Effects of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum TNF-alpha and IL-6 in liver cancer patients undergoing radiofrequency ablation

Objective: To analyse the impact of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum tumour necrosis factor-alpha [TNF-alpha], and interleukin-6 [IL-6] in liver cancer patients undergoing radiofrequency ablation [RFA]

Study Design: An experimental study

Place And Duration Of Study: Renmin Hospital of Wuhan University, Wuhan, China, from January 2017 to February 2018

Methodology: Eighty patients with small hepatocellular carcinoma [SHCC] were selected as the research object. They were divided into Group A and Group B with the random number table method, with 40 cases in each group. Group A were given dezocine-remifentanil intravenous anaesthesia and Group B were given midazolam-remifentanil intravenous anaesthesia. Patients' situations in the surgery were compared between the two groups. Changes in heart rate [HR], mean arterial pressure [MAP] and blood oxygen saturation [SpO₂] were recorded before the surgery [T₀], at 5 minutes after the RFA [T₁] and at the end of the RFA [T₂]. Levels of tumour necrosis factor-alpha; [TNF-alpha;] and interleukin-6 [IL-6] on the 1² day after the RFA were compared between the two groups

Results: The wake-up time in Group A was shorter than Group B [p<0.001], and the VAS pain score in Group A was lower than Group B [p<0.001]. At T₁, the MAP in Group A was higher than Group B [p<0.001]. There was no significant difference in MAP between the two groups at T₀ and T₂ [p=0.881, 0.696, respectively]. At T₁ and T₂, the HR in Group A was lower than Group B [all p<0.001]. There was no significant difference in HR between the two groups at T₀ [p=0.684]. There was no significant difference in SpO₂ between the two groups at T₀, T₁ and T₂ [p=0.654, 0.884 and 0.798, respectively]. On the 1st day after the RFA, the level of TNF-alpha;, IL-6 in Group A were lower than those of Group B [all p<0.001]. There was no significant difference in the incidence of intraoperative complications between the two groups [p=0.644]

Conclusion: Compared with midazolam-remifentanil intravenous anaesthesia, the dezocine-remifentanil method has a better analgesic effect, shorter wake-up time, and can effectively regulate the expression of inflammatory cytokines TNF-alpha; and IL-6. However, the effect of remifentanil on the respiratory function is dose-dependent. Therefore, respiratory cycle monitoring and management should be strengthened during the surgery

Correlation between treadmill exercise test assessing myocardial ischemia and coronary stenosis / 心血管康复医学杂志

Objective :To study correlation between treadmill exercise test assessing myocardial ischemia and coronary stenosis .Methods :A total of 150 patients with stable angina pectoris in our hospital ,according to vascular stenosis by coronary CT were divided into group A (stenosis＜ 50%,n＝ 50) ,group B (stenosis 50% ～75%,n＝ 50) and group C (stenosis ＞75%,n＝50).Coronary stenotic rate and ST depression during exercise test were compared a-mong three groups.Spearman method was used to analyze correlation between treadmill exercise positive rate and coronary stenosis .Results :Compared with group B ,there were significant rise in coronary diameter stenotic rate [(63.64 ± 4.21)% vs.(66.71 ± 4.46)%] and vascular diameter of reference segment [(2.92 ± 0.23) mm vs.(3.03 ± 0.21) mm] in group C ,P＜0.05 or ＜0.01. Along with coronary stenosis aggravated ,there was significant re-duction in onset time of ST depression [(712.3 ± 202.7) s vs.(602.3 ± 210.4) s vs.(501.2 ± 236.1) s] ,and signif-icant rise in duration [ (425.4 ± 200.5) s vs.(520.8 ± 205.8) s vs.(603.4 ± 198.4) s] and treadmill exercise posi-tive rate (64.00% vs.82.00% vs .92.00%) ,in group A ,B ,C respectively ;and ST depression extent of group C was significantly higher than that of group A [(2.4 ± 1.1) mV vs.(1.9 ± 0.8) mV] ,P＜0.05 or ＜0.01. Spearman correlation analysis indicated that treadmill exercise positive rate (myocardial ischemia rate ) was not significantly correlated with coronary stenotic degree (r＝3.425 , P＝0.126).Conclusion :Although treadmill exercise test pos-sesses important significance in diagnosis of myocardial ischemia ,but coronary stenotic degree is not correlated with myocardial ischemic degree .which should raise clinical attention

The Clinical Analysis of Necrotizing Enterocolitis / 昆明医科大学学报

Objective From May 2010 to May 2013 and from June 2013 to June 2016, we compared the clinical analysis of patients with necrotizing enterocolitis (NEC) in the Department of Pediatrics, studied incidence rate of NEC and the relationship between stages of NEC and prognosis, and compared the prognosis between the two three-year periods to provide the experience of diagnosis and treatment for clinical practice in the future. Methods The clinical data of patients diagnosed with NEC were retrospectively analyzed according to the diagnostic criteria of modified Bell staging classification using SPSS statistical software package. Early diagnosis rate and prognosis were compared between the two three-year periods. P＜0.05 showed that statistical significance was found. Results From May 2010 to May 2013, 40 cases of NEC were diagnosed in our hospital, among which 8 was in the first stage (20%),24 in the second stage (60%),and 8 in the third stage (20%) . The number of premature infants was 32, accounting for 80% , among which 25 cases were infants with very low birth weight accounting for 62.5% and 8 cases were full-term infants, accounting for 20% (P＜0.05) . In the study, 32 cases (80%) received traditional treatment, which was effective in stage Ⅰ. During the second stage, two abandoned the treatment was confirmed death in the follow-up, two underwent surgery successfully due to the progression of the disease and four (25%) died in the hospital. Statistic significance of treatment of internal medicine was found when comparing stage Ⅰ with stage Ⅱ (P＜0.05) . Ten children underwent surgery, among which one gave up treatment after the surgery because of financial problems and was found dead in the follow-up and four (60%) died in the hospital. The comparison of surgical treatment in patients in stage Ⅱ and Ⅲ showed no statistical significance (P＞0.05) . Fatality rates were statistically significant (P＜0.05) . From June 2013 to June 2016, 41 children were diagnosed with NEC in our hospital, including 24 cases in stage Ⅰ (59%), 14 in stage Ⅱ (34%), and 3 in stage Ⅲ (7%) . The number of premature infants was 33, accounting for 80%, among which 26 cases were infants with very low birth weight accounting for 62.5% and 8 cases were full-term infants, accounting for 20% (P＜0.05) . In the study, 35 cases (85.3%) received traditional treatment, which was effective in stage Ⅰ. During the second stage, one underwent surgery successfully due to the progression of the disease. Statistic significance of treatment of internal medicine was found when comparing stage Ⅰ with stage Ⅱ (P＜0.05) . Four children underwent surgery, among which one gave up treatment after the surgery because of financial problems and was found dead in the follow-up and the surgery was successful in other three. The comparison of surgical treatment in patients in stage Ⅱ and Ⅲ showed statistical significance (P＜0.05) . Fatality rates were statistically significant comparing the two three-year periods (P＜0.05) . The comparison of the rates of early diagnosis in the two three-year periods showed statistically significance (P＜0.001) . Conclusion Early diagnosis of NEC is the key to reduce mortality. Intestinal fatty acid binding protein (I-FABP) is a serological marker for early diagnosis of NEC. As an important factor, the reduction of the incidence of premature birth will result in the drop in the incidence of NEC.

Value of combined measurement of intestinal fatty acid-binding protein and fecal calprotectin in diagnosis of necrotizing enterocolitis in full-term neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates.</p><p><b>METHODS</b>A total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated.</p><p><b>RESULTS</b>The case group had significantly higher I-FABP and FC levels than the control group (P<0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P<0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P<0.05).</p><p><b>CONCLUSIONS</b>Children with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.</p>

Relationship between bronchial asthma severity and the levels of nerve growth factor in induced sputum / 国际儿科学杂志

Objective To explore the relationship between bronchial asthma severity and the levels of nerve growth factor(NGF) in induced sputum.Methods One hundred and seventy children with asthma were divided into two groups, including 87 cases of chronic duration group and 83 cases of acute phase group.Before treatment lung function test was conducted, induced sputum was taken immediaitely, the levels of NGF were measured by enzyme-linked immunosorbent assay and Eosinophils (EOS)in induced sputum were count.Comparative analysis was conducted.Results The levels of NGF,FEV1 ,FVC,PEF and EOS in duration group were significantly elevated compared with acute phase group (all P ＜ 0.05).Significant differences in NGF, FEV1, FVC, PEF and Eos were found by comparison of different extent in chronic duration group and acute phase group (all P ＜ 0.05), the levels of NGF were positive correlated with illness severity (all P ＜ 0.05) in children with afsthma in chronic duration and acute phase, the levels of NGF were positive correlation with FEV1, FVC, PE-Fand EOS (all P ＜ 0.05) in children with asthma in chronic duration, the levels of NGF were positive correlation with FEV1 and PEF in children with Asthma in acute phase,but the levels of NGF has no correlation with FVC and EOS (all P ＞ 0.05) in children with Asthma in acute phase.Conclusion The levels of NGF in induced sputum of children with asthma in acute phase are markedly elevated compared with children with asthma in chronic duration, the levels of NGF are positive correlated with illness severity in children with asthma in chronic duration and acute phase.

Clinical significance of serum intestinal fatty acid-binding protein in full-term infants with necrotizing enterocolitis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of intestinal fatty acid-binding protein (I-FABP) in full-term newborn infants with necrotizing enterocolitis (NEC).</p><p><b>METHODS</b>Forty-one full-term infants with a confirmed diagnosis of NEC from February 2012 to January 2014 were recruited as case group (stage I: 24 cases; stage II-III: 17 cases). Sixty-two children diagnosed with non-digestive diseases in the same period were recruited as the control group. Serum levels of I-FABP and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. The diagnostic value of I-FABP for NEC was assessed using the receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>Stage I and stage II-III cases in the case group had significantly higher serum I-FABP levels than the control group (P<0.05), and stage II-III cases had significantly higher serum I-FABP levels than stage I cases (P<0.05). The area under the ROC curve for serum I-FABP was 0.85 (95% CI: 0.78-0.92), with the optimal cut-off point of 2.25 ng/mL. Under this cut-off point, the sensitivity and specificity were 80.49% and 70.19%, respectively. There was no significant difference in serum CRP level between the case and control groups (P>0.05).</p><p><b>CONCLUSIONS</b>In newborn infants with NEC, serum I-FABP level increases significantly in stage I , and it is correlated with the disease severity. Therefore, serum I-FABP can be used as a biomarker for the diagnosis of NEC.</p>

Identification and subcellular localization of transporter associated with antigen processing(TAP)1-EGFP and TAP 2-EGFP fusion proteins in malignant melanoma / 中华皮肤科杂志

Objective To construct an eukaryotic expression vector for TAP genes fused with enhanced green fluorescent protein(EGFP)gene,and to analyze the expression and subcellular localization of the fusion protein in A375 human malignant melanoma cells transfected with the eukaryotic expression vector.Methods A375 cells were cotransfected with the combination of plasmid(P)TAP1-EGFP or pTAP2-EGFP and pDsRed2-endoplasmic reticulum(ER),or with pEGFP-TAP1 and-TAP2,or monotransfected with pTAP1-EGFP or pTAP2-EGFP alone.The monoclonal A375 cells stably expressing TAP were obtained by G418 selection.Then.the distribution and expression of fusion proteins were assessed in A375 cells by using fluorescence microscopy and Western blot,respectively.Flow cytometry was used to measure the expression of HLA class Ⅰ on A375 cells.Results Transfection of A375 cells with pTAP1-EGFP or pTAP1-EGFP and pTAP2-EGFP significantly increased the expression of TAP 1 and TAP 2 in as well as HLA class Ⅰ antigen on A375 cells.The green fluorescence of TAP1-EGFP and TAP2-EGFP overlapped with the red fluorescence of ER marker in cotransfected cells.indicating that TAP was localized subcellularly on the ER.Conclusions The expression vector for TAP-EGFP fusion gene has been constructed cuccessfully and expressed in A375 cells,and the expressed fusion protein is subcelluiarly localized to ER.This study will provide a basis for the research into subsequent immune response following induction of TAP expression.

EGCG enhances TRAIL-mediated apoptosis in human melanoma A375 cell line / 华中科技大学学报（医学）（英德文版）

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a promising anti-cancer agent. Epigallocatechin-3-gallate (EGCG) is a polyphenolic constituent of green tea. In this study, inhibitory effect of combined use of EGCG and TRAIL on human melanoma A375 cells was examined and the possible mechanism investigated. The cells were divided into 4 groups: control group, EGCG group (EGCG: 10, 20 mug/mL), TRAIL group (TRAIL: 25 ng/mL) and EGCG+TRAIL group (combined group). The growth inhibition was measured in the A375 cells treated with different concentrations of TRAIL ((25, 50, 75, 100, 125, 150 ng/mL) by MTT assay. The apoptosis was assessed by flow cytometry. The expressions of DR4 and DR5 were detected by flow cytometry and western blotting. The activities of caspase-8 and caspase-3 were determined by colorimetric assay. The results showed that TRAIL could dose-dependently inhibit the growth of A375 cells and the IC(50) of TRAIL was 150 ng/mL. The apoptosis rate was 11.8% in the TRAIL group, 5%-7% in the EGCG group and 48.9%-59.1% in the combined group. Significant difference was found in the apoptosis rate between the combined group and the EGCG or TRAIL group (P<0.05 for each). The expression of DR4 instead of DR5 was significantly increased in the EGCG group. The activity of caspase-3 rather than caspase-8 was substantially enhanced in the EGCG group. These results suggest that EGCG is useful for the TRAIL-based treatment for melanoma.

The evaluation of the Chinese intelligibility of patients with velopharyngeal incompetence / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the Chinese intelligibility of patients with velopharyngeal incompetence (VPI).</p><p><b>METHODS</b>100 patients with VPI and 32 normal students were selected for this study. Of 10 patients, 15 with cleft palate, 21 with congenital velopharyngeal incompetence, 56 with post-palatoplasty VPI and 8 with post-pharyngoplasty VPI. Chinese intelligibility was measured by three speech pathologists and relation between degree of abnormal articulation and Chinese intelligibility were studied.</p><p><b>RESULTS</b>Chinese intelligibility of the controls was 99.0% and the patients with VPI were 35.2%. Of the patients, the cleft palate was 19.9%, the congenital velopharyngeal incompetence was 32.8%, the post-palatoplasty VPI was 40.3% and the post-pharyngoplasty VPI was 35.2%. The data showed obvious difference among the controls and sub-types of VPI (P < 0.01).</p><p><b>CONCLUSIONS</b>(1) Chinese intelligibility of VPI accompanied with hypernasality is worse. (2) Of misarticulation of VPI, the cleft palate is the worst, in turn the others are the congenital velopharyngeal incompetence, the post-pharyngoplasty VPI and the post-palatoplasty VPI.</p>

The study of sweep pattern visual evoked potential acuity(SPVEP-A)and international standard visual acuity in amblyopic children / 眼科

Objective To evaluate the clinical application of sweep pattern visual evoked potential in assessing visual acuity (SPVEP-A)of amblyopic children.Design Prospective clinical study.Participants 80 patients(148 case)of amblyopic children and 26 children(52 case)with normal vision.Methods The correlation were analysed of SPVEP-A and E acuity in 80 amblyopic children and of SPVEP-A and PVEP-A in 26 children of normal visual.SPVEP-A was recorded with UTAS-E 3000(LKC)using gratings of 25 differ- ent spatial frequency from 0.2 to 18.8cpd as stimulus.The response were averaged and DFT on the monitor display.SPVEP-A was de- termined by extrapolate to 0 response amplitude.Both transient PVEP-A and SPVEP-A were examined in 26 normal children.The ob- jective visual acuity in PVEP were determined with the highest spatial frequency which evoked a recognizable response.Main Out- come Measures SPVEP-A,PVEP-A and E acuity.Results SPVEP-A were from 0.35 to 0.9 among 80 patients with corrected E acu- ity from 0.1 to 0.8.The correlation coefficient of SVEP-A-I with E acuity was 0.602 .The correlation coefficient of SPVEP-A.between reproducibility detection was 0.448.The correlation between SPVEP-A and E acuity in amblyopic slightly was higher than middle and severe amblyopia(r=0.773 vs r=0.590).In 26 normal children a correlation coefficient of 0.679 was obtained between E acuity anti PVEP-A but 0.424 between E acuity and SPVEP-A.Higher evaluation or lower evaluation of E acuity was found in SPVEP-A in this study.Acuity was upostimated in lower scope of E acuity and underestimated in higher scope of E acuity.The reproducibility and vari- ation were not satisified.Conclusion The sweep VEP is a objective method of amblyopic screening.There is significant positive corre- lation between SPVEP-A and E,but its variability is more great,so we should improve its stability and positive rate uheriorly.