Objective To evaluate the effects of different doses of dexmedetomidine on atrioventricular node (AVN) conduction function in the healthy volunteers.Methods Sixteen healthy volunteers of both sexes,aged 18-30 yr,with body mass index of 19-26 kg/m2,were included in the study.Dexmedetomidine was infused in a loading dose of 1.0 μg/kg over 10 min,followed by an infusion of 0.5 μg · kg-1 · h 1 for 50 min (Dose Ⅰ);1-2 weeks later,dexmedetomidine was infused in a loading dose of 1.5 μg/kg over 10 min,followed by an infusion of 0.75 μg · kg-1 · h-1 for 50 min (Dose Ⅱ).Before infusion of dexmedetomidine (T0) and at 15 and 35 min of infusion (T1.2),AVN Wenckebach point,AVN 2 ∶ 1 block point,AVN relative refractory period (AVNRRP),and AVN effective refractory period (AVNERP) were measured.Results AVN Wenckebach point and AVN 2 ∶ 1 block point were significantly decreased,and AVNRRP and AVNERP were significantly prolonged at T1,2 compared with those at T0 (P＜0.05).Compared with Dose Ⅰ,AVN Wenckebach point at T2 and AVN 2 ∶ 1 block point at T1,2 were significantly decreased,and AVNRRP and AVNERP were significantly prolonged at T1,2 in the subjects receiving Dose Ⅱ] (P＜0.05).Conclusion Dexmedetomidine can inhibit AVN conduction function in the healthy volunteers,and the inhibitory effect is enhanced with the increasing doses.

Objective To survey the knowledge requested by patients with coronary artery disease (CAD) after stent implantation.Methods A survey on CAD and stent-related knowledge requested by CAD patients with stent implantation was conducted with a self-designed questionnaire from September 2013 to November 2013.Total 362 patients (235 males and 127 females) aged (67 ± 12) years participated in the survey in Yuetan Community Health Service Center and Fuxing Hospital in Beijing.Open questions and heuristic questions were used together during the survey.Results The knowledge requested by patients were:diet management(255,70.4％),side effects of medication(241,66.6％),management of physical activity (221,61.0％),prevention of CAD(181,50.0％),withdrawal of medication(176,48.6％),the life of stents (168,46.4％),post-operation check-up items (162,44.8％),the causes of CAD (156,43.1％)and drug mechanisms(134,37.0％).Patients with stent implantation less than one year requested more knowledge about the cause of CAD (x2 =37.4,P ＜ 0.001),life-time of stent (x2 =39.9,P ＜0.001),prevention of CAD (x2 =13.4,P =0.001),post-operation check-up items (x2 =21.2,P =0.001) and requested less knowledge about withdrawal of medication (x2 =9.56,P =0.008),diet management (x2 =6.49,P =0.04) than those with more than one year.Patients aged ＜ 70 years requested more knowledge about the cause of CAD (x2 =31.6,P ＜ 0.001),prevention of CAD (x2 =9.99,P =0.007),life-time of stent (x2 =79.1,P ＜ 0.001),side effects of medication (x2 =7.84,P =0.02) than patients aged ＞ 70 years.Patients with education higher than junior high school requested more knowledge about the cause of CAD (x2 =26.6,P ＜ 0.001),prevention of CAD (x2 =14.4,P =0.001) and life-time of stents (x2 =7.82,P =0.02) than those with education lower than junior high school.Patients with education higher than junior college requested more knowledge about the cause of CAD (x2 =26.6,P ＜ 0.001) and post-operation check-up items (x2 =10.7,P =0.005) than those with education lower than junior college.Conclusion Some factors affect the knowledge requested by patients with coronary artery disease (CAD) after stent implantation,which should be considered in health education for CAD patients.

Background and purpose:Increased glucose metabolism is a characteristic of malignant tumors.This characteristic might be related to a facilitative glucose transporter(Glut-1) and the proliferating activities of tumors.This study was aimed to assess the relationship among the over-expression of facilitative glucose transporter(Glut-1) and proliferating cell nuclear antigen(PCNA) as well as the fluorine-18 fluorodeoxyglucose(18F-FDG) uptake of tumors in patients with nasopharyngeal carcinoma.Methods:Between March 2005 and August 2006,40 patients with nasopharyngeal carcinoma were imaged with 18F-FDG positron emission tomography(PET).Their maximum standard uptake values(SUVmax) were measured.The expression of Glut-1 and the proliferating cell nuclear antigen(PCNA) in the 40 cases were studied in paraffin sections by SP immunohistochemistry.Results:The 18F-FDG uptake of tumors of the 40 patients with nasopharyngeal carcinoma was 9.4?1.9(SUVmax).All 40 tumors tested Glut-1 positive and PCNA positive.The Glut-1 positive cells consisted of 45.18% of the tumor cell area,whereas the PCNA positive cells consisted of 36.18% of the tumor cell area.There were correlations between Glut-1 expression levels(r=0.369,P=0.019) and the tumors' 18F-FDG uptake but no correlations were found between PCNA expression level and the tumors' 18F-FDG uptake(r=0.135,P=0.407).Conclusion:Glut-1 over-expression correlates with 18F-FDG uptake whereas PCNA over-expression does not correlate with 18F-FDG uptake in patients with nasopharyngeal carcinoma.

Objective:To explore the clinical value on application of laparoscopic ultrasonography (Lap US) in the adnexal operation. Methods:Eleven patients including 7 cases of tubal pregnancy, 3 cases of teratoma of ovary and 1 case of endometrial cyst of ovary were examined by LapUS, then operated with laparoscopy.Results:The results showed that the modality presented is a big progress over the traditional operative management for adnexal diseas. Conclusions:It is a good approach for micro-surgery in the adnexal operation by laparoscopy.

In order to construct a prokaryotic expression vector of human receptor syt II N-fragment and to express recombinant MBP-Syt fusion protein in E.coli and to purify and identify its activity. According to codon preference of E.coli, a DNA fragment encoding human syt II N-fragment was synthesized, and then cloned into prokaryotic vector pMAL-c2x for sequencing. Then the recombinant plasmid pMAL-Syt was introduced into E.coli ER2566 by transformation for expression and the obtained engineered bacteria were induced by IPTG. The fusion protein was purified by amylose resin affinity chromatography and identified by SDS-PAGE and Western blot. The binding activity of the protein was determined by ELISA. It is concluded that MBP-Syt protein is of good binding activity.

Objective:To express the B subunit of Shiga-like toxin type Ⅱ,and analyze its expression form and receptor-binding activity.Methods:The slt2b gene was obtained from EHEC O157∶H7 by PCR,and cloned to the expression vector pET22b(+).The genetically engineered bacteria pET22b(+)-stx2B/BL21 expressed the recombinant StxB after induced with IPTG.The renatured inclusion bodies were purified by ion exchange chromatography.The expression form of rStx2B was investigated by denaturing and native electrophoresis.The receptor-binding activity was confirmed by fluorescence detection and flow cytometer.Result:The constructed genetically engineered bacteria expressed the rStx2B at a high level.The purified protein was obtained after denaturation,renaturation and ion exchange chromatography.According to the denaturing and native electrophoresis,the rStx2B was expressed in a dimmer form,which consists of two monomers cross linked with disulfide bridge.The rStx2B showed good receptor-binding activity by Hela-binding assay.Conclusion:The genetically engineered bacteria were constructed successfully.The receptor-binding activity of rStx2B was independent of the pentamers.

Objective To discuss the changes of neutrophil gelatinase-associated lipocalin (NGAL) in patients with primary nephrotic syndrome (PNS)and the correlation with renal pathological type,renal tubulointerstitial lesions and the clinical indicators.Methods Forty patients with PNS were divided into acute kidney injury (AKI) group and non-AKI group according to whether renal tubular necrosis (ATN) occurred in renal pathology.Moreover,on the basis of pathological type they were divided into minimal change disease (MCD) group,mesangial proliferative glomerulonephritis (MsPGN) group,focal segmental glomerulosclerosis (FSGS) group,membrane proliferative glomerulonephritis (MPGN) group and membranous nephropathy (MN) group.Twenty healthy subjects and normal kidney tissues which came from 20 patients with renal tumor nephrectomy and were distant from the tumor sites were the control groups.Enzyme-linked immunosorbent assay (ELISA) was applied to detect the serum and urine level of NGAL,and immunohistochemical staining was used to observe the expression of NGAL in the renal tissue.Results (1)The serum and urine level of NGAL and the expression of NGAL in the renal tissue in the PNS complicated with AKI group were significantly higher than that in the PNS without AKI group and in the control group(P ＜ 0.05).(2)The serum and urine level of NGAL and the expression of NGAL in the renal tissue were enhanced in MPGN group and FSGS group than that in the other three groups(P ＜ 0.05).(3) Before developing to severe tubulointerstitial lesions,with the aggravation of tubulointerstitial damage,the serum and urine level of NGAL and the expression of NGAL in the renal tissue were increased.But when renal tubular interstitial lesions developed to severe disease,serum level of NGAL and the expression of NGAL in the renal tissue were decreased(P ＜ 0.05).(4)The serum and urine level of NGAL and the expression of NGAL in the renal tissue were positively correlated with serum creatinine(r values were 0.198,0.352,0.146 respectively,P values were 0.048,0.000,0.028 respectively),were positively correlated with blood urea nitrogen(r values were 0.199,0.278,0.325 respectively,P values were 0.043,0.000,0.019 respectively),were negatively correlated with serum albumin(r values were-0.384,-0.318,-0.259 respectively,P values were 0.028,0.024,0.020 respectively) and were negatively correlated with urine osmotic pressure(r values were-0.250,-0.256,-0.277 respectively,P values were 0.012,0.027,0.002 respectively).Conclusion NGAL is a sensitive biological parameter for predicting AKI in the patients with PNS,and it can be used to evaluate the degree of tubulointerstitial lesions and renal function to a certain extent.

All the examination results of anesthesia interns from 1996 to 2003 were analyzed.The content and criteria of examination in anesthesia intern which was formulated by our university was evaluated.The cause of deficiency reflected by examination results and problems existing in education were analyzed to improve clinic training for anesthesia intern and cultivate excellent anesthesia specialist.

Objective To explore the predictive capability of different methods for difficult la-ryngoscopy and analyze its optimal cutoff value.Methods Three hundred consecutive patients (aged 18-65 years,weighing 42-88 kg,ASA physical status Ⅰ or Ⅱ)scheduled to undergo general anesthe-sia and surgery were invited to participate.Difficult airway assessments were performed by thyromen-tal height (TMH),thyromental distance (TMD),sternomental distance (SMD),modified Mallam-pati test (MMT)and ratio of height and TMD (RHTMD)before anesthetic induction.Cormack-Le-hane (C-L)grade of laryngoscopy view was assessed after induction.Sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV)and accuracy of these tests were calculated. Receiver operator characteristic (ROC)curve of TMH was performed to determine the optimal cutoff value of TMH.Results There were 22 patients diagnosed as difficult airway.Sensitivity,specificity, PPV,NPV and accuracy of TMH were higher than those of TMD,SMD and MMT tests.Sensitivity of RHTMD was lower than that of TMH test,and specificity,PPV,NPV and accuracy of RHTMD were similar to that of TMH.The optimal cutoff value of TMH was 4.9 cm through ROC curve. Conclusion The optimal cutoff value of TMH detecting difficult laryngoscopy was 4.9 cm.Similar to RHTMD,TMH appears to be more effective for prediction of difficult laryngoscopy than TMD, SMD and MMT.

Objective To investigate the diagnostic value of MRI in reversible splenial lesion syndrome (RESLES) in children.Methods The clinical and MRI imaging data of 14 cases of RESLES in children were retrospectively reviewed.There were 4 males and 10 females,aging 11 to 35 months.Average age was (20±3) months.MRI studies were conducted in all the cases.Two experienced doctors analyzed independently the images and reached consensus.Results Fourteen cases showed the single abnormal signal in the splenial of corpus callosum on the initial cerebral MRI.Lesions in 10 of 14 cases appeared as isointensity on T1WI,hypo-intensity in 4 cases.Lesions in 14 cases were appeared as hyper-intensity on T2WI,hyper-/slightly hyper-intensity on FLAIR T2WI.The lesions were round,oval or irregular,with fuzzy boundary.DWI showed round or oval high signal with clear boundary.No edema around the lesion and no occupying effect were detected.After treatment,8 of 14 cases were reviewed after 7-14 d,and the abnormal signal in the corpus callosum disappeared in 5 cases,while the range was significantly reduced in 3 cases.MRI were reexamined after 1-2 months in 5 cases,and the lesions disappeared in the corpus callosum.One case didn't have MRI examination again after treatment and the clinical symptoms disappeared.Conclusions The clinical manifestations of RESLES in children are lack of specificity.And the cerebral MRI imaging is characterized by the reversible solitary lesion of the splenium,which can provide a reliable basis for clinical diagnosis and prognosis.