Objective To compare the effects of dexmedetomidine and fentanyl on the median effective concentration (EC50) of propofol required for inducing respiratory depression.Methods ASA physical status Ⅰ or Ⅱ patients,aged 30-50 yr,weighing 50-75 kg,with body mass index of 22-28 kg/m2,scheduled for elective gynecological surgery under general anesthesia,were randomly divided into 3 groups:control group (group C),dexmedetomidine group (group D) and fentanyl group (group F).Dexmedetomidine 0.5 μg/kg and fentanyl 1.5 μg/kg in 10ml of normal saline were infused over 10 min in D and F groups,respectively,while the equal volume of normal saline was given in group C.Lidocaine was injected intravenously followed by target-controlled infusion of propofol.In C,D and F groups,the initial target concentration of propofol was 2.5,2.1 and 1.1 μg/ml,respectively,and the ratio between the two successive concentration gradients was 1.1.It was defined as positive when patients developed respiration depression.EC50 and 95％ confidence interval of propofol inducing respiratory depression were calculated.BIS values and OAA/S scores were recorded after admission to operating room (T0),after infusion of dexmedetomidine,fentanyl or normal saline,at 5 and 10 min after the start of propofol target-controlled infusion and after the target effect-site and plasma concentrations were balanced.Results EC50 (95％ confidence interval) of propofol required for inducing respiratory depression was 2.72 (2.55-2.91),2.15 (2.05-2.27)and 1.17(1.08-1.25) μg/ml in C,D and F groups,respectively.Compared with group C,the EC50 was significantly decreased in D and F groups and the BIS values and OAA/S scores were increased in group F (P ＜ 0.05),and no significant changes were found in the BIS values and OAA/S scores in group D (P ＞ 0.05).The EC50 was significantly decreased and the BIS values and OAA/S scores was increased in group F as compared with group D (P ＜ 0.05).When the BIS values reached 65 or OAA/S scores was 3,the effect-site concentration was significantly lower in D and F groups than in group C (P ＜ 0.05).In C,D and F groups,the percentage of patients who developed upper airway obstruction caused by glossocoma was 100％,60％ and 20％,respectively,and who developed decreased respiratory rate or apnea (RR≤ 8 bpm or respiratory arrest time≥ 15 s) was 0,40％ and 80％,respectively.Conclusion Although dexmedetomidine induces no respiratory depression,dexmedetomidine can enhance the potency of propofol required for inducing respiratory depression and the prtency is lower than that of small-dose fentanyl.

OBJECTIVETo investigate the protective effect of dexmedetomidine (Dex) preconditioning against ischemia/reperfusion (I/R) injuries in isolated rat hearts and its relation to mitochondrial permeability transition pore (mPTP) and mitochondrial ATP-sensitive K(+) channel (mitoKATP).

METHODSThe hearts of male SD rats were isolated to mount on the Langendorff apparatus and subjected to 30 min global ischemia followed by 120 min reperfusion. The isolated hearts were treated with Dex (10 nmol/L) before ischemia for 15 min. The left ventricular hemodynamic parameters,coronary flow (CF) and the lactate dehydrogenase (LDH) release in the coronary effluent at 5 min reperfusion were measured. The formazan content was assayed to determine the myocardial viability at the end of reperfusion.

RESULTSCompared with normal controls, I/R markedly decreased the left ventricular developed pressure and CF during the whole reperfusion period and the formazan content; while the left ventricular end diastolic pressure and LDH release were significantly increased. Dex preconditioning markedly improved the myocardial viability and cardiac function (P<0.01), which were reversed by the treatment with both atractyloside (20 μmol/L before ischemia), an opener of mPTP, and 5-hydroxydecanoate (100 μmol/L at the beginning of reperfusion), an inhibitor of mitoKATP, for 20 min.

CONCLUSIONDex has protective effect against I/R injuries in isolated rat hearts, which may be related to inhibiting the opening of mPTP at the beginning of reperfusion and activating mitoKATP before ischemia.

Animals ; Dexmedetomidine ; pharmacology ; In Vitro Techniques ; Ischemic Preconditioning, Myocardial ; Male ; Mitochondrial Membrane Transport Proteins ; drug effects ; Myocardial Reperfusion Injury ; physiopathology ; prevention & control ; Potassium Channels ; drug effects ; Rats ; Rats, Sprague-Dawley

Objective To explore the iodine nutritional status of people after adjusting iodine content in iodized salt in Anhui Province. Methods In 2014, 30 counties (cities, districts) were selected in Anhui Province according to the probability ratio sampling method (PPS), and one school was selected in each county (city, district), and 50 children aged 8 - 10 years were selected in each school. Urine and household salt samples were collected, urine and salt iodine levels were tested, and thyroid was examined using B-ultrasound. In the township where the school was located, 20 pregnant women's urine samples and household salt samples were collected for urine and salt iodine detection. The salt iodine level was measured by direct titration, Chuan salt and other fortified salt iodine levels were determined by arbitration method (GB/T 13025.7-2012). Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry (WS/T 107-2006). Results A total of 1575 children's household salt samples were collected, the median salt iodine was 23.77 mg/kg, the qualified iodized salt consumption rate was 93.65％(1475/1575); 600 household salt samples were collected from pregnant women, the salt iodine median was 23.50 mg/kg, the consumption rate of qualified iodine salt was 96.33％( 578/600 ) . A total of 1575 urine samples were collected from children, the median urinary iodine was 242.20 μg/L; six hundred urine samples were collected from pregnant women, and the median urinary iodine was 158.15μg/L, 43.33％(13/30) of the counties (cities, districts) pregnant wowen median urinary iodine < 150 μg/L. A total of 1575 thyroid glands were examined in children aged 8 to 10 years, and the thyroid enlargement rate was 3.75％ (59/1575). Conclusion The iodine nutrition of children aged 8 - 10 years in Anhui Province is higher than the appropriate level, but the iodine is not in the excessive state, and the iodine nutrition of pregnant women in some counties (cities, districts) is insufficient.

OBJECTIVE: To compare the accuracy of five warfarin-dosing algorithms and warfarin stable dose model (2.5 mg/day) for Shandong population. METHODS: One hundred and twenty five patients who achieved stable warfarin dose were enrolled. Clinical and genetic data were used to evaluate the value of each algorithm by calculating the percentage of patients whose predicted warfarin dose was within 20% of the actual stable therapeutic dose and mean absolute error (MAE). RESULTS: The frequency of patients with CYP2C9*1/*1, CYP2C9*1/*3 and CYP2C9*1/*2 genotype was 92.00%, 7.20%, 0.80%, respectively. That of VKORC1-1639 AA, AG and GG genotype was 82.40%, 15.20%, 2.40%, respectively. CYP4F2*1/*1, *1/*3, *3/*3 genotype was 50.40%, 39.20%, 10.40%, respectively. With the same genotypes for other loci, patients who carried at least one VKORC1-16398G mutant allele had increased warfarin stable daily dose compared with VKORC1-1639AA. Compared with CYP4F2*1/*1, those carrying at least one CYP4F2*3 mutant allele had warfarin stable daily dose increased by 5.9%-13.00%. The percentage of ideal prediction calculated from IWPC model (59.20%), Huang model (57.60%) and Ohno model (52.80%) were higher than others. The MAE were 0.35 (95%CI: 0.11-0.49), 0.15 (95%CI: 0.10-0.32), 0.39 (95%CI: 0.12-0.51), respectively. CONCLUSION The polymorphisms of CYP2C9, VKORC1 and CYP4F2 genes can influence the stable dose of warfarin in Shandong population. IWPC algorithm is suitable for guiding the use of warfarin in this population.
Anticoagulants ; administration & dosage ; Aryl Hydrocarbon Hydroxylases ; Cytochrome P-450 CYP2C9 ; genetics ; Cytochrome P450 Family 4 ; genetics ; Dose-Response Relationship, Drug ; Genotype ; Humans ; Models, Theoretical ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; administration & dosage

Objective:To analyze the clinical characteristics and diagnosis and treatment experiences of Langerhans cell histocytosis (LCH) in skull.Methods:Sixteen patients with cranial LCH admitted to our hospital from January 2015 to December 2019 were chosen in our study. Their clinical data, diagnosis and treatment procedures and prognoses were retrospectively analyzed.Results:Among the 16 patients, there were 13 males and 3 females, aged from 1 to 31 years. The clinical manifestations included space-occupying lesions of the skull; and imaging showed bone destruction of the skull, with or without involvement of other bones or organs. All patients were pathologically confirmed to have LCH after surgical total resection of the lesions. Routine whole-body bone scanning was performed after surgery: one was found to have local abnormal metabolic activity and received local radiotherapy; 8 were combined with other bone or organ involvement, and received chemotherapy. All the patients were followed up for 1-5 years, and no recurrence was found, and no one died.Conclusion:Good prognosis can be achieved in cranial LCH patients accepted resection by giving additional treatment according to the results of postoperative reexamination and combination use of standardized radiotherapy and chemotherapy.

Objective:To establish an automatic colorimetric method for determination of iodine in drinking water by enzyme-labeled instrument (hereinafter referred to as this method).Methods:The water iodine was measured in the range of 0 - 10 μg/L and 0 - 100 μg/L, experiments were carried out on linear relationship, detection limit, precision and accuracy of this method. And the results were compared with the National Reference Laboratory for Iodine Deficiency Disorders recommended arsenic cerium catalytic spectrophotometry method.Results:In the range of 0 - 10 μg/L and 0 - 100 μg/L, all│ r│ > 0.999 0, the detection limits were 0.6 and 1.1 μg/L (samples were 200 and 100 μl), respectively; the relative standard deviation ( RSD) of water samples of low, medium and high iodine mass concentrations were < 3%, the recovery rates ranged from 92.5% to 108.3% and 93.2% to 108.9%, with a total average recovery of 100.0% and 100.3%, respectively. This method and arsenic cerium catalytic spectrophotometry method were used to detect 40 water samples in the range of 0 - 10 μg/L and 0 - 100 μg/L, there was no significant difference in water iodine content between the two methods ( t = 0.99, P > 0.05). Conclusion:This method has good linear curve relationship for determination of water iodine content, good precision and high accuracy, and it is suitable for wide application.

Gene editing technology has been a hotspot in the field of biotechnology. CRISPR/Cas systems are efficient gene editing tools because of its specificity, simplicity and flexibility, these features enabled the rapid application of CRISPR/Cas systems in a variety of organisms. Moreover, the combination of transcriptional activator with dead Cas protein can achieve specific regulation of gene expression at the transcription level, which has made important contributions to the development of biotechnology in medical and agriculture. Overexpression of foreign genes is a common method to verify gene function and regulation. However, due to the limitation of vector capacity, it is difficult to achieve overexpression of multiple genes. CRISPR/Cas9 activation system can regulate the expression of multiple genes under the guidance of different guide RNAs to verify gene functions at the regulatory level. This review summarizes the composition of the CRISPR/Cas9 activation system and different activation strategies, and summarizes solutions for excessive activation. It may facilitate the application of CRISPR/Cas9 activation system in genetic improvement of cotton and herbicide resistance research.
Biotechnology ; CRISPR-Cas Systems/genetics* ; Gene Editing ; Phenotype ; RNA, Guide, Kinetoplastida/metabolism*

The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

Macrophages play an important role in material-related immune responses and bone formation, but the functionality of macrophage-derived extracellular vesicles (EVs) in material-mediated bone regeneration is still unclear. Here, we evaluated intracellular communication through small extracellular vesicles (sEVs) and its effects on endogenous bone regeneration mediated by biomimetic intrafibrillarly mineralized collagen (IMC). After implantation in the bone defect area, IMC generated more neobone and recruited more mesenchymal stem cells (MSCs) than did extrafibrillarly mineralized collagen (EMC). More CD63
Biomimetics ; Bone Regeneration ; Cell Differentiation ; Collagen ; Extracellular Vesicles ; Macrophages ; Osteogenesis