Objective To investigate the effects of desflurane on hemodynamics in aged patients.Methods Thirty ASA gradeⅠ Ⅱaged patients,scheduled for elective surgery,were studied. Anesthesia was induced with intravenous thiopentol,succinylcholine and fentanyl.After intubation coesophageal Doppler monitor was performed to measure CO,PV,HR,FTC,CVP,CI,MAP and SVR following inhalation of desflurane at 0 5MAC,1 0MAC,1 5MAC and 2 0MAC respectively.Results Compared with those before inhalation desflurane,MAP and SVR decreased more significantly at 1 0MAC,1 5MAC and 2 0MAC(P0 05),HR and FTC increased significantly at 1.0MAC,1.5MAC and 2.0MAC(P

This paper explored effect of AF internal fixation system in reduction of lumbar vertebral fracture.AF internal fixation system acts fixation and reduction roles for most of spinal blowout fracture through spinal hyperextension or devise opening to reduce fracture blocks in vertebral canal or anterior vertebrae.In addition,it alleviates neural compression to some extent.The collapsed vertebral reduction is achieved by traction of anterior and posterior longitudinal ligaments as well as intervertebral annulus fibrosus;the physiologic curvature and vertebral height are restored.Moreover,the spinal stability is maintained.Early functional exercise can promote fracture healing and reduce complications.In treatment of lumbar vertebral fracture by AF internal fixation system,screw entry,reduction,traction,and fusion are completed based on host biomechanics,and biocompatibility of implant and host should be paid more attention.

BACKGROUND:The mechanism of differentiation and proliferation of bone marrow-derived mesenchymal stem cells remains unclear. In addition, issues such as how signal pathways such as Ca2+and bone marrow-derived mesenchymal stem cellproliferation and differentiation signals form complex signal network remain poorly understood.
OBJECTIVE:To investigate the effect of Ca2+in the induced differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes.
METHODS:Bone marrow-derived mesenchymal stem cells were isolated from rat bone marrow using whone bone marrow adherence method, purified, amplified, and induced with hepatocyte growth factor. [Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells and control bone marrow-derived mesenchymal stem cells were detected with flow cytometry. Bone marrow-derived mesenchymal stem cells induced with hepatocyte growth factor were mixed with nimodipine of different concentration, and cells were divided into three groups:hepatocyte growth factor+nimodipine 10 mg/L, 50 or 100 mg/L groups. cellgrowth was observed with inverted phase contrast microscope and alpha 1-antitrypsin expression of the cells was confirmed by immunocytochemistry. The calcineurin M and the activation of extracellular signal regulated kinase pathway was detected by reverse transcription-PCR and western blotting, respectively.
RESULTS AND CONCLUSION:[Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells was higher than in the control group (P<0.05). After addition of a larger dose of nimodipine, no differentiation of cells was obeserved and growth of bone marrow-derived mesenchymal stem cells was getting worse. There were few alpha 1-antitrypsin positive cells in the nimodipine groups. Calcineurin Mexpression was significantly increased in directional differentiated bone marrow-derived mesenchymal stem cells and smal dose of nimodipine than the controls (P<0.05). However, no significant difference was found among middle, high dose nimodipine and control groups (P>0.05). These findings indicate that Ca2+could participate in the differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes incuded with cytokines, and also maintain the survival and proliferation of bone marrow-derived mesenchymal stem cells.

BACKGROUND:How to control functional activity of donor liver after cardiac death and maintain the optimal function of grafts are the key issues in organ transplantation study.
OBJECTIVE:To preliminarily explore the effect of warm ischemia injury on the morphology and function of rat donor liver after cardiac death.
METHODS:Cardiac death model was established in Sprague-Dawley rats and the successful models were divided into six groups:control group (warm ischemia for 0 minute), warm ischemia 10 group (warm ischemia for 10 minutes), warm ischemia 20 group (warm ischemia for 20 minutes), warm ischemia 30 group (warm ischemia for 30 minutes), warm ischemia 40 group (warm ischemia for 40 minutes) and warm ischemia 50 group (warm ischemia for 50 minutes). The rat liver specimens in each group were cut into ultrathin sections. The structure of liver cells was observed and photographed by electron microscopy. Flameng score was applied to analyze the degree of mitochondrial damage. Liver mitochondria were extracted and then spectrophotometry was used to assess the viability of cytochrome C oxidase.
RESULTS AND CONCLUSION:Under electron microscopy, there were no significant changes in liver cells within 30 minutes of warm ischemia, nuclear membrane was intact, mitochondria mildly swel ed, no mitochondrial crista ruptured, and Flameng score was<2 points. With the extension of warm ischemia time, the cells became swel ing, nuclear chromatin condensated, apoptotic body was clearly visible, mitochondrial matrix coagulated, mitochondria exhibited vacuolation, and Flameng score was 3-4 points. The viability of cytochrome C oxidase showed no significant difference within 30 minutes of warm ischemia, but began to significantly decrease at 40 and 50 minutes. The mitochondrial structure and function after liver injury is not obviously affected by 30 minutes of warm ischemia, and significant changes appear after 40 minutes.

OBJECTIVE To investigate the effect of the dosing time on the pharmacokinetics oferlotinib.METHODS Female C57BL mice were contained under standardized 12h light/dark circadianconditions (lights on at 7:00,off at 19:00)for 3 weeks and randomly assigned into six groups.Erlotinibhydrochloride was orally administrated to the mice in each group at 8:00,12:00,16:00,20:00,24:00and 4:00,respectively.Blood was drawn from the eyeballs of the mice at 12 different time points aftereach administration.The plasma concentration of erlotinib was determined through a high-performanceliquid-chromatographic assay and the parameters were calculated by WinNonlin. RESULTSThe area under curre (AUC)and mean residence time (MRT)of these groups were apparently differ-ent.AUC0 ~24 h and MRT0 ~24 h were the lowest in the 20:00 administration group as compared to othergroups (P<0.01 ).Tmax of the 20:00,24:00 and 4:00 groups was apparently higher than that of the8:00 and 12:00 groups (P<0.01 ).The clearance of the light phase groups was lower than that of thedark phase groups (P<0.01 ),with the highest in the 20:00 group.The peak value of cmax appeared inthe 12:00 group and the lowest in the 20:00 group (P<0.01 ).CONCLUSION Circadian rhythm playsa critical role in pharmacokinetics of erlotinib in mice.

AIM:By analyzing optical coherence tomography angiography (OCTA) characteristics of central serous chorioretinopathy (CSC) and comparing the differences of CSC between OCTA and indocyanine green angiography(ICGA), to explore if OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of photodynamic therapy (PDT).METHODS: We reviewed 30 eyes of 30 patients with CSC, who were diagnosed by fluorescein angiography (FFA) and ICGA at Beijing Tongren Eye Center from November 2015 to March 2016.All patients underwent best-corrected visual acuity (BCVA) measurement, intraocular pressure, slit-lamp examination, indirect ophthalmoscope, color fundus photography, FFA, ICGA and OCTA.FFA and ICGA were captured by Spectralis HRA + OCT (Spectralis HRA + OCT;Heidelberg Engineering, Heidelberg, Germany).OCTA was performed by RTVue XR Avanti device (OptovueInc, Fremont, CA) with 6mm×6mm Angio Retina mode.The software (version 2017.100.0.1;OptovueInc) automatically segmented the tissue into four layers, the characteristics of choriocapillaris layer were analyzed.At the same time, the differences between OCTA and ICGA images were compared among CSC patients.The maximum diameters and areas of both choroidal hyperperfusion in ICGA and high flow signal in OCTA were measured.Then, the paired t test was used to analyze the differences between the maximum diameter and area of OCTA and ICGA measurement.RESULTS: Among 30 cases, high blood flow signals of OCTA were clearly visible in 27 cases, namely the coarse grain region;the inner low flow signals surrounded by high blood flow signals were seen in 21 cases;the outer low flow signals surrounding high blood flow signals were seen in 7 cases.High blood flow signals of OCTA were corresponded with the choroidal hyperperfusion of ICGA images;among these 30 cases, there were low reflection shadows in choroidal hyperperfusion with ICGA for 22 cases, for 21 cases out of these 22 cases, low flow signals inside of high flow signals of OCTA could be seen;9 out of 30 cases, there were low reflection halo outside of choroidal hyperperfusion of ICGA, and 7 out of these 9 cases, low flow signals outside of high flow signals of OCTA could be seen;still for those 30 cases, leakage point in late ICGA could be seen with 14 cases, however, special flow signals in OCTA could not be seen for them.For ICGA, the maximum diameter of choroidal hyperperfusion was 1.589±0.295mm, whose area was 0.705±0.131mm2;while for OCTA, the maximum diameter of high flow signal was 1.576±0.293mm, whose area was 0.745±0.138mm2.By using paired t test, there was no statistical difference between the maximum diameter of choroidal hyperperfusion in ICGA and the maximum diameter of high flow signal in OCTA, nor difference between the area of ICGA and OCTA.CONCLUSION: The high flow signals can be clearly visible in OCTA, which are corresponded with choroidal hyperperfusion in ICGA.OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of PDT.

· AIM: To study the inhibitory effect of pyrrolidine dithiocarbamate (PDTC) on the inflammatory reaction in an experimental proliferative vitreoretinopathy (PVR)model with laser flare cell meter (LFCM).· METHODS: A total of 20 pigmented rabbits were divided into two groups randomly, with 10 rabbits in each group. After the creation of retinal holes, 0.1mL PDTC was injected intravitreally into the right eyes of Group 1(A1) and the left eyes of Group 1 (A2), and 0.1mL balanced saline solution (BSS) into the right eyes of Group2 (B1). One hour later, 0.1mL BSS into the eyes of A1,and 5000U IL-1 β in 0.1mL BSS was injected intravreally into the eyes of A2 and B1. Clinical evaluation and LFCM examination were performed before retinal injury (PO)and at 4h, 24h, 1, 2 and 4wk after the second injection(P4h, P24h, Plwk, P2wk and P4wk). Histopathologic and immunohistochemical examination were also performed at these time points.· RESULTS: PDTC could inhibit the inflammatory reaction obviously from P24h to P2wk. The eyes of A1 and A2 recovered earlier than those of B1. Although inflammatory reaction in the 3 groups resolved completely by the end of P2wk measured with the slit-lamp microscope,the eyes of the B1 still showed obvious aqueous flare judged by the LFCM compared with those of A1 and A2.Histopathologic and immunohistochemical examination showed that nuclear factor- κ B (NF- κ B) was activated by IL-1 β and the PDTC had inhibitory effect on it without obvious toxicity to retina.· CONCLUSION: Inflammatory reaction involves in the rabbit model of PVR induced by injecting intravitreally IL-1 β and the PDTC can relieve it significantly. The LFCM provides a new, sensitive, objective and noninvasive method to quantify the inflammatory reaction in the PVR model.

Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.

Objective:To investigate the effect of RNA-mediated interference EGFR (epidermal growth factor receptor) expression on the apoptosis of muitidrug-resisitant ovarian cancer cell line SKOV3/DDP. Methods: Small hairpin RNA (shRNA) targeting EGFR was synthesized and recombinant plasmid containing pEGFR-shRNA was constructed, pEGFR-shRNA was tansfected into SKOV3/DDP cells by liposome system, untransfected cells and SKOV3/DDP cells tansfected with nonspecific-shRNA (Ctrl-shRNA) were used as control. Expression of EGFR mRNA and protein in SKOV3/DDP cells was examined by RT-PCR and immunocytochemistry after transfection, respectively. The apopototic rates and cell cy-cles of SKOV3/DDP cells were detected by flow cytometry. Results: Compared with Ctrl-shRNA-transfected cells, the ex-pression of EGFR mRNA and protein in pEGFR-shRNA-transfected SKOV3/DDP cells was significantly inhibited. Flow cytometry results showed that cell cycle distribution in pEGFR-shRNA-transfected SKOV3/DDP cells was dramatically changed, and the apoptosis rate was significantly increased after further treatment with cisplatin for 24 h. Conclusion: EGFR-targeted interference RNA can inhibit the expression of EGFR in SKOV3/DDP cells, thereby regulating the cell cy-cle and increasing apoptosis of multidrug-resistant SKOV3/DDP cells.

Based on the analysis of current condition of local medical schools and medi-cal talents demand at the grassroots level,this paper indicates that,taking students’personality development as a breakthrough point,with practice platform construction as main part,supple-mented by multi-knowledge hierarchy and scientific and cultural exposure,backed by workable policy.