Objective:To identify the risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.Methods:The medical records from patients with acute fatty liver during pregnancy admitted to the hospital from January 2016 to April 2023, including baseline characteristics, clinical symptoms, laboratory examinations, complications, etc. were collected.Patients were divided into postoperative complication group and non-postoperative complication group according to whether the patients developed postoperative complications, and logistic regression analysis was used to identify the risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.Results:A total of 61 patients were included in this study, 26 patients developed postoperative complications, and the incidence was 43%. There were significant differences in the ratio of primigravida, ratio of jaundice, prothrombin time, activated partial thromboplastin time, alanine aminotransferase, total bilirubin, direct bilirubin, and serum creatinine concentrations between the two groups ( P<0.05). The results of logistic regression analysis showed that primigravida, prothrombin time and serum creatinine concentrations were risk factors for postoperative complications ( P<0.05). Conclusions:Primigravida, prothrombin time and serum creatinine concentrations are risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.

To study an automatic plan(AP) method for radiotherapy after breast-conserving surgery based on TiGRT system and and compare with manual plan (MP). The dosimetry parameters of 10 patients and the evaluation of scoring table were analyzed, it was found that the targets dose of AP were better than that of MP, but there was no statistical difference except for CI, The V5, V20 and V30 of affected lungs and whole lungs in AP were lower than all that in MP, the Dmean of hearts was slightly higher than that of MP, but the difference was not statistically significant, the MU of AP was increase by 16.1% compared with MP, the score of AP evaluation was increase by 6.1% compared with MP. So the AP could be programmed and automated while ensuring the quality of the plan, and can be used to design the plans for radiotherapy after breast-conserving surgery.
Breast Neoplasms/surgery* ; Female ; Humans ; Mastectomy, Segmental ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

Objective To evaluate the role of group Ⅱ metabotropic glutamate receptors (mGluRs) in cognitive decline caused by multiple administrations of ketamine in mice and the relationship with hippocampal glycogen synthase kinase-3 beta (GSK-3β) expression.Methods Forty-five SPF healthy female C57BL/6 mice,aged 6-8 weeks,weighing 20-30 g,were randomized into 3 groups (n=15 each) using a random number table method:control group (group C),ketamine group (group K) and mGluR agonist LY354740 group (group L+K).In K and L+K groups,ketamine 30 mg/kg was intraperitoneally injected three times a day at an 30-min interval for 14 consecutive days.LY354740 was intraperitoneally injected at 30 min before the first injection of ketamine in group L+K.The equal volume of normal saline was given instead in group C.Morris water maze test was performed the day after the last administration.The mice were then sacrificed,and hippocampi were harvested to determine the expression of GSK3β,NR2A and postsynaptic density protein 95 (PSD95) by Western blot.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,the expression of GSK3β3 and NR2A was up-regulated,and the expression of PSD95 was down-regulated in group K (P＜0.05),and no significant change was found in the parameters mentioned above in group L+K (P＞0.05).Compared with group K,the escape latency was significantly shortened,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased,the expression of GSK3β and NR2A was down-regulated,and the expression of PSD95 was up-regulated in group L+K (P＜0.05).Conclusion Group Ⅱ mGluRs are involved in the process of cognitive decline caused by multiple administrations of ketamine in mice,which is associated with up-regulated expression of hippocampal GSK-3β.

Objective To evaluate the role of nuclear factor kappa B (NF-κB) in cognitive decline in aged mice with sepsis.Methods Forty-five SPF healthy aged female C57BL/6 mice,aged 10-12 months,weighing 20-30 g,were assigned into 3 groups (n=15 each) using a random number table:control group (group C),sepsis group (group Sep) and NF-κB selective inhibitor pyrrolidine dithiocarbamate (PDTC) group (group PDTC).Lipopolysaccharide 250 μg/kg was injected intraperitoneally once a day for 7 consecutive days in Sep and PDTC groups,and in addition PDTC 50 mg/kg was injected intraperitoneally at 30 min before lipopolysaccharide injection once a day for 7 consecutive days in group PDTC.The equal volume of normal saline was given in group C.Five mice in each group were sacrificed at 2 h after the last administration,cardiac puncture was performed and blood samples were collected,and then the mice were sacrificed and hippocampi were harvested for determination of the levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β) and IL-6 in plasma and hippocampal tissues using enzyme-linked immunosorbent assay.Cognitive function was assessed using open field,elevated plus maze and Morris water maze tests at 24 h after the last administration in the other mice left in each group.Results Compared with group C,the levels of TNF-α,IL-1β and IL-6 in plasma and hippocampal tissues were significantly increased,the time of movement at the central region was shortened,the percentage of time spent in the open arms and number of entries into the open and closed arms were decreased,the escape latency was prolonged,the time of staying at the original platform quadrant was shortened,and the frequency of crossing the platform was decreased in group Sep (P＜0.05).Compared with group Sep,the levels of TNF-α,IL-1β5 and IL-6 in plasma and hippocampal tissues were significantly decreased,the time of movement at the central region was prolonged,the percentage of time spent in the open arms and number of entries into the open and closed arms were increased,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in group PDTC (P＜0.05).Conclusion NF-κB is involved in cognitive decline in aged mice with sepsis.

Objective To evaluate the efficacy of pressure support ventilation ( PSV ) in the infants undergoing laparoscopic hernia repair under sevoflurane anesthesia. Methods Thirty ASA physical statusⅠpediatric children, aged 9 months-1 yr, weighing 8.0-11.5 kg, undergoing elective laparoscopic hernia repair, were randomly assigned into 3 groups ( n=10 each) using a random number table: pressure control ventilation ( PCV) used for muscle relaxants in combination with low?concentration sevoflurane group ( group PCV1 ) , PCV used for high?concentration sevoflurane group ( group PCV2 ) , and PSV used for low?concentration sevoflurane group ( group PSV) . Anesthesia was induced with inhalation of 4%-6%sevoflurane and iv fentanyl 2 μg∕kg and succinylcholine 1.5 mg∕kg. The pediatric children were endotracheally intubated and mechanically ventilated. In PCV1 and PCV2 groups, PCV was used during operation. In group PSV, PCV was used first after intubation, and then PSV was applied after spontaneous breathing recovered. Anesthesia was maintained as follows: in group PCV1 , the end?tidal concentration of sevoflurane was maintained at 2.5% - 3.0%, and cisatracurium besylate 0.1 mg∕kg was injected intermittently as required; in group PCV1 , the end?tidal concentration of sevoflurane was maintained at 3.5%-4.0%; in group PSV, the end?tidal concentration of sevoflurane was maintained at 2.5%-3.0%, and succinylcholine 1.0 mg∕kg was injected intravenously before pneumoperitoneum. Narcotrend index value was maintained at 50-60 in PCV1 and PSV groups, or at 37-45 in PCV2 group. Heart rate ( HR) and mean arterial pressure (MAP) were recorded before induction of anesthesia (baseline), at the beginning of pneumoperitoneum, at 5 and 10 min of pneumoperitoneum, at the end of pneumoperitoneum, at the end of operation and immediately after extubation. The time interval from the end of surgery to extubation was recorded. Results Pulse oxygen saturation was 100% during anesthesia, and>95% during recovery from anesthesia in the three groups. Compared with the baseline value, HR was significantly faster, and MAP was increased during extubation in PCV1 and PCV2 groups, and no significant change was found in HR and MAP at each time point in group PSV. The time interval from the end of surgery to extubation was 30.3± 5.4, 18.4±4.3 and (4.1±1.2) min in PCV1, PCV2 and PSV groups, respectively. Compared with PCV1 and PCV2 groups, the time interval from the end of surgery to extubation was significantly shortened in group PSV. Conclusion When PSV is applied in the infants undergoing laparoscopic hernia repair under sevoflurane anesthesia, it can provide adequate ventilation, recovery from anesthesia is rapid, and no cardiovascular responses occur during extubation.

Objective To evaluate the effects of ulinastatin pretreatment on cognitive dysfunction induced by chronic exposure to ketamine in immature mice.Methods Thirty-six healthy male C57BL/6 mice,aged 21 days,weighing 20-30 g,were randomly divided into 3 groups (n =12 each) using a random number table:control group (group C),ketamine group (group K),and ulinastatin pretreatment group (group U).In K and U groups,ketamine 30 mg/kg was injected intraperitoneally three times a day at 30-minute intervals for 21 consecutive days,while in group U,ulinastatin 50 000 U/kg was injected intraperitoneally at 30 min before the first injection of ketamine everyday.Cognitive function was assessed using Morris water maze and open field tests at 24 h after the last administration of ketamine.Mice in each group were sacrificed immediately after the end of the tests and hippocampi were harvested to determine the contents of interleukin-6 (IL-6),IL-1 and tumor necrosis factor-α (TNF-α) using ELISA.Results Compared with group C,the escape latency was significantly prolonged,the time spent in the original platform and in the central area for the open field was shortened,the frequency of crossing the original platform was decreased,and the contents of IL-1,IL-6,and TNF-α were increased in group K (P ＜ 0.05),while there were no significant differences in the indexes mentioned above in group U (P ＞ 0.05).Compared with group K,the escape latency was significantly shortened,the time spent in the original platform and in the central area for the open field was prolonged,the frequency of crossing the original platform was increased,and the contents of IL-1,IL-6,and TNF-α were decreased in group U (P ＜ 0.05).Conclusion Ulinastatin pretreatment can improve cognitive dysfunction induced by chronic exposure to ketamine in immature mice,and inhibition of inflammatory responses in hippocampi may be involved in the mechanism.

Objective To investigate the effects of isoflurane anesthesia on proliferation and differentiation of neural stem cells (NSCs) in the dentate gyrus of neonatal rats.Methods Ten SD rats,aged 7 days,weighing 16-20 g,were randomly divided into 2 groups ( n =5 each):control group (group C) and isoflurane group (group 1) .The rats in group Ⅰ inhaled 2.5％ isoflurane for 3 min for induction and then anesthesia was maintained with 1.5 ％ isoflurane for 4 h,while the rats in group C only breathed the room air for 4 h.Bromodeoxyuridine (BrdU) 100 mg/kg was injected intraperitoneally right before the induction and after the end of administration to label NSCs and their progeny in the dentate gyrus.At 24 h after the 2nd administration of BrdU,double immunofluorescence for BrdU and NeuroD (a marker of neuroblasts and immature neurons) was used to assess NSC proliferation and neuronal differentiation.Results Compared with group C,the number of BrdU+ cells in group Ⅰ was significantly decreased,whereas the fraction of NeuroD+/BrdU+ differentiated cells was increased in the dentate gyrus( P ＜ 0.05 or 0.01 ).Conclusion Isoflurane anesthesia suppresses the proliferation of NSCs and induces neuronal differentiation of NSCs in the dentate gyrus of neonatal rats.

ObjectiveTo investigate the effects of isoflurane anesthesia on the expression of brain-derived neurotrophic factor (BDNF) and phosphorylated extracellular signal-regulated kinase (p-ERK) in neonatal rat hippocampus.MethodsForty-eight SD rats of both sexes,aged 7 days,weighing 12-17 g,were randomly divided into 2 groups ( n =24 each):control group (group C) and isoflurane anesthesia group (group Ⅰ).In group Ⅰ,the rats were exposed to2.5％ isotlurane for 3 min and then 1.5％ isoflurane was inhaled for 4 h,while in group C the rats were exposed to air for4 h.Arterial blood samples were collected immediately after anesthesia for blood gas analysis and for determination of the blood glucose concentration.Five rats in each group were sacrificed at 0,6,24 and 48 h after anesthesia (T1-4) and hippocanpi were removed for determination of the expression of potassiumchloride cotransporter 2 (KCC2),potassium-chloride cotrmsporter 1 (NKCC1),BDNF and p-ERK by Western blot.NKCC1/KCC2 ratio was calculated.ResultsAcid-base imbalance,hypoxemia and glycopenia were not found immediately after anesthesia in both groups.Compared with group C,KCC2 expression was significantly down-regulated and NKCC1/KCC2 ratio was increased at T3 and T4,and the expression of BDNF and p-ERK was dewn-regnlated at T1 and T2 in group Ⅰ (P＜0.05).There was no significant difference in NKCCI expression at each time point between groups Ⅰ and C ( P ＞ 0.05 )、ConclusionIsoflurane anesthesia delays the neuronal development in neonatal rat hippocampus through down-regulating the expression of BDNF and p-ERK.

Objective To investigate the effect of precondition with Toll-like receptor 4 monoclonal antibody (TLR4mAb) on lipopolysaccharide (LPS) -induced acute lung injury in mice.Methods A total of 45 male BALB/c mice were randomly divided into 3 groups:the control group ( group C),the sepsis group (group S) and the pretreatment group (group P).Mice in the group P and group S were injected intraperitoneally with LPS ( 10 mg/kg) to produce acute lung injury models.Mice in the group P was injected intraperitoneally with TLR4mAb (5 μg/g) 1 h before the injection of LPS.Expression of TLR4mRNA in lung tissue,expression of TNF-α and IL-6 in serum,water content of lung,and the pathomorphologic changes of lung were detected after 6 h,12 h and 24 h.One-way ANOVA was used for inter-group comparison and two-way ANOVA was used for intra-group comparison.Results Compared to group C,water content significantly increased at 12 h and 24 h in group S and group P; compared to group S,water content significantly decreased in group P at 12 h and 24 h.Compared to group C,the expression of IL-6 and TNF-α significantly increased in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of IL-6 and TNF-α significantly decreased at 6 h,12 h and 24 h in group P.Compared to group C,the expression of TLR4 mRNA increased significantly in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of TLR4 mRNA decreased significantly in group P at6 h,12 h and 24 h.Compared to group S,pathological damage of the lung was improved significantly in group P.Conclusions Precondition with TLR4mAb can attenuate LPS-induced acute lung injury,suppress the expression of inflammatory factors.Regulation of TLR4 pathway may be a promising therapeutic strategy for ALI.

Objective To investigate the effects of different concentrations of isoflurane on the caspase-3 expression in the hippocampus and S100β level of plasma in fetal rats. Methods 18 pregnant rats at gestational day 21 were divided into control group, 1. 3% isoflurane group,3% isoflurane group. Rats in the control group spontaneously breathed 100% oxygen for 1 h. Rats in the treatment groups breathed 1.3% or 3% isoflurane in 100% oxygen through an endotracheal tube, with mechanical ventilation for 1 h. Rat pups were delivered by cesarean section 6 h after treatment, and fetal blood was sampled from the left ventricle of each fetal heart and evaluated for S100β. Fetal brains were then evaluated for apoptosis, using caspase-3 immunohistochemistry in the CA1 region of the hippocampus. Results Compared to the control group ((1. 48 ± 0. 08) μg/L) and the 1. 3% isoflurane group( (1.53 ±0. 12)μg/L) ,the 3% isoflurane group showed significantly higher level of S100β( (3. 12 ±0. 15) μg/L, P＜0.05) . There was no differences in densities of caspase-3-positive cells between the control ((33 ±4) cell/mm ) and 1.3% isoflurane groups((31 ±5)cell/mm2). Compared to 1.3% isoflurane,isoflurane at a concentration of 3%((75 ± 7) cell/mm2, P＜0.05) for lh increased neurodegeneration in the hippocampal CA1 area in the developing brain of fetal rats. Conclusion Isoflurane can dose-dependently induce brain damage. Isoflurane at a concentration of 3% for lh can induce apoptosis in the hippocampal CA1 area and increase S100β levels of fetal rats.