Objective To investigate the relationship between intraoperative cerebral oxygen saturation (rSO2) and postoperative cognitive dysfunction with near-infrared cerebral oximeter (INVOS 5100) in patients operated under inhalational combined intravenous anesthesia, and to determine the critical rSO2 value below which postoperative cognitive dysfunction may occur. Methods Sixty ASAⅠ-Ⅱ patients of both sexes were selected, aged 62-80yr, weighed 58-77kg, scheduled for elective abdominal surgery or surgery on the low limb. All the patients were divided into three groups according to their educational background: in group Ⅰ were the illiterate and uneducated patients (n=20);group Ⅱ the primarily educated patients (<6yr education) (n=20), and group Ⅱ the well educated patients (>6yr education) (n=20). Each group was further divided into isoflurane and sevoflurane subgroups (n=10 in each subgroup). All patients received no pre-medication. Anesthesia was induced with intravenous atropine 0.3mg, propofol 1.0-1.5mg kg-1, fentanyl 2-3μg*kg-1 and vecuronium 0.1-0.2mg*kg-1, and maintained with isoflurane or sevoflurane inhalation(0.9-1.1 MAC) supplemented with intermittent i.v. boluses of fentanyl, and recorded after entering room (baseline) (T0), after O2 inhalation (T1), after induction of anesthesia (T2), after skin incision (T3), during operation (T4), the end of surgery (T5), and awaking (T6). Mini-Mental State Examination (MMSE) was performed before anesthesia and 1, 4, 8, 12 and 24h after surgery. BP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of inhalational anesthetics were continuously monitored during anesthesia. Results In all three groups rSO2 was significantly lower during operation (T4) and at the end of surgery (T5) than baseline (T0) (P<0.05). In all patients the MMSE scores at 1h after operation were significantly lower than the baseline value (P<0.05). The MMES scores in all patients significantly declined within 1-4h after surgery, and the cognitive function recovered at 4h after surgery in 85% patients. The critical values of rSO2 below which postoperative cognition dysfunction may occur were: 45 (group Ⅰ), 47 (group Ⅱ) and 49 (group Ⅲ) for isoflurane anesthesia subgroups;47 (group Ⅰ), 48 (group Ⅱ) and 50 (group Ⅲ) for sevoflurane subgroups. Conclusion The perioperative rSO2 should be maintained up to above 50% to reduce the incidence of postoperative cognitive dysfunction under inhalational combined intravenous anesthesia.

Objective To analyze the bispectral index (BIS) and the EEG nonlinear index (including Correlation dimension, D2; Approximate entropy, ApEn; Complexity, Cx.) during alternating periods of consciousness and unconsciousness produced by target-controlled infusions (TCI) of propofol. Methods We studied twenty patients (ASA Ⅰ～Ⅱ grades) undergoing the elected leg operations under epidural anesthesia. With TCI consciousness of the patient was controlled by an increase or decrease of concentration of propofol in a range of 0.3～0.5?g/ml for four times. Every target plasma concentration of propofol lasted 12 minutes. BIS, D2, ApEn and Cx were recorded simultaneously during the periods of consciousness and unconsciousness every 3 minutes. Results During consciousness and unconsciousness, the respective mean values for the four measurements were: BIS, 80.2?6.2 and 67.3?7.9; D2, 3.45?0.18 and 3.01?0.16; ApEn, 0.84?0.05 and 0.71?0.06; Cx, 0.55?0.05 and 0.44?0.05. Determined threshold values with 100% specificity during the state of unconsciousness were: BIS, 51 (sensitivity3.8%); D2, 2.90 (sensitivity 30.3%); ApEn, 0.69 (sensitivity42.3%); Cx, 0.41 (sensitivity 25.5%). Conclusion BIS, D2, ApEn and Cx can all reflect the change in consciousness and unconsciousness produced by TCI of propofol. Our findings suggest that of the four EEG variables, ApEn was best in identifying the transition from unconsciousness to consciousness.

Objective To study the effect of inhalational anesthetics on brain cortices under inhalational and intravenous combined anesthesia. Methods 45 patients were randomly divided into isoflurane group (n=15), sevoflurane group (n=15) and desoflurane group (n=15). The narcosis was maintained with inhalational and intravenous combined anesthesia. The EEG non-linear parameters including approximate entropy (ApEn) and correlation dimension (D 2 ) were recorded during operation periods. BP, HR, and SpO 2 were monitored routinely. Results Comparing with that at entrance to the operating room, the EEG activities of frontal and temporal cortices after anesthesia were more suppressed than other cortices. Comparing with that at entrance to the operating room, ApEn and D 2 were significantly declined in the three experimental groups (P

Objective To study effect of propofol on different areas of brain cortex under total intravenous propofol and fentanyl anesthesia. Methods 20 patients were randomly divided into propofol 8mg/(kg?h) group (n=10) and 10mg/(kg?h) group (n=10). The anesthesia was maintained by total intravenous propofol and fentanyl anesthesia. The EEG non-linear parameters, i.e. approximate entropy (ApEn)and correlation dimension (D 2), were recorded during perioperative periods. BP, HR, SpO 2 were monitored routinely. Results Compared with that at entry of OR, the EEG activities of frontal, parietal, and temporal cortices after anesthesia were more inhibited than that of other areas in both groups. Also EEG non-linear parameters were lower significantly after anesthesia in both groups compared with those at entry of OR (P

AIM: To construct lentiviral vector carrying the angiopoietin-1(Ang-1) gene,and make it express Ang-1 in the rat mesenchymal stem cells(rMSCs).METHODS: The cDNA encoding the CDS of Ang-1 gene was obtained from the placenta of the adult Fisher 344 rats with RT-PCR.After digestion with restrication endonuclease,the Ang-1 gene was recombined to construct the transfer plasmid PNL-Ang1-IRES2-EGFP.The three-plasmid system of lentiviral vector was consisted of PNL-Ang1-IRES2-EGFP,the packaging plasmid HELPER,and the envelope plasmid VSVG,which were co-transfected to 293T cells mediated by lipofectamin2000 to produce lentiviral particles.The rMSCs were infected by obtained lentiviral particles.The insertion of Ang-1 gene was detected by PCR,the mRNA expression of Ang-1 in rMSCs was detected with RT-PCR,the protein expression of Ang-1 was observed with immunocytochemistry and Western blotting methods.RESULTS: The result of sequencing showed that the cloned Ang-1 gene was consistent with the sequence reported in GenBank.After digestion with restrication endonuclease,the 1 512 bp fragment of Ang-1 gene and the 10.5 kb vector fragment of PNL-IRES2-EGFP were observed with gel electrophoresis.The insertion of Ang-1 gene in viral genome was confirmed.The EGFP expression was observed with the fluorescent microscope.In infected rMSCs,the mRNA and protein expressions of Ang-1 were confirmed.CONCLUSION: Lentiviral vector carrying Ang-1 gene has been successfully constructed.The infected rMSCs are able to express the Ang-1 mRNA and Ang-1 abundantly.This will facilitate the following exploratory development of Ang-1 gene-modified rMSCs.

Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.

OBJECTIVE:To establish the quality standard of Yanyan granules of concentrated sugar-free type. METHODS:Scrophularia ningpoensis,Menispermum dauricum,Radix et Rhizoma Glycyrrhizae in the granules were identified by TLC,and the content of linarin in Yanyan granules were determined by HPLC.RESULTS:The TLC spots were clear with high resolution.The linear range of linarin was 4.64～69.6 ?g(r=0.999 9) and the average recovery rate was 98.65%(RSD= 0.79%,n=6). CONCLUSION:The established standard is suitable for the quality control of the Yanyan granules of concentrated sugar-free type.

BACKGROUND: Peripheral nerve injuries are hoped to promote the regeneration of nerve repair by elevating brain-derived neurotrophic factor (BDNF) concentration in local injury regions. OBJECTIVE: To observe the recanalization of nerve fiber and motor function in sciatic nerve injury rats following BDNF gene-modified bone marrow mesenchymal stem cells (BMSCs). DESIGN, TIME AND SETTING: The randomized, controlled animal study was performed at the Fujian Institute of Neurology from May 2007 to May 2008. MATERIALS: Femur and tibia of F344 male rats aged 2 months were sterilely harvested to prepare BMSCs. BDNF gene-modified BMSCs were prepared using constructed chronic viral vector PNL-BDNF-IRES2-EGFP. METHODS: The right sciatic nerve injury models were made using 60 adult Sprague Dawley rats. All models were randomly assigned into phosphate buffer saline (PBS) group, BMSC group and BDNF gene-modified BMSC group. 2 ?L BPS, 2 ?L BMSC solution and 2 ?L BDNF modified BMSC solution were separately transfered into injury site of each group. MAIN OUTCOME MEASURES: The retrograde horseradish peroxidase tracing was practiced to observe neural cell number in the Lumbar 4 and 5 spinal cord anterior horn at 2 and 4 weeks after microinjection. Sciatic nerve function index was used to observe rat motor function of injured limbs. Fluorescence excitation and immunohistochemistry were employed to detect BMSC survival and BDNF expression. RESULTS: Cell number was more, and nerve function recovery was better in the Lumbar 4 and 5 spinal cord anterior horn in the BDNF gene-modified BMSC group than in the PBS and BMSC groups. BMSC survival was found in the injured sites in the BMSC and BDNF gene-modified BMSC groups. BDNF expression was significantly more in the BDNF gene-modified BMSC group than in the BMSC group. CONCLUSION: BDNF gene-modified BMSCs have promotion effects on the recanalization and functional recovery of nerve fiber following peripheral nerve injury.

Objective:To study the effects of group counseling which based on interpersonal activities and aimed at the college students with computer gaming addiction in China.Methods:Seventeen college students with computer game addiction were chosen as the experimental group,and 10 college students from another college were chosen as the control group.The two groups had no difference in the scores of Computer Gaming Addiction Invention(CGAI)and several other scales before group counseling.There were a pre-test and a post-test separately set when the group counseling was started and finished,focused on CGAI and negative emotions and cognitions.Results:In post-test,the score of CGAI in experimental group was significantly lower than that in control group[(92.6±16.7)vs.(105.9±13.0)] and lower than that in pre-test(98.9±16.4)by analysis of covariance(Ps<0.01).The scores of Beck Depression Inventory(BDI),Self-Rating Anxiety Scale(SAS),and the negative cognition of oneself in socical settings in experimental group were also lower than those in control group [(6.4±7.9)vs.(13.5±5.6),(39.7±6.4)vs.(49.9±10.3),(15.1±4.3)vs.(19.9±3.0),Ps<0.01],while the score of Rosenberg Self-Esteem Scale(SES)was higher than that of the control group [(29.3±2.9)vs.(24.6±4.8),P<0.01].Conclusion:Group counseling based on interpersonal activities has obvious effects on the college students with computer gaming addiction.

Objective To study the expression of transcription factor FOXO1 and FOXO3a on peripheral blood mononuclear cells (PBMC) in patients with active or inactive systemic lupus erythematosus (SLE) and investigate the effect of FOXO1 and FOXO3a on the clinical features of SLE. Methods Thirty SLE patients and 10 healthy controls were enrolled. PBMC were separated from the peripheral blood. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were applied to analyze the expression of FOXOI and FOXO3a. Results The level of FOXO1 expression was significantly decreased in active SLE patients compared with controls and patients with inactive SLE (P<0.05). The level of FOXO1 expression in inactive SLE patients was lower than that of the controls (P<0.05). The expression of FOXO1 mRNA was negatively correlated to SLEDAI. However, the level of FOXO3a was similar among the three groups. Conclusion The result suggests that FOXO1 may be involved in the pathogenesis of SLE and the expression level of FOXOI may be a good indicator for the disease activity of SLE.