OBJECTIVE:To investigate the effects of etomidate combined with propofol on painless gastrointestinal endoscopy and cognitive function of elderly patients. METHODS:Totally 90 elderly patients with painless gastrointestinal endoscopy were ran-domly divided into propofol group(30 cases),etomidate group(30 cases)and combination group(30 cases). Propofol group was given Fentanyl injection 1 μg/kg+Propofol injection 1.5 mg/kg;etomidate group was given Fentanyl injection 1 μg/kg+Etomidate injection 0.3 mg/kg;combination group was given Fentanyl injection 1 μg/kg+Propofol injection 1 mg/kg+Etomidate injection 0.15 mg/kg. The levels of SBP,DBP,HR,MAP and SpO2 at different time points,examination time,anesthesia induction time,recov-ery time and recovery time of orientation were observed in 3 groups. NCSE and MMSE score at different time points,the occur-rence of ADR were also observed in 3 groups. RESULTS:During examination,SBP,DBP,MAP and SpO2 of propofol group were significantly lower than before anesthesia,after examination and those of combination group,with statistical significance(P<0.05);but there was no statistical significance in above indexes of propofol group between during examination and before anesthesia (P>0.05). The recovery time and recovery time of orientation in combination group were significantly shorter than propofol group and etomidate group,with statistical significance(P<0.05),but there was no statistical significance in above indexes between etomidate group and propofol group(P>0.05). The proportion of patients'memory ability,computing ability,orientation ability passing examination in combination group were significantly higher than propofol group,with statistical significance(P<0.05). There was no statistical significance in above indexes between combination group and etomidate group,between etomidate group and propofol group(P>0.05). There was no statistical significance in MMSE score of combination group at different time points (P>0.05);MMSE score of propofol group 15,30 min after anesthesia and that of etomidate group 15 min after anesthesia were significantly lower before anesthesia and combination group,with statistical significance(P<0.05). There was no statistical signifi-cance in MMSE score of propofol group 1 h after anesthesia,etomidate group 30 min and 1 h after anesthesia,compared to before anesthesia(P>0.05). The incidence of apnea,hypotension and injection pain in combination group and etomidate group were low-er than propofol group,the motor response,myoclonus,nausea and vomiting in combination group and propofol group were lower than etomidate group,the tachycardia ease in combination group was lower than propofol group,with statistical significance(P<0.05). CONCLUSIONS:Etomidate combined with propofol anesthesia shows good therapeutic efficacy for painless gastrointestinal endoscopy of elderly patient,can reduce cognitive dysfunction and shortens recovery time,but doesn't increase the occurrence of ADR.

Objective To observe and analyze the changes of prostaglandin E2 (PGE-2)and elastase (EA)levels in the pulp blood of the patients with carious tooth complicated with exposed pulp and its influence on the curative effects of direct pulp capping treatment.Methods 80 cases of the patients with carious tooth complicated with exposed pulp treated with direct pulp capping treatment were selected as the observation group and 40 cases of the patients treated with normal removal of impacted third molar were selected as the control group.The levels of PGE-2 and EA in the pulp blood of the patients in the two groups before the treatments were detected and compared.A one-year follow-up was employed for the patients in the observation group and the curative effects were evaluated and compared.Results The levels of PGE-2 and EA in the pulp blood of the patients in the observation group were 132.28±63.55 ng/ml and 114.36±19.57μg/ml respectively,and the levels of PGE-2 and EA in the pulp blood of the patients in the control group were 0.61±1.26 ng/ml and 19.38±6.34μg/ml respectively.There were statistically significant differences between the two groups (t=43.129,29.675,P<0.05). There was a positive relationship between the PGE-2 level and EA level in the pulp blood of the patients in the observation group (r=0.782,P<0.05).The levels of PGE-2 and EA in the pulp blood before the treatment of the patients with suc-cessful effects were 84.63±13.17 ng/ml and 68.25±8.16μg/ml,and the levels of PGE-2 and EA in the pulp blood before the treatment of the patients with failed effects were 177.35±41.42 ng/ml and 152.36±16.28μg/ml.There were statisti-cally significant differences between the two types of patients (t=31.578,21.556,P<0.05).Conclusion The patients with carious tooth complicated with exposed pulp show the significantly increased expression levels of PGE-2 and EA in pulp blood.The higher expression levels of PGE-2 and EA before the treatment could put adverse influence on the curative effects of direct pulp capping treatment.The clinicians should give the comprehensive consideration to the specific condition of pa-tients to choose the proper treatment methods.

Objective To observe the effects of nerve impulses on the expression of carbonic anhydrase Ⅲ ( CAⅢ ) and its phosphatase activity, and to explore whether or not the cause of CAⅢ expressive decreased in skeletal muscles of myasthenia gravis( MG) is resulted from the obstruction of nerve impulse.Methods The motor nerves of extensor digitorum longus (EDL, mainly composed by fast fibers) and soleus (Sol, mainly composed by slow fibers) were cut off by operation of denervation.Levels and phosphatase activities of CAⅢ were analyzed at 7, 14, 28, and 56 d after denervation by Western blot and specific enzyme staining on the membrane following SDS-polyacrylamide gel electrophoresis, respectively.Results (1) Levels of CAⅢ in Sol of normal side (eg denervated contralateral) were much higher than that in EDL of normal side, and the levels in both Sol and EDL had an enhanced tendency with time (age) increase, especially for Sol.After denervation, the levels of CAⅢ in EDL were gradual increased, however, the level in Sol was 14 d after denervation as the boundary of ascension and then decline.( 2) The phosphatase activities of CAⅢ in Sol of normal sides were much higher than that in EDL of normal sides, and there were an enhanced tendency with time (age) increase in Sol, but no significant changes were found in EDL The enzyme activities in denervated Sol were lower(in the 14, 28, and 56 days after denervation: 14.39 ±1.93, 11.48 ±1.46, 9.04 ±1.46) much than their contralaterals(22.75 ± 1.80, 25.26 ±3.15, 25.82 ± 2.97; t = 0.002, 0.005, 0.002, all P ＜ 0.05), the enzyme activities in denervated EDL were also lower than their contralaterals, however, no significant differences were found.(3)It was consistent for CAⅢ levels and phosphatase activities in both Sol and EDL of normal sides.After denervation, however, the deviation of the CAⅢ levels and phosphatase activities happened, the levels of CAⅢ were increased, but the phosphatase activities were decreased.Conclusions The effect of nerve impulse transferring obstructed by denervation on CAⅢ expression of skeletal muscles is different from that by MG auto-antibody.The decrease of CAⅢ protein in the MG muscles may be not resulted from the nerve impulse transferring obstructed by MG auto-antibody.

Taking children malnutrition,diabetes insipidus and diarrhea as examples,it introduces doctor He Guantao’s clinical experience in treating children disease with ebony,viewing that he makes conclusion with practice,often curing hard diseases with smart formula descriptions.

OBJECTIVE: To investigate the statistical method of tri-allelic patterns of STR loci. METHODS: The DNAs of venous blood and blood stain samples from 8,846 unrelated individuals were extracted using magnetic bead method, and STR genotypes were determined by multiplex fluorescent amplification and capillary electrophoresis and analyzed using GeneMapper ID v3.2 software. The genotype frequency and allele frequency of trizonal were determined by direct counting and formula, respectively, in order to deduce the formula of trizonal in paternity test and individual recognition. RESULTS: Of the 8,846 individuals, four tri-alleles and three tri-genotypes were detected. The multiplying of allele frequency and actual rate showed significantly statistical difference. The formula of trizonal in paternity test and individual recognition was successfully deduced. CONCLUSION The frequency of the two alleles inherited as a whole in the population could be calculated by multiplying the frequencies of each allele in the tri-allelic patterns.
Alleles ; Gene Frequency ; Genetic Loci ; Genetics, Population ; Genotype ; Humans ; Microsatellite Repeats ; Polymorphism, Genetic

Objective:To study the behavior problems in children with Tourette syndrome and related family factors.Methods:132 children with Tourette syndrome were collected as our sample. Their parents completed CBCL (child behavior checklist) and FES (family environment scale).Results:The rate of behavior problems in this group was 26.5%, much higher than that of normal children (13.6%). The main factors having influence on this included expressiveness, independence and initiative, entertainment and moral religion. The Wald of the four factors in Logistic regression were 13.73, 10.35, 7.97 and 5.62(P

Objective To explore the clinical application of material decomposition technique on spectral CT imaging and evaluate hemodynamic changes in different liver lobes with liver cirrhosis.Methods 30 patients with liver cirrhosis diagnosed clinically in our hospital were collected and underwent enhanced scanning of abdomen with spectral CT protocol.The monochromatic energy images and iodine-based material decomposition (MD) images were reconstructed after scanning.The iodine concentration (IC) was measured in five liver lobes (the caudate, left lateral, left inner, right anterior and right posterior lobes) and the abdominal aorta of the same axial slice in both the arterial phase (AP) and portal venous phase (VP) on the iodine-water based material decomposition images.The arterial iodine fraction (AIF) and the portal venous iodine concentration (PVIC) as well as the normalized iodine concentration (NIC) during the AP and VP were calculated.The differences of IC,the NIC,the AIF,and the PVIC in five liver lobes in AP and VP were compared by using single factor analysis of variance.Results The IC,the NIC in both AP and VP and the AIF of the caudate liver lobe were higher than those of other four liver lobes, with statistically significant difference (P<0.05), while these values in the other four lobes showed no statistically significant difference (P>0.05).The PVIC of the caudate liver lobe was slightly lower than that of the other four liver lobes, however, the difference was not statistically significant (P=0.929).Conclusion The quantitative iodine concentration measurement of liver lobes on spectral CT material decomposition technique can evaluate the hemodynamic changes in liver lobes with liver cirrhosis,and provide more information about the change of blood flow in liver cirrhosis.

OBJECTIVE To analyze the characteristic of vancomycin-resistant Enterococcus(VRE) infection after orthotopic liver transplantation, and provide a basis to improve prophylaxis and therapy. METHODS A retrospective survey in 136 patients who underwent orthotopic liver transplantation was carried out to define the incidence, clinical feature and therapeutic outcome of VRE infection. RESULTS Eleven patients were infected by VRE in this study and the incidence of infection by VRE was 8.1% following liver transplantation. Totally 31 of the VRE isolates were isolated, including 26 Enterococcus faecium strains and 5 E. faecalis strains. Sites of VRE infection included abdomen(n=4), blood(n=2), and respiratory tract(n=2). In the other 3 patients, VRE was cultured from multiple sites. Among 11 patients with VRE infection, 4 were sensitive to teicoplanin, and 7 resistant to teicoplanin. So 4 patients received antibiotics with teicoplanin and 7 patients with linezolid. In this study, 10 patients were cured and 1 patient died of sepsis. CONCLUSIONS VRE has become an nosocomial pathogen of increasing importance in liver transplantation patients. The risk factor of VRE infection should be paid attention. Infection prophylaxis of VRE should be emphasized.

OBJECTIVE:To observe therapeutic efficacy and safety of Shensong yangxin capsule combined with low-dose ami-odarone in the treatment of ventricular tachyarrhythmia. METHODS:In retrospective analysis,106 patients with ventricular tachyar-rhythmia were divided into control group and observation with 53 cases in each group according to drug use. Based on conventional treatment,control group was additionally given Amiodarone tablet (first week:0.2 g each time,3 times a day;second week:0.2 g each time,2 times a day;third week to the end of the treatment:0.2 g each time,1 times a day),orally. Observation group was given Amiodarone tablet (first week:0.2 g each time,twice a day;second week to the end of the treatment:0.2 g each time,1 times daily),orally +Shensong yangxin capsule 1.6 g,3 times a day,orally. Both groups were treated for 8 weeks. Clinical effica-cy,blood pressure,heart rate and electrocardiogram(PR period and QT period)and the cardiac cardioversion time were compared between 2 groups,and the occurrence of ADR was also recorded during treatment. RESULTS:After treatment,total response rate of observation group(94.34%)was higher than that of control group(81.13%),the incidence of ADR was lower than that of con-trol group (3.77% vs. 13.21%) and the cardiac cardioversion time was shorter than that of control group,with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in heart rate between 2 groups;after treatment,heart rate of 2 groups were significantly lower than before,and observation group was significantly lower than control group,with statistical significance(P<0.05). There were no statistical significance in blood pressure、PR period and QT period between 2 groups before and after treatment (P>0.05). CONCLUSIONS:Based on conventional treatment, Shensong yangxin capsule combined with low-dose amiodarone have good therapeutic efficacy with rapid response for ventricular arrhythmia,it can significantly improve the heart rate of the patients,and the effect is faster with good safety .

Parkinson′s disease(PD)is a common disease caused by multiple factors and characterized by pathological degen?eration in the dopaminergic neural system. Based on its pathogenic factors,PD can be divided into several subtypes,so it is essential to develop therapeutic agents based on the main pathogenic factor of each subtype of PD. Recently it is confirmed that the mutation of leucine-rich repeat kinase 2(LRRK2)gene leads to increased activity of the LRRK2 notably,and then causes neurodegeneration. Thus developing LRRK2 inhibitors to modulate the kinase activity will be a novel therapy for the PD subtype which is caused by LRRK2 gene mutation. LRRK2,either a kinase or a GTPase,has two drug binding sites. Therefore,two types of LRRK2 inhibitors are being studied,one is the kinase inhibitor and the other is GTPase inhibitor. This paper summarizes the recent progress in the dis?covery and development of LRRK2 inhibitors.