Objective To investigate the median effective plasma target concentration of propo-fol (Cp50 )needed for lumbar surgery during inhalation-intravenous balanced anesthesia when BIS is 50.Methods Patients aged 40-56 years,scheduled for vertebral pulp ectomy were included.Anesthe-sia were maintained by TCI of propofol,sevoflurane 0.5 MAC,remifentanyl 0.2 μg·kg-1 ·min-1 , and vecuronium 0.08 mg·kg-1 ·h-1 .The target plasma concentration of propofol was initially set at 1.8 μg/ml,and adjusted by the sequential up-and-down methods,based on BIS index.The Cp50 of propofol and its 95% confidence interval (CI)were calculated.Results Twenty-six patients were en-rolled in this study.The median effective plasma target concentration of propofol was 1.61 μg/ml (95%CI 1.52-1.70)μg/ml.Conclusion The Cp50 of propofol needed for maintaining the BIS index of 50 is 1.61 μg/ml during the anesthesia with 0.5 MAC of sevoflurane combined with remifentanyl in lumbar surgery.

AIM: To investigate the effect of glibenclamide (Glib) on the viability and acid-base equilibrium of glioblastoma cells.METHODS: U251 cells and U87 cells were treated with Glib at different concentrations.The inhibitory rates were detected by CCK-8 assay.The effective dose was screened and the experiment was divided into control group and drug treatment groups.The migration ability was monitored by wound healing assay, and intracellular pH was detected by pH indicator fluorescent probe.The protein expression levels of inwardly-rectifying potassium channel 4.1 (Kir4.1) and monocarboxylate transport protein 1 (MCT1) were determined by Western blot.RESULTS: The half maximal inhibitory concentrations (IC50) of Glib for 48 h exposure of U251 cells and U87 cells were 400.20 μmol/L and 553.70 μmol/L, respectively.The effective inhibition doses of Glib for U251 cells were from the ranges of 100 μmol/L to 1 600 μmol/L, and those for U87 cells were from 50 μmol/L to 1 600 μmol/L in a concentration-dependent manner (P<0.05).Glib not only inhibited the migration (P<0.05) of U251 cells and U87 cells, which was negatively correlated with drug concentration (P<0.05), but also reduced the intracellular fluorescence intensity in experimental group (P<0.05), suggesting that with the increase in drug concentration, the intracellular pH decreased gradually (P<0.05).The protein expression of Kir4.1 and MCT1 was down-regulated by treatment with Glib, and was negatively correlated with concentration of Glib.CONCLUSION: Glib, a kind of potassium channel blocker, induces intracellular acidification via down-regulating the expression of Kir4.1 and MCT1, thus inhibiting the growth of glioblastoma in a certain dose range.

Objective To observe the acupoint massage on gestational diabetes about mellitus and pregnancy outcome.Methods Using simple random sampling method,96 cases of gestational diabetes mellitus were randomly divided into the observation group and control group.The control group were given the conventional treatment, the observation group were given acupoint massage,pregnancy outcomes and blood glucose in the two groups before and after intervention were compared.Results The two groups after treatment of fasting blood glucose,2h postprandial blood glucose and glycated hemoglobin levels were significantly lower than that those of before treatment, but the observation group[(6.92 ±0.66)mmol/L,(8.12 ±0.70)mmol/L,(6.88 ±0.39)%]improved significantly better than those of the control group[(7.93 ±1.03)mmol/L,(9.54 ±1.33)mmol/L,(7.95 ±0.63)%],the difference was statistically significant(t =3.27,2.39,2.73,all P<0.05).The observation group after treatment,the 2H C peptide levels in fasting serum C peptide and postprandial[(0.50 ±0.07)nmol/L,(0.54 ±0.06)nmol/L]signifi-cantly increased than those of the control group after treatment[(0.38 ±0.04)nmol/L,(0.49 ±0.04)nmol/L],with statistical significant differences(t=2.41,2.15,P<0.05).The patients in the control group after treatment,statistical average daily insulin dosage was (55.84 ±8.73) u,the observation group was (32.24 ±5.03) u,the observation group was significantly lower than that of the control group,the difference was statistically significant(t=13.84,P<0.05).The observation group cesarean section,polyhydramnios,postpartum hemorrhage,fetal distress,pregnancy induced hypertension incidence rate(12.50%,4.17%,2.08%,4.17%,0%) were lower than those of the control group(29.17%,16.67%,12.50%,22.92%,12.50%),the difference was statistically significant(χ2 =4.042, 3.877,3.852,7.206,6.400,all P<0.05).Conclusion The acupoint massage therapy can effectively enhance the gestational diabetes treatment effect,improve the pregnancy outcome in patients with gestational diabetes mellitus.

Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI).Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.

BACKGROUND: Monkeys, dogs, pigs, rabbits and other large animals have bean applied previously to prepare animal models of midpelatel suture expansion, but there are high cost, small sample size, difficult to obtain antibodies and other disadvantages, Wistar rats have wide heads to facilitate cavity operation, with low cost and high reproduction rata, as the midpalatal suture model, it is possible to overcome the above deficiencies. OBJECTIVE: To establish a rat model of midpalatal suture expansion, and to supply basement for further relative researches of animal models. METHODS: Twenty Wistar male rats of 5 weeks old, average weight of 65 g, were randomly divided into 2 groups, a experiment and a control, with 10 rats in each group. Rats in experimental group were placed on the expansion appliance, inserting into the diastema between the first and second molars, then stick to molar lingual using light-cured resin for retention. The rats in control group were sham operated, followed by one weak of active expansion. After expansion, the midpalatal sections were observed by X-ray and light microscopy. RESULTS AND CONCLUSION: Maxillary X-ray film showed that midpalatal suture in experimental group was significantly widened, molar lead to cheek. Observed by light microscopy, partial oral side of midpalatal suture in the experimental group was obviously enlarged, mesenchymst ceils were spindle, in the same direction to tension force, Below it, traumatic inflammatory response appeared, with a clear bleeding area. The midpalatal suture expansion model in rats is available, simple and reprodudble.

As an effective physical training method to improve the explosive power of athletes, plyometric training(exercise) has made great contributions to the physical training of Chinese Olympic Teams.However,the way this method is used for astronaut onboard training and the maintenance of human body strength is not yet clear enough.There is no training program or system of astronaut onboard training currently available that uses this training method in China.Based on the analysis of related researches at home and abroad, this paper comprehensively and systematically expounds the principles of plyometric training and research related to athletic performance.The view that this method is used for astronaut onboard training is also proposed innovatively in this paper.The aim of this study is to expand the field of physical training for astronauts and provide reference for the training of weightlessness protection in the field of aerospace in China.

Objective To explore the role of brain-derived neurotrophic factor (BDNF) in pathogenesis of autism. Methods 12.5 d pregnantWistar rats were injected sodium valproate (VPA) 600 mg/kg or normal saline (NS). Their newborn rats were observed ethologically.The expression of BDNF was measured in their temporal cortex with immunohistochemical stain. Results Compared with NS group, VPAgroup expressed less body mass (P<0.05), eyes opening delay (P<0.05), poorer coordination response (P<0.05), slower taxis response (P<0.05). The number of social behavior decreased (P<0.05), latency increased (P<0.05), duration shortened (P<0.05), repetitive activities increased(P<0.05). Purkinje cells reduced in cerebellum. The expression of BDNF increased significantly in temporal cortex 1 d, 7 d and 14 dpostnatally (P<0.01), but decreased 35 d and 49 d postnatally (P<0.01). Conclusion BDNF plays a role in the pathogenesis of autism.

As a metabolic disorder during pregnancy,gestational diabetes mellitus (GDM) has an important effects on fetal development,neonatal health and maternal long-term health,and is one of the pregnancy complications with high incidence.It is of great significance that we have an accurate understanding of the etiology and risk factors of GDM for its prevention and control.GDM is a complex disease with multiple etiologies.Current studies have shown that the occurrence of GDM may be the result of combined effect of heredity and environment,but the exact etiology is still unclear.In this paper,we summarized the possible etiologies and risk factors of GDM,so as to understand the occurrence and development of GDM better and to provide possible references for prevention and further etiological studies of GDM.

Objective To determine the relationship between characteristic damages in white matter and its executive dysfunction by magnetic resonance diffusion tensor imaging (DTI) in the patients with leukoaraiosis (LA). Methods A total of 23 patients with LA and 19 age,sex and education-matched healthy people as control were enrolled.Montreal cognitive assessment (MoCA),Stroop test,trail making test (TMT),digit-symbol test(DST),verbal fluence (VF) were applied to assess cognitive and executive functions.Fractional anisotropy (FA),apparent diffusion coefficient (ADC) and mean diffusivity (MD) in white matter lesion (WML) and normal appearing white matter (NAWM) were measured in LA group,the bilateral centrum semiovale,anterior and posterior periventricular white matter in control group were measured by DTI. The white matter DTI parameters were compared between the groups, the relationship between DTI parameters and executive function was investigated in LA group. Results In LA patients,distinct executive dysfunction were found.The scores of Stroop B [(69.4± 13.4) vs.(43.3 ± 5.0),t =8.03,P＜0.05)],Stroop C [(141.4±42.1) vs.(65.4±10.3),t=7.66,P＜0.05)]and Stroop C B[ (72.0±41.4) vs.(22.1±9.6),t=5.13,P＜0.05)],TMT-A[(73.2±15.3)vs.(31.2±7.2),t 10.97,P＜0.05) ],TMTB[(125.6±18.0) vs.(81.6±5.9),t=10.22,P＜0.05) ] andDST[ (24.8±5.6 )vs.(36.8±5.1),t=7.19,P＜0.05) ] were inferior in LA group to control group.The values of FA in centrum semiovale [(0.2±0.1) vs.(0.4±0.1) and (0.4±0.1),F =45.08,P＜0.05)],anterior periventricular white matter [(0.2±0.0) vs.(0.4±0.1) and (0.4±0.1),F =70.11,P＜0.05)] and posterior perivcntricular white matter[ (0.3±0.1) vs.(0.4±0.1) and (0.4±0.1),F=8.54,P＜0.05) ]of WML were reduced as compared with those of NAWM and control group.The values of ADC(×10- 3mm2/s) in the above three regions of WML [(1.2±0.2) vs.(0.8±0.1) and (0.8±0.1),F=46.77,P＜0.05)],[(1.2±0.3) vs.(0.8±0.0) and (0.8±0.1),F=68.22,P＜0.05)]and [(1.4±0.3) vs.(0.8±0.0) and (0.9±0.1),F=17.08,P＜0.05) ] were elevated,as compared with those of NAWM and control group,and the values of MD ( × 10-5 mm2/s) in the three regions of WML[ (127.8±14.5) vs. (95.3±26.4) and (100.8±9.4),F 19.72,P＜0.05) ],[(127.4±16.0) vs.(101.8±13.9) and (93.4±5.6),F=39.26,P＜0.05) ] and [(134.4±21.2)vs.(114.8=14.5) and (114.4±11.7),F=10.66,P＜0.05) ]were also increased,as compared with those of NAWM and control group.There was negative correlation of FA with Stroop C-B (r=-0.46,P＜0.05),TMT-A (r=-0.48,P＜0.05) and TMT-B (r=0.46,P＜0.05),while FA was positively related with DST test (r=0.42,P＜0.05) in anterior periventricular white matter.Conclusions DTI can detect the characteristic damages of white matter,which is strongly related with executive function impairments possibly induced by the damage of prefrontal-subcortical loop in the patients with LA.

Objective: To study the synergistic and additive effects of commonly used antibiotics on multi-drug resistant Gram-negative bacilli and to establish a database of combined pharmacodynamics in vitro. Methods: Seven antibiotics including fosfomycin (PHOS), levofloxacin (LEV), ceftazidime (CAZ), compound sulfamethoxazole (SMZ), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF) and imipenem (IMP) were selected and grouped into 21 drug pairs. Based on the results of extended spectrum β-lactamases (ESBLs) test and modified carbapenem inactivation method (mCIM), a total of 172 strains of multidrug-resistant Gram-negative bacilli were divided into four groups: 20 strains of carbapenem-resistant Klebsiella pneumoniae (group A), 50 strains of pan-resistant Acinetobacter baumannii (group B), 62 strains of ESBLs-producing Enterobacter (group C) and 40 strains of carbapenem-resistant Pseudomonas aeruginosa (group D). Chessboard dilution method was used to detect the in vitro combined efficacy of 21 drug pairs on drug-resistant bacteria from the four groups. Whonet 5.6 was used for statistical analysis. Results: All 172 strains were single drug resistant to the seven antibiotics. Results of the combined drug efficacy test showed that no antagonism was found in the four groups. In group A, ten drug pairs, especially the combination of PHOS+ LEV (30%, 6/20), had synergistic effects and 14 showed partial synergistic effects, but no additive effect was detected. Synergistic effects, partial synergistic effects and additive effects were respectively achieved by 12, ten and three drug pairs in group B. The LEV+ SMZ combination had synergistic effects against 56% (28/50) of the strains, which was the highest among all combinations. There were 14, 17 and 16 drug pairs showing synergistic effects, partial synergistic effects and additive effects in group C, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (30.6%, 19/62). There were 12, 14 and 13 drug pairs having synergistic effects, partial synergistic effects and additive effects in group D, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (20%, 8/40). Conclusions The combined use of quinolones, carbapenems, sulfonamides and PHOS could have good synergistic effects against multi-drug-resistant gram-negative bacilli. Monitoring the in vitro combined efficacy before treatment would improve the accuracy of antibiotic use and is of great clinical value.