Objective To investigate effects of intrathecal injection of sufentanil combined with bupivacaine on postoperative analgesia and immunity function in elderly patients under lower extremity orthopaedic surgery.Methods Totally 60 elderly patients with ASA Ⅰ or Ⅲ under lower extremity orthopaedic surgery were randomly divided into two groups:bupivacaine and sufentanil group (each n =30).3 ml bupivacaine (2 ml 0.75％ bupivacaine plus 1 ml 0.9％ normal saline) were given in bupivacaine after successful spinal anesthesia and 3 ml sufentanil (1 ml 0.75 ％ bupivacaine plus 1 ml 0.9％ normal saline and 1 ml with 5 μg sufentanil) were used in sufentanil group respectively.The anesthetic feeling and block level before operation recovery time were recorded postoperation.Visual analogue scale (VAS) and adverse reaction were recorded at 1,6,12,24 and 48 h after surgery.Cellular and humoral immunity function were recorded at the following time points:T0,the day before surgery; T1,the day after surgery; T2,the first 5 postoperative days; T3,the first 10 postoperative days; T4,the first 15 postoperative days.Results The sensory and motor block levels in sufentanil group were T9～～T10 and T11～T12 respectively,which were higher than in bupivacaine (T7～T8 and T8～T10).The recovery time in sufentanil group was shorter than in the bupivacaine (P＜0.05).There were no significant differences in VAS scale between the two groups at any postoperative time points (P＜0.05).The incidence of skin pruritus was higher in sufentanil group (6 cases) than in bupivacaine (P＜0.05).There were significant differences in the indexes for the immune condition including CD3+,CD4+/CD3+,CD4/HLADR,CD8/HLADR,B-cell,NK-cell between time points of T2[(48.7±2.3)％,(33.4±1.8)％,(10.2±1.8)％,(0.75±0.07)％,(1.02±0.16)％,(3.12 ±0.19) ％,(2.53±0.14)％,respectively] and T0 in bupivacaine (P＜0.05).There were significant differences in the indexes for the immune condition including CD3+,CD4+/CD3+,CD4/HLADR,CD8/HLADR,B-cell,NK-cell at T2 between sufentanil group [(54.5 ± 2.4) ％,(36.3 ± 1.7) ％,(15.1±1.6)％,(1.32±0.11)％,(1.25±0.14)％,(4.96±0.25)％,(4.17±0.10)％,respectively] and bupivacaine (P＜0.05).Conclusions Intrathecal injection of 5 μg sufentanil combined with low concentration bupivacaine can be safely and effectively applied in elderly patients under lower extremity orthopaedic surgery,and can reduce local anesthetic concentration,shorten recovery time of anesthesia and accelerate the recovery of postoperative immunity function.

0.05, E tube), and increased by 177% and 212% with mechanical stimulation (bubbling) at 30th min and 60th min (P

At present, the theory and experiment teaching of forensic toxicology are faced with difficulties such as lake of practical cases and toxic types, content being abstract and difficult to un-derstand. On that account, we collected and collated many typical cases from Public Security Bureau and our school's medico legal expertise center, and then a relatively systematic and complete teaching case base in forensic toxicology has been constructed, and will be supplement constantly, so as to pro-vide extensive teaching resources and improve the teaching quality of forensic toxicology.

To develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of epirubicin hydrochloride (EPI) in rat plasma, daunorubicin hydrochloride was used as internal standard. The plasma samples were deproteinated with methanol, and separation was performed on a reversed-phase CAPCELL PAK C18 column (3.0 mm x 50 mm, 3 microm). The mobile phase contained methanol-0.1% formic acid (80:20). Detection was carried out by multiple reaction monitoring on a HP1200-6410 QQQ LC/MS system. Different preparations of EPI solution, EPI-LIP (EPI-liposome) and EPI-LTSL (EPI-thermosensitive liposome) was administered in rats by i.v with the same dosage (12 mg kg(-1)). The pharmacokinetic model and parameters were fitted and calculated by the DAS ver2.0 software. The calibration curve was linear in the range of 0.01-50 microg mL(-1). The limit of quantification was 0.01 microg mL(-1). RSDs of intra- and interbatch precisions were all less than 11.9%. The average extract recovery was 89.3% and 92.1%, respectively. The pharmacokinetics of EPI in rats with all preparations were fitted to three compartments, which all fast distributed and slowly eliminated. The t1/2 alpha, t1/2 beta, t1/2 gamma, AUC(0-infinity), and MRT(0-infinity) of EPI-LTSL group were 7.5, 1.3, 12.6, 12.9, 3.7 times those of EPI solution group; and 1.6, 1.4, 12.3, 2.9, 2.6 times those of EPI-LIP group. Moreover, the CL of the latter two groups was about 13.4 times of the former EPI-LTSL group. EPI-LTSL can significantly improve AUC and prolong the circulation time of EPI in rat plasma.

Associations between "lipid-related" candidate genes, blood lipid concentrations and coronary artery disease (CHD) risk are not clear. We aimed to investigate the effect of three newly identified lipids loci from genome-wide association studies on CHD and blood lipid levels in Chinese Han population. The genotypes of SNPs at three newly identified lipid loci and blood lipids concentrations were examined in 1360 CHD patients and 1360 age- and sex-frequency matched controls from an unrelated Chinese Han population. Allele T of rs16996148 occurred less frequently in CHD patients with the odds ratio (OR) being 0.64 (95% CI 0.50 to 0.81), after adjusting for conventional risk factors and was associated with a 33% decreased CHD risk (P<0.01) comparing with the major allele G. Individuals with GT genotype had the lowest CHD risk. No associations were found between the polymorphisms of other two loci with CHD risk and all three SNPs had no effect on lipid profile in this population. SNP rs16996148 on chromosome 19p13 is significantly associated with lower risk for CHD in Chinese Han population. However, it remains unresolved why these lipid-related loci had significantly less effects than the correspondingly expected effects on blood lipids levels in this population.

The asialoglycoprotein receptor (ASGPR) was used to mediate drug carrier for hepatic targeted drug delivery, this article showed the enzyme-catalyzed esterification of galactose and vinyl stearate and a kind of ASGPR ligand-targeted which was used to insert the surface of liposome has been synthesized. The structure of product has been confirmed by TLC, ESI-MS and 1H NMR. The factors of types and quantity of enzyme, organic solvents, molar ratio of substrate, temperature and time of reaction have been studied. Results showed when using acetone as reaction medium, the quantity of Novozym 435 immobilized lipase was 30 mg mL(-1), molar ratio of galactose to vinyl stearate was 1:5, and reacted at 60 degrees C for 12 h, the transformation of vinyl stearate reached more than 70%. This study provides a novel and efficient route to the synthesis of ligand-targeted modifier.

Objective To investigate the prevalence of virulence genes(ply, pspA, nanA, lytA, psaA) among Streptococcus pneumoniae recently isolated from clinical patients. Methods The 133 strains were isolated from patients in three teaching hospitals in Chongqing from 2006 to 2008. Polymerase chain reaction was used to screen for virulence genes (ply, pspA, nanA, lytA, psaA). Results The positive rate of lytA, psaA, ply, nanA and pspA in 133 clinical isolates were 94.7%, 85.0%, 82.7%, 84. 2% and 60.2%, respectively. The positive rates of the lytA, psaA, ply, nanA and pspA genes in 87 common serotypes isolates was 100%, 87.4%, 86.2%, 89.7%, 67.8%, respectively. Conclusion The total positive rates of five virulence genes in the 133 clinical strains were high. The positive rates of five genes in the com-mon serotypes isolates were higher than those in the no-common serotypes. These genes are important virulence genes of Streptococcus pneumoniae. They could be candidates for protein vaccine of Streptococcus pneumoniae.

Translational medicine has become the current focus in the field of medicine and health.To promote the development of translational medicine,the government should play multiple roles as planner,investor,coordinator,and supervisor,and to take its due responsibilities.

The regional medical information system calls for regional information resources and hospital-level information resources be interconnected and intercommunicated.To meet this requirement,a HL7 CDA-based solution was proposed based on analysis of the current hospital information resources management.An information resources service portal was built to harmonize the management of both new and old resources,and the hierarchy management based on information granularity.The technical implementation of the system is compliant with the SOA architecture and health information standards.This ensures the interconnection and intercommunication between inner information and outer one,and uses information resources in an efficient,reasonable and safe manner.

Objective To investigate the relationship between the degree of serum cortisol suppression by low-dose dexamethasone (1 mg) and full serum cortisol suppression (suppression rate > 50% ) by high-dose dexamethasone (8 mg) in patients with Cushing syndrome, and to evaluate these tests in Cushing disease. Methods Ninty-one patients with Cushing syndrome were studied retrospectively. The relationship of 20%, 30%, 40%, and 50% cortisol suppression by overnight 1mg dexamethasone with full serum cortisol suppression by overnight 8 mg dexamethasone was analyzed, and the sensitivity and specificity in the diagnosis of Cushing disease were evaluated. Results The degree of cortisel suppression during overnight 1 mg dexamethasone suppression test was correlated with that during overnight 8 mg dexamethasone suppression test (r=0. 649,P<0. 001 ). 30, 22, 13, and 9 patients had greater than 20%, 30%, 40%, and 50% serum cortisol suppression respectively during overnight 1 mg dexamethasone suppression test. Among them, 23 ( 76. 7% ), 20 (90. 9% ), 12 (92.3%), and 9 ( 100.0% )patients had full serum cortisol suppression during overnight 8 mg dexamethasone suppression test. The sensitivity of the cutoff of greater than 20%, 30%, 40%, and 50% serum cortisol suppression for the diagnosis of Cushing disease was 52.8%, 32.7%, 22.6%, and 15.7%, and the specificity was 94.7%, 94.7%, 97.4%, and 97.4% respectively. Conclusions In patients with Cushing syndrome, greater than 20% serum cortisol suppression during overnight 1 mg dexamethasone suppression test is usually associated with full serum cortisol suppression during overnight 8 mg dexamethasone suppression test, and most of them are finally diagnosed as Cushing disease.