Objective To evaluate the efficacy of epidural block combined with general anesthesia for elderly upper abdominal surgery Methods Thirty-four elderly patients ,scheduled for elective upper abdominal surgery, ASA grade Ⅰ-Ⅱ, were divided randomly into study group (groupⅠ) and control group (group Ⅱ) In both groups anesthesia was induced with introvenous diazepam 0 1mg?kg -1, fentanyl 5?g?kg -1, etomidate 3mg?kg -1, atracurium 0 2 mg?kg -1 and succinylcholine 2 mg?kg -1, and was maintained with intravenous infusion of propofol 4-10ml/h and/or inhalation of 1% isoflurane and intermittent bolus of atracurium In groupⅠ epidural block was performed before induction Hemodynamics was measured with impendence cardiography and electroencephagram were monitored and intraoperative awareness, postoperative restlessness and anesthetic dosage were recorded, also the concentrations of plasma vasopressin and blood glucose were determined at pre-operation, incision and the end of surgery Results In group Ⅰ MAP,CO,HR incresed slightly during intubation, incision and extubation, and systemic vascular resistance (SVR) decreased during operation , but SVR was increased abruptly after extubation in group Ⅱ There were unsignificant changes in thoracic fluid index(TFI), stroke volume(SV), ejection volume index(EVI), EVI/TFI ratio in both groups during whole procedures SEF was recovered more earlier in group Ⅰthan that of in group Ⅱ after extubation The vasopressin and glucose levels increased significantly after-extubation compared with those before operation in group Ⅱ Conclusions The epidural block combined with general anesthesia can be more effectvely and safely applied to elderly upper abdominal surgery

Objective: To study an epidemiological methodology for domestic violence. Methods:A program was drawn,the epidemiological instruments were developed, investigators were trained, not only according to the principles of epidemiology but also being suited to Chinese condition. Then,We win over the support of government bodies, arouse the messes to action, and all clues from investigation were confirmed by interview with persons concerned.Spot check randomly was used for control of quality.Results:The reliability of the epidemiological instruments was 97%, the sensitivity was 95%, the specificity was 100%. The prevalence of domestic violence in life-time and past year was 16.2% and 11.6% respectively.Conclusion:This was a practical methodology in epidemiological survey for domestic violence in China.

Objective To study atrioventricular conduction during right coronary artery infarction and its correlation with sympathetic nerve.Method AIMI model by ligating the fight coronary artery of denervated autonomic nervous cats was used.The A,H and V-wave were measured from the His electrode by template matching.The AA,AH,HV intervals with and without sympathetic nerve stimulation were measured respectivelv.Results The decreased percentage of AH intervals was (7±5)% vs.(14±5)% (without pacing) and (12±2)% vs.(23±7)% (with pacing) respectively in ischemia and normal after sympathetic nerve stimulation,and the decreasing amplitude were 50% and 48% respectively.Conclusion The regulating function of sympathetic nerve on atrioventricular conduction decreased after ischemia related to the right coronary artery.This decrease may be one of the mechanisms that lead to atrioventficular block after acute inferior myocardial infarction.

Objective To investigate the influence of bloody cervical cell samples on human papillomavirus(HPV) genotyping detection using flowcytometry fluorescence hybridization kit.Methods According to the concentration of hemoglobin(Hb),cervical cell samples were divided into five groups,including group A with Hb of 0 g/L(10 cases),group B with 0 g/L100 g/L.In each group,50% samples were with initial positive results of HPV genotyping detection.Every sample was detected using sample volume of 50,100,200,500 and 1 000 μL different volumes for testing and analysis results.Results For all samples with initial negative results,five samples with initial positive results in group A and five samples with initial positive results,the detected results of different sample volume were without differences.In the 10 samples,with initial positive results of group C,D and E,there were four,four and nine samples respectively,were with false negative detected results of different sample volumes.Conclusion Bloody cervical cell samples could cause false negative results of HPV genotyping detection using flowcytometry fluorescence hybridization kit.It might be necessary to set optimal sample volume according to the concentration of Hb for ensuring the accuracy of genotyping detection.

Objective: To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD. Methods: The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. Results: A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005]. Conclusions The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

AIM: To investigate the effects of curcumin (Cur) on the expression of High mobility group box 1 protein (HMGB1), interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α) in amyloid-β(Aβ)-induced primary rat microglial cells.METHODS: Microglia were derived from the cerebral cortices of postnatal rat brains.The cells were i-dentified by immunocytochemistry using mouse anti rat Iba-1 monoclonal antibody.A cell model using primary rat microgli-al cells incubated with Aβ25-35 as an inflammation model of Alzheimer’s disease (AD) was set up.The morphological char-acters of primary rat microglial cells were observed.The concentration of Aβ25-35 and the treatment concentration of curcumin were selected by CCK-8 assay.Cultured primary rat microglial cells were divided into 5 groups: normal cell group, Aβ25-35 group, Cur group, Aβ25-35 +Cur group and Aβ25-35 +DMSO group.The expression of HMGB1, NF-κB, and receptor for advanced glycation end products (RAGE) was detected by Western blot.The levels of HMGB1, IL-1β, and TNF-αin the culture supernatant were measured by ELISA.RESULTS: The purity of primary microglias determined by Iba-1 immuno-fluorescence was more than 95%.The protein levels of HMGB1, RAGE and NF-κB were significantly increased after Aβ25-35 stimulation.After treatment with Cur, the protein levels of HMGB1, RAGE and NF-κB were significantly decreased (P <0.05).The levels of HMGB1, IL-1βand TNF-αin the supernatant were significantly increased after Aβ25-35 stimula-tion.Cur significantly decreased the level of HMGB1, IL-1βand TNF-αin the supernatant.CONCLUSION: Curcumin significantly inhibits neuroinflammation stimulated by Aβ25-35 in primary rat microglial cells.

This study was aimed to identify and distinguish Metacordyceps liangshanensis recorded by the Sichuan Province Traditional Chinese Medicine Standard from its adulterants and its relative species by combining ITS and COI barcode sequences in order to study the feasibility of this new method. After extracting DNA of 28 species of Cordyceps samples, DNA were amplified and sequenced. And then, ITS and COI sequences were received. Codon-Code Aligner V3.7.1 and Mega 5.0 were used to analyze the variable site and construct the N-J tree. The results showed that the minimum ITS inter-specific K-2P distance was relatively higher than the maximum intra-specific K-2P distance. The inter-specific sequence divergence between M. liangshanensis and its adulterants exhibited high while intra-specific sequence divergence exhibited low. And COI one was the same case. N-J tree of both ITS and COI indicated that same genus belonged together and each species belonged to relatively independent branch. It was concluded that based on the ITS and COI gene, the technology of DNA barcode can be an excellent identification of M. liangshanensis, its adulterants and its relative species. It provided technical support for the further research on species molecular identification and phylogenetics of Cordyceps .

Objective This study aimed to explore clinical characteristics of four types of obesity based on metabolic classification. Methods Forty-eight obese patients were divided according to their clinical characteristics into 4 groups including metabolic healthy obesity (MHO), hypometabolic obesity (LMO), hypermetabolic obesity (HMO), and metabolic obesity with inflammation (IMO). 20 normal weight individuals were also recruited as a control group. Body fat, body weight, visceral index, and basal metabolism were measured by Omron body fat meter. Fat content and its distribution were measured by dual energy X-ray absorptiometry. All participating patients underwent various tests for 75 g oral glucose tolerance, blood glucose, insulin, C peptide. Lipid profile, thyroid function and sex hormones levels, and inflammation factors were also measured. Results (1)Patients in MHO group had higher body fat content, but had no metabolic disorder and inflammation. Their hormones levels were normal. (2) Lower metabolic rate and lower hormones levels were found in the patients in LMO group with increasing visceral fat. Trunk/subcutaneous fat mass was significantly higher than that in MHO group(1. 19 ± 0. 25 vs 0. 97 ± 0. 32, P<0. 05). There were abnormal lipid and glucose metabolism in LMO group. The insulin action index was significantly lower than that in MHO group(0. 006 6 ± 0. 002 7 vs 0. 012 1 ± 0. 009 5, P<0. 05). The area under the curve of glucoseconcentrationwassignificantlyhigherinLMOgroupthanthatinMHOgroup[(18.71±8.68vs12.70±4.63) mmol/L, P<0. 05]. (3)Heart rate and blood pressure were higher in HMO group. The heart rate was significantly increased compared with that in MHO group [(90. 50 ± 8. 24 vs 73. 20 ± 14. 11) beat/min, P<0. 05]. The waist circumference was significantly larger than that in MHO group [(111. 88 ± 10. 54 vs 98. 05 ± 15. 56) cm, P<0. 05]. (4) In IMO group, insulin action index was significantly lower than MHO group (0. 007 0 ± 0. 003 3 vs 0.0121±0.0095,P<0.05). ThetrunkfatmassanduricacidlevelsweresignificantlyhigherthanMHOgroup [(17236.38±4610.60vs15816.10±5453.42)gand(468.28±121.32vs376.84±97.14) μmol/L,bothP<0. 05]. Patients in IMO group had acanthosis nigricans, but their glucose level was relatively normal. Conclusion The metabolic-based obese diagnosis is essential for understanding the obesity etiology and providing individualized treatment.

Objective To unravel the relationship between Toll-like receptor 4 (TLR4) expression in platelets and the activation of platelet in thrombocytopenia (TCP) in case of sepsis. Method A total of 64 patients with sepsis were prospectively studied with control. Platelet count (PC), mean platelet volume (MPV),platelet distribution width (PDW),platelet TLR4 expression, platelet PAC-1 expression, sCD40L and TNF-α concentrations were compared between healthy control group (15 cases) and sepsis group on admission and 3 d,Sd,and 9 days after admission. The changes of MPV and PDW in TCP and non-TCP subgroups of sepsis before and after treatment were recorded. Prognostic index was analyzed. Results The PC was lower in sepsis group (P=0.006), and MPV and PDW were higher in sepsis group than those in healthy control group (P = 0.046, P =0.001). Platelet TLR4 and PAC-1 expressions, and sCD40L and TNF-α levels also increased more significantly in sepsis group (P ＜ 0.001). PAC-1 expression and TNF- level were higher in TCP group than those in non-TCP group before and after treatment (P = 0.023, P = 0.011). The sCD40L concentration and platelet TLR4 expression were significantly higher in treated TCP groups than in non-TCP group (P = 0.047, P = 0.001). Compared with non-TCP,the rate of bleeding was higher (P = 0.024) and the length of ICU stay was longer (P = 0.013).The APACHE Ⅱ score and the 28-day mortality were higher in TCP group (P ＜ 0.01, P = 0.048). Conclusions The elevation of platelet TLR4 expression in sepsis along with platelet activation is closely related to the incidence of thrombocytopenia. The occurrence of TCP is a poor prognosis sign of sepsis.

lusions Cardiac MSCT can accurately assess the RV size and function in comparison to MRI. Patients with severe COPD have RV dysfunction.