Objecfive To observe the effect of high thoracic epidural block(HTEB)for preventing myocardial isehemia(MI)in pailents with coronary heart disease undergoing upper abdominal surgery. Methods Twenty patients undergoing upper abdominal surgery were randomly divided into two groups:M group(treated with HTEB,10 patients)was given both general anesthesia and HTEB and patient controlled epidural analgesia(PCEA)after operation and C group(without HTEB.10 patients)was given only general anesthesia and patient controlled intravenous analgesia(PCIA)after operation.The hemodynamies.ECG changes and serum troponin I and myoglobin and ereatine-kinase isozyme,the analgesia efficacy in M group were compared with those in C group.Results The hemodynamics in M group Was more stable than that in C group(P＜0.05).ComparedwithMgroup,thetotalnumberofST-segment depression attracheal extuba- tion moment and 10 hours after operation were significantly increased in C group(P＜0.05).The positive rates of Serum troponin I and creatine-kinase isozyme at 10 hours and 24 hours after operation in C group were much higherthan those in M group(P＜0.05).The an~tgesia effect in M group Was superiortothat in C group (P＜0.05)Conclusion The HTEB combined with general anesthesia may reduce mvocardial is- chemia in patients with coronary heart disease undergoing upper abdominal surgery.

Objective:To explore effect of relevant training on understanding of theory of naive biology for plant reproduction in 5- and 6-years old,and to attempt to provide demonstration for a debate of different views between domain universality and domain specificity cognitive development.Methods:48 preschoolers who did not comprehend concept of plant reproduction screened from 64 preschoolers ages 5 to 6 were surveyed by clinical method.Half of the 48 children were assigned to intervention group,the other to control group.The effects of intervention were compared by the experimental before-after design.Results:Relevant biological knowledge might widely accelerate 5- and 6-year-olds' understandings for plant reproduction,and 6-year-olds had more enhancement than 5-year-olds.Pass rates of intervention group were more 29.2% than control group in 5 year olds,and more 54.1% in 6 year olds.Conclusion:Acquiring specific knowledge will generally improve preschoolers' cognition on plant reproduction.Children' cognitive development is influenced jointly by both domain-specific and domain-general thinking.

OBJECTIVE:To evaluate the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA).METHODS:7 studies on the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA) were subjected to a meta-analysis using homogeneity test and combined effect test.RESULTS:Homogeneity test showed that the cited studies were homogeneous with ?2=25.14,df=6 and P=0.0003;and by combined test,the combined OR was 2.37(95% confidence interval=1.18～4.78,Z=2.41,P=0.02).CONCLUSION:Methotrexate demonstrated better toleration than gold salt for rheumatoid arthritis.

Objective To evaluate the efficacy and safety of different doses of prednisone combined with cyclosporine A(CSA) on the treatment of idiopathic membranous nephropathy (IMN). Methods The data of 64 patients with nephrotic syndrome (NS) diagnosed as IMN by renal biopsy were retrospectively analyzed. Median follow?up time was 10 (7, 19) months. The subjects were divided into 2 groups according to different prednisone dosage. Thirty?two cases were in the low?dose group:prednisone 0.15 mg·kg-1·d-1+CSA, and 32 cases in the moderate?dose group:prednisone 0.4?0.5 mg· kg-1·d-1+CSA. Clinical and laboratory data were collected at baseline, 1, 3, and 6 months after treatment. During follow?up, cumulative recurrence rate and adverse reactions after treatment were recorded. Results Serum albumin (sALB) were significantly increased and 24 h urinary protein (24hUP) significantly decreased after treatment for 1, 3, 6 months compared with baseline data in the two groups. Serum creatine (Scr) increased after treatment with time. The elevation of sALB and the reduction of 24hUP in the moderate?dose group were higher than that of low?dose group at 6 months after treatment (P<0.05). The effective rate of the low?dose and moderate?dose group was 65.6% and 87.5% at 6 months after treatment, respectively (χ2=4.267, P=0.039). Comparison of different doses of CSA in two groups at 6 months after treatment, in low?dose group: the effective rates of CSA<3 mg· kg-1·d-1 and >3 mg·kg-1·d-1 subgroup were 76.5% and 53.3%, respectively (P=0.296); In moderate?dose group:the effective rates of CSA<3 mg·kg-1·d-1 and>3 mg·kg-1·d-1 subgroup were 89.5%and 84.6%, respectively (P=0.077); there were similar effects in patients treated with different dose CSA in the two groups. About 20.4% of the total patients relapsed when followed up for 18 months (low dose group vs moderate?dose group: 9.5% vs 28.6%, P=0.136), which most occurred after prednisone withdrawal or during the reduction of cyclosporine. Renal function decreased in 57.8% patients (low dose group vs moderate?dose group:50%vs 65.6%), mainly in the elderly (9/11) and the long course of treatment of CSA. There was no significant difference on adverse reactions between the two groups (P>0.05). Renal function in patients with high Scr or high blood trough concentration of cyclosporine was difficult to fully recover. Conclusions Remission rate is lower in low?dose prednisone combined with cyclosporine than the moderate?dose group in the treatment of IMN for 6 months. The recurrence rate of IMN or the incidence of adverse reactions are similar between the two groups. Induction therapy of IMN with cyclosporin<3 mg·kg-1·d-1 is safe and effective. The incidence of renal function reduction in the elderly is high, and the renal function is difficult to restore in patients with Scr exceeding normal upper limits.

OBJECTIVETo evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODSFrom March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTSAll the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSIONThe technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; physiopathology ; surgery ; Patellofemoral Joint ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Objective To investigate the correlation between GSTP1 exon5 A/G polymorphism and clinic phenotype of COPD in the population of the Han nationality from southwest China.Methods Using PCR followed by restriction fragment length polymorphism(PCR-RFLP),genotypes of Ile105Val polymorphism in exon5 of GSTP1 were determined in 91 patients with COPD and 87 healthy control subjects.Results No significant differences were observed in the frequencies of genotypes and alleles of exon5 of GSTP1 between COPD patients and the healthy controls.The frequency of Ile105 in pink puffer patients was much more than that in the blue bloater patients.The CT scores of emphysema in patients with Ile105 was significantly higher than those with Val105.Conclusions The genetic polymorphism of exon5 of GSTP1 may not be associated with the susceptivity of COPD in the populations of the Han nationality from southwest China,but may be correlated with clinical phenotypes and lung parenchyma damage of COPD patients in the present population.

Objective To study the protection and mechanism of co-administration of vitamin E with coenzyme Q10(CoQ10) to valproate-associated hepatotoxicity in infantal rats.Methods The rat models were established by oral administration of valproic acid(VPA) in ablactation(21 days) Wistar rats,at doses of 500 mg/(kg?d) during 30 days,other groups received the same amount of VPA with phemobarbitone(PB) and co-administration with vitamin E and CoQ10.The changes of liver cell morphology and the blood coagulation test,as well as the contents of succinic dehydrogenase(SDH),cytochrome oxidase(CCO),cytochrome,the levels of glutothione(GSH) and malondial dehyde(MDA) in rat liver mitochondria were detected by chromatometry,HPLC,Oil-Red-O staining and electron microscope,respectively.Results 1.Average content of cytochrome aa3 in liver mitochondria of infantal rats were reduced by 58.80% and(61.80%) because of administration of VPA and VPA added with PB.The protection against the loss of cytochrome aa3 by coadministration of VitE and CoQ10 was obvious.As for activities of SDH and CCO,which affected by VPA and VPA added with PB in rats,were significantly lowered compared with control group(P

Objective To investigate the effect of human umbilical cord mesenchymal stem cells (UC-MSCs) on immune cells and inflammatory factors in septic rats.Methods 184 male Sprague-Dawley (SD) rats were divided into normal control group (n = 8), sham operation group (n = 48), sepsis model group (n = 64), and UC-MSCs treatment group (n = 64). An animal model of sepsis was produced by cecal ligation and puncture (CLP). In the UC-MSCs treatment group 1 mL UC-MSCs (2×106/mL) were injected intraperitoneally at 1 hour after the model establishment;the sham operation group and the sepsis model group were given the same amount of saline. Sixteen animals in each group of the sham operation group, sepsis model group, and UC-MSCs treatment group were observed for 72-hour survival rate. The percentages of CD4+ T cells and the ratio of helper T cells 1/2 (Th1/Th2) in whole blood cells were measured by flow cytometry at 12, 24, 48 and 72 hours after operation. The levels of tumor necrosis factor-α (TNF-α), high mobility group box 1 (HMGB1), interleukin-10 (IL-10) were measured by enzyme linked immunoabsorbent assay (ELISA).Results The 72-hour survival rate of the UC-MSCs treatment group was slightly higher than that of the sepsis model group [62.5% (10/16) vs. 50.0% (8/16),χ2 = 0.509,P > 0.05]. The percentage of CD4+ T cells and Th1/Th2 ratio in the sepsis model group were significantly higher than those in the sham operation group at 12 hours after operation, and decreased as the time prolonged to 48 hours. The levels of plasma inflammatory factors were significantly higher than those of sham operation group at 12 hours after operation, TNF-α and IL-10 were decreased at 48 hours after operation, while HMGB1 continued to increase until 72 hours after operation. Compared with those in the sepsis model group, the percentages of CD4+ T cells at 12 hours and 24 hours after operation [(49.66±0.91)% vs. (59.11±1.17)%, (41.80±0.89)% vs. (49.84±0.99)%], the levels of Th1/Th2 ratio at 12, 24, 48 hours after operation (0.745±0.065 vs. 1.254±0.115, 0.407±0.077 vs. 0.806±0.061, 0.280±0.057 vs. 0.454±0.049), and the levels of TNF-α and HMGB1 were significantly reduced at 12, 24, 48 and 72 hours after operation in the UC-MSCs treatment group [TNF-α(ng/L):52.60±6.60 vs. 58.03±6.53, 71.77±8.48 vs. 147.39±11.37, 111.83±10.76 vs. 271.36±19.04, 83.09±7.43 vs. 171.04±14.06; HMGB1 (ng/L): 149.12±9.89 vs. 187.33±12.79, 192.94±14.92 vs. 442.35±52.72, 1393.67±88.86 vs. 1950.90±126.66, 1875.84±111.67 vs. 2557.12±186.01], all with statistically significant differences (allP <0.05). The level of IL-10 was significantly higher at 12, 24, 48 and 72 hours after operation (ng/L: 65.46±5.51 vs. 33.32±4.17, 86.49±5.78 vs. 63.11±5.53, 142.73±9.94 vs. 106.81±6.36, 123.74±10.90 vs. 89.90±7.71, allP <0.01).Conclusion UC-MSCs can make CD4+ T cells in early sepsis, and Th1/Th2 ratio to normal, by reducing the levels of proinflammatory factors, and increasing the level of anti-inflammatory factor, and improve sepsis immune function status, but cannot improve the survival rate of animals.

Objectives To investigate the postoperative quality of life of cervical cancer patients treated by laparo-scopic surgery. Methods 27 cases of cervical cancer treated by laparoscopic surgery from May 2009 to September 2010 as observation group, 27 cases of cervical cancer treated by laparotomy treatment in the same period as control group. Observe and analyzed the clinical data, operation, postoperative recurrence and survival rates and postopera-tive FACT-G score between the two groups. Results Age, body mass index has no statistical difference between the two groups ( > 0.05), the blood loss in observation group was less than that in control group ( < 0.05), the lymph node dissection number in observation group was more than that in control group ( < 0.05), the exhaust time and hospital stay in observation group were less than that in control group ( <0.05), the 1-year, 3-year and 5-year re-currence rate and survival rate in observation group showed no significant difference compared with control group ( < 0.05). The 1-year, 3-year and 5-year FACT-G score in control group were higher than that in control group ( < 0.05). Conclusion Laparoscopic surgery for cervical cancer patients can reduce bleeding, shorten exhaust time and hospitalization time, improve postoperative FACT-G score and postoperative quality of life of cervical cancer pa-tients.