Objective:To observe the clinical effect of the combined use of dexmedetomidine and propofol for anesthesia in the elderly patients with painless gastroscopy. Methods:Totally 70 elderly patients with painless gastroscopy were selected and randomly divided into the observation group (35 cases) and the control group (35 cases). The observation group was given dexmedetomidine and propofol for anesthesia, while the control group was given propofol for anesthesia. The anesthesia induction time, the vital signs and recovery time of the patients, intraoperative complications and postoperative adverse reactions were observed and compared between the two groups. Results:The anesthesia induction time of the observation group was shorter than that of the control group (P<0. 01). The mean arterial pressure (MAP) in T2, T3 and T4 stage in the two groups were significantly lower than that in T1 stage (P<0. 05, P<0. 01). The HR in T3 stage and RR in T2 stage in the control group were lower than those in T1 stage (P<0. 05). The RR in T2 stage in the observation group was significantly lower than that in T1 stage (P<0. 05). The MAP in T2 and T3 stage in the observation group was significantly higher than that in the control group (P<0. 01), while that in T4 stage in the observation group was significant-ly lower than that in the control group (P<0. 05). The HR in T3 stage in the observation group was significantly higher than that in the control group (P<0. 05). The incidence of intraoperative complications in the observation group was 5. 7%, while that in the con-trol group was 22. 9%, and there was significant difference between the two groups (P<0. 05). The recovery time in the observation group was shorter than that in the control group (P<0. 01). Conclusion:Dexmedetomidine combined with propofol has better anes-thesia effect and higher safety than propofol alone, which is worthy of clinical promotion.

Objective To assay the expression chinse of ED1 positive cell in focal segmental glomemlosclerosis in rats,we investigated the relationship between the infiltration of mononuclear phagocytes and the progression of glomendar sclerosis.Methods We used 12 Wistar ratswhichwere dividedintotwo groups.1est group and coutrol group.Themodel offocal segmental glomerursclerosiswas ulade by in jecting PAN 9 mg/100g body weights.The rats ofcontrol group were injected 3ml 0.9％80diuln chloride.The proteinuria,serum creatinine,fipi&and protein of the rats were examined.The rata were killed at the 20th week.All the kidneys were kept and nlade into pathologic slEun-pie.1mmunohistochemical method was applied to detect the protein expression of FIN and the EDI positive cell in renal tissue of all the rats,and the number of Edl positive cell W88 counted.The results were analyzed by SPSS.Results The proteinuria of the mts in FSGS model group was significantly increased,the serum lipid ofthem was also increased.The pathology changes of the rat renal in model group showed that a part of giomemli appeared focal segmental sclerosis or all glomerular sclerosis,and the extracelhlar matrix accumulated.In the renal of model rats,the amount of EDI positive cells was significantly higher than that in normal rats(P

Objective To assess the anti-inflammatory and analgesic efects of Qinghouxiaoyan granules. Methods The rats were divided into blank group , Qinghouxiaoyan granules of high , medium , or low dose group, and aspirin group. Xylol-induced auricle swelling, carrageenan-induced paw swelling, Hac-induced blood capillary lealkage , and cotton pellet-induced graunloma were performed to assess the inflammatory effect; heat-plate test and Hac induced-twisting method were used to observe the analgesic efect. Results Qinghouxiaoyan granules played significant inhibitory action on xylene-induced inflammation , carrageenan-induced inflammation , and cotton-ball-induce granulation edema in different degrees; and decreased HAc-induced abdominal capillary permeability. The granules also showed significant analgesic effects on pain induced by heat and chemical stimu-lation in rats. Conclusion Qinghouxiaoyan granules has significant anti-inflammatory and analgesic effects.

Objective:To study the effects of rat interleukin-10 (rIL-10) gene treatment on the expression of collagen , matrix metalloproteinase 13(MMP13) and their specific inhibitors the tissue inhibitor of metalloproteinase 1(TIMP1) in porcine serum in-duced liver fibrosis rats then to explore the anti-fibrotic effect of rL-10.Methods:Thirty SD rats were divided into normal control and fibrosis model group.Normal control group (group C) was intraperitoneally injected with 0.5 ml normal sodium twice a week for 8 week, while the fibrosis model group was injected with equal volume of pig serum for 8 week.At the beginning of the 5th week, fibrosis model group was further randomly divided into a fibrosis model subgroup ( group M ) , rIL-10 gene treatment subgroup ( group I ) and empty vector control subgroup(group P).Rats in group C and M were injected with Ringer’s solution as a reagent control via the tail vein weekly, rats in group I were injected with the rIL-10 plasmid pcDNA3-rIL-10, and rats in group P were injected with empty vector pcDNA3.All rats were sacrificed at the end of 8th week, and the liver tissue samples were collected to observe deposition of collegan in liver tissue by sirius red staining and detected the expression of MMP 13 and TIMP1 in the liver tissue by SP immunohistochemistry .Re-sults:Sirius red staining showed that the area of the collegan deposition was dramatically increased in fibrosis model subgroup and emp -ty vector control subgroup compared with the normal control group , and the area of the collagen deposition was dramatically decreased in rIL-10 gene treatment subgroup compared with the fibrosis model and empty vector control subgroup .Immunohistochemistry analysis showed that the expression of MMP 13 and TIMP1 in fibrosis model subgroup and empty vector control subgroup was significantly higher than the normal control group , but compared with normal control group , expression of MMP13 was significantly increased and expres-sion of TIMP1 was significantly decreased in rIL-10 gene treatment subgroup .Compared with fibrosis model subgroup and empty vector control subgroup, the expression of MMP13 and TIMP1 was dramatically decreased in rIL-10 gene treatment subgroup.Conclusion:rIL-10 gene treatment attenuates the area of collagen deposition in liver fibrosis rats associated with downregulation of TIMP 1.

Objective To observe the effects and mechanism of pretreatment in rats with prostaglandin E1 on liver after hemorrhagic shock and resuscitation(HSR).Method In total,32 male SD rats were randomly(random number)divided into four groups(n=8):group A(sham group),group B(shock group),group C(HSR group)and group D(Lipo-PGEl+HSR).In group B,rats were sacrificed 90 min after shock,and in group C,rats were anesthetized and then subjected to hemorrhagic shock followed by resuscitation.In group D,rats were pretreated with Lipo-PGEI one hour before HSR.Liver function,NO and ET.1 were measured,and pathological changes of liver tissue in each group were observed,and the expres8ions of iNOS and ET.1 of liver tissue were measured by using immunohistochemistry 6 hours after HSR.Data were analyzed by analysis of variance,and P<0.05 was considered as significantly different in statitistics.Results The levels of liver iNOS and ET-I increased in HSR group compared with shock group [(O.225±0.080)vs.(0.082±0.021)and(0.292±0.047)vs.(0.082±0.035),P<0.05].Pretreatment with Lipo-PGEl markedly reduced the damage of Liver function,and lowered the levels of NO and ET-I.which were consistent with decrease in iNOS and ET-16 hours after HSR[(0.116±0.034)vs.(0.225±0.080)and(0.198±0.041)vs.(0.292±0.047),P<0.05].Conclusions Pretreatment with Lipo-PGEl could reduce liver injury after HSR.The mechanisms might be attributed to inhibiting iNOS and ET-1,regulating the balance of NO/ET-I.

Objective To investigate the influence of systematic health education on the disease cogni-tion and behavior of treatment compliance in patients with infectious diseases. Methods Patiens with infec-tious diseases in our department were divided into the control group(142 patients) and the experimental group (136 patients). The control group received common health education, the experimental group was given addi-tional knowledge education about infectious disease based upon routine education. The two groups were inves-tigated before and after intervention by adopting self-designed investigation scale.The cognition rate of disease and the rate of behavior of treatment compliance were compared by χ2 test. Results The cognition rate of disease and the rate of behavior of treatment compliance in the experimental group were higher than those of the control group. Conclusions Systematic health education can not only increase degree of disease cogni-tion but also improve behavior of treatment comphanee in patients with infectious diseases.

Aim To establish a method of hydrodynamic-based transfection(HBT) and provide a means in rats of the gene therapy of liver diseases,which allowed an efficient expression of rIL-10 gene in rat liver.Methods Using rIL-10 gene as a reporter gene,different volumes and doses of plasmid DNA solutions were rapidly injected into rat tail vein,then the serum and the tissue of liver,kidney,lung,spleen and heart in different time were collected and the expression of rIL-10 was detected by the methods of RT-PCR,ELISA and immunochemistry.Results Using rIL-10 gene as a reporter gene,the results demonstrated that an efficient transfer and expression of rIL-10 in rat liver could be achieved by a rapid injection of a large volume of rIL-10 DNA solution into rat via tail vein.Maintaining a stable expression of rIL-10 in serum could be assessed by repeated administration.Conclusion The HBT was a simple,convenient and efficient method of gene transfer and expression in rats,which could be used as an effective means to study further gene therapy of rIL-10 in liver diseases.

Objective: To address the significance of urinary podocytes in the diagnosis of human focal segmental glomerulosclerosis(FSGS). Methods: Twelve patients with FSGS and 20 patients with minimal change disease (MCD) were diagnosed by routine renal biopsy, and 8 healthy persons as controls. Morning urinary sediments was collected and centrifuged onto glass slides. Urinary podocytes were identified by immunofluorescent staining of podocyte specific protein Podocalyxin(PCX). The state of podocytes in glomeruli was observed using immunofluorescence. Results: Urinary podocytes were found in 8 out of 12 FSGS patients(66.67%), whereas none of 20 patients with MCD and control had podocytes in their urine. FSGS patients with positives urinary podocytes had prominent manifestation of nephropathy syndrome, whereas no nephrotic syndrome in patients with negative urinary podocytes. Focal absence of the expression of PCX, a marker protein of podocytes in glomeruli was found in FSGS patients, and the locations of absence were consistent with the lesions of focal sclerosis in glomeruli. In contrast, PCX was expressed integrally in MCD patients. Conclusion: Appearances of podocytes in urine of patients with nephropathy may be used as one of the reliable, convenient and unharmful accessorial methods for distinguished diagnosis of FSGS and MCD.

BACKGROUND: The principal deterrent to the success for hematopoietic stem cell transplantation (HSCT) is the complications after transplantation. The complications are associates with the conditioning regimens in the early stage. The highly-effective preparative regimens of proper dose and low-toxicity are the key to the successful HSCT.OBJECTIVE: To evaluate the curative effects and regimen related toxicity (RRT) of high-dose alkylating-agent-based chemotherapy as conditioning regimens for HSCT in the patients with hematological malignancies.DESIGN: Controlled study with observation.SETTING: Department of Hematology, Affiliated Hospital of Xuzhou Medical College.PARTICIPANTS: A total of 45 patients with leukemia and lymphoma hospitalized at Affiliated Hospital of Xuzhou Medical College from July 1997 to February 2006 were enrolled, including 31 males and 14 females. The median age was 31 years (from 7 to 52 years). The median course was 8 months (from 5 to 17 months) until transplantation.METHODS: Totally 45 patients with leukemia and lymphoma approached or got complete remission were treated by bone marrow transplantation and peripheral blood stem cell transplantation with preparative regimens of high-dose alkylating-agent-based chemotherapy. RRT was graded according to Bearman proposal, from grade 0 (no toxicity) to grade Ⅳ (fatal toxicity). The period of hematopoietic reconstitution, the rates of complete remission and relapse and disease-free survival were statistically observed in transplant recipients.MAIN OUTCOME MEASURES: Occurrence of RRT as conditioning regimens.RESULTS: ①Five patients did not show any toxicity. The greatest toxicity of grade Ⅲ was uncommon (13%, 6/45). Most of the cases with RRT were in grade Ⅰ - Ⅱ and severe oases in grade Ⅲ were rare. In grade Ⅰ - Ⅱ, stomatocace and gastrointestinal toxicity were common respectively of 73% (33/45) and 51% (23/45) which were recovered in short time after treatment; Heart toxicity was rare and only in grade Ⅰ, most of which were tachyoardia and changes of ST-T shape. The increase of transaminase was common in the clinical manifestations of liver RRT except two cases of HVOD.There were four oases of HC, in which one was delayed. RRT on kidney, lungs and CNS was uncommon. ②Totally 43 patients engrafted gained hematopoietic reconstitution, 2 patients died of implant failure (4%). Within the median follow-up period of 37 (8-102) months, 10 patients relapsed, 5 patients died of transplantation-related complications and 28 patients were alive in a disease-free situation (62.2%). The cause of death within 100 days after transplantation was ordinal as acute graft-versus-host disease (GVHD), cytomegalovirus (CMV) interstitial pneumonia, disseminated infections,multiple organ failure and early relapses.CONCLUSION: Alkylating-agent-based conditioning regimens may be well tolerated with low toxicities for HSCT in leukemia and lymphoma.

Objective To observe the relationship between plasma level of homocysteine(HCY) and ischemic stroke in young and middle-aged adults,explore the clinical signficance concerning the occurrence and development of ischemic stroke in young and middle-aged adults.Methods The plasma homocysteine level of 132 young and middle-aged adults patients with ischemic and 86 control peoples were measured by means of enzymatic cycling assay.Results The plasma homocysteine level in ischemic stroke was higher than that in control group( P ＜ 0.01 ).The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group of young and middleaged adults.The plasma homocysteine level and the infarcted focus was positively linearly correlated.Conclusion Hyperhomocysteinemia is a risk factor of ischemic stroke among young and middle-aged adults.The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group.The plasma homocysteine level can reflect the size of the infarcted focus and the degree of disease,and the plasma homocysteine level should serve as a kind of regular examination or as an index intervention can be taken,all of which are great importance to prevent ischemic stroke and reduce its morbilily.