Objective To investigate the effects of 3 different delivery methods on maternal and fetal complications during labor and determine better mode of delivery. Methods Sixty pregnant women with ASA class Ⅰ or Ⅱ were randomly divided into three groups with 20 cases each: the cesarean section group (group Ⅰ), the pain relief group (group Ⅱ) and normal delivery group (group Ⅲ). In group Ⅰ and Ⅱ, an epidural catheter was placed through L_(2-3) interval. 0.5% ropivacaine was injected via the epidural catheter for continuous epidural anesthesia in group Ⅰ. After a loading dose of 8-10 mL 0.125% ropivacaine+2 μg/mL fentany, the patient-controlled epidural analgesia (PCEA) during labor was started with bolus 5 mL, lockout interval 20 min and back ground infusion rate 6-8 mL/h in group Ⅱ. The level of block was controlled below T_(10). BP, HR and RR were continuously monitored during labor. Blood samples were taken from umbilical vein at delivery for blood gas analysis and determination of lactate concentration. Neonates were assessed by Apgar score and neurological and adaptive capacity score (NACS). Maternal postoperative complications were recorded. Results There was no statistical differences in plasma pH, PCO_2, PO_2, SO_2, Apgar score and NACS among 3 groups. The umbilical vein blood lactate concentration was significantly increased in group Ⅱ and Ⅲ compared to the group Ⅰ, while blood lactate concentration in group Ⅱ was lower than that in the group Ⅲ (P<0.05). Base excess (BE) was significantly higher in group Ⅲ than in group Ⅰ. Compared with group Ⅱ and Ⅲ, maternal postoperative complications such as urinary retention, postpartum hemorrhage and so on were increased significantly in group Ⅰ (P<0.05). PCEA provided satisfactory effect in group Ⅱ. Conclusions Epidural labor analgesia with 0.125% ropivacaine+2 μg/mL fentany can provide comparative and effective analgesia for pain relief during labor without adverse effects on the mothers and fetuses and may reduce the postoperative complications. It is a safer and more effective technique in pain relief during labor.

Objective To investigate the effects of acute hypervolemic hemodilution (AHH) with hydroxyethyl starch (HES) 130/0.4 on intestinal mucosal barrier in a rat model of sepsis.Methods Thirty healthy New Zealand rabbits of both sexes weighing 2.0-3.0 kg were randomly divided into 3 groups (n=10 each):group I sham operation; group II sepsis and group III AHH+sepsis.Sepsis was produced by modified colon ascendens stent peritonitis(CASP).At 4 h after CASP group III meceived HES 130/0.4 20 ml/kg iv at a rate of 20 ml/min.The MAP and HR were monitored and recorded at 4 h (before AHH) and 5,6,7,8 h after CASP.Blood samples were taken from carotid artery and superior mesenterie vein (SMV) at 4 h and 8 h after CASP for blood gas analysis and determination of plasma D-lactate concentration and intestinal oxygen extraction ratio.The rabbits were sacrificed at 8 h after CASP and a segment of ileum of 3 cm in length,5 cm from ileocecal valve,was removed for determination of wet/dry ileum weight ratio and microscopic examination.The degree of damage to intestinal mucous membrane was scored according to Chiu score (0=normal,5=severe damage).Results Sepsis-induced hypotension and metabolic acidosis,increased plasma D-lactate concentration,decreased intestinal oxygen extraction ratio,increased wet/dry ileum weight ratio and Chiu score in group II as compared with group I.AHH with HES 130/0.4 20 ml/kg significantly attenuated the scpsis-induced changes in group III.Conclusion AHH with HES 130/0.4 can attenuate damage to intestinal mucosal barrier produced by sepsis.

Objective To investigate the effects of acute hypervolemic hemodilution (AHH) on cerebral O2 supply/consumption and energy metabolism in patients undergoing elective surgery under general anesthesia combined with continuous epidural block. Methods Fourteen ASA Ⅰ or Ⅱ patients of both sexes (9 male, 5 female) aged 44-62 yrs weighing 55-70 kg undergoing elective surgery under general anesthesia combined with epidural block were enrolled in this study. Lactated Ringer's solution 6-8 ml?kg-1 was infused before anesthesia. After correct placement of epidural catheter was confirmed radial artery was cannulated for BP monitoring and blood sampling. BP, EGG, SpO2 and PET CO2 were continuously monitored during anesthesia. General anesthesia was induced with fentanyl, midazolam, propofol and rocuronium and maintained with iaoflurane and intermittent i. v. boluses of vecuronium. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 30-35 mm Hg. Epidural block was produced by a mixture of 1.33 % lidocaine + 0.167 % dicaine. Right internal jugular vein was retrogradely cannulated and advanced cephalad until jugular bulb for blood sampling. AHH was conducted by infusing 6% HES 20 ml?kg-1 at 50 ml?min-1 after induction of general anesthesia. Blood samples were taken from artery (a) and jugular venous bulb (jv) simultaneously before AHH (T0) at 15 min (T1) and 120 min (T2) after AHH was accomplished for blood gas analysis and determination of Hb, glucose and lactate concentrations. Cerebral O2 extraction rate (CERO2), glucose extraction rate (CMRglu) , arterial-jugular bulb venous O2 content difference (D a-jvO2) and arterial-jugular bulb venous lactate difference (VADL) were calculated. Results At the end of AHH Hct and Hb decreased by 20% as compared to the baseline values before AHH. S jvO2 was significantly higher, D a-jvO2 smaller and CERO2 lower at T1 than at T0. There were no significant differences in BP, HR, CMRglu and VADL at all time points. Conclusion AHH can increase cerebral O2 supply and has no significant effect on cerebral glucose metabolism during operation performed under general anesthesia combined with epidural block.

Objective:To detect differentiallyexpressed microRNAs (miRNAs)in plasma of schizophrenia and explore biomarker for diagnosis of schizophrenia.Methods:The discovery cohort tincluded 6 patients with schizophrenia meeting diagnostic criteria of schizophrenia of the Diagnostic and Statistical Manual of Mental Disor-der,Fourth Edition (DSM-IV),as well as 6 healthy control subjects,whose age and gender were matched to pa-tients.The expression of 754 miRNAs (Sanger human miRBase v14)in the discovery cohort was investigated by Taqman Array (Human MicroRNA A +B Cards Set v3.0).Then the quantitative reverse-transcription polymor-phism chain reaction (qRT-PCR)assay was conducted to validate differentially expressed miRNAs in an independ-ent replication cohort,which included 25 schizophrenia patients and 18 healthy control subjects.The student's t-tests were used to analyze the differential expression of miRNA between schizophrenia patients and controls.All analyses were performed in Significance Analysis of Microarrays (SAM)software.Results:Twenty down-regulated miRNAs were observed in discovery cohort.Four miRNAs,hsa-miR-15b-5p were down-regulated in both discovery and rep-licated cohorts.Conclusion:The present study suggests that aberrant expression of miRNA might be of potential im-portance as biomarkers in the diagnosis of schizophrenia.

Objective To compare the time-course of relaxant effect of rocuronium between patients with ocular and generalized myasthenia gravis (MG).Methods Twenty-seven ASA physical status I or Ⅱ patients with MG of both sexes,aged 12-64 yr,with body mass index of 17-26 kg/m2,scheduled for elective extended thymectomy,were divided into 2 groups according to Osserman stage:ocular group (group O,n =10) and generalized group (group G,n =17).Anesthesia was induced with iv injection of fentanyl 2 μg/kg,midazolam 0.05 mg/kg,and propofol 1.5 mg/kg.All patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg-1 · h-1 and remifentanil 0.2 μg· kg-1 · min-1.Twitch tension was monitored in the adductor pollicis muscle by train-of-four stimulation of the ulnar nerve (intensity 60 mA,interval 12 s,frequency 2 Hz,wave length 0.2 ms).Rocuronium 0.6 mg/kg was injected intravenously after calibration.Mean arterial pressure (MAP),HR,heart rate variability (HRV) and low frequency and high frequency (LF/HF) ratio was recorded.The onset time of muscle relaxation,time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were recorded.Results Compared with the baseline value,there were no significant changes in MAP,HR,HRV,LF/HF ratio at all time points in the two groups (P ＞ 0.05).Compared with group O,there was no significant change in the onset time of muscle relaxation,and the time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were significantly prolonged in group G (P ＜ 0.05).Conclusion The duration of rocuronium-induced neuromuscular block is significantly longer in patients with generalized MG than those with ocular MG,while the onset time is comparable between the two groups.

Objective To compare the effects of different modes of delivery on arterial oxygen saturation in the fetus.Methods One hundred and twenty ASA Ⅰ or Ⅱ parturients aged 22-32 yr with a single fetus at full term lying in normal headdown position were divided into 3 groups according to the modes of delivery (n =40 each):group cesarean section (group CS) ; group labor analgesia (group LA) and group spontaneous labor (group SL).In group CS cesarean section was performed under epidural anesthesia with 0.5％ ropivacaine.Epidural catheter was placed at L2,3 interspace in groups CS and LA.In group LA labor analgesia was started from the first stage and maintained until complete cervical dilatation.The patients received epidural PCA (PCEA) with O.125 ％ropivacaine plus fentanyl 2 μg/ml.PCEA setting was as follows:a loading dose of 8-10 ml; demand bolus 5 ml;20 min lockout; background infusion 6-10 ml/h.Blood samples were taken from umbilical artery at delivery for blood gas analysis and determination of serum concentrations of lactate,β-endorphin (β-EP) and neuropeptide Y (NP-Y).Apgar score and neurological and adaptive capacity score (NACS) were recorded.Results There was no significant difference in Apgar score,NACS and NP-Y and β-EP concentrations in umbilical arterial blood among the 3 groups.The lactate concentration and the absolute value of BE were significantly higher while pH was lower in group SL than in groups CS and LA.PO2 was significantly higher while PCO2 was lower in group LA than in groups SL and CS,and the lactate concentration and absolute value of BE were significantly lower while pH was higher in group LA than in group SL.Conclusion The 3 modes of delivery have significant effects on arterial oxygenation in fetus but have no clinical significance.

Objective To research the effect of molecular chimeric mice pre-T cells on proliferation ability of allogeneic mouse T cells.Methods The MHC-Ⅰ gene (H-2Kband H-2Db gene) were extracted and amplified by RT-PCR,the identified pre-T cells were transfected by the constructed eukaryotic expression vector of C57BL/6mouse MHC-I (pIRES-H-2Db and pIRES-H-2Kb),non-transfected group and sham pIRES-transfected control group were set.The molecular chimeric cells were transfused back to BALB/c mouse.After 7 days,T lymphocyte cells of each group were extracted,the ability of molecular chimeric cells inducing spleen T lymphocyte response to allogeneic T cells was observed through mixed lymphocyte culture (MLC).Results Sequencing of the plasmid we have constructed showed that insertion sequence contained C57BL/6 mice H-2Kb and H-2Db series which could be retrieved from GenBank.The result of flow cytometry analysis indicated that H-2Kb and H-2Db protein had an increased expression in pre-T cells,the difference with other two groups was statistically significant (P＜0.05).The result of MLC demonstrated that the stimulation index (SI) of T lymphocyte in co-injection transfected pIRES-H-2Kb and pIRES-H-2Db pre-T cells group (0.764±0.074) were significantly decreased compared with non-transfected group(0.983±0.081)and sham pIRES-transfected group(0.994±0.142) (P＜0.05).Conclusions The molecular chimeric pre-T cells infusion can reduce spleen T lymphocyte response to allogeneic T cells and it may induce immune tolerance in vivo.

Objective To study the effects of esmolol on fluid responsiveness and hemodynamic parameters in patients with septic shock.Methods A prospective self-control study was conducted.Fifteen septic shock patients undergoing mechanical ventilation admitted to Department of Critical Care Medicine of Yijishan Hospital from January 2015 to August 2015 were enrolled.All patients enrolled in this study were given the treatment based on American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus 2012.Esmolol was intravenously injected at a beginning rate of 6 mg·kg-1·h-1, and then the dose was adjusted to reduce heart rate by 10％ from baseline.The changes in hemodynamic and systemic oxygen metabolism indexes were monitored by pulse indicator continuous cardiac output (PiCCO) before and 2 hours after the esmolol administration, and the fluid responsiveness was evaluated by stroke volume variation (SVV).SVV ≥ 10％ was considered to be a positive fluid responsiveness.Results In 15 patients, 9 were male and 6 female, with an age of 65 ± 16.Among them 10 patients suffered from pulmonary infection, and 5 patients with abdominal infection.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 21 ±9;sequential organ failure score (SOFA) was 8 ±4.28-day mortality was 40.0％.SVV was significantly decreased after esmolol infusion as compared with baseline [(14 ± 5)％ vs.(17 ±7)％, t =2.400, P =0.031].Heart rate [HR (bpm): 100±4 vs.112±8, t =8.161, P =0.000], cardiac output [CO (L/min):6.13 ± 1.45 vs.7.88 ± 1.82, t =4.046, P =0.001], cardiac index [CI (mL·s-1·m-2): 51.51 ± 11.00 vs.66.18 ± 11.48, t =4.131, P =0.001], stroke volume index [SVI (mL/m2): 31.0 ± 6.4 vs.35.4 ± 6.5, t =2.577, P =0.020], the maximum rate of left ventricular pressure rise [dp/dt max (mmHg/s): 927±231 vs.1 194±294, t =3.775, P =0.002], global ejection fraction (GEF: 0.21 ±0.05 vs.0.24±0.06, t =3.091, P =0.008), cardiac function index (CFI: 5.03 ± 1.37 vs.6.59 ± 1.92, t =4.769, P =0.000) showed significant decrease during esmolol infusion.On the other hand, central venous pressure [CVP (mmHg, 1 mmHg =0.133 kPa): 9±3 vs.8±3, t =-3.617, P =0.003], diastolic blood pressure (DBP, mmHg: 69± 15 vs.66± 13, t =-2.656, P =0.019), systemic vascular resistance index (SVRI, kPa·s·L-1·m-2:206.8±69.8 vs.206.8±69.8, t =-3.255, P =0.006) were significantly increased during esmolol infusion.No significant difference was found in systolic blood pressure [SBP (mmHg): 120 ± 25 vs.123 ± 18, t =0.678, P =0.509],mean arterial pressure [MAP (mmHg): 86 ± 18 vs.85 ± 14, t =-0.693, P =0.500], global end diastolic volume index [GEDVI (mL/m2): 614 ± 84 vs.618 ± 64, t =0.218, P =0.830], extravascular lung water index [EVLWI (mL/kg):5.99±1.50 vs.5.73±1.14, t =-1.329, P =0.205], central venous oxygen saturation (ScvO2: 0.711±0.035 vs.0.704 ± 0.048, t =-0.298, P =0.773), arterial blood lactate [Lac (mmol/L): 3.1± 0.3 vs.3.0 ± 0.4, t =-0.997, P =0.345],and difference of central venous-arterial carbon dioxide partial pressure [Pcv-aCO2 (mmHg): 4.1 ± 0.9 vs.4.7 ± 0.5,t =1.445, P =0.182] as compared with those before esmolol treatment.Conclusion Heart rate control with esmolol infusion may reduce fluid responsiveness, cardiac function, heart rate and cardiac output without adverse effect on systemic perfusion in septic shock patients.

Objective To study the dose rate distribution on cultured cell plane and establish a reference dose rate table of in vitro cell line ~(125)I seed irradiator.Methods Thermoluminescence dosimetry(TLD) was used to measure the irradiation dose rate of a single 6711 model(~(125) I) seed with apparent activity of 10.323 MBq in water at point P.Meanwhile,the theoretic value of the irradiation dose rate at point P was calculated with theoretic formula.The difference between the calculated and observed values within 10% was set as standard to analyze the accuracy of the measurement.The irradiation dose rate of a single 6711 model(~(125) I) seed was measured in 1mm-thick polystyrene + water medium at point P.The value was applied to differential or non-differential proof along with the value from water medium to study the effect of 1 mm thick polystyrene on distribution of irradiation dose in water.Finally,by simulating the(~(125) I) seed plane irradiator with nine(~(125) I) seeds,the distribution table of irradiation dose rate on the cultured cell plane was calculated with theoretical formula.Results The observed value(n= 10) of irradiation dose rate with one(~(125) I) seed in water at point P was(0.359?0.023)cGy/h and the calculated value was 0.347cGy/h,the difference was within 10%.The observed value(n=10) of irradiation dose of one(~(125) I) seed in 1mm-thick polystyrene + water medium at point P was (0.350?0.027)cGy/h,which showed no statistical difference from the observed value in water under differential and non-differential proof.The reference table on dose rate distribution for cells exposed to(~(125) I) seed irradiation in vitro was developed.Conclusions 1mm-thick polystyrene gives no significant effect on irradiation dose rate distribution from(~(125) I) seeds in water.A reference table on the dose rate distribution for cells exposed to(~(125) I) seed irradiation in vitro has been developed,which can be used to determine an optimal irradiating strategy for future work.

AIM: To investigate the effect of low concentration desflurane on hemodynamics and fibrinolysis in patients during general anesthesia. METHODS: Twenty eight ASA grade Ⅰ-Ⅱ patients during general anesthesia, scheduled for elective chest surgery, were studied, and hemodynamics and fibrinolysis were observed after inhalation of desflurane at 0.5 and 1.0 MAC , respectively. RESULTS: Compared with those before anesthesia, SBP, DBP, and MAP remarkably decreased and HR significantly increased at intubation. However, the changes were more remarkable than those of before anesthesia when inhalation of desflurane at 0.5 and 1.0 MAC ; blood pressure did not further decreased; and HR did not increased in comparison with intubation. The level of plasma tissue plasminogen activator (t PA) remarkably increased and the level of plasma plasminogen activitor inhibitor (PAI) significantly decreased when inhalation of desflurane. The level of plasma t PA further increased and the level of plasma PAI further decreased as inhalation of increased desflurane concentration. CONCLUSION: There are some effects of low concentration desflurane on hemodynamics and fibrinolysis in patients with chest surgery during general anesthesia.