Objective To compare the renal effects of dopamine and dobutamine in patients with sepsis.Methods 90 patients with sepsis were admitted to this study.After resuscitation,each patient was randomly given different vasoactive agent.The changes in urine output,fractional excretion of sodium(FeNa),and creatinine clearance(CCr)were observed.Results The urine output and FeNa in dopamine group were increased significantly as compared with control group and dobutamine group[(3072±480),(2038±515)and(362±522)ml/24h,(3.80±1.09),(2.06±1.14)and(2.10±0.95)%](P＜0.05).Compared with control group and dopamine group,CCr increased significantly in dobutamine group[(79.2±39.1),(50.6±21.8)and(47.4±16.7)ml/min](P＜0.05).Conclusion Dopamine infusion markedly elevates urine output and FeNa,but has no effect on CCr.Dobutamine treatment misht significantly increase CCr,but has no effect on urine output.

Objective To investigate the effects of oestrogen-receptor(ER), progesterone-receptor(PR), vascular endothelial growth factor(VEGF) and kinase insert domaincontaining receptor(KDR) in uterine bleeding induced by intrauterine device(IUD). Methods Immunohistochemical method was used to detect the expressions of ER, PR, VEGF and KDR in endometrium from IUD bleeding group and normal control group, respectively. Microvessel density(MVD) was evaluated by using anti factor Ⅷ-related antigen (F8-RA) antibody to mark stromal microvessels. Results The expressions of ER, VEGF and KDR were significantly higher in IUD-induced endometrium bleeding group than those in control group(P0.05). MVD was significantly higher in IUD-induced endometrium bleeding than that in normal endometrium(P

Objective: To evaluate the clinical efficacy and side effects of icotinib combined with a subarachnoid space implantable pump for the treatment of leptomeningeal metastases (LM) from lung adenocarcinoma. Methods:Seven cases of LM from lung adeno-carcinoma with epidermal growth factor receptor mutation were included in the study from March 2011 to September 2015. With the aid of anesthetists, all patients were implanted with subarachnoid space implantable pumps to drain the cerebrospinal fluid (CSF) and then treated with icotinib (125 mg, three times a day) until disease progression or unacceptable toxicities. After 4 weeks, the efficacy and tolerability of icotinib were evaluated on the basis of symptoms, tumor markers from CSF, and brain gadolinium-enhanced magnet-ic resonance imaging scans. Results:Among the seven patients evaluated, no patient had complete response, two patients had partial response, four had stable disease, and one had progression. The patient who was progressive died at a month after therapy. The sur-vival time of all the other patients was more than 4 months. The common adverse effects of icotinib were skin rash and diarrhea, main-ly in grades 1 and 2. No infection of the local subarachnoid drainage tube was found in the abdominal wall. Conclusion:Icotinib com-bined with a subarachnoid space implantable pump for the treatment of LM from lung adenocarcinoma may be effective, and the tox-icities are tolerable. This method could also obviously alleviate the clinical symptoms and improve the quality of life of the patients, worthy of further study.

Objective To study the associations between neo-adjuvant chemotherapy (NACT)sensitivity and expression of relative proliferation and apoptosis genes in cervical cancer tissues. Furthermore,the potential roles of relative genes expression as monitor in the chemotherapy against cervical cancer tissues were studied. Methods Fifteen pathologically proved Ⅱ A stage cervical cancer patients with HPV 16 positive were divided into effective group and non-effective group according to the clinical response to NACT, the changes of HPV16-E6, p53 genes and proteins expressions were measured by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot. At the same time, MTT assay was used to detected proliferative activity to paclitaxel liposome and carboplatin (paraplatin) in HeLa cells. Results In effective group, the overall response rate was 73.3 % (11/15) and the HPV16-E6 mRNA and protein level after NACT was significantly decreased than that before NACT (t=3.359, t=3.614, P＜0.05), while p53mRNA and protein level increased significantly (t =5.852, t=2.838, P ＜0.05). However, there have no significant different between pre-NACT and Post-NACT of the two genes in the non-effective group. After using chemotherapy HeLa cells growth decreased. Conclusion HPV16-E6 and p53 expreesion level are useful paraneters in evaluating NACT response in cervical cancer tissues. The detection of the two genes expression is a method for predicting efficacy in NACT.

Objective To explore the effect of dexmedetomidine on hemodynamics in hypertensive patients undergoing thyroid surgery with local anesthesia.Methods Sixty patients with preoperatively diagnosed class Ⅰ to Ⅱ hypertension undergoing selective thyroidectomy were randomly divided into D (dexmedetomidine) and M (midazolam) groups (30 patients in each group).Doses of dexmedetomidine 0.5 μg/kg were finished in 20 minutes injection in patients of D group before the start of the surgery,then sequentially maintained at the rate of 0.1 ～ 0.5 μg/ (kg · h) with decreasing speed of 0.1 μg/(kg · h) when systolic pressure kept down to 110 mmHg or heart rare down to 60 bpm or Ramsay score of 3 points.The patients in M group were injected with midazolam 0.04 mg/kg 20 minutes before the start of surgery,then maintained at the rate of 0.02 ～ 0.05 mg/(kg · h),decreasing speed of 0.1 mg/(kg · h) to keep Ramsay score of 3 points if necessary.Two groups of patients with Ramsay score of 3 points but a high blood pressure (higher than 30％ of basic level) or heart rate (more than 100 bpm) were treated with drugs during operation.Record the systolic pressure,diastolic pressure,heart rate and Ramsay score at the time of before medication (T0),the injection of local anesthetics (T1),the start of surgery (T2),pain compliments required additional local anesthetics (T3),dealing with gland (T4) and the end of surgery,VAS in 8 h after operation and adverse reaction were recorded.Results In D group,the dosages of urapidil and esmolol [(10 ±5)mg and (0 ±0)mg] were significantly less than those in patients of M group [(60 ± 10) mg and (80 ±5) mg,t =14.82,t =19.78,P ＜ 0.05].Blood pressure and heart rate were all significantly decreased at the time of T1,T2 and T5 when comparing with T0(P ＜0.05 orP ＜0.01),and only heart rate was significantly decreased at the time of T3 and T4 (P ＜ 0.05).While in M group,blood pressure and heart rate were higher than basic levels at the time of T3 and T4 (P ＜ 0.05).Besides,lower blood pressure and heart rate were less than those in M group at all observed time expect T0 (P ＜ 0.05).Conclusions Good sedation effects can be produced by both dexmedetomidine and midazolam in hypertensive patients undergoing thyroid surgery with local anesthesia,but dexmedetomidine was determined more suitable in sedation and anti-hypertension in patients with light to moderate hypertension for better hemodynamic stability effect with local anesthesia.

BACKGROUND: Group pre-test has confirmed that amnion endothelial cell conditioned medium can induce human umbilical cord blood mesenchymal stem cells into dopaminergic neuron-like cells. In this process, neurotrophic factors and their receptors may play an important role. OBJECTIVE: To study the function of neurotrophic factors secreted by amniotic epithelial cells in the differentiation of human umbilical cord blood mesenchymal stem cells into neurons.METHODS: P1 human umbilical cord blood mesenchymal stem cells at 2×10~8 /L were incubated and assigned to 3 group. Control group was added with HG-DMEM medium. Induction group received human amniotic epithelial cell medium. Blocking agent group underwent blocking agent K252a fluid, and the incubated was conducted at 36 ℃ for 40 minutes, and then amniotic epithelial cell medium was added. Immunofluorescence chemistry was used to determine neuron specific enolase and dopamine transporter expression in human umbilical cord blood mesenchymal stem cells. Real-time quantitative PCR was employed to detect neuron specific enolase, dopamine transporter and tyrosine hydroxylase expression in human umbilical cord blood mesenchymal stem cells. RESULTS AND CONCLUSION: Nerve growth factor and brain-derived neurotrophic factor were observed in human amniotic supernatant. P1 human umbilical cord blood mesenchymal stem cells expressed Trka and Trkb. Forty-eight hours following induction, compared with the control group, positive expression of neuron specific enolase and dopamine transporter was significantly increased in the induction and blocking agent groups (P < 0.05), especially in the induction group (P < 0.05). Neuron specific enolase, dopamine transporter and tyrosine hydroxylase mRNA levels were significantly greater in the induction and blocking agent groups compared with the control group (P < 0.01), and each gene mRNA levels were significantly greater in the induction group than in the blocking agent group (P < 0.01). Results verified that neurotrophic factor in the human amniotic epithelial cells plays important effects on differentiation of human umbilical cord blood mesenchymal stem cells into neurons. The promotion effects are mediated by activating Trk receptor.

Atherosclerosis (AS) is a common underlying disease that hazard to human health.It is closely associated with stroke,hypertension,coronary artery disease,and diabetes.AS on the premise of vascular intimnal injury,excessive smooth muscle cell proliferation,inflammatory cell infiltration,oxidative stress,apoptosis and other mschanisms participate together.In eucaryotic organisms,most proteins are degraded by ubiquitin-proteasome system (UPS).An increasing number of evidence indicates that UPS is associated with the occurrenee and development of AS and complications.This article reviews the relationship between.UPS and AS,as well as the effect of ubiquitin-proteasome inhibitor on AS.

Objective To compare the sensitivities of the stimulation effect of human cord blood mesenchymal stem cells(CB-MSCs) and CB-MSCs of neuronal differentiation to lymphocytes(LCs) detected with carboxyfluorescein didcetate(CFSE) and MTT. Methods To prepare LCs from SD rat and divided into four group stimulating cells: 1. CB-MSCs;2. Dif-CB-HSCs;3. SH-SY5Y(positive control);4. Auto-LC(negative control).Stimulating cells were respectively Co-cultured with LCs. The proliferation of LCs was detected with MTT and CFSE ( n =3). Results CB-MSCs and Dif-CB-HSCs stimulated LCs to proliferate more weakly than positive control detected with MTT and CFSE. The quantity of proliferation of lymphocytes Co-cultured with CB-MSCs and Dif-CB-HSCs were higher than that of Auto-LC detected with CFSE. But MTT OD value of CB-MSCs and Dif-CB-HSCs was a little lower than that of Auto-LC. Statistical analysis results showed no significant difference.Conclusion CFSE can reflect proliferation status of lymphocytes better than MTT. CFSE shows more advantages in practical use.

Objective To investigate the dynamic expression of nitric oxide synthase(NOS) in the apoptosis of primary cultured rat cortical neruons following hypoxia/reoxygenation(H/R) and the protective role of extract of ginkgo biloba(EGB). Methods The cortical neurons of E16-17 days fetal rat were primarily cultured.The apoptosis model of primary cultured cortical nurons following H/R was established by using W-G staning,electromicroscopy,TUNEL staining.The dynamic expression of NOS different H/R times was investigated with NADPH-diaphorase histochemical method. Results H/R can cause apoptosis of primary cultured rat cortical neurons.In the experiment of H-2R-0,H-4R-0, H-6R-0,H-8R-0 and H-2R 18,H-4R 18,H-6R 18 H-8R 18,the apoptosis cells occurred after 4 hour hypoxia.The increasing of apoptosis cell acted as time-dependence and the peak value was at H-8R 18.The expression of NOS increased both after 2 hour hypoxia and reoxygenation 18 hour after 8 hour hypoxia compared with the normal control group.EGB could inhibit the increasing and decrease the percentage of apoptosis.Conclusion The apoptosis of primary cultured rat cortical neurons could be induced by H/R.The increasing of NO might be one of the mechannisms of apoptosis.EGB could singnificantly inhibit the apoptosis by means of inhibiting the expression of NOS and reducing the production of NO.;

Objective To summarize the treatment experience of refractory systemic juvenile idiopathic arthritis (JIA) by tocilizumab, and to explore the cost-effective treatment. Methods The clinical data of 6 pediatric patients with refractory systemic JIA treated by tocilizumab from 2014 to June 2016 were retrospectively analyzed in the aspects of course and effectiveness of tocilizumab, steroid reduction, adverse reaction, and growth. Results The median age of the six patients (3 males and 3 females) was 6 years, and the course of disease were from 16 to 63 months. All patients were treated by other immunosuppressive agents or biological agents in addition to steroid and traditional anti-rheumatic drug therapy. The courses of tocilizumab treatment were from 7 to 26 months and the median time was 9.5 months. All 6 patients responded to tocilizumab and achieved the clinical remission at different time. After the induced remission, the interval of the treatment intervention was increased from 2 weeks up to 4 weeks in 3 cases, and no disease activity was observed. Except one case, another 5 cases reduced and stopped the use of hormones at 5.8 months after tocilizumab treatment. After hormones was reduced and discontinued, the growth was improved. All 6 patients had no serious adverse reactions. Conclusions Tocilizumab is safe and effective for patients with refractory JIAs. The steroid can be reduced in short time to improve growth. After remission is induced, the interval of the treatment intervention could be prolonged.