Objective To compare the effects of small dose remifentanil and fentanyl on hemodynamic responses to orotracheal intubation in children.Methods Ninety ASAⅠorⅡchildren (57 males, 33 females) aged 3-9 yrs weighing 17-34 kg scheduled for elective plastic surgery under general anesthesia were randomly allocated to one of 3 groups (n = 30 each): groupⅠcontrol (C); groupⅡfentanyl (F) and groupⅢremifentanil (R) . The children were premedicated with intramuscular scopolamine 0.01 mg?kg-1(the maximum dose 0.3 mg) and midazolam 0.1 mg?kg-1.Anesthesia was induced with propofol 2.5 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group F fentanyl 2?g?kg-1 was injectedⅣ5 min before intubation while in group R remifentanil 1?g?kg-1 was injectedⅣover 30 seconds immediately after vecuronium. Tracheal intubation was performed at 2 min after vecuronium injection. Noninvasive BP and HR were recorded and RPP (SBP?HR) was calculated before (baseline) and immediately after induction (T1),during intubation (T2) and at 1,2,3,4, 5 min after intubation.Results BP was significantly decreased after induction of anesthesia (T1) as compared to the baseline values in all 3 groups (P

AIM: To investigate the inhibitory effect of Co-SZ eye drops on apoptosis of lens epithelial cells(LEC) induced by H_2O_2 and to study the cellular and molecular mechanisms.METHODS:(1) All lenses of Sprague-Dawley rats were incubated with H_2O_2 and Co-SZ eye drops.The apoptosis rates of LEC were determined by TUNEL method.The changes of LEC ultrastructure and the formation of apoptotic body were observed by electron microscopy.(2) Bovine LEC were incubated with H_2O_2 and Co-SZ eye drops.The inhibitory of LEC apoptosis was detected by MTT after incubation.The changes of fractional DNA content in LEC were detected by flow cytometry(FCM).[Ca~(2+)]i,cAMP and cGMP of LEC were determined by spectrofluoremeter and radioimmunoassay,respectively.RESULTS: The LEC apoptosis rates in Co-SZ eye drops group were decreased significantly compared with H_2O_2 group by TUNEL.The ultrastructure changes in LEC of Co-SZ eye drops group were lighter than that in H_2O_2 group.The LEC apoptosis rates of Co-SZ eye drops group were dose-dependently decreased significantly compared with H_2O_2 groups via MTT assay.LEC apoptosis induced by H_2O_2 was inhibited by Co-SZ eye drops,and showing dose-dependent.The DNA contents in LEC of Co-SZ group were increased.The [Ca~(2+)]i and cAMP in Co-SZ group were decreased obviously.The cGMP was increased.CONCLUSION: The LEC apoptosis induced by H_2O_2 was inhibited by Co-SZ eye drops.The mechanism of apoptosis inhibition by Co-SZ eye drops maybe contribute to the increase in DNA content.The signal transduction mechanisms are related to the decrease in [Ca~(2+)]i and cAMP and the increase in cGMP.

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.

Objective:To compare the clinical efficacy and safety between spleen total resection splenectomy and spleen partial splenectomy in the treatment of patients with traumatic spleen rupture.Methods:84 cases of patients with traumatic spleen rupture from March 2013 to March 2016 were selected and divided into two groups.42 cases in the spleen total resection group were treated with spleen total resection,while the other 42 cases in the spleen partial nephrectomy group were treated with spleen partial splenectomy.The operative effect,the levels of platelet count,serum IgA,IgG,IgM,CD3 +,CD4 +,CD8 +,CD4 + / CD8 + levels before and after treatment,the incidence of complications were compared between two groups.Results:The intraoperative blood loss,exhaust time,length of hospital stay of spleen partial nephrectomy group were shorter than those of the spleen total resection group,but the operation time of research group was longer than that of the spleen total resection group (P＜0.05).The platelet count,CD8+ of spleen partial nephrectomy group were lower than those of the spleen total resection group (P＜0.05).The IgA,IgG,IgM,CD3+,CD4+,CD8+,CD4+/CD8+ of spleen partial nephrectomy group were significantly higher than those of the spleen total resection group (P＜0.05).The incidence rate of complications in the spleen partial nephrectomy group was lower than that of the spleen total resection group (P＜0.05).Conclusion:Spleen partial splenectomy was more effective than spleen total resection in the treatment of traumatic splenic rupture,which had little effect on the platelet and immune function.

Objective To observe the effects of Qizhi Zhoufei Granules on IL-8, TNF-αand ET-1 in serum and bronchoalveolar lavage fluid (BALF) of chronic obstructive pulmonary disease (COPD) model rats, and to study its mechanism of preventing and treating COPD. Methods Wistar rats were randomly divided into blank group, model group, positive control group, Qizhi low-dose group, Qizhi medium-dose group and Qizhi high-dose group. The COPD model was established by smoking and infusing lipopolysaccharide (LPS). After 15 days, the rats were given the drugs by orally taking once a day. On the 43rd day, the change of IL-8, TNF-α and ET-1 content in serum and BALF were measured by radio-immunity assay. Results Compared with the blank group, the level of IL-8, TNF-α and ET-1 in serum and BALF were considerably raised in model group (P<0.05). Whereas compared with the model group, the level of TNF-αin serum of Qizhi high-dose group was remarkably lowered (P<0.05), the level of IL-8 in serum of Qizhi low-dose group and Qizhi high-dose group was remarkably lowered (P<0.05), the level of TNF-αin BALF of Qizhi medium-dose group was remarkably lowered (P<0.05), the level of IL-8 in BALF of Qizhi low-, medium- and high-dose group was remarkably lowered (P<0.05), and the level of ET-1 in BALF of Qizhi high-dose group and Qizhi medium-dose group was remarkably lowered (P<0.05). Conclusion Qizhi Zhoufei Granules have protective effect on lung tissue of COPD rats, and can adjust the content of IL-8, TNF-α and ET-1, which may be one of its mechanisms of intervening occurrence and development of COPD.

Objective:To investigate the status of viral reservoirs in prostate tissue of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to investigate the effect of highly active anti-retroviral therapy (HAART) on HIV-1 DNA in prostate tissue of HIV/AIDS patients.Methods:Twelve patients with HIV infection and hyperplasia of prostate who required surgical treatment and admitted to Guangzhou Eighth People′s Hospital from July 2017 to October 2019 were included. Blood and prostate specimens of these patients were collected, and HIV-1 RNA in plasma, CD4 + T lymphocyte count in peripheral blood and HIV-1 DNA level in prostate tissue were tested respectively. The independent sample t test or Mann-Whitney U test was used for statistical analysis. Results:Among the 12 patients, the CD4 + T lymphocytes was (519.8±121.5)/μL and HIV-1 DNA in the prostate tissue was 2 602 (365, 10 700) copies/10 6cells in six patients who had not started HAART. The CD4 + T lymphocytes was (182.8±69.7)/μL and the HIV-1 DNA in the prostate tissue was 144 (36, 563) copies/10 6cells in the six patients who underwent HAART for over six months. There were statistically significant differences in CD4 + T lymphocytes and HIV-1 DNA in the prostate tissue between the two groups ( t=-5.889 and Z=-2.082, respectively, both P<0.05). Conclusion:Prostate tissue can be used as an HIV-1 virus repository with or without HAART, and the size of the prostate tissue virus repository can be reduced by HAART after immune reconstitution.

Objective To analyze the expression and predictive value of serum tumor markers spectrum and chemokine protein in lung cancer and predictive value.Methods One hundred and fifty patients with lung cancer were selected as the observation group and contemporaneous 150 individuals undergoing physical examination served the control group.The levels of ProGRP,CEA,SCC and Cyfra21-1 were measured by chemiluminescence microparticle immunoassay.The chemokine protein was determined by multiple immunofluorescent assay.Results The levels of CCL28,LIF,LIGHT and GRO in the observation group were significantly higher than those in the control group (P＜0.05).The levels of CCL28,LIF,LIGHT and GRO in the observation group were higher than those in the control group.The levels of CCL28,NAP-2 and MDC in the observation group were lower than those in the control group (P＜0.05).Conclusion The regular detection of serum tumor markers spectrum and chemokine protein can predict the treatment prognosis and evaluate the clinical curative effect.

Base on the clinical characteristics of septic arthritis in a group of systemic lupus erythematosus patients,this study has found out that high systemic lupus erythematosus disease activity index,leucopenia,high cumulative dose of glucocorticoid,methylprednisolone intravenous pulse therapy and joint cavity puncture were closely correlated with septic arthritis.Once septic arthritis is suspected,culture specimens should be collected and appropriate antibiotics are suggested immediately.Also,surgical drainage is a very useful approach.

Objective To evaluate the clinical value of low-dose semicoronal computerized tomography (CT) of sacroiliac joints (SIJ) in the early diagnosis of ankylosing spondylitis (AS).Methods Patients who were diagnosed with AS and had received axial CT examination of SIJs over the past 2 years were recruited.All of them simultaneously underwent a low-dose semicoronal CT of SIJs.The clinical data were recorded.Radiation dose was compared between low-dose CT and the previous conventional axial CT.Image quality of low-dose CT was assessed and correlation between image quality and weight or body mass index (BMI) was analyzed.CT images of the two groups were graded by modified New York criteria, the Lee criteria and the Innsbruck criteria.The kappa coefficient was used to assess the consistency of grading between the two groups.Results Thirty-three patients were enrolled in this study.The effective dose (ED) of semicoronal SIJ CT was 3.37 mSv which was 49％ lower than conventional axial CT (6.56 mSv).Lower dose had the potential protection of gonads.The quality of images in male patients with BMI ＜ 25 kg/m2 and all female patients were good or excellent.There was a significant negative correlation between image quality and BMI (r =-0.746, P =0.000;r =-0.784, P =0.000;respectively).All patients were diagnosed as sacroiliitis by modified New York criteria and the grading of two groups was consistent.The consistency of grading between two groups was satisfactory no matter which classification criteria was used.(k =0.897 with Lee criteria;k =0.814 with Innsbruck criteria;P ＞ 0.05).Conclusions The radiation dose of semicoronal SIJ CT is significantly lower than that of the conventional axial CT with comparable efficacy of diagnosis.

Objective To investigate the reliability and validity of Hospice care quality assessment scale. Methods Eight experts in the field of hospice revised the Scale after Chinese localization. The scale data were analyzed after collation of 181 families fulfill the scale. Results The total scale Cronbach′s a coefficient was 0.851. The first dimension′s coefficient was 0.796. The second dimension′s coefficient was 0.622 and the third dimension′s coefficient was 0.827. In factor analysis of the scale, after varimax rotation, the number of characteristic roots>1 was 10 and made up of 70.88%of the total variance. Conclusions The hospice care quality assessment scale after Chinese localization has good reliability and validity and could be a tool to evaluate the clinical quality of care for dying patients.