Objective To discuss the application effect of joint remifentanil propofol anesthesia on upper gastrointestinal peristalsis in the painless gastroscopy.Methods 130 patients who taken painless gastroscopy were choosed,and using the random number table method,they were divided into the observation group and control group. Propofol anesthesia was used in the control group,joint remifentanil anesthesia was used in the observation group,and the anesthetic effect were recorded.Results In the observation group group,the excellent rate of anesthesia was 93.85%,the control group was 80.00%,there was statistically significant difference between the two groups (χ2 =5.481,P <0.05).The propofol dosage in the observation group was (1.73 ±0.24)mg/kg,patients awake time was (5.91 ±1.03)min,and departure from the hospital time was (14.58 ±2.79)min,while in the control group,the propofol dosage was (3.06 ±0.57)mg/kg,patients awake time was (9.44 ±1.87)min,and departure from the hospi-tal time was (22.05 ±4.86)min,there were statistically significant difference between the two groups (t =17.337, 13.330,10.747,all P <0.05).24 cases of observation group of patients with mild 36 cases,moderate,severe in 5 cases;23 cases of control group in patients with mild and moderate 27 cases,15 cases were severe,there was statistically significant difference between the two groups (χ2 =5.376,P <0.05).Conclusion Joint remifentanil propofol used in painless gastroscopy of anesthesia is better than only propofol anesthesia,and with little impact on patients with upper gastrointestinal system,it can reduce the dosage of propofol,shorten the patient awake time and time of departure from the hospital,so it is worth popularization and application in clinic.

OBJECTIVE: To investigate the regulating pattern of kidney-tonifying recipes and spleen-invigorating recipe on the expression of T lymphocyte apoptosis signaling-related genes in corticosterone-treated rats. METHODS: We analyzed the activation-induced T lymphocyte apoptpsis rate through TUNEL-labelled flow-cytometry assay, quantified the mRNA expression level of T cell apoptosis-regulating genes by using the fluoresecence real-time PCR, analyzed the activity of caspase-8 and caspase-3 by colorimetric assay. RESULTS: (1) T lymphocyte apoptosis rate of corticosterone-treated rats was higher than that of the normal control rats; T lymphocyte apoptosis rates of Youguiyin treated rats and Bushen Yishou Capsule treated rats were lower than that of the corticosterone-treated group; T lymphocyte apoptosis rate of Sijunzi Decoction treated rats displayed no significance compared with that of the corticosterone-treated group. (2) Pro-apoptotic genes such as Fas, FasL, TNFR1, and Bax displayed increased expression level in corticosterone-treated group compared with normal control group. Two kidney-tonifying recipes down-regruated the expression level of FasL and TNFR1, at the same time, both recipes up-regulated the expression level of Bcl-2. The spleen-invigorating recipe had up-regulating effect on the expression level of Bcl-2. And all these results had statistical significance. (3) The activities of caspase-8 and caspase-3 were increased in corticosterone-treated rats compared with normal control; both kidney-tonifying recipes had significant effect on decreasing the activities of these two apoptosis executioners. CONCLUSION: The excessive apoptosis of T cell in corticosterone-treated rats could be effectively modulated with two kidney-tonifying recipes. Down-regulating the expression of FasL and TNFR1 and up-regulating the expression of Bcl-2 as well as decreasing the activities of caspase-8 and caspase-3 may be the unique regulating pattern of tonifying-kidney method with respect to T cell apoptosis related genes in corticosterone-treated rats.

Objective To research the resistant characteristics, genotype and prevalence of vancomycin-resistant Enterococci( VRE) . Methods K-B disc diffusion method was used to determine the susceptibility, minimum inhibi-tory concentration ( MIC) for vancomycin of VRE was detected by E-test method;VRE was then subjected to PCR for resistance related genes;6 strains sequencing results of PCR product were contrastively analyzed the amino acid sequence by BLAST. Results 6 VREFm strains were found from 193 strains enterococci;6 VREFm strains were completely resistant to high unit gentamicin, ampicillin, ciprofloxacin, teicoplanin,but were sensitive to linezolid and macrodantin,MIC for vancomycin was more than 256 mg/L;Genotypes were vanA;Amino acids in vanA gene have changed with Asn83→Asp( AAC→GAC) . Conclusion VRE in our hospital is mostly multi-drug resistant , which bringS difficulty in clinical treatment for its infection. So the hospital should strengthen the prevention and monitoring, to prevent the spread of VRE strains in the hospital and popular.

Objective To investigate the role of monoclonal antibody of insulin-like growth factor Ⅰ receptor (IGF-ⅠR) in the proliferation and apoptosis of papillary thyroid carcinoma cell line CGTH W-3, and the effect of IGF-ⅠR monoclonal antibody on papillary thyroid carcinoma cells and normal follicular cells in primary culture. Methods MTT and TUNEL method were used to determine the proliferation and apoptosis of cells respectively after IGF-ⅠR monoclonal antibody intervention. Results The inhibitory effect on cell proliferation was enhanced with the increasing IGF-ⅠR monoclonal antibody concentration and duration of action. IGF-ⅠR monoclonal antibody induced apoptosis of CGTH W-3 cells remarkably even in the concentration of 50 nmol/L. Primary papillary thyroid carcinoma cells and normal follicular cells were inhibited by 100 nmol/L IGF-ⅠR monoclonal antibody, and the degree of inhibition was significantly higher in carcinoma cells than that in normal follicular cells (P

Objective To study the normal value on the motor conduction velocity(MCV) and F wave parameters in normal adults at different age,sex,and provide reasonable datum for clinic.Methods 155 healthy volunteers (male for 76 cases, female for 79 cases,age from 18 to 82 years old) were used as subjects.Distal latency,proximal latency, MCV,F wave latency,the duration between F and M waves (F MIPL),F wave conduction velocity (FCV) as well as the F wave ratio were recorded in bilateral median and ulnar nerves, F wave were elicited with stimulation at wrist.Results There were significant differences in M wave latency, MCV, FwPL, F MIPL and FCV between the different groups of age and sex, the latency of each individual wave was shorter in the female than in the male.the conduction velocity(CV) of the female was faster than the male. No significant differences in the F wave ratio were found between male and female, left and right limbs for the same nerve,median and ulnar nerves in the same Limb and in individuals at different age.MCV was usually faster in the proximal than in the distal.Conclusion MCV and F wave parameters changed progressively with increasing age. There were respective normal values in different age group and sex,F wave ratio might provide information in evaluating nerve conduction function in both of the proximal and distal end.

Objective To investigate the clinical efficacy of intravitreal injection of Lucentis combined with pan retinal photocoagulation and trabeculectomy for neovascular glaucoma(NVG). Methods Seventeen eyes of 15 patients with NVG were treated by 0.5 mg Lucentis intravitreal injection first. Trabeculectomy was performed 7 days later and Pan retinal photocoagulation 2 weeks later. Iris,anterior chamber angle neovascularization,intraocu?lar pressure ,and visual acuity were observed in the following 6 months. Results Iris and anterior chamber angle neovascularization were completely regressed 7 days after the injection in 17 eyes. Six months after photocoagulation, 6 eyes had different degrees of improvement in visual acuity,10 eyes no change in visual acuity and 1 eye decreased from anterior index to immediate manual. There was significant difference in pre?treatment IOP and postoperative IOP( t = 12.75 ,10.26 ,9.73 ,10.77 ,P < 0.01 ). No serious complications were observed after intravitreal injec?tion and trabeculectomy. Conclusions Intravitreal injection of Lucentis could significantly accelerate the regres?sion of iris and anterior chamber angle neovascularization ,which could improve the successful rate of trabeculecto?my and pan retinal photocoagulation. Intravitreal injection of Lucentis combined with trabeculectomy and panretinal photocoagulation is safe and effective for NVG.

Objective To explore the possible mechanism of the apoptosis of hepatoma cell line HepG2 induced by the combination use of GNRs@SiO2-FA and 125I seeds and to discuss its relationship with Bcl-2 and Bax protein expressions so as to provide theoretical basis for clinical treatment of hepatic cancer with interstitial brachytherapy by using 125I seeds. Methods In vitro cultured HepG2 cells were randomly divided into 4 groups: blank control group (not treated), simple GNRs@SiO2-FA group, simple 125I seeds group, and combination group (GNRs@SiO2-FA plus 125I seeds). The apoptosis of HepG2 cells was determined by flow cytometry. The expression of Bax mRNA and Bcl-2 mRNA of HepG2 cells were tested by RT-PCR. The apoptosis-related genes (Bax and Bcl-2) and the tumor proliferation cell nuclear antigen (Ki67) proteins expression on HepG2 cells were examined with immunohistochemistry method. Results The flow cytometry examination showed that the apoptosis rate of HepG2 cells in the simple GNRs@SiO2-FA group and simple 125I seeds group was higher than that in blank control group (P<0.05), and the apoptosis rate of the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group (P< 0.05). The expression level of Bax mRNA in the combination group was higher than that in the simple GNRs@SiO2-FA group and simple 125I seeds group, while the expression level of Bcl-2 mRNA in the combination group was obviously lower than that in the simple GNRs@SiO2-FA group and simple 125I seeds group. Bax protein was expressed on cytoplasm, Bcl-2 protein was expressed on cytoplasm and cell membrane, while Ki67 protein was expressed on nucleus. All of them presented as brown finely granular precipitations. Statistically significant differences in the amount of Bax, Bcl-2 and Ki67 protein expression existed between each other among the four groups (P< 0.05). The positive expression rate of Bax protein in the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, while the positive expression rate of Bcl-2 and Ki67 protein was significantly lower than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, and the differences were statistically significant (P < 0.05). Conclusion The combination use of GNRs@SiO2-FA and 125I seeds can more effectively induce the apoptosis of HepG2 cells. This effect may be accomplished through increasing the expression of Bax protein and inhibiting the expression of Bcl-2 and Ki67 proteins.

Objective To investigate the efficacy of dexmedetomidine on anesthesia analgesia and postopera-tive cognitive dysfunction (POCD)in elderly patients with lumbar surgery.Methods Ninety elderly patients with lumbar surgery were randomly divided into dexmedetomidine group (A group with 46 cases)and control group (B group with 44 cases)by the random number table method.A group received load dosage (1μg/kg)dexmedetomidine before anesthesia induction,and this process must last for more than 10 minutes,then the dexmedetomidine was main-tained at a speed of 0.5μg/(kg·h)during the operation.B group were given the same dosage normal saline in the same way instead.The amount of intraoperative sedation drugs was observed and analyzed in the two groups.MMSE was measured at one day before surgery and seven days after surgery.And,the incidence rate of POCD was compared between the two groups.Results The dosage of intraoperative sedation drugs of fentanyl[(0.57 ±0.11 )mg vs (0.78 ±0.13)mg;t =8.286,P =0.000],propofol[(522.5 ±137.2)mg vs (734.2 ±175.8)mg;t =6.384,P =0.000]and remifentanil[(0.92 ±0.26)mg vs (1.38 ±0.73)mg;t =3.947,P =0.000]in A group were significantly lower than those of group B.After treatment for 7 days,the MMSE score in A group[(27.57 ±1.58)points]was higher than that of B group[(25.02 ±2.14)points](t =6.451,P =0.000).The incidence rate of POCD in A group (6.52%)was significantly lower than that of B group (22.73%),and the difference was statistically significant (χ2 =4.779,P =0.028).Conclusion In elderly patients with lumbar surgery,the dexmedetomidine can cut down the dosage of intraoperative sedation drugs,and it also could reduce the incidence of POCD.

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .

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