Objective To observe the effects of parecoxib sodium on laparoscopic cholecystectomy ( LC ) patients after remifentanil fast track anesthesia.Methods 120 patients underwent general anesthesia for laparoscopic cholecystectomy were divided into two groups using random number table,60 cases in each group.The observation group was injected parecoxib sodium 40mg+saline solution 5 mL,while the control group was injected only saline so-lution 5mL prior to induction of anesthesia.The heart rate,mean arterial pressure,awaked time,pain score,agitation score and adverse reaction were compared.Results 5, 15, 30min after extubation, heart rate were ( 75.7 ± 4.8)times/min,(79.3 ±6.2)times/min,(74.2 ±5.2)times/min in the observation group and (85.2 ±3.8)times/min, (88.2 ±5.9)times/min,(86.1 ±6.2)times/min in the control group,and the mean arterial pressure were (103.5 ± 11.3)mmHg,(104.7 ±12.6)mmHg,(108.4 ±12.7)mmHg in the observation group and (132.3 ±16.3)mmHg, (135.2 ±14.6) mmHg,(133.6 ±11.8) mmHg in the control group,there were statistifically significant differences (t=4.722,4.357,4.236,4.732,4.367,4.063,all P <0.05).The pain score,agitation score were (2.5 ± 0.9)points,(1.4 ±0.8) points in the observation group,which were lower than (4.2 ±1.2) points,(3.2 ± 1.2)points in the control group(t =4.232,5.234,all P<0.05).Conclusion Parecoxib sodium can reduce the fast-track anesthesia agitation and pain,improve hemodynamics and stress response in LC patients.

Objective To investigate the relationship between homocysteine(Hcy)and blood uric acid(UA)in the patients with type 2 diabetes mellitus(T2DM)complicating hypertension.Methods 85 patients with T2DM complicating hypertension were se-lected as the groupⅠ,78 patients with simple T2DM as the group Ⅱ and 74 individuals with healthy physical examination as the group Ⅲ.Hcy,UA,TC,TG and HDL-C were measured in all the subjects.Results Compared with group Ⅲ(control),the levels of Hcy,UA,TC and TG in the group Ⅰand groupⅡwere significantly increased(P <0.05),but the level of HDL-C was significantly decreased(P <0.05).Compared with the group Ⅱ(T2DM),the levels of Hcy,UA,TC and TG in the group Ⅰwere significantly in-creased(P <0.05 ),but the level of HDL-C was obviously decreased,the difference had statistical significance (P <0.05 ).There was good positive correlation between the Hcy level and the UA level in the patients with T2DM complicating hypertension (r =0.658,P <0.05).Conclusion The levels of Hcy and UA are significantly increased in the patients with T2DM especially complica-ting hypertension.High Hcy and high UA are the important risk factors of T2DM complicating cardiocerebrovascular diseases.

Objective:To evaluate the effects of domestic recombinant adenovirus p53 injection (rAd-p53,Gendicine) combined with cisplatin (DDP) on growth and apoptosis of ovarian carcinoma cell lines. Methods:MTT assay, flow cytometry, and Western blotting were used to compare the effects of rAd-p53, DDP and their combination on the growth, cell cycle, apoptotic rate, and p53 protein expression of ovarian carcinoma cell lines. Results:rAd-p53 inhibited ovarian carcinoma cells proliferation in dosE- and timE-dependent manners. After combined treatment, the growth inhibition rate was significantly increased (P<0.01). There was no significant diffE-rence in the inhibition potency induced by combined treatment with different sequences (P>0.05). Combined treatment significantly arrested ovarian carcinoma cell lines in G0/G1 phase at 72 h, the cell number in S phase was significantly decreased and the apototic rate was significantly increased (P<0.01). High expression of p53 protein was detected in ovarian carcinoma cell lines at 72 h after administeration of rAd-p53. Conclusion:rAd-p53 tranfects the exogenous widE-type p53 into the genome group of human ovarian tumor cells, induces p53 protein expression, thereby arresting tumor cells at G0/G1 phase, inhibiting tumor growth, and inducing apoptosis.

Objective To know the role of inhibitor of DNA binding 2(Id2) in the development of neural stem cells(NSCs) in the anterior subventricular zone(SVZa). Methods To examine the expression of Id2 in SVZa,rostral migratory stream(RMS) and olfactory bulb(OB) in E14,P0,P7,P14,P30 adult and old rat brains by reverse transcriptase-polymerase chain reaction(RT-PCR),Western blotting and immunohistochemistry. Results The expression of Id2 peaked at the area of RMS,and was less positive in SVZa and the least in OB at different time courses of developing rat brains.The expression of Id2 in the three areas in E14 were higher than that on the postnatal day,higher in OB and RMS in adult than that on P0,and remain high in old.However,the expression of Id2 in SVZa in adult was weaker than that on P0.Conclusion The expression of Id2 in the deveolpment of SVZa NSCs indicates that Id2 plays an important role in blocking the differentiation of SVZa NSCs and increasing the proliferation of SVZa NSCs.

Objective To explore the correlation between delirium and dementia in elderly patients undergoing hip fracture surgery.Methods A prospective study was conducted on 118 elderly patients with hip fracture who were free from prefracture dementia.Caregivers or the relatives described the patients' prefracture cognition by the Informant Questionnaire on Cognitive Decline in the Elderly-short form (IQCODE SF).Delirium was assessed by the Confusion Assessment Method (CAM).After 6 months,cognition was reassessed by using 5 cognitive tests,taking DSM-Ⅳ as the diagnostic criteria.Results Among 32 cases (27％) suffered from delirium in the acute phase,12 cases (38％) reached to the diagnostic criteria of dementia after 6 months follow up,while there were 6 cases (7％) reached to the diagnostic criteria of dementia after 6 months follow-up in the group without delirium in the acute phase (x2 =16.81,P＜0.001).IQCODE-SF score had no statistically significant difference in the prediction of dementia.Conclusions In elderly patients without the history of dementia,delirium after hip fracture surgery is the major predictor of dementia within half years.

Degeneration of the lumbar facet joints is considered to be one of the main causes of low back pain,which severely impact the life quality of people.This article sums up the research advancement of the lumbar facet joints degeneration of domestic and foreign scholars in recent years,and summarizes the characteristics of the X-ray,CT and MRI and clinical significance of the degeneration of articular process,of which the characteristic of MRI was rarely reported domesticly.The purpose is to provide ideas and references for domestic scholars aiming to further clinical research of related fields in the future.

Objective To investigate the changes of the expression of GDNF and GDNFR?1 of long-term denervation of posterior cricoarytenoid muscles(PCAMs).Methods 38 patients with vocal paralysis were grouped into four according to their denervated period of time while 12 normal PCAMs as control group.Using double immunofluorescence stain,changes of GDNF and GDNFR1 expression were observed in myofibers at different time points after denervation.Results Double immunofluorescence stain with antibodies against GDNF and GDNFR1 showed no staining in the control group,and study groups.However,after the muscle denervation lasted for 6-12 months and 1-2 years,noted was a significant accumulation of GDNF and GDNFR1 protein in cytolemma and endochylema of myofiber.The mean grey scales and positive region ratios were compared using the image analysis system.The results revealed the levels of GDNF and GDNFR1 protein expression in 6-12 months group,1-2yr group changed significantly(P0.05).Conclusion The changes in expression of GDNF and the acceptor GDNFR-?1,a powerful neurotrophic factor,implied that a good nervous regenerated microenvironment in PCAMs within 2 years.This experiment indicated that denervated posterior cricoarytenoid muscles are able to regain their functions through reinneration within 2 years.

Objective This study was to observe the effects of different test conditions on the qualitative and quantitative detection of cryoglobulin .Methods We prepared 5 blood samples of different types of cryoglobulinemia . We detect the cryoglobulin qualitatively and quantitatively at different temperatures (37 ℃and room temperature of 20-25 ℃), and with different observation time (3 days and 7 days) and with different amount of blood (5 ml and 20 ml) .Further we will categorize the type of cryoglobulin and detect the components of cryoglobulin by immunofixation electrophoresis ( IFE) and other laboratory tests.Results (1) Blood samples from two groups were clotting and the serums were separated at 37 ℃ and room temperature respectively , and cryoglobulins of two groups were all qualitatively positive . Quantitative detection of cryoglobulins showed that the concentrations of cryoglobulins of room temperature group are lower than that of 37℃group;(2) Compared with 7 days, observing for only 3 days may lead to false-negative results in qualitative detection of cryoglobulin , and concentrations of cryoglobulin are also decreased;(3) Compared with 20 ml blood sample,5 ml blood sample is not enough for qualitative and quantitative detection of cryoglobulins .It may lead to false-negative results;(4) After purification, IFE and other laboratory tests can be used to categorize the types and find the components of cryoglobulins .Such examinations are helpful for finding the potential causes of cryoglobulinemia .Conclusions The positive of serum cryoglobulin is a key indicator of cryoglobulinemia .Detection of cryoglobulin can be affected by temperature, observed time and the blood volume for measurement .In addition, IFE and other laboratory tests are helpful for finding the type and the components of cryoglobulin .

BACKGROUND:There is no consensus on the choice of anatomic plate or dynamic hip screw for the treatment of intertrochanteric fracture. Current research is limited to smal-sample studies, and it is difficult to carry out a large-sample multicenter analysis. OBJECTIVE:To carry out Meta-analysis about the literature on anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures, in order to evaluate the efficacy of anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures. METHODS:The PubMed database (1995-2013), EMCC database (1995-2013), CBM database (1995-2013), CNKI database (1995-2013), VIP database (1989-2013) and Wanfang database (1995-2013) were searched by computer to col ect the control ed trials of anatomic plate versus dynamic hip screw for the treatment of intertrochanteric fractures. Then, the retrieved studies were screened according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated to extract useful y data, and Meta-analysis was performed by using the RevMan5.0 software. RESULTS AND CONCLUSION:A total of 19 control ed trials were included with a total of 1 730 cases. Among them, 764 cases were belonged to the anatomic plate group, and dynamic hip screw group included 966 cases. The Meta-analysis results indicated that there were no statistical y significant differences in fracture healing time, prognosis excellent and good rate and postoperative complications between two groups (P=0.34, 0.58, 0.80);the operative time, intraoperative blood loss and postoperative drainage volume in the anatomic plate group were lower than those in the dynamic hip screw group (P<0.000 01). The results indicate that anatomic plate and dynamic hip screw have the similar clinical efficacy for the treatment of intertrochanteric fractures, but the anatomical plate has relatively simple operation and less bleeding. Due to the poor quality of the included literatures and high bias occur and influence the effect, so more wel-designed multi-center randomized control ed trials should be performed to provide high-quality evidence.

Objective:To investigate the change in myogenin expression at different time in long-term denervated human posterior cricoarytenoid muscles(PCAMs),so as to provide a theoretical basis for timing of reinnervation.Methods: Thisty-eight specimens of denervated human PCAMs were divided into 4 groups according to the period of denervation: 6-12 months denervation group(n=12),1-2 years denervation group(n=10),2-3 years denervation group(n=8),and over 3 years denervation group(n=8).Another 12 specimens of normal PCAMs served as control.The patients in all groups were age-and sex-matched.The expression of myogenin protein and mRNA was studied using immunofluorescence staining and real-time PCR analysis,respectively.Results: Immunofluorescence staining showed that the positive myogenin expression was mainly!found in the myonuclei of PCAMs with a denervation period less than 3 years;no positive staining was found in the myonuclei of control group.The expression of myogenin in myonuclei and the ratio of positive cells were up-regulated in the 6-12 month denervation group compared with those in the control group;the expression and the ratio peaked in 1-2 years denervation group and decreased again in the 2-3 years denervation group,but was still significantly higher than those of the control group(all P