Objective To determine the dose-effect curve of fentanyl with respect to the suppression of somatic or hemodynamic responses to skin incision when plasma propofol concentration was maintained at 3 ?g?ml-1 by target-controlled infusion (TCI) .Methods Twenty-four ASA Ⅰ-Ⅱ patients aged 31-65 yrs undergoing elective surgery under general anesthesia were enrolled in this study. Anesthesia was induced with TCIs of fentanyl and propofol. The patients were randomized to receive fentanyl by TCI at a target plasma concentration of 1.0, 1.5, 2.25 or3.38 ng?ml-1 . The target plasma propofol concentration was set at 3 ?g?ml-1 in all patients. The patients were intubated when the patients failed to respond to verbal command and eyelash reflex was lost. Tracheal intubation was facilitated with succinylcholine 1 mg?kg-1. MAP, HR, ECG and SpO2 were monitored before and during anesthesia. The duration between the start of TCIs and skin incision was longer than 30 min for fentanyl and 15 min for propofol to ensure that the effect-site drug concentrations reached the steady-state. The changes in BP and HR and body / limb movement and other signs of inadequate depth of anesthesia like lacrimation, flushing and sweating during and immediately after skin incision were recorded. The fentanyl plasma concentrations (predicted target concentration) at which 50% of the patients did not respond to skin incision (Cp50) were calculated. Results The Cp50 of fentanyl based on somatic response was 1.84 ng?ml-1 . Its 95% confidince interval ranged from 1.46 ng?ml-1 to 2.33 ng?ml-1 . The Cp50 of fentanyl based on hemodynamic response was 2.67 ng?ml-1 with a 95% confidence interval from 1.96 ng?ml-1 to3.62 ng?ml-1. Conclusion When anesthesia is induced with TCIs of propofol and fentanyl, if target plasma propofol is set at 3 ?g?ml-1 , target fentanyl plasma concentration should be set at least at 5.12 ng?ml-1 to ensure adequate depth of anesthesia for skin incision.

Objective To assess the cleaning effect of central air conditioning ventilation systems. Methods During 2006—2007, the quality of 15 central air conditioning ventilation systems from 5 hotels in Tianjin were assessed before and after cleaning and disinfection. Results Before the central air conditioning ventilation systems being cleaned and disinfected, the medians of the dust in central air conditioning ventilation system, the aerobic bacterial counts in dust, the fungus counts in dust, the aerobic bacterial count in ventilation system, and the PM10 were 60.67 g/m2, 40 cfu/m2, 14 cfu/m2, 1 074 cfu/m3, 304 cfu/m3 and 0.09 mg/m3 respectively. After that, the medians were 0.26 g/m2, 0 cfu/m2, 0.2 cfu/m2, 219 cfu/m3, 121 cfu/m3 and 0.07 mg/m3 respectively. The eligible rates were 20%(3/15), 87.8%(36/41), 82.9%(34/41), 18.3%(11/60), 66.7%(40/60) and 65.7%(23/35) before the systems being cleaned and disinfected, by comparison, they were 100%(15/15), 100%(41/41), 100%(41/41), 91.7%(55/60), 96.7%(58/60) and 100%(35/35) after being cleaned and disinfected. Before the systems being cleaned and disinfected, the eligible rates of hemolytic streptococcus in ventilation systems, Legionella pneumophila in cooling water and condensed water were 100%(39/39), 80%(4/5) and 100%(5/5), after that, they were all 100%. Conclusion Cleaning and disinfecting is an effective way to improve the hygiene quality of central air conditioning ventilation systems. For protecting the people health, central air conditioning ventilation systems should be cleaned and disinfected regularly.

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

Objective To explore the correlation between the posterior vertebral muscle group aging degeneration and body mass index (BMI) in normal middle-aged and elderly women.Methods One hundred and fifteen women(48-75 years old) were divided into the middle-aged group (＜60 years old) and elderly group (≥60 years old).The muscle area of posterior vertebral muscle group and fat area at lumbar levels L3 were measured by quantitative computed tomography (QCT).The muscle fat infiltration (MFI),e.g.fat area/(muscle area + fat area),was calculated.The differences between the two groups were compared by using independent-samples t test.The correlation and linear regression analysis were used for analyzing the correlations between the muscle area,fat area and MFI with age and BMI.Results The BMI had no statistical difference between the two groups (P＞0.05),while the muscle area of posterior vertebral muscle group,fat area and MFI had statistical difference (t=2.182,-1.997,-2.604,P=0.031,0.048,0.010);the correlation and linear regression analysis showed that controlling the body height,body mass factor and age were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.275,0.320,t=2.915,3.445,P=0.004,0.001),while had no obvious correlation with the muscle area(r=-1.109,P =0.270);controlling age factor and BMI were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.361,0.307,t=3.945,3.277,P≤0.001),while had no obvious correlation with the muscle area(t=1.653,P=0.101).Conclusion In middle-aged and elderly women,the fat content of posterior vertebral muscle group is increased with the age increase.In evaluating the degeneration,especially greater body mass,the fat content of muscles and their proportion have more significance than the muscle area.

ObjectiveTo investigate the clinical effects of applying low abdominal superficial artery flap to repair skin and soft tissues defects in upper limbs.MethodsTotal 42 cases with soft tissues defects were recruited in this study.Seven cases were repaired using skin flaps with circumfiexa ilium superficial artery.Five cases were repaired using osteocutaneous flaps based on circumfiexa ilium superficial artery.Eleven cases were repaired using flaps with superficial epigastric artery.Seven cases were repaired using flaps with circumfiexa ilium superficial artery,lateral branches of superficial epigastric artery and musculocutaneous perforators of the fourth lumbar artery.Six cases were repaired using flaps with origin of circumfiexa ilium superficial artery,medial and lateral branch of superficial epigastric artery,and the deep and cutaneous branch of circumfiexa ilium superficial artery.ResultsAfter surgery,forty-two flaps all survived.Flaps areas were between 5 cm × 6 cm-9 cm × 30 cm.Followed up 6-24 months,the appearance,texture,color and function of flaps were recovered well and did not need to trim again.ConclusionLow abnominal superficial artery flap could be used to repair skin and soft tissues,also its texture is so thin and areas can be direct sutures,which,is an ideal method to forearm repairment.

Objective To investigate the clinical application of interventional combination embolization of spleen and kidney in treating traumatic splenic and renal hemorrhage. Methods Since Jan. 2010 to early 2014, a total of 24 patients with traumatic splenic and renal hemorrhage were admitted to authors’ hospital. After angiography, super-selective embolization with Gelfoam particles was employed to occlude the bleeding arteries. The results were analyzed. Results Technical success with single procedure was achieved in all the 24 patients. All 24 patients survived the trauma. The complication was mild. Follow-up examination showed that the embolization results were perfect. Conclusion For the treatment of traumatic splenic and renal hemorrhage, interventional combination embolization of spleen and kidney is safe and effective with reliable clinical results, and this technique can reduce visceral function damage to the greatest possible advantage.

UNLABELLEDThe periodontal ligament fibroblast (PDLF) was cultivated artificially as the cell to be tested, and then it was loaded with mechanical stress-strain of different values and for different times. The cell and nucleus projected areas and shapes as well as the structure of cytoskeleton were tested by use of confocal laser scanning microscope and immunity fluorescence technique. Then the relationship among the stress-strain, the time, the shape and the structure of cytoskeleton of the PDLF was detected.

RESULTSIn the trial groups of 0, 8%, 12%, 16% strain values, the cell and nucleus projected areas were proportional to strain (stress) and time. The diameter, density and order of the structure of cytoskeleton increased in the strain and time dependent fashion. In the trial group of 20% strain values, the cell and nucleus projected areas decreased with the increase of time, and the structure of cytoskeleton became disorderly. It was demonstrated in this study that the shape and structure of cytoskeleton of PDLF underwent regular changes when the PDLF was loaded with the mechanical stress-strain.

Cells, Cultured ; Cytoskeleton ; physiology ; Fibroblasts ; cytology ; physiology ; Humans ; Periodontal Ligament ; cytology ; Radioimmunoassay ; Stress, Mechanical ; Tensile Strength ; physiology

Objective: To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m², 10 mg/m² or 12 mg/m² as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) . Methods: A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m²) as induction chemotherapy in newly diagnosed patients of adult AML. Results: Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m² group and IDA 12 mg/m² group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m² group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m² was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m² when compared with the IDA 8 mg/m² was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×10⁹/L in IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×10⁹/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) . Conclusions For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m² is clinically superior to IDA 8 mg/m² and IDA 12 mg/m² in favorable intermediate AML subgroup. However, idarubicin 12 mg/m² is more suitable to adverse AML subgroup.

ObjectiveTo investigate the therapeutic effect of Ganmai Dazao Tang on breast cancer-related depression and explore the mechanism of the decoction in regulating immune inflammation and neurotransmitters via the mitogen-activated protein kinase （MAPK）/nuclear factor-κB （NF-κB） pathway. MethodBALB/c mice were randomized into control， model， fluoxetine （5 mg·kg^-1·d^-1）， and low- and high-dose （crude drug 20 and 40 g·kg^-1， respectively） Ganmai Dazao Tang groups （n=10）. The mouse model of 4T1 orthotopic transplantation-induced breast cancer-related depression-like behavior was established. The depression-like behavior of mice was assessed by the tail suspension test and the forced swimming test. RT-qPCR was employed to determine the mRNA levels of interleukin （IL）-17A， forkhead box P3 （FoxP3），IL-1β， IL-6， and tumor necrosis factor-α （TNF-α） in the cerebral cortex. Flow cytometry was employed to measure the proportions of immune cell subsets in the spleen and thymus. HPLC-MS/MS was employed to measure neurotransmitter levels in the cerebral cortex. Western blotting was employed to detect the activation of the MAPK/NF-κB pathway. ResultCompared with the model group， administration of Ganmai Dazao Tang at a dose of 40 g crude drug·kg^-1 continuously for 4 weeks shortened the immobility time of modeled mice in the tail suspension and forced swimming tests （P<0.05）， down-regulated the mRNA levels of IL-1β， IL-17A， and TNF-α （P<0.05）， increased the proportions of T cells， CD4⁺ T cells， B cells， helper T 17 （Th17） cells， and regulatory T （Treg） cells， and reduced the proportion of CD8⁺ T cells （P<0.05）. Furthermore， it lowered the levels of 5-hydroxyindoleacetic acid （5-HIAA） and kynurenine （Kyn）， decreased the kynurenine/tryptophan （Kyn/Trp） ratio （P<0.05）， increased the content of 5-hydroxytryptamine （5-HT）， and down-regulated the protein levels of phosphorylated extracellular signal-regulated kinase （p-ERK）， phosphorylated p38 MAPK， and phosphorylated nuclear factor-κB p65 （P<0.05）. ConclusionGanmai Dazao Tang can down-regulate the expression of inflammatory cytokines such as IL-1β， IL-17A， and TNF-α， restore 5-HT metabolism and Kyn/Trp balance， increase the 5-HT content， and reduce the activation of p38 MAPK， ERK， and the MAPK-mediated NF-κB signaling pathway to reduce neuroinflammation in the treatment of cancer-related depression.

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.