Association between multiple metals exposure and sleep disorders in a Chinese population: A mixture-based approach.

OBJECTIVE: Previous studies have suggested a possible association between metals and sleep disorders. This study aimed to explore the association between Zn, Cu, Se, Mg and Ca and sleep disorders in single and multi-metal co-exposure models. METHODS: Logistic regression models, restricted cubic spline model (RCS), Quantile g computation (Q-gcomp), Weighted Quantile Sum (WQS), and Bayesian kernel machine regression (BKMR) models were used to investigate the association between metal levels and sleep disorders. RESULTS: Logistic regression showed that in the total population, the second, third, and fourth quartile Zn concentration exhibited a lower risk of sleep disorders compared with the first quartile, with odds ratios (ORs) of 0.783, 0.711, and 0.704, respectively. Compared with Zn/Cu and Zn/Se in the first quartile, the third and fourth quartiles showed a lower risk of sleep disorders. In the 30-59 years group, the risk of sleep disorders was 0.699 times greater for the fourth quartile Mg concentration than that for the first quartile. The risk of sleep disorders in Mg/Ca concentration in the third quartile was 0.737 times higher than in the first quartile. Q-gcomp, WQS, and BKMR model analysis showed the negative overall effect of mixtures of the five metals on sleep disorders, with Zn being the largest contributor. CONCLUSION: Our study showed that plasma Zn, Mg, Zn/Cu, Zn/Se, and Mg/Ca reduced the risk of sleep disorders, and the combined effect of multiple metals was negatively associated with the risk of sleep disorders, with Zn being the largest contributor to this relationship.

Clinical and pathological analysis of 18 cases of cervical papillary squamous cell carcinoma / 中国综合临床

Objective:To improve the understanding of cervical papillary squamous cell carcinoma (PSCC), and to provide evidence for the diagnosis and treatment of PSCC.Methods:The clinicopathological and follow-up data of 18 patients diagnosed PSCC by preoperative cervical biopsy in Tangshan Gongren hospital were collected, the correlation of preoperative biopsy, liquid-based cells, and human papilloma virus (HPV) with postoperative pathology and prognosis was analyzed.Results:The concordance rate between preoperative biopsy and postoperative pathology was 50% (9/18). 4 patients showed the characteristic features of PSCC in their liquid-based cells of the 9 patients who were diagnosed as PSCC postoperatively (4/9), the HPV infection rate was 44.4% (4/9), the International Federation of Gynecology and Obstetrics stage were IA1-IB1, no lymph node metastasis, recurrence or death occurred in all patients.Conclusions:Cervical biopsy before operation has certain limitations in the diagnosis of PSCC, which requires a clear diagnosis by postoperative pathology. The HPV infection rate is lower, the stage is earlier and the prognosis is better in PSCC. Some patients can choose a less invasive surgical method than radical surgery.

Feasibility study on developing clinical pediatrics curriculum for medical students engaged in long schooling system in the pre-clinical stage / 中华医学教育探索杂志

Objective:To analyze the feasibility of developing clinical pediatrics curriculum for pediatric students at the pre-clinical stage, and to provide a basis for the subsequent curriculum construction.Methods:A total of 90 pediatric medical students were enrolled, including pre-clinical group (G1, third semester of the second year, n=47) and the clinical clerkship group (G2, seventh semester of the fourth year, n=43). A questionnaire survey was conducted to compare the two groups from three aspects: clinical interest, learning methods and learning ability. And 24 and 20 students were randomly selected from the two groups to participate a clinical course respectively. Both of the formative evaluation and in-class test were carried out to compare the learning performance and learning effect between G1 and G2. SPSS 22.0 was used for data analysis. The counting data were described by case number and rate, and the frequency between groups was compared by chi-square test. When the chi-square test condition is not met, Fisher's exact test was performed. Normal distribution test was carried out for measurement data. Two independent sample t test was conducted for the comparison between groups of normal distribution data and Mann-Whitney U test for the comparison between groups of skewed distribution respectively. Results:There was no significant difference in clinical interest and pre-clinical interest between the two groups (Fisher's exact probability method, P=0.252, 1.000). There were partial differences in learning methods: G1 spent more time learning after class ( Z=-2.36, P=0.018), learned more in spare time ( Z=2.53, P=0.011), learned more on the homework ( P=0.020), and had a higher preview rate ( Z=-5.07, P < 0.001). There were also partial differences in learning ability: G2 had better literature retrieval ability ( χ2=10.57, P=0.001); G2 had higher scores on class and extended class performance ( t=-3.18, P=0.004; t=-10.14, P<0.001). In terms of learning effect, G2 scored higher scores on only one multiple choice question ( t=-2.46, P=0.022). Conclusion:The pediatrics students at the pre-clinical stage have certain interest and ability to receive clinical pediatrics courses. Sufficient pre-class preparation and appropriate curriculum design are helpful to the early cultivation of student's clinical thinking.

Effect and mechanism of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients / 中华行为医学与脑科学杂志

Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.

Effects of hsa_circ_0045943 targeting miR-106a on the biological characteristics of gastric cancer cells / 西安交通大学学报(医学版)

【Objective】 To investigate the effects of hsa_circ_0045943 targeting miR-106a on the biological characteristics of gastric cancer cells and its mechanism. 【Methods】 Human gastric cancer cells MKN-45， AGS and gastric mucosal epithelial cells GES-1 were cultured； circ_0045943 was detected by real-time polymerase chain reaction. The overexpression and silencing of circ_0045943 adenovirus vectors OE-circRNA and sh-circRNA together with their negative controls OE-NC and sh-NC were constructed and transfected； CCK-8 method was used to detect the proliferation activity of AGS cells after overexpression and silencing of circ_0045943； TUNEL method was used to detect the cell apoptosis； transwell assay was used to detect the cell migration and invasion； and would healing assay was used to detect the cell migration. Starbase database screened the binding site of miR-106a and circ_0045943. Real-time PCR was used to detect the expression of miR-106a， and the expression of circ_0045943 and the changes of miR-106a after the treatment of OE-circRNA and sh-circRNA. 【Results】 Real-time PCR showed that the expression of circ_0045943 decreased in gastric cancer cells MKN-45 and AGS compared to GES-1 （Pboth<0.001）. CCK-8 showed that the absorbance value of AGS cells in OE-circRNA group was lower than that in sh-circRNA group （P24 h<0.01， P48 h<0.001， and P72 h<0.001）. TUNEL showed the number of apoptotic AGS cells increased after overexpression of circ_0045943， but decreased after silencing of circ_0045943. Transwell assay showed that the migration and invasion of AGS cells were lower in OE-circRNA group than in sh-circRNA group （Pboth<0.001）. The wound healing assay showed that the migration rate of AGS cells in OE-circRNA group was the lowest， but was high in sh-circRNA group （P<0.001）. Starbase retrieved that circ_0045943 and miR-106a had complementary binding sequences. Real-time PCR showed that miR-106a was highly expressed in gastric cancer cells （P<0.001）， and the expressions of circ_0045943 and miR-106a significantly differed after treatment with OE-circRNA and sh-circRNA （Pboth<0.001）. With the increase or decrease of circ_0045943， the expression of miR-106a changed in the opposite direction. 【Conclusion】 Circ_0045943 has low expression in gastric cancer， and promoting or inhibiting circ_0045943 expression may regulate the proliferation， apoptosis， migration and invasion of gastric cancer cells by targeting miR-106a.

Clinical significance and biological effects of LncRNA ANCR RNA expression in tumor tissues of gastric cancer patients / 中华内分泌外科杂志

Objective:To investigate the clinical significance of LncRNA anti-differetiation non-coding RNA (ANCR) expression in tumor tissues of gastric cancer patients and its biological effects on cells.Methods:72 cases of gastric cancer tissues and corresponding adjacent tissues were collected from Sep. 2016 to Jun. 2018 in our Hospital. Gastric cancer cell HGC-27 was cultured, lentiviral transfected ANCR cDNA full-length vector was used as a Test group in HGC-27 cells, and transfected blank vector as a control group. Real-time quantitative PCR (qPCR) was used to detect the expression of ANCR, transcription factor Oct4 and Sox2 mRNA in tissues or cells, Western blot was used to detect the expression levels of Oct4 and Sox2 in cells, CCK-8 assay was employed for detecting cell proliferation in both groups, and Transwell invasion and migration assay was used to detect the transfer ability of cells in the two groups.Results:The expressions of ANCR in gastric cancer and corresponding adjacent tissues were respectively 0.013 (0.006, 0.025) and 0.041 (0.011, 0.136) , and the expression of ANCR in gastric cancer tissues was significantly higher than that in adjacent tissues ( P<0.01) , and patients with high expression of ANCR had higher TNM stage and lower cell differentiation ( χ2=7.414 and 8.236, P<0.05) . The expressions of ANCR mRNA in control group and test group were respectively 1.000±0.064 and 6.250±0.889, Oct4 mRNA were respectively 1.000±0.208 and 2.815±0.349, Sox2 mRNA were respectively 1.000±0.173 and 2.526±0.390, Oct4 protein were respectively 1.000±0.148 and 3.396±0.105, Sox2 protein were respectively 1.000±0.119 and 2.916±0.130, and the expressions of ANCR, Oct4 and Sox2 mRNA in the test group were significantly higher than those in the control group ( P<0.01) ; the expression levels of Oct4 and Sox2 protein in the test group were significantly higher than those in the control group. The proliferation abilities of control group and test group were 7.164±0.426 and 9.627±0.605 in 72h, and 13.750±1.089 and 19.166±1.649 in 96h. The proliferation of cells in the Test group at 72 and 96 hours was significantly higher than that in the control group ( P<0.01) . The average number of invasive cells per visual field in control group and test group were 17.26±5.48 and 39.43±5.21, and number of migration cells were 30.49±7.74 and 62.20±7.51, and the number of migration and invasion cells in the Test group was significantly larger than that in the control group ( P<0.01) . Conclusions:The expression of LncRNA ANCR in tumor tissues of gastric cancer patients is significantly increased, and it is closely related to the progression of the disease of patients and the degree of cell malignancy. It can promote the expression of gastric cancer stem cell markers in vitro and enhance the ability of cell proliferation and metastasis.

Infection control measures and practice in gastrointestinal endoscopy departments during the novel coronavirus infection period / 西安交通大学学报(医学版)

【Objective】 To explore and evaluate infection control measures of preventing cross-contamination of novel coronavirus during gastrointestinal endoscopy treatment. 【Methods】 According to the hospital’s infection control requirements and related documents, infection control measures were formulated and implemented by combining with our actual clinical situation, including the management of the endoscope room, management and protection of patients and endoscopists. Then, we evaluated the effect of these measures. 【Results】 From January 25 to March 10, 2020, a total of 71 patients (53 males and 18 females) completed gastrointestinal endoscopy treatment, with an average age of 54 years (28-81 years). There were 36 (50.7%) cases of emergency treatment. All patients had been kept in quarantine for about 14 days (24±13), and no cross-contamination of novel coronavirus occurred. 【Conclusion】 During the novel coronavirus infection epidemic period, reasonable and effective measures should be taken to minimize the risk of infection in doctors and patients. The endoscope center should strengthen preoperative screening and management of patients, master indications of endoscopic procedures, complete endoscopists’ management and protection work, strictly follow the specifications of sterilizing gastrointestinal endoscopes, and construct the layout of "three zones and two passages".

Comparison of effects of different anesthetic methods on prognosis in patients with stage Ⅲ breast cancer / 中华麻醉学杂志

Objective:To compare the effects of different anesthetic methods on the prognosis in the patients with stage Ⅲ breast cancer.Methods:Based on a multicenter randomized controlled trial (NCT00418457), 274 patients with untreated stage Ⅲ breast cancer, aged 18-85 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, were enrolled in the study and assigned to thoracic paravertebral block (TPVB) combined with total intravenous anesthesia group (TPVB+ TIVA group, n=141) and general anesthesia group (GA group, n=133) by computer-generated randomization stratified by study site.The primary outcome parameter of this study was postoperative recurrence rate.The secondary outcome parameters were the degree of postoperative acute pain (assessed using visual analogue scale score), the incidence of postoperative nausea and vomiting (PONV), postoperative hospital stay time, and the incidence of persistent pain after breast cancer surgery (PPBCS) at 6 and 12 months after surgery (assessed using the modified Brief Pain Inventory). Results:Compared with group GA, no significant change was found in the postoperative recurrence rate ( HR=0.711, 95% confidence interval (CI) 0.418-1.210, P=0.209), the degree of postoperative acute pain and the incidence of PONV were decreased (mean difference ( MD) of visual analogue scale score -0.890, 95% CI -1.344--0.436, P<0.001; OR=0.236, 95% CI 0.083-0.674, P=0.007), and no significant change was found in postoperative hospital stay time and the incidence of PPBCS ( HR=1.000, 95% CI 0.778-1.286, P=1.000; OR=2.100, 95% CI 0.599-7.362, P=0.246) in group TPVB+ TIVA. Conclusion:Compared with general anesthesia alone, TPVB combined with total intravenous anesthesia can provide lower degree of postoperative acute pain and lower incidence of PONV, and exert no effects on postoperative recurrence, postoperative hospital stay time and PPBCS in patients with stage Ⅲ breast cancer.

Bioaccumulation of ytterbium oxide nanoparticles insinuate oxidative stress, inflammatory, and pathological lesions in ICR mice.

With the rapid development in nanoscience and nanotechnology, rare earth oxide nanomaterials (REO-NMs) have been increasingly used due to their unique physical and chemical characteristics. Despite the increasing applications of REO NPs, scarce information is available on their detrimental effects. In the current study, we investigate the toxic effect of ytterbium oxide nanoparticles (Yb2O3 NPs) in mouse model by using various techniques including inductively coupled plasma mass spectrometry (ICP-MS) analysis over 30 days of exposure. Furthermore, we elucidated lung lavage fluid of mice for biochemical and cytological analysis, and lung tissues for histopathology to interpret the NP side effects. We observed a significant concentration of Yb2O3 NPs accumulated in the lung, liver, kidney, and heart tissues. Similarly, increased bioaccumulation of Yb content was found in the olfactory bulb compared to other reigns of brain. The cytological analysis of bronchoalveolar lavage fluid (BALF) revealed a significant elevation in the percentage of neutrophils and lymphocytes. Biochemical analysis showed an instilled Yb2O3 NPs, showing signs of oxidative damage through up-regulation of 60-87% of MDA while down-regulation of 20-40% of GSH-PX and GSH content. The toxicity pattern was more evident from histopathological observations. These interpretations provide enough evidence of bioaccumulation of Yb2O3 NPs in mice tissues. Overall, our findings reveal that acute exposure of Yb2O3 NPs through intranasal inhalation may cause toxicity via oxidative stress, which leads to a chronic inflammatory response. Graphical abstract Graphical illustrations of experimental findings.

The review of common external birth defects / 中华整形外科杂志

Birth defects is one of the most important problems of human society. External birth defect is one of the major research fields of plastic surgery. This kind of disorders damages the body image of patients in mild or severe way, affects severely the social confidence of the patients themselves and their families. we summarized the research progress of the common external birth defects (the incidence top 10) from the aspects of pathogenesis, prevention, treatments and so on, in order to provide reference materials to the prevention and treatment of them.

AQURE PASSPORT Intracranial Catheter for Mechanical Thrombectomy in Acute Ischemic Stroke Patients.

OBJECTIVE: We report the first experience with a new intracranial catheter as an adjunct to mechanical thrombectomy in acute ischemic stroke patients. METHODS: We prospectively determined technical success, intended procedure (device delivery at target lesion) completion without a need for a different catheter, technical ease, and intended procedure completion without the occurrence of ≥3 unsuccessful attempts in acute ischemic stroke patients with intracranial occlusion. The initial site of occlusion and recanalization was graded based on Qureshi grading scheme. Grade 0 was used to define complete recanalization. RESULTS: A total of four procedures were performed in four patients with a mean age of 63.5 years (range 50-81 years). The occlusion was in the proximal middle cerebral artery in two patients, and posterior cerebral artery and basilar artery in one patient each. The procedures were technically successful and met the definition of technical ease in all patients. The distal-most segment where AQURE PASSPORT intracranial catheter was placed was in the supraclinoid internal carotid artery, proximal posterior cerebral artery, proximal middle cerebral artery, and proximal basilar artery in the four patients. Stent retrievers were used in three patients and primary angioplasty was performed in two patients. Complete recanalization was achieved in all four patients. The primary operator rated the performance of guide catheter as superior in all cases. CONCLUSION: The present study demonstrates the feasibility of performing mechanical thrombectomy for intracranial arterial occlusion with a new intracranial catheter having superior performance.

Establishment of electron beam computed tomography and rapid prototyping techniques for a cranial bone defect model in goat / 中华医学美学美容杂志

Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.

Traumatic diaphragmatic rupture with delayed presentation:diagnosis and surgical treatment / 中华胸心血管外科杂志

Objective To investigate the diagnosis and surgical therapy of delayed diaphragmatic rupture.Methods Forty patients with traumatic diaphragmatic rupture with delayed presentation were collected in Peking Uniom Medical College Hospital from January 2000 to December 2016.In all 40 patients, 36 patients had traumatic past history, 32 patients had clini-cal manifestations when diagnosed.Left-sided diaphragmatic rupture was found in 32 patients and right in 8 patients.1 patient received emergency surgery and 39 received selective surgery.38 patients received transthoracic surgery and 2 patients received combined thoracic-abdominal surgery.36 patients received direct diaphragm suture and 4 patients received patch repair.Re-sults All patients were recovered from the hospital.The median length of postoperative hospital stay was 11 days( range, 5-26 days).1 patient was found intestinal obstruction and received enterolysis 19 days after surgery.Conclusion Delayed traumat-ic diaphragmatic rupture is a rare but serious disease.Careful past history, physical examination and CT scan with reconstruc-tion of diaphragm are helpful in diagnosis and differential diagnosis.Surgical therapy after diagnosis is the best treatment.

Effect of thoracic paravertebral block combined with general anesthesia on long-term quality of life in patients undergoing breast cancer surgery / 中华麻醉学杂志

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on the long-term quality of life in the patients undergoing breast cancer surgery. Methods A total of 156 patients, aged 18-64 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing breast cancer surgery, were randomly assigned to TPVB combined with general anes-thesia group (TPVB+GA group, n= 78) and general anesthesia group (GA group, n = 78), and the pa-tients in two groups were matched with a ratio of 1 : 1. In group TPVB+GA, propofol (target effect-site concentration 2. 5-4. 0 μg∕ml) was given by target-controlled infusion, and patients received either single or multiple injections (T1-T5 ) of TPVB under ultrasound guidance at 30 min before induction of general an-esthesia. Group GA inhaled 2. 0％-2. 5％ sevoflurane. The patients were followed up at 6 and 12 months after operation, postoperative chronic pain and chronic pain affecting daily life were assessed using the mod-ified Brief Pain Inventory, the development of neuropathic pain using neuropathic pain questionnaire-short form, and the development of long-term health-related quality of life by using the 12-item short-form scale. Results There was no significant difference in the incidence of chronic pain and chronic pain affecting dai-ly life, incidence of neuropathic pain or quality of life scale score at 6 and 12 months postoperatively be-tween the two groups (P>0. 05). Conclusion TPVB combined with general anesthesia exerts no effect on the long-term quality of life in the patients undergoing breast cancer surgery.

Effect of thoracic paravertebral block combined with general anesthesia on early postoperative re-covery in patients undergoing breast cancer surgery / 中华麻醉学杂志

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on early postoperative recovery in patients undergoing breast cancer surgery. Meth-ods A total of 201 patients with untreated primary breast cancer, aged 18-69 yr, with body mass in-dex <35 kg∕m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery for treatment, were enrolled and randomly assigned to general anesthesia group (group GA, n =102) and TPVB combined with general anesthesia group (group TGA, n= 99). In group TGA, TPVB was performed under ultrasound guidance at 30 min before surgery, and 0. 75％ ropivacaine 5 ml was injected at each puncture site of T1-5 . In group GA, local infiltration anesthesia was performed with 1％ lidocaine 0. 2 ml at each puncture site. Anesthesia was induced with IV fentanyl, propofol and rocuronium in both groups. Anesthesia was maintained by inhaling sevoflurane ( group GA), target-controlled infusion of propofol (group TGA) and intermittent IV boluses of fentanyl or rocuronium. Bispectral index value was maintained at 40-60 during surgery. Verbal Rating Scale score was used to assess the severity of pain after surgery. Parecoxib sodium 40 mg, pethidine 50 mg, tramadol 50 mg or fentanyl 50 μg was selected and intrave-nously injected as rescue analgesics when Verbal Rating Scale pain score>4. The requirement for rescue analgesia and development of nausea and retching∕vomiting were recorded within 2 days after surgery. Chinese quality of recovery score was used to assess the early postoperative quality of recovery on days 1 and 2 after surgery. Results Compared with group GA, the quality of recovery score was significantly increased on days 1 and 2 after surgery, the incidence of postoperative nausea was decreased (P<0. 05), and no signifi-cant change was found in the requirement for rescue analgesia or incidence of retching∕vomiting after surgery in group TGA (P>0. 05). Conclusion TPVB combined with general anesthesia is more helpful than gen-eral anesthesia alone for early postoperative recovery in the patients undergoing breast cancer surgery.

K-wire leverage reduction and fixation via the triceps tendon for irreducible supracondylar humeral fractures / 中华创伤骨科杂志

Objective To evaluate K-wire leverage reduction and fixation via the triceps tendon for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ. Methods From June 2014 to March 2016, 31 children with irreducible supracondylar humeral fracture were treated operatively in our hospital. They were 23 boys and 8 girls, aged from 4 to 11 years ( average, 6. 3 years ) , involving 19 left and 12 right arms. Their clinical manifestations included elbow swelling at the affected arm, obvious tenderness, and limited movement of the elbow. The reduction was conducted under the guidance of C-arm roentgenography by inserting a piece of 3. 0 mm K-wire into the fracture ends via the posterior triceps tendon, inserting 2 pieces of 1. 5 or 2. 0 mm K-wire from the distal lateral humerus to the proximal through the opposite cortical bone, and inserting a piece of 1. 5 or 2. 0 mm K-wire into the opposite cortical bone through the ulnar aspect of the distal humerus. Results The operation time for the 31 patients ranged from 28 to 42 minutes ( 33 minutes on average ) . They were followed up for 6 to 18 months ( 12. 3 months on average ) . All fractures united after 4 to 6 weeks ( 4. 6 weeks on average ) . At the final follow-ups, the lengths of the affected and healthy arms were re-spectively 66. 4 ± 2. 7 cm and 66. 4 ± 2. 9 cm, showing no significant difference ( P> 0. 05 ) . The therapeutic outcomes by the Flynn criteria for the elbow function were rated at the final follow-up as excellent in 26 cases, as good in 4 and as fair in one, yielding an excellent to good rate of 96. 8％. Pin tract infection occurred in 2 patients, but no deep infection or osteomyelitis was observed during follow-ups. Conclusion K-wire leverage reduction and fixation via the triceps is an effective and simple treatment for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ.

Effect of stellate ganglion block on early postoperative cognitive function in elderly patients with orthopedic surgery / 中国基层医药

Objective To investigate the effect of stellate ganglion block ( SGB ) on early postoperative cognitive function in elderly patients undergoing orthopedic surgery .Methods 115 elderly patients with orthopedic surgery were selected as study objects ,and they were randomly divided into observation group (55 cases) and control group(60 cases) according to the digital table .The observation group received epidural anesthesia after SGB ,while the control group only received routine epidural anesthesia .Preoperation and postoperative 6h,3d and 7d,the mini mental state examination ( MMSE ) scores were measured and compared , the cognitive function was assessed .The MMSE score and postoperative cognitive dysfunction ( POCD) occurrence before and after surgery in the two groups were compared.Results In the observation group,the preoperative MMSE score was (29.36 ±2.54) points,the MMSE scores of 6h,3d and 7d after operation were (22.69 ±3.01) points,(25.33 ±2.69) points,(28.32 ± 3.04)points,respectively.The difference between preoperation and postoperation was statistically significant ( F =51.26,P <0.05).In the control group,the MMSE scores of before surgery and 6h,3d,7d after surgery were (29.69 ±2.17)points,(20.24 ±3.59)points,(21.87 ±2.02)points and (27.66 ±3.07)points,respectively,the difference was statistically significant (F=103.70,P<0.05).Before surgery,the MMSE score between the observa-tion group and control group had no statistically significant difference .6h and 3d after surgery,the MMSE scores of the observation group were higher than those of the control group (t=3.947,7.745,all P<0.05);7d after operation,the MMSE score between the two groups had no statistically significant difference (P>0.05).6h after surgery,the inci-dence rate of POCD of the observation group was 3.64％,which of the control group was 11.67％.3d after operation, the incidence rate of POCD was 1.82％ in the observation group and 3.33％ in the control group.There was no statistically significant difference in the incidence of POCD between the two groups at 6 and 3d after operation ( P>0.05).7d after operation,POCD was not detected in the observation group ,and the incidence rate of the control group was 3.33％.The total incidence rate of POCD was 5.45％ in the observation group and 18.33％ in the control group,and the incidence rate of the observation group was lower (χ2 =4.452,P<0.05).Conclusion SGB can improve the cognitive function of elderly patients after orthopedic surgery ,and it is worthy of clinical recommendation .

Research progress on treatment of syndromic craniosynostosis using posterior cranial vault distraction osteogenesis / 中华整形外科杂志

Craniosynostosis is a group of common congenital craniomaxillofacial deformities. Syndromic craniosynostosis is usually accompanied by increased intracranial pressure, craniocerebral growth restriction, craniofacial deformities and even chiari malformation. Traditional anterior or posterior skull reshaping has its drawbacks such as high surgical risk, high recurrence rate and unsatisfactory therapeutic efficacy, and so on. The operation technique of posterior cranial vault distraction is relatively simple. The treatment process is controllable, accurate and stable. It can largely expand the intracranial volume and improve the anterior and posterior skull configuration with a low risk of complications. To sum up, posterior cranial vault distraction osteogenesis can be a surgical procedure of choice when syndromic craniosynostosis is treated.