Objective To discuss the effects of remifentanfl for delthemte hypotension in intracranial aneurysm clamp operation,evaluating the feasibility and safety.Methods Twenty intracranial aneurysm patients undergoing occlusion surgery were prospectively randomized in to two groups:Group Ⅰ and Group Ⅱ.Group Ⅰ adopted remifentanil for deliberate hypotension and Group Ⅱ adopted sodium nitroprusside.The data were analyzed with SPSS 11.5 for Windows.Results Deliberate hypotension was achieved at the target mean arterial pressure(MAP)for remifentanil and nitroprusside respectively.During deliberate hypotension,HR in Group Ⅰ were lower than that in Group Ⅱ(P<0.01).RPP in Group Ⅰwere lower than that in Group Ⅱ(P<0.01).Blood loss in Group Ⅰ were lower than that in Group Ⅱ(P<0.05).Conclusion For general anesthesia in intracranial aneurysm clamp operation,using remifentanil for deliberate hypotemion is a good choice.

Object To define the molecular characters of differentiating Bupleurum chinense DC., B. scorzonerifolium Willd. from their allied species B. marginatum Wall. ex DC., B. smithii Wolff var. parvifolium Shan et Y.Li. and B. longiradiatum Turoz. Methods General DNA was isolated from fresh leaves of Bupleurum L. species by CTAB. The random amplified polymorphic DNA (RAPD) was used to identify them. Results Five Bupleurum L. species can be identified by primer OPA-1(5'-CAGGCCCTTC-3'), OPD-8 (5'-GTGTGCCCCA-3'), OPD-11 (5'-AGCGCCATTG-3'). Conclusion The method of RAPD can be used to identify the Bupleurum L. species and its allied species.

Objective Due to the anatomy of the scapula itself is exceptional,fracture is often associated with other damage.So it is particularly important to evaluate the patients,physical examination,as well as the choice of surgical approach during perioperative period.By studing of the relevant literatures,this article reviewed the anatomy and classification of the shoulder blades,patient assessment,surgical indications and approaches,as well as the functional exercise.

Objective To observe the effect of RNA interference binding immunoglobulin protein (BiP) on expression of bone markers and keytranscription factors in osteoblast exposed to fluoride.Methods MC3T3-E1 cells were used as osteoblast model in vitro.The cell viability was test with cell counting Kit-8 after cells were administrated with varying concentrations of fluoride [0.0 (control),0.1,1.0,2.0,4.0,8.0,16.0,20.0,32.0 and 64.0 mg/L] for different duration.Cells transfected with small interfering RNA (siRNA) BiP were exposed to fluoride (2.0,8.0 and 20.0 mg/L) for 2 days.Real-time PCR and Western blotting technique were used to determine the gene and protein levels of BiP.Meantime,the mRNA expression of bone markers and key transcription factors was investigated by real-time PCR.Results The difference of all viability in fluoride-dose groups was statistically significant exposed for 1,3,7 and 14 days (F =46.7,118.6,214.6,325.6,all P ＜ 0.05).Expression of BiP significantly increased in cells exposed to 20.0 mg/L compared to that of control (11.22 ± 3.25 vs.7.94 ± 1.31,P ＜ 0.05).The expression of alkaline phosphatase (ALP) elevated in cells exposed to 2.0 mg/L of fluoride (12.81 ± 3.62 vs.6.86 ± 2.13,P ＜ 0.01);conversely,it significantly reduced in cells exposed to 20.0 mg/L of fluoride (0.89 ± 0.17 vs.6.87 ± 2.14,P ＜ 0.01).Cells transfected with siRNA BiP significantly decreased the ALP expression in cells exposed to fluoride compared to that of cells only exposed to the same concentration of fluorine (12.81 ± 3.62 vs.7.43 ± 2.06;5.92 ± 2.38 vs.3.96 ± 0.21,all P ＜ 0.05).Cells transfected with siRNA BiP and administrated with 2.0 mg/L significantly reduced the osteocalcin expression (4.29 ± 0.99 vs.1.29 ± 0.86,P ＜ 0.01).Similarly,expression of runt-related transcription factor 2 (Runx2) significantly increased in cells exposed to 2.0 mg/L.However,expression of Runx2 significantly decreased in cells transfected with siRNA BiP and administrated with fluoride.Cells transfected with siRNA BiP significantly decreased the Runx2 expression in cells exposed to 2.0 mg/L and 20.0 mg/L compared to that of cells only exposed to the same concentration of fluorine (1.13 ± 0.22 vs.6.61 ± 0.48;0.02 ± 0.02 vs.1.50 ± 0.38,all P ＜ 0.01).As the downstream of Runx2,the expression of osterix in cells treated with different concentrations of fluoride was similar to that of Runx2.Conclusion BiP is not directly involved in the process of osteoblast differentiation induced by fluoride;instead,it affects the expression of bone markers and key transcription factors in osteoblast exposed to fluoride.

Objective To explore the neutrophil to lymphocyte ratio (NLR) and its relationship with the effect of chemotherapy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods The clinicopathological characteristics and outcome of 51 patients with DLBCL diagnosed by pathological biopsy and immunohistochemistry who received CHOP or R-CHOP regimen were collected and reviewed.According to the median of NLR,the patients were divided into low NLR group (NLR≤2.32) and high NLR group (NLR＞2.32).The prognostic influence of the NLR on overall survival (OS) was studied by Kaplan-Meier method and Log-rank test.To evaluate the independent prognostic relevance of NLR,univariate and multivariate Cox regression models were applied.Results The complete response (CR) rates of the low and high NLR groups were 71.4 ％ (20/28) and 39.1％ (9/23),respectively (P =0.02).The OS in the low NLR group was significantly better than that in the high NLR group (1,2 and 3-year OSs were 96.4 ％,90.4 ％ and 72.3 ％ vs 63.9 ％,52.7 ％ and 42.2 ％,respectively,P =0.009).Univariate and multivariate Cox regression models analysis showed that NLR ＞ 2.32 was an independent prognostic factor (P =0.016).Conclusion An elevated NLR before treatment indicates the poor effect of chemotherapy and prognosis of patients.NLR is an independent prognostic factor for DLBCL.

Objective To evaluate the CT and MR features of renal oncocytoma in order to improve the ability for recognition and ima-gingdiagnosis.Methods The CT and MR findings of renal oncocytoma in 12 patients proved by pathology were retrospectively analyzed.Results CT scans were performed in 12 patients,one of which was accompanied with the contralateral renal angiomyoliptoma.In all lesions, seven were in the right kidney and five in the left.The lesions were round or oval in shape with the diameter 1.5 cm-12.3 cm.On pre-contrast scan,the homogeneous density was found in 3,calcification in 2,and central scar tissue in 5.On post-contrast images,the parenchyma of tumor was obviously enhanced in the cortical phase.However,the enhancement was attenuated in the parenchymal phase.Seven patients underwent MRI at the same time,exhibiting iso-or hypointensity on T1 WI in 4 and heterogenous hyperintensity on T2 WI in 5.Dynamic contrast enhanced MRI demonstrated homogenous enhancement in 1 and heterogenous enhancement in others with delayed enhancement of the central scar.Conclusion Most renal oncocytomas show certain characteristics on CT or MRI, which are helpful for preoperative diagnosis and surgical therapy.

Objective To compare the operative results of removing large olfactory groove meningiomas(diameter≥3 cm)using either a unilat?eral or bilateral subfrontal approach ,and to determine whether there is an advantage in the unilateral approach. Methods Sixty?nine cases of large olfactory groove meningioma,treated in our department,by either a unilateral or bilateral subfrontal approach microsurgery were retrospec?tively reviewed. Removal grading,post?operative complications,and other clinical indices were evaluated. Results Total resection(Simpson Ⅰ or Ⅱ)was achieved in all the cases. There were lesser complications with use of the unilateral subfrontal approach. Conclusion Patients with ol?factory groove meningioma have a good prognosis when a unilateral subfrontal approach is used for surgery.

Intravascular stent as a foreign body exhibits obvious reaction following implantation,such as activation of coagulation system and elevation of serum C-reactive protein,inflammatory marker.After platelet is activated,P-selectin binds to the glycoprotein ligand 1 expressed on leukocyte,and forms congeries on the leukocyte.In addition,interleukin-1?,interleukin-6 and tumor necrosis factor-? are greatly secreted.The two factors are main reasons for restenosis following stent implantation.Studies on spiral CT angiography and transcranial Doppler sonography are important.

Objective To investigate the effect of Shenlongtang on the function of learning and memory of aging rats induced with D-glalactose. Methods 40 Wistar rats were dividied into control group, model group, treating group 1 (large dosage), treating group 2 (medial dosage), treating group 3 (lower dosage). The aging models were induced with D-galactose. The memory function was tested with passageway water maze. The activity of superoxide dismutase (SOD) and content of malodialdehyde (MDA) was measured. Results In the D-galactose model rats, the swimming time was prolonged significantly, and the correct number was decreased significantly compared with normal group (P<0.05). After Six weeks treating with Shenlongtang, the swimming time significantly shortened and the correct number increased significantly in large dosage group compared with the model group (P<0.05). The activity of SOD increased and the content of MDA decreased in large dosage group compared with that in the model group (P<0.05).Conclusion Shenlongtang can improve the learning and memory function of aging rats induced with D-glalactose and resist lipid peroxide in brain tissue.

Objective To explore the effect of surface electromyographic biofeedback (SEMG-BFT) combined with electrical stimulation on the swallowing function of stroke survivors with dysphagia,and to evaluate the electromyographic activity of the submental muscles in swallowing various foods so as to provide a basis for future rehabilitation of such patients.Methods Sixty patients were randomly divided into a treatment group and a control group,each of 28.Both groups were given low-frequency electrical stimulation and conventional swallowing training.The treatment group was additionally provided with SEMG-BFT.Before the treatment as well as after 2 and 4 weeks of treatment,the swallowing function of both groups was evaluated using the Kubota drinking water test (KDWT) and a Gugging swallowing screen (GUSS).Surface electromyographs of the submental muscles were recorded during empty swallowing,swallowing 10 ml of dilute liquid and swallowing 10 ml of paste.Results After two and four weeks of treatment,the average KDWT and GUSS scores of both groups had improved significantly,but that of the treatment group was significantly higher than that of the control group at each time point.After 2 and 4 weeks of treatment,significant differences were found in swallowing duration and the average amplitude of the sEMGs compared with before the treatment in both groups.The difference between the groups was significant at each time point.Conclusions SEMG-BFT combined with electrical stimulation can significantly improve swallowing function.Paste food can be used safely in the early evaluation and treatment of swallowing dysfunction.