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: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 to evaluate the clinical efficacy and safety of ADSCs infusion in patients with type 2 diabetes mellitus(t2DM). Methods Autologous ADSCs were cultured and identified. totally 48 cases of type 2 diabetes patients were divided into two groups:24 cases in A group re-ceived ADSCs and conventional treatment,while the other 24 cases in B group received conventional treatment. With 15 months′follow-up,FPG,2h-PGh,HbA1c,FC-P,AUCC,insulin medication changes and security on post-treatment 3,6,12 and 15 months were calculated. Results the AD-SCs which cultured met the clinical application of standards. FPG,2h-PGh and HbA1c in both groups were significantly decreased,and the values in A group were more impressive than B. there were significant improvement in FC-P,AUCC and insulin of A group compared with B group. there was not treatment related adverse events. Conclusion the clinical data demonstrate that the treatment with ADSCs can improve metabolic control and beta cell function in patients with t2DM. Moreover,the safety of the treatment method was considerable.

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 compare magnetic beads kit,agrose gel recovery kit and heparinase I three methods to purify the micro DNA from crude heparin, then use q-PCR to identify the species origins and select the best method.Methods Using magnetic beads kit,agrose gel recovery kit and heparinase I to purify micro DNA from crude heparin and combined the porcine,bovine and ovine identification kits to identify the species origins and conformed the minimum detection limit of different percentage of ovine crude heparin in porcine crude heparin.Results Three pretreatment methods all can solve the pretreatment difficulties and we found that the haparinase was the best method; the minimum detection limit was 0.01%of ovine crude heparin in porcine crude heparin.Conclusion The heparinase method is the best pretreatment method and can successfully solve the pretreatment difficulties.Heparinase combine the porcine, bovine and ovine identification kits can identify the species origins from crude heparin.

Objective To evaluate the relationship between abnormal lipid metabolism and the pathogenesis of pregnancy induced hypertension (PIH). Methods A prospective cohort study was carried out in 500 pregnant women. They were followed in the antenatal care outpatient clinic. Amcing them. 20 cases of mild PIH, 23 cases of moderate and severe PIH, 30 cases of normal pregnant women were studied. Serum lipid levels were measured before and after the onset of PIH (baseline and follow up). Data were analysed with F test. Results TG, VLDL, LP(a),FFA and FFA/Alb levels in all patients of PIH were significantly higher than those in the control group( P

BACKGROUND:Evaluation plan for the neuro-musculo-skeletal system model and motor function was little.However,the three-dimensional gait analysis can transfer qualitative analysis and object description which widely used in orthopedics and rehabilitation medicine to quantitative evaluation with more objective and precise.OBJECTIVE:To evaluate gait kinematics and kinetic changes after total knee replacement based on 12 months follow up using three-dimensional gait analysis.DESIGN,TIME AND SETTING:The comparative observation and case-control study was performed in the Gait Analysis Room of the Department of Rehabilitation Medicine in the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University from January 2007 to May 2008.PARTICIPANTS:Ten patients with knee osteoarthritis following total knee replacement were chosen as treatment group;concurrently,ten patients whose baseline data were matched with the treatment group without problems in nerve,muscle,skeletal system and equilibrium were selected as the control group.METHODS:Ten patients in the treatment group underwent rehabilitation training,then compared time-distance,kinematic,and mechanical parameters which were measured at 3,6,12 months after total knee replacement with the control group.MAIN OUTCOME MEASURES:Time-distance parameter,kinematic parameter,mechanical parameter and knee functional scores.RESULTS:Pace,step frequency,gait speed,and time of injured leg standing were notably decreased,while time of uninjured leg standing,duration of gait cycle were obvious prolonged compared with the control group(P

Objective To evaluate the value of MRI in diagnosing the bucket handle tear (BHT) of the knee meniscus.Methods Eighty four knees which underwent both MRI and arthroscopy (AS) examinations were analyzed. Results of AS were used as golden standard to evaluate the results of MRI. The evaluating criteria included primary reports, central displaced fragments of meniscus (CDFM), double posterior cruciate ligament sign (DPCLS) and the absent bow tie sign (ABTS). Results For MRI diagnosing BHT, the sensitivity and specificity of primary reports were 43% and 87%, respectively; the sensitivity and specificity of CDFM were 72% and 87%, respectively; the sensitivity and specificity of the DPCLF were 31% and 97%, respectively; and the sensitivity and specificity of the ABTS were 71% and 69%, respectively.Conclusions When MRI was applied to diagnose BHT, the CDFM had higher sensitivity and specificity, while the ABTS had higher sensitivity and lower specificity. The DPCLF had the highest specificity and the lowest sensitivity.

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.