Objective:To compare the cardiovascular effects of sufentanyl and fentanyl as combined with propofol in anesthesia during laparoscopic cholecystectomy(LC).Methods:Patients undergoing LC were randomly divided into two groups: 60 patients in the Sufentanyl group(group S,0.3 ?g/kg) and 53 patients in the Fentanyl group(group F,3 ?g/kg).The mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),and cardiac index(CI) were recorded before induction,before pneumoperitoneum,after pneumoperitoneum and at the end of operation.Results:There was no difference in MAP,HR,CO or CI between the two groups before induction.The values of HR and CO increased significantly in group F after preumoperitoneum comparing with the values before preumoperitoneum(P

Esophageal cancer is the leading cause of cancer-related deaths worldwide.A single intraoperative intervention is unlikely to benefit the outcome.A multimodal management plan that includes the use of TEA seems to demonstrate improved results in high-volume centers.Anesthetic management may contribute to the containment of pulmonary morbidity and anastomotic leakage by the use of TEA,protective ventilation strategies during OLV,prevention of tracheal aspiration,and judicious fluid management.

Immune response after blood transfusion is closely related to prognosis of the patients receiving blood productions. Thus, the safety and effectiveness are paid increasing attention.This article reviews immunological consequence and clinical manifesta-tions and response strategies after transfusion, which aims to provide reference for clinical transfusion decisions.

Objective: To observe the effect of atorvastatin on the level of serum high sensitivity C reactive protein(Hs-CRP) in young adult patients with hyperlipemia.Methods: Seventy-six young adult patients(aged 18-39 years) with hyperlipemia were treated with atorvastatin at 20 mg/d for 8 weeks.The levels of serum Hs-CRP and lipid were determined before and after the treatment.Results: The level of serum Hs-CRP was obviously higher than normal in the hyperlipemia patients and significantly decreased after 8 weeks of atorvastatin treatment(P

Objective To evaluation clinical efficacy and complications characteristics of vitrectomy on type 1 diabetes of diabetic retinopathy.Methods This was a retrospective review study.From January 2010 to January 2016,18 cases (28 eyes) under the age of 30 diagnosed as type 1 diabetes of diabetic retinopathy were treated in our hospital.All the patients were performed vitrectomy.The postoperative visual acuity and complications in and after operation were observed.Results The follow-upperiod was 6-72 months with the average of 43.0 months.Postoperative visual acuity improved or remained unchanged in 23 eyes (82.1％),and decreased in 5 eyes(17.9％).Our primary anatomic success rate was 92.3％.Complication in operation was iatrogenic retinal tear in 3 eyes.Postoperative complications consisted of anterior chamber fibrin exudation in 9 eyes,hyphema in 5 eyes,recurrent vitreous hemorrhage in 2 eyes,retinal detachment in 3 eyes,rubeosis of iris in 5 eyes and neovascular glaucoma in 4 eye.Conclusion For young patients of type 1 proliferative diabetic retinopathy,vitrectomy can restore retinal anatomical structure and function.Panrentinal photocoagulation and preoperative anti-VEGF injections in vitreous is necessary with serious neovascularization-related complications.

AIM: To establish the method of determining psoralen and isopsoralen in Bushen Yinao Capsules(Fructus Psoraleae,Radix et Rhizoma Ginseng Rubra,Poria,etc.). METHODS: HPLC conditions were as(follows:) Chromasil C_(18) column,a mobile phase of CH_3OH-H_2O(55∶45),and the wavelength at 247 nm. RESULTS: This method showed a good linear relationship in the ranges of 0.038-0.309 ?g(psoralen) and 0.036-0.295 ?g(isopsoralen).The average recoveries were 99.50% for psoralen(RSD was 0.91%,n=5) and 100.52% for isopsoralen(RSD was 1.70%,n=5). CONCLUSION: The method is simple,swift,accurate and practical in quality control of Bushen Yinao Capsules.

Objective To compare the clinical and pathological differences between IgM nephropathy (IgMN) and IgA nephropathy (IgAN) in children. Methods Clinical manifestations, laboratory examination results, and renal patholog-ical data from 38 children with IgMN and 40 children with IgAN were compared. Results The mean age of onset in IgMN group was younger than that in IgAN group (P<0.05), the mean course before renal biopsy of IgMN group was longer than that of IgAN group (P<0.05), but the incidence of gross hematuria, the level of urinary IgG and albumin, and the incidence of severe glomerular injury were all higher in IgAN group than those in IgMN group (P<0.05). In IgMN group, the level of serum albumin was lower and the urine albumin was higher in the cases with severe glomerular injury than those in the cases without severe glomerular injury (P<0.05);there were more males in those cases with sever glomerular injuries;the incidences of gross hematuria, the level of urine albumin and NAG, and the abnormal basement membrane thickness was higher in the cases with severe tubular injury than those in the cases without severe tubular injury (P<0.05). However, the incidence of severe glomerular injury had no signiifcant difference between the cases with severe and without severe renal tubular injury (P>0.05). In IgAN group, the incidence of proteinuria, RBC casts in tubular, C3 and ifbrinogen deposition, and foot process effacement were higher in the cases with severe glomerular injury than those in the cases without severe glomerular injury (P<0.05); the degree of impairment of renal function, the incidence of severe mesangial cell proliferation, and glomerular sclerosis were more serious in the cases with severe tubular injury than those in the cases without severe tubular injury (P<0.05). Conclusions The clinical and pathological features are different between IgMN and IgAN in children. The renal damage is less in IgMN than that in IgAN children. Different from IgAN children, there is no parallel relationship between tubular and glomerular injury in IgMN children.

Objective To investigate the effects and distribution of 4 efflux pumps and correlated mutation of regulatory gene in multi-drug resistance Pseudomonas aeruginosa (Pa) in Hunan province. Methods Forty non-duplicated clinical strains of multiple-drug-resistant Pseudomonas aeruginosa were collected in Hunan in 2008, then the phenotype was screened with efflux pumps inhibitor phenylalanine-L-β-naphthylamide and 4 antimicrobial susceptibility test discs. Genes of the efflux pump membrane fusion protein were amplified by PCR, and correlated efflux pump regulatory genes were amplified and sequenced to analyze the role of efflux pump gene expression in multi-drug resistance compared to that of 18 strains with non-multi-drug resistance. Re-suits The positivity rates of MexAB-OprM, MexCD-OprJ, MexEF-OprN, MexXY-OprM were 45.0% (18/40), 30.0% (12/40), 42.5% (17/40) and 12.5% (5/40) respectively with phenotype screening in multi-drug resistance group. The positivity rates of mexA, mexC, mexE and mexX were 100% (58/58), 22.5% (9/40), 45.0% (18/40) and 22.5% (9/40) with RT-PCR. The overexpressed positivity rates of mexA and mexX were 55.0% (22/40) and 22.5% (9/40) respectively by semi-quantitative analysis with real-time PCR. However, no over-expression of mexA and mexX in non-multi-drug resistance group with real-time PCR. The positive expression rates of mexC and mexE with RT-PCR were 11.1% (2/18), 38.9% (7/18) in non-multi-drug resistance group. The difference of overexpression of mexA and mexX was significant(P<0.001, P=0.045) between two groups. The strain Pa20 with mexA overexpressian displayed gene mutations in mexR(164GTC→GAG) and amino acid substitution(126Val→Glu), the strain Pa34 with overexpression of mexX had 164GCG→GAG,55Ala→GIu. Conclusion Most of Pa with multi-drug resistance contained the resistant mechanism of efflux pumps and most-ly due to the overexpression of MexAB-OprM and MexXY-OprM in Hunan. There are mostly regulatory genes mutation in the strains with overexpression of MexAB-OprM and MexXY-OprM.

so as to increase inclusion body by 32%when compared with placebo.Conclusion As a disulfide bond isomerase,DsbG may also have chaperone activity during EB infecting to host cell.

ObjectiveTo investigate the hemodynamic changes after multiple firearm injuries in a swine model. Methods Twelve pigs were divided into 2 groups randomly, with control group ( n =6) subjected to catheterization only. Multiple trauma group ( n =6) was subjected to tangential fracture of parietal bone and comminuted fractures of bilateral femora (ISS≥16) using 5 8 mm bullets. The hemodynamic changes, including MAP, PAP, PAWP, CO, SVRI and portal vein blood flow, were observed at different time intervals up to 72 h after trauma or catheterization. At the same time, gastric pHi was measured as well. Results Compared with control group pigs in multiple trauma group suffered a hyperdynamic circulation developed at 48～72 hours. The cardiac output rose and vascular resistance declined obviously. The pulmonary artery pressure and pulmonary capillary wedge pressure elevated significantly. Mean artery pressure, portal vein blood flow and gastric pHi declined significantly. Conclusion Without severe blood loss and hemorrhagic shock, the decrease of portal vein blood flow and viscera underperfusion still took place after multiple firearm injuries.