Effects of intravenous-inhalational anesthesia and intravenous anesthesia on implicit, explicit memory and stress response in patients undergoing gynecological tumor surgery / 肿瘤研究与临床

Objective:To investigate the effects of propofol combined with sevoflurane intravenous-inhalational anesthesia and propofol intravenous anesthesia on implicit memory, explicit memory and stress response in patients undergoing gynecological cancer surgery.Methods:A total of 48 patients undergoing gynecologic cancer surgery in the Second Hospital of Shanxi Medical University from August 2018 to May 2019 were selected. Random number table was used to divide patients into propofol intravenous anesthesia group (group A) and propofol combined with sevoflurane intravenous-inhalational anesthesia group (group B), 24 cases in each group. During the operation, the patients in group A were given continuous intravenous anesthesia with propofol and the patients in group B were given continuous intravenous anesthesia with propofol combined with sevoflurane. Minimal alveolar concentration (MAC) of sevoflurane was 0.5, and midazolam was not utilized throughout the whole anesthesia for both groups. The bispectral index (BIS) value of the two groups ranged from 45 to 55 during the operation. The concentration of cortisol, adrenocorticotropic hormone (ACTH) and prolactin(PRL) in elbow venous blood was measured before anesthesia induction (T 1) and 10 minutes after intraoperative auditory recording (T 2). Implicit and explicit memory scores were measured 12-24 h after operation. Results:Neither group produced explicit memory compared with 0 (group A: 0.012±0.007, t = 1.554, P > 0.05; group B: 0.016±0.002, t = 1.942, P > 0.05), and there was no significant difference in explicit memory score between the two groups ( t = -0.417, P > 0.05). Both groups produced implicit memory (group A: 0.089±0.050, t = 8.726, P < 0.05; group B: 0.189±0.060, t = 15.415, P < 0.05), and implicit memory score was higher in group B ( t = -6.215, P < 0.05). The level of cortisol, ACTH and PRL at time T 1 was not significantly different between the two groups (all P > 0.05), and the level of cortisol, ACTH and PRL in group B was higher than that in group A at time T 2 [(276±35) μg/L vs. (96±33) μg/L; (228±42.3) pg/ml vs. (14.1±1.7) pg/ml; (4 208±213) mU/ml vs. (3 805±196) mU/ml; t value was 18.634, 34.879, 12.605, all P < 0.05]. Conclusion:Propofol intravenous anesthesia can better inhibit the production of implicit memory and intraoperative stress response compared with propofol combined with sevoflurane intravenous-inhalational anesthesia.

Effect of anesthesia depth on stress response during single-lung ventilation in thoracic surgery / 肿瘤研究与临床

Objective:To study the effects of different anesthesia depths on stress response during single-lung ventilation in patients with thoracoscopic lobectomy.Methods:Sixty patients selected for elective thoracoscopic lobectomy in the Second Hospital of Shanxi Medical University from September 2018 to May 2019 were randomly divided into three groups according to the digital random table method, with 20 patients in each group. Group A maintained deep anesthesia with the bispectral index (BIS) 36-45, group B maintained moderate anesthesia with BIS 46-55, and group C did not undergo BIS monitoring. The changes of heart rate, mean arterial pressure (MAP), stress indexes cortisol and blood glucose before anesthesia induction (T 0), immediately after one-lung ventilation (T 1), 60 min after one-lung ventilation (T 2) and immediately after skin suture (T 3) in the three groups were compared. Results:The concentration of blood glucose in group A at T 1, T 2 and T 3 was (5.28±0.49) mmol/L, (5.34±0.49) mmol/L and (5.40±0.47) mmol/L, and the cortisol was (142.75±31.45) ng/ml, (181.36±19.62) ng/ml and (153.81±33.92) ng/ml; the blood glucose in group B was (5.63±0.35) mmol/L, (6.06±0.19) mmol/L and (5.79±0.44) mmol/L, and the cortisol was (168.45±31.16) ng/ml, (171.09±25.28) ng/ml and (159.39±18.77) ng/ml; the blood glucose in group C was (6.35±0.56) mmol/L, (7.04±0.26) mmol/L and (6.17±0.54) mmol/L, and the cortisol was (191.13±46.00) ng/ml, (283.25±30.07) ng/ml and (183.01±19.71) ng/ml, respectively. The blood glucose and cortisol levels in group C at T 1, T 2 and T 3 were higher than those in group A and group B (all P < 0.05). The MAP in group A at T 1, T 2 and T 3 were (69±5) mmHg (1 mmHg= 0.133 kPa), (67±6) mmHg and (75±7) mmHg, respectively, and group B was (80±8) mmHg, (79±4) mmHg and (84±9) mmHg, the differences between the two groups were statistically significant (all P < 0.05). There was significant difference in cortisol between group A and group B at T 1 ( P < 0.05). The heart rate and MAP at T 1, T 2 and T 3 in group A and group C were significantly different from those at T 0 (all P < 0.05). The heart rate and MAP at T 1 and T 2 in groups B were significantly different from those at T 0 (all P < 0.05). Conclusion:BIS anesthesia depth monitoring should be performed during single-lung ventilation in thoracic surgery, and BIS should be maintained at 46-55, which can not only inhibit the stress response but also have a slight effect on hemodynamics.

Effect of anesthesia depth on stress response during single-lung ventilation in thoracic surgery / 肿瘤研究与临床

Objective@#To study the effects of different anesthesia depths on stress response during single-lung ventilation in patients with thoracoscopic lobectomy.@*Methods@#Sixty patients selected for elective thoracoscopic lobectomy in the Second Hospital of Shanxi Medical University from September 2018 to May 2019 were randomly divided into three groups according to the digital random table method, with 20 patients in each group. Group A maintained deep anesthesia with the bispectral index (BIS) 36-45, group B maintained moderate anesthesia with BIS 46-55, and group C did not undergo BIS monitoring. The changes of heart rate, mean arterial pressure (MAP), stress indexes cortisol and blood glucose before anesthesia induction (T0), immediately after one-lung ventilation (T1), 60 min after one-lung ventilation (T2) and immediately after skin suture (T3) in the three groups were compared.@*Results@#The concentration of blood glucose in group A at T1, T2 and T3 was (5.28±0.49) mmol/L, (5.34±0.49) mmol/L and (5.40±0.47) mmol/L, and the cortisol was (142.75±31.45) ng/ml, (181.36±19.62) ng/ml and (153.81±33.92) ng/ml; the blood glucose in group B was (5.63±0.35) mmol/L, (6.06±0.19) mmol/L and (5.79±0.44) mmol/L, and the cortisol was (168.45±31.16) ng/ml, (171.09±25.28) ng/ml and (159.39±18.77) ng/ml; the blood glucose in group C was (6.35±0.56) mmol/L, (7.04±0.26) mmol/L and (6.17±0.54) mmol/L, and the cortisol was (191.13±46.00) ng/ml, (283.25±30.07) ng/ml and (183.01±19.71) ng/ml, respectively. The blood glucose and cortisol levels in group C at T1, T2 and T3 were higher than those in group A and group B (all P < 0.05). The MAP in group A at T1, T2 and T3 were (69±5) mmHg (1 mmHg= 0.133 kPa), (67±6) mmHg and (75±7) mmHg, respectively, and group B was (80±8) mmHg, (79±4) mmHg and (84±9) mmHg, the differences between the two groups were statistically significant (all P < 0.05). There was significant difference in cortisol between group A and group B at T1 (P < 0.05). The heart rate and MAP at T1, T2 and T3 in group A and group C were significantly different from those at T0 (all P < 0.05). The heart rate and MAP at T1 and T2 in groups B were significantly different from those at T0 (all P < 0.05).@*Conclusion@#BIS anesthesia depth monitoring should be performed during single-lung ventilation in thoracic surgery, and BIS should be maintained at 46-55, which can not only inhibit the stress response but also have a slight effect on hemodynamics.

Craniofacial morphology of child and adult deepbite: a cross-sectional study / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the changes in the craniofacial morphology ofdeepbite from childhood to adulthood using cross-sectional methods. To analyze the maxillofacial characteristics of adult deepbite.</p><p><b>METHODS</b>The sample included 159 children (with average age of 12.47 years old) and 81 adults (with average age of21.76 years old) with class III deepbite. The control group consisted of51 normal individuals (with average age of 18.41 years old). Lateral cephalometric radiographs were taken and recorded in a computer through a scanner. Cephalometric measurements were conducted by using Winceph 7.0 software, and results were analyzed with SPSS 12.0 software.</p><p><b>RESULTS</b>Significant differences between child and adult deepbite were observed in the following: N-ANS, ANS-Me, A-Ms, A-Ptm, Wits, Mo-Ms, Ii-Ii, A-B plane angle to the mandibular plane angle, Gonial angle, L1 to NB length, overjet, mandibular body to anterior cranial base, Mo-Mi, posterior facial height, U1 to NA length, Pog-Go, Cd-Go, occlusion plane angle to SN, and U1 to SN. In addition, significant differences between adult deepbite and normal occlusion were observed in SNB, ANB, convexity, APDI, ODI, Wits, A-B plane to mandibular plane, Gonial angle, overjet, mandibular body to anterior cranial base, S-Ptm, Mo-Mi U1 to SN; Pog-Go, Cd-Go, posterior cranial base, and occlusion plane to SN and posterior facial height.</p><p><b>CONCLUSION</b>Deepbite patients have certain growth potential after puberty, but the sagittal relationship of their jaws exhibits no improvement. Adult deepbite patients exhibit significant problems in the vertical and sagittal jaw positions.</p>

A three dimensional finite element analysis on en-masse retraction of maxillary anterior teeth by rocking-chair archwire in sliding mechanics / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of en-masse retraction of maxillary anterior teeth by rocking-chair archwire (RCA) in sliding mechanics.</p><p><b>METHODS</b>The three dimensional finite element model of maxillary teeth was created based on spiral CT data of a patient by ANSYS software. The forces on each tooth and the torques on the six center of resistance (CR) of the anterior teeth induced by the deformation of RCA with different depth and anterior retraction hook (ARH) with different height were calculated when retracted from a mini-implant between the first molar and the second premolar. The movements of anterior teeth were observed combining different depth of RCA with different height of ARH.</p><p><b>RESULTS</b>The clockwise torque in sliding mechanics to realize en-masse retraction of the anterior teeth could be counterbalanced by RCA of certain depth. The combination of 7.2 mm ARH and 2 mm RCA can be used to intrude and retract maxillary anterior teeth under the condition of applying mini-implant.</p><p><b>CONCLUSION</b>The excessive retraction that usually exists in traditional treatments can be avoided by RCA in sliding mechanics and intrusion and torque control during anterior segment retraction can also be achieved by this method.</p>

Effect of heavy ion beam irradiation on serum interleukin-2 level in a hamster model bearing cheek pouch carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in serum interleukin-2 (IL-2) level in a hamster model bearing cheek pouch carcinoma after heavy ion beams irradiation.</p><p><b>METHODS</b>The serum levels of IL-2 were detected using enzyme-linked immunosorbant assay in 40 hamsters bearing cheek pouch carcinoma before and after exposure to heavy ion beam irradiation, with 8 normal animals as control.</p><p><b>RESULTS</b>Serum IL-2 level was 0.16∓0.01 in the tumor-bearing hamsters before the irradiation, lower than that in the control group. After heavy ion beams irradiation at 4, 6, 8, and 12 Gy, serum IL-2 levels in the tumor-bearing hamsters were 0.18∓0.04, 0.22∓0.05, 0.15∓0.03, and 0.13∓0.04, respectively, showing a peak level after irradiation at 6 Gy and an obvious decrease following irradiation at greater doses.</p><p><b>CONCLUSION</b>Heavy ion beam irradiation causes alterations in serum IL-2 level with a dose-effect relation between them in hamsters bearing cheek pouch carcinoma.</p>

The Ethical Problems of Combined Surgical with Orthodontic Treatment / 中国医学伦理学

With the development of oral science and technology,combined surgical and orthodontic treatment becomes a new developing subject.This article clarifies the most important facets of the ethical problems for the successful combined surgical and orthodontic treatment;the author thinks noble medical morals, excellent medical technology,scrupulous science style and responsible attitude as the important subjective factors for this successful treatment.