Objective To investigate the efficacy of anesthesia with propofol-remifentanil given by targetcontrolled infusion (TCI) for thymectomy in patients with myasthenia gravis ( MG). Methods Forty-five ASA Ⅰ or Ⅱ MG patients aged 16-64 yr weighing 45-95 kg undergoing thymectomy were studied. Anesthesia was induced with TCI of propofol (target plasma concentration 4 μg/ml) and remifentanil (target effect-site concentration 4 ng/ml). Thracheal intubation was performed after topical anesthesia with 2% lidocaine 2-3 ml and then the patients were mechanically ventilated. Anesthesia was maintained with TCI of propofol ( target plasma concentration 3-5 μg/ml) and remifentail (target effect-site concentration 3-6 ng/ml). Sufentanil 0.15 μg/kg was injected intravenously for analgesia 30 min before operation. The success rate of intubationat at first attempt, body movement in response to skin incision, recovery time, extubation time, extubation condition at the end of operation and cardiovascular events were recorded. Results Thracheal intubation was performed successfully in all patients. The success rate of intubation at first attempt was 100%. No body movement occurred during skin incision in the patients.Recovery time was 1.0-3.2 min and extubation time 2.6-7.0 min. All patients were successfully extubated at the end of operation. Bradycardia developed in 3 patients and hypotension in 4 patients during induction, but they all returned to normal after symptomatic treatment. Bradycardia developed in 3 patients during operation, but returned to normal after symptomatic treatment. Conclusion Anesthesia with TCI of propofol and remifentanil can be used safely and effectively in MG patients undergoing thymectomy.

Tumors are classified into two major categories,benign and malignant.One main difference between malignant and benign tumors is their tendency to metastasize and recur.The metastasis itself is an ominous sign for prognosis and responsible for most cancer deaths.The metastatic "cascade" comprises a lot of steps,including escape from the primary tumor site,penetration of local stroma,entry of local vascular or lymphatic vessels,aggregation with platelets,interaction with and adhesion to distant endothelia,extravasation,recolonization,and expansion,all the time avoiding effective immune clearance and being able to survive.It has now been shown to contain stem cell-like cells called cancer stem cells(CSC) in several solid tumors.Although generally rare,these cells appear to be highly tumorigenic and may drive tumor formation and mediate tumor metastasis.

Angiogenesis is an important feature of malignant neoplasm and plays an essential role in the genesis,growth and metastasis of tumors. CT perfusion imaging (CTPI),as one of the functional imaging techniques reflecting neovascularity of neoplasm,perfectly combines anatomical imaging with physiological information and can be used in a range of clinical areas,such as differentiation between benign and malignant lesions,early detection of malignancy or metastasis,prediction of tumor behavior and the assessment of responses to therapies. Many researches have been done on perfusion CT in tumors of the brain,thyroid gland,salivary gland,mammary gland,lungs,liver,esophagus,kidney,colorectum,and so on. The present article reviews the basic principles of perfusion CT and its clinical application in tumors.

Up to date, there are two types of drugs approved to treat hepatitis B: interferons and nucleos (t) ide analogues. However, the therapies are limited in the clinical context because of the negative side effects of interferon-α and the development of substantial viral resistance to nucleos (t) idic inhibitors. Therefore, new drugs with novel structures and mechanisms are needed. In this article, the drugs approved by FDA or the European Commission for treating chronic hepatitis B virus infection, as well as those under clinical trials, and several compounds in preclinical studies are reviewed. Additionally, some potential targets and strategies to combat chronic hepatitis B virus infection are discussed.

Objective To investigate the imaging diagnostic value of the early avascular necrosis of the femoral head(ANFH) in adult.Methods There were 25 cases (34 hips) with early ANFH diagnosed by imaging and clinical data.Radiography,CT and MRI findings of ANFH were analysed comparatively.Results In the 34 ANFH included stage Ⅰ 13 hips,stage Ⅱ 21 hips.The diagnostic accurary was 32.4% for X-ray,61.8% for CT and 100% for MRI.Conclusion MRI is better than the other technique in early finding the lesions of ANFH,and the diagnostic sensitivity and accuracy of MRI are higher than that of CT and X-ray.

Objective To construct eukaryotic expression vector of antisense MBD1 gene fragment and to provide a tool for studying MBD1 gene function. Methods PCR primers were designed according to the coding sequence of MBD1 gene. Xba I and Kpn I recognition sequences and cutting sites were added to the 5' end of the sense and antisense primer respectively. The 342 bp specific PCR fragment was obtained from the cDNA of biliary tract carcinoma cell line QBC-939 using RT-PCR, the purified PCR fragment was then inserted reversely into the multiple cloning site of eukaryotic expression vector pcDNA3. 1 ( + ). The constructed recombinant plasmid was identified by PCR confirmation, Xba I and Kpn I double enzyme digestion and DNA sequencing. Results The 322 bp specific DNA band was obtained by PCR, Xba I and Kpn I double digestion produced a 327 bp and a 5. 4 kb DNA band which represent the inserted target gene fragment and the vector respectively. The sequencing result confirmed that the sequence of inserted fragment was correct. Conclusion The eukaryotic expression vector of antisense MBD1 gene fragment was constructed successfully by using gene cloning technique. It will be a useful tool for studying MBD1 gene function in DNA methylation and tumorigenesis.

Objective To analyze the current status of the drug resistance of enterococci and monitor the prevalence of drug-resistant strains of enterococci in hospital infection. Methods 318 strains of enterococci separated from infectious samples in nine general hospitals in Hubei were assayed and tested with regard to drug sensitivity and the software of WHONET4 was used to analyze the data. Results The separation ratio of ARE, HLARE, VRE and ARE complicated with HLARE was respectively 16.98% , 37.76% , 0 and 5.66% . Conclusion The drug resistance of enterococci shows the tendency of increasing and consequent hospital infection shows the tendency of scattered prevalence. Laboratories of clinical microorganisms ought to closely watch the detection and spread of VRE.

Objective To investigate the pharmacodynamics of sufentanil required to inhibit the body movement induced by tetanic stimulation and skin incision when combined with propofol in patients undergoing thoracic or abdominal surgery. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective thoracic or abdominal surgery were randomized into 5 groups sufentanil target effect-site concentration (Ce) (n = 10 each):0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml groups. Anesthesia was induced with TCI of propofol at the target plasma concentration of 3.0-3.2 μg/ml. As soon as the patients lost consciousness, infusion of sufentanil with the corresponding Ce was started in the each group. One tetanic stimulus (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) was given after the target effect-site and plasma concentrations were balanced. Tracheal intubation was facilitated with succinylcholine 1.5 mg/kg. The concentrations of propofol and sufentanil were maintained until 4 min after skin incision. The body movement was observed during tetanic stimulation and skin incision. The effective effect-site concentration (EC50, EC94) of sufentanil and 95% confidence interval (CI) were calculated using probit regression analysis. Results The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation when combined with propofol were 0.12 (95% CI 0.09-0.14) ng/ml and 0.20 (95% CI 0.17-0.31) ng/ml respectively. The EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 (95% CI 0.11-0.16) ng/ml and 0.21 (95% CI 0.17-0.29) ng/ml respectively. There was no significant difference in the EC50 and EC95 of sufentanil between the two different stimuli (P ＞ 0.05). Conclusion The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) when combined with propofol were 0.12 and 0.20 ng/ml respectively, the EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 and 0.21 ng/ml respectively and there was no significant difference in the pharmacodynamics between the two different stimuli, indicating that tetanic stimulation as an alternative to skin incision can be used to evaluate the pharmacodynamics of anesthetics.

Objective To compare the effect of electroacupuncture at head points and body points on glucose metabolism of the cerebral motor function regions in normal subjects.Methods To observe the change of glucose metabolism of cerebral motor area in normal subjects between before and after acupuncture during the movement by PET.Talairach coordinates(Atlas of brain) and statistical parametric mapping(SPM) software were used to deal with the acquired imaging data.Results ① Acupuncture at Baihui(GV20) and left Qubin(GB7) could increase metabolism of glucose in bilateral Lps and precuneus,the activation of left area in the brain being more significant.②Acupuncture at right Quchi(LI11) and Zusanli(ST36) change metabolism of glucose in left gyrus precentralis,right loblus paracentralis,right gyrus frontalis medialis,both cerebellums and both putarnens.Conclusion All acupoints can change glucose metabolism in cerebral structures related to motor function in the bilateral cerebral hemispheres,different acupoints active different motor areas.The function of acupuncture is a kind of comprehensive regulative process.

Objective To investigate if the endothelin-1 (ET-1),nitric oxide(NO) can affect renal artery blood flow and explore the clinical value of ultrasonography in hypertensive disorder complication pregnancy.Methods 18 patients of gestational hypertension,18 patients of gently preeclampsia,20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random.Color Doppler ultrasonography was used to detect the peak systolic velocity (PSV),end diastolic velocity (EDV),resistive index (RI),pulsatility index (PI) of renal interlobar artery.The levels of serum ET-1 and NO were measured by enzyme-linked immunosorbent assay (ELISA) and nitric acid recovery respectively.Results The level of EDV in preeclampsia patients were significant lower than the control group (P ＜0.05).The levels of RI,PI,S/D in preeclampsia patients were significant higher than the control group (P ＜0.05).The level of ET-1 in study group was higher than control group (P ＜0.01).The level of NO in study group was lower than control group (P ＜0.01).There was positive correlation between the RI,PI,S/D of renal interlobar artery and the level of serum ET-1.There was inverse correlation between the RI,PI,S/D of renal interlobar artery and the level of serum NO.Conclusions Endothelial dysfunction can cause unbalance of renal vessel systolic-diastolic function.The level of renal artery blood flow parameters can reflect the state of vessel function and have clinical value in hypertensive disorder complication pregnancy.