Objective:To evaluate the effect of different anesthesia methods on the immune function in the patients with oral squamous cell carcinoma.Methods:Forty patients of both sexes, aged 31-64 yr, with body mass index of 19-23 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective radical resection of oral squamous cell carcinoma and repair of the defect with free flap, were enrolled and randomized to receive either combined intravenous-inhalational anesthesia (VICA group, n=20) or total intravenous anesthesia (TIVA group, n=20) using a random number table method.In group VICA, anesthesia was induced with intravenous propofol 1.5-2.0 mg/kg, remifentanil 1-2 μg/kg, and cisatracurium 0.2 mg/kg, sevoflurane was continuously inhaled to maintain MAC at 1.3, sevoflurane inhalation was stopped at 1 h before the end of surgery, sevoflurane was replaced with propofol, propofol 4-6 mg·kg -1·h -1 was continuously infused until the end of operation, and dexmedetomidine 0.4 μg·kg -1·h -1, remifentanil 0.2-0.3 μg·kg -1·min -1 and cisatracurium 0.1 mg·kg -1·h -1 were intravenously infused at the same time to maintain anesthesia.In group TIVA, anesthesia induction was the same as those previously described in group VICA, and anesthesia was maintained with intravenous dexmedetomidine 0.4 μg·kg -1·h -1, propofol 4-6 mg·kg -1·h -1, remifentanil 0.2-0.3 μg·kg -1·min -1 and cisatracurium 0.1 mg·kg -1·h -1.Venous blood samples were taken at 30 min before anaesthesia induction (T 0), 3 h after anaesthesia (T 1), at the end of operation (T 2), and at 6, 24 and 48 h after operation (T 3-5) for determination of the serum concentrations of immunoglobulins (IgA, IgM, IgG), interleukins (IL-2, IL-6, IL-10, sIL-2Rα) and soluble interleukin-2 receptor alpha (sIL-2Rα) by enzyme-linked immunosorbent assay. Results:Compared with the baseline at T 0, the concentrations of serum sIL-2Rα at T 1-5, IL-2 at T 1-4 and IL-10 at T 1 were significantly decreased, the concentrations of serum IL-6 at T 1-5 and IL-10 at T 2-4 were increased, and the concentrations of serum IgA and IgM at T 1-5 were decreased in two groups, and the concentrations of serum IgG at T 1-5 in TIVA group and at T 1, 2 and T 4, 5 in VICA group were significantly decreased ( P<0.05).Compared with group TIVA, the concentrations of serum sIL-2Rα at T 2, 5, IL-6 at T 4, 5 and IL-10 at T 3, IgA at T 4 and IgG at T 3 were significantly increased, and the concentrations of serum IL-2 at T 1-5 and IgA at T 5 were decreased in group VICA ( P<0.05). Conclusions:Both general anesthesia methods have significant inhibitory effects on intraoperative and postoperative cellular immune function and humoral immune function in the patients with oral squamous cell carcinoma, and combined intravenous-inhalational anesthesia produces higher inhibitory effects on cellular immune function than total intravenous anesthesia.

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ²=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ²=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ²=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.

Objective To apply the big data on medical equipment quality inspection to scientific management of medical equipment.Methods The big data on medical equipment metrological verification and quality control were analyzed,and medical equipment performance curve was drawn based on the function on data standard deviation and time.Results The big data provided support for medical equipment bidding and purchase,preventive maintenance and precision benefit analysis.Conclusion Medical equipment big data is of great significance to enhance medical support ability,and contributes to the management of medical equipment and strategic equipment.

Objective To investigate the outcome of a new designed extramedullary femoral osteotomy module and to compare with conventional intramedullary system in clinical study.Methods The extramedullary femoral osteotomy module was designed with the extramedullary alignment rod connecting with the T type rod at right angle,and it had a 5°-7° adjustable valgus design.The positioning module fixation screw was parallel with the epicondylar axis.The coronal plane of the distal femur bone cut was orientated by the extramedullary alignment rod pointing to the inguinal midpoint,and the sagittal plane was orientated by the extramedullary alignment rod keeping parallel with the distal femoral medullary cavity.The terminal distal femoral bone cut was conducted with suitable osteotomy after the orientation.Sixty patients who underwent unilateral total knee arthroplasty (TKA) from October 2015 to March 2016 were randomly divided into intramedullary and extramedullary group for prospective controlled study.Blood loss,drainage and the incidence of deep vein thrombosis (DVT) were evaluated at one week postoperatively.Knee valgus angle and femoral prosthesis flexion angle were analyzed at two weeks postoperatively.Moreover,the extramedullary femoral osteotomy module was used in 273 patients (78 males and 195 females) with an average age of 68.7 (range,57-82 years old) who underwent unilateral TKA from April 2016 to January 2017.Blood loss,operation duration and lower limb ultrasonography preoperatively and at one week postoperatively were recorded.Knee valgus angle and femoral prosthesis flexion angle were measured at 2 weeks postoperatively.Range of knee motion and Hospital for Special Surgery (HSS) knee score at six weeks postoperatively were also reported.Results In the randomized controlled trial,blood loss and drainage in extramedullary group was less than that in intramedullary group (t=-3.330,P=0.004).There was no significant difference in the incidence of DVT at 1 week postoperatively (x2=2.269,P=0.132) and the knee valgus angle and femoral prosthesis flexion angle at 2 weeks postoperatively within the two groups.In the clinical application,operation time was 60.13± 13.69 min,and blood loss and drainage was 109.11±70.73 ml.There were four cases of popliteal vein thrombosis,nine cases of posterior tibial vein thrombosis,and seventeen cases of muscular venous thrombosis at one week postoperatively.The incidence rate of DVT was 11.0％.There was no symptomatic pulmonary embolism at three months postoperatively.Knee valgus angle was 7.34°±0.69°,and 211 knees accounting for 77.3％ were in the range of ±3° error.Femoral prosthesis flexion angle was 6.43°±1.59°,and 273 knees were all in the range of ±10° error.Range of knee motion improved from 54.52±5.96 preoperative to 86.20±4.92 at six weeks postoperative.HSS knee score improved from 100.88°±7.51° preoperative to 110.42°±7.08° at six weeks postoperative.Conclusion The new designed extramedullary femoral osteotomy module used in distal femoral osteotomy during TKA can significantly reduce the risk of bleeding and the incidence rate of DVT postoperatively.Furthermore,patients can obtain as excellent prosthesis position and limb alignment as conventional intramedullary system.

Objective To compare the effects between propofol and sevoflurane on NK cells and B lymphocytes in patients undergoing radical operation for tongue cancer.Methods Forty patients (male 25 cases,femal 1 5 cases,aged 44-67 years,ASA Ⅰ or Ⅱ)undergoing elective radical operation for tongue cancer were randomized into 2 groups:group P received 2.0-2.5 mg/kg propo-fol,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for induction and 4-6 mg · kg- 1 · h- 1 propofol, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance; group S received 8 %sevoflurane with 5 L/min fresh gas flow,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for in-duction and 2 %-3 % sevoflurane, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance. Peripheral venous blood samples were taken at 3 0 min before (T0 )and 1 h (T1 ),3 h (T2 )and 5 h (T3 )after induction of anesthesia,the end of operation (T4 )and at 2 4 h (T5 ),4 8 h (T6 )and 7 2 h (T7 )after operation for determination of the percentages of NK cells (CD3 - CD1 6 + 5 6 + )and B lymphocytes(CD3 - CD1 9 + )by the flow cytometer.Results Compared with T0 ,the percentages of CD3 - CD1 6 + 5 6 + and CD3 - CD1 9 + in two groups were significantly decreased at T1-T5 (P <0.0 5 ),and the percentage of CD3 - CD1 6 + 5 6 + in group S was significantly decreased at T6 (P <0.0 5 ).The percentage of CD3 - CD1 6 + 5 6 + in group S were significantly lower than that in group P at T2-T6 (P < 0.0 5 ).There were no significant difference in the percentages of CD3 - CD1 9 +between two groups at the same time points.Conclusion Compared with sevoflurane,propofol can maintain a higher percentage of NK cells,and was helpful to maintain the immune function in patients undergoing radical operation for tongue cancer.

Objective To explore the cleaning effects of biomembrane detergent on laparoscopy instruments in order to thoroughly clean the laparoscopy instruments in Operating Room, improve the quality of detergent of surgical instruments and prevent hospital infection. Methods A total of 400 polluted laparoscopy instruments in operating room were randomly divided into experimental group ( 200 instruments, biomembrane detergent) and control group ( 200 instruments, multi-enzyme detergent ) according to tossing a coin. The cleaning effect were compared between two groups after finishing cleaning. Results The percent of pass of cleaning laparoscopy instruments with biomembrane detergent was 98. 5% in experimental group which was better than that (80. 5%) in control group with a significant difference between two groups (P <0. 05). Conclusions Cleaning laparoscopy instruments with biomembrane detergent can improve the cleaning effect and ensure the quality of detergent of surgical instruments.

Primary seminal vesicle adenocarcinoma (PSVA) is an extremely rare disease without any unified diagnostic criterion. Differential diagnosis of PSVA from prostate cancer, colon cancer, and bladder cancer is necessary but difficult because of the lack of standard management. Radical resection is considered the mainstay of primary treatment that offers satisfactory prognosis. Most cases with PSVA are diagnosed at advanced stages because its early manifestation is nonspecific and it is rarely diagnosed in clinic. In this study, we described the case of a 52 year-old PSVA patient who was treated at the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, in July 2012. The patient underwent local excision, with tumor residuals visible under the naked eye. The patient benefits from a six-cycle paclitaxel (175 mg/m2) therapeutic regimen combined with cisplatin (60 mg/m2), as well as pelvic modulated radiotherapy with a radiation dose of 60 Gy/30 F. At present, the patient is disease-free and undergoes regu-lar follow-up.

Objective To investigate the effect of parecoxib on hippocampal inflammation following partial hepatectomy in rats.Methods 72 SPF male healthy SD rats were selected and randomly divided into four groups:control group(group C),anesthesia group(group A),operation group(group S),parecoxib group (group P ), each had 18 rats.Using partial hepatectomy operation trauma to establish animal model of hippocampal inflammation.Rats were sacrificed 1,3,7 days after anesthesia,the expression of inflammatory mediators in hippocampal tissue were detected.The expression of cyclooxygenase -2(COX-2)mRNA were detected by real-time quantitative PCR,and COX-2 and cysteine proteinase -3(Caspase-3)protein expression were detected by Western blot,the prostaglandin E2(PGE2)content were detected by enzyme linked immunosorbent assay(ELISA).Results Compared with control group,COX-2 expression(protein and mRNA),PGE2 production and Caspase-3 protein expression in group A had no significant difference.In group S and P,COX-2 expression,PGE2 and Caspase-3 protein expression increased significantly on 1st day postoperatively to 3rd day (P<0.05 or P<0.01),and they were obvious especially in the postoperative 1st day(P<0.01).The above inflammation index expression returned to normal in 7th days after operation.Compared with group S,COX-2 expression,PGE2 and Caspase-3 protein expression increased significantly on 1st day postoperatively to 3rd day(P <0.05 or P <0.01 ).Conclusion Partial hepatectomy could induce hippocampal inflammatory response in the rats.Parecoxib could suppress the hippocampal inflammation via the down-regulation expression of COX-2 mRNA and protein,PGE2 and Caspase-3 protein in rats.

BACKGROUND:The majority of people do not believe that the femoral component flexion in total knee arthroplasty affect or affect little postoperative function and it is the only that the radiographic films is not satisfactory.So it has not caused people's enollgh attention.But the femoral component flexion affects the results of total knee arthroplasty obviously.OnJECTIVE:To investigate the curative effects of femoral component installed in the position of flexion during the operative procedure of total knee arthroplasty(123 knees)on the follow up results in 78 patients.DESIGN:Grouping contrast observation.SETTlNG:First Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Cllinese Medicine.PARTlCIPANTS:123 knees(78 patients)were given total knee arthroplasty in the First Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Chinese Medicine from October 2001 to June 2004.Seventeen(13.8%,15 patients)knees were found with femoral component flexion(FCF),in which there were 5 male cases and 10 female cases,aged from 47 to 81 years old.106(63 patients)knees were found without FCF,in which there were 22 male cases and 41 female cases,aged from 47 to 79 years old.METHODS:Total knee arthroplasties about their HSS rating scores,ranges of motion and flexion contractures werecompared in the two groups before operation and after operation,and the degrees of the FCF angle and the distances of femoral component flexion were measured.MAIN OUTCOME MEASURES:①Femoral Drostllesis flexion measurement;②HSS scores and activity:③femoral prosthesis flexion angle and distance buckling;④adverse events and side effects.RESULTS:Follow up lasted for one year above.①The degrees of flexion of femoral components were from 7°to 19°(average 11.3°)and the distance of flexion was from 2 mm to 4 mm(average 2.6 mln)in those 17 knees of total knee arthroplasty.②Differences in HSS rating scores and range of motion were not statistically significant(P＞0.05)before operations between the group of femoral component flexion and the group of femoral component plane.However,after operations the above aspects in the group of femoral component flexion were less than that in the group of femoral component plane significantly(P=0.01,P＜0.01),and were statistically significant(P=0.02,P＜0.01)between post-operations and pre-operations in HSS rating scores and range of motion respectively in the two groups.③The statistic differences in cases and angles of flexion contractures of postperations between the group of femoral component flexion and the group of femoral component plane were significant(P＜0.01),the situation in the group of femornl component flexion were more bad than that in the group of femoral component plane,but were all improved significantly in cases and angles of flexion contractures after operations in the two groups(P＜0.05,P＜0.01).④There was one case with the right deep venous thrombosis and one case with myositis ossifican in non-FCF group,and there was one case in FCF group with impingement sign between patellar and component.CONCLUSION:The findings show that femoral component flexion will increase the incidence of knee flexion contracture and result in knee extension dysfunction after total knee arthroplasty surgery.

The correlation between aquaporin 1 (AQP1) and hypoxia-inducible factor 1 (HIF 1) in breast cancer tissues was preliminarily studied. In 155 cases of breast cancer, the expression levels of AQP1 were detected by immunohistochemisty in HIF1-positive group or HIF1-negative group, and the correlation between AQP1 and HIF1 was analyzed. The overexpression of AQP1 and HIF1 were observed in 155 cases of breast cancer tissues. The expression level of AQP1 in HIF1-positive group was significantly higher than that in HIF1-negative group. The positive expression rate of AQP1 was 296.55±24.67 and 168.37±37.53 in HIF1-positive group and HIF1-negative group respectively with the difference being very significant between them (P<0.001). It was concluded that AQP1 was overexpressed in the HIF1-positive group and there were some correlations between AQP1 and HIF1, suggesting they interact each other and regulate the oncogenesis of breast cancer.