Objective To explore the relationship between glycemic controls with periodontal diseases and disease conditions in patients with type 2 diabetes mellitus (T2DM).Methods Glycated hemoglobin A1c(HbA1c) and serum monocyte chemoattractant protein 1 (MCP-1) levels were measured in 34 normal subjects (control group) and 85 T2DM patients.The patients were assigned to four groups according to MCP-1 levels and complicating periodontal diseases.Both Pearson correlation analysis and univariate Logistic regression analysis were used.Results The levels of HbA1c and MCP-1 in T2DM group were significantly higher than those in control group (P ＜0.01);and the levels of HbA1c and MCP-1 in patients with periodontal disease were significantly higher than those without periodontal disease (P ＜ 0.01).In both normal MCP-1 with periodontal diseases and elevated MCP-1 without periodontal diseases groups,HbA1c level was significantly higher than that in normal MCP-1 without periodontal diseases group (P ＜ 0.01).In elevated MCP-1 with periodontal diseases group,patients had significantly higher HbA1 c levels than that in either periodontal diseases group or elevated MCP-1 group,respectively (P ＜ 0.01).In HbA1c≥7.0％ group,MCP-1 levels and the incidence of periodontal diseases were significantly higher than that in HbA1c ＜7.0％ group (P ＜0.01).HbA1c levels were positively correlated with MCP-1 levels in HbA1c≥7.0％ group (R2 =0.6004,P ＜ 0.01).Univariate regression analysis showed that HbA1c ≥7.0％ was the risk factor for complicating periodontal diseases in T2DM patients (OR =1.65,95％ CI:1.12 ～ 2.56,P ＜ 0.01).Conclusions Poor glycemic control is related to periodontal disease and the disease conditions in T2DM patients.Elevated HbA1c levels can be used as the assessing indicator for periodontal diseases of T2DM patients.

Objective To investigate the effects of ulinastatin on the expression of Toll-like receptor 4 (TLR4) during myocardial ischemia/reperfusion (I/R) in rats and the possible mechanism.Methods Thirty adult Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n =10 each):sham operation group (group S),I/R group and ulinastatin group (group U).Myocardial ischemia was induced by 30 min occlusion of left anterior descending coronary artery followed by reperfusion.Ulinastatin 1 × 104 IU/kg was injected intravenously at 5 min before reperfusion in group U,while the equal volume of normal saline was given in groups S and I/R.The animals were sacrificed at 5 h of reperfusion and myocardial specimens were obtained for microscopic examination and determination of myocardial apoptosis (using TUNEL),TLR4 expression (by immuno-histochemistry) and TNF-α content (by ELIAS).The apoptotic index was calculated.Results Compared with S group,the apoptotic index,TLR4 expression and TNF-α content were significantly increased in groups I/R and U (P ＜0.05).Compared with I/R group,the apoptotic index,TLR4 expression and TNF-α content were significantly decreased (P ＜ 0.05),and the pathological changes were significantly reduced in group U.Conclusion The mechanism by which ulinastatin alleviates myocardial I/R injury is related to inhibition of TLR4 expression and reduction of inflammatory responses during early I/R in rats.

Objective To explore the therapeutic effect of rhIL-11 and rhG-CSF on mouse bone marrow injury induced by neutron irradiation.Methods 130 male BALB/c mice were irradiated by 3.0 Gy neutron and mice peripheral blood cells,bone marrow pathological changes,bone marrow nucleated cell counts,AgNOR content,apoptosis and necrosis rates and Bax protein content were observed by means of blood cells automatic analyzer,HE staining,AgNOR staining,flow cytometry,immunohistochemistry staining and image analysis.Results In the irradiation group and the rhIL-11 group,the mice peripheral blood white blood cells,bone marrow nucleated cell counts and AgNOR content was decreased progressively.The Bax protein was positively or strongly positively expressed in the cytoplasm of the hematopoietic cells and the Bax protein content was increased progressively at 6 h,1 d,3 d after irradiation.In the irradiation group,the rates of apoptosis and necrosis in the mice hematopoietic cells were greatly increased and that of necrosis was significant at 6 h after irradiation.In the rhIL-11 + rhG-CSF group,the counts of bone marrow nucleated cell and AgNOR were increased and the Bax protein content was decreased at 3 d after irradiation,while in the rhIL-11 group,the indexes mentioned above were not obviously different compared with those of the irradiation group.Conclusions The mice bone marrow hematopoietic function is seriously damaged by 3.0 Gy neutron irradiation,rhIL-11 and rhG-CSF could improve the mice hernatopoietic function after neutron irradiation,and combination of them is more effective to stimulate the hematopoitic function than either of them alone.

Objective To evaluate the feasibility of induction with sevoflurane-midaaolam-remifentanil for tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.Methods Twenty-two ASA Ⅰ-Ⅲ patients with huge mediastinal tumor,aged 22-64 yr,weighing 48-76 kg,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midaaolam 0.03 mg/kg and inhalation of 8％ sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 8％,followed by decrement of 2％ every 30 s until 4％.When the eyelash reflex disappeared,remifentani1 2 μ g/kg was injected slowly over I min and sevoflurane inhalation was stopped 30 s later.The patients were mechanically ventilated after tracheal intubation.MAP and HR were recorded before induction and immediately before and 1 min after inlubation.The time of disappearance of eyelash reflex was recorded.The inlubation condition was evaluated using VibyMogensen score.Results The time period from sevoflurane inhalation to disappearance of eyelash reflex was(110 ± 14)s.The success rate of tracheal intubation at the first attempt was 86％.The position of the glottis was higher in 2 patients,and tracheal intubation was successfully performed under the guide of fiberoptic bronchoscope.The satisfactory intubation conditions were found in 86％ of cases.Compared with that before anesthesia induclion,MAP and HR were significantly decreased immediately after intubation and at 1 min after intubation(P ＜ 0.05).SpO2 ＞ 95％ in all patients.BIS was maintained at 45-55 during the period(before intubation until 1 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifenlail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.

Objective To evaluate the feasibility of induction with sevoflurane-midazolam-remifentail for tracheal intubation without muscle relaxants in neck brake patients.Methods Forty ASA Ⅰ or Ⅱ patients with cervical spine fracture with dislocation,aged 13-68 yr,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg and inhalation of 5%sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 5%,followed by decrement of 1% every 30 s until 3%.When the eyelash reflex disappeared,remifentanil 2 μg/kg was injected slowly over 45s and 30 s later sevoflurane inhalation was stopped.The patients were mechanically ventilated after tracheal intubation.The time of disappearance of eyelash reflex was recorded.The intubation condition was evaluated using VibyMogensen score.Results All patients were successfully intubated at the first attempt.The time period from sevoflurane inhalation to disappearance of eyslash reflex was(69 ± 4)s.Coughing occurred in 3 cases during intubation.The satisfactory intubation conditions were found in 100% of cases.SpO2 ＞ 95% in all patients.BlS was maintained at 45-55 during the period(before intubation until 3 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifentail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in neck brake patients.

Objective To explore the therapeutic effect of recombinant human interleukin(rhIL-11) and curcumin on jejunal damage in mice after neutron irradiation.Methods 140 male BALB/c mice were randomly divided into 4 groups:20 mice in healthy control group,60 mice in mere irradiation group,30 mice in IL-11 treatment group and 30 mice in curcumin treatment group.The mere irradiation group mice were wholly exposed to 3 Gy neutron irradiation.The treatment groups mice were intraperitoneally enterocoelia once a day for 5 d after irradiation.The mortality of the mice were observed.The mice in the control and mere irradiation groups were killed 6 h,1,3,and 6 d post-irradiation,respectively,and the mice of the 2 treatment groups were killed 3 and 6 d post-irradiation,respectively and the samples of jujunum were colleted.HE staining,argyrophilic of nucleaolar organizer regions staining,Feulgen staining,and image analysis were used to observe the pathology and levels of argyrophilic proteins and DNA.Results The mice in the mere irradiation group all died at 5 d post-irradiation,while 2 mice in the IL-11 treatment group and 3 in the curcumin group survived.Large area necrosis and exfoliation were found in the intestinal epithelial mucosa of the mere irradiated group mice since 6 h to 3 d after irradiation.Crypt cell regeneration was seen occasionally found 3 days later and much more 5 days later.Crypt cell regeneration was obviously found in the intestinal epithelial mucosa and lots of new villi were observed 5 d after irradiation in both treatment groups,however,the amounts of crypt cells and new villi of the curcumin treatment group were less than those of the IL-11 treatment group.The contents of AgNOR and DNA in the intestinal epithelial cells 5 days after irradiation of the 2 treatment groups were all significantly higher than those of the mere irradiation group (F = 0.015-0.035,all P ＜ 0.05) but without significant differences between them.Conclusions Jejunal damage in mice could be induced after 3 Gy neutron irradiation.rhIL-11 and curcumin might reduce the damage and promote the regeneration and repair of the intestinal epithelium.

Objective:To investigate the effects of different analgesic methods of hydromorphone on analgesic efficacy and sleep quality in patients with refractory cancer pain.Methods:Sixty patients with refractory cancer pain who received three-step analgesic treatment in Quzhou People's Hospital from August 2018 to December 2019 and acquired poor analgesic effects were included in this study. They were randomly assigned to undergo either an intravenous patient-controlled analgesia with hydromorphone (HV group, n = 30) or an intrathecal patient-controlled analgesia with hydromorphone (HI group, n = 30) for 10 consecutive days. The analgesic efficacy in each group was evaluated using the numerical rating scale (NRS) before and 2, 4, 24, 48 hours, and 10 days after administration. The frequency of breakthrough pain (BTP) at each time point was recorded. The sedation effect of medication was evaluated using the Ramsay score. The sleep quality of patients was evaluated using the Pittsburgh sleep quality index (PSQI). The activities of CD 3+, CD 4+, and CD 4+/CD 8+ lymphocyte subsets were measured by flow cytometry at different time points. The adverse reactions within 10 days after treatment were observed and recorded. Results:Before and at each time point after treatment, there were no significant differences in NRS score, the frequency of BTP, Ramsay score, and PSQI score between the two groups (NRS score: t = 0.45, 0.91, 0.52, 1.19, 0.97, 1.92, all P > 0.05; frequency of BTP: t = 0.34, 1.88, 0.86, 1.71, 1.22, 0.76, all P > 0.05; Ramsay score: t = 0.56, 0.46, 0.63, 0.22, 0.99, 0.14, all P > 0.05; PSQI: t = 0.86, 1.25, 1.46, 1.05, 0.57, 1.93, all P > 0.05). At each time point after treatment, the activities of CD 3+, CD 4+, and CD 4+/CD 8+ cells increased in each group, and the activities of CD 3+, CD 4+, and CD 4+/CD 8+ cells in the HI group were significantly higher than those in the HV group (CD 3+: t = 3.72, 3.12, 2.85, 3.13, 2.44, all P < 0.05; CD 4+: t = 3.62, 2.45, 3.31, 3.19, 2.70; all P > 0.05; CD 4+/CD 8+: t = 3.10, 2.74, 2.83, 3.24, 3.41, all P < 0.05). The total incidence of adverse reactions was slightly, but not significantly, lower in the HI group than the HV group [14.00% (7/30) vs. 26.00% (13/30), χ2 = 2.70, P = 0.100]. Conclusion:Compared with intravenous administration of hydromorphone, intrathecal administration of hydromorphone can better effectively relieve pain, decrease the frequency of BTP, improve sleep quality, has a good sedative effect, improve immune function, and has fewer adverse reactions.