Objective To observe the impacts on the patients with cardiovascular responses when applying propofol combined with different dose of remifentanil in tracheal intubation without the use of muscle relaxants for anesthesia induction. Methods Sixty patients undergoing selective general anesthesia operation of ASA Ⅰ -Ⅱ non-heart and brain surgery were divided into three groups by random digits table, and 20 cases for each group. Target-controlled infusion of remifentanil with respective plasma concentration of 2 ng/ml (group Ⅰ ), 3 ng/ml (group Ⅱ ) and 4 ng/ml (group Ⅲ). Target-controlled infusion of propofol after infusion of remifentanil for 5 min (3 μg/ml of plasma target concentration). The mean arterial pressure (MAP),heart rate (HR), intubation conditions and success rate of patients in different groups before induction(T1), at the beginning moment of propofol(T2),at the immediate moment before tracheal intubation (T3) and at the time of 1 min after tracheal intubation (T4). Results The grade of tracheal intubation was (10.5 ±2.9), (7.6 ±2.3), (5.8 ± 1.2) scores and the success rate of the first intubation was 50%( 10/20), 80%(16/20), 100%(20/20) in group Ⅰ ,Ⅱ and Ⅲ , there were significant differences among three groups (P＜ 0.05),group Ⅲ was superior to group Ⅰ and Ⅱ (P＜0.05). Comparing T2 and Tj,HR in group Ⅱ and Ⅲ slowed down significantly ( P ＜ 0.05), and in group Ⅲ slowed down more significantly (P＜0.05). Comparing T4 and T3,HR in group Ⅰ and Ⅱ quickened significantly, and group Ⅰ was higher than group Ⅱ and Ⅲ (P＜ 0.05). Comparing T3 and T2,MAP decreased significantly among three groups,comparing T4 and T3, MAP increased significantly in group Ⅰ which was higher than that in group Ⅱ and Ⅲ (P ＜ 0.05). Conclusions Without the use of muscle relaxants, propofol combined with remifentanil for 3-4 ng/ml can better restrain the tracheal intubation stress responses and won't cause significant cycle inhibition. They benefit to maintain the smooth intubation process of anesthesia induction.

OBJECTIVE:To observe clinical efficacy of specific 5-HT receptor antagonist granisetron combined with intravenous local anesthetic lidocaine pretreatment in minimizing propofol injection pain. METHODS:400 selective patients with laparoscopic cholecystectomy randomized into control group(group A),lidocaine group(group B),granisetron group(group C)and lidocaine combined with granisetron group(group D),n=100. Group A were treated with 3 mL normal saline and group B 20 mg lidocaine,group C 2 mg granisetron,group D 2 mg granisetron and 20 mg lidocaine. After 1 min the tourniquet released and a quarter of expected amount of propofol was given. Pain score of injection site was recorded. RESULTS:As group B、C and D,case number of injection nonpain in group A was higher than that of injection pain. There were statistical significance in the difference of case number and degree of injection pain among those groups(P

Objective To compare of sevoflurane and propofol on cerebral oxygen metabolism and postoperative cognitive function during anesthesia maintenance.MethodsSeventy emergency trauma patients admitted to Zhoushan Hospital from August 2014 to August 2015, whom were randomLy divided into two groups (n=35 each): The control group anesthesia maintained by propofol;while the observation group were maintained with sevoflurane anesthesia.The changes of cerebral oxygen metabolism were compared between the two groups at different time points during anesthesia maintenance, and the Mini-Mental State Examination(MMSE) score, Trail-Making Test(TMT)completion time and the incidence of adverse reactions after recovery were also compared.ResultsThe SjvO2 values of each group were much higher in 2 min after induction (T2), 2 min after tracheal extubation (T3) than those before anesthesia (T1), while the Da-jvO2 and COER values were significantly decreased in T2 and T3 than those in T1, and the differences were statistically significant (P<0.05).These values were wihtout significant difference between the two groups in each period.The TMT completion time of the control group was prolonged than before induction, while the MMSE score was decreased than before induction, and the differences were statistically significant (P<0.05).There was no significant difference in TMT completion time and MMSE score in the observation group before and after induction.The incidence of adverse reactions between the two groups was not statistically significant.The eye opening time, orientation recovery time and anal exhaust time of control group were much later than those in observation group, and the differences were statistically significant (P<0.05).ConclusionSevoflurane and propofol can meet the need of maintaining the cerebral oxygen balance during anesthesia maintenance, but sevoflurane anesthesia has fewer influences in post-operation cognitive function.

Objective To investigate the effects of Xiao Yao San on intracellular Ca2 + concentration in cultured rat hippocampal neurons in the state of chronic stress and study the mechanism of chronic stress injuring and XiaoYao San protecting. Methods MK-801 acts as tool,cultured rat hippocampal neurons were divided into seven groups, those were group 1 (control), group 2 (normal serum), group 3 (normal serum + Glu), group 4 (model serum + Glu), group 5 (model serum + Glu + MK-801), group 6 (Xiaoyaosan + Glu), group 7 (Xiaoyaosan + Glu + MK-801). to detect intracellular Ca2+ concentration in cultured hippocampal neurons in the simulated micro - environment of chronic stress and after intervention with the serum treated with Xiao Yao San by confocal laser microscope at the same period of time. Results Compared with group 1 (779.97 ± 36.81), concentration of Ca2+ intracellular of group 2 (1092.38 ± 36.41), group 3 (1472.49 ± 76. 19), group 4 (1509.52 ±104.69) and group 5 (1186.97 ±41.92) all increased significantly (P＜0.01) ,group 6 (908.74 ±40.24) increased too (P ＜ 0.05), compared with group 2, concentration of Ca2 + intracellular of group 3,4 and 5 all increased significantly (P ＜ 0.01), but group 7 (721.99 ± 60.33) decreased significantly (P ＜ 0.01). Compared with group 4, concentration of Ca2+ intracellular of group 6 and 7 decreased significantly (P＜ 0.01), group 5 decreased too (P ＜ 0.05), compared with group 6, concentration of Ca2 + intracellular of group 5 increased significantly (P ＜ 0.01),when group 7 decreased significantly (P＜0.01). Conclusion Serum of chronic stress treated with Xiao Yao San has the effect of inhibiting Ca2+ overload in hippocampal neurons,it may work through a variety of signaling pathways including Glu-NR-Ca2+ to maintain the steady-state of Ca2+ concentration in hippocampal neurons, and then to protect neurons from the neurotoxic effects of excitatory.

Objective To observe the mechanisms that Xiaoyao powder influences the hypothalamus-pituitary-adrenal (HPA) axis of chronic-stress rats. Methods Chronic stress rats were as researching object,and RU-38486 acted as tool drugs. The serum-GC density of rats were tested with ELISA,and the glucocortcoid(GR) in hippocampus neuron were tested with immunofluorescence,the CRH mRNA in hypothalamus were tested by in situ hybridization (ISH). Results Compared with normal group ( 1.09 ± 0.11 ;0.57 ± 0.10), the expression of GR in hippocampus of model group decreased(0.65 ± 0. 10; P ＜ 0. 01 ), and the expression of CRH mRNA in hypothalamus of model group increased ( 1.12 ±0. 11; P＜0. 0l ) ,the GR in hippocampus of RU-38486 group increased ( 1.59 ± 0. 11; P ＜ 0. 01 ), and the expression of CRH mRNA in hypothalamus of RU-38486 group reduced (0.48±0.10; P＜0.05) ,but both the expression of GR in hippocampus and the CRH mRNA in hypothalamus of Xiaoyao powder group were no change (0.62 ±0.08;0.97 ±0.13; P＞0.05). Compared with model group,both the expression of GR in hippocampus of RU-38486 and Xiaoyao powder group increased (P＜0. 01) ,and both the expression of CRH mRNA in hypothalamus of RU-38486 and Xiaoyao powder group reduced (P＜0.01). Conclusion Multi-stress can result in the expression of GR in hippocampus of rats decreasing and the expression of CRH mRNA in hypothalamus increasing, but those changes can be restrained by Xiaoyao powder, and it is the maybe mechanism of Xiaoyao Powder resisting chronic stress in HPA axis.

To study the anticoagulant effect of Xiang-Qi-Tang (XQT),the mice model of endotoxemia was established to detect the expression of coagulation factors and their regulatory proteins in serum and aorta.The results showed that XQT could decrease the expression of TF and increase the expression of tPA in the aorta of mice with endotoxemia,and also decrease the expression of sEPCR in the serum.We further found that XQT caused the decrease of sEPCR through the regulation of PKC δ and ADAM17 to contribute the anticoagulation in mice.This study may provide a new strategy for treating endotoxin-induced disease and provide evidences for further researching the pharmacological action of XQT.

OBJECTIVE:To provide reference for rational use of oral drugs in pediatrics department.METHODS:The prescriptions of oral medication for 1 070 children with respiratory diseases selected from pediatrics outpatient department of our hospital during Jan.2015-Dec.2016 were analyzed retrospectively in terms of drug category,use frequency,the rationality of drug use and prescription standardization,etc.RESULTS:Among 1 070 children,0-1 and 2-5 years of age accounted for 26.45％ and 37.76％,taking up the highest proportion.Among main types of disease,mnsillitis and bronchitis accounted for 48.60％ and 15.42％,taking up the highest proportion.The frequencies of antibiotics,Chinese patent medicines (medicines for the treatment of cough and asthma) and adjuvant drugs were in high level,being 51.78％,27.85％,28.79％.Among antibiotics,the frequencies of penicillins+β-lactamase inhibitor and second-generation cephalosporins were in high level,being 43.74％,40.84％.The rate of rational drug use was 92.51％,and that of irrational drug use was 7.85％.Irrational drug use manifested as excessive number of drugs (2.34％),excessive large dose (2.06％),irrational dosage form (2.24％) and irrational antibiotics use (5.05％).The rate of standard prescription was 91.31％,and the rate of nonstandard prescription was 8.69％.Nomtandard prescription manifested as nonstandard prescription writing.CONCLUSIONS:In the statistical period,common oral drugs for the children with respiratory systemn disease in the pediatrics outpatient department of our hospital are antibiotics,Chinese patent medicines (medicines for the treatment of cough and asthma) and adjuvant drags.The rationality of drug use and prescription standardization are generally good;but there are still some irrationality in the number of drugs,dosage form,dose and the use of antibiotics;prescription writing problems still exist.

Objective To investigate the correlation of glycosylated hemoglobin(HbA1C)levels with carotid atherosclerotic plaque and pulse wave velocity (PWV) in elderly patients with type 2 diabetes mellitus (T2DM).Methods There were 130 cases of elderly patients with T2DM,aged from 60 to 92 years,of whom there were 59 males.All subjects were divided into 3 groups based on the HbA1Clevels:the low level group (HbA1C＜7％,n=49),the middle level group (77％≤HbA1C＜ 8.5 ％,n =58) and the high level group (HbA1C ≥8.5 ％,n=23).Height,body weight,blood pressure,blood glucose,blood lipids,HbA1C and other indexes were collected and compared among groups.In addition,carotid ultrasound and PWV examinations were performed.Results There were significant difference in levels of systolic blood pressure (SBP),fasting blood glucose (FBG),high density lipoprotein cholesterol (HDL-C),carotid intima-media thickness (IMT),plaque score,plaque stability and PWV among groups (all P＜0.05).Correlation analysis showed that IMT levels were correlated with gender (r=0.389),age (r=0.296),FBG (r=0.203),HbA1C(r=0.405) and HDL-C (r =-0.208),all P ＜ 0.05.Carotid artery plaque score correlated with gender (r =0.321),age (r =0.355),HbA1C(r=0.340) and HDL-C (r=-0.249) (all P＜0.01)and there is a correlation between the stability of carotid plaques with body mass index (BMI) (r =-0.286),SBP (r =-0.188),HbA1C(r=-0.368) and HDL-C (r=0.405) (all P＜0.05);PWV was correlated with age (r=0.516),SBP (r=0.521),diastolic blood pressure (r=0.225),FBG (r=0.181),HbA1C(r=0.229),triglyceride (r =-0.253),total cholesterol (r=-0.311) and LDL-C (r=-0.244),all P＜ 0.05.Moreover,there was a correlation between IMT and PWV (r =0.234,P ＜ 0.01).Logistic regression analysis showed that gender,age and HbA1C were independently associated with IMT;gender,age,BMI and HbA1C were independently associated with carotid atherosclerosis plaque score;age,HbA1C and HDL-C were independently associated with the stability of carotid atherosclerotic plaque;age and SBP were independently associated with PWV.Conclusions HbA1C,SBP,HDL-C and BMI are independent risk factors for arteriosclerosis in elderly diabetics.

Objective To investigate the effect and its mechanism of D-pinitol on advanced glycation end products(AGEs)-induced proliferation and migration in mouse aortic vascular smooth muscle cells (VSMC).Methods VSMCs were isolated from mouse aorta and cultured in vitro.Effects of different concentrations of D-pinitol on proliferation and migration of VSMCs were observed by using the AGEs-induced glycosylation injury model of VSMCs.Cell proliferation and migration were detected by CCK-8 assay and cell scratch,respectively.The protein expression levels of transforming growth factor-β1(TGF-β1),p-smad2,p-smad3 and asporin were determined by Western blot.Results Compared with control group,AGEs group showed the increased protein expression levels of asporin,TGF-β1,p-smad2 and p-smad3 (40.06 ± 4.50 vs.17.47 ± 0.57),(55.25 ± 2.07 vs.14.42± 2.07),(0.97 ± 0.02 vs.0.47 ± 0.02),(0.45±0.01 vs.0.26 ± 0.02),all P＜ 0.01.Compared to AGEs group,D-pinitol group could inhibit the cell proliferation and migration and cause dose-dependent decreases of protein expressions of TGF-β1,p-smad2,p-smad3 and asporin(P ＜ 0.05 or P＜0.01).Conclusions D-pinitol can inhibit AGEs-induced cell proliferation and migration in mouse aortic VSMCs.Asporin may participate in the VSMCs extracellular matrix remodeling via TGF-β/smad pathway.

Mesocotyl elongation is a key trait influencing seedling emergence and establishment in direct-seeding rice cultivation. The phytohormone gibberellin (GA) has positive effects on mesocotyl elongation in rice. However, the physiological and molecular basis underlying the regulation of mesocotyl elongation mediated by GA priming under deep-sowing conditions remains largely unclear. In the present study, we performed a physiological and comprehensive transcriptomic analysis of the function of GA priming in mesocotyl elongation and seedling emergence using a direct-seeding