Objective To investigate the effects of remifentanil on NF-κB activity in a rabbit model of myocardial ischemia/reperfusion (I/R) injury. Methods Fifty New Zealand white rabbits were randomly divided into 5 groups (n = 10 each): sham operation group (group S); group I/R; low dose of remifentanil group (group L); median dose of remifentanil group (group M); high dose of remifentanil group (group H). In group I/R, L,M and H, myocardial I/R was produced by occlusion of left anterior descending artery for 30 min followed by 120 min reperfusion.In group S and I/R,10 min before ischemia,normal saline was infused at 5 ml·l·h-1 via the external jugular vein until the end of 120 min reperfusion. In group L, M and H, remifentanil was infused at 1, 5 and 10ug·kg·min-1 respectively 10 min before ischemia until the end of 120 min reperfusion,and the other procedures were the same as those in group I/R. The myocardial tissues were taken at the end of 120 min reperfusion for determination of NF-κB expression which was used to reflect the activity of NF-κB and microscopic examination. Results The activity of NF-κB was significantly higher in group I/R, L, M and H than in group S. The activity of NF-κB was gradually decreased with the increase in the dose of remifentanil in group L, M and H compared with group I/R. The microscopic examination showed that remifentanil significantly attenuated I/R-induced injury in a dose-dependent manner. Conclusion Infusion of remifentanil reduces myocardial I/R injury through decreasing the activity of NF-κB in a doee-dependent manner.

Objective To study the effects and mechanism of Huangqi against myocardium injury induced by ischemia and reperfusion in rats. Methods Totally 30 male Sprague-Dauley rats were randomly divided into three groups: control group (C group), ischemia/reperfusion group (I/R group), ischemic pretreatment with Huangqi group (H+I/R group), with 10 rats in each. The left anterior descending (LAD) coronary artery was ligated to establish the ischemia/reperfusion heart model. Huangqi was administered before the model was established in the H+I/R group. The pathologic changes of myocardial tissues (under light and electron microscopy), content of creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in serum, as well as activities of Na~+K~+-ATPase and Ca~(2+)-ATPase in myocardial tissues were observed. Results Light and electron microscopic examination showed that the necrotic degeneration and pathologic changes of myocardiocytes in Huangqi group were significantly milder than those in the model group. The levels of CK, LDH, MDA were decreased significantly in Huangqi group (P<0.05), the activities of SOD, Na~+K~+-ATPase and Ca~(2+)-ATPase in myocardial tissues in Huangqi group significantly increased (P<0.05). Conclusion Huangqi shows a significantly protective effect on myocardial I/R injury in rats. The mechanism may be related to multiple factors, including improving microcirculation, forming anti-oxygen free radicals and decreasing calcium overload.

Objective To study the effects and mechanism of Huangqi against myocardium injury induced by ischemia and reperfusion in rats.Methods Totally 30 male Sprague-Dauley rats were randomly divided into three groups: control group(C group),ischemia/reperfusion group(I/R group),ischemic pretreatment with Huangqi group(H+I/R group),with 10 rats in each.The left anterior descending(LAD) coronary artery was ligated to establish the ischemia/reperfusion heart model.Huangqi was administered before the model was established in the H+I/R group.The pathologic changes of myocardial tissues(under light and electron microscopy),content of creatine kinase(CK),lactate dehydrogenase(LDH),malondialdehyde(MDA) and the activity of superoxide dismutase(SOD) in serum,as well as activities of Na+K+-ATPase and Ca2+-ATPase in myocardial tissues were observed.Results Light and electron microscopic examination showed that the necrotic degeneration and pathologic changes of myocardiocytes in Huangqi group were significantly milder than those in the model group.The levels of CK,LDH,MDA were decreased significantly in Huangqi group(P

Objective To investigate the effects of inhaling isoflurane and enflurane on the spontaneous neural discharge of the neurones in rat hippocampus. Methods Whole cell patchclamp recording te chnique was used to observe the effects of isoflurane and enflurane on the spont aneous discharge rate of the neurons in the hippocampus on the brain slice of ne w-born SD rats. After decapitation, the whole brain of the rat was removed and put into artificial cerebrospinal fluid (ACSF) saturated with 1.36 g?L -1 O 2 and 0.098 g?L -1 CO 2 mixed gas at 4 ℃ . Brain was cut into 300～400 ? m thick slices containing the hippocampus. Whole cell patchc lamp recording technique was used to observe the effects of isoflurane with dif ferent concentrations on the spontaneous discharge rate of neurons in the hippoc ampus on the brain slices. Results Isoflurane and enfluran e could significantly inhibit the spontaneous neural discharge of neurons in the hippocampus in a dose-dependant manner. The effects of spontaneous neural disc harge of hippocampus inhibited by isoflurane (0.12 g?L -1 ～0.36 g?L -1 ) and enflurane (0.2 g?L -1 ～0.6 g?L -1 ) could be recove red following washing off with ACSF for 5 min. Conclusion T he spontaneous discharge rate of neurons in the hippocampus can be reversibly in hibited by isoflurane and enflurane. Hippocampus may be an important action site of anesthetics isoflurane and enflurane in the central nervous system.

OBJECTIVETo compare the differences in pain reaction, hemodynamics and clinical efficacy between extracorporeal shock wave lithotripsy (ESWL) after injection with flurphen mixture (mixture of droperidol and fentanyl citrate) at Shenshu (BL 23) and simple ESWL in the patients.

METHODSSixty-four cases of urinary calculi with ESWL were randomized into an observation group and a control group, 32 cases in each one. In the observation group, 15 to 20 min before ESWL, flurphen mixture (droperidol injection 1.25 mg and fentanyl citrate injection 0.05 mg were diluted to 6 mL with 0.9% sodium chloride solution 4.5 mL) was injected at bilateral Shenshu (BL 23). In the control group, no any adjuvant therapy and medication were used before ESWL. The changes in blood pressure and heart rate, visual analogue scale (VAS) score, lithotripsy frequency till calculi complete removal and the rate of calculi complete removal after the first lithotripsy were observed in the two groups.

RESULTSIn the control group, blood pressure and heart rate were higher during lithotripsy than those before lithotripsy (both P<0.05). In the observation group, the differences in blood pressure and heart rate were not significant statistically as compared with those before lithotripsy (both P>0.05). The blood pressure and heart rate during lithotripsy in the observation group were apparently lower than those in the control group (both P<0.05). VAS scores during lithotripsy in the observation group were lower apparently than those in the control group (both P<0.05). The lithotripsy frequency in the observation group was less than that in the control group. The rate of calculi complete removal in 1 week after the first lithotripsy in the observation group was higher than that in the control group [75.0% (24/32) vs 50.0% (16/32), P<0.05].

CONCLUSIONThe flurphen mixture at Shenshu (BL 23) significantly alleviates pain reaction in patients undergoing ESWL, avoids the fluctuation of hemodynamics and improves the clinical effect of lithotripsy.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Analgesics ; administration & dosage ; Female ; Hemodynamics ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Young Adult

Objective To explore the correlations of the MRI findings and its pathological typing in the focal cortical dysplasia (FCD) .Methods MR images of 74 patients with FCD confirmed by operation and histopathologic examination were analysed retro‐spectively .MRI findings with FCD were divided into three subtypes including radial band type ,hyperintensity type and mild type . The correlation of the FCD MRI findings and pathological typing is analysed .Results In 74 patients with FCD ,there were radial band type in 12 cases ,hyperintensity type in 32 cases ,and mild type in 30 cases respectively .M RI finding of radial band type FCD showed a tail of increased T2WI/FLAIR signal tapering down to the lateral ventricle .Hyperintensity type FCD showed increased T2 WI/FLAIR signal in the cortex and subcortical white matter ,accompanied with focal cortical thickening .Mild type FCD showed T2 WI/FLAIR subtle hyperintense signal in cortex with or without focal cortical thickening ,but there was no hyperintense signal in subcortical white matter .Most of radial band type FCD were ⅡB in pathology .Most of hyperintensity FCD were ⅡA and ⅡB .Mild type FCD was more found to beⅠA orⅠB .Conclusion Analysing MRI features would improve the accurate diagnosis of FCD and help to infer the pathological type .

Hereditary spastic paraplegia type 58 is rare, caused by pathogenic variations in KIF1C gene. Here, a case diagnosed in Qilu Hospital, Shandong University, was reported. The 15-year-old female suffered tremor in bilateral upper limbs which was aggravated gradually since age 8. Cerebellar ataxia, positive pyramidal tract sign and dystonic tremor were prominent on physical examination. The brain magnetic resonance imaging showed T 2-hyperintense signals in bilateral pyramidal tracts, optic radiations and superior cerebellar peduncles, with mild cerebellar atrophy. Whole exon sequencing revealed the unreported homozygous c.425_426delTG (p.V142Gfs*10) mutation which was presumed pathogenic.

OBJECTIVETo analysis and compare the clinical characteristics of Colles fractures between patients with osteoporotic and without osteoporotic.

METHODSFrom June 2007 to June 2009, 260 patients with Colles fracture were reviewed, including 60 males and 200 females, with a mean age of 66.5 years old. According to Cooney classification: 44 patients were type I, 83 patients were type II, 92 patients were type III and 41 patients were type IV. Among the patients, 96 patients were osteoporotic Colles fractures, and 164 patients without osteoporotic. The general information, invalidiation rate and short-term clinical results were compared between two groups.

RESULTSThere were no statistically difference of age, gender and fracture position between the two groups. There were more patients with type III and type IV, and higher invalidiation rate in osteoporotic Colles fracture group compared to those of no osteoporotic Colles fracture group (P<0.01). At the 6 months after treatment, the clinical effects of no osteoporotic Colles fracture group was better than that of osteoporotic Colles fracture group (P<0.01).

CONCLUSIONThe senile-osteoporotic Colles fracture has different clinical characteristics, which should be given special treatment, frequent review and communication between doctors and patients during the period of treatment.

Aged ; Case-Control Studies ; Colles' Fracture ; surgery ; External Fixators ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery

OBJECTIVETo investigate the clinical features and AGL gene mutations in a family with glycogen storage disease type IIIa (GSD IIIa).

METHODSClinical data for diagnosis, treatment and follow-up of a sick child with GSD III was collected and analyzed. Genomic DNA was extracted from the peripheral blood samples from the patient and his parents. Polymerase chain reaction and direct DNA sequencing were utilized to analyze all of the exons of the AGL gene.

RESULTSThe genotype of the child was found to be c.3710_3711delTA/IVS14+1G>T. The former was a maternally-inherited mutation, which has not been reported previously. The latter was an abnormal splice-site mutation inherited from the father.

CONCLUSIONBased on its clinical and molecular evidences, the patient was diagnosed as GSD IIIa in conjunction with retrobular optic neuritis.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child, Preschool ; China ; Female ; Glycogen Debranching Enzyme System ; genetics ; metabolism ; Glycogen Storage Disease Type III ; enzymology ; genetics ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Point Mutation

Objective: To investigate the clinical characteristics of extremely severe burn patients complicated with severe inhalation injury caused by dust explosion. Methods: The medical records of 13 extremely severe burn patients complicated with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident, who were admitted to the First Affiliated Hospital of Soochow University on August 2nd, 2014, were retrospectively analyzed. The following indicators were collected: (1) Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at post admission hour (PAH) 24. (2) Prognosis, death time, causes of death, and the mortality of patients with different sexes. (3) The number of times of airway electronic bronchoscopy, airway characteristics, and the corresponding onset time. (4) The number and result of microorganism culture of lesion tissue during the leukoplakia formation stage. Detection of Pseudomonas aeruginosa in patients with and without leukoplakia in airway mucosa. Fisher′s exact probability test was used to detect the mortality of patients with different sexes. Kappa test was used to detect the relevancy between leukoplakia and Pseudomonas aeruginosa. Results: (1) The APACHE Ⅱ score of patients of this group at PAH 24 was (19±3) points, and the SOFA score was (12±3) points. (2) Eight patients survived, while 5 patients died, and the time of death was 19-46 (34±10) d after injury. The main cause of death was multiple organ dysfunction syndrome, which was secondary to severe infection. One of the 7 male patients and 4 of the 6 female patients died, but there was no significantly statistical difference in mortality between patients of the two sexes (P>0.05). (3) Airway electronic bronchoscopy was performed 4-25 (10±5) times among patients of this group. Hyperemia and edema were found in the airway mucosa of all the 13 patients 2-3 weeks after injury; ulcer was found in the airway mucosa of 5 patients 2-4 weeks after injury; leukoplakia was found in the airway mucosa of 7 patients 4-14 weeks after injury; granulation formed in the airway mucosa of 7 patients 10-15 weeks after injury, and airway patency was affected, which was solved after local clamping or replacement of lengthened tracheal cannula. (4) During the leukoplakia formation stage, 19 cases of microorganism culture were performed basing on airway lesion tissue, and the results were 15 cases of Pseudomonas aeruginosa, 5 cases of Acinetobacter baumannii, 2 cases of Serratia marcescens, as well as 1 case of Stenotrophomonas maltophilia, Burkholderia cepacia, and Proteus mirabilis each. Among 7 patients with airway mucosa leukoplakia, 6 patients were detected with Pseudomonas aeruginosa. Among 6 patients without airway mucosa leukoplakia, 1 patient was detected with Pseudomonas aeruginosa. The appearance of leukoplakia was consistent with the detection of Pseudomonas aeruginosa (Kappa=0.69, P<0.05). Conclusions Most of these extremely severe burn patients complicated with severe inhalation injury caused by dust explosion survived, and there was no significant gender difference in mortality. Electronic bronchoscopy showed that the early manifestations of airway mucosa were hyperemia and edema, followed by varying degrees of erosion, ulcer, leukoplakia, and granulation formation, etc. Leukoplakia may be relevant to Pseudomonas aeruginosa infection.