Study on the correlation between gene polymorphisms of adiponectin and resistin levels and abdominal aortic aneurysm

Abstract Objectives: Abdominal Aortic Aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. This study aimed to examine the potential association of the +276G/T and −420C>G polymorphisms in the resistin gene with AAA susceptibility and progression. Method: We performed a retrospective study involving AAA patients and healthy controls, assessing the distribution of the +276G/T and −420C>G genotypes in both groups. Hardy-Weinberg equilibrium was assessed for both polymorphisms. Logistic regression was used to explore the influence of these genotypes on AAA occurrence and progression, adjusting for relevant confounders. Results: The distribution of +276G/T polymorphism did not significantly differ between AAA patients and controls. Conversely, a significant difference was observed in the genotype distribution of −420C>G polymorphism between the two groups. The CC genotype and CC/CG genotypes of −420C>G polymorphism were found to be associated with an increased risk and progression of AAA. Conclusions: The −420C>G polymorphism, particularly the CC genotype and CC/CG genotypes, might play a substantial role in AAA susceptibility and progression. The present findings underscore the need for further investigations to confirm these associations and fully elucidate the role of the resistin gene in AAA.

Research Status and Prospects of Non-Traumatic Fat Embolism in Forensic Medicine / 法医学杂志

In the practice of forensic pathology, fat embolism is one of the common causes of death, which can be divided into two categories: traumatic and non-traumatic. Non-traumatic fat embolism refers to the blockage of small blood vessels by fat droplets in the circulatory blood flow caused by non-traumatic factors such as underlying diseases, stress, poisoning and lipid metabolism disorders. At present, it is believed that the production of non-traumatic fat embolism is related to the disturbance of lipid metabolism, C-reactive protein-related cascade reaction, the agglutination of chylomicron and very low-density lipoprotein. The forensic identification of the cause of death of non-traumatic fat embolism is mainly based on the case, systematic autopsy, HE staining and fat staining, but it is often missed or misdiagnosed by forensic examiners because of its unknown risk factors, hidden onset, the difficulty of HE staining observation and irregular implementation of fat staining. In view of the lack of attention to non-traumatic fat embolism in forensic identification, this paper reviews the concepts, pathophysiological mechanism, research progress, existing problems and countermeasures of non-traumatic fat embolism, providing reference for forensic scholars.

Comparative study on the efficacy of different ways of common sclerosing agents used in ultrasonic intervention on the treatment of ovarian endometriosis cyst / 中华超声影像学杂志

Objective:To compare the efficacy of anhydrous ethanol and lauromacrogol in the treatment of ovarian endometriosis cyst (OEC), and to provide evidence for more effective use of these two sclerotic drugs.Methods:Thirty-three cysts in 30 patients with OEC, who were admitted to Taizhou Hospital of Zhejiang Province from February 2017 to June 2018, were treated by ultrasound interventional therapy, followed by catheter aspiration, saline cavity cleaning, anhydrous ethanol rinsing and sclerotherapy, and lauromacrogol alcohol 1∶1 mixed solution retained in the capsule (mixed group). The therapeutic effects were observed 6 and 12 months after operation. A total of 30 OEC in 28 cases admitted to the same hospital from 2013 to 2015 were retrospectively analyzed after similar treatment steps, but the intracapsular retention fluid was anhydrous ethanol (ethanol group). A total of 28 OEC in 26 patients admitted to the same hospital from 2015 to 2017 were washed with normal saline, then washed with lauromacrogol and retained in the capsule with lauromacrogol (lauromacrogol group). The therapeutic effects of 6 and 12 months after treatment between the three groups were compared.Results:According to the classification of cure, marked effect and inefficacy, there was a weak correlation among the three groups. The mixed group did not tend to be ineffective, while the lauromacrogol group tended to be ineffective 6 and 12 months after treatmen.the difference was statistically significant (adjusted standardized residual >2). According to the total effective (cure+ markedly effective) and ineffective classification, the effective rate of the mixed group was significantly higher than that of the lauromacrogol group ( P<0.016 7). There was no significant difference for the effective rate between the mixed group and the ethanol group, and between the ethanol group and the lauromacrogol group ( P>0.0167). Conclusions:The retention of ethanol-lauromacrogol mixture in the capsule of sclerotic OEC, after pre-rinsing with anhydrous ethanol is helpful to improve the curative effect of OEC and give full play to the therapeutic effect of common sclerosing agents used in ultrasound intervention.

Clinical characteristics and related factors of systemic lupus erythematosus with interstitial pneumonia / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical features, radiologic scores and clinically relevant risk factors prognosis of secondary interstitial lung disease (ILD) in patients with systemic lupus erythematosus (SLE).@*METHODS@#In this study, 60 SLE patients in Department of Rheumatology of the First Affiliated Hospital of Baotou Medical College and Taizhou First People's Hospital from January 2015 to March 2019 were retrospectively analyzed. All of those 60 patients with SLE underwent lung high resolution computed tomography (HRCT) examination. We used a 1 ∶1 case-control study. There was a matching of age and gender between the two groups. Thirty patients with SLE related ILD (SLE-ILD) were in the case group, and 30 patients with SLE without ILE (SLE non-ILD) were in the control group. The clinical features, pulmonary function test, radiologic characteristic of SLE patients were collected and were used to analyze SLE-ILD.@*RESULTS@#In this study, we reached the following conclusions: First, there were statistically significant differences in chest tightness/shortness of breath, Raynaud's phenomenon, and Velcro rale between SLE-ILD and SLE non-ILD patients (both P < 0.05); Second, hemoglobin (Hb) and albumin (ALB) in the patients of SLE-ILD had a significant decrease compared with the patients of SLE non-ILD. Blood urea nitrogen (BUN), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) increased in SLE-ILD patients compared with SLE non-ILD patients, the difference had statistical significance (P < 0.05); Third, for SLE-ILD patients, the most common type was non-specific interstitial pneumonia (NSIP), followed by usual interstitial pneumonia and lymphocytic interstitial pneumonia; Fourth, there was no significant difference in clinical-radiology-physiology scores between the different ILD types (P>0.05), similarly, the lung HRCT score and lung function between different ILD types had no significant difference (P>0.05); Fifth, multivariate Logistic regression analysis showed that decreased albumin and chest tightness/shortness of breath might be the risk factor for SLE-ILD.@*CONCLUSION@#There are statistically significant differences between the SLE-ILD group and SLE non-ILD group in terms of chest tightness/shortness of breath, Velcro rale and Raynaud's phenomenon. Decreased albumin and chest tightness/shortness of breath in SLE patients should be alerted to the occurrence of ILD. NSIP is the most common manifestation of SLE-ILD.

Relationship between cerebral hemorrhage and depression occurrence after craniocerebral injury surgery / 中国医师杂志

Objective To explore the relationship between cerebral hemorrhage and the occurrence of depression after craniocerebral injury surgery.Methods From March 2015 to March 2017,70 patients with craniocerebral injury in our hospital were selected as the subjects of study.They were divided into the observation group (n =30) and the control group (n =40) according to whether there was cerebral hemorrhage after operation.The National Institutes of Health Stroke Scale score (NIHSS),Hamilton Depression Scale score (HAMD),Glasgow Coma Score (GCS) and the levels of interleukin (IL)-1,IL-6 and high sensitivity C-reactive protein (hs-CRP) in patients with different degrees of cerebral hemorrhage were compared.The correlation between HAMD score and other indexes was analyzed.The influencing factors and independent risk factors of depression were analyzed.Results The levels of NIHSS,HAMD score and serum IL-1,IL-6 and hs-CRP in the observation group were higher than those in the control group after operation (t =13.655,36.587,45.274,46.334,70.489,P ＜ 0.05),while the GCS score was lower than that in the control group (t =15.517,P ＜ 0.05).Compared with mild and moderate cerebral hemorrhage,the NIHSS,HAMD scores and serum IL-1,IL-6 and hs-CRP were higher in patients with severe cerebral hemorrhage (F =8.825,10.254,23.615,18.745,7.245,P ＜ 0.05),while the GCS score was lower (F =7.459,P ＜ 0.05).The correlation analysis showed that the postoperative HAMD score was positively correlated with NIHSS score and serum IL-1,IL-6 and hs-CRP (r =0.289,0.364,0.333,0.258,P ＜ 0.05)and negatively correlated with the GCS score (r =-0.276,P ＜ 0.05).Univariate analysis showed that the level of culture,personality,cerebral hemorrhage degree and serum IL-6 and hs-CRP were the influencing factors of postoperative depression in patients with craniocerebral injury (t orx2 =6.076,6.300,8.361,30.224,99.575,P ＜ 0.05).Multivariate analysis showed that cerebral hemorrhage and hs-CRP were an independent risk factor for postoperative depression (P ＜ 0.05).Conclusions Cerebral hemorrhage after craniocerebral injury is closely related to the occurrence of depression,which may be related to the increase of stress-induced inflammatory factors after cerebral hemorrhage.

Development of Koreans Gut Quotient Measurement Scales / 대한소화기학회지

BACKGROUND/AIMS: The aim of this study was to develop ‘Koreans Gut Quotient Measurement Scales (GQ)’, in which Koreans respond to questionnaires about the subjective feelings and symptoms of their intestinal health status.METHODS: Among 66 items pooled from previous studies and 4 items that were added following a focus group interview, 15 items were chosen using the Delphi survey. The content validity was evaluated using the content validity ratio. Data collected from 1,120 people from the general public in Korea were analyzed to verify the reliability and validity of GQ.RESULTS: The finalized GQ consisted of 17 items (including two exploratory measurement items) that were classified into three independent factors based on exploratory factor analysis (EFA): ‘perceived intestine discomfort’, ‘bowel movement discomfort’, and ‘bowel movement control discomfort’. The discriminant and convergent validity of GQ were identified using EFA, reliability test, and confirmatory factor analysis. In addition, the criterion-related validity of GQ was identified using correlation and multiple regression analysis.CONCLUSIONS: The GQ, which is a simplified intestinal health index developed based on an easy questionnaire for the public to understand, can be used as a tool for the public to evaluate their own intestinal health and determine when to visit clinics.

Development of Koreans Gut Quotient Measurement Scales / 대한소화기병학회잡지

BACKGROUND/AIMS: The aim of this study was to develop ‘Koreans Gut Quotient Measurement Scales (GQ)’, in which Koreans respond to questionnaires about the subjective feelings and symptoms of their intestinal health status. METHODS: Among 66 items pooled from previous studies and 4 items that were added following a focus group interview, 15 items were chosen using the Delphi survey. The content validity was evaluated using the content validity ratio. Data collected from 1,120 people from the general public in Korea were analyzed to verify the reliability and validity of GQ. RESULTS: The finalized GQ consisted of 17 items (including two exploratory measurement items) that were classified into three independent factors based on exploratory factor analysis (EFA): ‘perceived intestine discomfort’, ‘bowel movement discomfort’, and ‘bowel movement control discomfort’. The discriminant and convergent validity of GQ were identified using EFA, reliability test, and confirmatory factor analysis. In addition, the criterion-related validity of GQ was identified using correlation and multiple regression analysis. CONCLUSIONS: The GQ, which is a simplified intestinal health index developed based on an easy questionnaire for the public to understand, can be used as a tool for the public to evaluate their own intestinal health and determine when to visit clinics.

A case study of nursing cooperation in axillobifemoral bypass surgery treating stent-graft infection after endovascular repair of abdominal aortic aneurysm / 中国实用护理杂志

Objective@#To summarize the nursing cooperation of axillobifemoral bypass surgery treating stent graft infection after endovascular aortic repair of abdominal aortic aneurysm.@*Methods@#To review a case of stent graft infection after endovascular aortic repair of abdominal aortic aneurysm and summarize the nursing cooperation of this patient retrospectively.@*Results@#After the medical care tacit cooperation and the infection protection, the procedure was successfully completed. The artificial blood vessels of the patient were unobstructed after the operation, and the pulse of both dorsalis pedis arteries was strong.@*Conclusions@#Axillobifemoral bypass surgery poses the characteristicsof long duration and complex. Designation of appropriate nursing measures, such as multi-incision management, thrombosis preventing and prevention of ischemia based on potential complications, are essentials of successful operation.

Status of healthcare-associated infection management in 42 Chinesemedi-cine hospitals in Fujian Province / 中国感染控制杂志

Objective To understand the status of healthcare-associated infection(HAI)management in traditional Chinese medicine hospitals as well as integrated traditional Chinese and Western medicine hospitals in Fujian Pro-vince,analyze the existing problems and weak links,and put forward corresponding improvement measures.Methods A questionnaire was designed through literature and expert consultation,from March to April 2016,42 secondary and above traditional Chinese medicine hospitals as well as integrated traditional Chinese and Western medicine hos-pitals in 8 cities of Fujian Province were conducted on-site investigation,data were analyzed.Results A total of 42 hospitals participated in the investigation,92.86% were traditional Chinese medicine hospitals,7.14% were inte-grated traditional Chinese and Western medicine hospitals;all hospitals set up HAI management committees and HAI management groups of clinical departments,there were 100 HAI management professionals(66 were full-time,34 were part-time),nursing staff accounted for 63.00%,junior college and undergraduate personnel accoun-ted for 84.00%,staff with intermediate and senior professional titles accounted for 79.00%.There were significant differences in academic disciplines and education levels among administrators in secondary and tertiary hospitals(P<0.05). All hospitals carried out HAI case surveillance,only 2.38% achieved HAI informational software monito-ring,83.33% carried out comprehensive and targeted monitoring,42.86%,71.43%,and 80.95% of hospitals car-ried out targeted monitoring on multidrug-resistant organisms,surgical site infection,and intensive care unit respec-tively.Conclusion The environment of majority of Chinese medicine hospitals in Fujian Province improved signifi-cantly,organizations of HAI management is rational,staffing and quality of HAI management personnel is imbal-anced,HAI monitoring is still at preliminary stage,lack information management,HAI management in key depart-ments is not optimistic.

Comparison of three internal fixation methods for treatment of intertrochanteric fracture of the femur in elder patients / 中国组织工程研究

BACKGROUND: At present, the treatment methods for intertrochanteric fracture of the femur in the aged are in two ways: Intramedullary fixation and extramedullary fixation. The advantages of intramedullary fixation with simple operation, small trauma and few complications have become the gold standard for the treatment of intertrochanteric fracture in the femur in the aged. OBJECTIVE: To explore the clinical curative effects of three internal fixation methods: dynamic hip screw, proximal femoral nail antirotation, and intramedullary nail InterTan in the treatment of intertrochanteric fractures of the femur in the aged. METHODS: A retrospective analysis of 120 cases of intertrochanteric fractures from January 2010 to January 2016 was performed. The patients were randomly divided into dynamic hip screw group (n=40), proximal femoral nail antirotation group (n=60) and InterTan group (n=20). The operative time, intraoperative blood loss, incision length, hospitalization time, postoperative weight-bearing time, fracture healing time, Harris score, and intraoperative and postoperative complications were recorded and compared among the three groups. RESULTS AND CONCLUSION: (1) Operative time, intraoperative blood loss, and incision length were significantly better in the InterTan group and proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). Above indexes were not significantly different between InterTan and proximal femoral nail antirotation groups (P > 0.05). (2) Postoperative weight-bearing time, fracture healing time, and Harris score one month after operation were significantly better in the InterTan group than in the proximal femoral nail antirotation and dynamic hip screw groups; above indexes were better in the proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). (3) Hospitalization time and Harris score at 6 and 12 months after operation were not significantly different among the three groups (P > 0.05). (4) The incidence rate of intraoperative and postoperative complications was significantly lower in the InterTan group and proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). (5) In summary, compared with dynamic hip screw system, proximal femoral nail antirotation and InterTan system are characterized by small trauma, simple operation, quick recovery, and fewer complications, and show good clinical therapy in the treatment of intertrochanteric fracture. Compared with proximal femoral nail antirotation system, InterTan system shows better fracture reduction and stability, shorter healing time, and better biomechanical advantages.

Assessment on right ventricular longitudinal strain and strain rate in prediabetes with two-dimensional speckle tracking imaging / 中华医学超声杂志（电子版）

Objective To predict the presence of impairment of right ventricular function in prediabetes using two-dimensional speckle tracking imaging. Methods From June 2012 to May 2016, a total of 110 patients from Zhejiang Taizhou Hospital of Taizhou Enze Medical Center (group) were recruited, including 40 controls, 33 prediabetes and 37 type 2 diabetes. The routine right ventricular parameters were measured. Longitudinal peak strain of right ventricular free wall (RVLPSF), ventricular septal (RVLPSS) and global longitudinal peak strain of right ventricle (RVLPSG) were measured with two-dimensional spekle tracking imaging, and global systolic strain rate (SRS), global early diastolic strain rate (SRE) and global late diastolic strain rate (SRL) of right ventricle were also measured. LVEDVI, LVESVI, LVEF, RVD, E/A, e/a, E/e, TAPSE, RVFAC, RVLPSF, RVLPSS, RVLPSG, SRS, SRE, and SRL in the above 3 groups were analyzed with LSD-t test. Results Compared with the controls: RVLPSF, RVLPSS, RVLPSG, SRS, and SRE were all statistically reduced in prediabetes[(-27.89±4.11)% vs(-21.78±3.62)%,(-20.08±4.11)% vs (-16.88±2.68)%, (-23.98±2.96)% vs (-19.33±2.13)%, -1.67±0.25 vs -1.18±0.24, and 1.84±0.23 vs 1.35±0.20,t=3.45,3.42,3.44,3.44,and 3.43,all P<0.01].RVLPSF,RVLPSS,RVLPSG,SRS,and SRE were all statistically reduced in diabetes[(-27.89±4.11)% vs(-20.97±3.88)%,(-20.08±4.11)% vs(-15.42±1.92)%, (-23.98±2.96)% vs(-18.19±2.29)%,-1.67±0.25 vs-1.08±0.23,and 1.84±0.23 vs 1.18±0.27,t=3.43,3.45,3.43, 3.42,and 3.42,all P<0.01].Compared the prediabetes:SRE was significantly reduced in diabetes(1.35±0.20 vs 1.18±0.27, t=3.45, P<0.01). Conclusions Diastolic and systolic function of right ventricle were already impaired in prediabetes, and speckle tracking imaging can quantitatively evaluate the impairment.

Correlation of polymorphism of rs1260326 loci in glucokinase regulatory protein gene with primary gout and hyperuricemia in Enshi population / 中华风湿病学杂志

Objective To investigate the relationship between rs1260326 polymorphism of glucokinase regulatory protein gene and hyperuricemia and primary gout in Enshi area populations.Methods One hundred and fifty-eight primary gout,190 hyperuricemia and 104 healthy controls (normal group) in total were collected.Hi-single nucleotide polymorphism (SNP) combined with multiplex polymerase chain reaction (PCR) with next generation sequencing techniques were used for gene polymorphism analysis,and the relationship between different alleles or genotypes and susceptibility to primary gout and hyperuricemia were analyzed.The measurement data and numeration data were statistically analyzed with t test and x2 test respectively.Logistic regression analysis was used to assess the relative risk of gout and hyperuricemia.Results The frequency of rs1260326 genotype CC,TC,TT was 8.8％(14/158),60.8％(96/158),30.4％(48/158) respectively in gout patients,15.8％ (30/190),54.7％ (104/190),29.5％ (56/190) in hyperuricemia patients,21.2％ (22/104),45.1％ (47/104),33.7％(35/104) in the normal group,the genotype distribution was significantly different in gout group and normal group (x2=9.895,P=0.007),and there was no difference between hyperuricemia group and normal group (x2=2.665,P=0.264).Allele C and T frequency was 39.2％(124/316) and 60.8％(192/316) in gout patients,43.2％(164/380) and 56.8％(216/380) in hyperuricemia patients,43.8％(91/208) and 56.2％(117/208) in the normal group.Allele T was the susceptible gene for gout.Logistic regression analysis showed that genotypes TC,TT,TC+TT increased the risk of gout.And Logistic regression analysis showed that rs1260326 single nucleotide polymorphism and hyperuricemia were no susceptibile.Conclusion Glucokinase regulatory protein (GCKR) rs1260326 sin-gle nucleotide polymorphism may be associated with primary gout risk in En Shi area,but has no significant correlation with hyperuricemia.

Independent external verification of the nomograms for predicting lymph node metastasis in penile cancer / 中华男科学杂志

<p><b>Objective</b>To evaluate the two newly established nomograms for predicting lymph node metastasis in penile cancer based on the clinical data on a large cohort of patients.</p><p><b>METHODS</b>We retrospectively studied the clinical data on 93 patients with penile cancer treated in the Center for Tumor Prevention and Treatment. Using the two recently established nomograms (Bhagat nomogram and Zhu nomogram), we predicted lymph node metastasis in the patients, analyzed the differences between prediction and the results of postoperative pathology, and compared the accuracy of prediction between the two nomograms with the receiver operating characteristic (ROC) curve and the area under the curve (AUC).</p><p><b>RESULTS</b>The median age of the patients was 55 (27－82) years. Positive lymph nodes were found in 31 cases (33.3%) postoperatively and in 9 (21.9%) of the 41 clinically negative cases. The AUC of the Bhagat nomogram was 0.739 and that of Zhu nomogram was 0.808, both of which were similar to the prediction accuracy of internal verification and manifested a medium predictive ability.</p><p><b>CONCLUSIONS</b>The newly established Bhagat and Zhu nomograms can be used for predicting lymph node metastasis in penile cancer, but with a low precision, and therefore cannot be relied exclusively for the option of inguinal lymphadenectomy.</p>

Cloning and expression analysis of C4H gene from Lepidium apetalum / 药学学报

Lepidium apetalum was used as an experimental material in this study. By analyzing the tran-scriptome data of L. apetalum and application of the specific primers, cDNA of cinnamate-4-hydroxylase (C4H) gene was isolated from L. apetalum and named as LaC4H (GenBank accession No. KX064050). Meanwhile, the bioinformatic analysis, prokaryotic expression, purification, tissue-specific expression analysis and expres-sion analysis after methyl jasmonate (MeJA) treatment were carried out. The results indicated that: ① The open reading frame (ORF) of LaC4H was 1 518 bp, which encoded a protein of 505 amino acid residues, with a predicted molecular mass of 57.73 kD. ② Bioinformatic analysis showed that LaC4H protein contained the conserved sequences of cytochrome P450 (CYP450) and 5 substrate recognition sites (SRSs) of CYP73A1, therefore LaC4H protein was a member of CYP450 superfamily. The phylogenetic analysis indicated that LaC4H protein showed the highest homology with C4H protein from cruciferous plants (such as AtC4H from Arabidopsis thaliana). ③ Through the construction of the prokaryotic expression vector pET-32a-LaC4H, the recombinant LaC4H protein was successfully expressed in E. coli BL21 (DE3) cells and the recombinant LaC4H protein was purified by Ni2+ affinity chromatography. ④ Real-time PCR analysis indicated that LaC4H was expressed in a high transcript level in stems, lower levels in leaves and flowers, the lowest level in roots. After MeJA treatment, the expression level of LaC4H in leaves was increased significantly to reach the highest level at 48 h. Furthermore, the expression levels of LaC4H were positively correlated with the flavonoids contents in leaves. The results of this study provide the fundamental information on LaC4H gene in the flavonoids biosyn-thesis pathway of L. apetalum.

Multimode and comprehensive treatment for relieving discomfort after uvulopalatopharyngoplasty / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the effect of multimode comprehensive treatments on relieving discomfort during postoperative 7 days in patients after uvulopalatopharyngoplasty (UPPP).METHODS A total of 60 patients who underwent UPPP were randomly divided into experimental group and control group.Multimode comprehensive therapy was applied in experimental group(n=30) during postoperative consecutive 7 days,which included gastrogavage,whole pharynx cavity cleaning care with aspirator,intravenous flubiprofen axetil injection 100 mg two times a day,nebulization of budesonide suspension liquid 2 mg two times a day.The treatment methods in control group(n=30) included liquid or soft diets,routine oral cavity care.Visual analogue scale (VAS) was applied to evaluate the discomfort degree including pharyngeal pain,globus and pharyngeal mucus accumulation.The incision healing degree was also recorded.RESULTS VAS scores were highest(6-7.5) in the first two days after UPPP in control group.Compared with control group,the scores of pharyngeal pain,globus and pharyngeal mucus accumulation were lower and the rate of incision complete heal was higher(53.3％) in experimental group(P＜0.05).CONCLUSION The period of most severe pharyngeal discomfort after UPPP is within 48 hours after operation.Multimode comprehensive treatment can relieve pain,improve subjective globus feeling and mucus accumulation,and promote incision healing.

Influence of dexmedetomidine combined with sufentanil on postoperative analgesia effect and immune function for patients undergoing lower limb fracture surgery / 中国医师进修杂志

Objective To explore the influence of dexmedetomidine combined with sufentanil on postoperative analgesia effect and immune function for patients undergoing lower limb fracture surgery. Methods One hundred cases patients of lower limb fracture undergoing open reduction and internal fixation of elective surgery in our hospital from January 2016 to November 2016 were selected ( ASAⅠ-Ⅱgrade, male 51 cases and female 49 cases, 30-65 years old, 50-75 kg). All cases were randomly divided into sufentanil group (Group S) and dexmedetomidine combined with sufentanil group (Group DS) according to the random number table, who used patient-controlled intravenous analgesia (PCIA). The PCIA drug formulations of two groups were as followings: sufentanil group (Group S) used 3 μg/h sufentanil+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;dexmedetomidine combined with sufentanil group (Group DS) used dexmedetomidine 0.1μg/(kg · h)+sufentanil 2μg/h+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;background infusion rate was 2 ml/h, and loading dose was 2 ml. Dose for patient-controlled analgesia (PCA) was 0.5 ml, and locking time was 15 min. The changes of pain, MAP, HR , sedation scores were recorded at 4 h (T1), 8 h (T2), 24 h (T3) and 48 h (T4) after operation; nausea and vomiting, hypotension, bradycardia, respiratory depression and other adverse reactions were aslo recorded at the same time. At 10 min before induction of anesthesia (T0) and T1-T4 after operation, the CD3+, CD4+, CD8+and NK cell activity of peripheral blood T lymphocyte subsets were determined using flow cytometry, and CD4 +/CD8 + ratio was calculated. Results The levels of MAP and HR in DS group at each time point after operation were lower than those in group S (P<0.05), the level of visual analogue score (VAS) in DS group at different time points were significantly lower than those of s group: (1.8 ± 0.3) scores vs. (2.5 ± 0.5) scores, (1.1 ± 0.5) scores vs. (1.9 ± 0.3) scores, (1.0 ± 0.5) scores vs. (1.8 ± 0.5) scores, (0.8 ± 0.3) scores vs. (1.5 ± 0.6) scores (P < 0.05), Ramsay Sedation score was significantly higher than that of s group: (3.5 ± 0.3) scores vs. (2.4 ± 0.6) scores, (3.3 ± 0.5) scores vs. (2.5 ± 0.3) scores, (3.5 ± 0.6) scores vs. (2.3 ± 0.5) scores, (3.2 ± 0.4) scores vs. (2.2 ± 0.5)scores (P<0.05);nausea and vomiting occurred in two patients after the operation of group DS , which was significantly lower than that of S group (P<0.05);compared with those at T0, CD3+, CD4+, CD4+/CD8+and NK cells in the two groups of patients decreased significantly at the time of T1-T4 (P<0.05);The levels of CD3+, CD4+, CD4+/CD8+and NK cells were significantly higher in group DS at T1- T4 than those in group S(P < 0.05). Conclusions Dexmedetomidine combined with sufentanil for analgesia in patients with lower limb fracture surgery has better effect. It decreases the incidence of nausea and vomiting, and improves the cellular immune function of patients.

Changes in proportion and function of peripheral CD4(+)LAP(+) regulatory T cells in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes in the proportion and function of peripheral CD4(+)LAP(+)regulatory T cells (CD4(+)LAP(+)Treg cells) in children with asthma, as well as the role of CD4(+)LAP(+)Treg cells in the pathogenesis of asthma.</p><p><b>METHODS</b>A total of 75 children who were diagnosed with asthma from March 2014 to September 2015 were enrolled as study subjects, and according to their conditions, they were divided into acute-stage asthma group (40 children) and remission-stage asthma group (35 patients). Another 30 children who underwent physical examination were enrolled as the healthy control group. Flow cytometry was used to determine the percentage of peripheral CD4(+)LAP(+)Treg cells, and [(3)H]-thymidine incorporation assay was performed to analyze the immunosuppression of CD4(+)LAP(+)Treg cells in each group.</p><p><b>RESULTS</b>The acute-stage asthma group showed significant reductions in the proportion of CD4(+)LAP(+)Treg cells compared with the remission-stage asthma group and the healthy control group (2.0%±1.0% vs 4.1%±2.4%/4.6%±3.0%; P<0.05). The acute-stage asthma group also showed a significant reduction in the immunosuppression rate of CD4(+)LAP(+)Treg cells compared with the remission-stage asthma group and the healthy control group (21%±4% vs 55%±9%/62%±11%; P<0.05).</p><p><b>CONCLUSIONS</b>In children with asthma, the reduction in the number and inhibitory function of peripheral CD4(+)LAP(+)Treg cells may be involved in the pathogenesis of asthma.</p>

Phenotypic modulation of bladder smooth muscle in diabetic rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate whether phenotypic modulation of bladder smooth muscle occurs in diabetic rats.</p><p><b>METHODS</b>Thirty-two male SD rats were randomly assigned into diabetic group and control group. Diabetic rat models were established by a single intraperitoneal injection of streptozotocin (60 mg/kg). Nine weeks later, the bladder tissues of the rats were examined for structural changes using HE and Masson's trichrome staining , and the expressions of myocardin, α-SMA, and SMMHC in bladder smooth muscles were detected with RT-PCR and Western blotting.</p><p><b>RESULTS</b>Compared with the control group, the diabetic rats showed obvious polydipsia and polyuria with significantly increased collagenous fibers and lowered expressions of myocardin, α-SMA, and SMMHC in the bladder tissue (P<0.05).</p><p><b>CONCLUSION</b>s In rats at 9 weeks after diabetic model establishment, phenotypic transition of the bladder smooth muscles occurs to cause bladder contractile dysfunction, which may play an important role in the pathology of diabetic bladder dysfunction.</p>

Oxycodone vs. fentanyl in the treatment of early post-operative pain after total knee replacement: randomized controlled trial

BACKGROUND: Total knee replacement is often accompanied by severe post-operative pain. Oxycodone has sufficient analgesic effects and somewhat greater, but tolerable side effects compared to fentanyl. However, most studies on the topic evaluate visceral pain relief. In this study, we determine the effectiveness of oxycodone for somatic pain and evaluate the incidence of side effects. METHODS: Sixty-nine patients were involved in a randomized control trial. Analgesic agents were administered to two experimental groups at a post anesthetic care unit (PACU) 15 min after PACU admission: a 50 µg fentanyl group (n = 40) and a 4 mg oxycodone group (n = 29), both with severe pain (numeric rating scale, NRS > 5). Changes in NRS at the PACU were measured. Additional analgesic agents were administered at 0–6, 6–12, 12–24, and 24–48 h after surgery. RESULTS: Total fentanyl consumption and the number of patients who required additional opioids were significantly lower in the oxycodone group than in the fentanyl group. Incidence of side effects was not significantly different between the two groups. CONCLUSIONS: Oxycodone shows a better analgesic effect than fentanyl in somatic pain in the acute phase of post-operative pain. The side effects of oxycodone are not significantly different from those of fentanyl.

Application of intraoperative neurophysiological monitoring in cervical intraspinal tumor surgery / 中华骨科杂志

Objective To investigate the efficiency of intraoperative neurophysiological monitoring in cervical spinal tumor surgery.Methods Retrospective case-control study comparing 23 cervical spinal tumor patients received surgery under neurophysiological monitoring (case) and 23 cases without neurophysiological monitoring (control).Results All of 46 cases,there were no significant differences of age,gender and preoperative neurological function.Duration of operation and estimated blood loss in the IONM cohort was less than the control group with significant difference.The preoperative JOA score of IONM group and control group were 12.0±2.4 and 12.7±2.1,with no significant difference.The postoperative JOA score of each group were 15.0±1.5 and 15.2±1.7,with no significant difference.The rate of cervical cord neurological improvement of IONM group was higher than control group,but there was no significant difference.In the IONM cohort,abnormal signal appeared in 8 cases,with 1 case developed new postoperative deficit,and the sensitivity and specificity of SEP were 100％ and 77.3％,the sensitivity and specificity of MEP were 100％ and 86.4％.Compared with preoperative SEP,4 cases showed major improvement (baseline increase ＞ 40％),2 cases showed moderate improvement (baseline increase:15％-40％).The coincidence rate of the SEP improvement and the AISA grade was 66.7％.Conclusion IONM could reduce the duration of operation and intraoperative blood loss.Changes of IONM were correlated with postoperative neurological function improvement.