Objective To investigate the effects,safety,controlling of controlled hypotension induced by remifentanil during endoscopic sinus surgery.Methods Forty patients with ASA grade Ⅰ～Ⅱ undergoing selective endoscopic sinus surgery,were randomly assigned into remifentanil group(A group)and nitroglycerin group(B group).After routine inducing,controlled hypotension was induced before the main procedure of surgery.A group was given remifentanil(1μg/kg)by intravenous injection,then remifentanil(0.3～0.8μg·kg~(-1)·min~(-1))was used in group A to keep mean arterial pressure between(MAP)60 and 80 mm Hg.B group was given fentanyl(0.03～0.08 μg·kg~(-1)·min~(-1))and nitroglycerin(2～5 μg·kg~(-1)·min~(-1))to keep mean arterial pressure(MAP)between 60 to 80 mm Hg till the main procedure of surgery was finished.Observing MAP and HR change before controlled hypotension,during controlled hypoteusion and after stopping controlled hypotension.Observing the time of opening-eyes,remove-tracheal tube and surgical field quality.Results The two groups were comparable with regard to the surgical field rating(P＞0.05).MAP in two groups during controlled hypotension were lower than those before controlled hypotension(P＜0.05),in A group,MAP were comparable with those in B group during controlled hypotension(P＞0.05).In B group there was rellexible tachycardia during controlled hypotension.HR in A group during controlled hypotension was lower than those before controlled hypotension(P＜0.05).HR during controlled hypotension in A group was lower than those in B group(P＜0.01).The time of opening-eyes,remove-tracheal tube in A group was less than those in B group(P＜0.01).ConclusionRemifentanil cound induce and sustain controlled hypoteusion.It was safe and feasible.It was better than nitroglycerin group for controlled hypotension in endoscopic sinus surgery.

90? superficial calcium is low.

Objective To study the safety and efficacy of laryngeal mask airway(LMA) used in breast cancer general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients with breast cancer scheduled for selective radical mastectomy under general anesthesia were allocated randomly to either laryngeal mask airway group(group A,n =20) or tracheal tube group(group B, n = 20). SBP, DBP, HR, SpO2 of patients before anesthesia(To)/after intubation immediately (T1) and 5 minutes(T2) after intubation tracheal tube or laryngeal mask intubation/after extubation immediately (T3) and 5 minutes(T4) of after extubation tracheal tube or laryngeal mask were recorded. The different incidence of anesthetic complications and side effect were observed in both groups because intubation and extubation. Results In group B, SBP, DBP and HR were significantly higher than those in group A at T1 and T3 (P ＜ 0.05). Agitation, bucking and pharyngodynia incidence rate in group B were significantly higher than group A(P ＜ 0.05). Conclusion Ventilation with LMA in patients underwent breast cancer radical correction was better than endotracheal intubation general anesthesia in keeping stable hemodynamics and producing less anesthetic complications.

Objective To evaluate the outcome and prognosis of prostate carcinoma treated with three-dimensional conformal radiation therapy(3DCRT). Methods From 2000 to 2004,37 patients were so treated. Two patients have been lost to follow up. Twenty-four patients underwent orchiectomy before 3DCRT,20 patients received chemotherapy combined with hormone therapy and 4 received radiation castration. All patients were treated with a median dose of 72Gy(60-76Gy),2Gy/f ,5 fractions/w. Results With a median follow-up time of 27 months(6-107months),the 3- and 5-year survival rate was 80% and 70%, respectively. Longrank analysis showed age, PSA level before treatment, lymph node metastasis, distant metastasis, total dose and combined modality were prognostic factors for the survival. Cox model multivariate analysis showed PSA level before treatment, total dose and combined modality were prognostic factors for the survival. Conclusions The outcome of three-dimensional conformal radiation therapy for T2-T4 prostate carcinoma is safe and effective with tolerable side effects. PSA level before treatment, total dose and combined modality are prognostic factors for the survival.

Objective To identify a myeloid differentiation factor 88(MyD88)in Oncomelania hupensis,and characterize the role of MyD88 against Schistosoma japonicum infection. Methods The complete cDNA of MyD88 in O. hupensis was ob-tained by using rapid amplification of cDNA ends(RACE),and homologues sequences and conserved domains were aligned and the structure of MyD88 was predicted either. A phylogenetic tree of MyD88 was further constructed with other species. In ad-dition,the mRNA expression level of O. hupensis MyD88 before and after S. japonicum infection was investigated by real-time quantitative PCR(RT-qPCR). Results The cDNA of O. hupensis MyD88 consisted of 1406 bp open reading frame(ORF),en-coding 468 amino acid residues,which contained death domain and Toll/interlrukin-1 receptor(TIR)domain,the typical fea-tures of MyD88 family proteins. The predicted amino acid sequence of O. hupensis MyD88 shared 38%-52%identity with other mollusc. O. hupensis MyD88 was phylogenetically closeted to Biomphalaria glabrata MyD88. The O. hupensis MyD88 existed in all selected tissues and expressed highly in hemocyte,up-regulated after S. japonicum infection in all selected tissues except cephalopodium,especially higher in whole snail and hemocyte. Conclusion MyD88-dependent signaling pathway is present in O. hupensis and plays an important role in innate immune response against S. japonicum infection.

Objective To investigate the correlation between serum levels of 25 hydroxyvitamin D and immunoglobulin E(IgE)in adults.Methods There were 1 969 participants over the age of 19 were enrolled in this studied,serum total IgE,dermatophagoides farinae(Df)-specific IgE,and serum 25(OH)D levels were analyzed.Other variables included sex,age,body mass index,smoking history,and economic status were collected.Adjusted regression analysis was used to examine the independent association of 25(OH)D with serum IgE levels.Results The average serum 25(OH)D level of 1 969 patients was(18.0±6.5)μg/L,the prevalence of asthma,allergic rhinitis,and atopic dermatitis were 15.2％(299/1 969),2.8％(63/1 969)and 3.0％(68/1 969)respectively,however,there was no significant difference in serum 25(OH)D levels in patients with allergic rhinitis.All subjects were divided into four groups according to the serum 25(OH)D level: Q1:less than and equal to 13.4 μg/L,Q2:more then and equal to 13.4 μg/L but less then and equal to 17.0 μg/L,Q3: more then and equal to 17.0 μg/L but less then and equal to 21.7 μg/L,and Q4: more than and equal to 21.8 μg/L.The median TIgE level increased with higher quartiles in the Kruskal-Wallis test.The prevalence of Df in Q1,Q2,Q3,Q4 group were 39.8％,33.2％,38.7％and 43.1％,respectively.Linear regression analysis indicated that 25(OH)D levels were positively correlated with lgTIgE(regression coefficient:0.011,95％CI 0.001-0.021),25(OH)D in male patients with dust mite allergy was positively correlated with lgTIgE(regression coefficient:0.026,95％CI 0.010-0.043).There was no significant correlation between 25(OH)D and lgTIgE in the other groups.Conclusion Adult serum 25(OH)D levels is positively correlated with total IgE levels.

OBJECTIVETo evaluate clinical applicability of a novel technique that can quantify the lamivudine-resistant mutants of hepatitis B virus (HBV) in the serum of patients utilizing gene microarray technology.

METHODSThe oligonucleotide microarray was designed to detect 3 important mutational positions. Fifty-one patients who were receiving lamivudine therapy were selected as subjects. The oligonucleotide microarray and traditional sequencing were applied to detect the lamivudine resistant mutation, the monitoring lasted for 24 months. Then the clinical result was analyzed and the obtained data were compared between the two methods.

RESULTSLamivudine resistant mutation was detected in 39 percent of the patients during the 2 years period. The results of the oligonucleotide microarray technique was consistent to the results of traditional sequencing in accuracy and the miroarray was more sensitive in detection of the mixed infection.

CONCLUSIONApplication of the oligonucleotide microarray for quantitative detection of lamivudine-resistant mutation of HBV is feasible.

Antiviral Agents ; therapeutic use ; Drug Resistance, Viral ; Female ; Hepatitis B ; drug therapy ; virology ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Humans ; Lamivudine ; therapeutic use ; Male ; Mutation ; Oligonucleotide Array Sequence Analysis ; methods

Objective To investigate the molecular characterization of a Chinese pedigree with rare β thalassemia genotype.Methods Phenotypic analysis was performed using standard hematological tests to measure red blood cell parameters, including RBC,Hb,MCV,MCH,MCHC and RDW.SPIFE automatic Hb agarose gel electrophoresis instrument was used to measure hemoglobin fraction Hb A,Hb A2 and Hb F.The alleles of β thalassemia mutation were determined by RDB assay, and then cloning and sequencing were performed to define the mutation sites.Results The proband and his father had typical microcytic hypochromic anemia with low MCV and MCH(79.8, 63.1 fl and 19.9, 20.9 pg, respectively) and high level of Hb A2 (5.66% and 5.60%, respectively).The proband′s mother had normal MCV and MCH. β thalassemia mutation analysis with RDB assay showed that the proband had thalassemia minor resulting from double mutations on one globin gene.One showed codons 41/42 (-TTCT) mutation and the other was CAP mutation from positions +40 to +43 in the promoter region.These two mutations were inherited from his father.The genotype of the proband and his father was β41/42、CAP/βA ,and the genotype of his mother was βA/βA.Conclusions It′s rare that double mutations occur on single β globin gene, with one mutation on CD41/42(-TTCT) and the other mutation from positions +40 to +43 relative to the mRNA cap site in the promoter region.The findings enrich knowledge of the mutation spectrum of β thalassemia.

Objective: To explore the influencing factors of cognitive impairment in patients with silicosis, and to analyze the effect of brain-derived neurotrophic factor (BDNF) on cognitive function. Methods: In March 2021, 484 silicosis patients from April 2018 to April 2020 were included in the study. The Montreal Cognitive Assessment Scale of Chinese version was used to evaluate their cognitive function, and they were divided into the cognitive impairment group (n=282) and the non cognitive impairment group (n=202) , another 30 healthy persons from body check were served as control group. The concentrations of BDNF were compared between the three groups. And the receiver operating characteristic (ROC) curve was drawed to analyze the value of BDNF in predicting cognitive impairment in silicosis patients. And the logistic regression analysis was used to explore the risk factors of cognitive impairment. Results: The incidence of cognitive impairment in silicosis patients was 58.26% (282/484) . The level of BDNF in the cognitive impairment group[ (10.32±2.11) mg/L] was significantly lower than that in the non cognitive impairment group[ (13.43±3.45) mg/L] (t=-12.27, P<0.001) . The results of ROC curve analysis showed that the area unde the curve of BDNF in predicting cognitive impairment of silicosis patients was 0.763 (95%CI: 0.613-0.874, P=0.024) , the cut off value was 10 mg/L, the sensitivity was 0.88, and the specificity was 0.84. Logistic regression analysis showed that the level of BDNF (≤10 mg/L) , age (≥65 years old) , course of disease (≥5 years) and diabetes mellitus were the risk factors of cognitive impairment in silicosis patients (OR=2.346, 95%CI: 1.654-3.103; OR=1.757, 95%CI: 1.214-1.998; OR=1.346, 95%CI: 1.112-1.564; OR=1.165, 95%CI: 1.102-1.542, P=0.001, 0.012, 0.027, 0.036) . Conclusion: BDNF may be one of the indicator to predict the risk of cognitive impairment in patients with silicosis.
Aged ; Brain-Derived Neurotrophic Factor ; Cognitive Dysfunction/etiology* ; Diabetes Mellitus, Type 2 ; Humans ; ROC Curve ; Silicosis/complications*

Objective The rapid multiplex PCR (MPCR) system for detection of genes encoding aminoglycoside resistance in Staphylococcus aureus was developed. The distribution of antibiotic resistant genes acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in Guangzhou was analyzed using the established system.Methods S. aureus strains were identified and susceptibility tests were performed using VITEK-60 or PHOENIX-100 system as recommended by the manufacturer. Aminoglycoside resistance was determined by disk diffusion method. MPCR system for detection of antibiotic resistance genes was optimized.Results The MPCR assay was established successfully. The prevalence of acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in the 124 clinical S. aureus isolates was 62.1%, 32.3% and 1.6%, respectively as analyzed by MPCR. Good correlation between antibiotic resistance phenotypes and genotypes was observed. One or more of the genes encoding aminoglycoside modifying enzymes could be detected in all gentamicin- or netilmicin- or amikacin-resistant isolates. The acc(6')-Ie+aph(2″) gene was identified in 72 of 74 mecA-positive isolates.Conclusions This MPCR system could be used for rapid and reliable analysis of the antibiotic-resistant genotypes of clinical S. aureus isolates. The gene acc(6')-Ie+aph(2″) may be the predominant determinant of aminoglycoside resistance, followed by gene aph(3')-Ⅲa. The prevalence of ant(4')-Ia gene is relatively low.