Objective To evaluate the changes in cerebral oxygen delivery/consumption and glucose metabolism during laparoscopic gynecologic surgery under propofol-fentanyl anesthesia.Methods Fifteen ASA Ⅰ or Ⅱ patients aged 20-59 yrs weighing 47-65 kg undergoing laparoscopic gynecologic surgery under propofol-fentanyl anesthesia were studied. The patients were premedicated with scopolamine 0.3 mg, midazolam 0.02 mg?kg-1 and fentanyl-droperidol mixture 0.03 ml?kg-1 Ⅳ. Anesthesia was induced with fentanyl 2 ?g?kg-1, propofol 2 mg? kg-1 and vecuronium 0.1 mg?kg-1 and maintained with TCI of propofol with target effect-site concentration set at 3-4 ?g? ml-1 and intermittent Ⅳ boluses of fentanyl and vecuronium. The patients were mechanically ventilated (VT = 7 ml? kg-1 RR = 14 bpm, I: E = 1:2). PET CO2 was maintained at 35-45 mm Hg. Radial artery was cannulated for BP monitoring and blood sampling. Left internal jugular vein was cannulated and advanced cephalad until a resistance was met. The depth of insertion was about 11-14 cm. After the pneumoperitoneum was established ( Ultra-abdominal pressure = 15 mm Hg) , the patients were placed in head-down position. Blood samples were taken from radial artery and internal jugular vein simultaneously before anesthesia ( T1 , baseline), before pneumoperitoneum (T2) and at 10, 20 and 60 min after pneumoperitoneum was established (T3-5) for blood gas analysis and determination of plasma glucose and lactic acid concentration. Arterio-jugular oxygen content difference ( Da-jv O2 ), arterio-jugular plasma lactic acid difference ( Da-jv. Lac ), cerebral oxygen consumption and cerebral glucose extraction rate (GluER) were calculated. Jugular bulb pressure (JBP) was recorded at blood sampling.Results After pneumoperitoneum was established JBP increased significantly. Jugular bulb oxygen saturation (Sjv O2 ) increased significantly. Da-jv, O2 and cerebral oxygen extraction rate ( OER) decreased significantly after pneumoperitoneum (T3-5 ) . Plasma glucose level increased along with the pneumoperitoneum, while the Da-jv Glu, Da-jv Lac remained constant. Conclusion During laparoscopic gynecologic surgery under propofotfentanyl anesthesia cerebral venous pressure is elevated and cerebral oxygen supply exceeds oxygen consumption. Blood glucose level increases during pneumoperitoneum. However brain energy metabolism is not affected during pneumoperitoneum with patient in head-down position.

Drooling in waking in children older than 4 years is considered as abnormal, which may be resulted from the saliva control barriers in children with cerebral palsy, and impair their nutrition, sociality and mental health, etc. Evaluation of salivation can be subjective and objective, which including visual analogue scale, Teacher Drooling Scale, Drooling Frequency and Severity Scale, drooling quotient and Drooling Impact Scale, etc., in the former, and Saxon test and swab approach, etc., in the latter. The treatment mainly included oral move-ment training, correcting pathological factors, biofeedback, medicine and surgery. Physiotherapy and acupuncture were also reported for sali-vation in children with cerebral palsy.

Objective To evaluate the effect of isoflurane on the expression of matrix metalloproteinase 2 (MMP-2) in human tongue cancer cell.Methods Tea8113 cells at the logarithmic growth phase were seeded into 96-well plates (200 μl/hole) with the density of 5 × 103/ml,6-well plates (5 ml/hole) with the density of 1 ×105/ml,culture dishes (5 ml/dish) with the density of 5 × 105/ml or Transwell chamber (200 μl cell suspension for upper chamber with a density of 5 × 105/ml,10 ％ blood serum medium 500 μl for lower chamber).The cells wererandomly divided into 3 group (n =30 each):control group (group C),2％ isoflurane 2 h group (group Ⅰ1) and 2％ isoflurane 4 h group (group Ⅰ2).2％ isoflurane was added to the culture medium and the cells were incubated for 2 and 4 h in groups Ⅰ1 and Ⅰ2,respectively.The cell viability was detected by MTT assay.The cell apoptosis was assessed by flow cytometry.The migration and invasion of the cells were measured by cell wound scratch assay and Transwell chamber assay,respectively.The expression of MMP-2 and MMP-2 mRNA was detected by immunocytochemistry and RT-PCR,respectively.Results The cell viability and migration of cells were significantly increased,the apoptotic rate was decreased,and the expression of MMP-2 and MMP-2 mRNA was up-regulated in groups Ⅰ1 and Ⅰ2,and the invasion of the cells were increased in group Ⅰ2 as compared with group C (P ＜ 0.05).Compared with group Ⅰ1,the cell viability and migration and invasion of the cells were significantly increased,the apoptotic rate was decreased,and the expression of MMP-2 and MMP-2 mRNA was up-regulated in group Ⅰ2 (P ＜0.05).Conclusion Isoflurane enhances the migration and invasion of the cancer cells by up-regulating the expression of MMP-2 in human tongue cancer Tea8113 cells.

Objective To observe the efficacy of Complex Oral Motor Scoring (COMS) and diadochokinetic rate (DR) on evaluation of oral motor dysfunction and speech disorders in children with cerebral palsy. Methods 107 children with cerebral palsy were tested with Chinese-version Articulation Test, Simple Oral Motor Scoring (SOMS), COMS and DR. The correlation among SOMS, COMS and DR was analysesd. Results 85 children were abnormal in SOMS and 94 in COMS. Oral dyskinesia was found in all the children with spastic quadriplegia, dyskinetic, ataxia and mixed type of cerebral palsy, and less in the type of spastic diplegia and hemiplegia. DR was the least in spastic quadriplegia, dyskinetic, mixed type of cerebral palsy, more in the type of ataxia and spastic diplegia, and the most in hemiplegia. The coefficient of correlation among the SOMS, COMS, the longest pronunciation and DR were more than 0.8 (P<0.01). Conclusion The incidence and severity of oral dyskinesia and dysarthria are associated with the types of cerebral palsy. There is good correlation among SOMS, COMS, longest pronunciation and DR.

The aim of this study is to investigate the therapeutic effect of RegIII-proinsulin-pBudCE4.1 plasmid on streptozotocin (STZ)-induced type 1 diabetes mellitus and its underlying mechanisms. The model of type 1 diabetes mellitus was established by intraperitoneal injections of STZ (40 mg kg(-1)) to Balb/c mice for five consecutive days. Then, ten type 1 diabetic mice were intramuscularly injected with 100 microg RegIII-proinsulin-pBudCE4.1 plasmid for 4 weeks (one time/week) and the blood glucose levels were monitored every week; whereas another ten diabetic mice served as negative control group were injected with pBudCE4.1 vector at the same dose. Normal control and model control mice were treated with normal saline at identical volume under the same way. Western blotting, MTT assay, ELISA, HE staining and Tunel assay were applied to explore the underlying mechanisms. Results showed that RegIII-proinsulin-pBudCE4.1 plasmid ameliorated the hyperglycemia symptoms in diabetic mouse remarkably. It induced an immunological tolerance state in type 1 diabetic mice by inhibiting the proliferation of splenic lymphocytes and recovering Th1/Th2 balance evidenced by MTT and ELISA analysis. Furthermore, it elevated insulin concentration in the serum of type 1 diabetic mice and promoted the regeneration of beta cells supported by the results of HE staining and Tunel assay. In conclusion, RegIII-proinsulin-pBudCE4.1 plasmid possesses powerful anti-diabetic ability, which may be involved in the inducing of immunological tolerance and enhancing beta cells recovery.

This study examined the potential antilithic effects of a traditional Chinese medicine Urtica dentata Hand (UDH) in experimental rats and screened the optimal extract of UDH as a possible therapeutic agent for kidney stones. The rat model of urinary calcium oxalate stones was induced by intragastric (i.g.) administration of 2 mL of 1.25% ethylene glycol (EG) and 1% ammonium chloride (AC) for 28 days and was confirmed by Color Doppler ultrasound imaging. The rats in different experimental groups were then intragastrically given petroleum ether extract (PEE), N-butanol extract (NBE), aqueous extract (AqE) of UDH, Jieshitong (positive control drug), and saline, respectively. Treatment with NBE significantly reduced the elevated levels of urinary calcium, uric acid, phosphate, as well as increased urinary output. Accordingly, the increased calcium, oxalate levels and the number of calcium oxalate crystals deposits were remarkably reverted in the renal tissue of NBE-treated rats. In addition, NBE also prevented the impairment of renal function to decrease the contents of blood urea nitrogen (BUN) and creatinine. Taken together, these data suggest that NBE of UDH has a beneficial effect on calcium oxalate urinary stones in rats by flushing the stones out and protecting renal function.

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

Objective To analyze the incidence and severity of drooling in children with cerebral palsy and explore its correlation with oral dyskinesia,dysphagia and gross motor function.Methods A hundred children with cerebral palsy treated in Qingdao Women's and Children's Hospital between July 2013 and 2016 and 50 healthy children examined in the health examination center were assessed using the drooling severity scale,oral motor assessment,a dysphagia disorders survey (DDS) and the gross motor function classification system (GMFCS).The relationship between drooling severity,oral dyskinesia,dysphagia and their gross motor function was analyzed.Results Of the 100 children with cerebral palsy,32％ displayed drooling (at levels Ⅱ through Ⅴ),which was significantly higher than among the healthy controls.Another sixty-eight displayed level Ⅰ drooling.The severity of drooling was significantly different among children with different cerebral palsies.The drooling of children with spastic quadriplegia,dyskinesia or mixed-type cerebral palsy was the most severe,followed by those with ataxia and spastic diplegia whose drooling was often mild.No hemiplegic child drooled at level Ⅱ.Drooling severity was negatively correlated with the oral motor score,but positively correlated with the average DDS and GMFCS scores.Conclusions About one third of cerebral palsy children suffer from drooling.Their drooling severity is closely associated with the type of the cerebral palsy,oral dyskinesia,dysphagia and GMFCS levels.

Objective:To investigate whether endoplasmic reticulum aminopeptidase 1 ( ERAP1) is a susceptible gene for pre-eclampsia (PE) and the possible mechanism in the pathogenesis. Methods:This retrospective study included 990 PE patients (case group) and 1 240 healthy pregnant women (control group) in six prefecture-level tertiary hospitals in Shandong Province, including the Affiliated Hospital of Qingdao University and Zaozhuang Maternal and Child Health Hospital, from September 2018 to April 2021. Peripheral blood were collected for DNA extraction. Single-nucleotide polymorphisms in the ERAP1 gene (rs30187, rs27044, and rs469783 loci) were analyzed by Taqman probe polymerase chain reaction (PCR). Two missense mutant plasmids, rs30187(c.1583A>G) and rs27044(c.2188C>G), were constructed by point mutation induction based on wild-type plasmids. Six groups (knock-down control, knock-down, over-expression control, over-expression, variant 1 and 2 groups) were set up in this study. After transfecting Htr8 cells with different transfection molecules, the expression of ERAP1 at mRNA and protein levels were detected. Besides, the effects of different transfections on cell function were detected using Transwell migration assay, Transwell invasion assay, cell scratch assay, and CCK-8 assay. Statistical analysis was performed using two independent samples t-test, rank sum test, and Chi-square test. Results:(1) There were significant differences in the genetic distribution of rs30187 (Genotype: χ2=29.25, Allele: χ2=4.68) and rs469783 (Genotype: χ2=7.01, Allele: χ2=6.45) as well as the genotype distribution of rs27044 ( χ2=28.95) between the case group and the control group (all P<0.05). Statistical analysis of the genetic model revealed that rs30187 and rs27044, both recessive models, were statistically different between the two groups with a higher frequency of CC genotypes in the case group ( χ2=20.82 and 19.97, both P<0.05), but a lower frequency in CC dominant gene pattern for rs469783 ( χ2=5.82, P=0.016). (2) Compared with the knock-down control group, the knock-down group showed significantly inhibited expression of ERAP1 (mRNA: 0.5±0.1 vs 1.0±0.0, t=7.49; protein: 0.4±0.1 vs 0.7±0.1, t=2.81; both P<0.05), reduced cell migration rate after 48 h of scratching [(16.5%±1.8%) vs (23.8%±2.4%), t=3.33, P=0.031] and decreased number of cells crossing Transwell chambers after 24 h of culture (423.7±21.3 vs 499.0±24.6, t=3.29, P=0.031). Compared with the over-expression group, variant 1 group and variant 2 group showed significantly inhibited expression of ERAP1 at mRNA (both P<0.001) and protein ( P=0.003 and 0.006) levels after transfection, decreased number of cells crossing Transwell chambers ( P=0.001 and 0.032) and down-regulated cell migration rate after 48 h of scratching [variant 1: P=0.004; variant 2: (21.1±4.6)% vs (28.3±1.1)%, t=2.10, P=0.099]. ERAP1 expression at both mRNA ( P<0.001) and protein ( P=0.008) levels, as well as cell proliferation ( P<0.001) and invasion ability ( P<0.001), were all enhanced in the over-expression group than those in the over-expression control group. Moreover, the migration rate of cells after 48 h of scratching ( P=0.002) and the number of cells crossing Transwell chambers after 24 h of culture ( P=0.001) were also increased. Conclusions:The rs30187, rs27044, and rs46978 on ERAP1 gene were all associated with PE susceptibility, with more carriers of the CC genotype in PE patients at rs30187 and rs27044 loci and more carriers of the CC genotype in healthy gravida at rs469783 locus. ERAP1 may be involved in the pathogenesis of PE by affecting the migratory and invasive ability of trophoblast cells.

OBJECTIVETo explore the association of perioperative blood transfusion (PBT) with survival of gastric cancer after surgery.

METHODSWe retrospectively reviewed the medical records of 1 000 gastric cancer patients, including 738 non-transfused (73.8%) and 262 transfused (26.2%) cases. A one to one match was created using propensity score analysis, except preoperative hemoglobin level and operative blood loss. The survival was analyzed by Kaplan-Meier survival model.

RESULTSThe 5-year survival rate of the 1 000 cases of gastric cancer patients was 39.9%. Before matching, there was a significant difference between transfused group (33.6%) and non-transfused group (49.1%, P<0.005). Univariate analysis showed that age, tumor size, hemoglobin level, albumin level, depth of invasion, lymph node metastasis, lymph node dissection, surgery mode, adjuvant chemotherapy, blood loss and blood transfusion during perioperative period were associated with prognosis in the gastric cancer patients (all P<0.05). Multivariate analysis showed that tumor invasion, lymph node metastasis, lymph node dissection, chemotherapy and perioperative blood transfusion were independent prognostic factors in gastric cancer (all P<0.05). After matching, the 5-year survival rate of the 262 non-transfused patients was 37.7%, while that of the 262 transfused patients was 33.6% (P>0.05).

CONCLUSIONSPerioperative blood transfusion has no significant effect on the prognosis of gastric cancer patients.

Analysis of Variance ; Blood Transfusion ; mortality ; Humans ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymphatic Metastasis ; Perioperative Period ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; mortality ; pathology ; surgery ; Survival Rate