Objective:To evaluate the effect of ultrasound guided modified-subcostal approach to anterior quadratus lumborum block (MSC-AQLB) on postoperative pain relief in open gynecological tumor surgery.Methods:Fifty patients with open gynecological tumor surgery admitted to the Changsha Central Hospital from June 2022 to March 2023 were selected, aged 35-70 years old, with American Society of Anesthesiologist (ASA) grades Ⅰ-Ⅱ. They were randomly divided into two groups using a random number table: an improved subcostal lumbar quadratus anterior block combined with general anesthesia group (MQ group) and a simple general anesthesia group (GA group), with 25 patients in each group. Before induction of general anesthesia, the MQ group received bilateral MSC-AQLB under ultrasound guidance, with 20 ml of 0.4% ropivacaine administered to both sides; The GA group did not receive nerve block. Both groups received intravenous inhalation combined with general anesthesia during the surgery, and both groups received patient-controlled intravenous analgesia (PCIA) with sufentanil after the surgery. The block plane of the MQ group at 5 and 15 minutes after block was recorded, as well as the resting and active (cough) Visual Analogue Scale (VAS) of patients in both groups at extubation (T 1), departure from post anesthesia care unit (PACU) (T 2), postoperative 6 hours (T 3), 12 hours (T 4), 24 hours (T 5), and 48 hours (T 6), the effective and total compressions of the analgesic pump within 48 hours after surgery, the analgesic recovery rate, and postoperative patient satisfaction, the incidence of nausea and vomiting, complications related to nerve block (local anesthetic poisoning, muscle weakness, pneumothorax, bleeding, accidental entry into the abdominal cavity, kidney damage, etc.)were also recorded. Resultsl:The highest and lowest blocking planes of bilateral MSC-AQLB under ultrasound guidance were T 6 and L 1 (at 5 minutes), T 5 and L 2 (at 15 minutes), respectively. The resting and active VAS scores of the MQ group at T 1 to T 6 were significantly lower than those of the GA group (all P<0.05), and the effective press frequency, total press frequency, and analgesic recovery rate of the analgesic pump within 48 hours were significantly lower than those of the GA group (all P<0.05). The postoperative analgesic satisfaction score was higher than that of the GA group ( P<0.05), and the incidence of nausea and vomiting within 48 hours after surgery was significantly lower than that of the GA group ( P<0.05). The MQ group of patients did not experience complications related to nerve block such as kidney injury and muscle weakness. Conclusions:In open gynecological tumor surgery, ultrasound guided MSC-AQLB can effectively reduce postoperative pain scores, reduce the dosage of postoperative analgesics, reduce the incidence of nausea and vomiting, and significantly improve patient satisfaction with pain relief.

Objective:To investigate the effect of ultrasound-guided lumbar quadratus muscle plane block combined with general anesthesia on the analgesic effect during and after laparoscopic colon cancer radical surgery in elderly patients.Methods:A prospective study was conducted on 61 elderly patients who underwent radical colon cancer surgery at the Changsha Central Hospital Affiliated to South China University from May 2022 to February 2023, with American Society of Anesthesiologist (ASA) grades Ⅱ to Ⅲ. They were randomly divided into SA and GA groups using a random number table method, with 31 patients in the SA group and 30 patients in the GA group. The SA group received ultrasound-guided plane block of the upper lumbar quadratus muscle in the arcuate ligament combined with general anesthesia, while the GA group received simple general anesthesia. Record the mean artery pressure (MAP) and heart rate (HR) of two groups of patients at the time of entering the operating room (T 0), 5 minutes before skin incision (T 1), at skin incision (T 2), 30 minutes after surgery (T 3), at surgery end (T 4), and during anesthesia resuscitation and extubation (T 5); The Visual Analogue Scale (VAS) of two groups of patients at T 5, upon returning to the ward (T 6), 6 hours (T 7), 12 hours (T 8), 24 hours (T 9), and 48 hours (T 10) after surgery were recorded; The dosage of sufentanil, remifentanil, and propofol used during surgery, anesthesia recovery time, total number of analgesic pump presses within 48 hours after surgery, Lovett muscle strength score, early postoperative recovery, and adverse reactions within 48 hours after surgery were also recorded. Resultsl:The MAP and HR of the SA group were lower than those of the GA group at T 1-5 (all P<0.05); The VAS score of the SA group was lower than that of the GA group at T 5-10 (all P<0.05); The intraoperative dosage of propofol, remifentanil, and sufentanil in the SA group was lower than that in the GA group (all P<0.05); The anesthesia recovery time and first time out of bed in the SA group were earlier than those in the GA group (all P<0.05); The total number of times the analgesic pump was pressed within 48 hours after surgery was less than that of the GA group ( P<0.05); The incidence of nausea and vomiting within 48 hours after surgery in the SA group was lower than that in the GA group ( P<0.05). There was no statistically significant difference in postoperative Lovett muscle strength score, hospital stay, and dizziness incidence between the two groups of patients (all P>0.05). Conclusions:Ultrasound-guided lumbar quadratus muscle plane block on the arcuate ligament can significantly reduce the dosage of intraoperative general anesthesia drugs and postoperative analgesics in elderly patients undergoing laparoscopic colon cancer surgery, reduce postoperative pain scores, effectively alleviate postoperative pain, and thus advance the patient′s first time out of bed activity, reduce postoperative complications, and promote rapid recovery.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. Methods: The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method. Results: Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%. Conclusion The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

Objective To explore the characteristics of short-term static balance of obese children by comparing the excursion of center of pressure (COP) in obese and non-obese children under six kinds of standing circumstances. Methods By using the Footscan balance plate system, parameters of COP excursion for 47 obese children and 50 non-obese children standing on both feet or single foot with eyes open or eyes closed for 10 seconds were obtained, respectively. Results The maximum COP displacement in anterior-posterior direction of obese children was significantly greater than that of non-obese children during standing on both feet with eyes closed. During standing on left foot with eyes open, the sway velocity of obese boys was significantly lower than that of non-obese boys; the maximum COP displacement in medial-lateral direction of obese boys was significantly lower than that of non-obese boys and the maximum displacement of COP in medial-lateral direction of obese girls was significantly greater than that of non-obese girls. The sway velocity of boys was significantly greater than that of girls during standing on left foot with eyes closed. Conclusions In short period of time, the static balance of obese children in anterior-posterior direction was worse than that of non-obese children during standing on both feet with eyes closed. Obesity had different impacts on static balance of different genders. The performance of static balance for obese boys was better than that of non-obese boys, while the performance of static balance for obese girls was worse than that of non-obese girls during standing on left foot with eyes open. Girls had a better static balance performance than boys during standing on left foot with eyes closed. There were no significant differences in static balance performance between boys and girls under the other circumstances. As static balance of children is affected by obesity and gender, it is suggested that different methods of losing weight should be considered for obese children of different genders.

Objective To investigate the effect of intravenous ultrafine superparamagnetic iron oxide nanoparticles feraheme (generic name:ferumoxytol) on cerebral infarction volume and inflammatory response in mice with permanent middle cerebral artery occlusion.Methods Thirty C57BL/6J mice were divided into sham operation group,saline control group,and feraheme group by the random number table (n =10 in each group).A permanent right middle cerebral artery occlusion model was induced by the modified suture method in the saline control group and the feraheme group,and no suture was inserted into the mice of the sham operation group.The intervention was performed by tail vein injection at 24 h after modeling.The sham operation group and the feraheme group were injected with 18 mg/kg feraheme,and the saline control group was injected with the same volume of normal saline.The neurobehavioral scores were conducted at 24 h (before the feraheme or saline injection) and 48 h (before the MRI exam) after modeling.MRI scans were performed at 48 h after modeling,and the cerebral infarction volume was calculated according to T2-weighted imaging.After the end of the scan,orbital blood was collected for the detection of serum tumor necrosis factor (TNF)-α,interleukin (IL)-1 β,and IL-6 levels.Then,the mice were sacrificed and the brain tissue was taken for HE staining and Ibal immunohistochemical staining.Results There were no significant differences in the infarct volume and neurological function score between the saline control group and the feraheme group.The serum levels of TNF-α,IL-1β,and IL-6 in the saline control group and the feraheme group were significantly higher than those in the sham operation group (P ＜0.05),but there was no significant difference between the saline control group and the feraheme group.Conclusion Intravenous injection of 18 mg/kg feraheme at 24 h after cerebral ischemia did not affect the infarct volume and inflammatory response,suggesting that this dose of feraheme can be used for molecular imaging studies of inflammatory response after cerebral ischemia.

BACKGROUND:Children usually wear school bags when walking, and overweight school bags do harm to the lower extremity and foot, thus affecting the child development. OBJECTIVE:To investigate the effect of obesity on gait characteristics of children wearing school bags during walking. METHODS:Forty pupils were enrolled in accordance with body mass index and China school-age children and adolescents overweight, obesity screening body mass index classification standard, including 20 obese children (body mass index: (28.13±3.4) kg/m2) and 20 non-obese ones (body mass index: (17.44±1.57) kg/m2). The gait parameters of children wearing school bags during walking were measured using a 2-m Footscan Plantar Pressure Plate System from RSscan International. RESULTS AND CONCLUSION: Compared with the non-obese children, the peak pressures under the metatarsal heads II-V, midfoot and heel lateral were significantly higher in obese children wearing school bags during walking (P < 0.05). The time to peak pressures under the toes II-V, the metatarsal heads IV, V and midfoot was also significantly higher (P < 0.05). In addition, the arch index for the foot, and right foot axis angle were significantly larger in the obese children as compared with the non-obese children (P < 0.05). To conclude, obese children wearing school bags during walking have weaker walking stability with flatter foot pattern, the larger foot axis angle and dynamic plantar pressure distribution changes compared with non-obese children, which can result in foot damage.

BACKGROUND:The etiology of anterior cruciate ligament injury remains unclear yet, and some researchers have pointed that interior and exterior factors both contribute to anterior cruciate ligament injury;additionally, the genetic factor interior factors stand out. Collagen genes COL1A1, COL5A1, and COL12A1 are reported to be associated with anterior cruciate ligament injury in Caucasian populations. OBJECTIVE:To investigate the association of polymorphisms of COL1A1, COL5A1 and COL12A1 genes with anterior cruciate ligament injury in Chinese Han population . METHODS:105 patients with anterior cruciate ligament injury were enrolled and 110 patients without history of anterior cruciate ligament injury were as controlls. The first intron rs1800012 in COL1A1, rs127722 and rs13946 in the 3'-UTR region of COL5A1 gene, rs970547 and rs240736 in the 65 and 29 regions of COL12A1 extron were detected and classified by restriction fragment length polymorphism and genetic sequencing technology. RESULTS AND CONCLUSION:rs1800012, rs12722 and rs13946 genotypes, phenotypes and haplotypes in COL1A1 and COL5A1 genes showed no significant differences between groups. rs970547 and rs240736 genotypes as well as phenotypes and haplotypes in COL12A1 also showed no significant differences between groups. However, there was a significant difference in rs970547 gene frequence in male patients between groups. In conclusion, the Sp1 binding site of COL1A1 rs1800012 is not the susceptibility locus of anterior cruciate ligament injury in Chinese Han population. COL5A1 genes rs12722 and rs13946 in COL5A1 are not closely related to anterior cruciate ligament injury. COL12A1 rs970547 and rs240736 have a certain association with anterior cruciate ligament injury in Chinese men. Male individuals with COL12A1 rs970547 A allelicgene and AA genotype are likely to be susceptible to anterior cruciate ligament injury in Chinese Han population.

Objective To explore the application effect of preoperative interview by collective multidisciplinary education model in patients with breast cancer.Methods 126 patients with breast cancer, having undergone radical surgery from February 2015 to February. 2016, were selected and divided, by random number table method, into observation group and control group, each with 63 cases. Traditional mode of preoperative interview was conducted to patients in the control group, while preoperative interview by collective multidisciplinary education model was conducted to patients in the observation group. Anxiety, depression, stress response and satisfaction toward nursing between patients in the two groups were compared before and after intervention.Results After the interview, scores of anxiety and depression of patients in the observation group were (11.2±1.5) and (15.9±0.8) points, while the scores in the control group were (12.5±1.3) and (22.4±1.4) (t=2.032,5.007;P<0.01). Relief of anxiety and depression in the observation group was significantly better than that in the control group (P<0.05). Inside the operating room, before anesthesia was done, heart rate and systolic pressure of patients in the observation group were (71.5±3.9) time/min and (127.3±10.8) mmHg, all lower than that in the control group, which were (81.2±4.7) time/min and (145.2±12.6) mmHg (t=2.975 and 3.382,P<0.05). Satisfaction toward nursing in the observation group was 96.8%, higher than that in the control group, 82.5% (χ2=6.892,P<0.01).Conclusions Preoperative interview by collective multidisciplinary education model to patients with breast cancer can reduce their anxiety and depression, relieve stress response and improve satisfaction towards nursing.

This study aimed at investigating the effects of the extract of Chinese herb,Nansheteng (C.orbiculatus Thunb.),on human HepG2 cells through the overexpression of mTOR.The GV238-mTOR recombinant plasmids were transfected into HepG2 cells using molecular biological technology.The expression level of mTOR was evaluated by means of relative activity of luciferase and western blot.Human hepatic carcinoma HepG2/mTOR++ cells were treated with C.orbiculatus extract in different concentrations (20,40,80,160 and 320 tg·mL-1) for 24 h.The mTOR protein expression was detected by western blot.It was found that the protein expression of mTOR in transfected HepG2 cells was significantly enhanced.C.orbiculatus extract significantly inhibited the proliferation of HepG2/mTOR++ cells.Simultaneously,C.orbiculatus extract inhibited mTOR at its protein level in a dose-dependent manner.In conclusion,we successfully constructed recombinant mTOR cloning vectors,and established the stable HepG2 cell line with the overexpression of mTOR.Besides,C.orbiculatus extract significantly inhibited mTOR protein expression in human hepatic carcinoma HepG2 cells.

Objective To observe CT features of ovarian thecofibroma and the clinical significance.Methods CT manifestations, clinical data and pathological diagnosis of 12 cases of ovarian thecofibroma proved by pathology were retrospectively analysed.Results The CT manifestation of ovarian thecofibroma was typical,which was showed as following:on one side of the attachment area tumor,single,ovoid or class circular shape,most boundary clear,equal or slightly low density solid masses,internal or boundary ar-ea accompanied by a small amount low density area,mild delay enhancement in solid ingredients or no obvious enhancement.Conclu-sion CT examination is important for qualitative diagnosis of ovarian thecofibroma and finding complications.