Objective To investigate the protective effects of dexmedetomidine on bupivacaine-induced neurotoxicity. Methods Mouse neuroblastoma cell line N2a cells were divided into four groups. The cells in the control group were incu?bated with no drug adding while the cells in bupivacaine group were treated with 1 000 μmol/L bupivacaine for 24 h. The cells in the group Dex1 and Dex2 were incubated with 1 000 μmol/L bupivacaine and 50 μmol/L, 200 μmol/L dexmedetomi?dine for 24 h respectively. MTT assay was used to evaluate the cell viability. The reactive oxygen species (ROS) activity, mito?chondrial membrane potential (MMP), the expression of Caspase-3 and apoptotic rate of N2a cells were detected by flow cy?tometry. Results The cell viabilities were significantly decreased after being treated with 1 000 μmol/L bupivacaine, MMP was also significantly decreased, and apoptotic rates, levels of ROS and Caspase-3 were significantly increased. The bupiva?caine-induced cytotoxicity was inhibited by dexmedetomidine (50 and 200 μmol/L), which resulted in the increase in the cell viability and MMP, but decrease in apoptotic rate and levels of ROS and Caspase-3. These effects were more significant in 200 μmol/L dexmedetomidine group than those of 50 μmol/L dexmedetomidine group. Conclusion Dexmedetomidine at?tenuates bupivacaine-induced cytotoxicity of N2a cells, which may be related with the inhibition of ROS, the decrease in MMP and Caspase-3, and inhibiting appotosis in N2a cells.

Objective To evaluate the neurotoxic effects of intrathecal (IT) chloroprocaine on the spinal cord in rats. Methods Forty male SD rats weighted 180 ～250g, which IT catheters were successfully placed, were randomly divided into 4 groups( n = 10 each). Group NS received normal saline 40 μl IT, group CP_1 received 2% chloroprocaine 40 μl IT, group CP_2 received 3% chloroprocaine 26.7 μl IT, and group CP_3 received 3% chloroprocaine 40 μl IT. The onset time of bilateral hindlimb paralysis were recorded. Degree of motor block was assessed and scored before (T_1, baseline) and at 10, 30, 60, 120, and 150 min (T_(1-6)) after IT injection. On the 3rd day after IT injection , specimens were obtained from lumbar spinal cord for mincroscopic examination. Results The onset time of bilateral hindlimb paralysis in group CP, and CP_3 was shorter than that in group CP_1. The onset time of bilateral hindlimb paralysis in group CP, was shorter than that in group CP_2. The motor block scores in group CP_1 and CP_2(T_(2-4))and group CP_3(T_(2_5)) were higher than that in group NS. The motor block scores in both group CP_1 and CP_2 at T_(4-5) was lower than group CP_3. The tissue damage in group CP_3 was severer, compared with group CP_1 and CP_2. Conclusion Large dose of 3% chloroprocaine may produce neurotoxicity to the spinal cord.

Objective To study the clinical efficacy and safety of leflunomide combined with irbesartan in the treatment of lupus nephritis . Methods 80 cases of patients with lupus nephritis in Yueqing Hospital Affiliated to Wenzhou Medical University from May 2014 to May 2016 were selected and randomly divided into leflunomide group ( leflunomide combined with irbesartan group ) and cyclophosphamide group ( cyclophosphamide combined with irbesartan group),40 cases in each group.The urine indexes and blood indexes levels,clinical curative effect,adverse reaction of the two groups were statistically analyzed.Results The 24h urine protein,urine beta 2-MG,urine red blood cell count,blood beta beta2-MG,ESR,Cr levels of the leflunomide group were significantly lower (P<0.05),the serum albumin,C3 levels were significantly higher (P<0.05),the total treatment efficiency 97.5%was significantly higher than the cyclophosphamide group 82.5%(P<0.05),the incidence of adverse reactions 5.0%was significantly lower than the cyclophosphamide group 22.5%(P<0.05).Conclusion Leflunomide combined with irbesartan is safe and effective in the treatment of lupus nephritis.

Objective To investigate the expression of membrane type 1 matrix metalloproteinase(MT1-MMP) in the esophageal carcinoma tissues and in normal periearcinomatous tissues and its clinical significance. Methods Immunohistochemistry was used to study the expression of MT1-MMP in esophageal carcinoma tissues and normal tissues in distance for 5-7 em from tumor. Results Among 54esophageal carcinoma specimens, the positive expression rate of MT1-MMP was 87.0%, while all of themwere expressed a small quantity in normal esophageal epithelial tissues, the expression in the esophageal carcinoma tissues was significantly higher than those in normal esophageal epithelial tissues (P ＜ 0.01 ).The degree of MT1-MMP expressions was associated with the depth of tumor invasion (P ＜ 0.01 ), the invasion of the lymph nodes(P ＜ 0.01 ) and the relapse and/or metastasis of the tumors for three years after surgery(P ＜0.01 ), and was also related to differentiation of tumor cells (P ＜ 0.01 ). Conclusions The expression of MT1-MMP in the esophageal carcinoma tissues is well associated with the depth of tumor invasion, the invasion of the lymph nodes, the differentiation of tumor cells and relapse and/or metastasis of the tumors for three years after surgery. MT1-MMP plays an important rote in the invasion and metastasis in the patients with esophageal carcinoma.

Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

AIM: To investigate the effect of suberoylanilide hydroxamic acid (SAHA) on the apoptosis of hu-man small-cell lung cancer H446 cells and its possible mechanism.METHODS: H446 cells were incubated in the medi-um containing SAHA.CCK-8 assay was used to detect the anti-tumor effect of SAHA on the H446 cells, and IC50 values of SAHA were calculated.Flow cytometry was used to analyze the apoptosis.After Notch3 gene was silenced, the pro-apopto-tic effect of SAHA on the H446 cells was inhibited ( P <0.05).Eukaryotic expression plasmid containing N3ICD was transfected into the H446 cells, so that N3ICD was expressed in the H446 cells.The mRNA expression of Notch3 was measured by RT-PCR.The protein levels of Notch3, N3ICD, Puma and cleaved caspase-3 were determined by Western blot.RESULTS: SAHA remarkably reduced the cell viability in a dose-dependent manner (P <0.05), and the IC50 value of SAHA was 1.91 μmol/L.SAHA induced apoptosis in a dose-dependent manner (P <0.05).The expression of Notch3 gene was negative in the H446 cells, SAHA reactivated Notch3 gene and Notch3 pathway in a dose-dependent manner (P <0.05).Notch3 knockdown inhibited apoptosis induced by SAHA (P <0.05).Over-expression of N3ICD up-regula-ted the protein levels of Puma and cleaved caspase-3.CONCLUSION: SAHA induces apoptosis in human small-cell lung cancer H446 cells by activating Notch3 pathway and up-regulating the protein level of Puma.

OBJECTIVE:To investigate the distribution and drug resistance of Acinetobacter baumannii in our hospital,and provide reference for rational use of antibiotics. METHODS:Clinical specimen of inpatients in our hospital from Jan. 2012 to Dec. 2015 was collected,the identification of strains and drug sensitivity test were performed by the VITEK-2 microorganism analyzer;use rate of antibiotics and detection of multidrug-resistant and pandrug-resistant A. baumannii for inpatients in our hospital were an-alyzed,and their correlation was detected by Pearson correlation analysis. RESULTS:Totally 2 468 strains of A. baumannii were isolated in our hospital during 2012-2015,mainly derived from sputum samples (88.2%),distributed in respiratory medicine de-partment(47.0%)and ICU(13.1%);A. baumannii showed totally high drug resistance to common antibiotics,and only sensitive to tigecycline. Totally 386(79.3%),434(61.6%),358(53.4%)and 291(48.0%)strains multidrug-resistant A. baumannii were detected every year in our hospital;and pandrug-resistant A. baumannii were 336(69.0%),385(54.7%),331(49.3%)and 256 (42.2%) strains,respectively. There was a positive correlation between the percentage of multidrug-resistant and pandrug-resistant A. baumannii in total strains and use rate of antibiotics (r=0.987、0.981,P<0.05). CONCLUSIONS:A. baumannii has emerged as an important pathogen in hospital acquired infections,which mainly caused respiratory system infection;the drug resistance situ-ation is not optimistic,tigecycline can be used as one of the best choice for treatment of A. baumannii infections;our hospital should continue to control the use of antibiotics to decrease the emerging of drug resistance strains.

OBJECTIVE:To investigate the dissolubility of commercial metformin hydrochloride tablets from different manufactories.METHODS:The in vitro dissolubility of 14 kinds of commercial metformin hydrochloride tablets was determined by basket method and the dissolution parameters were analyzed with variance analysis method.RESULTS:The in vitro dissolubility of 14 kinds of metformin hydrochloride tablets fitted to the request of ChP2000,but the dissolution parameters were different.CONCLUSION:The statistical results indicate that there are significant differences between products from different factories(P

OBJECTIVETo explore the technique of temperature control on the abdomen in penetrating moxibustion through observing moxibustion time on the abdomen, abdominal skin temperature and effect after moxibustion so as to provide the safe, effective and easily applicable method for penetrating moxibustion.

METHODSThirty-two patients were selected in an observation group, 32 healthy persons in a control group. In the observation group, the penetrating moxibustion was applied to the corresponding acupoint locations according to different symptoms. In the control group, moxibustion was used on the abdomen around the umbilicus. The skin temperature was recorded once every minute. The skin temperature of known heat sensation, the time of known heat sensation, the known reduced temperature, the time of temperature reducing, the skin temperature difference, the duration of penetrating moxibustion and the reaction of moxibustion from participants were recorded.

RESULTSThe differences in the skin temperature of known heat sensation, the time of known heat sensation and the duration of penetrating moxibustion were significant statistically in comparison between the observation group and the control group (all P<0.01). The differences in the known reduced temperature, the time of temperature reducing and the skin tem- perature difference were not significant (all P>0.05). The differences were significant statistically in skin rashes and moxibustion reaction (gastrointestinal peristalsis, chills, ant climbing feeling and hunger, etc.) between the two groups (P<0.01). The differences were not significant statistically in flushing, sweating and blisters (all P>0.05).

CONCLUSION(1) The level of temperature sensitivity in the observation group is lower than that in the control group. During penetrating moxibustion, the sensations such as gastrointestinal peristalsis, chills, ant climbing feeling and hunger appear easily, suggesting the positive self-adjustment in the body. (2) During penetrating moxibustion, the warm feeling is penetrated not just from the epidermis to the abdominal cavity and lumbar region, but also up to thehead and down to the knee. (3) The flushing, sweating and skin rashes are the important indices for the effectiveness of penetrating moxibustion. (4) The temperature control is the core technique of penetrating moxibustion. The penetrating moxibustion in 28 min to 32 min and the temperature controlled in 43 degrees C to 45 degrees C can solve the moxibustion smoky impact to the environment, but also relieve pains of the patients.

Abdomen ; physiology ; Acupuncture Points ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Skin Temperature ; Thermosensing ; Young Adult

Objective To investigate the efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus. Methods From November 2008 to August 2009, 40 patients with gastric diseases and nonobese type 2 diabetes mellitus were admitted to the Changhai Hospital, and their clinical data were prospectively studied. All patients were randomly divided into 4 groups; 10 patients received Billroth I distal gastrectomy +gastroduodenal anastomosis (BⅠ group) , 10 received proximal gastrectomy + remanant gastric esophageal anastomosis ( PG group), 10 received total gastrectomy + esophagoduodenal Y-anastomosis ( RY group) and 10received subtotal gastrectomy Billroth Ⅱ gastro-jejunostomy (BⅡ group). The length of hospital stay, pre- and postoperative body mass indexes (BMIs) , waist circumferences, levels of fasting blood glucose (FBG) , glycated hemoglobin ( GHbA1) , fasting serum insulin (FSI) and fasting C-peptide (FCP) of patients in the 4 groups were compared. All data were analyzed using analysis of variance, LSD-t test, paired t test or chi-square test. Results The clinical effects of the 4 different operative procedures on the gastric diseases were similar. The levels of FBG were (8.0 ±2.9)mmol/L before operation and (5.9 ±0.7)mmol/L after operation in the RY group, with a significant difference (t = 2. 342, P < 0. 05). The preoperative level of GHbA1 in the RY group was 7.7% ± 1.1%, which was significantly higher than 6. 9% ± 0. 6% at 2 months after the operation and 6. 1 % ± 0. 4% at 6 months after the operation (t = 4. 920, 3.012, P < 0.05). The preoperative level of FCP in the RY group was (1.30 ±0.54) μg/L, which was significantly lower than (1.95 ± 0.86) μg/L at 2 months after the operation and (2.18 ± 0.63)μg/L at 6 months after the operation (t =6. 063, 4. 651, P < 0.05). The levels of FSI in the RY group at postoperative month 1, 2 and 6 were (18 ±5) , (19 ±3) , (21 ±3) mU/L, which were significantly higher than the level of FSI [(11 ±4) mU/L]before operation (t =3. 158, 4. 502, 7. 517, P <0. 05). Preoperative levels of FBG, GHbA1, FSI and FCP in the B Ⅱ group were (8. 3 ± 1. 3) mmol/L, 7. 7% ±0. 9% , (13±4)mU/L and (1.34±0.48) μg/L, which were ignificantly different from (6.7 ± 1.2)mmol/L, 6.8%± 0.8%, (18±4)mU/L and ( 1.68 ±0.46) μg/L at postoperative month 1, (6.4 ± 1.3)mmol/L, 6.3% ±0.6% ,(18±4)mU/L and (1. 96 ± 0. 67) μg/L at postoperative month 2, and (5. 6 ±0. 7) mmol/L, 6.0%±0.3%, (19 ± 4) mU/L and (2.27 ± 0. 59) |μg/L at postoperative month 6 (t = 2. 468, 2. 598, 6. 028; 3. 055, 4. 586,4.572; 3.618, 5.860, 8.577; 2.300, 3.511, 3.943, P<0.05). The levels of FBG,GHbA1 and FCP in the 4 groups at 2 months after surgery were significantly different from those at 6 months after surgery (F = 4. 699,14. 378; 7.411, 29. 192; 3. 335, 9. 334, P < 0.05). The levels of FSI in the 4 groups at different time points were significantly different (F =2. 896, 7. 012, 11. 998, P < 0.05). Conclusion The efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus is satisfactory.