Objective To investigate the impact of propofol and midazolam on the time course of extubation in patients with mechanical ventilation.Methods The patients were randomly divided into the propofol group(n=37)and the midazolam group(n=52),which were further divided into three sedation stratums.The administration of two drugs were stoped immediately while weaning from the ventilator.The awakening time and extubation time of the two groups were recorded and compared with each other.Results Both awakening time and extubation time of the propofol groups were shorter than those of the midazolam group(P

Objective To explore the relationship between phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammals target protein rapamycin (mTOR) signal transduction pathway and Barrett esophagus genesis.Methods A total of 140 rats were divided into sham operated group (n=10),iron group (n =10),esophageal duodenal side anastomosis group (n =30),esophageal duodenal side anastomosis plus iron group (n-30),esophageal gastric duodenal side anastomosis group (n=30) and esophageal gastric duodenal anastomosis plus iron group (n=30).In the end,10 normal esophagus tissue specimens,62 reflux esophagitis tissue specimens and 34 Barrett's esophagus tissue specimens were obtained.The expression levels of epidermal growth factor receptor (EGFR),Akt,phospho Akt (p-Akt),phospho-mTOR (p-mTOR) protein were detected by immunohistochemistry.Single factor analysis of variance,SNK between two groups and nonparametric correlation analysis were performed for statistical analysis.Results The protein expression levels of EGFR,Akt,p-Akt,p-mTOR in Barret(s esophagus tissues were higher than those in reflux esophagitis tissues and normal esophagus tissues (EGFR 0.1799±0.0367 vs 0.0438±0.0025 and 0.0277±0.0069,q=6.79,4.13; Akt 0.1874±0.0250 vs 0.0986±0.0093 and 0.0383±0.0048,q=6.51,3.56; p-Akt 0.1418±0.0130 vs 0.0592±0.0027 and 0.0281 ±0.0017,q=7.68,3.99; p-mTOR 0.1591±0.0275 vs 0.0674 ±0.0059 and 0.0112±0.0017,q=5.62,4.11; all P＜0.05).The protein expression levels of EGFR,Akt,p-Akt,and p-mTORin reflux esophagitis tissues were higher than those in normal esophagus tissues(q=4.67,4.29,4.27,4.03; all P＜0.05).Conclusion PI3K/Akt/mTOR signal transduction pathway were activated in reflux esophagitis and Barrett's esophagus,which provided theoretical basis for clinical multi-target treatment for diseases.

BACKGROUND:Gait analysis enable to convert qualitative analysis and description used for a long time in orthopedic examination and rehabilitative treatment into objective and precise quantitative assessment. At the present, with the development of science and technology, three-dimensional (3D) gait analysis is more and more widely, extensively used in orthopedic surgery and rehabilitation medicine abroad, while much less in China.OBJECTIVE: To study the parameters of time-distance, kinematics, kinetic and electromyography (EMG) in healthy subjects and patients with backbone, hip, knee or ankle joint diseases.DESIGN: Comparative observation and control study.PARTICIPANTS: From December 2004 to July 2005, 40 healthy subjects and 112 patients suffering from backbone and hip, knee, ankle joint disease were selected from the Department of Rehabilitative Medicine, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University and analyzed by three dimensional gait analysis system (VICON 612 system made by Britain VICON Company). 112 patients including 42 males with the mean age of (46.2 ± 2.3) years and 70 females with the mean age (41.2 ± 3.5) years were screened by skilled clinicians after surgical and rehabilitative treatment.Among them there were 21 patients with cervical vertebra, 26 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis. The number of hip, knee, ankle joint disease was 12, 34, 19 respectively. Total hip replacement was included in hip joint disease, anterior cruciate ligament (ACL) reconstruction was included in knee joint disease, talipes equinovarus was included in ankle joint disease. Meanwhile, 40 healthy subjects who were 20-40 years old, male or female, without any clinical symptom of backbone and limbs volunteered in the study.METHODS :Gait analysis were carried out on 40 healthy volunteers and 112 operational and rehabilitative treatment patients with spinal and lower limb diseases using VICON 612 system made by Britain VICON Company.MAIN OUTCOME MEASURES: The time-distance parameters (cadence, step length, walking speed), kinematics parameters (knee flexion/extension degree, hip flexion/extension degree, ankle dorsi/plantar degree), kinetic parameters (knee force in Z axis, hip force in Z axis, normalized force in Z axis) and EMG parameters (vastus lateralis SEMG) of lower limbs were examined.RESULTS: A total of 40 healthy subjects and 112 patients were involved in the analysis of results. ① Time-distance parameter: Cadence, as well as step length and walking speed of patients with backbone disease, patients with hip joint disease, patients with knee joint disease, and patients with ankle joint disease were lower than those of healthy subjects,and the difference between two groups was significant (P ＜ 0.05-0.01). ② Kinematic and kinetic parameters of all joints in upper limbs: One year after left ACL knee reconstruction, the extension of left knee in initial contact phase was 9° less than that of right one and the stress in Z axis of left knee was much less than that of right one; One year after left THA,the flexion of left hip in initial contact phase was 8.5° less than that of right one, the extension of left hip in terminal stance phase was 3° less than that of right one, during stance phase the stress in Z axis of left hip was much less than that of right one; As to an infantile paralysis patient with talipes equinovarus, the dorsiflexion of left ankle in initial contact phase was 12° less than that of right one, the plantar flexion of left ankle in terminal stance phase was 5° less than that of right one. The stress in Z axis of left ankle during stance phase was much less than that of right one. However, the difference in range of motion and stress in Z axis was not significant between the left and right knee joint in healthy people. ③ One year after left total knee arthroplasty, the dynamic surface electromyogram signals of left vastus lateralis is much lower than that of right vastus lateralis in a gait cycle.CONCLUSION: 3D gait analysis enables tprovide objective basis for making operation scheme for orthopedic surgery and after-operation rehabilitation therapy, and assessing curative effect of rehabilitation therapy.

In order to investigate the effect of Polo-like kinase-1 (Plk1) depletion on cell cycle progression and cell growth in lung cancer cells, a recombinant plasmid containing antisense RNA targeting Plk1 (pcDNA3-Plk1) was transfected into A549 cells by lipofectine. RT-PCR and Western-blot were used to detect the Plk1 gene expression. Cell proliferation was evaluated by direct cell counting and bromodeoxyuridine (BrdU) labeling. Cell cycle distribution and apoptosis were examined by flow cytometry, and the inhibition rate (IR) by vinorebline (NVB) was determined by MTT assay. The results showed that after transfection of pcDNA3-Plk1 into A549 cells, the expression levels of Plk1 mRNA and protein were greatly decreased. In pcDNA3-Plk1 transfected groups, abnormal morphological changes of cells and growth inhibition were observed, and the BrdU labeling index was significantly lower than in the control groups (P<0.05). Cells in pcDNA3-Plk1 transfected groups were arresed in G2/M phase and apoptosis was detectable 72 h post transfection. IR induced by vinorebline in pcDNA3-Plk1 transfected groups was significantly higher than in other groups. These data suggested that antisense RNA targeting Plk1 could suppress the Plk1 expression, and therefore, significantly inhibit cell proliferation and induce cell cycle arrest and apoptosis. Moreover, it sensitized lung cancer cells to chemotherapy.

Objective To determine the efficacy and safety of acarbose in the treatment of senile postprandial hypotension (PPH). Methods Forty three senile in-patients with PPH were recruited. Blood pressure and heart rate(HR) were recorded for 120 minutes by using non-invasive ambulatory blood pressure monitoring system. The participants had semiliquid standard meals with or without acarbose on two following days. The ejection fraction(EF) and fractional shortening(FS) were measured by two dimensional echocardiography before treatment. Results The magnitudes of the falls in systolic, diastolic and mean arterial blood pressure (SBP、DBP、MAP) (all P

Objective To study the antagonistic effects of grape procyanidin(GPC)or lipoic acid(LA)to the rat liver cell peroxidative damage induced by~(60)Co ? radiation.Methods The cultured rat liver cells(1?10~9/L)were prepared from 10 rats aged 1 week,the survival rate was above 85%.The cultured liver cells were divided into the negative control group(without radiation), GPC group(75 mg/L),LA group(100 mg/L)and the positive control group(containing no antioxidants),which were radiated by (60)~Co ? radiation(2.5 Gy,90 cm,10 s).The SOD,GSH-Px activity,MDA level and comet assay were determined.Results Compared with the positive control group,in the GPC group and LA group,the activity of hepatic SOD and GSH-Px were significantly higher (P

Objective To study the antagonistic effect of N-acetyl-L-cysteine(NAC)and ?-lipoic acid(LA)to the oxidative damage in the liver and kidney of rats induced by the condensate of cooking oil fume(COF).Methods SD rats were randomly divided into 4 groups,8 in each,the blank control,COF group(10 ml/kg,subcutaneous injection),COF plus NAC(2 mmol/kg, intraperitoneal injection)and COF plus LA(0.35 mmol/kg,intraperitoneal injection).Forty-eight hours after treatment,the activity of SOD,GSH-Px and MDA level in the livers and kidneys were determined.Results In the kidney,compared with the COF group, both of NAC and LA could increase the activity of kidney SOD and GSH-Px and decreased the MDA level significantly,the same results were seen in the liver.Conclusion Both of N-aeetyl-L-cysteine and ?-lipoic acid has an obvious antagonistic effect to the oxidative damage in the liver and kidney of rats induced by the condensates of cooking oil fume.

BACKGROUND:Studies have shown that human telomerase reverse transcriptase gene (hTERT) transfection can significantly extend the life cycle of bone marrow mesenchymal stem cels so that the cels can continue to maintain pluripotency.
OBJECTIVE:To investigate the effects of hTERT gene-modified bone marrow mesenchymal stem cels on hepatocyte proliferation and apoptosis.
METHODS:Bone marrow mesenchymal stem cels from rats were isolated and cultured using direct adherent method. Then, hTERT eukaryotic expression plasmid, pCIneo-hTERT, was transferred into the cels using liposome transfection method. The hTERT-modified bone marrow mesenchymal stem cels were co-cultured with hepatocytes at 1:1 (observation group), and meanwhile, non-transfected bone marrow mesenchyam stem cels were co-cultured with hepatocytes at 1:1 (control group), and hepatocytes cultured alone served as single culture group. Effects of bone marrow mesenchymal stem cels on hepatocyte proliferation and apoptosis were observed by MTT assay and immunofluorescence staining.
RESULTS AND CONCLUSION:The proliferative rate of hepatocytes was significantly higher in the observation group than the control and single culture groups (P < 0.05), and the survival rate of hepatocytes was significantly higher in the observation group than the single culture group (P < 0.05). Experimental findings suggest hTERT-modified bone marrow mesenchymal stem cels can inhibit hepatocyte apoptosis but promote hepatocyte proliferation, so as to improve hepatocyte function.

Objective The purpose of this study was to investigate the value of chest CT in the evaluation ofchildren with suspected foreign body aspiration. Methods Chest CT was performed in 45consecutive children with suspected foreign body aspiration. The patients were examined with 16-slice Multidetector CT (MDCT) using 100 ～ 150 kV,30 ～ 50 mA, 1 mm section thickness. 1.2 pitch ratio, and 0.6 ～1.0 mm reconstruction interval. multiplanar reformatted (MPR) imaging were carried out after MDCT examinations. Results Chest CT revealed all foreign bodies in 42 of the 45 patients. Three patients with suspected foreign body aspiration did not show evidence of foreign body on CT,and they were treated with antibiotics for one week. These patients avoided unnecessary operations and recovered completely. The other 42 patients had evidence of foreign bodies in their bronchi. We designed the surgerical plan and selected appropriate foreign body forceps based on the CT scans. All of the foreign bodies were removed successfully, and no severe complications were observed. The location, shape, and volume of the foreign bodies found at surgery were consistent with the CT images. Conclusion The diagnosis of foreign body aspiration of the airwayin children can be accomplished by using chest CT. It is often useful in delineating the exact shape, location, volume and form of a bronchial foreign body and can help the surgeon plan for operative bronchoscopy and safe removal of the foreign body.

AIM: The synthesis of sarmentosin. METHODS: Condensation of butane-1,2,4-triol-1,2-acetonide(3) with α-D-glucopyranosyl bromide tetraacetate in the presence of Ag2O and molecular sieves gave the desired β-glucoside 4,which was transformed into sarmentosin via a reaction sequence of 7 steps. RESULTS: The overall yield is 5.8%. CONCLUSION: The first synthesis of sarmentosin(1),a potent natural GPT lowering agent,was achieved.