Objective To investigate the compatible stability of esketamine hydrochloride,sufentanil citrate,butorphanol tartrate,and metoclopramide in 0.9%sodium chloride injection,and to provide a reference for the rational use of medication for postoperative analgesia.Methods The four drugs were compounded by simulating the clinical concentrations of the drugs,and the samples were taken at 0,4,8,12,24 and 48 h under light-shielded and light-exposed conditions at room temperature.The appearance,pH value,relative drug content,and insoluble particles were determined.Results The appearance of esketamine hydrochloride,sufentanil citrate,butorphanol tartrate,and metoclopramide concoction was clear at 48 h.The pH values were in the range of 4.69 to 4.79,and the relative drug content of the four drugs were in the range of 95%to 105%.The number of insoluble particles exceeded the specified range in the Chinese Pharmacopoeia(2020 edition)at 4 h and 8 h.Conclusions Under light-shielded and light-exposed conditions at room temperature,the appearance,pH value and relative drug content of the compounded solution remained stable for 48 h.However,the number of insoluble particles exceeded the specified standard.Therefore,it is not recommended to mix the above 4 drugs with 0.9%sodium chloride injection for use in analgesic pumps.

Objective To discuss the effect of body posture change on the catheter tip position of totally implantable venous access port (TIVAP).Methods Under ultrasound guidance,implantation of TIVAP was carried out through bedside puncturing of internal jugular vein or subclavian vein.After the implantation of TIVAP,X-ray chest films of both erect position and supine position were taken to check the catheter tip position.The distance from the upper edge of the first thoracic vertebra to the catheter tip was separately measured on the erect position and supine position chest films.The shift of the catheter tip position was judged by the difference in the distance measured on chest films as well as by the comparison with the bony anatomic marks.Results Successful implantation of TIVAP was accomplished in 86 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP moved caudally in 71 patients,with the mean displace distance being (12.29±7.48) mm;the catheter tip of TIVAP moved cephalad in 31 patients,with the mean displace distance being (5.00±3.79) mm;and the catheter tip of TIVAP remained in the same position in 2 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP had a tendency to move toward the foot side,the average displace distance was (-9.32±9.36) mm,the difference in catheter tip location between two photographic positions was statistically significant (P＜0.000 1).No statistically significant correlation existed between the changes of catheter tip position and the sex,age,height,weight as well as body mass index (P＞0.05).Conclusion After the implantation of TIVAP,the position of catheter tip will change with patient's body posture.When patient's posture changes from erect position to supine position the tip of the catheter tends to shift towards the atrium.

Objective:To investigate the association between catechol-O-methyl transferase (COMT)Vall58Met polymorphism and prepulse inhibition of the auditory startle reflex (PPI) in patients with schizophrenia.Methods:Totally 178 patients with schizophrenia and 190 healthy volunteers were recruited.The auditory startle reflex was detected by using SR-HLAB monitoring system.The indexed of the auditory startle reflex included the amplitude,habituation％ and PPI30,PPI60,PPI120 (the lead interval was set 30 ms,60 ms,120 ms).COMT Vall58Met polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP).The differences of PPI among COMT genotypes were compared.Results:Compared to the healthy volunteers,patients with schizophrenia had a significant lower the amplitude of auditory startle reflex[(563± 460) mV vs (695 ± 447) mY,P ＜ 0.05] and habituation％ [(32 ± 46) vs (48 ± 33),P ＜ 0.01] as well as the ％PPI120[(27 ± 5) vs (35 ± 3),P ＜ 0.05].The significant differences in COMT allelic and genotypic distribions were observed between patients with schizophrenia and healthy volunteers (x2 =8.16,11.74,Ps ＜ 0.05).The significant main effect of COMT genotype on habituation％ was observed (P ＜0.05) but no interaction genotype by diagnosis on the amplitude of auditory startle reflex,habituation％ and ％ PPI120 was observed (Ps ＞ 0.05).Conclusions:There may be a correlation between COMT genotype and adaptability,but not between COMT genotype and PPI deficit present in patients with schizophrenia

Objective To compare the curative effect of transarterial chemoembolization (TACE)plus microwave ablation (MWA) with that of pure TACE in treating hepatocellular carcinoma (HCC) larger than 5 cm in diameter.Methods The clinical data of 208 patients with HCC,who were admitted to authors' hospital to receive treatment during the period from June 2014 to December 2015,were retrospectively analyzed.The patients were divided into combination group (n=40,treated with TACE+MWA) and TACE group (n=168,treated with TACE only).By using 1 ∶ 1 pairing,the curative results of the two groups were analyzed.The survival of patient was taken as the primary observation index,and both the one-month solidtumor response value determined with modified Response Evaluation Criteria in Solid Tumors (mRECIST)and the reduction in AFP level were the secondary observation indexes.Results A total of 31 pairings were accomplished.The baseline data of the paired groups were comparable.The results indicated that half-,one-,1.5-,2-and 2.5-year survival rates in the combination group were 96.8％,90.3％,86.8％,82.5％ and 70.7％ respectively,which were significantly better than those of 77.4％,61.3％,53.6％,48.2％ and 24.1％ respectively in the TACE group (P=0.011).The one-month tumor-control rate and the reduction degree in AFP level of the combination group were better than those of the TACE group.No severe complications occurred in both groups.Conclusion For the treatment of HCC that is larger than 5 cm in diameter,TACE combined with MWA is superior to pure TACE in increasing survival rate as well as in improving tumor-control rate.

Objective: To study clinical characteristics and anatomical distributions of pulmonary embolism (PE) in suspicious PE patients and to explore if CT coronary angiography (CTCA) may simultaneously exclude PE. Methods: A total of 403 consecutive patients with suspicious PE admitted to cardiology department of our hospital from 2013-01 to 2014-10 were retrospectively studied. According to embolus distribution by CT pulmonary angiography (CTPA) and CTCA, the patients were divided into 2 groups: PE group,n=261 and Non-PE group,n=142. The clinical symptoms and imaging characteristics were analyzed and compared between 2 groups. Results: The overall prevalence of PE was 64.8% (261/403), suspicious PE patients were all with chest distress, palpitation, chest pain and syncope. Compared with Non-PE group, the patients in PE group were with more female gender and palpitation, while less chest pain,P<0.05; the symptoms of syncope and chest distress were similar between 2 group,P>0.05. In PE group, the sign of emboli were found in 245/261 patients (93.9%) at CTCA scanning area, the rest 16 patients (6.1%) had the small area of PE, and the emboli were only located at both upper pulmonary arteries. Conclusion: In patients with dififculty of breath, palpitation, chest pain and syncope, coronary artery disease (CAD) and PE should be simultaneously considered for accurate diagnosis. CTCA may meanwhile ifnd PE during CAD diagnosis.

Objective:To explore the relation of cognitive function correlates to P50 sensory gating in patients with schizophrenia.Methods:Totally 106 patients with drug-na¨ive first-episode schizophrenia and 86 healthy con-trol subjects matched for age,sex and education were recruited.All patients met the Diagnostic and Statistical Man-ual of Mental Disorders,Fourth Edition (DSM-IV)criteria for schizophrenia.Their cognitive function were assessed with the MATRICS Consensus Cognitive Battery (MCCB).The P50 auditory gating potential were recorded in all subjects using conditioning-testing stimulus paradigm and stimulus train paradigm.The P50 components were meas-ured in S1 S2 latency,S1 S2 amplitude and P50 suppression ratios.Results:Compared with the controls subjects, the patients with schizophrenia had significantly longer S1[60.8 ±7.8)ms vs.(56.3 ±7.0)ms,P <0.05]S2 la-tency [(59.1 ±10.2)ms vs.(55.7 ±10.7)ms,P <0.05],lower S1 amplitude [(2.8 ±1.8)μV vs.(3.5 ±1.6)μV,P <0.05],less amplitude difference (S1-S2)[(1.5 ±1.8)μV vs.(2.2 ±1.4)μV,P <0.05]and higher P50 suppression ratios (S2 /S1 )[(59.7 ±65.6)vs.(37.6 ±30.0),P <0.05].Schizophrenia patients had lower score than control subjects in all cognitive domains of MCCB (Ps <0.05).No differences in neurocognitive performance were found between subjects in the normal P50 ratio and the abnormal in healthy controls or patients with schizo-phrenia (Ps >0.05).No significant correlation was found between P50 gating measures (P50 ratio and P50 ampli-tude difference)and neuropsychological measures in MCCB scores (Ps >0.05).Conclusion:There may be no as-sociation between P50 deficits and cognitive measures in patients with drug-na¨ive first-episode schizophrenia.

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To assess the association between human CYP1A1 gene polymorphisms and coronary artery disease (CAD) among the Uygur population of China.Methods Genotypes of CYP1A1 single nucleotide polymorphisms (SNPs:rs4886605,rs 12441817,rs4646422 and rs1048943) were detected by real-time PCR in 293 CAD patients and 408 controls.Results Among the Uygur group,distribution of genotypes and allele of rs4886605 were both significantly different between CAD and the controls (all P＜0.05).The dominant model (CC vs.CT + TT) of rs4886605 was significantly lower among CAD patients than in controls.Significant differences were retained after the adjustment was made in all the participants (OR=0.368,95％CI:0.185-0.530,P=0.018) and in men (OR=0.350,95％CI:0.235-0.568,P=0.015).Distributions of genotypes and allele of rs12441817 were both significantly different between CAD and the controls (all P＜0.05).The dominant model (TT vs.CT+CC) of rs12441817 was significantly lower among patients CAD than in controls.Significant difference were retained after the adjustment was made,in total participants (OR=0.253,95％ CI:0.231-0.546,P=0.016) and in men (OR=0.241,95％ CI:0.132-0.478,P=0.002).Conclusion Both rs4886605 and rs12441817 SNPs of the CYP1A1 gene were associated with CAD in the Uygur population of China.

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.