Objective To evaluate the accuracy and clinical practicality of DNA chip in comparison with serology in typing of human leukocyte antigen A (HLA-A) in Han's individuals of donor-recipients of transplantation. Methods 120 peripheral blood samples were obtained from donor-recipients of transplantation. Each sample was divided into two parts and HLA-A antigens were identified by DNA chip in one part and by serology in another. Samples in which the HLA-A typing results by these 2 methods were discordant were verified by polymerase chain reaction with sequence specific primers (PCR-SSP). Accuracy and clinical practicability of both methods were compared according to the typing results. Results Serological typing for HLA-A took 3 h, while DNA chip typing 4. 5-5 h. 112 samples have been typed successfully. Typing results were same in 91 samples and discordant in 21 cases. The verified results showed that DNA chip made 2 incorrect typing and the error rate was 2%. Meanwhile, serology made 19 mistakes, consisting of 5 antigens being incorrectly interpreted and 14 "blanks" turning out to be definable alleles. The discrepancy rate was 17 %. Conclusions DNA chip typing for HLA-A is suitable for clinical application in Chinese Han's population with a greater precision than serology. It may replace the serology in future after being improved and perfected.

Objective To investigate the effect of esmolol pretreatment on propofol injection pain..Methods Ninety patients undergoing breast cancer surgery under general anesthesia were ran-domly assigned into three groups (n=30 each).Group E were pretreated with 5 mg/ml(total 2 ml)es-molol group L with 20 mg/ml (total 2 ml)lidocaine and group N with 2 ml normal saline.After one minute,each group was administrated propofol intravenouly.The pain and hemodynamic data were re-corded.Results Compared with group N,propofol injection pain degree decreased obviously in groups E and L (P <0.05).propofol injection pain occurred in 25 (83.3%)in group N,was signifi-cantly higher than that of 12 (40.0%)in group E and 14 (46.7%)in group L (P <0.05),propofol injection pain had no significant difference between groups E and L.Compared with T1 ,SBP,DBP decreased in groups E and L at T2 ,SBP decreased in group N at T2 significantly (P <0.05).Com-pared with T2 ,DBP was significantly higher at T3 in group E (P <0.05).Conclusion Pretreatment with low dose esmolol was effective in attenuating pain during propofol injection.

Objective To compare the effects of different doses of dexmedetomidine on postoperative analgesia and sedation.Methods From January 2014 to November 2015,60 cases who needed postoperative analgesia and sedation in our hospital were selected.According to the dosage of dexmedetomidine,they were divided into control group and observation group,30 cases in each group.Two groups of patients were given analgesia pump for analgesia, with 0.5μg·kg-1·h-1,1.0μg·kg-1·h-1 two doses of dexmedetomidine,and analgesia 48 h.At different time points,the VAS pain score,Ramsay sedation score of the two groups were compared,the calm satisfaction in both two groups was recorded,the average incidence of delirium and delirium score in the process of the treatment and the occurrence of adverse reactions were observed.Results With the extension of time of postoperative analgesia,VAS scores in each group decreased,VAS scores in the observation group after 4h,8h,12h were (3.01 ±0.53)points, (1.95 ±0.58)points,(1.52 ±0.35)points,which were lower than those of the control group[(3.92 ±0.32)points, (2.86 ±0.67)points,(2.25 ±0.78)points],the differences were statistically significant (t=3.42,4.11,2.43,all P<0.05).After 24h,48 h,VAS score between the two groups had no significant difference(P>0.05).Postoperative 4h Ramsay score between the two groups had no significant difference (P >0.05 ).With increased postoperative analgesia time,Ramsay scores in two groups decreased,postoperative 8h,12h,Ramsay scores in the observation group [(2.95 ±0.83)points,(2.22 ±0.55)points]were lower than the control group[(3.76 ±0.78)points,(2.98 ± 0.89)points,t=3.45,2.38,all P<0.05].Postoperative 24h,48 h,the Ramsay scores between the two groups had no significant difference(P>0.05).The sedation satisfaction of the observation group (96.67%)was higher than the control group (86.67%),the incidence rate of delirium and delirium average score [3.33%,(15.11 ± 2.03)points]were lower than the control group[13.33%,(19.23 ±2.21 )points],the differences were significant between the two groups (t =4.32,4.32,3.27,all P<0.05 ).After treatment,the adverse reactions were mainly bradycardia,nausea,vomiting,drowsiness,respiratory depression,urinary retention.The overall incidence rate of adverse reactions between the two groups had no significant difference (P >0.05 ).Conclusion The effect of 1 .0μg·kg-1 · h-1 concentration dexmedetomidine within 24h of postoperative analgesia sedative is best,it can reduce the incidence of postoperative delirium,and without obvious drug side effects.

Objective To investigate the changes in the expression of acid-sensing ion channel 3(ASIC3)in the dorsal root ganglion(DRG)in a rat model of bone cancer pain.Methods Twenty-four female SD rats,aged 3-4 yr,weighing 180-220 g,were randomly divided into 2 groups:sham operation group(group S,n =8)and bone cancer pain group(group P,n =16).Bone cancer pain was induced by intra-tibial inoculation of 10 μl Walker 256 cancer cell suspension in group P,while group S received intra-tibial inoculation of 5 μl normal saline.Body weight and paw withdrawal threshold to mechanical stimulation with yon Frey filaments(MWT)were measured at 0,1,3,5,7,9,1 1 and 14 d after cancer cell inoculation.The tibia was removed at 14 d after cancer cell inoculation in group S and at 7 and 14 d after cancer cell inoculation in group P for pathological and imaging examinations.The tumor cell growth and bony destruction were observed.The expression of ASIC3 in the DRG was determined by immunolluorescence.Results Pathological damage occurred at 14 d after cancer cell inoculation,bony destruction was observed obviously,ant cortical bone was missing in many places.Compared with group S,body weight at T3-7 and MWT al T2-7:were significantly decreaed,and the expression of ASIC3 was up-regulated at 14 d after cancer cell inoculation in group P(P ＜ 0.05).Conclusion Up-regulation of the expression of ASIC3 in the DRG is involved in the developntent and maiutenence ot bone cancer pain in rars.

Objective To investigate the effect of tannic acid on glomerular mesangial cells (GMC),and to clarify the mechanism of tannic acid in improving the pathological changes of diabetic nephropathy (DN)from the aspect of oxidative stress and micro-inflammation. Methods The glomerular mesangial cells were treated with glucose (30 mmol·L-1 )or advanced glycosylation end-products (AGEs)bovine serum albumin(BSA)(250 mg·L-1 )and then different concentrations of tannic acid (10,20,40 and 80μmol·L-1 )were added into the GMC.The cells cultured by normal glucose or treated with BSA were used as control groups and then the level of malonic dialdehyde (MDA), glutathione peroxidase (GSH-Px ), superoxide Dismutase (SOD ), CAT (Catalase ) activities and 8-hydroxy-2′-deoxyguanosine(8-OHdG)levels in the culture supernatant 48 h after culture were determined by colorimetry and ELISA method. The expressions of intercellular cell adhesion molecule-1 (ICAM-1 ) protein, monocyte chemotactic protein 1 (MCP-1 ) and ICAM-1 mRNA in GMC were detected by immunohistochemical staining and RT-PCR method.Results Compared with high glucose and AGEs groups,the MDA levels in tannic acid groups were reduced significantly(P<0.05);the activities of GSH-Px,SOD and CAT were increased significantly(P<0.05 or P<0.01);the 8-OHdG levels in annic acid groups were significantly reduced (P<0.05). Compared with high glucose and AGEs groups,the expressions levels of ICAM-1 protein in 40 and 80μmol· L-1 tannic acid groups were decreased (P<0.05 ). The mRNA expressions levels of MCP-1 and ICAM-1 were significantly lower than those in high glucose group (P<0.01 ).Conclusion Tannic acid could protect GMC against the damage of oxidative and inflammatory mediators,thereby delaying and improving the glomerular lesions of DN.

Objective To analyze the relationship between the expression of protection of telomeres 1 (POT1) and the pathogenesis of acute myeloid leukemia (AML). Methods 62 patients with de novo AML (case group) and 10 patients with iron deficiency anemia (control group) were enrolled in this study. The quantitative real-time polymerase chain reaction (PCR) and Western blot were used to detect the expression of POT1 in AML patients. Results There were 62 de novo AML patients, including 2 cases M1, 14 cases M2, 12 cases M3, 14 cases M4, 17 cases M5, 2 cases M6 and 1 case AML without classification. According to the risk stratification, high risk group (24 cases), medium risk group (22 cases) and low risk group (16 cases) were divided. Compared with that in the controls, POT1 expression levels in patients with AML were significantly decreased both in mRNA and protein level (P< 0.05). The relative expression levels of POT1 mRNA and protein in patients with M2, M4 and M5 were significantly lower than those in the controls (P< 0.05). The expression levels of POT1 in high risk group, medium risk group and low risk group were significantly decreased than those in the controls (P<0.05). Compared with that in the controls, The relative POT1 mRNA expression was significantly decreased in M3 patients (P< 0.05), but not in protein level. POT1 protein expression was showed both in the cytoplasm and nucleus. There was no significant difference of the expression of POT1 protein between cytoplasm and nucleus (P> 0.05). Conclusions POT1 may be involved in the pathogenesis of AML. POT1 protein expresses in both cytoplasm and nucleus, and the regulatory mechanism may be related to the telomere length.

Objective To investigate the application of ultrasound-guided vacuum-assisted biopsy for breast masses in primary hospital and the degree of patients' cognition.Methods A retrospective analysis of 1691 female patients in the department of breast diseaseofHuidongwomen and children hospital from September 2012 to September 2014 undergoing biopsy, 1004 casesofultrasound-guided vacuum-assisted biopsy with 1325 masses, and 687 Cases of open surgery with 712 masses, all confirmed by pathological examination after operation.Results In 1325 masses in 7 breast cancercases accounted for 0.7％.Twenty-one (2.1％)cases of postoperative subcutaneous ecchymosis, hematoma in 10(1％) cases.Operation takes 2-26 min.Average hospitalization expenses of unilateral lesions was 6490 yuan.712 masesby open surgery in 9 infiltrating ductal carcinoma accounts for 3.8％ , 8(1.2％) postoperative cases of subcutaneous ecchymosis, 0 case withhematoma, operationtakes 35 to 74 minutes.Average hospitalization expenses of unilateral lesions was 3805 yuan.The follow-up of 3 to 27 months.Recurrenceof 5 fibroadenoma by vacuum-assisted biopsy and 3 by open surgery, there was no difference between its (P ＞ 0.05).Survey was found 97.4％ good cosmetic effectby vacuum-assisted biopsy, significantly higher than open surgery (P ＜ 0.05).There were mild pain after two kinds of operations, no difference (P ＞ 0.05).The cost of vacuum-assisted biopsy was higher than 2485 vuan of open operation.Grade 4a in 993cases with ultrasonic diagnosis found 2 cases of breast cancer (0.2％) in two groups of patients, and grade 4b in 132 cases found 10 cases of breast cancer (7.6％) and 2 cases in grade 5 was breast cancer (100％), and nobreast cancer in 2-3 grade was found.Conclusions Ultrasound-guided vacuum-assisted biopsy is not only fast and accurate diagnosis of early breast cancer, but also be further one-step surgical biopsy of benign tumor in primary hospital, and is safe, simple and convenient operation with high postoperative satisfaction.Strictly select a case can reduce hematoma complications.The ultrasonic BIRADS grade has good guidance for breast masses of diagnosis and treatment, and can reduce the missed diagnosis of breast cancer.Ultrasound-guided vacuum-assisted biopsyand BIRADS grade of breast massesare appropriate technology for diagnosis and treatment in the primary hospitals.

Objective To evaluate the efficacy of gabapentin for prevention of post-thoracotomy pain syndrome (PTPS).Methods Sixty-nine ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 46-69 yr,weighing 47-78 kg,scheduled for elective resection for lung cancer under general anesthesia combined with epidural block,were randomly divided into 2 groups using a random number table:group A (n =36) and group B (n =33).In group A,gabapentin 300 mg was given orally at 2 h before operation and gabapentin 100 mg was given orally three times a day from 1st day after operation until 10th day after operation.Group B received placebo instead of gabapentin.Epidural blockade with ropivacaine and sufentanil was performed before induction of anesthesia and the level of block was controlled at T4-10.Patient-controlled epidural analgesia (PCEA) was performed within 3 days after operation and VAS scores were maintained ≤ 3.The development of pain (numeric rating scale score ＞ 4) within 6 months after operation and the duration were recorded.The consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation were recorded.The adverse reactions such as postoperative drowsiness,dizziness,fatigue were also recorded.Results Compared with B group,the incidence of pain within 6 months after operation was significantly decreased,the duration of pain was shortened (P ＜ 0.05),and no significant changes were found in the consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation in A group (P ＞ 0.05).No adverse reactions developed in group B.Mild dizziness and fatigue occurred in 2 patients in group A.Conclusion Gabapentin (continuous application at 2 h before operation and 10 days after operation) can reduce the development of PTPS in patients with no obvious adverse reactions.

Objective To investigate the relationship between apolipoprotein E ( ApoE ) gene polymorphism and cerebral infarction patients with different gender and etiological typing. Methods A total of 91 patients with cerebral infarction aged≥60 years ( cerebral infarction group) were enrolled. They were divided into either a large artery atherosclerotic (LAA) stroke group (n=37) or a small artery occlusion (SAO) stroke group (n=54) according to the Trial of Org 10172 in acute stroke treatment (TOAST) classification. A total of 105 age-,sex-,and residence-matched healthy subjects were enrolled as controls. A Nested Allele-Specific Multiplex Polymerase Chain Reaction Method was used to detect the ApoE gene polymorphism. The ApoE gene polymorphism of cerebral infarction of different gender and etiological typing were compared. Results ( 1 ) ApoE Genotypes of E2/2, E2/3, E2/4, E3/3, and E3/4 were detected,but the ApoE E4/4 was not detected. (2) There were no significant differences in the frequencies of ApoE genotypes and each gene carrier frequency between the cerebral infarction group and the control group (all P>0. 05). There was significant difference in ApoE genotype frequencies and each gene carrier frequency of the males between the cerebral infarction group and the control group (P<0. 01,P<0. 05). Both the E3/3 genotype frequency (56. 1%) and ε3 carrier frequency (78. 0%) of the cerebral infarction group were lower than the males of the control group ( 79. 2% and 89. 6% respectively );both the E3/4 genotype frequency (31. 7%) and ε4 carrier frequency (15. 9%) were higher than the control group (7. 5% and 3. 8%respectively). There was no significant differences in the ApoE genotype frequency and gene carrier frequency in female participants between the two groups (all P>0. 05). (3) There were no significant differences in the ApoE genotype frequency and gene carrier frequency among the LAA,SAO,and control groups. There was significant difference in the ApoE genotype frequency and gene carrier frequency in males between the LAA group and the control group (P>0. 01);the genotype frequencies of E2/3 and E3/E3 (6. 7% and 46. 7%),ε2,as well as theε3 carrier frequency (3. 3% and 73. 3%) of LAA were lower than those of the control group (13. 2%,79. 2%,6. 6%,and 89. 6%,respectively);the E3/4 genotype frequency andε4 carrier frequency of the LAA subtype were 46. 7% and 23. 3% respectively. They were all higher than 7. 5% and 3. 8% in the control group. However,there were no significant differences in males among the SAO group,the control group,and the 3 groups of females ( the LAA subtype,SAO subtypes,and the control group) (P>0. 05). Conclusion ε4 gene may be a risk factor for LAA in males. The association of ApoE gene polymorphism with cerebral infarction in females is not found.

Objective To determine the optimum dose of oxycodone inhibiting responses to tracheal intubation with a double-lumen endobronchial tube in patients undergoing one-lung ventilation (OLV).Methods Sixty adult patients aged 55-64 yr, weighing 60-80 kg, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective thoracic surgery requiring OLV, were randomly divided into 3 different doses of oxycodone groups (O1-3 groups, n =20 each).Anesthesia was induced with iv midazolam 0.05 mg/kg, oxycodone 0.30, 0.35 and 0.40 mg/kg (O1.3 groups, respectively) , propofol 1.5 mg/kg and rocuronium 0.9 mg/kg.The patients were tracheally intubated using a double-lumen endobronchial tube and mechanically ventilated.Before anesthesia induction (T0) , immediately before and after intubation (T1,2) , and 1 and 5 min after intubation (T3.4) , arterial blood samples were taken to determine the concentrations of serum norepinephrine (NE) and epinephrine (E) using high-performance liquid chromatography.The occurrence of bucking, body movement, hypertension, and tachycardia were observed.Results The concentrations of serum NE and E were significantly increased at T2,3 than at T1 in group O1 (P＜0.05).Compared with group O1 , the concentrations of serum NE and E were significantly decreased at T2,3 , and the incidence of bucking, body movement, hypertension, and tachycardia was decreased in O2 and O3 groups (P＜0.05).There was no significant difference in the parameters mentioned above between O2 and O3 groups (P ＞ 0.05).Conclusion The optimum dose of oxycodone inhibiting responses to tracheal intubation with a double-lumen endobronchial tube is 0.35 mg/kg in patients undergoing OLV.