Objective To evaluate the clinic efficacy of sufentanil and remifentanil by target- controlled infusion (TCI) combined with propofol in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixty patients,ASA Ⅰ ～ Ⅱ,undergoing elective EBUS-TBNA were randomly divided into group S ( sufentanil group),group R (remifentanil group) and group SR (sufentanil + remifentanil group),each group were twenty patients.The anesthesia of all groups is propofol intravenous anesthesia with 2％ lidocaine topical anesthesia,to controll BIS between 50 and 60 during surgery.Heart rate(HR),mean arterial pressure(MAP) pulse oxygen saturation( SpO2 ) and respiratory rate (RR) were recorded and compared 5mins after entering room(T0),30mins after the beginning of surgery(T1 ) and after surgery(T3).Arterial blood gas and the times of cough during surgery were also recorded and compared in all groups.The use of propofol and lidocaine,the wake-up time,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were also obtained.Results ( 1 ) RR decreased distinctly in group R and PaCO2 increased distinctly in group S and group R compared with that of group SR (P ＜0.05) during surgery.(2)The times of cough and the wake-up time lessened distinctly in group R and group SR compared with that of group S ( P ＜0.05 ).(3) The use of propofol and lidocaine,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were similar in all groups ( P ＞ 0.05 ).Conclusion Sufentanil compounded remifentanil by TCI combined with propofol is a safe and feasible anesthesia option for EBUS-TBNA,which provides better efficacy,high satisfaction and less side effects compared with using alone of sufentanil and remifentanil respectively.

Fungal elicitors are a group of chemicals that can stimulate the secondary metabolite production in plants and microbial cells. After being recognized, it could enhance the expression of related genes through the signal-transduction pathway; regulate the activity of the enzyme involved in the biosynthesis of secondary metabolites. In recent years, the inducible mechanism of fungal elicitors has been studied deeply worldwide. Meanwhile, it has acquired wide concern in the area of biological industry, especially in the fermentation industry. This paper addresses the application and prospect of fungal elicitors in the secondary metabolites of plant and microbial cells.
Alkaloids ; biosynthesis ; genetics ; Camptothecin ; biosynthesis ; Fermentation ; Fungi ; genetics ; metabolism ; Industrial Microbiology ; methods ; Paclitaxel ; biosynthesis ; Plants, Medicinal ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; Secondary Metabolism

BACKGROUND: Fine motor function impairment is the most common complication in various eneephalopathy in children and is the key factor to hinder the normal development. Acupuncture injection brings not only the stimulation of needling but also the pharmaceutical action into play. In combination with occupational therapy,it improves probably the therapeutic effects.DESIGN: Retrospective analysis based on the patients.SETTING: Rehabilitation center of a university-affiliated hospital.OBJECTIVE: To probe into the effective method for the treatment of fine motor function impairment of children with encephalopathy.PARTICIPANTS: Totally 31 children with encephalopathy were admitted in clinic of the hospital from November 2001 to October 2002. Inclusion criteria: ① To conform to the diagnostic criteria on cerebral palsy and metal retardation. ② Age<5 years old. ③ Having be assessed with peabody developmental motor scale-fine motor(PDMS-FM) before and after treatment.Exclusion criteria: ① To be less than one session treatment. ② To suffer from progressive disorders and palsy caused by various encephalitis and encephalopathy. ③ Transient delayed motor development . Of those patients,19 cases were male,12 cases female,aged varied from 4 months to 5years. 94% of patients were younger than 3 years old. Twenty cases were in full-term delivery. Eleven cases were born prematurely.METHODS: Thirty-one patients were treated primarily with acupunc ture injection in combination with occupational therapy. Assessment was carried on with PDMS-FM.MAIN OUTCOME MEASURES: Primary results: To observe the motor improvement in children with encephalopathy. Secondary results: To observe the changes in fine motor quotient (FMQ) before and after treatment.RESULTS: FMQ was increased in 21 cases(68%),grasp capacity index was elevated in 27 cases(87%) and capacity index of visual perception was improved in 31 cases.CONCLUSION: Acupuncture has firmly achieved remarkable therapeutic effects on fine motor function impairment in children with encephalopatby in combination with occupational therapy.

Objective To analyse the difference between stage Ⅰ pure bronchioloalveolar carcinoma (BAC) and stage Ⅰ adenocarcinoma of the lung among operative cases.Methods We use the Lobectomy Cases Registration and Statistics System database (2006-2011) to compare the epidemiology,clinical presentation,image characteristics,surgical outcomes,recurrence and overall survival between BAC and adenocarcinoma groups.All the patients received lobectomy procedure in the department of thoracic surgery of Peking University People' s Hospital.Results Excluding those cases with both BAC and adenocarcinoma aspects,337 patients were enrolled.Thirty-nine patients were stage Ⅰ pure BAC and 298 patients were stage Ⅰadenocarcinoma.BAC has its proper clinical spectrum,occurring more frequently in women (69.2％ vs.52.0％,P =0.042)and in younger patients (57.4 vs.61.8,P =0.014).BAC also seems to be less dependent on tobacco exposure (12.8％ vs.29.9％,P =0.026).The percentage of ground-glass opacity (GGO) in CT scan of BAC patients was much more than that registered in adenocarcinoma patients (35.9％ vs.9.7％,P ＜0.001).And the tumor size of BAC group was smaller than that of the adenocarcinoma group (1.4 cm vs.2.3 cm,P ＜0.001).The operation method,time,blood loss and complications were similar between the two groups.Kaplan-Meier survival curves showed that both 3-year disease-free survival (DFS) and overall survival (OS) were significantly higher in patients affected by BAC (100％ vs.76.1％,P =0.030 and 100％ vs.86.1％,P =0.041).Conclusion BAC presents specificity in its epidemical,clinical,radiological and evolutionary aspects.Stage Ⅰ pure BAC patients have better prognosis following video-assisted thoracoscopic lobectomy and system lymph node dissection than the similar stage adenocarcinoma patients.

Objective To study the vulnerability of astrocytes bearing mutant SOD1 under the oxidative stress.Methods The cytotoxicity of the serum deprived astrocytes was measured by MTT.The level of ROS was shown by fluorescence of DCF through confocal microscopy.The expression of Nrf2,HO1 and NQO1 in the different cells was detected by Western blot.Results The level of cellular toxicity was higher in the astrocytes bearing mutant SOD1 exposed to the oxidative stress than the astrocytes hearing wild type SOD1.In the astrocytes bearing mutant SOD1,the expression of Nrf2,HO1 and NQO1 decreased.In the presence of mutant SOD1,an unexpected 44 per-cent decrease of Nrf2 was detected.This was associated with a decreases in multiple downstream phase Ⅱ detoxif-ying enzymes and antioxidant enzymes,known as NQO1 and HO1.Furthermore,our results showed that the ex-pression of NQO1 increased 1.5 and 2.5-fold by EGCG at 5 and 10 μmol/L.EGCG also elevated the expression of total Nrf2.Confocal microscopy showed that EGCG caused Nrf2 translocation from the cytoplasm to the nucleus.Conclusion Decrease in Nrf2 expression is the mechanism to explain the vulnerability of astrocytes bearing mutant SOD1 and EGCG strengthened antioxidation function by upregulating the activity of Nrf2.

Objective To investigate the role of S100B protein in the pathogenesis of patients with Japanese encephalitis (JE).Methods A total of 45 patients were enrolled in the Second Hospital of Hebei Medical University from August 2013 to October 2013,who were diagnosed as JE on the basis of clinical features and positive IgM antibodies against JE virus measured by enzyme-linked immunosorbent assay (ELISA) from the Center of Disease Control of Shijiazhuang.The JE patients were divided into initial phase group,acute phase group and convalescence group based on the course,mild JE group,moderate JE group and severe JE group based on the severity,MRI-no-lesion group and MRI lesions group based on the imaging findings of JE.Twelve cases with no evidence of infection in central nervous system in the meantime were chosen as control.The S100B protein was measured by ELISA.Results The content of S100B protein in cerebrospinal fluid was as follows:522.76 (393.35,620.37) pg/ml in mild JE group (acute phase group:609.77 (549.27,779.71) pg/ml,convalescence group:420.48 (344.36,453.19) pg/ml),792.09 (705.47,1 108.96) pg/ml in moderate JE group (acute phase group:770.19 (646.31,1 069.54) pg/ml,convalescence group:803.45 (602.90,1 396.84) pg/ml),and 1 021.94 (680.84,1 302.15) pg/ml in severe JE group (acute phase group:981.82 (680.84,1 826.28) pg/ml,convalescence group:989.00 (553.62,1 207.67) pg/ml).The S100B protein content was 561.52 (454.36,814.56) pg/ml,803.45 (602.90,1 104.01) pg/ml,762.22 (594.95,1 044.97) pg/ml,581.76 (442.51,1 069.10) pg/ml in MRI-no-lesion group,MRI lesions group,total acute phase group and total convalescence group,respectively.While in control group,the S100B protein content was 266.71 (205.72,390.05) pg/ml.The contents of S100B protein in moderate JE group,severe JE group,total acute phase group,total convalescence group,MRI-no-lesion group,MRI lesions group were higher than that in control group (H =4.864,5.497,5.075,3.918,2.971,4.981,P =0.000,0.000,0.000,0.000,0.009,0.000).The contents of S100B protein in mild JE group was lower than that in moderate JE group and severe JE group (H =-2.786,-3.514,P =0.032,0.003).Conclusions The level of S100B protein in cerebrospinal fluid is related with the severity,duration and imaging presentation of JE patients.The dynamic monitoring of S100B protein levels is of great significance for assessment of the patients' condition and curative effect.

The therapeutic effect of acupuncture in treating the patients with urine retention after spinal and craniocerebral injuries was observed.Methods:Eighty patients with urine retention were divided into treatment group and control group.The patients in the treatment group were treated by puncturing Baliao (BL 31-34),Zhongii(CV 3) and Guanyuan (CV 4).The patients in the control group were treated by routine therapy of Western medicine.Resuits:In treatment group,33 cases were cured,5 cases got effectiveness and 2 cases had no effectiveness.In control group,25 cases were cured,7 cases got effectiveness and 8 cases had no effectiveness.Conclusion:The therapeutic effect of acupuncture was superior to that of routine therapy of Westem medicine in treating urine retention following spinal and craniocerebral injuries.

OBJECTIVE To investigate the clinical distribution and resistance of Acinetobacter baumannii.METHODS The bacteria were identified by BioMerieux VITEK32.Susceptibility was tested by Kirby-Bauer method.RESULTS Among specimens from which A.baumannii was examined,sputum accounted for 78.64%,secretion(9.62%)and urine(6.81%).A.baumannii was mainly distributed at ICU ward(29.58%)and then was respiratory ward(21.36%).The resistance of A.baumannii was serious.The antibiotic drugs which had the low resistance were ?-lactam/?-lactamase inhibitor combinations such as sulperazone(22.14%)and carbapenems such as meropenem(32.95%),imipenem(33.04%),and so on.CONCLUSIONS The infecton of multi-drug resistant A.baumannii has increasing tendency.Therefore monitoring A.baumannii constantly and regularly,finding out resistant strains timely and adjusting the treatment methods are very important for the prevention of nosocomial infection.

Objective To investigate the features of the cerebrospinal fluid (CSF) in the modified ZeiM-Neelsen (MZN) positive tuberculous mengningitis (TBM).Methods We retrospectively reviewed the clinical data of 170 patients with tuberculous meningitis confirmed by MZN stain from December 2012 to July 2015.The purpose of the present study was to investigate the relationship of MZN staining and CSF cytology.Results Among 170 patients with TBM confirmed by MZN staining,128 cases had first detectable acid-fast bacillus (AFB) in earlier stage.The cytology included 15.5％ mixed cellular cytology,58.5％ lymphoid cytology,19.5％ neutrophilic cytology and 6.5％ normal cytology.Twenty-four cases had first detectable AFB within 1-2 months following disease onset.The cytology included 13.1％ mixed cellular cytology,56.6％ lymphoid cytology,21.7％ neutrophilic cytology and 8.7％ normal cytology.Eighteen cases had first detectable AFB 2 months after disease onset.The cytology included 26.7％ mixed cellular cytology,46.7％ lymphoid cytology,20.0％ neutrophilic cytology,6.6％ normal cytology.There was no significant difference in median time of first detectable AFB among those four types of cytology (P=0.812).There was significant difference in median time of first detectable AFB between patients with and without anti-TB therapy [21.5 (12.3,37.8) days vs.8.5 (6.0,16.3)days,P＜0.001].There was no significant difference in median time MZN stain turning negative between patients with and without anti-TB therapy [11 (5.75,19.25) days vs.6(4.25,10.75)days,P=0.230].Conclusions AFB can be detectable within a month after the onset of TBM in most of cases.(MZN) positive staining is not associated with the major type of cytology.Anti-TB therapy may delay the first detectable time of AFB.

Congresses as Topic ; Hearing Tests ; Humans ; Infant, Newborn ; Neonatal Screening