Objective To compare the effect of quadratus lumborum block at supra-arcuate ligament(SA-QLB)and erector spinae plane block(ESPB)on postoperative analgesia and recovery quality in the pa-tients undergoing thoracoscopic surgery.Methods Sixty patients undergoing elective thoracoscopic surgery,aged 18-70 years old,ASA grade Ⅰ-Ⅱ,served as the study subjects and were randomly divided into the two groups by the random number table method:SA-QLB group(group Q,n=30)and ESPB(group E,n=30).Before induction of general anesthesia,the group Q conducted SA-QLB in the operation side under the ultra-sound guide and the group E conducted ESPB,the both were given 30 mL of 0.25％ropivacaine.All patients in both groups were given the patient-controlled intravenous analgesia(PCIA)after surgery.The dosage of remifentanil during surgery,recovery time,Visual Analogue Scale(VAS)score at rest and cough at 1,6,12,24,48 h after surgery,first pressing time of patient-controlled analgesia,times of effective pressing,dosage of sufentanil and number of cases of rescue analgesia at 24 h after surgery,forced vital capacity(FVC)and forced expiratory volume first second(FEV1)at 1 h before surgery and 24 h after surgery,scores of quality recovery at postoperative 24 h(QoR-15)and Barthel score,hospitalization duration after operation and the occurrence of adverse reactions were recorded.Results Compared with the group E,the intraoperative remifentanil dos-age in the group Q was decreased(P＜0.05);the VAS scores in rest and cough at postoperative 6,12,24 h were decreased(P＜0.05);the first pressing time of postoperative analgesia pump in the group Q was pro-longed,number of effective pressures of analgesia pump,dosage of sufentanil and cases number of remedy an-algesia were decreased(P＜0.05);FEV1 and FVC at postoperative 24 h in the group Q were significantly in-creased(P＜0.05);the scores of QoR-15 and Barthel at postoperative 24 h were increased(P＜0.05).The in-cidence rates of postoperative nausea and vomiting in the group Q were lower than those in the group E(P＜0.05),and no serious adverse events occurred in the two groups.Conclusion Compared with ESPB,SA-QLB could provide more perfect postoperative analgesia effect,which is conducive to postoperative early pulmonary function recovery,and the postoperative recovery quality is higher.

Objective To investigate the analgesic effect and safety of transincisional quadratus lumborum block(TQLB)technique for laparoscopic nephrectomy.Methods Sixty patients scheduled for laparoscopic nephrectomy at the Affiliated Lihuili Hospital of Ningbo University from December 2023 to March 2024,the patients were randomly divided into TQLB group(T group)and control group(C group)using a random number table method,with 30 cases in each group.C group received general anesthesia with tracheal intubation,while T group received general anesthesia with tracheal intubation combined with TQLB.Two groups of patients were routinely given sufentanil controlled intravenous analgesia pump after surgery.Record the wound healing status of two groups of patients,postoperative 24h sufentanil consumption,resting and exercise time numerical rating scale(NRS)scores at 6h,12h,and 24h postoperatively,range of sensory blockade at 2h postoperatively,number of salvage analgesia cases at 24h postoperatively,analgesic satisfaction score,and incidence of postoperative complications.Results Compared with group C,patients in group T had a reduced consumption of sufentanil 24h after surgery(P＜0.001);The resting and exercise NRS scores decreased at 6h,12h,and 24h after surgery(P＜0.05);The number of postoperative 24h rescue analgesia cases and the satisfaction score of analgesia were both lower than C group(P＜0.05);The incidence of postoperative nausea and vomiting in group T was lower(P＜0.05);Both groups of patients did not experience serious complications.Conclusion TQLB appears to offer effective postoperative analgesia during the early stages of laparoscopic nephrectomy,while also reducing the occurrence of complications.This suggests that it could serve as a safe and efficient alternative for analgesic management in such surgical procedures.

Objective:To analyze the influence of serological indexes on the liver cirrhosis (LC) in patients with chronic hepatitis B, and to construct a nomogram model.Methods:The clinical data of 220 patients with chronic hepatitis B in Xianning Central Hospital from January 2019 to December 2021 were retrospectively analyzed. Among them, 42 patients developed LC (LC group), and 178 cases did not develop LC (non-LC group). The patient′s fasting peripheral venous blood was taken in the morning. The platelet, red blood cell, white blood cell, fasting blood glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), triacylglycerol (TG), total cholesterol (TC), total bilirubin (TBiL), albumin, globulin, alkaline phosphatase (ALP), γ-glutamyltransferase (GGT), prothrombin time (PT), thrombin time (TT), D-dimer (D-D), alpha-fetoprotein (AFP) and C-reactive protein (CRP) were detected. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of each index in predicting LC in patients with chronic hepatitis B. Multivariate Logistic regression was used to analyze the independent risk factors for LC in patients with chronic hepatitis B. The R software "rms" package was used to construct a nomogram model to predict the LC in patients with chronic hepatitis B, the correction curve was used to internally verify the prediction model, and the decision curve evaluated the efficacy of the prediction model.Results:The TBiL, ALP, GGT, PT, TT, D-D, AFP and CRP in LC group were significantly higher than those in non-LC group: (50.57 ± 5.61) μmol/L vs. (46.69 ± 3.92) μmol/L, (105.23 ± 30.60) U/L vs. (75.14 ± 26.45) U/L, (68.73 ± 19.47) U/L vs. (50.39 ± 14.21) U/L, (13.88 ± 1.98) s vs. (13.01 ± 2.10) s, (18.88 ± 2.56) s vs. (15.98 ± 2.43) s, (2.62 ± 1.04) mg/L vs. (1.34 ± 0.63) mg/L, (4.19 ± 1.95) μg/L vs. (2.66 ± 1.21) μg/L and (8.54 ± 1.22) mg/L vs. (7.47 ± 0.79) mg/L, the platelet, ALT, AST and albumin were significantly lower than those in the non-LC group: (129.63 ± 32.66) × 10 9/L vs. (183.53 ± 56.31) ×10 9/L, (131.27 ± 22.19) U/L vs. (157.57 ± 38.67) U/L, (112.76 ± 19.57) U/L vs. (125.16 ± 21.84) U/L and (29.79 ± 6.17) g/L vs. (33.52 ± 5.89) g/L, and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in red blood cell, white blood cell, fasting blood glucose, TG, TC and globulin between the two groups ( P>0.05). ROC curve analysis result showed that the area under the curve (AUC) of AFP, platelet, ALT, AST, ALP, GGT, TBiL, albumin, D-D, CRP, PT and TT for predicting LC in patients with chronic hepatitis B were 0.731, 0.798, 0.723, 0.676, 0.766, 0.762, 0.710, 0.673, 0.856, 0.759, 0.603 and 0.786, and the optimal cut-off values were 4.64 μg/L, 162.56 × 10 9/L, 155.67 U/L, 122.37 U/L, 95.17 U/L, 68.96 U/L, 49.95 μmol/L, 28.8 g/L, 1.64 mg/L, 8.55 mg/L, 12 s and 18 s. Multivariate Logistic regression analysis result showed that AFP (>4.64 μg/L), platelet (≤162.56 × 10 9/L), ALP (>95.17 U/L), GGT (>68.96 U/L), D-D (>1.64 mg/L) and TT (>18 s) were independent risk factors for LC in patients with chronic hepatitis B ( OR = 1.278, 1.428, 1.488, 1.356, 1.513 and 1.369; 95% CI 1.109 to 1.369, 1.269 to 1.623, 1.217 to 1.894, 1.127 to 1.669, 1.342 to 1.878 and 1.169 to 1.583; P<0.05 or <0.01). The AFP, platelet, ALP, GGT, D-D and TT were used as predictors to construct a nomogram model for predicting the LC in patients with chronic hepatitis B. The correction curve of the nomogram model to predict the LC in patients with chronic hepatitis B was close to the ideal curve (C-index was 0.739, 95% CI 0.615 to 0.876); the decision curve analysis result showed that the prediction model had higher clinical net benefit when the risk threshold > 0.26 than a single index, and that it had significantly additional clinical net benefit. Conclusions:The AFP, platelets, ALP, GGT, D-D and TT are independent risk factors for LC in patients with chronic hepatitis B, and the nomogram model constructed based on these factors could provide important guidance for the prevention and treatment of LC in patients with chronic hepatitis B.

Objective:To explore the correlation between the semiquantitative score of bone ultrasound and the WOMAC OA index in knee osteoarthritis.Methods:From March 2017 to December 2018, 118 patients with knee osteoarthritis diagnosed and treated in Taizhou Hospital of Traditional Chinese Medicine were selected in the research.The patients' bone erosion, joint effusion, synovium hyperplasia and meniscus were evaluated by ultrasound semiquantitative scoring system.Osteoarthritis index of the patients was investigated at the same time.The correlation between the semiquantitative score of myoskeletal ultrasound and WOMAC OA index in knee osteoarthritis was analyzed.Results:In 118 patients with knee osteoarthritis, the semiquantitative scores of myoskeletal ultrasound of bone erosion was (2.33±0.37)points, joint effusion was (2.05±0.26)points, synovial hyperplasia was (2.24±0.15)points, abnormal meniscus position was (1.67±0.28)points, meniscus shape and signal was (1.15±0.14)points.The WOMAC OA index scores of patients' pain was (29.52±6.68)points, stiffness was (11.43±3.78)points, dysfunction was (93.85±18.73)points, and total score was (134.80±29.19)points.The scores of bone erosion, joint effusion, synovium hyperplasia and meniscus in semiquantitative score of muscle and bone ultrasound were positively correlated with the total score of WOMAC OA index( r=0.435, 0.317, 0.429, 0.294, 0.282, all P<0.05). Conclusion:Semiquantitative score of muscle and bone ultrasound can better reflect the degree of knee joint injury, which is positively correlated with WOMAC OA index.We can use the semiquantitative score of muscle and bone ultrasound and WOMAC OA index to predict the condition of patients with knee osteoarthritis.

Lung cancer is the most common malignant tumor worldwide. There are more than 700000 new cases diagnosed as lung cancer each year in China, of which 80％-85％ are non-small cell lung cancer (NSCLC). The mutation proportion of epidermal growth factor receptor (EGFR) may reach up to 40％-55％. EGFR-tyrosine kinase inhibitor (EGFR-TKI) has become the standard first-line treatment method for advanced NSCLC patients with EGFR mutation. Chinese oncologists have done a large number of clinical studies, providing an important evidence-based medicine proof for treatment of advanced NSCLC with EGFR mutation.

Objective To investigate the value of detecting peripheral blood epidermal growth factor receptor (EGFR) gene in predicting the therapeutic efficacy of advanced non-small cell lung cancer. Methods A total of 150 patients with stage ⅢA-Ⅳ non-small cell lung cancer diagnosed in Shanxi Provincial Cancer Hospital from October 2013 to February 2015 were collected. The peripheral blood EGFR gene was detected by amplification refractory mutation system (ARMS). The relationship between the mutation rate and the clinicopathological features of patients was observed, and 80 patients were selected into the follow-up treatment according to the inclusion criteria. Forty patients (all 19 or 21 exon mutations) in group A with EGFR gene mutation were treated with gefitinib orally. Forty patients with wild type EGFR gene in group B underwent 4 cycles of NP regimen. Efficacy and progression-free survival were evaluated in both groups. Results The mutation rate of EGFR gene was 33.3 ％ (50 cases), of which 29 were exon 19, 18 were exon 21 and 3 were exon 18 and 20. The mutation rate of EGFR gene was higher in female, adenocarcinoma and non-smoker (all P<0.05). Among the 80 patients who received follow-up treatment, the effective rate [67.5％(27/40) vs. 32.5 ％ (13/40)] and disease control rate [85.0 ％ (34/40) vs. 65.0 ％ (26/40)] in group A were significantly higher than those in group B, and the median PFS was prolonged (9.00 months vs. 4.25 months),the differences were statistically significant (χ2=9.800, P=0.002;χ2=4.267, P=0.039;χ2= 15.792, P<0.001). Conclusion The detection of peripheral blood EGFR mutation can be used to predict the efficacy of tyrosine kinase inhibitors in non-small cell lung cancer.

Objective To explore the changes of platelet count in children with bronchial pneumonia and its clinical significance in the disease.Methods 320 cases of bronchial pneumonia were retrospectively analyzed after hospitalization.According to the number of platelet count,the cases were divided into increased platelet count group (>400 ×109 /L)and normal platelet group(100 -400 ×109 /L),and the clinical data of two groups were statistically analyzed,such as age,gender,dyspnea,treatment,white blood cell count,hemoglobin,C -reactive protein.Results In 320 cases,62 cases'platelet count increased,258 cases were normal.Compared with the normal platelet group,the cases in increased platelet count group had the following characteristics:younger(<1 year old mainly,accounted for 46.77%;the former was between 1 and 3 years old mainly,accounted for 40.70%;Z =2.08),treatment time pro-longed (7.37 ±1.90)d,the former was (6.79 ±1.51)d,white blood cell count increased [(10.71 ±3.91)×109 /L,the former was (9.37 ±3.56)×109 /L,t =2.61,P <0.05];the incidence rate of dyspnea was higher (74.19%, the former was 52.33%,χ2 =9.73),hemoglobin decreased [(104 ±14)g/L,the former was (111 ±13)g/L,t =3.34],C -reactive protein increased [(24.42 ±12.73)mg/L,the former was (18.31 ±8.86)mg/L,t =3.58,P <0.01].There was no significant difference in gender between the two groups.Conclusion Children with bronchial pneumonia who platelet count increased are younger and their diseases are more serious.Observation the platelet count change can help to rightly judge and effective treat.

To assess the ability of the previously selected human vaginal isolates of Lactobacillus crispatus (L. crispatus) T79-3, T90-1 and Lactobacillus jensenii (L. jensenii) T118-3, T231-1 to inhibit the growth of Staphylococcus aureus and block their adhesion to HeLa cells. The inhibitory bioactive substances produced by these Lactobacillus were also identified. Inhibitory substances interaction tests were carried out by using a streak-diffusion method on agar plates. Three types of interaction were performed to determine the inhibitory effect of Lactobacillus on adhesion of Staphylococcus aureus to HeLa cells: Exclusion Group (Lactobacillus and HeLa followed by pathogens), Competition Group (Lactobacillus, HeLa and pathogens together) and Displacement Group (pathogens and HeLa followed by the addition of Lactobacillus). The number of HeLa cells adhered to Staphylococcus aureus was quantified by bacteria colony counts on LB plate. The results showed that lactic acids produced by the Lactobacillus are the main substances that can inhibit Staphylococcus aureus growth and there is variation among the three types of interaction regarding the inhibitory activity against Staphylococcus aureus. The effects of Lactobacillus on blocking the adhesion to HeLa cells were concentration dependent. All four Lactobacillus isolates displayed the ability to inhibit Staphylococcus aureus growth and block Staphylococcus aureus adherence to HeLa cells. Exclusion Group was the most effective, and T79-3 showed greater capacity to block Staphylococcus aureus adherence compared with the other three isolates. The present study suggests the potential ability of L. crispatus T79-3 as probiotic for the treatment and prevention of urogenital infections in women.
Bacterial Adhesion ; physiology ; Cell Wall ; chemistry ; Female ; HeLa Cells ; Humans ; Lactobacillus ; classification ; physiology ; Probiotics ; Staphylococcus aureus ; growth & development ; pathogenicity ; Vagina ; microbiology

We selected and characterized isolates of Lactobacillus crispatus (L. crispatus) for potential preventing infections of the female reproductive tract. We cultured vaginal swabs from healthy volunteers on de Man, Rogosa and Sharpe (MRS) agar and identified the isolates at the species level by 16S rRNA sequence and genotyped the isolates of Lactobacillus by PCR amplification of repetitive bacterial DNA elements (rep-PCR). Furthermore, 10 L. crispatus strains were assessed for hydrogen peroxide (H2O2) and acid production. Overall 65 isolates were confirmed to be Lactobacillus by sequence analogy, among them 19 were L. crispatus, 17 were Lactobacillus jensenii and 12 were Lactobacillus fermentum. rep-PCR produced specie and strain-specific genomic fingerprints for the Lactobacillus isolates. The selected 10 L. crispatus isolates produced highly acidic environment after growth in MRS. The isolates T22-3 and T29-5 demonstrated high production of H2O2. This study indicated that there are individual differences with vaginal Lactobacillus colonization, and strain diversity within vaginal L. crispatus isolates, T22-3 and T29-5 might be candidates for restoring urogenital health environment in females.
Adult ; Female ; Genotype ; Humans ; Hydrogen Peroxide ; metabolism ; Interspersed Repetitive Sequences ; Lactobacillus ; classification ; genetics ; isolation & purification ; physiology ; Polymerase Chain Reaction ; methods ; Vagina ; microbiology

To evaluate PCR-sequencing for clinical detection of human papillomavirus (HPV) genotypes in cervical cell specimens, we applied PCR-sequencing to HPV detection and genotyping by general primer PGMY09/11, which targets the HPV most conserved L1 gene. Samples with multiple infections were subjected to HPV type-specific PCR. Among the 325 cervical samples, 228 were HPV positive, of which 66 showed multiple infections. In all, 27 different HPV genotypes were identified, with HPV 16 being the most prevalent, followed by HPV 58 and 52. The prevalence of high-risk HPV infection increased with the severity of cervical lesions (P < 0.05), whereas the proportion of multiple infections declined significantly from LSIL to SCC (P < 0.05). Both rates of overall and high-risk HPV infection were the highest in 21-30 age groups. There was substantial agreement between the HC2 and PCR-sequencing assay for detection of high-risk HPV (kappa = 0.675). PCR-sequencing was effective in HPV detection and genotyping, and it could be potentially applied to large scale HPV screening.
Adult ; Aged ; Cervix Uteri ; pathology ; virology ; China ; epidemiology ; Female ; Genotype ; Human papillomavirus 16 ; isolation & purification ; Humans ; Middle Aged ; Papillomaviridae ; genetics ; isolation & purification ; Papillomavirus Infections ; epidemiology ; virology ; Polymerase Chain Reaction ; methods ; Vaginal Smears ; Young Adult