Objective To investigate the effects of different doses of oxycodone on postoperative pain and stress response in patients undergoing gynecological laparoscopic surgery. Methods Sixty patients scheduled for gynecological laparoscopy,aging from 18 to 50 years old,of ASA Ⅰ or Ⅱ,were included and randomized into three groups:control group (group C),low dose of oxycodone group (group L),high dose of oxycodone group (group H),20 cases in each group.Pa-tients in group L,H received 0.05,0.1 mg/kg oxycodone respectively while paitents in group C re-ceived saline 5 ml 1 5 min before the end of the surgery.Visual analogue scale(VAS)pain score and RASS score were measured on 1,6,12 and 24 h postoperatively.Glucose and serum cortisol were also measured before the operation and on time points of 6,12 and 24 h after the operation.Adverse effects were recorded too.Results Compared with group C,VAS were significantly lower in group L and H within 1 hour postoperatively.(P <0.05).VAS was significantly lower in group H than that in group C and L at 6 h postoperatively (P <0.05 ).The RASS scores of group L and H were significantly lower than those in group C (P <0.05)at 1 h postoperatively.Blood glucose and serum cortisol of group L and H increased at 6,12 and 24 h after operation (P <0.05).Compared with group C,blood glucose and serum cortisol were significantly lower in group L and group H at 6,12 h after operation (P <0.05).There was no significant difference in the incidence of adverse reactions in each group. Conclusion Oxycodone 0.1 mg/kg injected before the end of gynecological laparoscopic surgery could effectively relieve postoperative pain with less adverse reactions,and decrease postoperation stress re-sponse.

Objective:To provide a normal reference range for anogenital distance (AGD) in full-term neonates and to investigate factors possibly affecting neonatal AGD.Methods:Neonates with gestational age ≥37 weeks who were delivered in the Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from November 2017 to March 2019 were enrolled.General information on mothers and newborns were collected and neonatal AGD were measured.The distance from the male anus center to the base of the scrotum was determined to be the male AGD, and the distance from the female anus center to the posterior labia was recorded as the female AGD.The effects of maternal and neonatal factors on neonatal AGD were analyzed.Results:A total of 1 078 newborns were included, including 586 males and 492 females.Male AGD [(22.90±3.80) mm] was significantly greater than female AGD [(11.80±2.10) mm] ( t=22.316, P<0.05). The AGD of singleton neonates was significantly greater than that of neonatal twins [males: (23.01±3.82) mm vs.(21.18±1.88) mm, females: (11.89±2.08) mm vs.(10.98±1.75) mm, t=26.185, 18.326, all P<0.05]. Neonatal gestational age, birth weight, head circumference and length were significantly associated with AGD (all P<0.05). Maternal factors (including age, height, weight, body mass index, gravidity, parity, occupation, etc.) were not significantly associated with neonatal AGD (all P>0.05). The AGD of 10 children with genital malformation was significantly smaller than that of males with normal genital appearance [(22.89±1.99) mm vs.(23.55±3.78) mm]( t=15.362, P=0.006). Conclusions:The reference ranges of AGD in full-term males and females in Shanghai are(22.90±3.80) mm and (11.80±2.10) mm, respectively.The neonatal gestational age, birth weight, head circumference and length may be the intrinsic factors affecting neonatal AGD.

Objective To evaluate the efficacy of MRI-detected extramural venous invasion (mrEMVI) in predicting tumor responses to preoperative chemoradiatiotherapy (pre-CRT) in patients with locally advanced rectal cancer (LARC).Methods The clinicopathological data,tumor response and mrEMVI information of 47 LARC from February 2013 to December 2014 were retrospectively collected.mrEMVI was given 0-4 score according to the degree,3-4 score were defined as mrEMVI positive;patients with mrEMVI positive were divided into three subgroups according to vascular size (large,middle and small).Association between different mrEMVI subgroup and tumor response was analyzed using Fisher exact test.Result 26 patients were mrEMVI positive.18 and 8 patients scored 3 and 4 for mrEMVI positive,respectively;16,6 and 4 patients were small,middle and larger vessels of mrEMVI positive,respectively.Patients with mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.019).Scored 4 and larger vessel of mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.038 and 0.017).Conclusions mrEMVI positive score 4 or larger vessel predict poor tumor response to pre-CRT in patients of locally advanced rectal cancer.

High expression of Fightless I (FLII) is associated to multiple tumors. Based on our previous study that FLII might be involved in the nuclear export, we assessed the possible interaction of FLII with the nuclear envelop associating proteins Importin β and Nup88. We first constructed GST-FLII, GST-LRR recombinant plasmids and transformed them into the Rosetta strain to produce GST-FLII, GST-LRR fusion protein. After purification of these proteins, GST-pull down, as well as co-immunoprecipitation, were used to test the interaction of FLII with Importin β and Nup88. FLII interacted with Importin β and Nup88, and FLII LRR domain is responsible for these interactions. Thus, FLII may play a role in nuclear export through interaction with Importin β and Nup88.
Humans ; Microfilament Proteins ; metabolism ; Nuclear Pore Complex Proteins ; metabolism ; Receptors, Cytoplasmic and Nuclear ; metabolism ; Recombinant Fusion Proteins ; metabolism ; beta Karyopherins ; metabolism

Objective To assess the predictive value of Berden classification in ANCA associated glomerulonephritis.Methods Patients with confirmed ANCA associated glomerulonephritis were included,by retrieving the medical database in Peking Union Medical College Hospital from January 2000 to May 2015.Their detailed information during hospitalization and follow-up was recorded.The patients were divided into four categories based on Berden classification.The differences in clinical characters,renal function and response for treatment were compared.Results Among the 88 patients with ANCA-associated glomerulonephritis,19 (21.6％),21 (23.9％),32 (36.4％)and 16 (18.2％) patients were classified as focal,mixed,crescentic and sclerotic category.22 patients developed ESRD,and 19 patients died during follow up (1 patient developed ESRD before died).The mean estimated glomerular filtration rate (eGFR) at baseline was 68.04,25.45,30.04,15.16 ml·min-1·(1.73 m2)-1 (P ＜ 0.05) in focal,crescentic,mixed and sclerotic category,respectively.During follow-up period,focal category always had the best renal function,while sclerotic category had the worst renal function.Crescentic category and mixed category were similar and in the middle.Remission rate at 6m was 62.5％,73.7％,57.5％,30.8％(P ＞ 0.05).And crescentic category had the greatest improvement in eGFR at 6m.Conclusions Focal category had relatively preserved renal function and favorable renal outcome,while the sclerotic category had the worst renal outcome.Crescentic and mixed category had an intermediate outcome.We support the use of the Berden classification in predicting the renal prognosis of patients with ANCA associated glomerulonephritis.

Objective To evaluate the role of Toll-like receptor 4 (TLR4)-p38 mitogen-assoliated protein kinase (p38MAPK)-nuclear factor kappa B (NF-κB) signaling pathway in sevoflurane-induced decrease in cognitive function of aged rats.Methods Sixty SPF healthy male Sprague-Dawley rats,aged 20 months,weighing 550-750 g,were divided into 5 groups (n =12 each) using a random number table method:control group (C group),sevoflurane group (S group),TAK242 plus sevoflurane group (TS group),SB202190 plus sevoflurane group (SS group),and PDTC plus sevoflurane group (PS group).All the rats were intubated after anesthesia and connected to an animal ventilator.TAK242,SB202190 and PDTC 10 μl were injected into the lateral cerebral ventricle in TS,SS and PS groups,respectively,and normal saline containing the equal volume of DMSO was given in C and S groups.Starting from 10 min after lateral cerebral ventricle injection,4％ sevoflurane was inhaled for 6 h via the tracheal tube,with the inhaled oxygen concentration 30％ and oxygen flow rate 2 L/min.The mixture of air and oxygen was inhaled in C group.The learning and memory ability was assessed by Morris water maze test at 7 days after the end of sevoflurane anesthesia,and the escape latency and swimming distance were recorded.Animals were sacrificed after the end of Morris water maze test,and brains were removed and hippocampi were isolated for determination of neural apoptosis (by TUNEL),contents of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) in hippocampal tissues (by enzyme-linked immunosorbent assay),and expression of caspase-3,phosphorylated p38MAPK (p-p38MAPK),total p38MAPK (t-p38MAPK) and NF-κB in nucleus (by Western blot).The apoptosis rate and p-p38MAPK/t-p38MAPK ratio were calculated.Results Compared with C group,the escape latency and swimming distance were significantly prolonged at each time point,the apoptosis rate and contents of TNF-oα and IL-1β were increased,the expression of caspase-3,p-p38MAPK and NF-κB was up-regulated,and p-p38MAPK/t-p38MAPK ratio was increased in the other four groups (P＜0.05).Compared with S group,the escape latency and swimming distance were significantly shortened at each time point,the apoptosis rate and contents of TNF-α and IL-1β were decreased,and the expression of caspase-3 was down-regulated in TS,SS and PS groups,the expression of NF-κB was significantly down-regulated in TS and SS groups,and the expression of p-p38MAPK was significantly down-regulated,and p-p38MAPK/t-p38MAPK ratio was decreased in TS group (P＜0.05).Compared with TS group,the escape latency and swimming distance were significantly prolonged at each time point,the apoptosis rate and contents of TNF-α and IL-1β were increased,the expression of caspase-3 and p-p38MAPK was up-regulated,and p-p38MAPK/t-p38MAPK ratio was increased in SS and PS groups,and the expression of NF-κB was significantly up-regulated in PS group (P＜0.05).The expression of NF-κB was significantly up-regulated in PS group when compared with SS group (P＜0.05).Conclusion TLR4-p38MAPKNF-κB signaling pathway is involved in sevoflurane-induced decrease in cognitive function of aged rats.

Objective To evaluate the role of Toll-like receptor 4 (TLR4) signaling pathway in sevoflurane anesthesia-induced cognitive dysfunction in aged rats.Methods Twenty-seven SPF healthy male Sprague-Dawley rats,aged 20 months,weighing 550-750 g,were divided into 3 groups (n =9 each) using a random number table:control group (C group),sevoflurane anesthesia group (S group) and TLR4 antagonist plus sevoflurane anesthesia group (TS group).TLR4 monoclonal antibody 30 μl was injected into the lateral cerebral ventricle in group TS,and the equal volume of serum containing no antibody was injected into the lateral cerebral ventricle in C and S groups.At 10 min after completion of injection,S and TS groups inhaled the mixture of 4％ sevoflurane and 30％ oxygen for 6 h,and group C only inhaled the mixture of air and oxygen.Morris water maze test was performed at 24 h after the end of sevoflurane anesthesia.The animals were sacrificed after completion of Morris water maze test,brains were removed and hippocampi were isolated for determination of nerve cell apoptosis (using TUNEL) and expression of activated caspase-3 (using immunofluorescent staining).Nerve cell apoptosis rate was calculated.The expression of high-mobility group box 1 protein (HMGB1) mRNA in hippocampi was measured by Northern blot assay at 6 h after the end of sevoflurane anesthesia.The expression of amyloid precursor protein (APP) and amyloid beta protein (Aβ) in hippocampi was assessed by Western blot at 24 h after the end of sevoflurane anesthesia.Results Compared with C group,the escape latency was significantly prolonged,nerve cell apoptosis rate was increased,the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was up-regulated in group S,and nerve cell apoptosis rate was increased,the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was up-regulated (P＜0.05),and no significant change was found in the escape latency in group TS (P＞0.05).Compared with S group,the escape latency was significantly shortened,nerve cell apoptosis rate was decreased,and the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was down-regulated in group TS (P＜0.05).Conclusion Activation of TLR4 signaling pathway is involved in the mechanism of sevoflurane anesthesia-induced cognitive dysfunction in aged rats.

Objective To explore the effect of erythropoietin (EPO) attenuating apoptosis in old rat hippocampal neuronal cells exposed to sevoflurane and the role of toll like receptor 4.Methods Twenty months old SD rats,male,550-750 g,in accordance with the random number table,were divided into 3 groups (n =9):control group (group C),sevoflurane treatment (group S),and sevoflurane plus EPO treatment (group ES).The rats in group S and ES were subjected to inhale 4％ sevoflurane for 6 h,but the rats in group C were inhaled air-oxygen only.The rats in group ES were injected with EPO into caudal vein at 24 h,48 h,and 72 h after sevoflurane exposure.The cognitive ability was assessed by Morris water maze test;the effects of hippocampal apoptosis were assessed by TUNEL assays;the expressions of TLR4 mRNA was measured by RT-PCR assay;mitochondrial membrane potential (MMP) was assessed by JC-1 fluorescence;the expressions of APP and Aβ were assessed by western blot.Results Compared with group C,there were significant increases of escape latency period,neuronal apoptosis,TLR4 mRNA,and APP and Aβ expression,but a decrease of MMP in group S (P＜0.05).Compared with group S,there were significant decreases of escape latency period,neuronal apoptosis,TLR4 mRNA,and APP and Aβ expression,but a increase of MMP in group ES (P＜0.05).Conclusion The attenuation of rat hippocampal neuronal apoptosis induced by EPO could be associated with inhibition of TLR4,improvement of MMP,as well as inhibition of APP and Aβ activity.

Objective To evaluate the role of mitochondrial ATP sensitive potassium ( mito-KATP ) channel in dexmedetomidine-induced inhibition of subarachnoid hemorrhage ( SAH )-caused programmed cell death ( PCD) in cardiomyocytes of rats. Methods On hundred and twenty clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 350-400 g, were divided into 5 groups ( n=24 each) using a random number table method: sham operation group ( group Sham ) , SAH group, SAH plus dexmedetomidine group ( group SD) , 5-HD plus SAH and dexmedetomidine group ( group HSD) and 5-HD plus SAH group ( group HS) . The rats were subjected to SAH by intracranial vascular puncture after being anesthetized with pentobarbital sodium. Dexmedetomidine 5 μg∕kg was infused for 10 min via the jugular vein starting from the time point after intracranial vascular puncture, followed by a continuous infusion of 5μg·kg-1 ·h-1 for 1 h in SD and HSD groups. 5-HD 30 mg∕kg was intraperitoneally injected at 1 h before intracranial vascular puncture in HSD and HS groups. Blood samples were collected from the abdominal aor-ta at 24 h after intracranial vascular puncture for determination of serum cardiac troponin I ( cTnI) concen-trations. The animals were then sacrificed, and myocardial specimens were collected for determination of PCD rate ( by TUNEL) , reactive oxygen species ( ROS) activity ( by DCFH-DA assay) , and expression of cleaved caspase-3, cleaved caspase-1 and interleukin-1beta ( IL-1β) ( by Western blot) . Results Com-pared with group Sham, the serum concentrations of cTnI, PCD rate and ROS activity were significantly in-creased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in SAH, SD, HSD and HS groups ( P<0. 05) . Compared with group SAH, the serum concentrations of cTnI, PCD rate and ROS activity were significantly decreased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas down-regulated in group SD, and the serum concentrations of cTnI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in group HS ( P<0. 05) . Compared with group SD, the serum concentrations of cT-nI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1β was up-regulated in group HSD ( P<0. 05) . Compared with group HSD, the serum concentrations of cTnI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in group HS ( P<0. 05) . Conclusion mito-KATP channel is involved in dexmedetomidine-induced inhibition of PCD in cardiomyocytes of rats with SAH.

Objective To explore the changes of cognitive ability in elderly rats induced by sevoflurane exposure,and their relation with Toll like receptor 4 (TLR4)-MyD88 signal pathway.Methods Forty-eight male SD rats,weighting 550-750 g,in accordance with the random number table,were divided into 4 groups (n=12):control group (C group),sevoflurane treatment group (S group),sevoflurane plus TAK242 treatment group (TS group),and sevoflurane plus ST2825 treatment group (SS group).The rats in S,TS and SS groups were subjected to inhale 4％ sevoflurane for 6 h,but the rats in C group were inhaled by air-oxygen only.The rats in TS and SS group were injected with 20 μL TAK242 (1 g/L) or 20 μL ST2825 (1 g/L) via lateral ventricle 10 min before sevoflurane exposure,respectively.The cognitive ability was assessed by Morris water maze test and open field test;the levels of hippocampal tumor necrosis factor (TNF)-α and interleukin (IL)-1β were assessed by ELISA;the Aβ expressions was assessed by Western blotting.Results As compared with those in the C group,significant increase of escape latency,time of the animals spent in the central square,and TNF-α,IL-1β and Aβ expressions,but decrease of number of crossing the grid,and smaller number of standing on the back legs were noted in the S group (P＜0.05).As compared with S group,TS and SS group had significantly decreased escape latency,time of the animals spent in the central square,and TNF-oα,IL-1β and Aβ expressions,but statistically larger number of crossing the grid and number of standing on the back legs (P＜0.05).Conclusion The cognitive dysfunction of elderly rats induced by sevoflurane exposure could be associated with TLR4-MyD88 signal pathway.