Objective To study the sedation and amnesia of midazolam in patients with different ages of lumbar epidural anesthesia . Methods From January to July 2015, 235 patients in the first affiliated of xian jiaotong unniversity,who were implemented abdominal surgery under combined spinal epidural anesthesia and American Society of anesthesiologists (ASA) grade was I-II , were divided into three groups:young group (n=70); middle-aged group (n =82); elderly group (n =83).Intraoperative continuous monitoring of respiratory and circulatory function index,and recorded MAP,SpO2, HR before and 5, 15, 30 min after injection.ResuIts MAP, HR and SpO2 of three groups were compared with the same time points pre-and post used of midazolam, there was no significant difference among indicators.; Compared with the same group at different time points, MAP(FYG =9.2547,FMG =12.8181,FOG =17.77)和 SpO2 (FYG =190.3835,FMG =196.2393,FOG =270.5609),there were significant difference.The difference was not statistically significant between HR group and the same group at different time points and forgetting degree and sedation score , but compared with OG,there were significant difference(P<0.05).The total number of adverse reactions in YG group and MG group was less than that of OG group(X2 =11.2516,X2 =10.4491, P<0.05).ConcIusion The effect of the same dose of midazolam on sedation and amnesia in patients with different ages of lumbar epidural anesthesia is different, and the degree of the effect of the elderly patients is significant,but will produce more adverse reactions.Therefore, in the combined spinal epidural anesthesia,it is necessary to consider the patient's individual differences, rational use of sedative and narcotic drugs.

BACKGROUND:The main component of cartilage, type Ⅱ col agen gene expression in chondrocyte is positively correlated with SOX9 concentration in a dose-dependent manner.
OBJECTIVE:To observe the variation of SOX9 and type Ⅱ col agen mRNA content at different periods in the differentiation process (osteogenic, chondrogenic, adipogenic induction) of mesenchymal stem cel s, and to explore the correlation of SOX9 expression and type Ⅱ col agen.
METHODS:Bone marrow mesenchymal stem cel s were isolated from 4-week-old Kunming mice, and cultured in vitro to passage 3. The cel phenotype was identified with flow cytometry. Cel s were divided into three groups and subjected to three kinds of induction conditions favorable for adipogenic, chondrogenic and osteogenic differentiation, and each group was observed at three time points. In addition, the non-induced cel s were used as a control group. The total RNA of cel s was extracted at 3, 7, 14 days after induction, and SOX9 and type Ⅱ col agen mRNA was quantified with reverse transcription-polymerase chain reaction. The induced cel s were stained by immunofluorescence to observe the differentiation and perform statistical analysis.
RESULTS AND CONCLUSION:Passage 3 bone marrow mesenchymal stem cel s grew wel , and cel phenotype was confirmed as stem cel s by flow cytometry. The staining results showed that, the cel s differentiated into chondrocytes, adipocytes and osteoblasts. The SOX9 mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in osteogenic differentiation group, and the lowest in adipogenic differentiation group. Type Ⅱ col agen mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in adipogenic differentiation group, and the lowest in osteogenic differentiation group. SOX9 expression in chondrogenic differentiation group increased at 3 and 7 days, and then decreased at 14 days. While type Ⅱ col agen expression increased at 3, 7, 14 days. SOX9 mRNA levels increased as the osteogenic differentiation, while type Ⅱ col agen expression gradual y decreased. There was no significant difference in the SOX9 mRNA expression between adipogenic differentiation group and control group (P>0.05), while type Ⅱ col agen expression was not regularly changed. Experimental findings suggest that, critical effect of SOX9 in chondrogenic differentiation is better than that in osteogenic and adipogenic differentiation. SOX9 is associated with type Ⅱcol agen, which may alter along with the SOX9 in the early chondrogenic differentiation;SOX9 may play a fine-tuning role in the process of chondrogenic and osteogenic differentiation.

AIM: To investigate the anti-leukemia effect, the restricted usage and clonal expansion of TCR V? subfamily T cells from donor peripheral blood induced by chronic myelogenous leukemia(CML) cells, K562 cells and bcr-abl peptide, respectively. METHODS: T cells in donor's peripheral blood were stimulated with CML cells, K562 cells and bcr3-abl2 peptide and amplified by MLTC, to induce the CML specific cytotoxic T lymphocytes. The induced T cells were further analyzed for the restricted usage and clonal expansion of TCR V? subfamilies by using RT-PCR and genescan analysis, and the detection of specific cytotoxicity in CML by LDH release assay. RESULTS: 10-13 V? subfamilies were expressed in T cells from donor peripheral blood which were induced with CML cells, K562 cells and bcr-abl peptide in 1-2 weeks by MLTC. Oligoclonal T cell in V?16, V?21 and oligoclonal tendency T cells in V?5, V?13 subfamilies were identified in induced T cells, which have the ability of specific cytoxicity to CML cells and K562 cells. CONCLUSION: The anti-CML cytotocity T cells were induced by CML cells, K562 cells and bcr-abl peptide. These induced T cells with specific cytoxicity effect may come from the clonal expansion TCR V? subfamily T cells.

AIM: To investigate the expression of SCL (stem cell leukemia) gene in bone marrow stromal cells (BMSCs) and bone marrow hematopoietic cells from patients with aplastic anemia (AA) and normal individuals. METHODS: Bone marrow stromal cells from AA (9 cases) and normal individuals (33 cases) were amplified by long-term in vitro culture. The adherent and nonadherent cells were collected respectively. RT-PCR-ELISA assay was then performed to detect the expression of SCL gene and the housekeeping gene ?_2 microglobulin (?_2M). The expression ratio of SCL gene were analyzed and its expression level was normalized by ?_2M gene acting as an internal calibration for the purpose of semi-quantitative analysis. RESULTS: The expression ratio of SCL gene was lower in BMSCs from AA (22.2%) than that in normal controls (69.7%, P

AIM: To investigate the expression of transcription factor GATA-3 gene in the bone marrow stromal cells (BMSCs) from patients with aplastic anemia (AA) and normal controls. METHODS: The expression of GATA-3 gene was analyzed by using RT-PCR-ELISA in BMSCs from 34 normal cases and 9 cases with AA. The standardized semi-quantitative expression level of GATA-3 gene in BMSCs from patients with AA was compared with normal controls. RESULTS: The expression of GATA-3 gene was detected in BMSCs from both normal controls and the cases with AA. The expression level of GATA-3 gene in BMSCs from AA was significant higher than that from the normal controls (P

Objective:To investigate the immediate and lasting effects of enhanced external counterpulsation(EECP)on blood pressure in elderly patients with hypertension.Methods:In this real-world prospective non-randomized controlled study, the elderly hypertensive patients who were newly diagnosed as hypertension or had poor blood pressure control in the Geriatrics Department of Shandong University Qilu Hospital from May 2019 to December 2019, were enrolled as EECP group, and those with systolic blood pressure(SBP)≥180mmHg(1mmHg=0.133 kPa)or had contraindications for EECP treatment were excluded from EECP group(28 cases). Based on the 1∶1 ratio being consistent with the tendency score-matching method, patients' blood pressure was matched at 3 d before the start of the EECP treatment course, with other matched data of baseline data, coexisting disease, cardiovascular medication were choosed as control group(n=28). The EECP group received an additional 36 hours of EECP treatment(6 times/week, 1 hour/time)including lifestyle improvement and anti-hypertensive drugs.The patient's supine blood pressure was collected 3 minutes before each EECP treatment(baseline), 30 minutes during treatment, and 3 minutes after treatment.In the EECP group, family self-measured blood pressure was collected 3 days before the start of the 6-week treatment course(0w), the 6th week(6w)of the treatment course, and the 2nd week(+ 2w), 4th week(+ 4w)and 12th week(+ 12w)after the end of the treatment course, respectively.And the data of control group were collected at the same time point mentioned above.Results:Compared with baseline, the average immediate SBP of elderly hypertensive patients at the 30th minute of EECP treatment was decreased by(5.5±13.6)mmHg( P<0.001), and the average immediate diabolic blood pressure(DBP)was decreased by(1.1±7.5)mmHg( P<0.001). When the baseline SBP was between 160 and 169 mmHg, the probability of a further increase in SBP during treatment was 2.2%(2/89 cases), and when the baseline SBP was between 170 and 179 mmHg, the probability of a further increase in SBP during treatment was 0%(0/57). At 6 weeks, the decrease in SBP was significantly greater in the EECP group than in the control group[(-17.0±8.7)mmHg vs.(-10.5±7.3)mmHg, P<0.01], and the difference continued to + 2w[(-15.5±6.6)mmHg vs.(-10.6±2.5)mmHg, P<0.01]and + 4w[(-13.3±5.4)mmHg vs.(-10.7±2.1)mmHg, P<0.05]. At + 12w, the blood pressure drop was still greater in EECP group than in the control group, but it did not achieve statistically significant differences.Smoking history, history of diabetes, family history of hypertension, and improvement of comorbidities were the key factors that affect the continuous anti-hypertensive effect of EECP. Conclusions:EECP treatment has an immediate effect on lowering blood pressure in elderly hypertensive patients.A 6-week course of EECP treatment has a sustained effect on lowering blood pressure, and the effect can last from 4 to 12 weeks after the end of the course of treatment.

Objective:To explore the application value of non-invasive pressure-strain loop (PSL) in evaluating left ventricular systolic function of young strength athletes with different heart rates.Methods:Thirty-five young wrestlers were collected randomly and divided into 2 groups according to the heart rate: group 1 (heart rate of 40-59 beats/min, n=20) and group 2 (heart rate of 60-80 beats/min, n=15). Thirty healthy young males were selected as the control group at the same period. Non-invasive PSL was used to obtain left ventricular global longitudinal strain (GLS), longitudinal peak strain dispersion (PSD), global myocardial work index (GWI), global constructive myocardial work (GCW), global wasted myocardial work (GWW) and global myocardial work efficiency (GWE) in three groups, and the differences between them were measured. Results:Compared with the control group, GWE in the athlete group 1 and 2 reduced, PSD, GWW were increased, and GWI, GCW in the athlete group 1 were decreased, and all differences were statistically significant (all P<0.05). Compared with the athlete group 1, PSD, GWI, GCW, GWW in the athlete group 2 increased and GWE was reduced (all P<0.05). Conclusions:PSL can quantitatively evaluate the left ventricular myocardial work of young strength athletes with different heart rates, and then assess the effect of heart rates on the left ventricular systolic function of athletes.

Objective:To explore the application value of ultrasonic layer-specific strain technology in evaluating left ventricular systolic function in young male strength athletes.Methods:In October 2018, 30 professional young male wrestlers from Henan Provincial Heavy Sports Management Center (athlete group) and 30 healthy young males matched with age (control group) were randomly selected.Using traditional echocardiography combined with stratified strain technique, heart rate (HR), left ventricular end-diastolic diameter(LVDd), interventricular septal thickness on diastole(IVSTd), postwall thickness on diastole (PWTd), relative wall thickness (RWT), end diastolic volume index(EDVI), end systolic volume index (ESVI), ejection fraction (LVEF), stroke volume index (SVI), cardiac index (CI), spherical index (SPI), endocardial myocardial global longitudinal strain(GLSendo), mid-myocardial global longitudinal strain(GLSmid), epicardial myocardial global longitudinal strain(GLSepi), peak strain dispersion(PSD) and whole myocardial longitudinal strain cross-wall difference (ΔLS) were measured respectively. The differences between the two sets of data were analyzed.ROC curves were plotted to analyze and compare the stratified strain parameters performance to predict left ventricular systolic function or synchrony in athletes.Results:The values of LVDd, PWTd, IVSTd, RWT, SPI, EDVI, ESVI and SVI in athelete group were higher than those of the control group. And the values of HR, GLSendo, GLSmid, GLSepi and ΔLS were lower than those of the control group.The differences were statistically significant (all P<0.05). There was no significant difference in LVEF, CI and PSD between the two groups (all P>0.05). The areas under the ROC curve of GLSendo, GLSmid and GLSepi for athletes′ left ventricular systolic function were 0.753, 0.747 and 0.726, respectively, and the optimal cut-off values were -22.34%, -19.95%, -17.35%, respectively. Conclusions:Long-term high-intensity exercise can lead to subclinical changes in left ventricular systolic function, and ultrasonic layer-specific strain technology can more accurately and specifically evaluate left ventricular systolic dysfunction. Among the GLS parameters, GLSendo is the optimal parameter for testing the left ventricular systolic function of athletes.

Objective To study the characteristics of noise hazards in automobile sand casting industry and understand the impact of noise on the health of automobile foundry workers, and to provide scientific data support for the control of noise hazards. Methods An automobile sand casting enterprise was selected as the research object. The post noise intensity test results from 2010 to 2019, the noise spectrum test results of each post in 2019, and the prevalence of occupational noise deafness in the 10 years from 2010 to 2019 were analyzed and sorted out. Using chi-square test and t-test the noise hazard characteristics and noise intensity changes were statistically analyzed. Results 1. The noise LEX.8h exceeding standard rate of foundry enterprises in the 10 years from 2010 to 2019 was not statistically significant（χ²=6.76, P=0.66), and the mean value of noise LEX.8h fluctuated horizontally in the 10 years, which was basically stable between 80 - 90 dB (A). 2. The mean value of noise intensity of sand falling, sand preparation, cleaning and shot blasting in the first five years was significantly different compared to that in the last five years. There was no statistically significant difference in other posts. 3. Among all posts in the foundry sand casting industry, the noise spectrum of core-making and cleaning posts was mainly medium and high frequency, while the noise spectrum of other posts was mainly medium and low frequency. 4, Cases of occupational noise deafness were mainly concentrated in cleaning and polishing workers, melting chemical workers, inspectors and other types of workers. Conclusions The noise hazards in the automobile foundry sand casting industry are mainly concentrated on the posts of molding, and sand falling, and the noise intensity and the over standard rate remain high in the past 10 years. The noise of each post is mainly medium and low frequency, and the noise of a few individual posts is mainly medium and high frequency. In recent years, due to the automatic renewal of equipment, the noise intensity of some posts such as sand dropping, sand mixing, cleaning and shot blasting has decreased, but the overall noise exceeding standard rate has basically not changed, and the noise hazard is still serious. The noise hazard of foundry sand casting enterprises is difficult to be controlled, and the risk of hearing loss of foundry workers is still high.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.