Objective To compare the BIS values in patients under anesthesia with minimum alveolar concentration (MAC) of sevoflurane and median effective concentration (EC50) of propofol at loss of consciousness.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,undergoing elective surgery under general anesthesia,were equally and randomly divided into 2 groups:inhalational anesthesia with sevoflurane group (group Sev) and intravenous anesthesia with propofol ( group Pro).The end-tidal concentration of sevoflurane was monitored using Aestiva anesthesia machine (Datex Ohmeda) in group Sev.Anesthesia was induced with intravenous injection of etomidate 0.3 mg/kg,rocuronium 1 mg/kg,and remifentanil 0.2 μg/kg.The patients were mechanically ventilated after tracheal intubafion.Sevoflurane inhalation was started 12.5 min after intubation in group Sev.Propofol was given by target-controlled infusion with the target plasma concentration set at 3.8 μg/ml 12.5 min after intubation in group Pro.When the effect-site concentrations of propofol reached EC50 of propofol at loss of consciousness (2.2 μg/ml),1.3 EC50(2.86 μg/ml) and 1.5 EC50 (3.3μg/ml) and when the end-tidal concentrations of sevoflurane reached 1.0,1.3 and 1.5 MAC,BIS value,MAP and HR were recorded.Results HR was significantly higher at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 in group Pro than in group Sev ( P ＜0.05).BIS value was significantly decreased at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 compared with that at 1.0 MAC or EC50(P ＜0.05).There was no significant difference in MAP and BIS value at each time point between the two groups ( P ＞ 0.05).Conclusion No significant change in BIS values is found in patients under anesthesia with 1.0,1.3 and 1.5 MAC of sevoflurane and with 1.0,1.3 and 1.5 EC50 of propofol.

Objective: To improve the present method for casualty forecasting using the risk analysis theory. Methods: Empirical data were extracted from 11 urban aggressive combats during and after WW II, and the distribution of daily casualty was determined. Based on quantitative judgment model, several factors such as the number of soldiers, terrain, weather, general situation, suddenness, and combat efficacy were configured; Monte Carlo simulation was applied for simulation,and a forecasting model was setup with Microsoft Excel and Crystal Ball 2000 software for risk analysis of the simulation outcome. Results: The distribution of daily casualty during urban aggressive military action could be represented by normal distribution. With the values of the aforementioned factors, the result of 1000 tests showed that the mean daily casualty rate was 0. 42%, with the standard deviation being 0. 21%. Conclusion: Monte Carlo simulation is an effective means to improve the present casualty forecasting method.

Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Infant ; Infectious Mononucleosis ; diagnosis ; Male ; Suppuration ; diagnosis ; Tonsillitis ; diagnosis

Protein ubiquitin-like modification of Neddylation is an important post-translational modification mode of protein to widely regulate cell cycle, growth, development and other biological processes. Recent studies have found that MLN4924, small molecule inhibitor of Neddylation modification, has a significant anti-tumor effect, which can inhibit the tumor growth by inducing cell cycle arrest, senescence and apoptosis, and inhibiting tumor angiogenesis. This paper reviews the related mechanism research of cell programmed death induced by Neddylation modification pathway inhibitor MLN4924.

Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.

Objective: To study the chemical constituents from Fritillaria pallidiflora. Methods: The constituents were isolated from F. pallidiflora and purified by column chromatography, and the structures were identified by spectra analysis and chemical methods. Results: Sixteen compounds were isolated from F. pallidiflora, including phenolic acids, esters, alkaloids, and the structures were identified as 1,4-diphenylbutane (1), cis-cinnamic acid (2), 4-hydroxy-3-methoxybenzaldehyde (3), acetovanillone (4), 9-octadecenoicacidmethylester (5), methyl ferulate (6), 1-O-feruloylglycerol (7), trans-isoferulic acid (8), syringaresinol (9), pinoresinol (10), 2,3-O-diferuloylglycerol (11), 1,3-O-diferuloyl-glycerol (12), cyclo (L-Pro-L-Ala) (13), cyclo (L-Leu-L-Val) (14), bis (diethylene glycol)phthalate (15), and cyclo-(Phe-Val) (16). Conclusion: All compounds are isolated from F. pallidiflora for the first time, and componds 1, 3-8, 10-13, 15, and 16 are isolated from the genus of Fritillaria for the first time.

Objective To observe the C-V curve of source point of 12 channels in patients with lumbar disc herniation. Methods 40 patients with lumbar disc herniation were examined with Cowital Human Meridian Diagnosing and Analyzing System, which can achieve quantitative analysis on C-V curve from the source points of 12 channels. The curves obtained before and after treatment were comparisd. Results The abnormal rates of source point on kidney and bladder meridians were more than those on the other meridians. The improving rates of source point on kidney and bladder meridians were better than those of the other meridians after treatment. Conclusion C-V curve observation can be used to diagnose, deduct and evaluate treatment for the lumbar disc herniation.

Objective To observe the effect of bifidobacterial lipoteichoic acid (BLTA) on cellular immunity of mice with systemic Candida albicans infection .Methods Systemic C .albicans infection model in immunocompromised mice were established by injecting standard strain of C .albicans via caudal vein .The effects of BLTA on thymus index ,spleen index ,splenic lymphocytes proliferation and NK cells cytotoxicity were observed as well as serum levels of cytokines .Results After systemic C .albicans infec‐tion in immunocompromised mice ,thymus index ,spleen index and splenic lymphocytes proliferation activity were decreased (P>0 .05) ,NK cells cytotoxicity was decreased significantly (P< 0 .05) ,IL‐2 ,IL‐4 and INF‐γ levels were increased slightly (P>0 .05) ,IL‐10 levels were increased significantly(P<0 .05) .After treated by BLTA ,thymus index ,spleen index ,splenic lymphocytes proliferation and NK cells cytotoxicity were increased significantly (P<0 .01) ,IL‐2 and INF‐γ levels were increased significantly (P<0 .05) ,IL‐4 levels showed little change ,IL‐10 levels were decreased significantly (P<0 .01) .Conclusion BLTA can improve immune status of immunocompromised mice ,which can restore and enhance the compromised cellular immunity of mice with sys‐temic C .albicans infection .

Objective To measure the peak skin dose (PSD) in two cardiovascular interventional procedures,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) using radiochromic film.Methods Gafchromic XR-RV3 film was selected to measure PSD in two hospitals.The films were placed on the table underneath the patient during interventional surgery.The kV,mA,fluoroscopy time,dose-area product (DAP),and cumulative dose at reference point and other relevant information were recorded for all cases.Using the Epson V750 flatbed scanner for scanning and analyzing film,FilmQA software was chosen to analyze the pixel value of red,green and blue color channels.The PSD was determined using red channel data.The correlation and linear regression analysis between PSD and device-displayed parameters was carried out.Results PSD were measured using XR-RV3 film for 26 CA and 19 CA + PTCA procedures.For CA procedures,maximum fluoroscopy time,cumulative dose and DAP were 17.62 min,1 498.50 mGy and 109.68 Gy · cm2,respectively.The maximum PSD was 361.20 mGy.However,for CA + PTCA procedures,maximum fluoroscopy time,cumulative dose and DAP were 64.48 min,6 976.20 mGy and 5 336.00 Gy· cm2,respectively.One patient with CA + PTCA procedures was found to have received the PSD value more than 2 Gy,up to 2 195.70 mGy.DAP was found to be a good indicator (R2 =0.815,P ＜0.05) of PSD for CA procedure,and correlated with cumulative dose (R2 =0.916,P ＜ 0.05) for CA + PTCA procedures.Conclusions The PSD value of some patients in cardiac interventional procedures would exceed 2 Gy,the threshold of deterministic effects recommended by ICRP.The dose-related parameters value showed on DSA device can only used to estimate PSD roughly.Using XR-RV3 film accurate measurement of the PSD in interventional projects is a very fast and effective method.

One hundred and four patients aged of 65 years or above with cardiocerebral vascular diseases admitted from March to September 2008 were enrolled in the study. The fast plasma glucose (FPG) and 2 hours postprandial blood glucose (2 hPG) were tested. For patients with undiagnosed diabetes, if FPG≥7.0 mmol/L, 2 hPG≥11.1 mmol/L, their blood sugar index was checked again; if 2hPG was 7.8 mmol/L to 11.1 mmol/L, FPG from 6.1 mmol/L to 7.0 mmol/L, Oral glucose tolerance test (OGTT) was performed. Among the 104 patients, 30 cases of diabetes were diagnosed previously accounting for 28.8 %; 7 cases were newly diagnosed accounting for 6.8%; 21 cases were diagnosed as impaired glucose regulation accounting for 20.2%, with a total rate of sugar metabolism abnormality of 55.8%. The results indicate that blood glucose index should be regularly checked for elderly patients with cardiocerebral vascular diseases.