Objective To investigate effects and safety of dexmedetomidine on the prevention of abnormal mental in patients after liver transplantation.Methods 160 patients after liver transplantation were randomly divided into the two groups using the drawing method:midazolam group(n =80),dexmedetomidine group(n =80),compared the two groups of patients with general,mental abnormality and the occurrence of adverse reactions.Results There were no significant differences in the general situation (gender,age,postoperative ventilator time,ICU stay time,oper-ation time,blood FK506 concentration,APACHEII score 24 hours after operation)of the two groups of patients (P >0.05),the spirit of the abnormal rate of the observation group was lower than that of the control group (P =0.009), incidence of hypotension and hypertension in the observation group was higher than that in the control group (P =0.035,0.029).Conclusion Dexmedetomidine can effectively reduce the postoperative mental disorders in patients in the early stage after liver transplantation.

Adolescent ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Fiber Optic Technology ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male

Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pierre Robin Syndrome ; diagnosis ; physiopathology ; therapy ; Prognosis

As the major commercial source of natural rubber,Hevea brasiliensis attracts much attention.However,the heterozygous nature,long breeding cycle are strong limitations for conventional breeding.While genetic engineering,which can be used to widen the germplasm base and produce desirable agronomic traits quickly and efficiently,offers a viable alternative approach to complement traditional breeding.Comprehensive analysis indicates that in the past two decades,with calli derived from immature anther or integumental tissues of immature fruit as receptors,both biolistic and Agrobacterium-mediated transformation methods were employed for developping rubber genotypes with improved latex yield,tolerance to tapping panel dryness syndrome,producing high-value recombinant proteins,etc.Being recalcitrant to tissue culture,the transformation efficiency of Hevea is comparatively low,and the procedures are still needed to optimize.Finally,breeding objectives and strategies to improve transformation efficiency were also proposed in the review.

Background Recently,there were many studies on corneal innervations during mammalian development.However,there were fewer studies on discussing corneal innervations before and after mouse eye openings.Objective The present study was to investigate the change in the regulation of corneal nerve fiber length and density before and after mouse eye openings to offer a basis for clinical research in human.Methods Thirty SPF C57BL/6 mice were divided into postnatal 1 day(P1 d),P7 d,P13 d(1 day before eye opening),P14 d(eye halfopened),P17 d(1 day after eye opening)and P23 d(7 day after eye opening)groups,with 5 mice and 10 eyes for each group.Entire corneal stretches were prepared and immunostaining with an anti-neuron-specific β-Ⅲ tubulin antibody was performed to label the corneal nerve fibers.Confocal microscopic pictures from the corneal dorsal-nasal region (DN),dorsal-temporal(DT),ventral-nasal region(VN)and ventral-temporal(VT)were taken using Delta Vision Core.From these pictures,the mouse corneal area,total length and density of nerve fibers in the 4 regions were calculated.The use of the animals complied with Statement of ARVO.Results Corneal areas of P1 d,P7d,P13 d,P14 d,P17 d and P23 d mice were(0.404±0.007),(1.362±0.154),(1.573±0.080),(1.603±0.046),(1.847±0.052),(2.445±0.798)mm2,respectively ; the total lengths of nerve fibers were(3.718±1.044),(19.065±3.350),(23.687±0.907),(27.309±2.477),(31.989±3.976),(41.214±1.573)mm,respectively ; the densities of nerve fibers were(9.592±1.138),(14.506±1.908),(15.088±1.241),(16.772±1.897),(16.821±2.102),(17.660±1.216)mm/mm2,respectively,all showing significant increases with age(F =22.906,P =0.000 ; F =0.424,P =0.000 ; F =2.375,P=0.000).A positive correlation of the increasing corneal areas and increasing lengths of nerve fibers was found(r=0.983,P＜0.01).Nerve fiber densities in the four corneal regions significantly increased with age(DN region:F =0.159,P =0.000 ; DT region:F =2.1 72,P =0.001 ; VN region:F =1.998,P =0.000 ; VT region:F=2.352,P=0.000).From P13 d to P14 d,the corneal nerve fiber densities in the DN region decreased by 6.0％ without significant difference(t =0.589,P =0.572); and the corneal nerve fiber densities in the DT region,VN region and VT region decreased by 4.6％,5.5％ and 0.1％,respectively,without significant difference from P14 d to P17 d(t=0.549,P=0.596;t=0.701,P=0.501 ;t=-0.100,P=0.919).Conclusions The development of nerve fibers in the whole cornea or the four corneal regions is influenced by eye opening in mouse to various extents.From P13 d to P14 d,the corneal nerve fiber densities in the DN region decreased by 6.0％ without significant difference.From P14 d to P17 d,the corneal nerve fiber densities in the DT region,VN region and VT region decrease by 4.6％,5.5％ and 0.1％,respectively,without significant difference.Afterwards,the growth of nerve fibers increased in pace and the growth rate is recovered.

Objective:To utilize MRI and plain films to observe the changes of soft tissue structures in patients with developmental dysplasia of the hip (DDH) after closed reduction, and explore the concentric reduction rate, the "docking" rate and the femoral head necrosis rate after reduction.Methods:Retrospective analysis of unilateral completely dislocated DDH patients with closed reduction and spica casting in our hospital from October 2012 to July 2018. MRI was performed on the day of closed reduction and every 2-3 months after operation. Pelvic plain films were performed before operation and follow-up. The labro-chondral complex (LCC) of the hip was divided into 4 types on MRI images, and the reliability and repeatability of LCC classification were evaluated by intra-class correlation coefficient. Trend chi-square test or Fisher exact probability method was used to analyze the variation of thickening rate of ligamentum teres, transverse ligaments and pulvinar during MRI follow-up, and the difference of cartilaginous acetabular head index was evaluated by analysis of variance of repeated measurements or Mann-Whitney U test. The concentric reduction rate of the femoral head after performing closed reduction, the "docking" rate of the femoral headwhen the cast was changed for the last time were analyzed, and the necrosis rate of the femoral head were followed up for 18 months or more after reduction.Results:A total of 63 DDH patients (63 hips) with closed reduction were included. Intra-class correlation coefficient of LCC classification was 0.84 between observers (95%CI: 0.74-0.91) and 0.94 within observers (95%CI: 0.90-0.97) . Most LCC classifications were type 4 on the day of CR (93.7%, 59/63) , and return to normal (type 1 classifications) at the second follow-up (50.9%, 28/55). ligamentum teres, transverse ligaments and pulvinar were hypertrophic (94.5%-100%) on the day of CR, and decreased to 10.9%-12.7% at the second follow-up, which had statistically differences ( χ2=88.6; χ2=86.4; χ2=97.9, P<0.05). The cartilaginous acetabular head index was 68.1±12.1 on the day of CR, and increased to 84.4±7.0 at the second follow-up, which had statistically difference ( Z=-3.15, P=0.002). 58.7% femoral heads were "docking", 8.6% femoral head had necrosis. Conclusion:The abnormal soft tissue structures in the hip joint mostly recovered gradually after closed reduction, and 60% femoral heads could be docked, the short-term risk of the femoral head necrosis was low.

OBJECTIVETo analyze the factors which influence the safety and prognosis of aorta replacement combined with coronary artery bypass grafting (CABG) for thoracic aortic aneurysm associated with coronary artery disease.

METHODSFrom May 1982 to October 2002, 67 patients with thoracic aortic aneurysm were admitted, and 24 of them combined with CABG. Of the 24 patients, 9 received descending aorta replacement combined with CABG, and the other 15 received the ascending aorta replacement combined with CABG. The treatment results were compared with the other 43 patients only undergoing the thoracic aortic replacement.

RESULTSThe mortality rate of the patients with aorta replacement combined with CABG was 13% (3/24). Though the descending aorta replacement combined with CABG could make the cardiopulmonary bypass time and selective cerebral perfusion time longer, (278 +/- 54) min and (188 +/- 59) min respectively, no significant difference was observed in postoperative complications, 3-year survival rate, 3-year-cardiac-event-free rate compared with the patients only undergoing the thoracic aortic replacement (P > 0.05).

CONCLUSIONSThe aorta replacement combined with CABG can be performed safely, and the revascularization for coronary artery disease is useful for preventing occurrence of cardiac events.

Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; complications ; surgery ; Blood Vessel Prosthesis Implantation ; Coronary Artery Bypass ; Coronary Artery Disease ; complications ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Time Factors

Objective To evaluate the association of COX2 genetic variants with the risk of esophageal cancer and the interaction of COX2 genetic variants with Hp infection. Methods A total of 119 patients with esophageal cancer and 238 frequency-matched controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. Odds ratios (OR) and 95% confidence intervals ( CI) were estimated by logistic regression. Results Case-control analysis showed an increased risk of developing esophageal cancer for 1195 GA(OR =2.69,95% CI= 1. 46-5. 14) and 1195AA ( OR = 2. 30,95% CI = 1.23-4. 89) genotype carriers,respectively, compared with non 1195 GG carriers. When stratified by Hp status, the significantly increased risk of esophageal cancer was found among Hp carrier with OR (95%CI) =2.74 (1.35-5.96) ,but not among Hp non-carriers. Conclusion Genetic polymorphism in COX2 promoter region may play an important role in esophageal cancer by Hp infection.

OBJECTIVETo detect body composition and evaluate the influence of body composition on nutritional assessment of burned patients by BIA(bioelectrical impedance analysis).

METHODSBody composition was determined in 38 burned patients (32male, 6female) with total burn area 10% approximately 80%(mean 33.1%+17.61%) by BIA during day 1 to day 70 after burns. All patients were divided into two groups: 20 cases in group A (total burn areas >30%), 18 cases in group B (TBSA <30%). Adequate number calories provided by indirect calorimetry.a

RESULTStwo patients died of MODS in the two groups, 36 patients were survived, mean days of stay hospital 33.1+17.6, the value of lean body mass and body fat mass are gradually decreased, lean body mass is especially lower in the two groups despite provided adequate number calories, there is a significant difference in static analysis in the two groups(P<0.05).a

CONCLUSIONThe serve catabolism is prevalent in treatment procedure of the burned patients with major burn, the lower of lean body mass is not changing despite provide adequate caloris in the two groups. It is a simple and precisely method that bioelectrical impedance analysis could measure body composition; it may help objectively assess nutritional status of severe burned patients.

Adolescent ; Adult ; Aged ; Body Composition ; physiology ; Burns ; metabolism ; Electric Impedance ; Energy Metabolism ; physiology ; Female ; Humans ; Male ; Middle Aged ; Nutrition Assessment ; Young Adult

Objective To construct the bp26 deletion mutant of Brucella vaccine strain M5-90 (M5-90Δbp26),to compare its immunogenicity with parental strain(M5-90),and to develope a new candidate vaccine strain of Brucella melitensis with reduced virulence that can be used to distinguish vaccinated livestock from infected animals.Methods Mutant vaccine strain of Brucella melitensis was constructed by conventional molecular biology techniques then the genetic stability of mutant M5-90Δbp26 was tested and its conventional bacteriological nature was identified; 1.0 × 109 CFU/2 ml doses of M5-90Δbp26 strain and the parental strain were used to vaccinate 3 sheep; sera were analyzed for reactivity against BP26 by Western blotting and for agglutination activity; to analyze the virulence of mutant and parental strain,mice were injected with 1.0 × 106,6.0 × 106 and 2.0 × 107 CFU/0.2 ml doses of M5-90 and M5-90Δbp26,respectively,and clinical symptoms were monitored and the death of mice was recorded.Results The M5-90Δbp26 was successfully generated and reversion was not observed in 15 generations.The size of PCR products was 629 bp while the parental strain was 1279 bp.The sequence analysis showed a 650 bp missing in M5-90Δbp26.The conventional bacteria identification tests confirmed that the mutant was depth variant strain,including mono-specific antiserum M type transformed into R,and the BK2 phage based splitting assay converted from the positive to the negative.Western blotting showed the purified BP26 protein was recognized by the serum against the parental strain while not by the serum against M5-90Δbp26 strain.Agglutination test showed the level of the serum antibody induced by M5-90Δbp26 strain(1:50) was significantly lower than that of serum induced by parental strain(＞ 1:800).Virulence test showed that M5-90Δbp26 strain was less virulent than parental strain.Conclusions M5-90Δbp26 has been successfully constructed.M5-90Δbp26 of Brucella melitensis has the characteristic of reduced virulence and has a potential as brucellosis candidate vaccine strain permitting serological discrimination between diseased and vaccinated livestock.