Objective To evaluate whether low-dose ropivacaine in combination with sufentanil could produce effective spinal anaesthesia for severe preeclamptic parturients during cesarean section.Methods 40 severe preeclampsia parturients undergoing elective caesarean delivery under combined spinal-epidural anaesthesia were randomly divided into two groups based on a computer-generated grouping number sheet,each group in 20 cases.Group A received intrathecal ropivacaine 15mg (1.5mL)+10% dextrose 1mL with normal saline 0.5mL.Group B received intrathecal ropivacaine 10mg (1mL) + sufentanil 5μg(1mL) + 10% dextrose 1mL.Blood pressure,heart rate and oxygen saturation were documented at 2 min intervals for 10 min after local anaesthetic was administered.Sensory and motor block were assessed at 2.5 min intervals after spinal injection.The side effects such as hypotension,nausea and vomiting during surgery were recorded.Results The onset of motor block was longer[(4.8±2.1) min vs.(4.2±1.5) min,t=-2.83,P<0.01],and the duration was shorter[(75.9±25.2) min vs.(115.4±29.5)min,t=10.75,P<0.01] in group B than those in group A.The number of patients who had Bromage score 3 in group A was more than that in group B.Compared with group A,the duration of complete analgesia[(180±35) min vs.(120±27) min,t=15.48,P<0.001]and effective analgesia[(245±29)min vs.(184±34)min;t=16.21,P<0.001] increased in group B.More patients were sleepy but easily rousable in group B than in group A (9cases vs.0cases,χ2=8.53,P<0.01).The incidence rate of hypotension was significantly higher(45.0% vs.20.0%,χ2=4.29,P<0.05) in group A than that in group B.Compared with group A,the incidence rate of hypotension(45.0% vs.20.0%,χ2=4.29,P<0.05),vomiting(30.0% vs.5.0%,χ2=4.33,P<0.05) and shivering (50.0% vs.10.0%,χ2=7.62,P<0.01) were lower in group B.The incidence of pruritus was significantly higher in group B (χ2=10.16,P<0.01).Conclusion Hyperbaric ropivacaine 10 mg with sufentanil 5μg could produce effective spinal anaesthesia for severe preeclamptic parturients during cesarean section with less hypotension,vomiting and shivering,and longer lasting analgesia than hyperbaric ropivacaine 15 mg.

Objective To study the alteration of telomerase activity of MCF 7 cell line of breast cancer in the presence of different anticancer drugs. Methods The hyperplasia and viability of MCF 7 cell were detected by cell counting and trypan blue exclusion, and the telomerase activity was measured by TRAP.The alteration of MCF 7 cell and its related factors of telomerase activity were observed on cell growing in different condition. Results In abscence of drug, there was a positive correlation between hyperplasia and telomerase activity of the cell(r= 0.901 ). Adriamycin, paclitaxel and cisplatin could obviously inhibit the growth and reduce the telomerase activity of the cell in a dose-dependent and time-dependent fashion, and this reduction in telomerase activity closely correlated with the reduction in the number of viable cells. Conclusions Adriamycin, paclitaxel and cisplatin can inhibit the growth of MCF 7 cell, which may be correlated with the reduction in telomerase activity and cell viability.

BACKGROUNDTo investigate the effects of cisplatin on proliferation, telomerase activity, cell cycle, p53, bcl-2 and proliferating cell nuclear antigen (PCNA) expressions of human lung adenocarcinoma SLC-89 cells induced by cisplatin and to find out the possible mechanisms.

METHODSSLC-89 cells were treated with cisplatin of different concentrations for 72 h. Then, the proliferation of the cells was measured by MTT method, telomerase activity was measured by telomeric repeat amplification protocol with ELISA (TRAP-ELISA), and cell cycle, p53, bcl-2 and PCNA expressions of the cells were detected by flow cytometry (FCM) respectively.

RESULTSCisplatin could obviously inhibit the proliferation of the cells, and IC₅₀ value for cisplatin treatment was 18.47 mg/L. Cisplatin could obviously down-regulate telomerase activity, decrease S phase cells, increase G₀/G₁ phase cells, decline the expressions of bcl-2 and PCNA proteins and induce the expression of p53 protein of SLC-89 cells in a concentration-dependent fashion.

CONCLUSIONSCisplatin can obviously inhibit the proliferation of SLC-89, change the distribution of cell cycle, decline telomerase activity and expressions of bcl-2 and PCNA proteins, and induce expression of p53 protein, which may be the important mechanisms of cisplatin's anticancer action.

Objective:To develop a comprehensive ability evaluation system for general practice management post in community health service institutions.Methods:Based on the previous studies and literature search on competency of general practitioners in various clinical posts, the first draft of the comprehensive ability indicator system for general management posts was designed. From November 2019 to January 2020, the comprehensive ability indicator system, classification and scoring method and evaluation method for general management posts were determined through three rounds of Delphi consultation.Results:Seventeen experts with administrative management experiences were invited for consultation, including 3 directors in charge and 14 general practice managers. The response rate of valid questionnaires in the three rounds of consultation were all 17/17, the authority of experts were all>0.7, and the coordination coefficients of expert opinions were 0.142, 0.212, and 0.532 (all P<0.01). The 11 evaluation indexes of the comprehensive ability of community general management posts were: achievement orientation, initiative, interpersonal understanding, service consciousness, influence, organization, training others, teamwork, team leadership, professional skills and confidence. Methods suitable for evaluation the ability of psychological test indicators were achievement orientation, interpersonal understanding, service consciousness and self-confident;appropriate indicators for no-leader group discussion were initiation, influence, team work, team leadership;appropriate indicators for in-tray test ability were organized cognition, professional skills;and the appropriate indicator for the ability of the structured interview was training others. Conclusions:The comprehensive ability evaluation system for community general management posts established in this study is scientific and practical, which may provide objective standard basis for the ability evaluation of community health management talents.

Objective:To investigate the risk factors for nonunion after surgery for femoral shaft fractures in order to reduce them.Methods:The clinical data were retrospectively analyzed of the 804 patients with femoral shaft fracture who had been treated from January 2014 to December 2020 at Department of Orthopaedics, Xijing Hospital. There were 575 males and 229 females, aged from 18 to 96 years (average, 43.7 years). The patients were divided into 2 groups according to whether nonunion had occurred after surgery: a nonunion group of 112 cases and a fracture healing group of 692 cases. The preoperative general data, such as age, gender and fracture type, as well as intraoperative and postoperative data, such as operation time, internal fixation method, reduction method and internal fixation failure, were compared between the 2 groups. Items with P<0.05 were included in the multivariate logistic regression analysis to identify the risk factors for nonunion. Results:There were statistically significant differences between the nonunion group and the fracture healing group in smoking history, drinking history, injury mechanism, injury type, multiple injuries, fracture AO classification, fixation method, internal fixation failure, postoperative infection and use of non-steroid anti-inflammtory drugs ( P<0.05). Multivariate logistic regression analysis showed that smoking ( OR=3.261, 95% CI: 2.072 to 5.133, P<0.001), high energy injury ( OR=2.010, 95% CI: 1.085 to 3.722, P=0.026), multiple injuries ( OR=3.354, 95% CI: 1.985 to 5.669, P<0.001), AO type 32-C fracture (type 32-C fracture used as a reference, P=0.034), internal fixation failure ( OR=3.517, 95% CI: 1.806 to 6.849, P<0.001), external stent fixation (external stent fixation used as a reference, P=0.009) were the risk factors for nonunion after femoral shaft fractures. Conclusions:After surgery for patients with femoral shaft fracture, special attention should be paid to those with a smoking habit, high-energy injury, multiple injuries, AO type 32-C fracture, external stent fixation or a failed internal fixation, because they are high-risk groups prone to postoperative nonunion.

Bisecting N-acetylglucosamine(GlcNAc),a GlcNAc linked to the core β-mannose resi-due via a β1,4 linkage,is a special type of N-glycosylation that has been reported to be involved in various biological processes,such as cell adhesion and fetal development.This N-glycan structure is abundant in human trophoblasts,which is postulated to be resistant to natural killer cell-mediated cytotoxicity,enabling a mother to nourish a fetus without rejection.In this study,we hypothesized that the human amniotic membrane,which serves as the last barrier for the fetus,may also express bisected-type glycans.To test this hypothesis,glycomic analysis of the human amniotic membrane was performed,and bisected N-glycans were detected.Furthermore,our pro-teomic data,which have been previously employed to explore human missing proteins,were ana-lyzed and the presence of bisecting GlcNAc-modified peptides was confirmed.A total of 41 glycoproteins with 43 glycopeptides were found to possess a bisecting GlcNAc,and 25 of these gly-coproteins were reported to exhibit this type of modification for the first time.These results provide insights into the potential roles of bisecting GlcNAc modification in the human amniotic membrane,and can be beneficial to functional studies on glycoproteins with bisecting GlcNAc modifications and functional studies on immune suppression in human placenta.

Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN).AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.