Objective To evaluate the effects of dexmedetomidine on lidocaine-induced apoptosis in rat cortical neurons.Methods The cortical neurons obtained from Sprague-Dawley fetal rats were seeded in 24 multiwell plates at a density of 1 × 105 cells/ml,and the cortical neurons of 80 wells were randomly divided into 4 groups (n =20 each):control group (group C),lidocaine group (group L),dexmedetomidine group (group D) and lidocaine + dexmedetomidine group (group L+ D).The cells were cultured routinely in group C.The cells were exposed to lidocaine with a final concentration of 1 mmol/L in group L.The cells were exposed to dexmedetomidine with a final concentration of 3 μmol/L in group D.The cells were exposed to lidocaine and dexmedetomidine with the final concentrations of 1 mmol/L and 3 μmol/L,respectively,in group L + D.After 4 h incubation,the neurons were subjected to DAPI staining for detection of apoptosis,and the apoptosis rate was calculated.Western blot analysis was used to measure the expression of phosphorylated Akt (p-Akt),Akt and caspase-3.Results Compared with group C,the apoptosis rate was significantly increased,the expression of p-Akt was down-regulated,and the expression of caspase-3 was up-regulated in L and L + D groups (P ＜ 0.05),while no significant changes were found in the indexes mentioned above in group D (P ＞ 0.05).Compared with group L,the apoptosis rate was significantly decreased,the expression of p-Akt was up-regulated,and the expression of caspase-3 was down-regulated in L + D group (P ＜ 0.05).There was no significant difference in the expression of Akt between the four groups (P ＞ 0.05).Conclusion Dexmedetomidine can reduce lidocaine-induced apoptosis in rat cortical neurons,and activation of Akt may be involved in the underlying mechanism.

Objective To investigate the role of Akt signaling in the protective effect of dexmedetomidine preconditioning on the lipopolysaccharide(LPS)-induced acute lung injury (ALI) in rat .Methods Twenty-two SD rats were randomly divided into 4 groups:before LPS injection group(T0 group) ,1 h after LPS injection group(T1 group) ,3 h after LPS injection group(T2 group) and 6 h after LPS injection group(T3 group) ,the expression of Akt and p-Akt in the process of LPS-induced ALI was investigated . Another 54 rats were divided into 3 groups :control group(C group) ,6 hours of ALI group(ALI group) and Dexmedetomidine+ALI group(D+ ALI group) ,the expression of p-Akt in lung tissues ,the protein concentration in bronchoalveolar lavage fluid (BALF) ,apoptotic index and the pathological changes in the lung tissues were observed .Forty rats were divided into ALI group and ALI + D group to investigate the 48 h-survival ratio .Results Compared with T0 group ,the level of p-Akt expression in T1 ,T2 , T3 groups were deceased in a time-dependent manner(P<0 .05) .Compared with ALI group ,p-Akt in D + ALI group increased significantly(P<0 .05) but was still lower than that in C group(P<0 .05);the protein concentration in BALF and the apoptotic in-dex in D + ALI groups were significantly lower than those in ALI group(P<0 .05) ,but still higher than those in C group(P<0 .05) .The 48 h survival ratio was significantly decreased in D + ALI group comparing with ALI group(P<0 .05) .Conclusion Dexmedetomidine preconditioning might display protective effect via activating p-Akt signaling pathway in LPS-induced ALI .

Objective To evaluate the efficacy of different doses of dexmedetomidine mixed with ropivacaine for brachial plexus block.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,weighing 40-70 kg,scheduled for upper extremity surgery under brachial plexus block,were randomly divided into 6 groups (n =20 each):ropivacaine group (group R) and different doses of dexmedetomidine groups (groups RD1-5).Brachial plexus block was performed using the interscalene approach.In group R,interscalene brachial plexus block was performed using 0.5 ％ ropivacaine 25 ml (single injection).In groups RD1.5,interscalene brachial plexus block was induced with a mixture (25 ml) of dexmedetomidine 0.25,0.50,0.75,1.00,1.25μg/kg and 0.5 ％ ropivacaine,respectively.The onset time and duration of sensory and motor block were recorded.The adverse effects such as adverse cardiovascular events,excessive sedation,and pneumothorax were also recorded.Results Compared with group R,the onset time was significantly shortened,and the duration of block was prolonged (P ＜ 0.05).Compared with groups RD1 and RD2,the onset time was significantly shortened,and the duration of block was prolonged in groups RD3 5 (P ＜ 0.05).There was no significant difference in the parameters mentioned above between groups RD1 and RD2 or among groups RD3,RD4 and RD5 (P ＞ 0.05).Some patients developed bradycardia,hypotension or excessive sedation in groups RD4 and RD5,while no adverse effects were observed in the other groups.Conclusion Dexmedetomidine 0.75 μg/kg mixed with 0.5 ％ ropivacaine 25 ml can be safely and effectively used for brachial plexus block in patients.

Objective To investigate the effects of exogenous prostaglandin E 1 (PGE 1) on expression of platelet derived growth factor B (PDGF-B) mRNA and its receptor ? protein in rabbit with schistosomiasis. Methods In this study, 14 rabbits were infected with cercaria of S. japonicum percutaneously. PGE 1 ( 2.5 ?g/kg?d -1 ) was given intravenously to 7 rabbits from the 60th day to day 120. The expressions of PDGF-B mRNA, PDGFR ? protein and ?-SMA were detected by RT-PCR, Western blotting and immunohistochemistry, respectively. Endogenous IFN-? was measured by in situ hybridization. Results Up-regulated expressions of PDGF-B mRNA, receptor ? protein as well as ?-SMA were observed in rabbits with Schistosome hepatic fibrosis. The increased expressions of PDGF mRNA and receptor ? were suppressed in rabbits treated with exogenous PGE 1 (29.42?5.05 vs 41.37?7.23, P

Objective Screening OSAHS patients on pregnancy with Modified Epworth Sleepiness Scale( Epworth sleepiness scale,ESS)and to assess its effect. Methods 22 patients underwent the pregnancy,and pregnancy with OSAHS( mild in 23 cases,22 cases of moderate and severe in 19 cases)group were 64 people, By ESS and modified ESS score, EP and modified EP values was derived. The neck circumference ( NC), body mass index (BMI) was measured. Conduct of polysomnography ( PSG), apnea hypopnea index ( AHI ) and lowest oxygen saturation ( LSaO2 )ESS and modified ESS correlation with the AHI was analyzed and ROC curves was drawn. Results The EP value of pregnancy with mild OSAHS group has no significant difference between normal pregnancy group( P ＞ 0.05) ;the rest of pregnancy OSAHS group modified EP, EP values and the normal pregnancy group were significantly different ( all P＜0.05) ;modified EP, EP, NC, BMI values positively correlated with the AHI value, the correlation coefficient r were :0.876,0.748,0.671,0.670 ( all P ＜ 0.001 ) ;modified EP, EP, NC, BM I of the A UC values were 0.901,0.819,0.750, 0.779; when the modified EP = 8.5, had higher sensitivity ( 84.4% ) and specificity ( 90.9% ).Conclusion Modified ESS on pregnancy OSAHS patients had better clinical value of screening.

Objective:To research the solubilization of sulfobutyl ether-β-cyclodextrin ( SEB-β-CD) on voriconazole and the sta-bility of voriconazole with different pH values. Methods:Phase-solubility diagram was applied to study the solubilization of SEB-β-CD on voriconazole. Meanwhile, the impurity of voriconazole was determined to study the stability. Results:SBE-β-CD could increase the solubility of voriconazole significantly and the apparent stability constant was similar within the pH range of 5. 0-8. 0. The stability of voriconazole was decreased with the increase of pH. Conclusion:SEB-β-CD is an ideal solubilizer for voriconazole, while the stability is influenced by pH.

OBJECTIVE:To compare the composition changes of Aurantii fructus before and after fermentation processing and optimize its fermentation processing technology. METHODS:UPLC was conducted to compare the raw and fermentation processed products of same batch of Aurantii fructus,and ensure the chromatographic peaks after fermentation processing. Using peak areas of 4 chromatographic peaks and mildew characteristics of samples as index,fermentation temperature,humidity and time as factor, L9(34)orthogonal test was designed to optimize the fermentation processing technology,and verified it. RESULTS:After fermenta-tion processing,Aurantii fructus obviously showed 2 new monosaccharide glycosides components;the optimized fermentation tech-nology was as follows as fermentation temperature of 30 ℃,humidity of 70% and time of 7 d;verification test results showed RSD of each indicator of decoction pieces prepared by optimized fermentation technology in 3 tests were lower than 2.0%(n=3). CONCLUSIONS:Fermentation processing may lead obvious chemical composition changes in Aurantii fructus;the optimized fer-mentation processing technology can increase the contents of characteristic peaks.

Objective To study the application effect of fibrin sealant(FS) during operation for late-stage portal hypertension caused by schistosomiasis.Methods From Jun,2003 to Jun,2005,92 cases of(late-stage) portal hypertension caused by schistosomiasis treated by portal-systemic disconn-ection(PSD)(operation) were divided into two groups,namely PSD group and PSD+FS group.The early complications such as fever and exudate in splenic fossa,as well as long term complications such as recurrent bleeding,(hypertensive) gastropathy were compared in the 2 groups,and encephalopathy were compared between 64 cases of patients with FS and 28 cases of patients without FS.Results The patients undergoing PSD+FS showed decreased the exudate in splenic fossa and fever(P0 05).Conclusions FS application during operation is effective in attenuating early and long term operative complications of portal hypertension caused by(schistosomiasis),and improving outcome of surgical treatment.

German family physicians practice independently in clinics, and provide primary health care services. General practitioners are a type of specialists. The basis for the self-management of German doctors is the homogeneous medical education in Germany. The new round of medical education reform emphasizes the theory and practical training throughout the entire process of medical education. All medical students in Germany need to go to the clinic for internship and be familiar with primary health care models. Post-graduation education sets rotation plans and assessment standards according to the characteristics of general practice specialties, emphasizes the clinical practice time in the clinics, and urges doctors to continue medical education through the payment of medical insurance. This article draws on the German general practitioner training model, proposes to strengthen the enlightenment of general practice education during the education of undergraduate medical colleges, and strengthen the clinical practice of general practitioners and the construction of general practice training bases, as well as improve the ability of the community physician faculties, in order to provide a reference for the training of general practitioners in China.

Objective:To investigate the serum 25-hydroxyvitamin D [25(OH) D] levels in elderly patients with hip and vertebral compression fractures (VCF).Method:Ninety patients (58 males and 32 females) aged over 60 years with hip fracture and 120 patients (88 males and 32 females) aged over 60 years with VCF admitted in the Aviation General Hospital from January 2017 to June 2019 were enrolled. Serum 25(OH)D levels were measured.Results:Serum level of 25 (OH) D in hip fracture patients was (9.0±6.8) μg/L, the 25 (OH) D level was lower than the normal value(<19.0 μg/L)in 79 patients and<3 μg/L in 24 patients. The level of 25(OH)D in VCF patients was (16.7±10.6) μg/L, the 25 (OH) D level was<19.0 μg/L in 78 patients (65.0%) and <3 μg/L in 10 patients (8.3%). The low level of 25(OH)D was negatively correlated with age in two groups ( r=-0.367, P=0.01; r=-0.313, P=0.04). The mean level of 25 (OH) D in the hip fracture group was lower than that in the VCF group ( t=5.960, P<0.01), and the low 25(OH)D rate in the former group was significantly higher than that in the latter group (χ 2=14.14, P<0.01; χ 2=12.74, P<0.01). The 25(OH)D value of female VCF patients was (14.5±8.8) μg/L, which was significantly lower than that of male patients (22.5±12.9) μg/L ( t=3.882, P<0.01).Among hip fracture patients, the 25(OH)D level in patients with fracture history was (8.3±6.9) μg/L, which was significantly lower than that of patients without fracture history (10.8±6.9) μg/L, and the difference was statistically significamt ( t=2.123, P=0.04). The serum osteocalcin level was (20.5±19.8) μg/L in patients with fracture history, which was significantly higher than that in patients without fracture history [(10.6±5.4) μg/L, t=3.245, P<0.01]. Conclusion:Elderly patients with new hip fractures have more severely low vitamin D level than patients with new VCF, and patients with previous fracture history have lower vitamin D levels than patients without fracture history.