Objective To compare the effect of target-controlled infusion (TCI) and manual controlled infusion (MCI) of propofol in out-patients undergoing gastroscopy with the sedative depth monitoring by bispectral index (BIS).Methods Forty-eight patients with physical status Ⅰ-Ⅱ scheduled for an elective gastroscopy under general anesthesia were enrolled in this study. All patients were randomly divided into two groups, group T (n=24) and group M (n=24). Before induction, all patients were received a single dose of fentanyl (1 ?g/kg) intravenously. With the monitoring of BIS, the gastroscope was inserted in by the time of BIS value less than 60. Patients in group T received a propofol infusion with the initial plasma concentration of 1 ?g/ml and then the dose was titrated upward by 0.5 ?g/ml each time till the BIS values was less than 60 and then propofol was maintained at a concentration of 2-3 ?g/ml. In the group M, propofol was infused at a rate of 4 g/h until the BIS was less than 60 and then propofol was administrated at a rate of 4-6 mg?h -1?kg -1. During the period of gastroscopy, the sedation depth was maintained by BIS value of 40 to 60. The infusion was stopped by the end of biopsy in both groups. The time from induction to put in the endoscopy, the examination maintenance and the duration of anesthesia, the induction and total amounts of propofol infused were recorded and the average infusion rate was calculated. Results The induction time was significantly shorter in group T than in group M. The duration of examination, time from the induction to opening the eyes and time from induction to the orientation were not significantly different between two groups. Propofol consumption for induction and maintenance was much higher in group M than in group T. The average infusion rate was not significantly different in both groups. The BIS values were almost same at the beginning of gastroscopy and at opening the eyes. The plasma concentration and effect-site concentration were (4.25 ?0.94) ?g/ml and (1.78?0.66)?g/ml at the time of beginning of gastroscopy; while being (1.34?0.39) ?g/ml, ( 1.77?0.40) ?g/ml at the time of opening the eyes. There were 3 cases in group T and 7 cases in group M had sidereactions during the gastroscopy, respectively, but all were mild. Conclusions BIS could be a good sedative depth monitor in total intravenous anesthesia in out-patients gastroscopy. Target-controlled infusion system can help us to get accurate depth of anesthesia quickly and stably, and decrease the consumption of propofol and side effects as well.

Objective Analyse the causes,diagnosis and treatment for delayed hemorrhage after distal radical gastrectomy.Methods Retrospective study on 45 patients combined with intro-abdominal hemorrhage after distal radical gastrectomy from January 2008 to June 2013.Results Thirteen patients combined with delayed hemorrhage in these 45 patients,all of 13 patients had intro-abdominal hemorrhage in 1week to 4 weeks after operation.And 5 of the 13 patiens were intermittent intro-abdominal hemorrhage 1 week after operation,these patients were demonstrated the blood come from gastroduodenal artery pseudoaneurysm fracture by CT and DSA examine,and they were cured by interventional embolization.Other 8 patients were marginal ulcer hemorrhage diagnosed by gastroscope,and they stoped bleeding with the help of gastroscope.Conclusions The causes of delayed hemorrhage after distal radical gastrectomy were complicated,and CT,DSA and endoscope can use for diagnosis.What was more,interventional embolization and endoscope were helpful for curing the intro-abdominal hemorrhage,avoiding re-operation.

Adult ; Aged ; Aged, 80 and over ; Female ; Helicobacter Infections ; metabolism ; Helicobacter pylori ; classification ; pathogenicity ; Humans ; Lymphatic Metastasis ; Male ; Microvessels ; pathology ; Middle Aged ; Neoplasm Invasiveness ; Neovascularization, Pathologic ; microbiology ; pathology ; Stomach Neoplasms ; blood supply ; metabolism ; microbiology ; Vascular Endothelial Growth Factors ; metabolism

Objective To investigate the expression of Dickkopf-3 (Dkk-3) in esophageal cancer and normal esophageal tissue and the relationship between Dkk-3 expression and the biological behaveior of esophageal cancer. Methods Immunohistochemical method of S-P was used to examine Dkk-3 expression in 69 cases of esophageal squamous cell carcinoma and 5 cases of normal esophageal tissue with non-tumor tissue microarray and the results were analyzed and correlated with their clinical and pathological features. Results Positive Dkk-3 expression was observed in 65.7% (44/67) of the esophageal squamous cell carcinoma cases, but only one of the five cases with normal esophageal tissue showed positive microvascular expression of Dkk-3. In cases with positive expression of Dkk-3 significant differences were found in fiber membrane infiltration, depth of invasion, lymph node metastasis and TNM staging (P < 0. 05), while no significant differences were found in the age, gender and pathological grading (P > 0. 05). Conclusions The upregnlation of Dkk-3 expression in esophageal squamous cell carcinoma may contribute to tumor invasion and metastasis.

OBJECTIVETo promote development and utilization of Ophiocordyceps gracilis in xinjiang and provide basic data for researching and sustainable developing medicine fungus related to O. gracilis.

METHODA white strain SFYT002 isolated from the sclerotium of O. gracilis in Xinjiang was researched by morphological observation, ITS and 18SrDNA sequencing. The ITS and 18SrDNA sequences of the strain were determined, BLAST was compared with the other sequences of Tolypocladium in GenBank. The phylogenetic trees of ITS and 18SrDNA sequences were analyzed in Tolypocladium. In addition, the filter paper method was used to study the antibacterial effects.

RESULTThe main morphological characters of this strain were white cotton-like colonies, phialide with inflated base, drastically sharping with partially bending tips, small and transparent budding spores with being always assemble to spearhead and globular, subglobular or ellipse conidiospores. The phylogenetic trees of ITS and 18SrDNA sequences were constructed and analyzed in Tolypocladium. It was resulted that Tolypocladium was confirmed to be monophyletic, and the strain SFYT002 was the same as the systematic position of others of T. inflatum. Meanwhile, the antibacterial test was performed against the 4 common pathogenic bacteria. It was showed that both fermentation and its extracts of different polar from this strain possessed good anti-bacteria capacities.

CONCLUSIONThe strain SFYT02 was identified as T. inflatum, and inhibited effectively growth of bacteria.

Anti-Bacterial Agents ; isolation & purification ; pharmacology ; China ; DNA, Fungal ; genetics ; DNA, Intergenic ; genetics ; Hypocreales ; genetics ; isolation & purification ; physiology ; Medicine, Chinese Traditional ; methods ; Mycelium ; Phylogeny

Objective:To explore the clinical effect ofpaishitang combined with tamsulosin hydrochloride on the patient with up per urinary calculi after extracorporeal shock wave lithotripsy (ESWL).Methods:120 cases with upper urinary calculi in our hospital from January 2015 to September 2016 were selected and divided into two groups according to the random number table,60 cases in each group.ESWL was given to both groups of patients and provided with tamsulosin hydrochloride postoperation,then paishitang were additionally given to the patients in the observation group.The clinical effect and changes of serum creatinine (Scr),neutrophil gelatinase as sociated lipocalin (NGAL),cystatin C (Cys-C) and glomerular filtration rate (GFR) levels before and after treatment were compared between two groups.Results:The total effective rate of observation group was 96.67％,which was 86.67％ in the control group,no signifi cant difference was found in the total effective rate between the two groups(P＜0.05).The stone discharge rate was 95.00％ in the observation group,which was significantly higher than that of the control group (P＜0.05);the incidence rate of renal colic was 6.67％,which was significantly lower than that of the control group(P＜0.05),the stone discharge time and the duration of hematuria were significantly shorter than those in the control group (P＜0.01).There was no significant difference in the recurrence rate between the two groups within one year (P＞0.05).The serum NGAL and Cys-C levels of both groups were gradually increased while the GFR levels were gradually decreased on the 1st,2nd day postoperation,but all the index mentioned above gradually recovered on the 3rd day postoperation.The levels of NGAL and Cys-C in the observation group were significantly lower than those in the control group on the 1st,3rd day postoperation while the GFR was significantly higher in the observation group than those of control group on the 1st,3rd day postoperation(P＜0.01).No significant difference was found in the Scr at different time points postoperation between two groups(P＞0.05).Conclusion:Paishitang combined with tamsulosin hydrochloride had significant clinical effect on thpatient with upper urinary calculus after ESWL and could effectively improve the renal injury induced by ESWL.

Objective To detect the expression of BAT2L protein in developmental brain of rats.Methods Expression,distribution and location of BAT2L protein in developmental brain rats on embryonic day 18,postnatal days 1,7 and 15 and in adult at different time points were detected by Western blotting analysis,immunohistochemistry and immunofluorescence,respectively.Results Western blotting showed that the BAT2L protein expression level was higher in brain of rats on embryonic day 18,postnatal days 1 and 7 than on postnatal day 15 and in brain of adult rats.Immunohistochemistry and immunofluorescence showed that the BAT2L protein was distributed and located in cell membrane and cytoplasm of neurons but not in nuclei and extra-cellular space.Positive neurons were widely distributed in cerebral and cerebellar cortex,hippocampus and cerebral ganglion.The morphology of neurons was significantly different in newborn and adult rats.Positive prominences and branches of certain neurons were found in brain tissues of newborn rats but hardly in those of adult rats.Conclusion BAT2L protein is specifically expressed in cell body,membrane and prominence of neurons in brain of rats.

Objective To study the effect of lincomycin hydrochloride on the intestinal mucosal barrier of mice. Methods A total of 24 mice were equally and randomly divided into normal control group and model group. Mice in the model group were administered with 8 mg · kg-1 · d-1 of lincomycin hydrochloride through gastric lavage for 3 days to establish the model of intestinal mucosa injury and alteration of intestinal flora in mice. The intestinal flora was tested,bacterial translocation was analyzed,and mucosa permeability was determined by measuring diamine oxidase( DAO)in plasma. Results Lincomycin hydrochloride led to alteration of intestinal flora in mice after oral administration for three days in mice. The aerobes translocation rate was 16. 7% and 52. 3% in the normal and model groups,respectively(P〈0. 01). The anaerobes translocation rate was 8. 3% and 68. 2% in the normal and model groups,respectively(P〈0. 01). The plasma concentration of diamine oxidase was increased from(2. 08±0. 05)mg·mL-1 in the normal group to(7. 18±0. 10)mg·mL-1 in the model group(P〈0. 01). Conclusion Lincomycin hydrochloride damages intestinal mucosal barrier in mice.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system for determine the margin of early gastric cancer and precancerous lesions.Methods From February 2008 to October 2011,a total of 51 patients with early gastric cancer or high-grade intraepithelial neoplasm who received ESD were enrolled and randomly divided into experimental group to determine lesion margin by FICE (n =26) and control group to identify lesion margin by indigo carmine (n =25).Histological complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.Results The histological complete resection rate,acute minor bleeding rate and post-ESD abdominal pain rate in experimental group were 2.3％ (24/26),88.5％ (23/26),15.4％ (4/26) and 73.1％ (19/26),which were not significantly different from those of control group,i.e.,92.0％ (23/25),84.0％ (21/25),12.0％ (3/25)and 72.0％ (18/25) (P＞0.05).The mean operation time of in experimental group was shorter than that of control group (P ＜ 0.05).No massive bleeding,delayed bleeding or perforation occurred in either group.Follow-up showed no local residue or recurrence.Conclusion FICE is safe and effective to determine the tumor demarcation of early gastric cancer and high-grade intraepithelial neoplasm,and needs less operation time.

Objective Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) was performed for diagnosis and treatment of the pelvic Lesions and safety of this method were evaluated.Methods EUS-FNA was performed in 52 patients with pelvic Lesions selected by EUS,CT or MRI between March 2009 and June 2012.Both 19 and 22 gauge needles were used for EUS-FNA.The tissue specimens were analyzed by cytologic or histologic examination.The pelvic cystic lesions were drained and in which purulent lesions were lavaged with Metronidazole repeatedly.Results All patients recieved fine needle biopsy of the pelvic lesions.Among the 52 lesions,there were 42 solid lesions,10 cystic lesions.In solid lesions,cytology and pathology demonstrated malignant tumors in 28 patients,3 cases of malignant stromal tumors,3 cases of Inflammatory mass cases,2 cases of lymphoma,1 case of dermoid cyst,5 cases of other.In cystic lesions,2 cases of serous cystadenoma,perirectal abscess in 8 cases.6 purulent lesions were lavaged with Metronidazole repeatedly.Diagnosis rates of samples for immunohistology remained similar between 22 gauge and 19 gauge needles (P ＞0.05).During the operation,8 cases of perirectal abscess patients have different degree of pain.There were no other complications after the procedures except one patient suffering from fever.Conclusion EUS-guided FNA is minimaly invasive,a safe and accurate method for diagnosis of pelvic lesions.