and aloe vera gel group was 157.5 yuan. Among the three groups pairwise comparison, the differences in triethanolamine cream group and aloe vera gel group were statistically significant in pain (χ2=9.62,P<0.05), aloe vera gel group was better than the group of triethanolamine cream, the differences among radiation dermatitis grade, size and radiation dose of radiation dermatitis occurred the first time were not statistically significant (P>0.05). The difference between in lifuning group and triethanolamine cream group in pain had no statistically significant (χ2=2.47,P>0.05), other indexes had significant differences (P < 0.05). Lifuning was better than the triethanolamine cream to reduce and delay the onset and deterioration of radiation dermatitis and could prevent a widening of the area of radiation dermatitis;aloe vera gel group and lifuning group had a significant difference in radioepidermitis grade (χ2=6.32,P<0.05). Lifuning was better than the aloe vera gel and was more conducive to reduce and delay the occurrence of radiation dermatitis, other indexes differences had no statistically significant (P>0.05). Conclusions Considering the efficacy, pain and price three aspects which skin external use prevention and treatment radiation dermatitis patients with nasopharyngeal carcinoma, lifuning as the mixture of triethanolamine and aloe can effectively reduce and delay the chance of radiation dermatitis, reduce the radiation field experience of local pain, and affordable, the patients are more acceptable, it′s worthy of clinical use.

Objective To investigate the effects of intrathecal different doses of dexmedetomidine hydrochloride in spinal block by ropivacaine hydrochloride . Methods Forty lower limb surgery scheduled for elective under spinal anesthesia, were randomly divided into 2 groups (n = 20 each): the control and the treatment groups.The control and the treatment group were intrathecally injected with 4,12 μg dexmedetomidine hydrochloride respectively.The 0.75% ropivacaine hydrochloride 1.5 mL was injected for spinal anesthesia.SBP,DBP,HR,SpO2 and Ramsay Sedation Score were recorded before the spinal anesthesia conduct and thereafter every five minutes. And the onset and duration of block were recorded,adverse reaction like nausea, vomiting and respiratory depression were also observed. Results Compared with the control group,the onset of sensory block was shorter [(6.9±2.6) min vs (8.7±2.9) min] (P<0.05),and the duration of sensory and motor block was longer in the treatment group[(130.8±30.1) min vs (115.9±23.9) min] (P<0.05) and [(145.9±29.0) min vs (130.0±30.1) min] (P<0.05). Conclusion Intrathecal dexmedetomidine hydrochloride at 12 μg improves anesthesia via shortening the sensory block onset and prolonging sensory and motor block,which maintains hemodynamically stable,and does not generate adverse reactions as nausea,vomiting,bradycardia and respiratory depression.

Objective To investigate the effect of dexmedetomidine on sedation and cognitive function in elderly pa-tients after abdominal operation. Methods From January 2013 to January 2014 in our department,100 cases of abdominal operation were randomly divided into observation group (infusion of dexmedetomidine﹚ and control group (infusion of saline﹚,50 cases in each group, compared two groups of patients before treatment and 10 min after administration, 30 min after administration of Ramsay score changes,changes in the two groups before operation 1 days, 1 days after operation,postoperative 3 days,7 days after operation,MMSE score, the two groups before operation (T0﹚, 5 min after operation(T1﹚,before extubation 15 min T2﹚,extubation 30 min(T3﹚systolic blood pressure (SBP﹚,diastolic blood pres-sure (DBP﹚,heart rate(HR﹚ and oxygen saturation(SpO2﹚changes. Results Patients with 10 min after administration, 30 min Ramsay after administration scores were higher than those in the control group,there was significant difference (P<0.05﹚. The MMSE score of the patients in control group after operation 1 d, postoperative were lower than that of the observation group,there was significant difference (P<0.05﹚. 2 groups of patients with T2 in T3,SBP levels were significantly higher than T0,but the control group was significantly higher than those in the observation group,there was significant difference(P<0.05﹚. Patients in the control group DBP level was T0 increased significantly,and the level of DBP in patients with T2 group,T3 was significantly higher than that in the control group,and the observation of DBP level significantly changes in T0-T2 group were not significant (P>0.05﹚. Patients in control group and T1-T3 in HR were higher than that of the observation group,there was significant difference(P<0.05﹚. Conclusion Dexmedetomidine for sedation in elderly patients after abdominal operation,the cognitive function of patients recovered quickly,and can maintain the stability of hemodynamics.

Objective To investigate the effects of different anesthesia methods on immunity in patients underwent radical resection of rectal carcinoma.Methods 82 patients underwent radical resection of rectal carcinoma were divided into two groups,each group had 41 cases.A group received total intravenous anesthesia while B group received total intravenous anesthesia combined with eqidural anesthesia.CD3+,CD4+,CD4+/CD8+,CD3+HLA-DR+and NK cells were inspected before induction of anesthesia(T0),2 h after skin incision(T1),2 h(T2) and 24 h(T3) after the end of operation.The T-lymphocyte subsets,activated T cells and NK cells were measured by flow cytometry. Visual analogue scale(VAS) was observed at T2 and T3.Results The VAS score of T2,T3 in A group[(3.86 ± 0.46)points,(3.62 ±0.26)points]were higher than those in B group[(1.67 ±0.57)points,(1.94 ±0.42)points] (all P<0.05).The percentages of CD3+,CD4+,CD4+/CD8+,CD3+HLA-DR+and NK cells of T1,T2,T3 were lower than those of T0 in A group(all P<0.05);The percentages of CD3+,CD4+,CD4+/CD8+,CD3+HLA-DR+and NK cells of T1, T2 were lower than those of T0 in B group ( all P <0.05 );The percentages of CD3+, CD4+, CD4+/CD8+, CD3+HLA-DR+ and NK cells of T1, T2, T3 in A group were lower than those in B group ( all P <0.05 ). Conclusion Total intravenous anesthesia combined with eqidural anesthesia produces less immune suppression than total intravenous anesthesia.

Objective To prepare CD133 specific-binding peptide conjugated liposome loaded paclitaxel and evaluate the efficiency of cellular uptake and the ability of inhibiting A549 lung cancer stem cell.Methods Liposomes were prepared by film-ultrasonic method.The partical size,zeta-potential and entrapment efficiency of liposomes were evaluated.Cellular uptake effciency of A549 lung cancer stem cell for liposomes were explored.The anti-proliferation efficiency of TLP-PTX to A549 lung cancer stem cell was evaluated by MTT assay.Tumor spheroids were used to evaluate anti-tumor ability of TLP-PTX to A549 lung cancer stem cell. Results The particle diameter of TLP-PTX was (115.8 ±8.3)nm and the entrapment efficiency of PTX was 88.5%.CD133 specific-binding peptide could enhance the efficiency of cellar uptake.The uptaken efficiency of TLP by A549 lung cancer stem cell were 2.6 times higher than that of LP(P<0.05 ).The MTT Results showed that the toxicity of TLP-PTX on A549 lung cancer stem cell was significantly stronger than LP-PTX and paclitaxel solution(P<0.05 ).The tumor inhibition test results showed that TLP-PTX has good anti-tumor effect. Conclusion TLP-PTX can specifically recognize the surface marker CD133 of A549 lung cancer stem cell,facilitate liposomes into cells and inhibit A549 lung cancer stem cell proliferation.TLP-PTX is an effective drug delivery system targeting to A549 lung cancer stem cell.

Objective To construct RGD-TAT modified liposomes(RGD-TAT-LPs)and evaluate its glioma targeting efficiency.Methods RGD-TAT-LPs was constructed by film-ultrasonic method,its appearance,particle size and Zeta potential were mearsured. Cellular uptake of LPs,TAT-LPs, RGD-LPs and RGD-TAT-LPs was used to evaluate the affinity to C6 cells.C6 cells were xenografted in athymic mice to establish the animal model,which were used to evaluate the distribution of liposomes in vivo. Results The particle diameter of RGD-TAT-LPs was (1 16.5 ±1 1.3 )nm,and its Zeta potential was (23.2 ±3.5 )mV. Cellular uptake experiments demonstrated the cell uptake efficiency of RGD-TAT-LPs by C6 cells were 2.9-fold,2.3-fold and 4.7-fold than that of RGD-LPs,TAT-LPs and LPs respectively. The in vivo imaging showed that RGD-TAT-LPs had the strongest fluorescence intensity in brain. Conclusion The RGD-TAT-LPs might serve as a promising delivery system of antitumor drugs.

Objective To provide theoretical basis for clinical treatment of all-ceramic crown prosthodontics,the influence of cement thickness on the stress distribution in all-ceramic crowns under load was studied numerically.Methods The finite element analysis(FEA) model of a standard mandibular first molar was established using spiral CT and CAD software,and then it was applied to analyze the stress distribution of all-ceramic crowns under vertical loading using FEA software.Results Stress concentration was found in mesial and distal cement;the stress distribution at the cement upper and lower interface was found to be similar,and the stress magnitude discrepancy between the two interfaces was small;the stress of the model with 0.15 mm cement in the cervix was lower about 30% than the one of the 0.05 mm model.Conclusions The cement thickness plays an important role in the stress distribution of all-ceramic restoration system.The model with 0.15 mm cement shows a better resistance to destruction among the three models investigated.