Objective To evaluate the effects of dexmedetomidine on postoperative cognitive function in the aged patients undergoing carotid endarterectomy.Methods Forty patients,aged 65-80 yr,of ASA physical status Ⅱ or Ⅲ,scheduled for elective carotid endarterectomy,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group DEX).Anesthesia was induced with midazolam,etomidate,fentanyl and rocuronium.The patients were tracheally intubated.In group DEX,a loading dose of dexmedetomidine 0.03 μg· kg-1 ·min-1 was infused intravenously for 10 min starting from the time point before induction,and dexmedetomidine 0.30μg· kg-1 ·min-1 was infused until 30 min before the end of operation starting from the end of intubation.The equal volume of normal saline was given instead of dexmedetomidine in group C.At 1 day before operation (To) and 6 and 24 h after operation (T1.2),venous blood samples were collected for determination of serum brain-derived neurotrophic factor (BDNF) concentrations.The cognitive function of the patients was assessed using Mini-Mental State Examination (MMSE) at To,T2,and 48 h,72 h,7days and 1 month after operation (T3-6).Results Compared with the baseline value at T0,the serum BDNFconcentrations were significantly increased at T1 in the two groups,MMSE scores were decreased at T2,3 in groupC,and MMSE scores were decreased,and the serum BDNF concentrations were increased at T2 in group DEX.Compared with group C,the MMSE scores were significantly increased at T3.4,the serum BDNF concentrations were increased at T2,and no significant change was found in MMSE scores at T5.6 in group DEX.Conclusion Dexmedetomidine is helpful in improving postoperative cognitive function and in promoting the recovery of postoperative cognitive function,and the mechanism may be related to enhanced production of endogenous BDNF in the aged patients undergoing carotid endarterectomy.

To improve the anesthesia skills of younger anesthesiologists ,department of anes-thesiology of the Affiliated Hospital of Yangzhou University formed the tutorial system based on tutori-al team. Through enhancing the selection of tutors,establishing of tutorial team and conducting clini-cal skill guidance and scientific research ability training,department of anesthesiology aimed to devel-op personal quality,clinical and scientific research ability of younger anesthesiologists in the process of clinical completion and application of scientific research subject.

Targeted to the junior nursing students in our university, we applied experiential teaching in the course of Obstetrics and Gynecology Nursing to carry out humanistic care infiltration education, which mainly included three parts: aesthetic activities in theoretical class, experiential activities in experimental class and enlightenment after class. After class, compared with the nursing students who were educated by traditional teaching methods, the quality of humanistic care of nursing students who accepted experiential teaching was improved more obviously. It is suggested that the application of experiential teaching is effective in infiltrating humanistic care education in nursing professional courses, which is also in line with the development of nursing discipline.

OBJECTIVETo analyze the effect of endophytic fungi on expression amount of key enzyme genes SS (squalene synthase gene), SE (squalene epoxidase gene) and bAS (beta-amyrin synthase gene) in saponin biosynthesis and saponins content in Eleutherococcus senticosus.

METHODWound method was used for back meeting the endophytic fungi to E. senticosus. With GAPDH as internal control gene, the expression of key enzyme genes was detected by real time PCR method. E. senticosus saponins content was measured by spectrophotometry method.

RESULTWhen wound method back meeting P116-1a and P116-1b after 30 d, the expression content of SS improved significantly (P < 0.05), however the back meeting of P109-4 and P312-1 didnt change the expression of SS. After that SS expression showed reduction-equality-reduction varying trend. Thirty days after back meeting P312-1, the expression content of SE improved significantly (P < 0.05). Ninty days after back meeting P116-1b and P312-1, the expression content of SE improved significantly to 130%,161%, respectively (P < 0.05). After 120 d, back meeting four endophytic fungi, the expression of SE were significantly higher than the control (P < 0.05). Back meeting four endophytic fungi form 60 d to 120 d, the expression of bAS was significantly higher than the control (P < 0.05). The back meeting four endophytic fungi improved E. senticosus saponins content significantly (P < 0.05).

CONCLUSIONEndophytic fungi P116-1a, P116-1b, P1094 and P312-1 significantly effected the expression of key enzyme genes SS, SE and bAS and then affected E. senticosus saponins content. Among the genes, bAS was key target gene.

Eleutherococcus ; chemistry ; metabolism ; microbiology ; Endophytes ; physiology ; Farnesyl-Diphosphate Farnesyltransferase ; genetics ; Fungi ; physiology ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Plant ; Intramolecular Transferases ; genetics ; Saponins ; analysis ; biosynthesis ; Squalene Monooxygenase ; genetics

Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia on postoperative analgesia of patients undergoing thoracotomy. Methods Ninety patients, all genders, ASA Ⅰ or Ⅱ, aged 35-64, BMI 18-24 kg/m2, undergoing radical operation for esophageal carcinoma were randomly divided into three groups (each group 30 patients): group C received general anesthesia, group R received ropivacaine for thoracic paravertebral nerve block and group RD received dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve block.Three groups all used intravenous infusion of propofol, refentanyl and inhalation sevoflurane for anesthesia maintenance, and PCIA pump started before the end of surgery in 3 groups.Meanwhile, group R and group RD received ultrasound-guided T4-T8thoracic paravertebral nerve blocks by multiple injections on operation side preoperatively.In group R, the mixture of 0.5% ropivacaine 19 ml and 1ml of normal saline was injected, and in group RD, the mixture of dexmedetomidine 1 μg/kg and 19 ml of 0.5% ropivacaine was injected.The analgesia process lasted 48 h after surgery of these 3 groups, and the VAS score was maintained<4 points.When the VAS score was 4 or more points, intravenous injection of morphine 5- 10 mg was delivered. Postoperative PCIA liquid and morphine consumption, somnolence, nausea, vomiting, respiratory depression, itching and urinary retention was recorded. Additionally, the occurrences of adverse events about thoracic paravertebral nerve blocks were recorded.Results The dosages of propofol, refentanyl in group R and group RD were lower than those in group G:(7.2 ± 0.6),(6.1 ± 0.5)mg/(kg·h)vs.(8.1 ± 0.5)mg/(kg·h), and there were significant differences(P<0.05).The dosage of propofol in group RD was lower than that in group R: (6.1 ± 0.5) mg/(kg·h) vs. (7.2 ± 0.6) mg/(kg·h), and there was significant difference (P <0.05). Compared with group G, the consumption of PCIA liqud and the usage rate of morphine was reduced in group R and group RD (P < 0.05); the consumption of PCIA liqud and the usage rate of morphine was lower in group RD than that in group R(P<0.05).The rate of nausea and vomiting and itch in group R and group RD was lower than that in group G,and there were significant differences(P<0.05). No significant difference in somnolence showed between three groups (P > 0.05). Conclusions Ropivacaine combined with dexmedetomidine for target thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia can significantly improve the efficacy of postoperative analgesia after thoracotomy, meanwhile,it can also save the dosage of anesthetic drugs during the operation.

Objective To investigate the causes of infertility and its pathological mechanism in female SD rats with spontaneous dwarfism(short stature rat,SSR).Methods Adult wildtype and SSR female SD rats were used in this study.A vaginal smear was used to observe changes in the motile cycle.Ovulation promotion was compared using the simultaneous estrus supernumerary ovulation method.Ovarian and uterine weight and body weight,and ovarian and uterine indices were measured.AMH,E2,FSH,LH,and FSH/LH levels in serum were measured.Transcriptome sequencing of ovarian tissues was performed to analyze gene expression differences.Results No abnormalities were observed in the estrous cycle of SSR female rats.The body weight of SSR female rats was significantly lower than that of wildtype rats,and their ovarian and uterine indices were significantly higher than that of wildtype rats.The mean number of ovulations was significantly higher in wildtype rats than in SSR female infertile rats(P<0.001).Serum AMH(P<0.01)and E2(P<0.05)levels were significantly higher in wildtype rats than in SSR female infertile rats,and serum levels of FSH,LH,and FSH/LH(P<0.05)were significantly lower in SSR infertile females than in SSR infertile rats,while PROG showed no significant difference.Transcriptome sequencing yielded 250 differentially expressed genes,including 190 upregulated and 60 downregulated genes.p53 signaling pathway and cytokine-cytokine receptor interaction.The MCC,MNC,EPC,and degree calculations of the CytoHubba plug-in were used to screen the top 10 significant nodes.The intersection was used to finally obtain nine hub genes,namely Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2.Conclusions Infertility in SSR female rats may be related to a decreased ovarian reserve function and poor ovarian response.Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2 were associated with infertility,laying a theoretical foundation to further explore infertility mechanisms.