Objective To assess the median effective dose (ED50) of patient- controlled intravenous remifentanil labor analgesia. Methods Forty primiparas were selected and randomly divided into 5 groups with 8 cases in each group. Patient-controlled intravenous administration of remifentanil was performed among the 5 groups with differrent doses:0.80μg/kg(R1 group), 0.67μg/kg (R2 group), 0.56μg/kg (R3 group), 0.47μg/kg (R4 group), and 0.39μg/kg(R5 group). Probit regression method was adopted to calculate the ED50 and 95% confidence interval of the patient-controlled intravenous remifentanil labor analgesia. The visual analogue scales (VAS) scores following the labor analgesia, pulse oxygen saturation, maternal heart rate, sedation scores and newborn Apgar scores were recorded. Results The ED50 remained at 0.576 μg/kg and the 95% confidence interval was 0.390-0.701μg/kg. The blood pressure and heart rate remained at normal limits, and there were no significant differences among five groups (P>0.05). The newborn 1, 5 min Apgar scores and umbilical arterial pH were no significant differences among five groups (P>0.05). The second stage of labor time, rate of using oxytocin were showed no significant differences among five groups (P>0.05). The VAS scores and sedation scores were no significant differences among five groups (P>0.05). Conclusion The ED50 of patient-controlled intravenous remifentanil labor analgesia is 0.576 μg/kg, and the 95% confidence interval remains at 0.390-0.701μg/kg.

Objective To investigated the neuroprotective effect of PTEN inhibitor BPV on cerebral ischemia-reperfusion injury in rats and its mechanism. Methods Male Sprague-Dawley rats were used to induce a reperfusion model of middle cerebral artery occlusion for 1 h. During the reperfusion, the BPV solution (0. 2 mg/kg daily) or the equal volume of saline was injected intraperitonealy immediately. The neurological deficit scores were conducted at day 1, 3,5, and 7 after ischemia-reperfusion. At day 4, triphenyl tetrazolium chloride staining was used to assess cerebral infarction volume. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) in cortical ischemic border zones. Real-time quantitative polymerase chain reaction was used to detect the expression level of PTEN mRNA. Western blotting was used to detect the expression levels of PI3K, Akt, and p-GSK-3β. At day 7, Bielschowsky silver staining was used to detect the axonal distribution in the ischemic border zone of the striatum. Immunohistochemical staining was used to detect the expression of myelin basic protein (MBP). Results At day 4 after ischemia-reperfusion, the infarct volume (32. 27% ± 1. 71% vs. 45. 49% ± 2. 12% ; P < 0. 001), TNF-α concentration in the cortical ischemic border zones (134. 17 ± 10. 38 pg/ml vs. 264. 17 ± 24. 84 pg/ml; P < ), and PTEN mRNA level (1. 19 ± 0. 08 vs. 2. 50 ± 0. 06; P < 0. 001) in the rats of the BPV group were al significantly lower than those of the normal saline group. The IL-10 concentration (186. 83 ± 10. 83 pg/ml vs. 147. 83 ± 11. 62 pg/ml; P < 0. 001), and the expression levels of PI3K (0. 43 ± 0. 08 vs. 0. 26 ± 0. 06; P = 0. 004), Akt (0. 52 ± 0. 05 vs. 0. 40 ± 0. 04;P = 0. 001), and p-GSK-3β (0. 75 ± 0. 08 vs. 0. 38 ± 0. 06; P < 0. 001) were al significantly higher than those of the normal saline group. At day 7 after ischemia-reperfusion, the neurological deficit score (4. 83 ± 0. 41 vs. 6. 33 ± 0. 52; P < 0. 001) in the rats of the BPV group was significantly lower than that of the normal saline group. The axon densities in the ischemic border zones (35. 51% ± 2. 45% vs. 25. 31% ± 2. 79% ; P < 0. 001) and the expression level of MBP (32. 56% ± 3. 46% vs. 27. 81% ± 4. 18% ; P = 0. 037) were significantly higher than those of the normal saline group. Conclusions BPV has neuroprotective effect for cerebral ischemia-reperfusion injury in rats. Its mechanism may be associated with the up-regulation of PTEN downstream proteins PI3K, Akt and p-GSK-3β expression to regulate inflammatory mediators and reduce the inflammatory response.

Objective To evaluate the effect of Astragalus injection on serum SOD and MDA in patients during supratentorial tumor resection. Methods Twenty-four patients with ASAⅠorⅡ degree, aged 20~55 years old, undergoing supratentorial tumor resection were randomized into the control group (group C) and the Astragalus group (group R), with 12 cases in each group. Patients in group R received 250 mL 0.9% sodium chloride in addition with 20 mL Astragalus injection. Patients in group C received the same amount of 0.9%sodium chloride. Blood samples were taken from jugular venous bulb before induction of anesthesia (T1), intubation (T2), open dura instantly (T3), 1 h after the dura opened (T4), 24 h after the dura opened (T5), and 48 h after the dura opened (T6). The levels of serum SOD and MDA were determined. Results The serum SOD in both group R and group C was lower at T3~6 than that at T1 , but the serum SOD in group R reduced significantly compared with group C (P < 0.05); The serum MDA in both group R and group C at T4~6 was higher than that at T1, but the serum MDA in group R increased significantly compared with group C (P <0.05). Conclusion Astragalus injection can enhance the serum SOD activity and reduce MDA output in patients during supratentorial tumor resection.

Through the study on mathematical logic relation in the syndrome theory of traditional Chinese medicine (TCM), it revealed that the mathematical logic relation among three basic elements in the judgment of syndromes, which were the disease cause (a), disease location (b), disease nature (c) and syndrome (z), was f(z)=a+b+c. The mathematical logic relation between syndrome (z) and symptom (zi) was f(z)= z1+z2+z3+…+zi. The obvious feature reflected by the complexity of syndromes was the construction number of symptoms. During the syndrome differentiation process, the mathematical logic relation between symptom and disease cause, location, nature and syndrome was z1+z2+z3+…+zi =a+b+c= f(z). However, syndromes generally exhibited a nonlinear relationship of point-set topology. After calculation, 79 major single TCM syndromes had a total of more than 6.5×105 different forms. The number within a certain range of syndrome group was approximately 6.6×10100. The super huge data “Googol” may be the root of complex TCM syndromes. The results showed that the researches on “element of syndrome” using the bayesian networks, the neural network algorithm and the algorithm of double levels of frequency power were irrelevant to the mathematical logic relation of the intrinsic relations of syndrome theory. Therefore, “element of syndrome” was a false proposition feature in the study of TCM basic theory. The established syndrome differentiation method with“element of syndrome” as its core was not conformed to the inherent law of TCM theory and clinical practice.

Objective To investigate clinic value of real-time shear wave elastography (SWE) in indentifying benign salivary gland mass through measuring tissue elastic properties of the benign mass in salivary gland.Methods Seventy-four patients with benign salivary gland mass were enrolled.All of them have been obtained the average elasticity modulus of the mass by SWE before surgery,including parotid mixed tumor (22),parotid adenolymphoma (13) and sub maxillary gland mixed tumor (6),adenolymphoma (33).Statistical analysis was done between groups.Results The average elasticity modulus in parotid mixed tumor group and sub maxillary gland mixed tumor group exhibited (133.53 ± 3.35)kPa and (125.57 ± 2.89)kPa respectively.The average elasticity modulus in parotid aden lymphoma group and sub maxillary gland adenolymphoma group exhibited (65.60 ± 2.33)kPa and (64.60 ± 1.93)kPa respectively.There was no significant difference between mixed tumor group and there was no significant difference between adenolymphoma group.There were significant differences between mixed tumor group and adenolymphoma group.ConcLusions The SWE can distinguish salivary gland benign mass from different originates,which can provide more evidence for clinical diagnosis.

Objective This research is aimed to investigate the efficacy and toxicity of icotinib for lung adenocarcinoma pa-tients with poor performance status and unknown EGFR gene status .Methods A total of 27 lung adenocarcinom patients with poor Eastern Cooperative Oncology Group-Performance status(ECOG-PS) and unknown EGFR gene status referred to Chongqing Canc-er Institute from August 2012 to August 2014 were analyzed .Icotinib (125 mg) was orally administered three times per day .Asess the efficacy and adverse reaction ,calculate survival rates .Results Among the 27 patients ,the objective response rate(ORR) and disease control rates(DCR) were 29 .6% and 81 .5% ,respectively .The median progression free survival time was 6 .0 months .A to-tal of 70 .4% of patients had an significant improvment in ECOG-PS scores ,following icotinib treatment (Z= - 2 .157 ,P= 0 .031) . Fatigue ,anorexia and diarrhea were the most frequent adverse reaction ,which defined as grade 1 to 2 rashes .Conclusion Lung ade-nocarcinoma patients with poor performance status and unknown EGFR gene status may benefit from icotinib therapy ,and patients were tolerated well .

AIM: To investigate the functions of GR in the course of hepatic secondary injury after severe multiple injury. METHODS: Rat model was produced by adopting severe thoracic impact injury accompanied with mono-side femur fracture, and glucocorticoid receptor was blocked before severe multiple injury. Hepatic macropathology and alterations under light microscope were examined. Maximal binding volume of glucocorticoid receptor (GR) in hepatic tissue was assayed by radio-ligand binding assay and protein content was assayed by Western blot. RESULTS: Maximal binding volume and protein content of GR were gradually decreased in hepatic tissue after severe multiple injury, obviously lower than that in normal control at 4 h after trauma ( P

Objective To develop a rapid quantitative detecting assay for point-of-care testing ( POCT ) of N-terminal pro-brain natriuretic peptide ( NT-proBNP ) in serum by the fluorescence immunochromatographic technology.Methods Applying double-antibody sandwich assay to establish the quantitative NT-proBNP kit.The performance of quantitative NT-proBNP kit was evaluated by the sensitivity , specificity, accuracy, precision, stability and clinical effectiveness.It compared the research kit and conference kit by the parallel experience in the 1 056(605 males, 451 females)serum specimen collected from Guangdong Provincial People′s Hospital, Sun Yat-sen Memorial Hospital and Children′s Hospital of Zhengzhou between February 2013 to April 2014.Statistical significance of the results was assessed by correlation analysis , linear regression , receive operating characteristic ( ROC) curve analysis , negative and positive consistent.Results The report range of the NT-proBNP kit was 18-35 000 ng/L.The coefficient of variation ( CV) values for low , median and high concentration calibrators respectively were all less than 15%.Common interfering substances in human serum specimens such as bilirubin , triglyceride and cholesterol were found no significant affect on NT-proBNP antigen detection and the CV were no more than 15%.According to the results of detection for calibrators , the shelf time of the NT-proBNP diagnostic kit should be longer than 12 months.The NT-proBNP kit and reference kit had good correlation ( Y=1.048 9X developed reference +121.54, R2 =0.956 6, n=1 056) to detect the target protein through the parallel experiments and the deviation of the quantitative results of clinical serum samples showed no statistical significance (Z=0.88, P=0.379>0.05).The clinical assays of two different diagnostic kits showed good consistency based on the ROC curve evaluation which is compared by two cut-off values (300 and 450 ng/L).The areas under ROC curve were 0.981 and 0.978 respectively.Conclusions A novel NT-proBNP chromatographic quantitative immunofluorescence detection method was developed in this study .The performance evaluation data indicated that the kit is suitable for rapid detection of serum NT -proBNP.

Objective To establish an assay for the detection of Streptococcus pneumoniae by real-time fluorescence quantititive polymerase chain reaction (PCR).Methods Special primers and probe for the autolysin A (lytA)gene were designed.The sensitivity and specificity of primers and probe were studied,and cut-off of cycle threshold was assayed.158 clinical specimens were confirmed by real-time fluorescence quantitative PCR and bacterial culture method.Results Primer and probe design for LytA gene could sensitively detect serotype Streptococcus pneumoniae strains of common pathogenic,and the sensitivity was 100 copies.Among 35 strains of Streptococcus pneumoniae,34 cases were detected to be positive for Streptococcus pneumoniae by real-time fluorescence quantitative PCR,while 1 case was detected to be negative;among 15 strains of non-Streptococcus pneumoniae, all were detected to be negative.Among the 158 clinical sputum specimens,34 cases with Streptococcus pneumoniae were detected by real-time fluorescence quantitative PCR,while only 10 cases with Streptococcus pneumoniae were detected by the culture method.White blood cells count and time in hospital of cases with Streptococcus pneumoniae were higher than those of cases without Streptococcus pneumoniae (P <0.05 ). Conclusion Real-time fluorescence quantitative PCR is a sensitive and specific assay for the detection of Streptococcus pneumoniae.It can be used for the diagnosis of Streptococcus pneumoniae.

Objective To investigate the possible mechanisms of the attribution of psychological stress to the temporomandibular joint disorder(TMD) ,through the evaluation of the animal model and detection of the proinflammatory cytokines in the TMJ.Methods The animal models of communication box were built to mimic the psychological stress.The concentration of the serum Cor and ACTH was detected in the control group, Psychological Stress group ( PS group), and diazepam ( anti-anxiety drug) group ( PS + DI group).The expression of the proinflammatory cytokines IL-1 and IL-6 in the rat TMJ in the different phases of psychologicalstress was detected by RT-PCR.Results The results of the serum concen- tration of Cor and ACTH showed that there was significant difference between the control group and the PS group(P＜0.01 ) ,while no significant difference between the control group and the PS + DI group(P＞0.05).The expressions of IL-1 and IL-6 were comapared in all group.The expressions of IL-1 in CON group were (0.453± 0.021 ) mg/L, (0.439 ± 0.028 ) mg/L and (0.454 ± 0.023 )mg/L.These values were markedly increased compared with those of the PS group(0.981 ±0.024)mg/L, (0.746±0.017)mg/L and (0.510 ±0.016)mg/L respectively, P＜0.01 ) ,but no significant differences compared with PS + DI group(0.549 ± 0.014 ) mg/L, ( 0.498 ± 0.014 ) mg/L and ( 0.444 ± 0.022 ) mg/L respectively, P ＞ 0.05).Similar changes were observed in expressions of IL-6.The expressions of IL-6 in the CON rats were (0.525 ±0.028)mg/L,(0.515 ±0.028)mg/L and (0.518 ±0.022)mg/L,respectively,while those of PS group were(0.820 ± 0.023 ) mg/L, (0.694 ± 0.019 ) mg/L and (0.579 ± 0.015 ) mg/L, respectively, which were significan- tly higher in the PS groups(P＜ 0.05 ).But there were no significant differences between CON group and PS + DI group( (0.599 ±0.015)mg/L, (0.541 ±0.015)mg/L, (0.487 ±0.008)mg/L respectively, P＞0.05).Conclusion The psychological stress can play important role in the formation of TMD.