Objective To explore miR-21 regulation of Smad7 in lung cancer A549 cell line as well as its impact on the proliferation of lung cancer A549 cell line. Methods miR-21 mimic and inhibitors in lung cancer A549 cell line were transfected by using Lipofectamine 2000 Reagent. After 48 h, Western blot and qRT-PCR were applied to assess the expression of protein and mRNA of Smad7 . MTT assay was used to determine the proliferation influence of the transfected lung cancer A549 cell line. Results Western blot and qRT-PCR showed that A549 cell trans-fected miR-21 mimic exhibited down-regulated Smad7 protein and mRNA expression, and A549 cell transfected miR-21 inhibitor exhibited up-regulated Smad7 protein and mRNA expression. The A549 cell proliferation activity decreased significantly after transfected miR-21 inhibitors. Conclusion miR-21 inhibitors can increase Smad7 pro-tein and mRNA expression, and suppress the proliferation activity of lung cancer A549 cell significantly.

Objective To investigate the clinical characteristics,diagnosis,therapy and maternal and perinatal prognosis of generalized pustular psoriasis of pregnancy.Methods Clinical data for seven inpatients with generalized pustular psoriasis of pregnancy were retrospectively analyzed from January 1,2005 to December 31,2012.Results Three patients had family history of psoriasis and five had previous history of psoriasis.All skin lesions were large patches of erythema,with needlepoint to miliary size pustules and scales.Two patients had oral involvement and three had nail involvement.Biopsy and bacterial culture were performed on five patients,in whom histopathological changes of pustular psoriasis were found,and bacterial culture was negative except in one patient.Among the patients,four had confirmed cause of disease; six patients were complicated with fever; four had increased leukocytes; seven had elevated neutrophils and C-reactive protein;five had increased total protein; and six had increased albumin.The disease was diagnosed according to the clinical manifestations and laboratory tests.Comprehensive treatment with glucocorticosteroids,antibiotics and local treatment were performed.Four patients had live births,and three patients underwent odinopoeia.Two babies were healthy,one had died,and another had varus foot deformity.Three patients had pustular relapse after labor.Conclusions Fetal-placental functions of patients with generalized pustular psoriasis of pregnancy should be monitored closely.Early diagnosis,treatment and termination of pregnancy can improve the maternal and perinatal prognosis.

Objective To evaluate the efficacy of automated medication management system in increasing clinical anesthesia management specification.Methods Sixty registered anesthesiologists of both sexes in our hospital,residents or attending physicians,with 1-10 yr of work experience,were divided into 2 groups (n =30 each) using a random number table:traditional medication management mode group (group T) and automated medication management system group (group A).In the clinical anesthesia work,traditional artificial management mode was used in group T,the mode of automated medication management system was used in group A,and 2 licensed pharmacists worked in the center pharmacy of our hospital were introduced for each group.Time of taking medicine was recorded by licensed pharmacists,and the error rates of taking medicine and recording were determined by licensed pharmacists.Results Compared with group T,the error rates of taking medicine and recording were significantly decreased (P＜0.01),and no significant change was found in the time of taking medicine in group A (P＞0.05).Medication errors including taking wrong anesthesia drug,wrong prescription recording,wrong names of the common drugs and drug omission were not detected in group A.Conclusion Application of automated medication management system can reduce the occurrence of errors made in taking medicine and recording,specify medication management and increase the quality of clinical anesthesia management.

Objective To evaluate the changes in the expression of NRF-1 in the spinal cord during remifentail-induced hyperalgesia in a rat model of incisional pain.Methods Forty-eight Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C); incisional pain group (group Ⅰ); remifentanil group (group R); incisional pain + remifentanil group (group Ⅰ + R).All the rats were anesthetized with sevoflurane.A 1-cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hindpaw in I and I + R groups.In C and I groups,normal saline was subcutaneously infused for 30 min.In group I + R,remifentanil (0.04 mg/kg,0.4ml) was subcutaneously infused for 30 min starting from the onset of skin incision.Paw withdrawal threshold to mechanical stimulation (PWMT) was measured at 24 h before operation and at 2,6,12,24 and 48 h after operation.After measurement of PWMT at 48 h,the rats were sacrificed and L4,5 segments of the spinal cord were removed rapidly to detect the expression of nuclear respiratory factor 1 (NRF-1) by immunofluorescence and Western blot.Results Compared with group C,PWMT was significantly decreased at each time point after operation,and the expression of NRF-1 in the spinal cord was up-regulated in I and I + R groups (P ＜ 0.05).Compared with group I,PWMT was significantly decreased at each time point after operation,and the expression of NRF-1 in the spinal cord was up-regulated in group I + R (P ＜ 0.05).Conclusion Up-regulation of NRF-1 expression in the spinal cord may be involved in the development of remifentail-induced hyperalgesia in a rat model of incisional pain.

The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

Objective To share our experience in the placement of a peripherally inserted central cathe -ter ( PICC) in critically ill patients intensive care unit ( ICU) .Method The clinical data of a critically ill pa-tient placed with PICC from neurosurgery department were collected and analyzed .Result A 78-year-old male patient diagnosed with type I respiratory failure , aspiration pneumonia , hypertension , and cerebral infarction sequelae successfully received ultrasound-guided modified Seldinger puncture technique for PICC and was trea-ted with intravenous nutrition after repeatedly vascular puncturing failure .Conclusion PICC placement is an effective method for patients in ICU to protect the peripheral vein and lower the incidence of catheter related in -fections.

Splenic arteriovenous fistula is a rare disease and is also easy to be misdiagnosed.Clinical manifestations of the splenic arteriovenous fistula include portal hypertension,esophageal gastric varices,gastro-intestinal bleeding,diarrhea,abdominal pain,ascites,dyspnoea and heart failure.One patient with splenic arteriovenous fistula after splenectomy was treated at the First Affiliated Hospital of Soochow University from April to May in 2014.The patient was cured successfully by percutaneous transarterial embolization and celiac arteriography with the aid of interventional radiology.Hepatic and renal functions of the patient got a normal condition combined with a missing of the ascites and portal hypertension by abdominal enhanced computed tomography at postoperative month 2.

Objective To investigate the influence of different respiratory parameter setting during gynecological laparoscopic surgery on early postoperative cognitive function.Methods Eighty patients undergoing elective ovarian cancer or cervical cancer were grouped randomly into groups A, B,C and D.In group A patients were ventilated with respiratory parameters of VT 8 ml/kg,RR 12 times/min.While patients in groups B,C and D with identical minute volume 105 ml/kg though with respective RR of 12,1 5 and 18 times/min respectively.Patients in four groups were all graded by the MMSE at time points of preoperation(T0 ),postoperative 1 h(T1 ),6 h(T2 ),24 h(T3 ),48 h(T4 ), 72 h(T5 ).PaCO2 of arterial blood gas were tested before pneumoperitoneum(Ta)and immediately af-ter pneumoperitoneum(Tb).Results PaCO2 at Tb was higher in each group than that at Ta(P <0.05).Patients in group A showed the highest PaCO2 at Tb while PaCO2 in group C were lowest. The MMSE scores in group C were significantly higher than those in other groups at T1-T3 (P <0.05).The values at T4 in group A were lower (P <0.05)than those in other groups.Values at T1-T4 in group A were lower than that at T0 (P <0.05).In groups B and D at T1-T3 MMSE scores were lower than those at T0 and patients in group C showed lower MMSE scores at T1 and T2 (P <0.05).Conclusion Early postoperative cognitive function can be improved by regulating intraoperative respiratory parameters properly and increasing minute volume adequately in gynecological laparoscopic surgery.

Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and∕or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at≥36 weeks of gestation, were enrolled in the study. Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell?salvage machine and then filtered using a leukocyte depletion filter during cesarean section. The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood. The fetal squamous cells were counted using papanicolaou staining. The concentrations of a?fetoprotein, tissue factor, endothelin?1 and histamine were measured by enzyme linked immunosorbent assay. The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a?fetoprotein and endothelial?1, and fetal red blood cells were decreased in the washed samples. Compared with washed samples, the fetal squamous cell count, concentrations of a?fetoprotein and fetal red blood cells were significantly decreased in filtered samples. Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a?fetoprotein and endothelial?1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section.

Objective To establish in vitro metabolism of fentanyl by human liver microsomes in Chinese population.Methods Thirty patients undergoing elective operation on liver were enrolled in the study.Normal liver specimens were obtained during removal of liver and gall for preparation of liver microsomes (by calcium precipitation) which were used for establishment of the liver microsomal incubation system for fentanyl.Fentanyl served as the metabolic substrate in the incubation reaction.The concentration of fentanyl in the incubation medium was detected at 0,5,10,15,20 and 30 min of incubation using HPLC-UV.Sufentanil served as the interior label element.The n-hexane-ethanol absolute was used to extract the sample.The chromatographic column used in this method was Grace C18 (4.6 mm × 250.0 mm,5 μm).The mobile phase was methyl cyanide-KH2PO4 buffer solution with the flow rate of 1.0 ml/min,detection wavelength of 205 nm and sample size of 20 μl.Linear regression analysis was performed by using the least-squares method.The specimens of the blank incubation system with the final concentration of fentanyl 0.6,2.4 and 10.0 μg/ml were obtained to determine the recovery,precision and stability.The metabolic rate of fentanyl in human hepatic microsomes was calculated.Results Fentanyl and the interior label element sufentanil were separated completely,and the retention time were 5.730 and 9.336 min,respectively.Endogenous matrix of microsomes did not interfere with the analysis.Regression equation was C =0.945 8A-0.140 4,R2 =0.999 2.C was the concentration of fentanyl,and A was the peak area ratio of fentanyl versus sufentanil.The recovery of incubation system with low,medium and high concentrations of fentanyl was 85％-115％,and relative standard deviation (RSD) was less than 10％.The RSD of intra-and inter-day precision and stability was less than 10％.The method was proved to meet the requirements of biological sample analysis.The metabolic rate of fentanyl was (1.6 + 0.8) nmol/min per milligram protein in human hepatic microsomes of 30 cases.Conclusion The in vitro metabolism of fentanyl by human liver microsomes is convenient,and the detectability is high,so it can be used for the research on the in vitro metabolism of fentanyl in Chinese population.