Objective To observe the clinical effects and intubation condition of different doses of domestic cisatricurium(CA) in children. Methods Forty-five peadiatric patients aged 2 to 12 years old scheduled for selective surgery were randomized to three groups of 2 ED_(95) CA(0. 08 mg/kg), 3ED_(95) CA(0. 12 mg/kg) and 4ED_(95) CA(0. 16 mg/kg) (C_2, C_3, C_4 groups). Neuromuscular blockade was monitored with TOF-Guard. The conditions for trachea[intuDation were scored and the onset time, clinical duration, recovery index were recored. ResultsTracheal intubation was performed successfully in all patients. The conditions for tracheal intubation were scored greater 5 points in groups of C_3 and C_4 ,which was only 33. 3% of patients in group C_2. The onset time was shortened and the duration of action was prolonged as the dose of CA increased. But the recovery index of three groups were smilar. Conclusion An increase of CA dosage can shorten the onset time and prolong the duration of action and 3ED_(95) CA is suitable for tracheal intubation in children.

Extracellular vesicles (EV) are widely distributed, rich in content, and fully participate in the regulation of important cellular physiological activities. As a new technology for tumor diagnosis, the natural advantages of EV include protecting its contents, being easy to obtain from various biofluids, having the potential to be truly non-invasive and high tissue fidelity. In order to transfer EV for clinical use, many isolation technologies such as microfluidics, immunochips, nano-flow cytometry and acoustic capture have been continuously developed. At present, several EV tumor diagnostic products have been applied in the clinical setting. However, due to the great differences in detection methods and platforms, there are still some technical difficulties in its clinical applications. With the accumulation of clinical evidence and the continuous improvement of clinical diagnostic methods, the liquid biopsy based on EV can finally be applied in the clinic.

Objective To explore the infections of human cytomegalovirus (HCMV) in chronic hepatitis C patients and the hepatic impairment in chronic hepatitis C patients co-infected with HCMV.Methods HCMV-DNA was determined by fluorescence quantitative-PCR (FQ-PCR) in 95 patients with chronic hepatitis C (observation group) and 95 healthy controls(control group) and HCMV active infections were analyzed.HCV-RNA was determined by FQ-PCR in observation group,and the difference of HCMV-DNA positive rate between high HCV-RNA(＞ 104 copies/ml) and low HCV-RNA(≤ 104 copies/ml) was analyzed.Alanine aminotransferase (ALT),aspartate aminotransferase (AST) were determined by rate method in two groups and the hepatic impairment was analyzed.Results Twenty-five cases with positive HCMV-DNA in observation group,the positive rate was 26.3％(25/95).Five cases with positive HCMV-DNA in control group,the positive rate was 5.3％(5/95).There was significant difference between two groups for HCMV-DNA (x2 =14.29,P ＜0.01).Twenty-one cases with positive HCMV-DNA in 43 cases of high HCV-RNA patients,the positive rate was 48.8％(21/43).Four cases with positive HCMV-DNA in 52 cases of low HCV-RNA patients,the positive rate was 7.7％(4/52).There was significant difference between the two (x2 =19.90,P ＜ 0.01).ALT,AST in observation group was higher than that in control group (P ＜ 0.01).ALT,AST in chronic hepatitis C patients positive for HCMV-DNA was higher than that in chronic hepatitis C patients negative for HCMV-DNA significantly (P ＜ 0.01).Conclusions HCMV in chronic hepatitis C patients becomes active again and co-infects easily.When chronic hepatitis C patients co-infect HCMV actively,hepatic is further injured.

Objective To study medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children.Methods The clinical data of 178 cases of indirect inguihal hernia with large sacs in children were retrospectively analyzed.After high suture ligation of the internal ring with pediatric laparoscopy,all of the internal tings were covered with the same side of medial umbilical ligament to further strengthen.Results All cases were discharged from hospital 1～2 days after surgery.No recurrence and no any other complications could be found after following up 3～18 months.Conclusion Pediatric laparoscopic application of medial umbilical ligament to further cover the internal ring could significantly reduce the rate of recurrence for indirect inguinal hernia with large sac.This method of operation waft safe and feasible.It Was worth promoting.

The common complication of ischemic brain injury was ischemic brain edema,which was closely related to the function of the blood-brain barrier (BBB).In vitro studies,which have shown that vascular endothelial growth factor (VEGF) could bind to the receptor to activate a variety of cell signaling pathways,by inhibiting cell apoptosis,reduce oxidative stress and play a protective role in the brain.Fulong Antithrombotic Pill,Shenfu Injection,Naotaitong Granule and others traditional Chinese medicine can regulate the treatment of BBB injury by VEGF regulation.This article reviewde the study progress of VEGF and its related pathways in ischemic brain injury,and the treatment of BBB injury by Chinese medicine by interventional VEGF and its related pathways,which provide a theoretical basis for the clinical treatment of cerebral ischemic abnormalities and the development of new drugs.

AIM: To test the contents of tanshinone Ⅱ_A and salvianolic acid B in 56 batches of samples by HPLC,evaluate the current quality of Compound Danshen Tables. METHODS: HPLC,chromatographic conditions: The detection column was Agela-C_(18)(5 ?m,46 mm?250 mm) for tanshinone Ⅱ_A,mobile phase was methanol-water(73(∶)27),UV detection wavelength was set at 270 nm.The flow rate was 1 mL/min.The detection column of Agela-C_(18)(5 ?m,4.6 mm?250mm) was used for salvianolic acid with mobile phase of acetonitrile-methanol-formic acid-water(10(∶)30(∶)1(∶)59). UV wavelength was set at 286 nm.The flow rate was 1 mL/min.(RESULTS:) The most of samples conform to the requirement of Chinese Pharmacopoeia(2005),but the content of tanshinone Ⅱ_A was widely different and three batches of salvianolic acid B were lower than the requirement of Chinese Pharmacopoeia(2005). CONCLUSION: The quality of Compound Danshen Tables will be improved.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.

The significance and contents of regional medical cloud construction based on information sharing were summarized according tothe three-circle theory, and the status quo and difficulties of the first diagnosis system, with the implementation of health information system for Xiamen residents as an example, and suggestions were pro-posed for the development of regional medical big data.

As a new type of intercellular signaling rector, extracellular vesicles (EV) are involved in almost the whole process of tumorigenesis, progression, metastasis, and drug resistance. Therefore, EV have become the ideal biomarker candidates and research hotspots for cancer diagnosis and treatment. However, EV tumor biomarker research mainly focused on RNA and protein, and a small part of the research focused on lipids at the early stage. EV DNA has received little attention and its diagnostic value has gradually been recognized in recent years. Study on the biological characteristics and function of EV DNA may highlight its potential in tumor diagnosis.

Aim To study the mechanism of synergistic antitumor of EBB and doxorubicin in doxorubicin-resistant MCF-7/ADR breast carcinoma cells.Methods The antitumor activity of doxorubiein alone and its combination with EBB were measured by MTT assay in MCF-7/ADR and MCF-7cells. The rate of doxorubicin-induced apoptosis and the protein and mRNA levels of P-glycoprotein(P-gp) were determined in MCF-7/ADR treated with EBB by flow cytometry (FACS), respectively.Laser scanning confocal microscopy was used to detect the intracellular accumulation of drug in EBB-treated MCF-7 and MCF-7/ADR cells.Results EBB had antitumor effects for MCF-7 and MCF-7/ADR.It could potentiate the antitumor effect of dororubicin with CDI of 0.73 and 0.49 for MCF-7 and MCF-7/ADR,respectively.EBB and doxorubicin acted synergistically in elevating apoptosis of MCF-7/ADR and downregulating the expression of P-gp in a dose-dependent manner in MCF-7/ADR.EBB restored the intracellular accumulation of doxorubicin in MCF-7/ADR cells in a dose-dependent manner.After pretreatment with EBB for 24 h and 48 h,the intracellular accumulation of doxorubicin and Rh123 was obviousely restored in MCF-7/ADR cells compared with control in a time-dependent manner.Conclusion EBB is a potential agent which has strong inhibitory effect on both multidrug resistant cells and their parental cells.EBB can significantly potentiate the antitumor effects of dororubicin in MCF-7/ADR cells by blocking the function of P-glycoprotein and inhibiting the expression of P-glycoprotein.