ObjectiveTo evaluate the effects of dexmedetomidine on the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.MethodsSixty ASA Ⅰ -Ⅲ patients,aged ≥65 yr,undergoing elective orthopedic operation,were randomly assigned to one of 3 groups ( n =20 each):control group (group C) ; dexmedetomidine 0.25 μg/kg group (group D1 ) and dexmnedetomidine 0.50 μg/kg group (group D2).In groups D1 and D2,15 min befone anesthesia induction,dexmedetomidine 0.25 μg/kg and 0.50 μg/kg were infused over 15 min respectively,while the equal volume of normal saline 15 ml was given instead of dexmedetomidine in group C.After anesthesia induction,tracheal intubation was performed and the patients were mechanically ventilated.General anesthesia was used in the three groups.Flurbiprofen 1 mg/kg was injected intravenously immediately before skin incision.The time for recovery of spontaneous breathing,emergence time,extubation time,and adverse reactions were recorded.Pain was assessed with verbal rating scale (VRS) at 5 min after emergence from anesthesia.ResultsCompared with group C,the incidence of agitation,bucking,and adverse cardiovascular events and VRS score were significantly decreased,and the rate of effective analgesia was significantly increased in groups D1 and D2,and the emergence time and extubation time were significantly prolonged in group D2(P ＜0.05).Compared with group D1,the emergence time and extubation time were significantly prolonged in group D2(P＜0.05).There was no significant difference in VRS score,the rate of effective analgesia and the incidence of adverse renctions between groups D1 and D2(P＞0.05).ConclusionⅣ infusion of dexmedetomidine 0.25 μg/kg before induction of general anesthesia can effectively improve the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.

Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.

The crystal form of solid substance had intrinsic correlation with its three dimensional crystal morphology. Based on the characterization of the three dimensional crystal morphology of clopidogrel bisulfate, this research is to establish a model based on the three dimensional morphological parameters. The granular samples composed of polymorphs of clopidogrel bisulfate and microcrystalline cellulose (MCC) were scanned by synchrotron radiation X-ray microscopic CT technology (SR-microCT) and the three dimensional structural models for which were constructed. Seven groups of three dimensional morphological parameters were calculated. Finally, the mathematical model was established with the multi-layer perception (MLP) artificial neutral network methods to identify and predict the polymorphs of clopidogrel bisulfate. The success rate of the model prediction for the polymorphs of clopidogrel bisulfate was 92.7% and the area under the ROC curve was 96.2%. The polymorphs of drugs could be identified and predicted through the numerical description of the three dimensional morphology. The volume, number of the vertices and the surface area were the major determinants for the identification of the polymorphs of clopidogrel bisulfate.

BACKGROUND:Kinesio taping is often used for the treatment of various sports injuries.The methods of foot and ankle sports taping are complex and diverse.Among them,Fascia taping is applicable to a wider range of people and can be used for different foot posture types,but it still lacks of practical verification,and its specific biomechanical role is not clear. OBJECTIVE:To observe the changes in plantar pressure characteristics of subjects with different foot positions during walking and jogging after Fascia taping. METHODS:Thirty-seven young healthy subjects were recruited from the Yantai campus of Binzhou Medical University to conduct the test.They were scored according to the foot posture index-six items version,and were divided into the supination foot group,the neutral foot group,and the pronation foot group.The static foot morphological indexes(including navicular drop,arch height index,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch)and the pressure-time integral of each foot zone during walking and jogging were collected and calculated respectively before and after Kinesio taping.The specific biomechanical mechanism of Fascia taping was analyzed. RESULTS AND CONCLUSION:(1)General data:There was no statistical difference among the three groups of subjects in general data,such as gender,height,and body mass index(P>0.05).Before taping,there was a significant difference in the foot morphological indexes and the areas of the outer front foot,midfoot,and hindfoot between different foot posture groups(P<0.01).(2)Static foot morphological indexes:After taping,there was no statistically significant difference between the groups in navicular drop,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch(P>0.05),while there was still a significant difference between the groups in the arch height index(P<0.05).In the supination foot group,the arch height index increased slightly,but there was no significant difference before and after taping(P>0.05).In the pronation foot group,the navicular drop and arch height flexibility-longitudinal arch was significantly reduced,and the arch height index was increased.There was a significant difference before and after taping(P<0.05).(3)The index of plantar pressure during walking:After taping,there was no significant difference between the three groups in the area of lateral forefoot and medial midfoot(P>0.05).In the pronation foot group,the lateral load of the forefoot increased after taping(P<0.05).In the supination position group,the load of the lateral forefoot and midfoot regions increased significantly(P<0.05),while the difference in the rear foot region was not significant(P>0.05).(4)The index of plantar pressure during jogging:After taping,there was no statistically significant difference between groups in the lateral forefoot(P>0.05).In the pronation foot group,the load of the medial forefoot increased significantly(P<0.05).In the supination position group,the load of the lateral forefoot,the middle foot and the rear foot region increased significantly(P<0.05).(5)The results showed that the Fascia taping was suitable for different foot postures.It could not only correct the static foot structure of subjects with different foot postures,but also regulate the abnormal plantar pressure distribution during the dynamic activities of walking and jogging,and the load of the midfoot,forefoot,and hindfoot in the supination and pronation posture tended to normal foot posture load level.

Objective: To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments. Methods: History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan. Results: At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal. Conclusions The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .

BACKGROUND: Transcription factor (TF) can bind specific sequences that either promotes or represses the transcription of target genes, and exerts important effects on tumorigenesis, migration, invasion. Staphylococcal nuclease-containing structural domain 1 (SND1), which is a transcriptional co-activator, is considered as a promising target for tumor therapy. However, its role in lung adenocarcinoma (LUAD) remains unclear. This study aims to explore the role of SND1 in LUAD. METHODS: Data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Clinical Proteomic Tumor Analysis Consortium (CPTAC), and Human Protein Atlas (HPA) database was obtained to explore the association between SND1 and the prognosis, as well as the immune cell infiltration, and subcellular localization in LUAD tissues. Furthermore, the functional role of SND1 in LUAD was verified in vitro. EdU assay, CCK-8 assay, flow cytometry, scratch assay, Transwell assay and Western blot were performed. RESULTS: SND1 was found to be upregulated and high expression of SND1 is correlated with poor prognosis of LUAD patients. In addition, SND1 was predominantly present in the cytoplasm of LUAD cells. Enrichment analysis showed that SND1 was closely associated with the cell cycle, as well as DNA replication, and chromosome segregation. Immune infiltration analysis showed that SND1 was closely associated with various immune cell populations, including T cells, B cells, cytotoxic cells and dendritic cells. In vitro studies demonstrated that silencing of SND1 inhibited cell proliferation, invasion and migration of LUAD cells. Besides, cell cycle was blocked at G1 phase by down-regulating SND1. CONCLUSIONS SND1 might be an important prognostic biomarker of LUAD and may promote LUAD cells proliferation and migration.
Humans ; Prognosis ; Proteomics ; Lung Neoplasms/genetics* ; Oncogenes ; Adenocarcinoma of Lung/genetics* ; Biomarkers ; Endonucleases/genetics*