近年来,免疫治疗的兴起改变了非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗格局.抗血管生成药物使肿瘤局部血管正常化,有助于免疫效应细胞浸润,这一机制与免疫检查点抑制剂(immune checkpoint inhibitor,ICI)存在协同增效作用.本文将对抗血管生成药物与ICI联合治疗NSCLC的作用机制进行阐述,并对相关临床研究进行汇总分析,旨在为NSCLC患者提供更多的治疗选择.

目的 探讨程序性死亡受体-1(PD-1)和程序性死亡受体-配体1(PD-L1)抑制剂联合抗血管生成药物治疗晚期非小细胞肺癌(NSCLC)的临床疗效和不良反应,并探索潜在的预后相关因素.方法 回顾性分析2015年1月至2019年12月于我院接受PD-1/PD-L1抑制剂联合抗血管生成药物治疗的49例晚期NSCLC患者,观察患者的临床疗效、不良反应及生存情况,并探讨治疗前外周血粒淋比(NLR)和乳酸脱氢酶(LDH)与生存预后的相关性.结果 共纳入49例晚期NSCLC患者,其中完全缓解(CR)0例,部分缓解(PR)14例,疾病稳定(SD)22例,总体客观缓解率(ORR)为28.6％,疾病控制率(DCR)为73.5％.至随访截止时间,全组患者的中位无进展生存期(PFS)为5.7个月(95％CI:4.6～6.8个月),中位总生存期(OS)为12.9个月(95％CI:4.7～21.1个月).多因素Cox回归分析结果显示,治疗前LDH水平是影响患者PFS(HR=3.020,95％CI:1.539～5.925,P=0.001)和OS(HR=2.403,95％CI:1.157～4.990,P=0.019)的独立预后因素.35例患者发生了药物相关不良反应,其中较常见的为疲劳、皮疹、恶心、腹泻、高血压等.3～4级不良反应的发生率为8.2％(4/49),分别为腹泻1例、肺炎1例、肝功能损伤1例及中性粒细胞减少1例.结论 PD-1/PD-L1抑制剂联合抗血管生成药物治疗晚期NSCLC显示了良好的临床疗效,且不良反应相对可控.治疗前外周血LDH水平是影响患者PFS和OS的独立预后因素,有助于筛选能从该治疗方案中获益的潜在人群.

肝癌作为全球范围内最常见的消化系统恶性肿瘤,其发病率和死亡率呈逐年上升的趋势.肝细胞癌(hepatocellular carcinoma,HCC)的一线用药有耐药性和较高的毒性,亟需开发新的分子靶向药物.表皮生长因子受体(epidermal growth factor receptor,EGFR)在HCC细胞中高表达,参与相关信号转导途径,对HCC的发生、发展和转移均有重要作用,因此靶向抑制EGFR或许能有效抑制HCC的生长和转移.目前对EGFR靶向药物在HCC中的作用机制研究有限,本文重点从EGFR靶向药物治疗HCC的作用机制总结最新研究进展,并探讨其发展前景,为临床治疗提供指导.

背景 据报道,合并症可能与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的生存及预后相关,而鲜有研究评价合并症与免疫治疗的关系.目的 评估年龄校正查尔森合并症指数(age-adjusted Charlson comorbidity index,aCCI)与使用抗PD1免疫检查点抑制剂治疗的老年晚期NSCLC患者临床预后的关系.方法 回顾性分析解放军总医院第一医学中心2014年1月1日- 2019年12月31日收治的年龄≥70岁且经抗PD-1免疫治疗的ⅢA ～ ⅣB期NSCLC患者的临床资料.使用单因素和多因素Cox回归分析不同临床特征与预后的关系,使用Kaplan-Meier生存曲线分析不同因素对患者生存的影响.结果 共有118例患者纳入研究,男性94例,平均年龄为74.7岁.低aCCI评分组(＜9分)的中位无进展生存期(progression-free survival, PFS)为10.6个月(95% CI: 6.0～15.2),高aCCI评分组(≥9分)的中位PFS为6.1个月(95% CI:4.8～7.4);低aCCI评分组的中位总生存期(overall survival,OS)为33.9个月(95% CI:13.7～54.1),高aCCI评分组的中位OS为11.7个月(95% CI:9.5～13.9);低aCCI评分组的生存预后(PFS和OS)明显优于高aCCI评分组(P均＜0.01).Cox回归分析提示美国东部肿瘤协作组行为状态(Eastern Cooperative Oncology Group performance status,ECOG PS)评分和aCCI与老年NSCLC患者预后独立关联.结论 利用aCCI评估的合并症负担可以预测应用抗PD1免疫治疗的老年晚期NSCLC患者的预后,但还需进一步的大规模前瞻性研究来验证.

目的 探讨真实世界中,程序性死亡受体?1(PD?1)和程序性死亡受体?配体1(PD?L1)抑制剂治疗复发小细胞肺癌(SCLC)的有效性和安全性,并分析潜在的预后相关因素.方法 回顾性分析2015年6月至2019年6月在解放军总医院接受PD?1/PD?L1抑制剂治疗的复发SCLC患者.通过收集患者的基本临床特征、客观缓解率(ORR)、无进展生存期(PFS)、总生存期(OS)及免疫相关不良反应(irAEs)等资料,探讨治疗的临床疗效、不良反应及潜在的预后相关因素.结果 共纳入50例SCLC患者,总体ORR为26.0％,疾病控制率(DCR)为68.0％.至随访截止时间,全组患者的中位PFS为4.1(95％CI:2.6～5.6)个月,中位OS为9.8(95％CI:6.4～13.2)个月.单因素分析结果显示,年龄、病理分期、衍生粒淋比(dNLR)及血清乳酸脱氢酶(LDH)水平与患者PFS相关(P<0.05);年龄、病理分期、KPS评分及LDH水平与患者OS相关(P<0.05).Cox多因素回归分析结果显示,年龄(HR=2.142,95％CI:1.009～4.547,P=0.047)和病理分期(HR=4.533,95％CI:1.958～10.493,P=0.001)是影响SCLC患者PFS的独立预后因素;KPS评分(HR=0.422,95％CI:0.192～0.927,P=0.032)、病理分期(HR=4.542,95％CI:1.553～13.284,P=0.006)及LDH水平(HR=3.799,95％CI:1.703～8.470,P=0.001)是影响SCLC患者OS的独立预后因素.19例患者发生了irAEs,其中疲劳5例(10.0％)、恶心4例(8.0％)、肺炎4例(8.0％)、甲状腺功能紊乱3例(6.0％)、腹泻2例(4.0％)、垂体功能下降1例(2.0％),最严重的irAEs为2例3级肺炎,应用糖皮质激素等处理后好转.结论 在真实世界中,PD?1/PD?L1 抑制剂为复发SCLC 患者带来了生存获益,且不良反应相对可控. 血清 LDH水平可预测复发SCLC患者免疫治疗的OS,有助于选择免疫治疗的潜在获益人群.

目的 探究肿瘤内科“四生”培训的策略及其效果,为“四生”培训工作的开展提供参考依据.方法 采用考核评分和调查评估的方法,分析本院肿瘤内科个性化“四生”培训工作开展前后的理论和实践考核成绩,调查“四生”对培训模式的认可情况.结果 个性化“四生”培训工作开展后,理论和实践考核成绩均高于培训后,差异有统计学意义(P＜0.05).个性化“四生”培训工作开展后,“四生”各自评情况均优于开展前,差异有统计学意义(P＜0.05).结论 肿瘤内科个性化“四生”培训的开展,对“四生”综合素质的提升和医疗工作的开展均有重要意义.

目的 探究补体及凝血级联途径在原因不明复发性自然流产(URSA)发病机制中的作用.方法 应用iTRAQ技术对4例URSA患者在淋巴细胞免疫治疗(LIT)前后的血浆蛋白质进行定量分析.显著差异蛋白以变化倍数>1.2和Q值<0.05两个条件进行筛选,然后将显著差异蛋白进行GO富集分析和KEGG富集分析.结果 共鉴定出97个差异蛋白分子,其中53个上调蛋白分子、44个下调蛋白分子.GO功能分析显示,显著差异蛋白分子主要参与胞外区、脂质结合和运输的生物学过程;在代谢通路分析中,补体和凝血级联途径是URSA患者在LIT前后受影响最大的分子代谢活动(P=0.0001).经治疗后,纤维蛋白原(FIB)、凝血因子(ⅩⅢ)(F13)、补体C5、肝素辅因子Ⅱ(HCⅡ)、蛋白S(PS)和蛋白C(PC)等显著上调;凝血因子X(F10)和C1抑制剂(C1INH)等水平显著下调.结论 补体和凝血级联途径中的显著差异蛋白分子可能与URSA发病有关,有望成为URSA早期诊断和LIT治疗的生物学靶标.

目的 探讨HLA-Ⅰ类(A、B、C)、Ⅱ类(DRB1、DQB1)基因多态性与原因不明复发性自然流产(unexplained recurrentspontaneous abortion,URSA)的关联.方法 选取解放军总医院第五医学中心免疫学实验室2014-2017年收治的25例URSA夫妇和同期50例正常妊娠夫妇进行HLA-A、B、C、DRB1及DQB1位点的基因分型,并分析HLA各基因频率及夫妇间HLA抗原相容性在病例组与对照组中的分布.结果 URSA夫妇HLA-DQB1*05基因频率显著低于对照组(6％ vs15％,OR=0.4,P=0.024);URSA妻子组HLA-A* 11、B*48、DQB1*06基因分布频率明显高于对照组(30％vs 15％、10％ vs0、38％ vs 19％;OR=2.4、24.6、2.6;P均＜0.05);A*02基因分布频率显著低于对照组(16％vs 31％,OR=0.4,P=0.048);URSA丈夫组HLA-C*03、DRB1*12、DQB1*03基因分布频率明显高于对照组(36％ vs 19％、22％vs 8％、50％vs 33％;OR为2.4、3.2、2.0;P均＜0.05);HLA-C*01、C*06基因分布频率显著低于对照组(6％ vs 19％、4％ vs 18％;OR=0.3、0.2;P均＜0.05).URSA夫妇间各位点HLA抗原相容性与对照组比较均无统计学差异.结论 HLA*1 1、B*48、DQB1*06是URSA妻子易感基因,A*02是URSA妻子保护基因.C*03、DRB1*12、DQB1*03是URSA丈夫易感基因,C*01、C*06是URSA丈夫保护基因.DQB1*05是URSA夫妇的共同保护基因.

目的 探讨阿可拉定联合常规方案对二线或多线治疗耐药后晚期非小细胞肺癌的疗效及安全性.方法 纳入2017年1月-2018年10月在解放军总医院第一医学中心肿瘤内科治疗的晚期非小细胞肺癌患者33例,根据常规治疗方案中是否联合阿可拉定分为阿可拉定组及常规治疗组.其中阿可拉定组14例,常规治疗组19例,观察两组的近期疗效、无进展生存时间(progress-free survival,PFS)及不良反应.结果 两组年龄、性别、病理类型、肿瘤大小、分期、治疗方案、治疗线数等基线资料差异无统计学意义(P＞0.05),mPFS阿可拉定组为5个月,常规治疗组为3个月,两组差异有统计学意义(P=0.002).阿可拉定组客观缓解率(overall response rate,ORR)和疾病控制率(disease control rate,DCR)均高于常规治疗组(ORR:7.14％vs5.26％;DCR:78.6％vs53.2％),但差异无统计学意义.两组Ⅲ～Ⅳ级不良反应的类型及发生率无统计学差异.结论 采用阿可拉定联合常规方案治疗晚期非小细胞肺癌具有一定的临床疗效,且安全耐受性好.

Objective To study the possible mechanism of medium-chain fatty acid (MCFA) in reducing body weight by observing the effect of MCFA on the expression of TLR4 signaling pathway related molecules in small intestine tissues of mice with obesity induced by high-fat diet.Methods Thirty-six C57BL/6J high-fat diet-induced obese mice were randomly divided into octanoic acid group,capric acid group and oleic acid group (each n =12) according to their fasting body weight.After exposure to the high-fat diets (containing 2％ octanoic acid(C8∶0),capric acid (C10∶0)and oleic acid (C18∶ 1) respectively) for 16 weeks,their body,liver and mesenteric,epididymal and perirenal fat pads were weighed.Meanwhile,lipid metabolism related indexes in serum were measured.Tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and interleukin-1 (IL-1) levels in small intestine were measured by ELISA.The expression of toll-like receptor 4 (TLR4),myeloid differentiation factor 88 (MyD88) and TNF-α mRNA in small intestine tissues were measured by real-time RT-PCR.Results The weight of body,liver and epididymal fat pads,the level of TNF-α and the expression of TLR4 mRNA in small intestine tissues were significantly lower in octanoic acid group and capric acid group than in oleic acid group (all P＜0.05).The concentrations of total cholesterol (TC) and free fatty acid (FFA) in serum,the levels of IL-6 and IL-1 and the expression of MyD88 and TNF-α mRNA in small intestine tissues were significantly lower in octanoic acid group than in oleic acid group (all P＜0.05),whereas the serum concentration of high-density lipoprotein cholesterol (HDL-C) and the ratio of serum HDL-C to LDL-C (low-density lipoprotein cholesterol) were significantly higher in octanoic acid group than in oleic acid group (both P＜0.05).The levels of triglyceride (TG) and free fatty acid (FFA) in serum were significantly lower in capric acid group than in oleic acid group (both P＜0.05).Conclusions MCFA may effectively reduce the body weight of obese individuals via reducing inflammatory factors by down-regulating TLR4 signaling pathway related molecules in small intestine tissues.

To summarize the clinical features of eyeball rupture with or without orbital fracture and explore the differences between them. In all, 197 patients were observed, and the following data were recorded: sex, age, time of injury, place of injury, cause of trauma, zone of eye injury, intraocular content prolapse, surgical methods and the therapeutic process, visual acuity after injury, and the final best corrected visual acuity. The results were analyzed for statistically significant differences.There was no significant difference (P>.05) in the age, sex, or cause of injury. Patients with eyeball rupture with fracture had poorer vision than did those in the simple eyeball rupture group; eyeball rupture with fracture also had a higher probability of enucleation.In this study, the clinical results show that prognosis of eyeball rupture with orbital fracture is worse than that of eyeball rupture without orbital fracture.

[Objective] To compare the effects of different fatty acid sources on acute intestinal inflammation induced by LPS in mice.[Method] Totally 40 twelve-week old male C57BL / 6J mice were challenged with intraperitoneal injection with LPS (3.5mg / kg).After 24 hours,the LPS-chanllenged mice were randomly divided into five groups according to their fasting body weight including corn oil group (ω-6 fatty acid),olive oil group (ω-9 fatty acids),perilla oil group (ω-3 fatty acid),medium-long-chain oil group (medium chain fatty acid) and LPS injury group (glucose).Gavage mice according to the different group,and 7 days later,blood sample and small intestine tissue were collected and the level of inflammation factors and the mRNA expression of related molecules in TLR4 pathway were determined.Biopsy of the small intestine of mice was observed.Body weight of mice were measured every day during the study period.[Result] At the end of the study,body weight of mice in each group were increased,olive oil group and perilla oil group were significantly higher than LPS injury group and corn oil group (P ＜ 0.05).The concentrations of TNF-α,IL-1β,IL-6 in serum and small intestine,and the expression mRNA TLR4,MyD88 and TNF-α in small intestine tissue was the lowest in medium chain oil group,and were significantly lower than LPS injury group and corn oil group (P ＜ 0.05).Small intestine tissue pathological results showed that LPS injury group was the worst,corn oil group was a little worse,and olive oil group was in the medium.Medium chain oil and perilla oil group had no obvious injury.[Conclusion] It may be better for LPS induced intestine injury by gavage oil containing medium chain fatty acid,ω-3 fatty acid or ω-9 fatty acid.The mechanism may be via reducing inflarmnatory factors release by inhibiting TLR4 signaling pathway.

Objective To observe the effect of Maca or compound Maca on symptoms of menopause syndrome (as well as fatigue,depression and anxiety,hormone levels and antioxidant indexes).Methods This was a randomized controlled double-blind trial.Eighty subjects with menopausal syndrome were recruited and randomly assigned into compound Maca group (compound Maca,6 tablets/day,n=40) and Maca group (Maca,7 tablets/day,n=40).The intervention lasted for 3 months,and then the changes of Kupperman score,FS-14 score,PHQ-9 score and GAD-7 score,serum estrogen level and antioxidant index between two groups and self-contrast were compared.Results Seven subjects were lost to follow-up (8.75％),and the rest of subjects (compound Maca group,n=37;Maca group,n=36) were included in analysis.Comparison between pre-intervention and post-intervention revealed that Maca and compound Maca were both able to enhance memory,improve insomnia,alleviate symptoms of urinary system and reduce serum malondialdehyde (MDA) level (P ＜ 0.05 respectively);Compared with Maca group in post-intervention,compound Maca could improve memory and insomnia more significantly (P ＜ 0.05,respectively).Conclusion Oral supplement of Maca or compound Maca can improve memory and insomnia,alleviate symptoms of urinary system,and enhance the ability anfioxidation in the menopausal women,and the effect of compand Maca in improving memory function is more significant.

[Objective] To investigate the effects of the complex powder of black rice and auricularia auricular on blood lipid and blood glucose on the metabolic syndrome.[Method] A total of 60 metabdic syndrome patients were enrdled and randomly divided into two groups supplemented with the complex powder of black rice and auricularia auricular group or brown rice group.During the period of experiment (1month),records of diet were made every half a month.Blood biochemical variables,vitamin level and anthropometric measurements were measured at the initial and final time of the study.[Result] Four patients were excluded from the study.There were 27and 29 subjects left in the complex powder of black rice and auricularia auricular group and brown rice group,respectively.No sex difference was noted between the two groups.There was no significant difference in all parameters between the two groups at the intial time.After study,fasting blood-glucose,LDL-C and postprandial blood triacylglycerol were significantly lower in the complex powder of black rice and auricularia auricular group.The vitamin B9 level were significantly higher in the complex powder of black rice and auricularia auricular group.The vitamin B1 and vitamin B9 level were significantly higher compared with before experiment in the complex powder of black rice and auricularia auricular group.The vitamin B1 and vitamin E level were significantly higher compared with before experiment in brown rice group [Conclusion] The complex powder of black rice and auricularia auricular can decrease fasting blood-glucose,LDL-C and postprandial blood triacylglycerol of the metabolic syndrome,it can be used as staple food for metabolic syndrome.

Nuclear respiratory factor‑2α (NRF‑2α) is an important transcription factor that regulates mitochondrial oxidative phosphorylation and regeneration. NRF‑2α regulates mitochondrial transcription factors (mTF)A and B, and mitochondrial DNA by indirectly regulating the mitochondrial respiratory enzyme chain subunit. In addition, NRF‑2α is involved in the mitochondrial energy metabolism. Peroxisome proliferator‑activated receptor γ coactivator 1α (PGC‑1α), is an important transcription coactivator of NRF‑2α. Adenosine monophosphate‑activated protein kinase (AMPK) is considered an important effector in the regulation of the energy metabolism balance of nervous system microenvironments. However, the signaling mechanism underlying the energy coupling of PGC‑1α and NRF‑2α in visual cortical neurons remains to be elucidated. The present study used a primary culture system of rat visual cortical neurons in order to investigate whether AMPK is involved in the regulation of NRF‑2α and PGC‑1α expression in cortical neurons. The results of the present study indicated that KCl depolarization rapidly activated AMPK, and significantly increased the expression levels of PGC‑1α, NRF‑2α and mtTFA, as well as adenosine triphosphate production in cultured neurons. Similarly, the AMPK agonists 5‑aminoimidazole‑4‑carboxamide riboside and resveratrol significantly increased the mRNA expression levels of PGC‑1α and NRF‑2α in cultured neurons. These responses were blocked by compound C, an AMPK inhibitor. In conclusion, AMPK is an important transcriptional regulator of the neuronal excitation response, and exerts its regulatory effects via the PGC‑1α/NRF‑2α signaling pathway.

恶性肿瘤危害巨大,绝大多数患者明确诊断时已经是中晚期,预后差[12]。因此,建立一种方便、微创、灵敏、特异的诊断和监测手段势在必行。研究人员发现肿瘤是一种最常见的基因疾病,不同癌症有不同的诱因和症状,但都可以通过基因突变得到解释。循环肿瘤DNA是存在于血液中的细胞外游离DNA,具有无创、实时、可重复和操作简便等特点,通过对肿瘤患者循环肿瘤 DNA的动态监测,可能为患者的早期诊断、用药选择、病情监测提供全面的实时信息。本文对近年来国内外有关循环肿瘤DNA及其在恶性肿瘤诊疗中应用的研究综述如下。

Current clinically available treatments for rheumatoid arthritis (RA) fail to cure the disease or unsatisfactorily halt disease progression. To overcome these limitations, the development of therapeutic DNA vaccines and boosters may offer new promising strategies. Because type II collagen (CII) as a critical autoantigen in RA and native chicken type II collagen (nCCII) has been used to effectively treat RA, we previously developed a novel therapeutic DNA vaccine encoding CCII (pcDNA-CCOL2A1) with efficacy comparable to that of the current "gold standard", methotrexate(MTX). Here, we systemically evaluated the safety and immunogenicity of the pcDNA-CCOL2A1 vaccine in normal Wistar rats. Group 1 received only a single intramuscular injection into the hind leg with pcDNA-CCOL2A1 at the maximum dosage of 3 mg/kg on day 0; Group 2 was injected with normal saline (NS) as a negative control. All rats were monitored daily for any systemic adverse events, reactions at the injection site, and changes in body weights. Plasma and tissues from all experimental rats were collected on day 14 for routine examinations of hematology and biochemistry parameters, anti-CII IgG antibody reactivity, and histopathology. Our results indicated clearly that at the maximum dosage of 3 mg/kg, the pcDNA-CCOL2A1 vaccine was safe and well-tolerated. No abnormal clinical signs or deaths occurred in the pcDNA-CCOL2A1 group compared with the NS group. Furthermore, no major alterations were observed in hematology, biochemistry, and histopathology, even at the maximum dose. In particularly, no anti-CII IgG antibodies were detected in vaccinated normal rats at 14 d after vaccination; this was relevant because we previously demonstrated that the pcDNA-CCOL2A1 vaccine, when administered at the therapeutic dosage of 300 μg/kg alone, did not induce anti-CII IgG antibody production and significantly reduced levels of anti-CII IgG antibodies in the plasma of rats with established collagen-induced arthritis (CIA). This is the first study demonstrating the safety and immunogenicity of a DNA vaccine encoding CCII for treating RA in normal rats. These results may support the use of this novel therapeutic DNA vaccine for the treatment of RA in the future.

The optimal selection of recipient-donor pair and accurate prediction of acute graft-versus-host disease (aGVHD) severity are always the two most crucial works in allogeneic hematopoietic stem cell transplantation (allo-HSCT), which currently rests mostly with HLA compatibility, the most polymorphic loci in the human genome, in clinic. Thus, there is an urgent need for a rapid and reliable quantitative system for optimal recipient-donor pairs selection and accurate prediction of aGVHD severity prior to allo-HSCT. For these reasons, we have developed a new selection/prediction system for optimal recipient-donor selection and effective prediction of aGVHD severity based on HLA three-dimensional (3D) structure modeling (HLA-TDSM) discrepancy, and applied this system in a pilot randomized clinical allo-HSCT study. The 37 patient-donor pairs in the study were typed at low- and high-resolution levels for HLA-A/-B/-DRB1/-DQB1 loci. HLA-TDSM system covering the 10000 alleles in HLA class I and II consists of the revised local and coordinate root-mean-square deviation (RMSD) values for each locus. Its accuracy and reliability were confirmed using stably transfected Hmy2.CIR–HLA-B cells, TCR Vβ gene scan, and antigen-specific alloreactive cytotoxic lymphocytes. Based on the preliminary results, we theoretically defined all HLA acceptable versus unacceptable mismatched alleles. More importantly, HLA-TDSM enabled a successful retrospective verification and prospective prediction for aGVHD severity in a pilot randomized clinical allo-HSCT study of 32 recipient-donor transplant pairs. There was a strong direct correlation between single/total revised RMSD and aGVHD severity (92% in retrospective group vs 95% in prospective group). These results seem to be closely related to the 3D structure discrepancy of mismatched HLA-alleles, but not the number or loci of mismatched HLA-alleles. Our data first provide the proof-of-concept that HLA-TDSM is essential for optimal selection of recipient-donor pairs and effective prediction of aGVHD severity before allo-HSCT.

Objective:To compare the effect of different oxygen flow rates on the relief of postoperative nausea and vomitting in female patients.Methods:A total of 80 female patients receiving urological laparoscopic surgery were randomly divided into two groups:one group receiving a oxygen flow rate of 3 L/min and the other of 5 L/min. All the cases received oxygen inhalation for 6 h soon after surgery.The incidence of nausea and vomitting 24 h after surgery was recorded.Results:The cases receiving an oxygen flow rate of 5 L/min had significantly lower incidence of nausea and vomitting than the group of 3 L/min.Conclusions:Increased oxygen flow rate can reduce the incidence of nausea and vomitting in female patients after receiving urological laparoscopic surgery and promote patients'post-operative rehabilitation.

Objective To study the expression profile of nucleus respiration factors (NRFs) and related genes in a rat neuron model after KCl(25mmol/L)-mediated membrane depolarization. Methods Primary cultured visual cortical neurons of newborn rats were stimulated with KCl (25mmol/L). The cells were collected at 1, 3, 5, 7 and 10h after stimulation, and the intracellular RNA was extracted and amplified by RT-PCR. The expressions of NRFs subtypes (NRF-1, NRF-2α and NRF-2β) in neuron, upstream gene PGC-1 and downstream gene mtTFA were then examined. Results NRFs gene expressed differently after KCl stimulation: the expression of NRF-1 reached peak value two times at 3h and 7h, respectively, after simulation. NRF-2α reached the peak at 3h after simulation, and then it declined at 5h, followed by a rise again, and it then maintained at that level, while NRF-2β reached a peak value at 7h after stimulation. The expression of mtTFA expression reached peak value two times at 3h and 7h, respectively, after simulation, while the expression of PGC-1 was up-regulated progressively for two times, reaching the peak value at 10h after stimulation. The expressions of NRF-1, NRF-2α and NRF-2β were significantly different compared with that of controls (P<0.05). Conclusion NRFs in visual cortex have different reaction mode, and they may play different roles in response to stimulation.