Objective To investigate anesthesia efficacy and safety between two drugs joint propofol intrave-nous anesthesia for colonoscopy,to provide reference for clinical treatment.Methods 120 routine colonoscopy patients were selected,they were randomly divided into control group and observation group,60 cases in each group. Patients of the control group were given ketamine and propofol before examination.Patients in the observation group were given fentanyl and propofol for intravenous anesthesia before the examination.The arterial pressure MAP,heart rate,HR,pulse oximetry SpO2 ,recovery time,time away from the hospital,anesthetic effects and adverse reactions were compared between the two groups.Results Anesthesia excellent rate in the observation group was 86.67%,that was 85.00% in the control group,the difference was not significant (χ2 =0.984,P =0.114).In the observation group,the recovery time and time away from the hospital were (7.44 ±1.24)min,(19.11 ±2.67)min,which were significantly shorter than those in the control group,the differences were statistically significant (t =5.847,P =0.004;t =6.922,P =0.001).The MAP,SpO2,HR at different time points showed statistically significant differences between the two groups(P >0.05).The incidence rate of adverse reactions in the observation group was 21.67%, that in the control group was 36.67%,the difference was not statistically significant (χ2 =5.665,P =0.007). Conclusion Fentanyl and propofol for intravenous anesthesia in colonoscopy has good anesthetic effect and good safety,which is worthy of clinical application.

OBJECTIVETo investigate the relationship between the level of di-2-ethylhexyl phthalate (DEHP) and idiopathic oligoasthenospermia by measuring the content of DEHP in the semen samples of different subjects.

METHODSWe obtained semen samples from 100 infertile men with idiopathic oligoasthenospermia, 50 working all the year round in the plastic greenhouse (group A) and the other 50 constantly dining from plastic meal boxes (group B). We also enrolled 50 normal male volunteers as controls (group C). We conducted semen analyses using a computer-assisted sperm analyzer, measured the DEHP concentration by reversed-phase high-pressure liquid chromatography, and subjected the data to statistic processing by t-test and correlation analysis.

RESULTSThe mean concentrations of DEHP in the seminal plasma were (0.72 +/- 0.48), (0.71 +/- 0.49) and (0.21 +/- 0.18) mg/L in groups A, B and C, respectively, significantly higher in A and B than in C (both P < 0.05). The DEHP concentration was negatively correlated with sperm motility (P < 0.05).

CONCLUSIONThe DEHP level in the seminal plasma is higher in infertile men frequently exposed to plastic products than in normal males and excessive DEHP may be one of the important factors of idiopathic male infertility.

Adult ; Case-Control Studies ; Diethylhexyl Phthalate ; adverse effects ; Humans ; Male ; Oligospermia ; etiology ; Plastics ; adverse effects ; Semen ; chemistry

It is reported by current investigations,that BNP can suppress heart hypertrophy but it can also depress compensatory hypertrophic response.BNP is an useful marker in the early diagnosis,prognosis,therapy guiding of heart failure and coronary heart disease,but comorbid conditions should be considered in the diagnosis of heart failure.The polymorphism in the 5'-flanking region of the NPPB gene is found to be related with essential hypertension.On the basis of some investigation,it is supposed that the instillation of BNP at the early stage of hypertension will contribute to therapy of hypertension.

Objective To determine the association between homocysteine and severity of large cerebral artery atherosclerosis.Methods Total 152 ischemic stroke patients were evaluated using transcranial Doppler(TCD),magnetic resonance angiography(MRA) or digital substraction angiography(DSA).Severity of cerebral artery atherosclerosis was scaled by number of stenosed or occluded artery.Results There were 83 patients in low level homocysteine group with mean Hcy level(15.31?3.08)?mol/L,while 69 patients in high level homocysteine group with mean Hcy(34.47?21.38)?mol/L.Number of abnormal intra-and extra-artery was 1.86?1.51 and 1.52?1.46 respectively.No significant difference was demonstrated in the number of abnormal artery between two groups.No correlation was noted between Hcy and number of abnormal artery.Conclusion There is no relationship between high homocysteine and severity of large cerebral artery atherosclerosis in ischemic stroke patients.Homocysteine might be the marker of the disease.

Objective To discuss combined detection of pleural biopsy under medical thoracoscopy and pulmonary serum tumor markers in diagnosis of pleural effusion with unknown reason.Methods 76 patients with pleural effusion caused by unknown reason from January 2014 to March 2016 were retrospectively analyzed. Pleural biopsy was conducted under medical thoracoscopy and sent for pathological examination, and 10 ml venous blood was collected from these patients upon admission for testing serum tumor markers (CEA, SCC-AG, ProGRP and CYFRA21-1).Results Among the 76 patients, there were 32 cases with benign lesions (14 with pulmonary tuberculosis, 9 with inlfammatory lesions, 6 with granulomatous inlfammation, 2 with empyema and 1 with hamartoma) and 44 cases with malignant lesions (18 with adenocarcinoma, 13 with squamous carcinoma, 6 with small cell lung cancer, 3 with adeno-squamous carcinoma, 2 with mesothelioma, 1 with large cell carcinoma and 1 with thymoma). The detection of serum tumor markers showed statistically significant differences in the levels of CEA, SCC-AG, ProGRP and CYFRA21-1 in serum between the malignant pleural effusion group and benign pleural effusion group (P = 0.021,P = 0.006,P = 0.003 andP = 0.010). The levels of various serum tumor markers in the malignant pleural effusion group were obviously higher than those in the benign pleural effusion group. According to the pathological results, patients with pleural effusions not caused by lung cancer (2 with mesothelioma and 1 with thymoma) were eliminated from 44 patients with malignant pleural effusions. The rest 41 patients with pleural effusions caused by lung cancer were divided into non-small cell lung cancer and small cell lung cancer according to the pathological types. The results showed that there were statistically signiifcant differences in the levels of CEA, ProGRP and CYFRA21-1 between non-small cell lung cancer and small cell lung cancer (P = 0.036,P = 0.005 andP = 0.008), while there was no statistically signiifcant difference in the level of SCC-AG (P = 0.811).Conclusions Due to high detection rate and high accuracy in detecting pleural effusions caused by unknown reason, medical thoracoscopy is of great signiifcance, especially for the diagnosis of malignant pleural effusions of pleural metastases. However, serum indicators may provide important reference values for us before the pathological results are available. Thus, it is an important means of diagnosing malignant pleural effusions caused by lung cancer and should be promoted in clinic.

Objective To observe the analgesic and sedative effects of dezocine injection on the medical thoracoscopy check -up.Methods 98 cases of patients with unexplained pleural effusion were randomly divided into sedation group(dezocine group,49 cases)and anesthesia group(local anesthesia by lidocaine,49 cases)by adopting digital expression method.Sedation group was intravenously injected with 5mg dezocine before the operation,and another 5mg dezocine was mixed with 100mL of 0.9% sodium chloride for intravenous drip,with 10mL of 2%lidocaine for local anesthesia during the operation;anesthesia group was only administered with 10mL of 2% lidocaine for local anesthesia.Verbal rating scales(VRS)results and visual analogue scales(VAS)results of the two group patients,as well as their hemodynamics and pleural reaction were recorded.Results The VAS scores of the sedation group and anesthesia group were (4.3 ±2.2)points and (2.1 ±1.9)points,respectively,VRS scores were (3.5 ± 1.1)points and (1.4 ±1.1 )points,there were statistically significant differences(t =0.415,P =0.019 and t =0.293,P =0.006,respectively).The two groups had basically similar operation duration,but the sedation group had more stable hemodynamic indexes such as maximum heart rate,systolic pressure,diastolic pressure and pleural reaction,including cough,dizziness,chest tightness,sweating,etc.Conclusion Dezocine injection can be used in medical thoracoscopy check -up and treatment,with significant analgesic effect and less adverse reaction,effectively alleviating the discomfort of thoracoscopy check -up,and improving patients′compliance and comfort,so as to enhance the success rate of thoracoscopy check -up.

Objective To explore the application value of minimally invasive surgery in the treatment of lumbar spinal tuberculosis, and to provide reference for clinical treatment of spinal tuberculosis. Methods Data of 252 cases of patients with lumbar spinal tuberculosis treated by conservative treatment in our hospital from January 2005 to December 2014 were retrospectively analyzed. Patients were divided into four groups on the basis of systemic application of antituberculosis chemotherapy. A total of 154 patients were given simple local chemotherapy of percutaneous placement of focus catheter (group A), 48 patients were received percutaneous perfusion drainage and local chemotherapy (group B), 32 patients underwent percutaneous puncture catheter debridement combined with local chemotherapy (group C), and 18 patients were given percutaneous debridement and internal fixation combined with local chemotherapy catheter (group D). Data of erythrocyte sedimentation rate (ESR), visual analogue scale (VAS), Oswestry disability index (ODI) score and the modified MacNab criteria were recorded before operation and at the end of the follow-up in four groups of patients. Results Of the 252 patients, 228 were followed up and 214 patients achieved clinical cure. The lost access were15 cases in group A, 5 cases in group B, 2 cases in group C and 2 cases in group D. The total rate of lost visit was 9.52%. The follow up duration ranged from 25-126 months. The mean duration of follow-up was 68(60, 76) months. A total 214 cases reached the standard of clinical cure. No complications (retrograde infection and cross infection) were found in all patients during treatment. ESR was statistically decreased to (7.26 ± 3.43) mm/1 h at the last follow-up (t=35.06, P=0.023) compared with that (44.96 ± 12.42) mm/1 h before operation. The VAS and ODI were 1.5(1, 3) and 30(25, 35)% at the last follow-up, which were significantly improved than those [7.5(7.0, 8.0) and 60(55, 65)%] before operation (Z=13.641 and 6.806, P<0.05). According to the improved MacNab criteria, the overall excellent and good rates for patients were 86.4%(197/228) at the last follow-up. Conclusion According to the stepped care and personalized treatment, patients of lumbar tuberculosis are preoperative comprehensive evaluated, and most patients can achieve long-term stability and a better clinical efficacy after interventional and minimally invasive treatment.

Objective To study the effectiveness of family-integrated-care (FICare) for preterm infants with moderate to severe bronchopuhnonary dysplasia (BPD) in neonatal intensive care unit (NICU).Method Preterm infants with moderate to severe BPD in Hunan Children's Hospital from January 2015 to March 2016 were selected as the objects.These infants were assigned into two groups (FICare group and control group) in the base of whether the parents agreed to implement FICare.If the infant was enrolled into FICare group,the parents need to spend 3 hours in ward every day,and participate in nursing services under the guidance of nurses.The nursing services included bathing,cuddling,skin care,breast-feeding,and so on.If the infant was enrolled into control group,these nursing services were implemented by nurses.Oxygen exposure time,breast-feeding rate,time of begin oral feeding,time of total oral feeding,weight growth rate during hospitalization,weight of discharge,length of stay,readmission rate within 30 days,the rate of parents that mastered basic care knowledge and skills when discharge from hospital,the rate of satisfaction,and the rate of follow-up within 30 days of the two groups were compared.Result There were 106 cases in our study,54 in the FICare group and 52 in the control group.Compare the FICare group and the control group,there were statistical differences between two groups in the follow aspects (all P ＜ 0.05):oxygen exposure time [(57.1 ±20.9) d vs.(71.4 ±32.6) d],breast-feeding rate (77.8％ vs.44.2％),time of total oral feeding [(46.1 4 19.6) d vs.(59.4 ± 30.2) d,length of stay [(65.8 ± 18.4) d vs.(84.3 ±35.0) d],the rate of parents that mastered basic care knowledge and skills when discharge from hospital (96.3％ vs.82.7％),the rate of satisfaction (94.4％ vs.84.6％),the rate of follow-up within 30 days (92.6％ vs.73.1％).Conclusion FICare could significantly reduce oxygen exposure time of preterm infants with moderate to severe BPD,could improve the level of parents mastered basic care knowledge and skills of preterm infants,especially in critically ill preterm children,and could shorten length of stay of them.FICare is beneficial to the healthy growth of premature infants with BPD.

Objective: To identify the Chinese medicinal granule (CMG) by measuring IR fingerprints. Methods : 12 species drugs were extracted with butanone respectively and then the obtained extracts were measured by the FT-IR spectrometer. Results : By IR fingerprint of 12 kinds of CMG, we found that different batches of the same CMG had a stable and repeatable fingerprint. Conclusion : By using IR fingerprint, CMG can be identified. It provides a rapid monitoring for drug identification and quality control.

Background Pterygium is one of the common ocular surface disorders,and the main drugs for pterygium include dexamethasone (DXM),interferon α-2b (IFN-α2b),mitomycin C (MMC),5-fluorouracil (5-FU),cyclosporin A (CsA) and tacrolimus (FKS06).However,the efficacy of these drugs on the fibroblasts from recurrence pterygium is unelucidated.Objective This study was to compare the efficacy of DXM,IFN-o2b,MMC,5-FU,CsA and FK506 on proliferation and apoptosis of recurrent pterygium-derived fibroblasts in vitro.Methods The specimens of recurrence pterygium were collected during surgery in Tianjin Medical University Ophthalmological Hospital from May 2015 to July 2016 under the written informed consent.Fibroblasts were isolated and cultured by explant culture method and identified by immunochemistry.DXM,IFN-α2b,MMC,5-FU,CsA and FK506 were added into the medium for 48 hours,respectively,and the cells cultured without drug were used as the control group.The inhibitory efficiency of different concentrations of DXM,IFN-α2b,MMC,5-FU,CsA and FK506 on the cell proliferation was assayed by cell counting kit-8 (CCK-8),and 50％ inhibiting concentration (IC50) of the drugs was calculated.The cells were treated by the IC50 dose of drugs for 48 hours,and cell apoptotic proportion and cell cycle were assessed by flow cytometry analysis.The expression of proliferating cell nuclear antigen (PCNA) in the cells after treated by drugs was detected by immunochemistry.Results Cultured cells grew well with the fusiform shape and radial arrangement.Vimentine showed the positive expression and keratin was absently expressed in the cells.The IC50 to the cells was (3.5×103±2.83×10-2)mg/L,(6.1×102±3.6×10-3)mg/L,(3.2×10-1±1×10-4)mg/L,(2.2× 101 ± 1.2× 10-3) mg/L,(6.3 × 101 ±2.5 × 10-3) mg/L and (6.0× 101 ± 0.0× 100) mg/L in the DXM,IFN-α2b,MMC,5-FU,CsA and FK506,respectively.In the 48 hours after treated by the IC50 drugs,the apoptotic ratio was (35.00± 3.21)％,(30.37±1.67)％,(26.11±0.75)％,(22.01±0.07)％,(20.95±1.68)％ and (19.85±0.52)％ in the IFN-α2b group,CsA group,MMC group,FK506 group,DXM group and 5-FU group,which was significantly higher than (11.38±2.18) ％ in the control group (all at P＜0.05).The cell proportion of G0/G1 phase,S phase and G2/M phase was (85.64±2.62)％,(5.29±1.56)％ and (2.73-±2.66)％ in the control group,and the cell proportion of G0/G1 phase was reduced,while that of S phase or G2/M phase was considerably increased in various drug groups (all at P＜0.05),with the blocking efficiency of cell cycle was in turn MMC,CsA,5-FU,DXM,IFN-α2b and FK506.The expressional rate of PCNA in the cells was (95.00 ± 2.00) ％,(82.67 ± 5.04) ％,(80.00 ± 2.78) ％,(64.00± 6.55)％,(38.00±3.00)％,(32.00±4.36)％ and (29.67±3.02)％ in the control group,FK506 group,DXM group,5-FU group,IFN-α2b group,CsA group and MMC group,showing a significant difference among the groups (F=25.995,P＜0.01),and the expressional rate of PCNA was significant lower in various drug groups than that in the control group (all at P＜0.05).Conclusions DXM,IFN-α2b,MMC,5-FU,CsA and FK506 are all able to inhibit the proliferation and promote the apoptosis of recurrent pterygium-derived fibroblasts in vitro,and MMC and CsA appear to have a stronger effect.