Renal protection should be taken into account when we treat chronic gouty arthritis patients combined with chronic kidney disease.Several drugs should be individualized and adjusted dosage according to renal function parameters such as GFR.At the same time,we should closely monitor the side-effects of drugs.

Problems which should be emphasized in pediatric anesthesiology teaching were expounded based on anesthesia teaching practice and requirements of the cultivation 21 century anesthesia professionals.This paper emphasized the special anatomical,physiological and pharmacological characteristics of children,preoperative preparation,building of moral and legal concept and self-learning ability.

OBJECTIVETo assess the association between polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene C677T locus and nonsyndromic cleft lip with or without cleft palate (NSCL/P) in Shanxi Province of China.

METHODSBlood samples from 150 patients and their parents and 150 controls and their mothers were collected. The polymorphism of MTHFR gene C677T locus were analyzed by the methods of polymerase chain reaction and restriction fragment length polymorphism technique(PCR-RFLP). Case-control analysis, transmission-disequilibrium test(TDT) and haplotype-based haplotype relative risk analysis(HHRR) were used to study the correlation between the gene mutation and NSCL/P.

RESULTSHardy-Weinberg equilibrium test results showed that, the offspring and mother genotype in the case group and the control group was not deviated from the Hardy-Weinberg law of genetic equilibrium (P > 0.05). The distribution of genotype CC, CT and TT in offspring had significant difference between the two groups (P < 0.05). In the offspring and mother of case group and the control group, the carriers of the TT genotype compared to CC genotype, the OR are greater than 1 and 95% CI do not contain 1 (offspring OR: 2.692, 95% CI: 1.319-5.495; mother OR: 2.469, 95% CI: 1.136-5.363). The distribution of C allele and T mutation gene were significantly different in the offspring and mother between the two groups (P < 0.05). The TDT test showed: chi2 = 4.507, P < 0.05. The HHRR test showed: P < 0.05.

CONCLUSIONThe single nucleotide polymorphism of MTHFR C677T locus is associated with the development of NSCL/P in Shanxi Province.

Child ; Child, Preschool ; China ; Cleft Lip ; genetics ; Cleft Palate ; genetics ; Female ; Humans ; Infant ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Polymorphism, Single Nucleotide

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.

Objective To investigate the clinical value of ventricular intracranial pressure monitoring in treatment of severe craniocerebral trauma with high intracranial pressure.Methods A retrospective analysis was conducted on forty cases of severe craniocerebral trauma with GCS score of 3-5 undergone bilateral decompressive craniectomy from October 2010 to January 2012.The patients were divided into three groups:Group A (12 cases received craniotomy after the placement of ventricular intracranial pressure probe) ; Group B (15 cases had craniotomy ahead of the probe placement) ; control group (13 cases had probe placement alone).Intracranial pressure control,dose and duration of administration of dehydrator and prognosis were compared among groups.Results Groups A and B showed a better result in aspects of controlling intracranial pressure within 15 mm Hg,dose and duration of mannitol treatment,and prognosis,as compared with control group (P ＜ 0.05).Furthermore,Group A had seven cases of severe disability or in vegetable state,but only three cases in Group B (P ＜ 0.05).Conclusion Ventricular intracranial pressure monitoring can effectively reduce intracranial pressure,raise treatment success rate and decline the use of mannitol in management of severe craniocerebral trauma.

Objective To comprehensively evaluate the effect of the program of treatment and assistance to advanced schis-tosomiasis patients in Hunan Province from 2004 to 2013. Methods The fund investment of the program,the profits of hospi-tals and the improvement of the patients’health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process,and the program was assessed comprehensively. Results The evaluation index system includ-ing 6 primary indices and 33 secondary indices was established. Among all the primary indices,the score of the treatment and assistance(22.25)was the highest,and that of the satisfaction assessment(8.15)was the lowest,and the score of the compre-hensive assessment was 87.06. The average cure rate of the patients was 13.08%from 2004 to 2013. More than 60%of the pa-tients’disease condition got better,and nearly 70%of the patients’psychological condition improved,and more than 70%of patients’self-help ability and social contact improved,as well as family happiness increased. In addition,the annual average cost for caretakers decreased by 2000 Yuan,and the profits of all the fixed-point hospitals for treatment and assistance in-creased. Conclusion The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious,and the government should continuously invest in the program.

AIM: To investigate the relationship betw een ADRP and the development of atherosclerosis. METHODS: Antisense oligodeoxynucleotide of mouse ADRP was constr ucted. The mouse peritoneum macrophages were cultured with Ox-LDL or Ox-LDL plus the antisense fragment. The cellular cholesterol was measured and the expressio n of ADRP was observed with RT-PCR and western blotting. New Zealand white rabbi ts were fed with high cholesterol chow for 12 weeks. The levels of serum lipid a nd cholesterol content of aortic wall were investigated. The areas of fatty stre ak of the aortas was measured after staining with Sudan Ⅳ. The aortic, and live r specimens with HE and immunohistochemistry staining were observed under light microscopes. RESULTS: Antisense oligodeoxynucleotides of mouse ADRP decreased cellular cholesterol ester, induced cellular lipid droplets and the expression of ADRP. The expression of ADRP was induced by high-cholesterol-diet feeding in rabbit atherosclerotic lesions. The fatty streak of the aorta with immunohistoch emistry staining was strongly positive for ADRP in animals fed with high cholest erol chow, and the liver was negative with or without high cholesterol chow. CONCLUSIONS: The expression of ADRP in vessel walls is related t o the atherosclerosis, and has a potential role in lipid accumulation in macroph ages and pathogenesis of atherosclerosis.

AIM: Based on the finding of adipophilin expression with the increase in cellular cholesterol, the aim of the present study was to look for the active site of adipophilin in cellular cholesteryl metabolism. METHODS: Mouse peritoneal macrophages were incubated with 80 mg/L Ox-LDL (Ox-LDL group) or 80 mg/L Ox-LDL plus 1 mmol/L adipophilin antisense oligonucleotides (Ox-LDL+antisense group), respectively. At the various time points, the incubated cell samples were observed with adipophilin immunofluorescence staining, flow cytometric analysis and cellular cholesterol analysis. RESULTS: The Ox-LDL+antisense group cells contained significantly lower cholesteryl ester (19.9?1.9) mg/g (protein) than that of cells in Ox-LDL group (46.6?3.4) mg/g (protein) at 4 days. From 12 h, expression of adipophilin in Ox-LDL group increased more quickly than that of the cells in Ox-LDL+antisense group. At day 4, the level of adipophilin expression in Ox-LDL group was significantly higher than that in Ox-LDL+antisense group. During the observation, the amount of Ox-r[CL-3H] LDL taking up increased gradually in both groups, however, from day 1 the taking up amount in Ox-LDL+antisense group was less than that in Ox-LDL group. There was a statistical difference between the two groups from day 2 to day 4. From 6 h to day 2, the relative ACAT activity increased in both groups. The relative ACAT activity kept unchanged from day 2 to day 4 in the two groups. At day 2, the relative ACAT activity in Ox-LDL+antisense group was significantly lower than that in Ox-LDL group. Correlative analysis between activity of ACAT and adipophilin expression showed than R2 were 0.6176 and 0.8212 (P

Objective To evaluate the effect of hypoxemia factor on hippocampal long-term potentiation(LTP)in newborn rats undergoing propofol anesthesia. Methods Forty-two pathogen-free healthy Sprague-Dawley rats(21 males,21 females),aged 7 days,weighing 14-18 g,were divided into 3 groups(n=14 each)using a random number table:propofol plus air group(group PA),propofol plus pure oxygen group(group PO)and intralipid plus pure oxygen group(group IO).Propofol 50 mg/kg was injected intraperitoneally once a day for 7 consecutive days in PA and PO groups. Intralipid 5.0 ml/kg was injected intraperitoneally once a day for 7 consecutive days in IO group. The rats were exposed to air or pure oxygen for 6 h after the end of each injection. The arterial oxygen saturation and respiratory rate were determined after administration. The rats were returned to the cage after recovery of righting reflex. Six rats in each group were selected for preparation of hippocampal slices at 24 h after the last injection on 7th day,and the electric stimulation-induced field excitatory post synaptic potential(fEPSP)and success rate of LTP induction were recorded. Morris water maze test was performed in the other rats at 2 weeks after administration to assess the cognitive function. Results Compared with group IO,the respiratory rate,amplitude of fEPSP and success rate of LTP induction were significantly decreased,and the escape latency was prolonged in group PO(P<0.05).Compared with group PO,the arterial oxygen saturation,amplitude of fEPSP and success rate of LTP induction were significantly decreased,the escape latency was prolonged,and the number of crossing the original platform was decreased in group PA(P<0.05).Conclusion Hypoxemia factor increases propofol-induced neurotoxicity in the central nervous system of newborn rats.

To observe the effects of diabetogenic (high fat high sucrose, lacking choleserol) diet on atherogenesis in New Zealand white rabbits. Two groups of New Zealand white rabbits received regular rabbit chow (the normal control), or high fat high sucrose diet for 4 months. The levels of plasma total cholesterol, HDL cholesterol, triglycerides, insulin, and glucose were investigated, the areas of fatty streak of the aortae were measured after staining with Sodan IV, and the aortic, coronary specimens were observed with light and electron microscopies. The plasma glucose, triglycerides, and total cholesterol were increased significantly by high fat high sucrose feeding. At the end of 4 months, the early charateristics of atherosclerosis were present in the animals' vascular specimens. Our findings suggest that high fat high sucrose feeding can induce hyperglycemia, hypertriglyceridemia and atherosclerosis in New Zealand white rabbits, and this could be a potential animal model for studying the mechanisms of diabetes-accelerated atherosclerosis. This study raised a question: What is the mechanism by which high fat high sucrose feeding induces atherosclerosis?. The related hypothesis was given in this article.