BACKGROUND: The inheritance tendency and immunity imbalance of atherosclerotic brain infarction (ABI) have attracted the attention of many scholars at home and abroad, which suggests that immune mechanism plays a key role in ABI development. It has been found that ABI is related to polymorphism of human immune inheritance gene (HLA), particularly HLA-DR gene.OBJECTIVE: To investigate the correlation between HLA and ABI immune heredity.DESIGN: Single sample and single factor analysis.SETTING: Sino-Japanese Friendship Hospital of Jilin University; Neurological Department of the First Hospital of Harbin City.PARTICIPANTS: Totally 31 patients in experimental group and 30 healthy people in control group, whose three generations were of the Han Nationality in north China and who had no blood relation, were selected from Department of Neurology in First Hospital of Harbin between January 1998 and December 2000.METHODS: The experiment was conducted in the Blood Research Center of Department of Neurology in First Hospital of Harbin between June and December 2003.5 mL peripheral blood in both groups was taken to extract genome DNA with the previous method. Human HLA gene map had been described at gene bank in the Internet, in which mono-nucleic acid obtained from HLA of the sixth chromosome were retrieved. Each DR and DQ allele, sense primer and antisense primer were composed selectively. Amplification of DNA fragment was checked respectively and specifically. The primer was provided by Shanghai Gene Research Institute. PCR instrument (4 800) and its related reagents produced by PE Company (the US) were used. Fourfold table exact probability method was used to calculate the relative risk (RR) and P value.which was obviously higher than that of other sites (P ＜ 0.05). However,associated with the ABI susceptible gene of the Han Nationality in north China.

ObjectiveTo investigate the effect of dexmedetomidine on postoperative intracranial pressure (ICP) in patients with severe brain injury.MethodsNinety ASA Ⅱ or Ⅲ patients with severe brain injury,aged 19-64 yr,with Glasgow coma scale 3-7,undergoing emergency craniotomy,were randomly divided into 3 groups (n =30 each):control group (group C) and 2 different doses of dexmedetomidine groups (groups D1,D2 ).Anesthesia was induced with propofol 1.5-2.0 mg/kg,fentanyl 4 μg/kg and vecuronium 0.1 mg/kg and maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of vecuronium.The patients were mechanically ventilated after tracheal intubation.Dexmedetomidine 0.3 and 0.7 μg· kg- 1· h- 1 were infused after tracheal intubation in groups D1 and D2 respectively and the infusion was maintained for 48 h.ICP was monitored after operation and maintained ＜ 30 mm Hg by iv injection of hexadecadrol,mannitol and glycerol fructose within 2 d after operation.Venous blood samples were obtained from peripheral vein after anesthesia induction and at 6,12 and 24 h after operation (T0-3) for determination of sertum IL-1β and TNF-α concentrations by ELISA.The clinical results were evaluated using Glasgow prognosis score at 3 months after operation.The amount of hexadecadrol,mannitol and glycerol fructose consumed during 2 d after operation was recorded.ResultsCompared with T0,serum IL-1βand TNF-α concentrations were significantly higher at T1-3 in the three groups ( P ＜ 0.05).The serum IL-1β and TNF-α concentrations at T1-3 and the amount of hexadecadrol,mannitol and glycerol fructose consumed were significantly lower,and the clinical results were significant better in groups D1 and D2 than in group C,and in group D2 than in group D1 ( P ＜ 0.05).ConclusionDexmedetomidine can reduce postoperative ICP in patients with severe brain injury in a dose-dependent manner which is helpful for improving prognosis.The decrease in IL-1β and TNF-α levels and inhibition of inflammatory response may be involved in the mechanism.

BACKGROUND: Properties of cancellous bone is significant for metabolic diseases, fracture and joint retrograde diseases.OBJECTIVE: To study the biomechanical properties of cancellous bone.DESIGN: Experimental observation based on femur specimens as the single sample.SETTING: Laboratory of Orthopaedic Biomechanics Ninth Affiliated Hospital Shanghai Second Medical University.PARTICIPANTS: The study was completed in the Laboratory of Orthopaedic Biomechanics, Shanghai Ninth People's Hospital from May to July in 2001,totally 19 male cadaveric femoral heads were selected.METHODS: Totally 19 cadeveric cancellouce bone specimens(about 30years old) from the bearing area of fresh femur head were tested by compression test.MAIN OUTCOME MEASURES: Yield load limiting stress, limiting strain, energy value and elastic modulus of specimens.RESULTS: The compressive data of cancellous bone were measured, the average value of yield load was (410.64 ± 190.29) N , limiting stress was (8.69 ± 3.75) MPa, limiting strain was (10. 84 ±6.58)%, energy value was (2.54 ± 1.89)J, modulus of elasticity was (40.77 ± 32. 12)MPa, At the early time of loading, the cancellous bone showed elastic deformation, then CONCLUSION: The trial indicates that biomechanical properties lighten the pressure of external compression.

BACKGROUND: Quite a number of in vitro experiments indicate that low dose He-Ne laser can stimulate the cell growth and blood vessel regeneration therefore to improve the damages caused by ischemia. However, it needs further study on the in vivo experiments.OBJECTIVE: To study the protective effects of intravascular low dose laser irradiation to ischemic reperfusion of rats and explore its mechanism.DESIGN: A randomised and controlled trial based on experinental animals.SETTING: Department of Neurology of a hospital of a university.MATERIALS: The experiment was completed in the Surgery Experimental Animal Center of West China Hospital of Sichuan University. Healthy male SD rats of class Ⅱ which aged between 5 to 6 months with weight of 372 to 418 grams[mean weight(388.48 ± 10. 57) g] were provided by Animal Research Center of Sichuan University.INTERVENTIONS: Middle cerebral artery ischemia model of rats was prepared. Forty SD rats were randomly divided into treatment group and control group with each of 20 rats. Intravascular low dose He-Ne laser irradiation was conducted to rats in treatment group one time every other day, 20 minutes per time and 3 times for a course. Vein puncture was conducted to rats in control group without laser input.MAIN OUTCOME MEASURES: Ratio of infarcted volume RESULTS: The ratio of the cerebral infarction volume in treatment group was (10.43 ± 1.04) and is much lower than that of control group(16.78 ± 1.12).There was statistical difference between two groups( t = 27.14, P ＜ 0.05).CONCLUSION: Intravascular low dose He-Ne laser irradiation has protective effects to cerebral ischemia of rats.

Objective To investigate the correlation between histone deacetylase 9 gene ( HDAC9 ) single nucleotide polymorphisms and ischemic stroke ( IS) subtypes. Methods A total of 202 patients with IS were enrolled prospectively. According to the Trial of Org 10172 in Acute Stroke Treatment ( TOAST) classification,the patients with IS were divided into large artery atherosclerotic stroke group (LAA,n=149) and the small-artery occlusive stroke group (SAO,n=53). A total of 201 age- and sex-matched healthy subjects over the same period were enrolled as the control group. Polymerase chain reaction-ligase detection reaction ( PCR-LDR ) was used to perform genotyping for HDAC9 gene rs11984041 and rs2107595 loci in all subjects. The correlation between genotype and IS was analyzed with multivariate logistic regression analysis. Results ( 1 ) In all the subjects detected, the genotype detected from rs11984041 loci was type CC,and 3 genotypes including CC,CT,and TT were detected from rs2107595 loci. (2) There were significant differences in dominance model (CT+TT,CC) genotypes and allele frequencies among the LAA, SAO, and control group dominance model ( CT +TT, CC ) and (χ2 =8. 635,P=0. 013, χ2 =10. 309,P=0. 006);and there were no significant differences in dominance model (CT+TT,CC) and allele frequencies among the 3 groups (after adjustment all P>0. 017). Compared with the control group,there were significant differences in the CC,CT,and TT genotypes and allele frequencies in the LAA group (χ2 =7. 446;P=0. 006). In the dominance models (CT+TT),there was significant difference in genotype frequencies between the LAA group ( 65. 1%,97/149 ) and the control group (52. 2%,105/201) (χ2 =5. 800;P=0. 016). (3) Multivariate logistic regression analysis showed that in addition to gender,hypertension,smoking,and high level of low-density lipoprotein,the dominance model CT+TT genotype was associated with the LAA type IS ( CT+TT genotype:OR,1. 909,95% CI 1. 055-3. 454,P =0. 033). Conclusion In addition to the risk factors for cerebrovascular disease such as gender,hypertension,smoking,and high level of low-density lipoprotein,HDAC9 gene polymorphisms may be associated with the LAA type IS. rs2107595 locus CT + TT genotype may be an independent risk factor for LAA type IS.

Objective To investigate the association between serum ferritin(SF) level at early and mid trimester of pregnancy and gestational diabetes mellitus (GDM) and insulin resistance (IR).Methods A total of 192 cases of women who were accepted antenatal examination from the first trimester of pregnancy at Yueqing People Hospital from July,2012 to October,2013 was prospectively analyzed and followed up.All cases were divided into two groups:96 cases of GDM pregnant women who were diagnosed as GDM at mid trimester of pregnancy as GDM group,and 96 cases of pregnant women with normal glucose tolerance at the same time as the control,normal glucose tolerance (NGT group).The differences in clinical data were compared between two groups.The relationship between SF level and fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment insulin resistance (HOMA-IR),and C-peptide was investigated with Spearman rank correlation analysis.The predictive values of SF and relative variables to GDM were calculated by receiver operating characteristic curve (ROC) or Logistic regression analysis.Results (1) There was statistically significant difference in body weight and body mass index (BMI) at prepregnancy and mid trimester of pregnancy,Hb,FPG,FINS,SF,and C-peptide at the first trimester of pregnancy,SF level and FPG and HOMA-IR and C-peptide at mid trimester of pregnancy between two groups (P ＜ 0.01 or P ＜ 0.05).(2) As showed by Spearman rank correlation analysis,there was statistical correlation between SF at mid trimester of pregnancy,and FPG,FINS,HOMA-IR and C-peptide (P ＜0.01 or P ＜ 0.05);while no statistical correlation was found between SF at the first trimester of pregnancy and the same factors above (P ＞ 0.05).(3) The area under the ROC curve of SF at mid trimester of pregnancy for GDM was 0.653.The sensitivity and specificity were 68.8％ and 59.4％ in predicting GDM at the cut-off value of 16.61 ng/ml.As showed by Logistic regression analysis,high level of SF at mid trimester of pregnancy was a independent risk factor for GDM.Odds ratio (OR) was 1.032 (95％ CI:1.008 ～ 1.058,P ＜ 0.01).Conclusions The relationship between SF at different trimester of pregnancy and GDM is variant.There is relationship between high level SF of mid trimester of pregnancy in GDM pregnant women and IR.The level of SF might predict the occurrence of GDM.

A 29-year-old male patient with extranodal NK/T-cell lymphoma,a nasal type lymphoma with involvement of skin as the first symptom,was reported.The patient presented with swelling in the left side of the nose and suffered intermittent fever for 1 month.The fester in the oral mucosa and skin under the left nostril and redness,and the swelling on the orbit of the left eye lasted for 1 week.Physical examination showed that the left side of nose was swelling,and the skin below the left nostril was anabrotic and crusted.There were different ulcers in his jaws and buccal mucosa.Bilateral eyelid was redness and swelling,especially in the left side.Binocular conjunctival was congestive.The diagnosis of extranodal NK/T-cell lymphoma (nasal type) was confirmed by biopsy and immunohistochemistry.

Objective To investigate the effect of preemptive analgesia with parecoxib sodium on postoperative cognitive junction in the elderly patients.Methods Sixty ASA ⅠorⅡ patients aged 69-83 yr weighing 47-73 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 2 groups (n=30 each):control group (group C) and parecoxib group (group P).Their preoperative mini-mental state examination scores were more than 23.Parecoxib sodium 40 mg in 5 ml normal saline was injected iv before induction of anesthesia in group P. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients. VAS score was maintained ≤3. If VAS score was more than 3, a bolus of fentanyl 0.2 μg/kg was given iv.Venous blood samples were taken at 1 day before and 1, 4, 24 and 72 h after operation for determination of plasma concentrations of cortisol.Cognitive function was assessed by mini-mental state examination. The total amount of fentanyl and tramadol consumed was recorded. Results Plasma cortisol concentrations and incidence of postoperative cognitive dysfunction were significantly lower and the total amount of fentanyl and tramadol consumed was smaller in group P than in group C.Conclusion Preemptive analgesia with parecoxib sodium 40 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.

Objective To evaluate the incidence of postanesthetic shivering in patients undergoing radical operation for lung cancer under dexmedetomidine-assisted anesthesia.Methods Eighty ASA Ⅰ or Ⅱ patients,aged 50-75 yr,height 158-180 cm,weighing 48-79 kg,scheduled for radical operation for lung cancer under general anesthesia combined with epidural anesthesia,were randomly divided into 2 groups ( n =40 each): normal saline control group (group C) and dexmedetomidine group(group D).Anesthesia was induced with midazolam,fentanyl,propofol and rocuronium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with sevoflurane inhalation and intermittent epidural ropivacaine.BIS was maintained at 40-55.Group D received dexmedetomidine intravenous infusion at 0.5 μg · kg- 1· h- 1 from immediately after tracheal intubation until 1 h before the end of operation,and group C received the equal volume of normal saline.The shivering within 1 h after operation was scored and recorded.Results The incidence rate of postanesthetic shivering was 50％ in group C and 10％ in group D.Compared with group C,the incidence rate and degree of shivering were decreased in group D( P ＜ 0.05).Conclusion Dexmedetomidine-assisted anesthesia can reduce the incidence of postanesthetic shivering in patients undergoing radical operation for lung cancer.

Objective To explore the effects of multidisciplinary comprehensive pulmonary rehabilitation on aged patients with pneumo-coniosis. Methods From January, 2012 to January, 2015, 85 old stable inpatients with pneumoconiosis were divided into control group (n=40) and rehabilitation group (n=45). Both groups accepted routine medicine, while the rehabilitation group received multidisciplinary com-prehensive pulmonary rehabilitation for twelve weeks. They were assessed with cardiopulmonary exercise test, BODE index and quality of life before and after treatment. Results The maximum work, maximal oxygen uptake, 6-minute walk distance, scores of modified Version of the British Medical Researsh Council Respiratory Questionnaire, BODE index, activities of daily living, social activities, depression and anx-iety improved in the rehabilitation group after treatment (t>3.379, P<0.01), and were better than those in the control group (t>2.201, P<0.05). No imporvement was found in all the indices in the control group after treatment (t<2.339, P>0.05). Conclusion Multidisciplinary comprehensive pulmonary rehabilitation can effectively improve exercise tolerance and quality of life in aged patients with pneumoconiosis.