Objective To compare the anesthesia effect and adverse effect of subarachnoid block anesthesia with different doses of sufentanil combined with bupivacaine 7.5 mg in aged patients,and explore the suitable dosage of sufentanil.Methods Eighty aged patients with ASA grade Ⅰ-Ⅲ undergoing elective lower limb surgery were divided into 4 groups by random digits table and each group was in 20 cases:group Ⅰ received bupivacaine 7.5 mg,group Ⅱ received bupivacaine 7.5 mg+sufentanil 2.5 μg,group Ⅲ received bupivacaine 7.5 mg+ sufentanil 5.0 μg,group Ⅳ received bupivacaine 7.5 mg+ sufentanil 7.5 μg.The vital signs,degree of motor and sensory nerve blockade and adverse effect were observed.Results Compared with base blood pressure,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in group Ⅰ was significantly decreased after intrathecal injecton 15,30,45,60 minutes(P ＜0.05).There were no significant differences in the degree of motor nerve blockade in four groups(P ＞ 0.05).The time of sensory nerve blockade in group Ⅰ[(194 ± 58)min]was significantly shorter than that in group Ⅱ,Ⅲ,Ⅳ[(255 ±44),(242 ±58),(308 ± 123)min](P ＜0.05).The time of sensory nerve blockade in group Ⅳ was significantly longer compared with group Ⅱ and Ⅲ(P ＜ 0.05).The number of pruritus in group Ⅳ(10 cases)was significantly more than that in group Ⅰ and Ⅱ(0,4 cases)(P＜0.05).Conclusion Subarachnoid block anesthesia with sufentanil 2.5 or 5.0 μg combined with bupivacaine 7.5 mg in aged patients is safe and effective.

BACKGROUND: It has been proved that the rare earth compounds can obviously restrain the growth of tumor in vitro and in vivo.OBJECTIVE: To check the effect of chlorinated lanthanum (LaCl3) on the expressions of cyclin D1 and cyclin dependent kinase 4 (CDK4) of hepatocellular carcinoma cells.DESIGN: Controlled observation.SETTING: Department of Nephropathy, First Clinical Hospital, Jilin University. MATERIALS: The experiment was carried out in the cell culture laboratory (province-level) of Department of Histology and Embryology, Jilin University from July 2002 to June 2003. Wells of the microwell plate seeded with CBRH-7919 cells were randomly divided into 4 groups according to the dose of LaCl3: control, 0.01, 0.1, 1.0 mmol/L LaCl3. And each group was further divided into three subgroups according to the culture time: 1, 3, 5 days, with 6 wells for each.METHODS: The growth of CBRH-7919 cells was monitored following treated with 0.01, 0.1, 1.0 mmol/L LaCl3 for 1, 3, 5 days in vitro, respectively. ① Absorbance(A) of each well was measured by MTT assay.② The changes of distribution of cells into different phases of cell cycle were detected by flow cytometry. ③ Cyclin D1 and CDK4 expression was detected by immunocytochemical analysis.MAIN OUTCOME MEASURES: The expression of cyclin D1 and CDK4 in CBRH-7919 cells of different doses of LaCl3 at different time.RESULTS: Effect of LaCl3 on the growth of CBRH-7919: On days 3 and 5, the A value of each well in the 0.1 and 1.0 mmol/L LaCl3 groups was respectively significantly lower than that in the control group (day 3: 1.140±0:070, 0.706±0.092,1.461±0.087; day 5: 1.888±0.020,0.625±0.037,2.544±0.032, respectively) (P ＜ 0.05,0.001 ). ②Effect of LaCl3 on the percentage of CBRH-7919 cells at G0/G1 stage: On days 1, 3, and 5, the percentage of CBRH-7919 cells at G0/G1 stage in the 1.0 mol/L LaCl3 group was respectively significantly higher than that in the blank control group [(60.70±0.20)%, (39.49±0.67)%; (61.66±0.97)%, (45.56±1.00)%; (69.92±0.18)%, (49.24±0.27)%, (P ＜ 0.01,0.001 )]; On day 5, the percentage of CBRH-7919 cells at G0/G1 stage in the 0.1 mol/L LaCl3 group was respectively significantly higher than that in the blank control group[(58.88±0.73)%, (49.24±0.27)%, P ＜ 0.05]. ③ Effect of LaCl3 on the expressions of cyclin D1 and CDK4 of CBRH-7919 cells: On day 1, the expressions of cyclin D1 and CDK4 of CBRH-7919 cells in the 0.1 and 1.0 mmol/L LaCl3 groups were respectively lower than those in the blank control group (expression of cyclin D1: 562±35,453±22,860±82;expression of CDK4: 705±84,680±28,762±16, P ＜ 0.05, 0.01 and 0.001).CONCLUSION: LaCl3 inhibited the growth of CBRH-7919 cells correlating down-regulating cyclin D1 and CDK4 as reflected on the cell cycle arrest of CBRH-7919 cells from G1 stage to S stage.

Objective To observe the effects of repeated +10 Gz stress on cerebral lipid peroxidation,liver and renal function in rats and the prophylactic effects of antioxidant tea polyphenols(TP).Method Twenty-four male Wistar rats were randomly divided into three groups(n=8 each):group A(control),group B(+10 Gz),and group C(TP).Group B and C were exposed to repeated +10 Gz stress(each for 30s,onset rate about 0.5 G/s,3 times/d with +1 Gz 1 min intervals,3 d/wk,4 weeks in total),but group A was only submitted to +1 Gz.TP(200 mg/kg) was given orally in group C about 1 h prior to the +Gz experiment,while distilled water was given in group A and B.Lipid peroxidation in the brain,liver and renal functions and serum lipids were determined.Results As compared with the control,lipid peroxidation in rat cerebral homogenate,mitochondria and cytoplasm was significantly increased( P<0.05),and serum creatinine concentration was markedly elevated after repeated +10 Gz stress(P<0.01).But,TP had significant inhibitory effect on +10 Gz stress induced peroxidative injury in rat brain and reduced the serum creatinine level.There were no differences of serum triglyceride and total cholesterol concentrations and glutamic-pyruvic transaminase activity among the three groups.Conclusion These results indicated that repeated high +Gz stress could bring about peroxidative injury in brain and harmful effect on renal function,and natural antioxidant TP had signficant protective effects.

Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate(UAER)in 24 hours,serum lipid and blood rheology in early diabetic nephropathy.Methods One hundred and fifty normotensive early diabetic nephmpathy were randomly divided into control group,Shenkang injection group and Shenkang injection with Irbesartan group.Three groups were treated with diabetic education,dietary regimen,suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose(FBG)was less than 7.0 mmol/L and postprandial blood glucose(PBG)was less than 10.0 mmol/L.The control group was treated with oral anti-hyperglycemic agents or/and insulin.Shenkang injection group was additionally treated with Shenkang solution.Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2-3 U.Shenkang solution was intravenously guttaed once a day.Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0.15 g,once a day,taken orally.A course was taken for 3 weeks.The levels of UAER,serum lipid and blood rheology were detected immediately and 9 weeks after treatment.Results In the Shenkang injection group,compared with those before treatment,them were significant difference in UAER (87.44 ±10.06)μg/min vs.(116.55 ± 33.42)μg/min),serum lipid( (4.22 ± 0.70)mmol/L vs.(4.88 ± 0.69 )mmol/L)and blood rheology( (5.77 ±0.53)mPa·s vs.(7.38 ± 0.41)mPa·s)(P ＜ 0.05).In the Shenkang injection with Irbesartan group,compared to those before treatment,there were also significant difference in UAER ( (61.90 ±28.02)μg/min vs.(123.37 ± 29.98)μg/min),serum lipid( (4.00 ± 0.14)mmol/L vs.(4.90 ± 0.12)mmol/L)and blood rheology( (5.11 ±0.41)mPa·s vs.(7.27 ± 0.44)mpa·s)(P ＜ 0.05).Whearas in the control group,no significant difference were found compared with those before treatment.Furthermore,the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group(P ＜ 0.05).Conclusions Shenkang injection can reduce UAER,decrease serum lipid and improve renal blood rheology.Iteffectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.

Objective To investigate the effects of trimetazidine on the oxidative stress in maintenance he-modialysis (MHD) patients. Methods Eighty-six MHD patients and 30 healthy volunteers were recruited in the study. The activity of glutathione peroxidase (GSHPx) was measured by colorimetry and superoxide dismutase (SOD) in serum was measured by hydroxylamine method. The levels of serum malondialdehyde (MDA) were meas-ured by thiobarbituric acid reaction. Serum advanced oxidation protein products (AOPP) levels were measured by enzyme-linked immunosorbent assay (ELISA). All MHD patients were randomly divided into two groups, treatment group (n = 46) and control group (n = 40), who had undergone hemodialysis for at least three months before the study and were in a stable clinic status without signs of infection or disease activity. In the treatment group,20 mg of trimetazidine was taken orally three times each day for twenty-four weeks, when the parameters for oxidative stress were studied. The levels of GSHPx. SOD, MDA and AOPP in serum were measured before and after the treat-ment. Results At the initiation of the investigation, the serum levels of GSHPx [(584.37±215.70) μmol/L, (580.87±309.12) μmol/L vs (769.06±302.46) μmol/L] and SOD [(347.87±82.09) kU/L, (348.16±75.33) kU/L vs (428.34±15.23)kU/L] in the M HD patients were significantly lower than those in the normal eontrol group (P < 0.01), whereas the content of MDA [(4.94±1.32) nmol/L, (4.97±1.61) nmol/L vs (3.56±0.46)nmol/L] and AOPP [(120.95±59.24) μg/L,(121.76±69.12) μg/L vs (47.69±20.15) μg/L] in MHD patients was higher than those in the control group( P < 0.05 and P <0.01, respectively). After treatment for twelve weeks, the scores of GSHPx and SOD were significantly increased in the treatment group compared to that before treatment (P <0.01). However, the contents of the MDA and AOPP decreased. There were significant differences in the levels of GSHPx, SOD,MDA and AOPP between the two groups of MHD patients after the treatment with trim-etazidine. Conclusions Trimetazidine in maintenance hemodialysis patients appears to be associated with an im-provement of oxidative stress.

Background Congenital aniridia is a rare congenital autosomal dominant disease,which is shown as aniridia of double eyes,and the paired box gene 6 (Pax6) gene mutation is now known to be associated with congenital aniridia.Objective This study was to screen the Pax6 gene mutation in patients with congenital aniridia.Methods Eleven patients with congenital aniridia were enrolled in Tianjin Eye Hospital from August 2012 to October 2015,including 6 patients from 3 congenital aniridia family and 5 sporadic patients.All patients received routine ophthalmic examination.Peripheral venous blood of 3 ml was collected from the patients for DNA extraction according to the standard process of DNA isolation instructions,and all the exons of Pax6 gene,Elp4 gene,exon 5 ' and 3',intron splice sequence and SIMO sequence were amplified by PCR.Pax6 genes of the patients were sequenced using Sanger direct sequencing and multiplex ligation dependent probe amplification (MLPA) and compared with those of 500 ocular trauma patients.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any medical examination.Results Iris absence was found in all the patients,and the visions acuity was hand motion to 0.2.Lens dislocation was seen in 1 patient.Direct sequencing results found that three patients in AN-O1 family were c.688g＞t (p.E230X) mutation of Pax6 gene,and 3 of 5 sporadic patients carried c.468g＞a (p.W156X),c.613c＞t (p.Q205X) and c.141 +2t＞c mutant of Pax6 gene,and the c.688g＞t (pE230X) mutation was a novel-discovered mutation.No any mutation in Pax6,Elp4 gene and SIMO fragment was detected in 1 patient from AN-02 family,2 patients from AN-03 family and 2 sporadic patients by both direct sequencing and MLPA validation.No above-mentioned mutation was found in 500 normal individuals.Conclusions The mutation of Pax6 gene is a pathogenic mutation in congenital aniridia patients,and c.688g＞t (p.E230X) is a novel Pax6 mutant,which expanded the mutation spectrum of Pax6 gene.

Background Oculocutaneous albinism (OCA) is a hereditary disease of pigment absence in eyes,skin and hair due to the lack of congenital melanocyte.OCA is classified into 7 types based on different genetic mutations,and the mutation of tyrosinase (TYR) gene causes OCA type 1 (OCA1).OCA has obvious genetic heterogeneity and phenotypic heterogeneity.The molecular diagnosis of the mutant gene is helpful for the classification and molecular pathogenesis study of OCA.Objective This study was to screen the TYR mutation in OCA patients,and to analyze the association between the gene mutation type and clinical phenotype.Methods Ten patients with OCA were enrolled in Tianjin Ophthalmological Hospital from January 2011 to December 2014.The clinical and ocular manifestations of the patients were examined.Peripheral venous blood 3 ml was collected in the patients and their lineal relatives for the extraction of genomic DNA.Extracted DNA was amplified by PCR and the TYR gene sequence was analyzed,including all 5 exon coding sequence and exon 5 ' and 3' end and the non-coding region sequence of intron splicing in TYR gene.This study complied with Helsinki Declaration and the protocol was approved by Ethic Committee of Tianjin Eye Hospital.Informed consent was obtained from each subject.Results All the patients showed white or reddish hair and snow-white skin,and different degrees of pigment lack was seen in iris.The best corrected visual acuity of the patients was 0.05-0.2,and 3 patients complicated with nystagmus.Fundus findings showed a sunset-like change and dysplasia of macula.The TYR gene sequencing revealed that patient 1 was OCA1A subtype,with the compound heterozygous mutant of c.832C＞T (p.R278X) and c.1217C＞T (p.P406L),and his/her parents occurred the heterozygous mutation of exons P406L and R278X.The phenotype of the patient 1 was white hair and white iris.The patient 3 was OCA1B subtype,with the compound heterozygous mutations of c.1265G＞A (p.R422Q) and c.1217C＞T (p.P406L),showing an appearance of reddish brown hair and sallow iris.TYR gene mutant was not detected in other 8 patients.Conclusions The mutation of TYR gene is the main cause of OCA1 type.The phenotype of OCA1A subtype is no pigment in eyes and hair,and one of OCA1B subtype was obviously lessening of pigment.The difference of mutant genes of OCA is the cause of genetic and phenotypic heterogeneity.

Except common histologic type,some special histological types and clinico-pathological features of gastric cancer,such as neuroendocrine carcinoma,hepatoid adenocarcinoma,lymphoepithelioma-like gastric carcinoma and hereditary diffuse gastric cancer,etc,because of there special diagnosis and treatment measures and prognosis,should be taken into account in our clinical work.This article reviews the clinical progress of diagnosis,treatment and prognosis of the four special kinds of gastric cancer mentioned above.

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Objective To study the effects of LaCl3 on P16 and P21 expressions of hepatocellular carcinoma cells.Methods The experiment was divided into 4 groups.In experiment groups,CBRH-7919 cells were cultivated with 0.01,0.10 and 1.00 mmol?L-1 LaCl3 in DMEM containing 10% calf serum.In control group,CBRH-7919 was cultivated in DMEM containing 10% calf serum without LaCl3.The growth of CBRH-7919 cells was observed following treated with 0.01,0.10,1.00 mmol?L-1 LaCl3 for 1,3,5 d in vitro, respectively,the changes of cell cycle were detected by flow cytometry.At the same time,P16 and P21 were detected by immunocytochemical analysis.Results Compared with control group,the inhibitory rate of growth of CBRH-7919 cells was increased evidently when treated with 0.1 and 1.00 mmol?L-1 LaCl3 for 3 and 5 d(P