Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for transversus abdominis plane (TAP) block combined with general anesthesia in the patients undergoing gynecological laparoscopy.Methods Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-50 yr, with body mass index of 18-24 kg/m2, scheduled for elective gynecological laparoscopic ovarian cyst resection under general anesthesia, were randomly divided into 3 groups (n =30 each) using a random number table: general anesthesia group (group G) , general anesthesia + ropivacaine for TAP block group (group G+R), and general anesthesia + dexanedetomidine mixed with ropivacaine for TAP block group (group G+DR).After the end of anesthesia induction, ultrasound-guided left-sided unilateral TAP block was performed in G+R and G+DR groups.In G+R and G+DR groups, 20 ml of 0.375％ ropivacaine and 20 ml of 0.375％ ropivacaine mixed with 1 μg/kg dexmedetomidine were injected, respectively.After induction of general anesthesia, the laryngeal mask airway (LMA) was inserted, and the patients were mechanically ventilated in the 3 groups.Anesthesia was maintenaned with iv infusion of remifentanil 0.2 μg · kg-1 · min-1 and propofol 4-8 mg · kg-1 · h-1.Narcotrend index was maintained at 37-46.Only group G received postoperative intravenous analgesia.The occurrence of TAP block-related adverse events was recorded.The emergence time, time for recovery of spontaneous breathing, time for removal of LMA, and Steward score at 5 min after removal of LMA were recorded.The occurrence of postoperative nausea and vomiting, and respiratory depression was recorded.Results Compared with G and G+R groups,the emergence time, time for recovery of spontaneous breathing, and time for removal of LMA were significantly shortened (P＜0.05 or 0.01) , and no significant change was found in Steward score in group G+DR (P＞0.05).There was no significant difference in the above parameters between group G and group G+R (P＞0.05).Compared with group G, the incidence of postoperative nausea and vomiting was significantly decreased in G+R and G+DR groups (P＜0.05).VAS score was maintained ≤ 3 after operation in the 3 groups.No TAP block-related adverse events were found in G+R and G+DR groups.Conclusion Dexmedetomidine mixed with ropivacaine provides faster recovery from anesthesia, and avoids postoperative hyperalgesia when used for TAP block combined with general anesthesia in the patients undergoing gynecological laparoscopy.

Objective To observe the inhibitory effect of LaCl_3 on the growth of human hepatocellular carcinoma cell lines SMMC-7721 and its mechanism.Methods The cells were treated with different doses of LaCl_3 and the growth curve,colony inhibitory rates,the levels of AFP of cultured cells were detected at 1,3,5 and 7 days after they were dealed with LaCl_3.The changes of cell cycle were detected by flow cytometry and the expressions of cell cycle protein CyclinD_1,PCNA,CDK_4 and P16 were observed by immunocytochemistry staining.Results MTT test showed that SMMC-7721 cell proliterating activity was obviously inhibited by LaCl_3 in a time and dose related manner at concentrations of 0.50 and 1.00 mmol?L~(-1).The colony forming inhibitory rate of 0.10,0.50 and(1.00 mmol?L~(-1))LaCl_3 were 51%, 67% and 97% (P

Objective:To compare effects of APF and APF-La(NO3)3 on enamel surface layer and to probe the mechanism of combined application of APF-La(NO3)3 on deciduous molars. Methods:9 caries-free second lower molars were selected and divided randomly into two groups: APF group (n=4) and APF-La(NO3)3 group (n=5). All teeth were cut into two parts, paralleled to axis of the teeth, along the line connecting mesial buccal and lingual cusps. Mesial parts were experimental group and distal parts were control group. Spot analysis of EPMA was performed to measure concentration of F or/and La in enamel surface layers, and compare changes of concentration of F in enamel surface layers treated with APF solution and changes of concentration of F and La treated with APF-La(NO3)3 solution. Results: ①Concentrations of F in enamel surface layers increased in APF experimental group. ②Concentrations of F and La increased in deciduous teeth enamel surface layers of APF-La(NO3)3 experimental group. ③ Increment of F in cusp of deciduous molar is the same as that of pit in APF experimental group. ④ Increment of F and La in cusp of deciduous molar was the same as that of pit in APF-La(NO3)3 experimental group. Conclusion:Compared with APF, treatment by APF-La(NO3)3 can increase the concentrations of both La and F in enamel surface layer while there is no difference of increment between cusp and pit in each group. The result can provide useful data for prevention of caries in children.

BACKGROUND: Most of the literatures only reported that there is a great difference between diabetics who have a high 24-hour urinary albumin excretion rate and those without renal damage, but there is no obvious difference between cases of microalbuminuria and those without renal damage.OBJECTIVE: To probe into the relationship between diabetic nephropathy and osteoporosis.DESIGN: A case-control study.SETTING: Department of Endocrinology, West China Hospital of Sichuan University.PARTICIPANTS: According to the diagnostic standard set by the American Diabetes Association in 1997 (fasting blood glucose ≥ 7 mmol/L,postprandial blood glucose ≥ 11.1 mmol/L), 96 diabetic patients were selected, including 56 males ＜ 60 years old and 40 females who had not entered the menopausal period, excluding the influence of age and osteoporosis caused by menopause. The average age of the subjects was (48.7±10.5)years, their duration were from one month to twenty-one years with the aver age of (7.85±2.56) years, and their general information had no significant differences.METHODS: According to the urine albumine excretion rate and renal function, the patients were divided into four groups: normal albuminuria group (n=48), microalbuminuria group (n=28), macroalbuminuria group (n=15), renal failure group (n=5). The bone mineral densities of lumbar spines (L2-4), femoral neck, Ward's triangle and trochanter were detected with Dual energy X-ray absorptiometry, and then the fasting blood glucose,2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate were compared between the patients with and without osteoporosis.MAIN OUTCOME MEASURES: The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate, as well as the bone mineral density, were observed in all the patients.RESULTS: The L2-3 bone mineral density in the macroalbuminuria group was significantly different from that in the microalbuminuria group (P ＜ 0.05). The proximal femur bone mineral density in the microalbuminuria group was significantly different from that in the normal albuminuria group (P ＜ 0.05). The bone mineral densities of proximal femur and lumbar spine in the renal failure group were significantly decreased as compared with those in the other groups (P ＜ 0.01). The disease course,glycosylated hemoglobin A, alkaline phosphatase and body mass index were significantly different between the patients with and without osteoporosis (P ＜ 0.05).CONCLUSION: The incidence rate of osteoporosis is increased with the aggravation of nephropathy, and diabetic nephropathy may be closely correlated with the decrease of bone mineral density and the occurrence of osteoporosis.

Objective To investigate the mechanism of inhibitor of calpain on hyperglycemia-induced apoptosis in cultured rat cardiomyocyte.Methods Cardiomyocytes were randomly divided into three groups (control,high glucose,and ALLN).MTT assay was used to detect the viability of cultured cardiomyocytes.Laser confocal microscopy was used to observe the mitochondrial permeable transition and membrane potential.The change of Caspase-3 activity in cardiomyocytes was detected by western blot.Results MTT assay showed that,after 72 h of hyperglycemia,the viability of cardiomyocytes was significantly declined (55％ ± 11％),and the viability in the ALLN pretreatment group was (70％ ± 15％) (P ＜0.05).After hyperglycemia,the mitochondrial permeable transition of cardiomyocyte was increased (30％ ± 15％ vs 60％ ± 11％,P ＜0.05),and membrane potential was declined.Hyperglycemia could increase the expression of cleaved capsase-3,while with pretreatment of ALLN the expression of cleaved caspase-3 was downregulation(0.42 ± 0.11 vs 0.21 ±0.12,P ＜0.05).Conclusions The calpain inhibitor can protect cardiomyocytes from apoptosis under the high glucose condition.

Interaction in classroom teaching is a bilateral activity that is difficult to control. Teachers and students are the two main aspects to realize the synchronization of teachers and students' thinking. For teachers, teachers should first make full use of multimedia resources, bring a colorful courseware into class-room teaching; secondly, teachers should stimulate students' interest in a reasonable way, so as to inject vitality into the classroom teaching; finally, teachers should mobilize the students' thinking and carefully regulate the changes in thinking between teachers and students through a proper teaching methods. In terms of students, students should not only give full play to their initiative, but also actively cooperate with teachers in order to realize the thought synchronization between teachers and students in classroom teaching and learning interaction and ultimately achieve the desired results.

Objective:To evaluate volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal class Ⅲ malocclusion.Methods:Literatures about volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal class Ⅲ malocclusion were searched from the database:Cochrane library,Embase,PubMed,Web of Science,Wangfang,China Science and Technology Journal Database (VIP),Chinese Biomedical Medicine Database (CBM) and China National Knowledge Infrastructure(CNKI).All the literatures were evaluated by Newcastle-Ottawa Scale(NOS) and analyzed by RevMan 5.3.Results:9 studies with 204 cases about volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal Ⅲ malocclusion were included.Meta-analysis showed that after treatment there was no statistical difference about the nasopharyngeal volume change and the total volume change(P＞0.05);there was statistically significant difference about oropharyngeal volume change (P＜0.05).Conclusion:It might be better to consider orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion with certain risk factors about OSAHS,but there was still a risk of airway narrow after orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion.

Objective To study signs of ultrasonography in multiple renal arteritis (MRA) by color Doppler flow imaging(CDFI) and X-ray angiography.Methods 2-D ultrasonography and color Doppler were performed on 23 cases of MRA with 39 diseased blood vessels.The morphology and diameters of stenonsed renal arteries of the kidneys were observed respectively by 2-D ultrasonography and CDFI.CDFI was adopted to observe maximum of velocity(Vmax),minimum of velocity(Vmin),resistance index(RI),acclerate(ACC) and acclerated time(TA) of the renal arteries,and the values were compared with those by X-ray angiography and with those of the normal controls.Results MRA's renal volume and diameter were significantly different from those of controls ( P

Purpose:To evaluate the effects of thymosin ?1 (T?1) in chemotherapy of NSCLC. Methods:We have conducted a prospective randomized controlled clinical trial.40 non-treated cases of stage Ⅲ-Ⅳ NSCLC were randomized into T?1 group ( chemotherapy combined with thymosin ?1) and control group (chemotherapy alone). The number of T cell subgroups, the activity of NK cell and phagocytic index of neutrophilic granulocyte in peripheral blood were detected and quality of life and changes of cancer lesions were evaluated before and after treatment. Results:After treatment,the levels of CD4 in the T?1 group was significantly higher than before treatment(P0.05). There was no significant difference of myelosuppression between the two groups. No infections or severe toxicity occurred in the T?1 group. One severe lung infection was seen in the control group.There was better quality of life for the T?1 group compared with the control group(P

Objective To provide a specific,sensitive,reproducible HPLC method for the determination of doxepin in urine and whole blood with doxapram as the internal standard.Methods The sample preparation was simple and time-saving by using an Oasis pretreatment cartridge.Separations were achieved by a Lichrospher  100 RP-18e (250mm?4.0mm,5?m)column kept at 50 ℃,and the DAD detector was set at 230nm and 250nm.Results The detection limit was 2 ng/ml in urine and whole blood.The results showed excellent linearity.The relative standard deviation of between-day and within-day assay was Less than 6.75%,and absolute recoveries were higher than 85%.Conclusion The method for determination of doxepin in urine and whole blood is effective,simple and reliable,which may be applicable to the practical cases.