Objective To compare target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia and intravenous combined with inhalation anesthesia in hemodynamic changes and side effects in elderly patients with laparoseopic cholecystectomy.Methods 56 ASA Ⅰ-Ⅱ patients aged ＞60 Y undergoing elective laparoscopie cholecystectomy were randomly divided into propofol-remifentanil target controlled infusion group (observation group)(n=28)and inhalation anesthesia group(using intravenous anesthesia was maintained with isoflurane inhalation)(n=28).HR,SBP,DBP,PETCO2,initial consciousness time,extubation time,side-effects were recorded at each time points.Results The change extent of HR and blood pressure in observation group was lower than inhalation anesthesia group.The initial recovery time,recovery time of spontaneous breathing and extubation time in the observation group Was better than anesthesia group(all P＜0.05).The side-effects in observation group were significantly lower than inhalation anesthesia group(all P＜0.05).Conclusion Laparoscopic cholecystectomy in elderly patients by target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia could significantly inhibit the stress response,and effectively maintain the stability of hemodynamic,and rapid postoperative recovery,fewer adverse reactions.It Was an ideal anesthesia methods in elderly patients with laparoscopic cholecystectomy.

The article reviews the change of thyroid function in the women during pregnancy and the development of fetal thyroid function and introduces the principles of treating pregnancy with hyperthyroidism or hypothyroidism.

Objective To explore the effect of family cohesion and adaptability on coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.Methods 96 patients suffered high paraplegia caused by cervical spine fracture were questionnaired by family cohesion and adaptability scale and bricf fatiguc assessment scale after 1 week of operation.And they were divided into the fatigue group and non-fatigue group,the scores of family cohesion and adaptability were compared between the two groups,and thepearson correlation analysis and multivariate linear regression analysis were used to explore the effect of family cohesion and adaptability on coping with fatigue.Results ①65.63％ (63/96) patients suffered coping with fatigue in high paraplegia patients caused by cervical spine fracture.②The scores of teal family cohesion and real family adaptability in the fatigue group were significantly lower than those in the non-fatigue group(P＜0.05) ; the scores of dissatisfaction of family cohesion and dissatisfaction of family adaptability in the fatigue group were significantly higher than those in the non-fatigue group(t=-2.630,-3.359,10.469,17.821,P＜ 0.05).③Pearson correlation analysis showed that the score of coping with fatigue was negatively correlated with the real family cohesion(r=-0.463,P=0.015) and real family adaptability(r=-0.486,P=0.021),and positively correlated with the score of dissatisfaction of family cohesion (r=0.395,P=0.036) and dissatisfaction of family adaptability (r=0.524,P=0.020).④Multivariate linear regression analysis showed that the real family cohesion,real family adaptability,dissatisfaction of family cohesion and dissatisfaction of family adaptability were the influencing factors of coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.Conclusions Family cohesion and adaptability was correlated with the coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.

Objective To explore the relationship between family care and postoperative cognitive dysfunction(POCD) in patients undergoing spinal surgery.Methods Patients undergoing spinal surgery were questionnaired by Family APGAR Index and Mini-Mental State Examination (MMSE) 1 week after operation.They were divided into the POCD group and non-POCD group,and the scale of Family APGAR Index was compared between the two groups.Then the pearson correlation analysis and multivariate linear regression analysis were used to explore the effect of family care on POCD.Results ①35％ (35/100) patients undergoing spinal surgery sufferd POCD.②The partnership,affection,resolve and the total score of Family APGAR Index in the POCD group ((1.25 ± 0.45),(1.36 ± 0.41),(1.27 ± 0.42),(5.85 ± 1.30)) were significantly lower than that in the nonPOCD group((1.63 ± 0.56),(1.63 ± 0.52),(1.65 ± 0.51),(6.74 ± 1.56)) (P ＜ 0.05).③Pearson correla tion analysis showed that the MMSE was negatively correlated with the partnership,affection and resolve(r=-0.426,-0.382,-0.482,P ＜ 0.05).④Multivariate linear regression analysis showed that the resolve,partnership,affection were the influence factor of POCD in patients undergoing spinal surgery.Conclusions The decline of family care can lead to POCD.

Objective: To investigate the role of retinoic acid (RA) in the differentiation, and maturation of dendritic cells (DCs) derived from cord blood monocytes, and its mechanism. Method: Nine cord blood samples were collected from healthy and well nourished newborns. Monocytes were isolated and cultured in vitro. Cells were divided into 4 groups: control group; retinoid acid receptor ? (RAR? )agonist group (RA group); RAR? antagonist group (RO group) and agonist plus antagonist group (RA+RO group). Part cells were collected in D9, and the surface markers on cells were detected by flow cytometer. The mixed lymphocyte reaction (allo-MLR) was used to evaluate the ability of DC to induce proliferation of T cells and the influence by RA and RAR?. Th cytokines were measured in protein level by ELISA and in mRNA levels by RT-PCR to decipher the effect of RA and RAR? in the regulation of Th1/Th2 balance by DCs. Results: The differentiation and maturation of DCs were inhibited significantly in RA group compared with control group. When RO was added into the culture, the effects of RA can be reversed. After MLR , the suppression effect of RA on allo-T cell proliferation was inversed by RO. During the influence of DC on Th cell polarization, RO could inhibit the down-regulation of Th1 cytokine (IFN-?) as well as the up- regulation of Th2 cytokines (IL-4, IL-10) by RA, whether on protein levels or on mRNA levels. Conclusion: Retinoic acid inhibited the differentiation and maturation of DC derived from cord blood monocytes, reduced the ability to stimulate allo-T lymphocytes proliferation by DCs, and made immune response bias to Th2. RAR? plays a very important role in the regulation of RA on DCs.

Objective: To investigate the effects and mechanisms of vitamin A on tracheal mucosal immunity. Method: The rat model with vitamin A deficiency (VAD) was established. By use of immunohistochemical, RT-quantity PCR and ELISA methods, the number of dendritic cells (DCs, OX-62 positive cells), the maturation of DCs (the positive areas of CD80 and CCR7), the pathogen recognition receptors (the positive areas of TLR2 and of TLR4) and TLRs signal transduction (the mRNA level of MyD88), as well as cytokines production in tracheal mucous membrane were detected. Results: In VAD rats, the number of DCs in trachea was increased, but the expressions of CD80 and CCR7 were similar with control group. The TLR2 and MyD88 mRNA levels were up-regulated, and IL-12 production was also raised. However, Th2 cytokines IL-4 and IL-6 were reduced significantly in protein and mRNA levels, and the production of IL-10 protein was declined compared with the control. Conclusion: In VAD rats, the number of DCs, receptors of pathogens recognition, and cytokines production in trachea mucosa were significantly changed. The affection of VAD on DCs may play important role in the impaired mucosal immunity of trachea.

Obesity has a harmful impact on health and is imposed by both environmental and genetic factors. Recently, over 60 obesity-related susceptible loci have been identified through genome-wide association study. However, it still remained unknown whether these loci were specific or generalized to the ethnic groups for genetic distinction. This review summarized the obesity-related susceptible loci in Asian populations, which were recently identified among Europeans or Asians.

Objective To observe the effect of intra-articular injection of CM-chitosan on nuclear factor κB (NF-κB) activation and nitric synthase expression in rat osteoarthritis cartilage,and to explore the mechanism of inhibition of joint destruction.Methods Thirty-six SD rats were randomly divided into three groups:A,B,C,12 in each group.Group A was the sham group,group B,C rats had the medial collateral ligaments cut off and part of medial meniscus were removed to establish osteoarthristis model.Group C rats were injected with 3％ carboxymethyl chitosan intra-articularly 0.15 mg/kg 5 weeks later,and then repeated injection every 1 week.Animals were sacrificed 11 weeks after surgery.The gross changes of cartilage and the expression of NF-κB (P65) were compared by immunohistochemistry,the protein expression of I-κB and P65 in nucleus were detected by Western-bloting.Inducible nitric oxide synthase (iNOS) mRNA and protein expres-sion were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and western blot.The general score of cartilage was analyzed by H test,the rest data was analyzed by one-way ANOVA.Results The cartilage degeneration scores pf group C (intra-articular injection of CM-chitosan group) were significantly less than those of group B.The protein expression of NF-κB of the articular cartilage in group C (106±7)was significantly lower than group B (147±8),the I-κB degradation was inhibited significantly in group C,and the expression of iNOS mRNA and iNOS protein were reduced in OA art~icular cartilage of arthritis rat chondrocytes,therefore,it had protective effect on articular cartilage.Conclusion CMC may inhibit NF-κB signaling pathway by inhibiting the degradation of I-κB in cartilage,which reduces iNOS mRNA and protein expression in rat osteoarthritis cartilage,thereby protects rat osteoarthritis cartilage cells.

Objective To improve the diagnostic value of MRI on orbital diseases,especially on benign and malignant tumors,through analyzing the characteristics of orbital diseases with dynamic contrast-enhanced MRI.Methods Forty-one patients with solitary orbital masses, including 31 benign tumors and 10 malignant tumors,underwent MR examinations. All the cases were verified by pathology.1.5 T MR system and head coil were employed.Conventional scan was performed with axial,sagittal,and coronal T_1WI,as well as axial T_2WI and the slice thickness of 4 mm.After the injection of contrast agents,dynamic contrast-enhanced MRI was immediately performed so as to observe dynamic changes of lesions.Enhancement rates(E%) was calculated and time-intensity curve was portraited according to the signal intensity of conventional scan and dynamic-contrast enhanced scan.SPASS Ver10.0 was used to do the statistical analysis,while cartographies were completed with Powerpoint.Results(1)Comparision between benign and malignant tumors in average enhanced rates of the 1~(st) minute: it was higher than 60% in malignant tumors,while lower than 60% in benign ones(P

Objective To investigate the neuroprotective effect of extraction of gastrodia elata on status epilepticus induced by Li-pilocarpine in rats. Methods 144 SD rats were randomly divided into 4 groups: saline control (5 ml/kg twice daily), small dose gastrodia group (5 ml/kg twice daily), large dose gastrodia group (10 ml/kg twice daily) and lamotrigine group (20 mg/kg twice daily). The status epilepticus was induced 3 d after treatment. The duration of status epilepticus, neuron loss, the rate of spontaneous seizure and the score of mossy fiber sprouting were analyzed. Results Large dose gastrodia or lamotrigine administration can shorten the duration of status epilepticus and decrease the neuron loss compared with the small dose gastrodia and control administration. But all treatments cannot prevent mossy fiber sprouting and spontaneous seizures. Conclusion 20 ml/kg gastrodia or 40 mg/kg lamotrigine administration can shorten the duration of status epilepticus induced by Li-pilocarpine, and decrease the neuron loss of CA1, CA3 of hippocampus and hilus of dentate gyrus, but cannot prevent epileptogenesis after brain insult.