Objective To evaluate the performance of bispectral index (BIS),auditory evoked potential index (AEPI) and cardiovascular response to electrical tetanus stimulus (ETS) for monitoring depth of sedation induced by propofol , analgesia produced by fenanyl and depth of isoflurane anesthesia. Methods Twenty ASA Ⅰ or Ⅱ patients of both sexes (11 males,9 females) aged 18-56 yr, weighing 50-80 kg undergoing elective brain surgery were studied. The patients were unpremedicated. The baseline BIS, AEPI, BP(SP, DP) and HR were measured before anesthesia. Propofol was infused at 0.25 mg?kg-1?min-1 and the infusion was stopped when the total amount of propofol infused reached 5 mg?kg-1 at the end of 20 min infusion. Fentanyl 2 ?g?kg-1 was then given i.v. Three minutes later the patients were intubated and mechanically ventilated. Tracheal intubation was facilitated by vecuronium 0.1 mg?kg-1. Anesthesia was maintained with isoflurane. Depth of sedation was measured using OAA/S scale during propofol infusion. ETS was given at the following time points: when the amount of propofol infused reached 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 mg?kg-1,2 min after fentanyl administration and at 0.7, 1.0, 1.3 MAC isoflurane (end-tidal isoflurane concentration). BIS and AEPI values before and after ETS and changes in BP and HR (ABP, AHR) after ETS and the time for BP and HR to return to the pre-ETS value in 50% and 90% of the patients (TBP50%,TBP90%,THR50%,THR90% ) were recorded. Results BIS and AEPI were positively correlated with sedation depth. There were no significant changes in BIS and AEPI after ETS, but SP, DP and HR increased significantly after ETS( P

Objective To investigate in vitro effects of tanshinoneⅡA on the autophagy of A375 melanoma cells and related signaling pathway. Methods Some cultured A375 cells were divided into 5 groups to be treated with tanshinoneⅡA at concentrations of 0.5, 1, 2 and 4 mg/L, and DMEM containing 0.1% dimethyl sulfoxide (DMSO), respectively, for 24, 48, 72 hours. Methyl thiazol tetrazolium (MTT) assay was performed to estimate the proliferative activity of A375 cells. Some cultured A375 cells were divided into 4 groups to be treated with 1, 2 and 4 mg/L tanshinone ⅡA(1?, 2?and 4?mg/L tanshinone group), and DMEM containing 0.1% DMSO (control group), respectively, for 48 hours. Then, flow cytometry was conducted to count autophagosome?positive cells, and Western blot analysis to determine protein expression of autophagy?associated proteins Beclin?1, microtubule?associated protein 1 light chain 3 (LC3)?Ⅱ, phosphatidylinositol 3?kinase(PI3K), protein kinase B(Akt), mammalian target of rapamycin (mTOR)and p70 ribosomal protein S6 kinase 1(p70S6K1). Results MTT assay showed that 24?, 48?, 72?hour treatments with tanshinone ⅡA at concentrations of 0.5, 1, 2 and 4 mg/L all could inhibit the proliferative activity of A375 cells, and the inhibitory effects increased in a dose? and time?dependent manner(F = 2 564.12, 1 235.25, both P < 0.05). The percentage of autophagosome?positive cells and protein expression of Beclin?1 and LC3?Ⅱincreased gradually and significantly in the 1?, 2?and 4?mg/L tanshinone groups(autophagosome?positive cells: 6.91% ± 0.35%, 13.11% ± 0.73%, 25.51% ± 0.83%, respectively; Beclin?1: 0.33 ± 0.01, 0.53 ± 0.04, 0.63 ± 0.02, respectively; LC3?Ⅱ: 0.41 ± 0.01, 0.52 ± 0.02, 0.64 ± 0.02, respectively), after 48?hour treatment, which were significantly different between the tanshinone groups(all P<0.05), and higher in the tanshinone groups than in the control group(0.41%±0.02%;0.09 ± 0.02;0.21 ± 0.01, all P<0.05). However, the protein expression of PI3K, phosphorylated Akt(p?Akt), p?mTOR and p?p70S6K1 in the PI3K?Akt?mTOR?p70S6K1 signaling pathway decreased gradually and significantly with the increase in tanshinone concentrations after 48?hour treatment, and were significantly lower in all the tanshinone groups than in the control group (all P < 0.05). Conclusion Tanshinone ⅡA can promote the auophagy of A375 cells, likely by blocking the PI3K?Akt?mtTOR?p70S6K1 signaling pathway.

Objective To evaluate effects of tanshinone ⅡAon the invasion and migration of melanoma A375 cells,as well as on the mRNA and protein expression of CXC chemokine receptor type 7 (CXCR7).Methods In vitro cultured A375 cells were divided into 4 groups to be treated with tanshinone ⅡA at different concentrations of 1,2 and 4 mg/L,and 0.1％ dimethyl sulfoxide (DMSO) (control group) for 48 hours,respectively.Wound scratch assay and Transwell invasion assay were conducted to estimate the migratory and invasive abilities of A375 cells,respectively,and real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis to determine the mRNA and protein expression of CXCR7 in A375 cells,respectively.Results After 48-hour treatment,the 1-,2-and 4-mg/L tanshinone ⅡA groups showed significantly decreased number of A375 cells crossing the polycarbonate membrane per high-power field (× 200) (71.00 ± 4.00,51.00-± 2.00 and 37.00 ± 3.61,respectively) in Transwell invasion assay,as well as decreased number of A375 cells migrating to the scratch zone (301 ± 3.00,253.00 ± 3.61 and 126.00 ± 7.00,respectively) in wound scratch assay,compared with the control group (105.33 ± 6.51,332.00 ± 6.24,respectively,all P ＜ 0.05).Additionally,qRT-PCR and Western blot analysis revealed that the mRNA and protein expression of CXCR7 was significantly lower in the 1-,2-and 4-mg/L tanshinone ⅡA groups than in the control groups (CXCR7 mRNA:0.63-± 0.04,0.44 ± 0.02 and 0.31 ± 0.01 vs.1.00 ± 0.02;CXCR7 protein:0.573 ± 0.015,0.416 ± 0.011 and 0.260-± 0.055 vs.0.9000 ± 0.010;all P ＜ 0.05).Moreover,inhibitory effects of tanshinone ⅡA on the migration and invasion of A375 cells,as well as on the mRNA and protein expression of CXCR7,were significantly enhanced with the increase of tanshinone ⅡA concentrations (all P ＜ 0.05).Conclusion Tanshinone ⅡA can inhibit the migratory and invasive abilities of melanoma A375 cells by down-regulating CXCR7 expression.

Objective To explore the analgesic mechanisms of sufentanil. Methods 17 (8 male, 9 female) healthy right-handed volunteersreceived functional magnetic resonance imaging (fMRI) scan before and after sufentanil 0.2 ng/ml administration respectively. Thalamuswas as the region of interest (ROI). All the processing works were carried out using the Statistical Parametric Mapping. Results Comparedwith the basic state, significantly weaker functional connectivity was mainly found in the region of bilateral rectal gyrus and the left inferiaorbital gyrus of the frontal lobe, while significantly greater functional connectivity was found in bilateral cerebellum, the right cingulategyrus and the left middle temporal gyrus (P<0.001, cluster>13 mm3). Conclusion Thalamus plays a key role in the central analgesia ofsufentanil, which associated with the functional connectivity of bilateral rectal gyrus and the left inferia orbital gyrus of the frontal lobe, bilateralcerebellum, the right cingulate gyrus and the left middle temporal gyrus.

Objective To explore the analgesic mechanisms of sufentanil. Methods 17 (8 male, 9 female) healthy right-handed volunteersreceived functional magnetic resonance imaging (fMRI) scan before and after sufentanil 0.2 ng/ml administration respectively. Thalamuswas as the region of interest (ROI). All the processing works were carried out using the Statistical Parametric Mapping. Results Comparedwith the basic state, significantly weaker functional connectivity was mainly found in the region of bilateral rectal gyrus and the left inferiaorbital gyrus of the frontal lobe, while significantly greater functional connectivity was found in bilateral cerebellum, the right cingulategyrus and the left middle temporal gyrus (P<0.001, cluster>13 mm3). Conclusion Thalamus plays a key role in the central analgesia ofsufentanil, which associated with the functional connectivity of bilateral rectal gyrus and the left inferia orbital gyrus of the frontal lobe, bilateralcerebellum, the right cingulate gyrus and the left middle temporal gyrus.

BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P ＜ 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful reaction and it is worth in popularization in treatment of pain.

Objective To evaluate the value of the periportal free air(PPFA) sign at computed tomography(CT) in distinguishing between upper and lower gastrointestinal(GI) tract perforation. Methods CT images of 62 patients with surgically proven GI tract perforation were retrospectively analyzed. 62 cases included upper and lower GI tract perforation in 35 cases and 27 cases,respective-ly. When there was free air in the periportal area,it was defined as positive periportal free air(PPFA) sign. The difference of PPFA sign in upper and lower GI tract perforation, and the sensitivity, specificity, positive predictive value, negative predictive value and ac-curacy of PPFA sign in diagnosing gastrointestinal perforation were analysed respectively. Results The PPFA sign was seen in 33 of 35(94%) patients with upper GI tract perforation,but only in 10 of 27 (37%) patients with lower GI tract perforation,there was sig-nificant difference between them(P<0.05). For diagnosis of super GI perforation with PPFA sign, the sensitivity, specificity, positive predictive value,negative predictive value and accuracy were 94% (33/35), 63%(17/27), 770%(33/43), 89%(17/19) and 81% (50/ 62), respectively. Conclusion The PPFA sign is a useful finding in distinguishing between upper and lower GI tract perforation.

Objective To study the effects of pulsed radiofrequency(PRF)and radiofrequency thermocoagulation(RFTC)in the treatment of idiopathic infraorbital neuralgia.Methods 16 patients suffering idiopathic infraorbital neuralgia were randomly divided into PRF(n=8)and RFTC(n=8).Numeral rating scale(NRS),pain relief(PR)and effective rate of treatment was performed before operation and at 1 hour、1 st day、7th day、15th day、1 st month、3rd month and 6th month after operation.Results The preoperative and postoperative impedance of thefirst,second and third operation in RFTC group were(490±86)Ω and(424±82)Ω,(492±90)Ω and(432±84)Ω,(481±98)Ω and(409±85)Ω respectively and the postoperative impedance was significantly decreased(P＜0.05).The preoperative NRS in group PRF and RFTC were 9(7～10)and 8.5(7～10)respectively and the postoperative NRS at all points in two groups were significantly decreased as compared with the preoperative NRS(P＜0.05).The PR at 7 and 15d in group PRF were 3(0～4)and that in group RFFC were 4(3～4)(P＜0.05).There were no significant differences in effective rate of treatment at each time between two groups(P＞0.05).Numbness appeared after operation in group PRF and disappeared in a week,however,that was persistent and all sense disappeared in group RFTC.Conclusion Curative effect of PRF for idiopathic infraorbital neuralgia is as well as RFTC and it is a kind of safe and effective technology that causes less side effects.

Objective:To evaluate the molecular diagnosis marker of papillary thyroid carcinoma (PTC),the relationship between lymphatic metastasis of central neck compartment PTC,and the opera-tion indication of prophylactic central neck dissection.Methods:We conducted a retrospective study, including 275 PTC patients and detected their BRAF mutation rates during 201 2 and 201 4 and explored the risk factors of the central node lymphatic metastasis by Logistic regression model.Results:Of the 275 PTC patients,224 (81 .5%)were female and 51 (1 8.5%)were male.BRAF mutational rates were 53.8% (1 48 /275)and lymphatic metastasis 57.8% (1 59 /275).Multivariate analysis showed calcifica-tion (ORadjusted =1 .47,95%CI:1 .1 0 -1 .98,P =0.01 ),tumor diameter (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)and age (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)were associa-ted with lymphatic metastasis.In stratified analysis,BRAF mutation (ORadjusted =3.1 9,95%CI:1 .1 8 -9.43,P =0.023 )in clear boarder group and BRAF mutation (ORadjusted =4.84,95% CI:1 .68 -1 3.84,P =0.003)in calcification group were more likely to have lymphatic metastases.Conclusion:Central neck metastasis takes up a high ratio in papillary thyroid cancer patients,BRAF mutation in pa-pillary thyroid carcinoma is a characteristic molecular event.Furthermore,patients with calcification un-der ultrasound detection,lower age group and longer tumor diameter are more susceptible to suffer central neck metastasis.Especially for stratified analysis,non-calcified BRAF mutation or BRAF mutation with clear border under ultrasound detection are more susceptible to suffer central neck metastasis,and radical prophylactic central neck dissection should be carried on for these patients.

〔Abstract〕 The paper introduces the characteristics, methods and achivements of regional health informatization construction of Luoy-ang health information security project, overviews the construction ideas of regional informatization, providing basis for future development and references for similar projects implementation.