Objective To explore the safety of different doses of bupivacaine combined with epidural anes-thesia for delivery women undergoing cesarean operation.Methods A total of 120 cases of parturient women with cesarean section surgery were randomly divided into A,B,C three groups (40 cases in each group).A group was subarachnoidly given 0.5% levobupivacaine 1.5mL(7.5mg),B group was given 0.5% levobupivacaine 2.0mL (10.0mg),C group was given 0.5% levobupivacaine 2.5mL(12.5mg).The anesthesia effect in three groups was recorded.Results 5 min after anesthesia,the central venous pressure,heart rate,blood oxygen saturation in A group were (79.47 ±10.65)mmHg,(83.94 ±8.21)times/min,(98.16 ±1.17)%,which in B group were (76.38 ± 10.15)mmHg,(84.03 ±8.19)times/min,(98.48 ±1.06)%,which in C group were (66.28 ±18.49)mmHg, (76.38 ±5.68)times/min,(95.03 ±0.45)%.10 min after anesthesia,the central venous pressure,heart rate,blood oxygen saturation in A group were (83.54 ±10.03)mmHg,(84.03 ±8.34)times/min,(98.25 ±1.19)%,which in B group were (82.46 ±10.11 )mmHg,(83.95 ±8.24)times/min,(98.04 ±1.15 )%,which in C group were (69.06 ±17.03)mmHg,(74.19 ±5.48)times/min,(94.85 ±0.41 )%,the changes of heart function index in A group and B group had statistically significant differences compared with those in C group(F =5.165,6.487,7.125, 6.145,5.378,6.145,all P <0.05 ).In A group,excellent anesthesia in 9 cases,good in 17 cases,and poor in 14 cases;those in B group were 24 cases,13 cases,3 cases;those in C group were 28 cases,11 cases and 1 case.The anesthesia effect of B group and C group was significantly higher than A group(χ2 =4.887,P <0.05).In A group, hypotension occurred in 1 case,bradycardia in 2 cases,2 cases had nausea and vomiting,shortness of breath 0 case.In B group,hypotension occurred in 2 cases,2 cases of bradycardia,nausea and vomiting 3 cases,difficulty in breathing in 1 case.In C group,15 cases of hypotension,bradycardia in 11 cases,14 cases had nausea and vomiting,dyspnea in 7 cases.The incidence rate of adverse reactions of C group was higher than A group and B group(χ2 =4.168,5.122, 4.784,5.122,all P <0.05).Conclusion The anesthesia effects of levobupivacaine combined spinal and epidural anesthesia in cesarean section surgery is related with dosage,the greater the dosage,the anesthesia effect is stronger, but the circulation disturbance,the greater the use the share such as 10mg dose of levobupivacaine is more suitable, worthy of popularization and application in clinic.

Objective To discuss the value of MRI in diagnosis of complications related to pregnancy.Methods MRI were per-formed in 22 cases of late pregnancy,7 cases of postpartum with vagina bleeding,and 1 case with eight weeks of gestation following irregular vagina bleeding,respectively.The position of placenta and umbilical cord were observed in the cases of late pregnancy.The shape and signal features of embryo were evaluated in the case of eight weeks gestation following irregular vagina bleeding.Residual placenta and its relationship with the wall of uterus were analyzed in the cases of postpartum with vagina bleeding.Results Among the 22 cases of late pregnancy,normal position of placenta were in 4 cases,placenta previa were in 18 cases,umbilical cord winding around fetal neck in 8 cases.9 cases of placenta previa complicated with placenta accreta were comfirmed by cesarean delivery,how-ever,only 6 cases of placenta accreta were detected on MRI.The residual placenta with placenta accreta was found in all 7 cases of postpartum patients.Hydatidiform mole was proved by pathology in the case of eight weeks gestation following irregular vagina bleeding,and it was showed as a mass with hypointensity on T1 WI and hyperintensity on T2 WI in uterine cavity.Conclusion The complications related to pregnancy such as placenta previa,umbilical cord winding around fetal neck,residual placenta,placenta ac-creta could be correctly displayed on MRI.Hydatidiform mole also could be diagnosed by combining the clinical symptoms with MR images.

ObjectiveTo compare the recovery rates calculated according to different criteriain patients with urogenital Chlamydia trachomatis (Ct) infection after treatment with azithromycin. Methods Clinical data on outpatients who were diagnosed with urogenital Ct infection and treated with azithromycin in the sexually transmitted disease(STD) outpatient clinic of Tianjin Medical University General Hospital were retrospectively reviewed. Recovery rates were calculated according to the improvement of symptom and (or) reexamination results of Ct at 1,5 and 9 weeks after the end of treatment.ResultsSignificant differences were observed between the recovery rates calculated according to symptom improvement and those according to laboratory reexamination results.No obvious correlation existed between the presence of symptom and positive reexamination results.The recovery rates calculated according to the second reexamination result differed significantly from those according to the first reexamination result,but were similar to those according to the third reexamination result. ConclusionsThe cure of Ct infection should be determined according to laboratory test results,and two times of reexamination at 1 and 5 weeks after the final treatment are recommended.

Bipolar disorder (BD) is a chronic mental illness with high recurrence rate and disability. As one of the core symptoms, cognitive impairment may occurs at every stage of the disease. Evidence from the neuroimaging studies revealed that the abnormal brain volumes, the blood flow and oxygen saturation of key brain areas are related to executive impairment in patients with bipolar disorder. This article reviews current structural and functional neuroimaging studies about the executive impairment of patients with euthymic bipolar disorder and research progresses.

Objective To investigate the relationship between cognitive function of first-episode schizophrenic patients and dopamine D1 receptor gene. Methods A total of 112 first-episode schizophrenic patients and 60 healthy controls were evaluated with Wechsler adult intelligence scale ( WAIS-R), Wechsler memory scale (WMS) and Wisconsin card sort test (WCST) ,and genotyped one polymorphism (rs4532) within DRD1 gene using TaqMan SNP genotyping assay. Results There were no significant differences on the frequencies of the genotypes and alleles of rs4532 polymorphism between patients with schizophrenia and normal controls ( x2 =2.90, P=0.35; x2 = 0.01, P= 0. 93 ). There were significant differences in all index of WCST between two groups (P ＜0.01 ). Patients with rs4532G allele had worse WCST performance than those without G allele ((60.9 ± 13.2)%vs (44.9 ±21.3)%, t=4.79, P=0.00002). Conclusion Rs4532 polymorphism of DRD1 gene may be associated with executive function impairment in schizophrenic patients.

[ ABSTRACT] AIM:To observe the effect of ginsenoside Rb 1 on the proliferation and the expression of serotonin transporter (SERT), 5-hydroxytryptamine 1B receptor (5-HT1BR) in rat pulmonary artery smooth muscle cells (PASMCs) under hypoxia condition and the relationship with Rho /Rho-kinase signal pathway .METHODS: PASMCs were isolated from the adult male SD rats and primarily cultured .The subcultured cells from the 4th generation to the 6th generation were harvested and divided into normal group , and hypoxia group , different concentrations of Rb 1 incubation groups treated with 50, 100 and 200 mg/L ginsenoside Rb1 under hypoxia (HR50, HR100 and HR200 groups, respectively).The viability of the PASMCs was measured by CCK-8 assay.BrdU positive cells were determined using flow cytometry .The expression of serotonin transporter and 5-HT1BR at mRNA and protein levels was detected by RT-PCR and Western blot, respectively. The PASMCs were randomly divided into normal group , hypoxia group , HR200 group and hypoxia +Y-27632 incubation group ( HY group ) .The mRNA expression of Rho-kinase and phosphorylated myosin phosphatase target subunit 1 ( p-MYPT1) protein level were investigated by RT-PCR and Western blot, respectively.RESULTS: Compared with normal group, the proliferation of PASMCs in hypoxia group was significantly increased (P<0.01).The cell viability and the ex-pression of SERT and 5-HT1B R at mRNA and protein levels in all different concentrations of Rb 1 groups were obviously de-creased compared with hypoxia group ( P<0.05 ) .The mRNA expression of Rho-kinase and protein level of p-MYPT1 were markedly decreased in HR200 group, and no significant difference compared with HY group was observed ( P <0.01).CONCLUSION: Treatment with ginsenoside Rb1 might prevent hypoxia-induced proliferation of PASMCs and over-expression of SERT and 5-HT1B R through inhibiting the Rho/Rho-kinase pathway .

Objective To compare the characterization and myocardial differentiation capacity of amniotic fluid-derived mesenchymal stromal cells (AF MSCs) and umbilical cord Wharton's Jelly-derived mesenchymal stromal cells (WJ MSCs). Methods The human AF MSCs were cultured from amniotic fluid samples obtained by amniocentesis. The umbilical cord WJ MSCs were obtained from Wharton's Jelly of umbilical cords of infants delivered full-term by normal labor. The morphology, growth curves, and analyses by flow cytometry of cell surface markers were compared between the two types of cells. Myocardial genes (GATA-4, c-TnT, α-actin, and Cx43) were detected by real-time PCR and the corresponding protein expressions were detected by Western blot analysis after myocardial induced in AF MSCs and WJ MSCs. Results Our findings revealed AF MSCs and WJ MSCs shared similar morphological characteristics of the fibroblastoid shape. The AF MSCs were easily obtained than the WJ MSCs and had a shorter time to reach adherence of 2.7 ± 1.6 days to WJ MSCs of 6.5 ± 1.8 days. The growth curves by MTT cytotoxic assay showed the AF MSCs had a similar proliferative capacity at passage 5 and passage 10. However, the proliferative capacities of WJ MSCs were decreased at 5 passage relative to 10 passage. Both AF stem cells and WJ stem cells had the characteristics of mesenchymal stromal cells with some characteristics of embryonic stem cells. They express CD29 and CD105, but not CD34. They were positive for Class I major histocompatibility (MHC I) antigens (HLA-ABC), and were negative, or mildly positive, for MHC Class II (HLA-DR) antigen. Oct-4 was positive in all the two cells types. Both AF MSCs and WJ MSCs could differentiate along myocardium. The differentiation capacities were detected by the expression of GATA-4, c-TnT, α-actin, Cx43 after myocardial induction. Conclusions Both AF MSCs and WJ MSCs have the potential clinical application for myogenesis in cardiac regenerative therapy.

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.

Objective To investigate the radiosensitizing effect of 17AAG-cypate micelles on human non-small cell lung cancer A549 cells and its possible mechanism.Methods (1) A single-hit multi-target model formula was used to analyze the radiosensitizing effects of 17AAG-M and 17AAG-cypate-M.(2) The effects of 17AAG-cypate-M on the viability of A549 cells under laser and X-ray irradiation were analyzed by MTT assay.(3) The effect of the drugs on the cell senescence was observed by β-galactosidase staining assay.(4) The effects of different treatment conditions on DNA damage repair were analyzed by γ-H2AX immunofluorescence staining assay.(5) The expression of p-Erk1/2 and p-Akt was measured by Western blot.The paired t test was used for analyzing the differences between groups.Results Compared with the X-ray irradiation group,the X-ray+17AAG-cypate-M group had a lower mean lethal dose and a sensitization enhancement ratio greater than 1,indicating that 17AAG-cypate-M had a radiosensitizing effect.Compared with the 17AAG-M group,the 17AAG-cypate-M group showed significantly lower cell viability (P<0.01),a significantly higher percentage of aging cells (P<0.01),and significantly further delayed DNA damage repair (P<0.01).And the 17AAG-cypate-M group had lower expression of p-Erk1/2 and p-Akt than the 17AAG-M group.Conclusions Compared with 17AAG-M,17AAG-cypate-M has a higher radiosensitizing effect on A549 cells.The mechanism might be inducing the cell senescence,delaying DNA damage repair,and inhibiting the expression of p-Erk1/2 and p-Akt.

Objective To investigate the feasibility of online and offline cone-beam CT (CBCT) guided radiotherapy for lung cancer. Methods Fourteen patients with lung tumor treated by three-dimen-sional conformal radiotherapy were investigated. Online kV CBCT scan,image registration and setup correc-tion were performed before and immediately after radiotherapy. CBCT online-guided correction data were used to calculate the population-based CTV-PTV margins under the condition of non-correction and correction in every fraction respectively. The numbers of initial images and the population-based CTV-PTV margins af-ter the offline compensation of the system setup error were evaluated with the permission of 0.5 mm and 1.5 mm maximal residue error,respectively. Results Under the condition of non-correction,the required mar-gins for total error were 5.7 mm,8.0 mm and 7.8 mm in the left-right(x axis) ,cranio-caudal(y axis) and anterior-posterior(z axis) directions, respectively. When the tumor was corrected in every fraction, the re-quired margins for intra-fraction error were 2.4 mm,2.4 mm and 2.3 mm in x,y and z axes, respectively. To correct the systematic setup error,9 sets of CBCT images for 3.3 mm,3.7 mm and 3.6 mm PTV margins, and 7 sets of CBCT images for 3.9 mm,4.3 mm and 4.3 mm PTV margins in x,y and z axes were necessary when 0. 5 mm and 1.5 mm maximal residue errosr were permited respectively. Conclusions Both of the online CBCT correction and the offline adaptive correction can markedly reduce the impact of setup error and reduce the required PTV margins accordingly. It is feasible to deliver the online and offline image guided ra-diation for patients with lung tumor.