Objective:To compare the recovery effect of continuous infusion of dexmedetomidine combined with oxycodone or sufentanil in the anesthesia intensive care unit (AICU) in elderly patients after thoracoscopic radical surgery for lung cancer.Methods:Using the method of prospective study, 80 elderly lung cancer patients underwent selective thoracoscopic radical surgery under general anesthesia in Nanjing First Hospital from February 2021 to May 2022 were selected. The patients were divided into dexmedetomidine combined with sufentanil group (S group) and dexmedetomidine combined with oxycodone group (Q group) by random digits table method with 40 cases each group. On the basis of routine monitoring and treatment after operation, the patients in Q group were continuously injected with oxycodone 0.03 mg/(kg·h) and dexmedetomidine 0.4 μg/(kg·h) through analgesia pump, the patients in S group were continuously injected with sufentanil 0.03 mg/(kg·h) and dexmedetomidine 0.4 μg/(kg·h) through analgesia pump. The wake-up time, extubation time, awakening quality (Aldrete score and bucking score) and comfort level (Bruggrmann comfort scale score, BCS score) after entering the AICU were record; the sedation score (Ramsay score) and pain relief score (numerical rating scale score, NRS score) and hemodynamic changes (mean arterial pressure and heart rate) 3, 5, 7, 10 and 14 h after entering the AICU were record; the level of serum inflammatory factors, including tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) immediately, 5 h and 14 h after entering the AICU; press times of analgesia pump, adverse events, bleeding volume of drainage tube during AICU and overall satisfaction score when leaving the AICU were record.Results:The bucking score in Q group was significantly lower than that in S group: (1.02 ± 0.77) scores vs. (1.88 ± 0.34) scores, the Aldrete score and BCS score were significantly higher than those in S group: (8.93 ± 0.25) scores vs. (5.97 ± 0.32) scores and (3.03 ± 0.32) scores vs. (0.93 ± 0.52) scores, and there were statistical differences ( P<0.01); there were no statistical difference in wake-up time and extubation time between two groups ( P>0.05). There were no statistical difference Ramassy score, NRS score 3 and 5 h after entering the AICU, mean arterial pressure and heart rate between two groups ( P>0.05); the Ramassy score 7, 10 and 14 h after entering the AICU in Q group was significantly lower than that in S group, the NRS score, mean arterial pressure and heart rate were significantly lower than those in S group, and there were statistical differences ( P<0.01). There were no statistical differences in TNF-α, IL-6 and CRP immediately after entering the AICU between two groups ( P>0.05); the TNF-α, IL-6 and CRP 5 and 14 h after entering the AICU in Q group were significantly lower than those in S group, and there were statistical difference ( P<0.01). The press times of analgesia pump, bleeding volume of drainage tube and the incidences of nausea vomiting, respiratory depression, lethargy, restlessness, fever and lung infection in Q group were significantly lower than those in S group: (4.63 ± 1.10) times vs. (18.80 ± 1.54) times, (129.67 ± 4.14) ml vs. (164.00 ± 8.14) ml, 10.0% (4/40) vs. 52.5% (21/40), 2.5% (1/40) vs. 25.0% (10/40), 7.5% (3/40) vs. 47.5% (19/40), 0 vs. 20.0% (8/40), 2.5% (1/40) vs. 22.5% (9/40) and 2.5% (1/40) vs. 20.0% (8/40), and there were statistical differences ( P<0.01 or <0.05); there was no severe hypotension, severe bradycardia and delirium in both groups. The overall satisfaction score in Q group was significantly higher than that in S group: (3.53 ± 0.63) scores vs. (2.70 ± 0.65) scores, and there was statistical difference ( P<0.01). Conclusions:Continuous micro-pump infusion of dexmedetomidine combined with oxycodone in AICU elderly patients with lung cancer after thoracoscopic radical surgery can significantly improve the quality of recovery and comfort during extubation, without affecting the extubation time, and can effectively reduce the degree of pain, stress and inflammatory reaction in the early recovery period, and reduce the incidence of adverse events after surgery.

China’s anti-epidemic actions has always adhered to the value of people first and life first, which has profoundly affected the perception of medical humanism by the whole society, especially medical workers. The epidemic prevention and control has put forward new requirements for medical personnel to practice medical humanism, reflecting the unique connotation of the times. In the context of normalized epidemic prevention and control, it is timely to reshape the humanistic spirit of medicine, which has extremely important value of the times. On the basis of explaining the connotation and significance of medical humanism, this paper analyzed the impact and influence of the epidemic on the medical humanism of medical personnel. The value orientation of medical humanism, which is the unity of synergy and innovation, the unity of doctor’s kindness and social responsibility, and the unity of national spirit and human health community, was constructed, and suggestions for reconstructing medical humanism were put forward in terms of improving institutional norms, strengthening education and training, promoting the synergistic development of medical technology and medical humanism, and creating a harmonious humanistic atmosphere.

Objective To investigate the lamina windowing small gap and the vertebrae pedicle bone graft in the treatment of thoracolumbar burst fractures of the curative effect.Methods 132 patients with thoracolumbar burst fracture of were selecteds, the average random divided into open the window and pedicle group, open a window line set of lamina windowing small gap vertebral body bone graft and pedicle group through pedicle vertebral body bone graft, through intraoperative records, hospital records and postoperative follow-up of collecting morphological index, operation index, JOA score and Frankel classification of spinal cord injury in order to evaluate the clinical curative effect of two kinds of operative methods.Results The operation time in the pedicle group was (103.58±14.37) min, which was more than that of the fenestration group [ (85.72±12.96) min], the incision drainage rate in the pedicle group [ (100.96±5.29) ml] was less than that in the fenestration group [ (178.52±12.41) ml], and the postoperative pain score in the pedicle group [ (15.37±2.86) ] was higher than that in the fenestration group [ (8.26±4.52) ], the healing time of fractures in the pedicle group [ (20.85±0.60) weeks ]was less than that of the fenestration group [ (24.29±1.06) weeks].The difference was all statistically significant (P＜0.05).After treatment, the intervertebral space height of the pedicle group [ (11.55±1.94) mm] was significantly higher than that of the fenestration group [ (9.53±1.92) mm], and the difference was statistically significant (P＜0.05).After treatment, the JOA scores of patients in the pedicle group[7.78±1.39, 4.93±0.92, 13.84±2.74] were significantly higher than those in the open window group[6.24±1.20, 4.50±0.83, 12.43±2.52] (P＜0.05).The difference between the composition of Frankel spinal cord injury in the pedicle group and the fenestration group was statistically significant (P＜0.05).Conclusion Compared with small fenestration through the intervertebral space, this surgical method can promote the fracture healing and improve the symptoms of patients more rapidly, and is more suitable for the surgical treatment of thoracolumbar burst fracture patients.

Objective To explore the effect and mechanism of Toll-like receptor 4 (TLR4) on cerebral ischemia/reperfusion injury. Methods Rats were divided into a sham group, MCAO group, and MCAO+TAK group. Cerebral cortices were removed on day 1, 3, 7, and 14 post surgery. Morphological staining and Western blotting were used to detect pathological changes and TLR4 and P-IKKα/β expression in brain tissues. Results The pathological changes in the MCAO+TAK group were more severe than in the MCAO group on day 1 post surgery. However, the MCAO group exhibited more severe damage at the other time points. TLR4 expression was lowest in the cerebral cortices of the sham group. On day 1 and 14 post surgery, TLR4 expression was lower in the MCAO group than in the MCAO+TAK group, while on day 3 and 7 post surgery, TLR4 expression was higher in the MCAO group than in the MCAO+TAK group. P-IKKα/β expression was highest in the cerebral cortices of the MCAO group at all time points except for day 1. Conclusion TLR4 may alleviate cerebral ischemia reperfusion injury in rats on day 1 post surgery; however, TLR4 may exacerbate ischemia repeifusion injury 3 to 14 days post surgery. The mechanism may be due to the effect of P-IKKα/β expression in the cerebral cortex.

OBJECTIVE:To provide reference for improving the food and drug inspection and testing system in Gansu prov-ince. METHODS:The food and drug inspection and testing institutions in Gansu province were investigated by using questionnaires and interview. Information about resource allocation,operational capacity and business scope in various levels of food and drug in-spection and testing institutions in Gansu province were collected. Problems existing in food and drug inspection and testing system in Gansu province were analyzed,and countermeasures were put forward. RESULTS & CONCLUSIONS:The food and drug in-spection and testing system in Gansu province is not perfect,showing unreasonable resource allocation,lack of inspection and test-ing resources as a whole,low resource utilization,imperfect management mechanism,weak normativity and other problems. In or-der to achieve the improvement of food and drug inspection and testing system in Gansu province,countermeasures were put for-ward,including optimizing resource allocation of inspection and testing,enhancing facility and capacity,improving the utilization of existing resources,improving management mechanism,process and standard.

Objective To investigate the effectiveness of ultrasound in evaluating the degree of xerostomia in the patients with nasopharyngeal carcinoma ( NPC) receiving intensity?modulated radiotherapy (IMRT). Methods A total of 30 NPC patients who were admitted to our hospital from May 2013 to December 2014 were enrolled in this study. The degree of xerostomia in these NPC patients was scored according to the Radiation Therapy Oncology Group scoring criteria. Color Doppler ultrasound was used to measure the peak systolic blood flow velocity of the parotid gland and submandibular gland and the changes in vascular diameter of the parotid gland in the NPC patients before, during, and after IMRT. The correlation between each parameter and the degree of xerostomia was determined by analysis of variance. Results In the 28 NPC patients included in the statistical analysis, the degree of xerostomia during IMRT was significantly higher than that before IMRT ( P=0024 ) , and the degree of xerostomia at 3 months after IMRT was significantly lower than that during IMRT ( P=0035) . The peak systolic blood flow velocity of the parotid gland and submandibular gland and the proportion of patients with decreases in vascular diameter of the parotid gland during IMRT were significantly higher than those before IMRT ( P=0001 and 0003;P=0001);the above parameters at 3 months after IMRT were significantly lower than those during IMRT ( P=0008 and 0012;P=0001) . During IMRT and after IMRT, the degree of xerostomia was significantly correlated with the peak systolic blood flow velocity of the parotid gland ( r=0563, P=0026;r=0409, P=0031) . Conclusions Ultrasound can be used as a noninvasive detection for the hemodynamic changes in the parotid gland, and it has a certain clinical reference value for evaluating the degree of xerostomia in NPC patients during and after IMRT.

TCM service trades are an inevitable choice for TCM development, and also one of the most important levels in the national development strategy pattern. For the Belt and Road, it is necessary to promote the rapid development of TCM service trades, not only for promoting transformation cross domain development of TCM industry in Gansu, but also for promoting Gansu economic and social development. Based on the analysis of the significance and opportunities of the TCM service trades, this article proposed the specific strategies for promoting the development of TCM service trades in Gansu Province.

OBJECTIVE:To study pharmacognosy of Melilotus officinalis.METHODS:Qualitative identification of M.officinalis was conducted in respects of morphology,macroscopic characters,microscopic identification,UV spectra for medicinal extracts and IR spectra for medicinal powder.RESULTS:Nineteen bundles of rays were distributed in the radial bundle of root cross section of M.officinalis.The main vein vascular bundle of leaf cross section had a palisade tissue passing over it.The pith of the cross section of the stem occupied 4/5 of the whole cross section.The cross section of the leafstalk was heart-shaped,and unequal vascular bundles arranged in a triangular array.There were glandular hairs,which consist of three cells,and unicellular non glandular hairs in leaf epidermis.The crystal fibers of calcium oxalate crystals and infinitive blowhole were found in the leaves;glandular hairs and non glandular hairs could be found in the leafstalk under tissue dissociation;verrucous like protuberance and threaded catheter were found on the surface.The UV spectrum of extract and two order derivative IR spectrum of the medicinal powder showed obvious characteristics.CONCLUSIONS:Established method can be used for pharmacognostic identification of M.officinalis.

Objective: To investigate the changes in protein expression in patients with 1-bromopropane (1-BP) poisoning using high-throughput proteomic technique and to screen out protein markers. Methods: Serum samples were collected from 3 patients with 1-BP poisoning and 15 controls. The label-free proteomic tech-nique was used for the quantitation and identification of proteins expressed in these samples, and the results were compared between the patients with 1-BP poisoning and the control population. The bioinformatics tools were used to analyze the function of differentially expressed proteins. Results: Compared with the control popula-tion, the patients with 1-BP poisoning had >2-fold upregulation of 38 proteins and >2-fold downregulation of 68 proteins. The differentially expressed proteins were mainly involved in immune response, signal transduction, and stress response. Conclusion The proteins screened out may be potential protein markers for 1-BP poison-ing, which provides reliable and precise methods and thoughts for the diagnosis of 1-BP poisoning.

Objective To evaluate the effects of sevoflurane on right ventricular systolic function after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting(CABG). Methods Eighteen patients with coronary heart disease,13 males,5 females,ASA Ⅱ or Ⅲ,aged 50-80 years,measuring 1 50-182 cm in height,weighing 5 1-96 kg,scheduled for CABG under CPB were enrolled in this study.Anesthesia was maintained with intravenous anesthesia, and 1 MAC sevoflurane inhalation lasted for 60 min after CPB.Hemodynamic indicators such as HR,MAP, CVP,cardiac output (CO),Systemic vascular resistance (SVR)and right ventricular parameters in-cluding tricuspid annular plane systolic excursion (TAPSE)and velocity (TAPSV)were recorded be-fore sternotomy (T2 ),30 min after CPB (T3 ),60 min after CPB (T4 ).Results Compared with T1 , CO was increased at T2 (P <0.05);compared with T2 ,CO was decreased at T3 and T4 (P <0.05 or P <0.01),with a statistical significance;compared with T1 ,TAPSE and TAPSV were increased at T2 (P <0.05 or P <0.01);compared with T2 ,TAPSE and TAPSV were decreased at T3 and T4 (P<0.05);with a statistical significance in TAPSE and TAPSV.Conclusion For the patients undergo-ing CABG under CPB,1 MAC sevoflurane inhalation after CPB can reduce right ventricular systolic function,which,however,is within the normal ranges.