Objective To investigate the effect of propofol combined with remifentanil or sufentanil on cognitive function in patients undergoing awake craniotomy. Methods Sixty ASA Ⅰ or Ⅱ neurosurgical patients undergoing resection of glioma in cerebral cortical functional area were divided into 2 groups by random digits table: propofol + remifentanil (group RF, 30 cases) and propofol + sufentanil (group SF, 30 cases). Scalp nerve block and local infiltration of incision and dura mater were performed in both groups with 0.5% ropivacaine. Propofol, remifentanil and sufentanil were administered by target controlled infusion. The target plasma concentration of remifentanil was set at 1-2 ng/ml and that of sufentanil at 0.1-0.2 ng/ml,propofol was set at 3-6 μg/ml at open skull stage. The patients were inserted laryngeal mask and mechanically ventilated. Bispectral index (BIS) was monitored as the depth of anesthesia. Mini-mental scale examination (MMSE) was investigated at the time of preoperative,intraoperative wake-up after the patients had been targeted capacity. Results Blood concentration of propofol in group RF was (1.10 ± 0.06)μg/ml, group SF was (0.98 ± 0.05)μ g/ml in patients during intraoperative wake-up. BIS in group RF changed from 46.4 ± 2.5 to 90.8 ± 3.2 during wake-up, group SF from 44.8 ± 2.1 to 89.9 ± 3.2. The cognitive function score was not significantly different at the time of preoperative and intraoperative assessment. Conclusion Propofol combined with remifentanil or sufentanil has no effect on cognitive function for the patients undergoing awake craniotomy.

Objective: To investigate the therapeutic effects of ets-1 antisense oligoxydeonucleotide(AsODN) on gastric carcinoma. Methods: Cultured SGC-7901 cells were devided into control group, sense oligoxydeonucleotide(sODN) group and AsODN group. After transfection for 24 h, expression of ets-1mRNA was detected by RT-PCR, growth inhibition was detected by colone formation assay, in vitro invasive ability assay was carried out in Transwell chamber,the animal model of xenotransplanted gastric carcinoma in nude mice was established to detect invasive ability in vivo. Results: ets-1 AsODN could under-regulate the expression of ets-1 mRNA, number of colone formation of AsODN group was significantly lower than the other two groups(24.2?4.8 vs 47.6?8.1 vs 44.3?7.6, P

Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.

Objective To investigate cell-killing and bystander effects on gallbladder cancer (GBC-SD) cells transferred with double suicide genes (CD and HSV-tk). Methods CD and HSV-tk genes were transfected into PA317 cells using lipofectamine. GBC-SD cells were infected with viral supernatant. GBC-SD/CD+tk cells were treated with 5-FC and/or GCV. GBC-SD/CD+tk and GBC-SD were inoculated subcutaneously into the nude mice respectively and treated with GCV and 5-FC for 21 days. Results The killing effect of 5-FC and GCV in combination on GBC-SD/CD+tk cells is more effective than using 5-FC or GCV alone. The local bystander effect is significant while the distant bystander effect was not obvious. Conclusion The cell-killing efficacy of chemotherapy on GBC-SD transfected with double suicide gene was significantly increased, and the bystander effect was obvious.

AIM: To determine the combined effect of transmuscle laser revascularization (TMR) and endothelial progenitor cells(EPCs) treatment on ischemic hindlimb of nude rats.METHODS: Mononuclear cells (MNCs) isolated from human umbilical cord-blood (HUCB) by density gradient centrifugation were expanded in vitro. Immunocytochemistry and flow cytometry studies were performed. EPCs were labeled with 1, 1'- dioctadecyl-1 to 3, 3, 3', 3'- tetramethyl-indocarbocyanine perchlorate (DiI) before injected into the laser induced channels or ischemic region. Acute ischemic limb was created in 4 groups of nude rats by ligating right external iliac artery. All animals were divided randomly into the following four groups: TMR+EPCs group: local transplantation of EPCs into laser channels; TMR group: transmuscular channels were created without EPCs; EPCs group: EPCs were injected into ischemic hindlimb; control group: ischemic model without TMR or EPCs. All rats underwent femoral artery ultrasonic blood flow measurements of the ischemic and nonischemic limbs to obtained a flow ratio [femoral artery flow index (FAFI): right femoral artery flow /left femoral artery flow] at baseline (after ligating artery immediately) and 28 days postoperation, and then the samples of ischemic limb muscle underwent histochemical and immunohistologic analysis. RESULTS: The attached cells expressed endothelial cell (ECs) markers (KDR, CD34, CD31, AC133 and von Willebrand factor) and exhibited function similar to that of ECs judged by Ac-LDL incorporation. Flow cytometric analysis disclosed that AT cells were positive for CD34 (62%?7%) and AC133 (57.2%?9.8%) at day 7 of culture. 28 days after therapy, FAFI was significantly higher in the TMR +EPCs (0.66?0.09, P0.05). FAFI in the control group was unchanged and no difference was found between TMR group and control group. TMR+EPCs (5.66?0.77), TMR (4.96?0.31) as well as EPCs (4.68?0.44) treatment resulted in an increased number of capillaries in the treated regional area compared with control group (2.60?0.31, P

Abstract A chiral separation and residue determination method for cis-epoxiconazole enantiomers in apple, grape and tea samples was developed and validated by ultra performance convergence chromatography combined with quadrupole time-of-flight mass spectrometry ( UPC2-QTOF/MS) . The Chrial CCA column was used to separate cis-epoxiconazole enantiomers and the chromatography conditions ( mobile phase modifier and proportion, column temperature, automated backpressure regulator, and auxiliary solvent ) were optimized. Samples were extracted by acetonitrile, and respectively purified by Cleanert TPT or Pesti-Carb solid phase extraction ( SPE ) columns, then analyzed by UPC2-QTOF/MS. The optimum conditions were as follows:mobile phase was CO2/isopropanol (95: 5, V/V), flow-rate was 2. 0 mL/min, automated backpressure regulator (ABPR) was 13. 79 MPa, column temperature was 30℃, with a post-column mauxiliary solvent of methanol/water (1:1, V/V) containing 2 mmol/L ammonium formate. The analyte was quantified by matrix external standard method. The results showed that linear range of this method was 0. 01-1. 00 mg/L, and the correlation coefficients were above 0 . 99 . The recoveries of cis-epoxiconazole enantiomers at three spiked levels (0. 005, 0. 025 and 0. 25 mg/kg) in fruit matrix were 67. 9%-92. 8% with relative standard deviations (RSDs, n=6) less than 10%, and the limit of quantification (LOQ) of enantiomers was 0. 005 mg/kg. The recoveries of cis-epoxiconazole enantiomers at three spiked levels (0. 01, 0. 05 and 0. 5 mg/kg) in black tea were 74 . 1% -84 . 0% with RSDs ( n=6 ) less than 8%, and the LOQ for these two enantiomers was 0. 01 mg/kg. This method is rapid, convenient and reliable, and could meet the requirement of residue analysis.

Objective:To investigate the gene subtypes of cervical human papilloma virus (HPV) infection in pregnant and non-pregnant women .Methods :From February 2012 to May 2013 ,cervical epithelial cells in 684 women of childbearing age (non-pregnant women) and 857 pregnant women in Jinshan Hospital ,Fudan University were collected .Polymerase chain reaction (PCR) and gene-chip technique were used to detect HPV gene subtype .Results :A total of 195 positive results were found in non-pregnant women with the HPV infection rate of 28 .5% .The predominant types of HPV infection were type 43 ,16 and 58 .A total of 102 positive results were found in pregnant women with the HPV infection rate of 11 .9% .The predominant types of HPV infection were type 43 ,16 and 58 .The infection rates of pregnant women in less than 30 years of age ,30 to 40 years old ,more than 40 year old were 10 .9% ,15 .1% and 30% ,respectively .The infection rates of non-pregnant women in less than 30 years ,30 to 40 years old ,more than 40 year old were 25 .3% ,25 .2% and 32 .2% ,respectively .Conclusions :The HPV infection rate of pregnant women was lower than that of non-pregnant women .The main HPV infection subtypes of the pregnant women and the non-pregnant women were the same .HPV43 ,16 and 58 were the predominant subtypes in this hospi-tal .The infection rate of non-pregnant women increased significantly in accordonce with age .

Objective:To investigate changes of natural killer (NK) cell subsets and interleukin-18 (IL-18) level in peripheral blood of patients with alopecia areata, and to assess the regulatory effect of IL-18 on NK cell activity.Methods:A total of 67 patients with alopecia areata (alopecia areata group) and 25 healthy volunteers (control group) were collected from Shanxi Provincial People′s Hospital between December 2019 and January 2021. Peripheral blood mononuclear cells (PBMCs) and plasma were isolated. The percentage of NK cell subsets was investigated by flow cytometry, and plasma IL-18 level was measured by enzyme-linked immunosorbent assay. PBMCs were stimulated with recombinant human IL-18, and co-culture systems of PBMCs with 721.221 cells, K562 cells and P815-Ab cells were established separately. NK cell function was assessed by determining the percentage of CD107a-expressing NK cells and fluorescence intensity of CD16 + NK cells. Comparisons between groups were performed using t test or paired t test. Results:Compared with the control group, the alopecia areata group showed significantly decreased percentage of CD56 +CD16 - NK cells (8.12% ± 3.14% vs. 10.78% ± 4.08%, t = 3.33, P = 0.001) , but significantly increased percentage of CD56 +CD16 + NK cells (46.08% ± 15.21% vs. 32.14% ± 10.45%, t = 4.22, P < 0.001) , and there was no significant difference in the percentage of CD56 -CD16 + NK cells between the alopecia areata group and control group (28.81% ± 8.65% vs. 27.09% ± 7.62%, t = 0.88, P = 0.383) . The plasma IL-18 level was significantly higher in the alopecia areata group than in the control group (112.0 ± 23.72 pg/ml vs. 99.34 ± 15.15 pg/ml, t = 2.48, P = 0.015) . After co-culture with 721.221 cells, K562 cells and P815-Ab cells, the percentage of CD107a-expressing NK cells was significantly higher in NK cells from the alopecia areata group (9.53% ± 1.70%, 5.15% ± 1.35%, 6.50% ± 1.64%, respectively) than in those from the control group (5.00% ± 1.17%, 4.40% ± 1.09%, 5.13% ± 1.36%, respectively, all P < 0.05) . After the stimulation with P815-Ab cells, the alopecia areata group showed significantly decreased fluorescence intensity of CD16 + NK cells (151.10% ± 59.30%) compared with the control group (221.90% ± 93.56%, t = 4.31, P < 0.001) . After IL-18 stimulation, the percentage of CD107a-expressing NK cells significantly increased in the co-culture system of NK cells with 721.221 cells compared with the unstimulated co-culture system (14.47% ± 2.67% vs. 9.93% ± 1.94%, t = 6.00, P < 0.001) , while there was no significant difference between the IL-8-stimulated co-culture system of NK cells with K562 cells or P815-Ab cells and the unstimulated co-culture systems (both P > 0.05) . Conclusion:IL-18 could enhance NK cell activity in patients with alopecia areata, likely by promoting natural cytotoxicity receptor-mediated cytotoxicity.

Objective:To investigate changes in the peripheral interleukin-35 (IL-35) level in patients with alopecia areata, and to assess its modulatory effect on regulatory T (Treg) cell activities.Methods:Totally, 81 patients with alopecia areata (alopecia areata group) and 27 healthy volunteers (control group) were enrolled from Shanxi Provincial People′s Hospital between December 2019 and January 2021. Sera and peripheral blood mononuclear cells (PBMCs) were isolated. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum IL-35 level, real-time fluorescence-based quantitative PCR to determine the mRNA expression of IL-35 subunits EBI3 and IL-12p35, and flow cytometry to determine the proportion of CD4 + CD25 + CD127 dim/- Treg cells. Sorted Treg cells were stimulated by recombinant human IL-35, ELISA was performed to detect levels of perforin and granzyme B in the culture supernatant, and real-time fluorescence-based quantitative PCR to determine the mRNA expression of EBI3, IL-12p35, and immune checkpoint molecules, such as programmed death protein 1 (PD-1) , T cell immunoglobulin and mucin protein-3 (Tim-3) , cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and lymphocyte activation gene-3 (LAG-3) in Treg cells. IL-35-stimulated or unstimulated Treg cells were co-cultured with autologous PBMCs, and cell counting kit-8 (CCK8) assay was conducted to assess cellular proliferative activity. Measurement data were compared between 2 groups by using t test, comparisons among multiple groups were carried out by using one-way analysis of variance, correlation analysis was carried out by using Pearson correlation analysis, and enumeration data were compared by using chi-square test. Results:Compared with the control group, the alopecia areata group showed significantly decreased IL-35 levels (90.10 ± 11.98 ng/L vs. 100.74 ± 28.71 ng/L, t= 2.71, P= 0.008) , mRNA expression of EBI3 and IL-12p35 in PBMCs (EBI3: 1.06 ± 0.15 vs. 1.25 ± 0.11, t= 6.09, P < 0.001; IL-12p35: 1.00 ± 0.15 vs. 1.38 ± 0.22, t= 10.16, P < 0.001) , and proportions of Treg cells (5.91% ± 1.17% vs. 6.85% ± 1.23%, t= 3.54, P= 0.001) . In the alopecia areata group, the proportion of Treg cells was positively correlated with the serum IL-35 level ( r= 0.25, P= 0.026) , and the mRNA expression of EBI3 and IL-12p35 in PBMCs ( r= 0.31, 0.24, P= 0.004, 0.032, respectively) . Compared with the control group, the unstimulated Treg cells from the alopecia areata group showed significantly decreased supernatant levels of perforin and granzyme B, mRNA expression of EBI3, IL-12p35 and immune checkpoint molecules ( P < 0.05 or 0.001) , as well as weakened inhibitory effect on the proliferative activity of PBMCs ( P= 0.013) . There was no significant difference in the level of perforin or granzyme B between the recombinant human IL-35-stimulated and unstimulated Treg cells from the patients with alopecia areata (both P > 0.05) . However, the mRNA expression of EBI3, IL-12p35 and immune checkpoint molecules was significantly higher in the IL-35-stimulated Treg cells than in the unstimulated Treg cells in the alopecia areata group ( P < 0.05 or 0.001) , and the inhibitory effect on the proliferative activity of PBMCs was also significantly enhanced in the IL-35-stimulated Treg cells compared with the unstimulated Treg cells ( P= 0.037) . Conclusion:The peripheral IL-35 level was significantly decreased in the patients with alopecia areata, which was closely associated with reduced activities of Treg cells, and IL-35 may be involved in the occurrence of alopecia areata.

Objective To propose a concept of irreducible tibial shaft fractures and to discuss their imaging characteristics and clinical significance.Methods A retrospective study was performed in 21 patients with tibial shaft fracture who had received intraoperative intramedullary nailing after limited open reduction at Department of Orthopaedics,The Second Affiliated Hospital to Anhui Medical University from November 2013 to June 2018.They were 14 males and 7 females,aged from 21 to 66 years (average,34.9 years).There were 15 left and 6 right sides.Firstly,closed reduction was performed followed by traction,folding and rotation,but repeated attempts failed to achieve smooth reduction or insertion of guide wire.Next,local limited open reduction had to be performed for intramedullary nailing.The X-ray and CT images of the tibial fractures were collected to analyze their imaging characteristics.The imaging manifestations were characterized into 4 types:single-segment type with intact fibula,multiple-segment type,interlocking type where the distal and proximal ends interlock commonly seen in short spiral and short oblique fractures,and incarceration type where the fracture interspace is blocked by a bone fragment.The therapeutic efficacy was evaluated at the final follow-up by knee scores of The Hospital for Special Surgery (HSS) and Kofoed ankle scores.Results Of the 21 patients,2 were single-segment type,4 multiple-segment type,13 interlocking type and 2 incarceration type.They were followed up for 7 to 50 months (average,22.7 months).The fractures united after 5 to 16 months (average,7.3 months).Postoperative knee pain was observed in 3 cases and delayed fracture union in 2.Osteomyelitis,superficial wound infection,implant breakage or malunion occurred in none of the patients.The therapeutic efficacy evaluated at the final follow-up by HSS knee scores and Kofoed ankle scores revealed 15 excellent,4 good and 2 fair cases,yielding an excellent to good rate of 90.5％.Conclusion The concept of irreducible tibial shaft fractures may lead to preoperative awareness on the part of the surgeons so that ineffective repeated reductions can be spared and the damage to the blood supply to the fracture ends and the operation time can be reduced.