Objective To investigate the effects of dexmedetomidine plus ropivacanie on lumbar plexus-sciatic nerve blocks and sedation. Methods One hundred and twenty patients( ASA Ⅰ-Ⅲ) scheduled for unilateral arthroscopy of the knee received lumbar plexus-sciatic nerve blocks. The patients were randomly divided into 4 groups(n = 30 in each). In group R,dexmedetomidine was not used for nerve. In group RLD,dexmedetomidine was only used for lumbar-plexus block. In group RSD,dexmedeto-midine was only used for sciatic nerve block. In group RD,dexmedetomidine was used for both lumbar-plexus block and sciatic nerve block. Onset time and maximum time of sensory and motor block,duration of analgesia,Ramsay scores,HR,and the incidence of anesthetic toxicity were recorded at different time points(T0-T4). Results There were no significant differences in the onset time of sensory and motor block among the groups(P > 0. 05). However,there were significant differences in the maximum time of sensory and motor block for the lumbar plexus among the RLD group[(1008. 00 ± 104. 99)min and (800. 00 ± 97. 56)min],RD group[(922. 00 ± 149. 05)min and(732. 00 ± 139. 52)min],RSD group [(768. 00 ± 108. 48)min and(602. 00 ± 84. 09)min],and R group[(742. 00 ± 129. 44)min and (612. 00 ± 109. 62)min]. There were significant differences in the maximum time of sensory and motor block for the sciatic nerve among the RLD group[(1006. 00 ± 117. 58)min and(810. 00 ± 105. 41) min],RD group[(932. 00 ± 144. 18)min and(744. 00 ± 136. 09)min],RSD group[(738. 00 ± 120. 16)min and(582. 00 ± 96. 04)min],and R group[(708. 00 ± 126. 45)min and(548. 00 ± 111. 12)min]. Compare with the R group,the Ramsay scores of at the time point of T1-T4 were higher and the HRs were lower in the RLD group,RSD group and RD group. There were significant differences in the analgesia duration among the RLD group[(1006. 00 ± 117. 58)min],RD group[(918. 00 ± 83. 60)min],RSD group[(898. 00 ± 131. 34)min],and R group[(808. 00 ± 119. 72)min]. No local anesthetic intoxication was noticed. Conclusion Perineural dexmedetomidine plus ropivacaine increase the effects of lumbar plexus-sciatic nerve blocks in a dose-dependent manner. Dexmedetomidine provides a good sedative effect,however,it may lead to bradycardia.

The effects of normothermic or hypothermic cardiopulmonary bypass(CPB)on hemodynamics, plasma levels of endothelin(ET)and atrial natriuetic peptide(ANP)were comparatively studied in dogs with Swan-Ganz catheter technique and radioimmunoassay. The results showed the total peripheral resistance(TPR)during hypothermic CPB was significantly higher than that of the normothermic. Plasm ET levels increased significantly during hypothermic CPB but remained stable during normothermic CPB. Plasma ANP levels almost unchanged during either CPB. Plasma ET level was positively correlated to TPR but ANT level was not. The results suggest that the increased ET levels may be one of the causes of higher TPR during hypothermic CPB;the stable ET levels contributes to the maintenance of cardiovascular function during and after normothermic CPB and the ANP amount secreted beyond the heart has little effect on the plasma level and hemodynamics during CPB.

Objective:To assess the relationship between Insulin-like growth factor-I(IGF-I) and TCM syndrome of acute cerebral infarction by measuring IGF-I levels in patients of acute cerebral infarction.Methods:100 patients of acute cerebral infarction with 48 hours after onset were divided into three groups by TCM syndrome.The IGF-I levels in plasma were measured by saturation analysis of radioimmunoassay.Results:The IGF-I levels in plasma was(10.39?1.56)ng/ml in the group of wind-phlegm syndrome and stasis,(12.96?2.27)ng/ml in the group of wind-phlegm syndrome and exuberance of re,(13.54?3.22)ng/ml in the group of stirring of wind due to de ciency of yin.These values showed statistically signi cant di erence between groups.Conclusion:Acute cerebral infarction occured most frequently in the group of wind-phlegm syndrome and stasis,the IGF-I levels showed signi cant decrease in this group.

Objective To investigate the clinical effect of dexmedetomidine combined with ropi-vacanie in brachial plexus block (BPB)through modified coracoid approach.Methods Sixty patients scheduled for selective upper extremity surgery were randomly divided into two groups,30 patients in each group.BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine (200 mg)was diluted into 40 ml in group R (n=30)and ropivacaine (200 mg)+1 μg/kg dexmedetomidine diluted into 40 ml in group RD (n=30).Motor and sensory block onset times and blockade durations were recorded.HR,SBP,DBP and SpO2 were recorded before drug administration and 1 5,30,60,90 and 120 min after drug administration.Visual Analog Scale (VAS)of normal up-per extremity in group RD was recorded before drug administration and 30 min after drug administra-tion.Side effects were recorded in both groups.Results Sensory and motor block onset time was sig-nificantly longer in group R than those in group RD;Sensory and motor blockade durations in group R was significantly shorter than in those group RD (P <0.01).Compared with group RD,MAP,HR at 30,60,90,120 minutes after drug administration were significantly higher in group R(P <0.05 ). VAS of normal upper extremity in group RD before drug administration and 30 min after drug admin-istration had no statistical significance.7 patients were treated with atropine for bradycardia in group RD.Conclusion Dexmedetomidine combined with ropivacaine for BPB shortens the sensory and motor block onset time and prolongs the duration of sensory and motor blockade.

Objective To investigate the predictive value of dose?volume histograms ( DVHs ) of organs at risk ( OARs ) including the bladder, rectum, and small intestine in volumetric modulated arc therapy ( VMAT) plans for cervical cancer. Methods A total of 100 VMAT plans for cervical cancer were assigned into the learning group. The correlation of the anatomical information with the V30 , V40 , and V50 values of the bladder, rectum, and small intestine was evaluated in the group. The support vector regression ( SVR) algorithm was used to establish the correspondence between the anatomical information and the DVHs of OARs. The DVHs of OARs in the verification group containing 20 VMAT plans were predicted based on the anatomical information. Results The DVHs of the bladder, rectum, and small intestine were likely to be influenced mainly by the spatial relationship between these OARs and target volume. In the verification group, the prediction errors of V30,V40 and V50 by SVR algorithm were-2.4%±3. 5%,-2.5%±3. 8%, and-1.5%±4. 9% for the bladder, 0.5%±2. 6%,-1.5%±5. 1%, and-2.0%±7. 4% for the rectum, and-2.9%± 5. 3%, 2.7%±7. 7%, and 5.3%±11. 1% for the small intestine, respectively. Conclusions After learning the correlation between the anatomical information and the DVHs of OARs from prior VMAT plans for cervical cancer, SVR algorithm can precisely predict the DVHs of the bladder, rectum, and small intestine based on the anatomical information.

Objective A method was established for genotyping of hepatitis B virus (HBV A-D genotype),based on the PCR-restriction fragment length polymorphism (RFLP) created by Hinf Ⅰ,Ear Ⅰ,Apo Ⅰ action on an amplified segment of the S region.Methods Clinical diagnosis research.One hundred and twenty-eight HBV S sequences obtained from GeneBank were analyzed for restriction enzyme sites that would be genotype-specific.Restriction patterns following digestion with restriction enzymes Hif Ⅰ,Ear Ⅰ,Apo Ⅰ were determined to identify A-D HBV genotypes.The method was used to detect the HBV genotype of fifty severe hepatitis patients due to chronic hepatitis B in China.Then the detection results were confirmed by direct sequencing.Results The new genotyping method was established,named simple PCR-RFLP,which could identify HBV genotypes A to D.Genotypes B,C,B/C and A or D could be determined by a single step digestion with Hif Ⅰ.Eight patients of genotype A/B/C classified by single step digestion with Hif Ⅰ were conformed as genotype B variant by further digestion and direct sequencing.Extracted randomly and diluted into different concentration,three specimens were tested for genotype of HBV repeatedly and respectively.The results were all in accord with the originals,and the lowest detection limit of HBV DNA was 7 ～ 9 IU/ml.This was particularly useful in China where genotypes B and C were predominant.Twenty-three of genotype B and ten genotype C patients were classified from these fifty severe hepatitis B patients by a single step digestion with Hif Ⅰ through the simple PCR-RFLP method.The same results were also obtained by direct sequencing of PCR products (Kappa =1.00,P =0.001).The simple PCR-RFLP method was superior to direct sequencing in detecting HBV B/C polyinfection (9 cases and 0 case; x2 =18.00,P =0.001).Conclusions Both the sensitivity and repetitiveness of Simple PCR-RFLP method are satisfactory.It is superior to direct sequencing in detecting HBV B/C polyinfection,and simple,convenient.

Objective To compare the influence for intravenous dexmedetomidine and midazolam during combined spinal and epidural anesthesia (CSEA) on sedation,respiratory and circulatory.Methods Ninety patients with lower extremity fractures and internal fixation,were divided into dexmedetomidine group,midazolam group and control group by random digits table with 30 cases each.CSEA was performed at L3-4 interspace.After block reached T8 level,dexmedetomidine,midazolam and 0.9％ sodium chloride were given to the three groups.Ramsay score,mean arterial pressure (MAP),heart rate (HR),partial pressure of carbon dioxide in end expiratory gas (PErCO2),respiratory rate (RR) were recorded before anesthesia(T0),after CSEA (T1),and 10,15,30,45,60 min after giving drug (T2-T6),and intraoperative awareness was recorded.Results Ramsay score in dexmedetomidine group and midazolam group at T2-T6 were higher than those in the group T0,T1 and concurrent control group (P ＜ 0.05),MAP were lower than those in the group T0,T1 and concurrent control group (P ＜ 0.05).HR in dexmedetomidine group at T2-T6 were lower than those in concurrent midazolam group and control group (P ＜ 0.05).PETCO2 in midazolam group at T2-T6 were higher than those in concurrent dexmedetomidine group and control group (P ＜ 0.05),RR were lower than those in concurrent dexmedetomidine group and control group (P ＜ 0.05).The rate of intraoperative awareness in dexmedetomidine group and midazolam group was lower than that in control group [16.7％(5/30) and 13.3％(4/30) vs.93.3％(28/30),P＜0.05].Conclusions Dexmedetomidine and midazolam provide good sedation to reduce intraoperative awareness,slight inhibition of blood pressure.Dexmedetomidine can decrease HR,but it does not influence respiratory function.Midazolam restrains respiratory function.

Objective To observe the influence of once pre-injection dexmedetomidine(DEX) on clinical effect in general anesthesia induction.Methods Sixty patients,ASA Ⅰ-Ⅲ,no sex limitation,undergoing elective laparoscopic cholecystectomy under general anesthesia were selected and divided into the 1ug/kg DEX group(D) and normal saline control group(C),30 cases in each group.The BIS values were recorded after medication infusion.Then the target controlled infusion(Marsh mode) of propofol was performed according to the plasma concentration.The plasma concentration was gradually increased until BIS value reaching 40.Then the effect-site concentration(Ce) of propofol was recorded at this time and sufentanil 0.5ug/kg was injected within 10 s.The bucking incidence rate within 1 min after injection of sufentanil was recorded and cisatracurium was injected again.The tracheal intubation was performed when the TOF value was 0.The time of train-of-four stimulation(TOF) to 0(effect onset time) and intubation time were recorded.The hemodynamic indexes were recorded at pre-administration(T0),post-administration(T1),after induction(T2),and after intubation(T3).The incidence rate of intraoperative awareness was recorded.Results The bucking incidence rate at 1 min after sufentanil injection in the group D was significantly lower than that in the group C(3.33％ vs.13.3％,P＜0.01).Ce of propofol in the group D was lower than that in the group C(P＜0.01).HR af T1 in the group D was decreased;HR and MAP at T2 in the group C were decreased,which at T3 were increased.No intraoperative awareness occurred in all cases.Conclusion Pre-injection of DEX 1ug/kg before induction can decrease the propofol dose and maintains hemodynamic stability.

To indicate the relationship between structure and function of loops from Bacillus thuringiensis insecticidal crystal protein Cry1Ba, and the influence of amino acids mutation on toxicity against diamond back moth Plutella xylostella, five mutations at the loops of Cry1Ba were constructed by overlapping primer PCR, and expressed in E. coli BL21 (DE3). Bioassay results showed that the toxicity of mutation M1 (loop1: 340WSNTR344-deletion), compared with that of Cry1Ba (LC50 0.96 microg/mL), decreased significantly with LC50 35.51 microg/mL. And the toxicity of mutation M2 (402Y-G), M3 (400GIYLEP405-PSAV), M4 (400GIYLEPIH407-ILGS) was also reduced to some extent respectively. Only M5 (mutation at loop3: 472LQSRV476 - AGAVYTL) showed slightly increased activity against P. xylostella, but not significantly (LC50 0.81 microg/mL). Referring to the structures of Cry1Ba which was predicted using Swiss-Model software, and bioassay data, we can conclude that loop1 and loop2 play a important role on determining the activity of Cry1Ba against P. xylostella.
Animals ; Bacillus thuringiensis ; genetics ; metabolism ; Bacterial Proteins ; chemistry ; genetics ; Endotoxins ; chemistry ; genetics ; Escherichia coli ; genetics ; metabolism ; Hemolysin Proteins ; chemistry ; genetics ; Models, Molecular ; Moths ; microbiology ; Mutation ; Protein Structure, Secondary ; Structure-Activity Relationship

Objective: To investigate the incidence and related independent risk factors of depression in treatment-naïve Han ethnic Chinese patients with chronic hepatitis C. Methods: Nine hundred and ninety-seven Han Chinese patients with confirmed chronic HCV infection were enrolled. Beck’s depression inventory scale was used to assess depression score. Patients were divided into two groups according to the score: score≥17, depression group (16.85%, 168/997); score <17, no depression group (83.15%, 829/997). Multivariate logistic regression was used to analyze independent risk factors related with the onset of depression in patients with chronic hepatitis C. Results: There was a statistically significant difference between the two groups in terms of gender distribution, marital status, education level, income level and smoking status (P < 0.05). Independent risk factors were female [odds ratio (OR) = 3.85; 95% CI: 2.28-6.50, P = 0.001], decompensated cirrhosis [OR = 2.31; 95% CI: 1.20-4.48, P = 0.013], unmarried [OR = 2.01; 95% CI: 1.12-3.60, P = 0.019], separated [OR = 17.39; 95% CI: 1.64-184.47, P = 0.018], divorced [OR = 3.82; 95% CI: 1.36-10.74, P = 0.011], without higher education [OR = 2.04; 95% CI: 1.22-3.42, P = 0.007], low income [OR = 3.94; 95% CI: 1.38-11.28, P = 0.011], middle income [OR = 2.96; 95% CI: 1.02-8.62, P = 0.047], uninterrupted smoking [OR = 3.67; 95% CI: 2.13-6.31, P = 0.001], and previously smoked [OR = 3.33, 95% CI: 1.66-6.68, P = 0.001]. Conclusion The incidence of depression in patients with chronic hepatitis C is relatively high. The independent risk factors related with depression include female, unmarried, separated, and divorced, without higher education, low and middle-income level, smoking and disease progression to decompensated cirrhosis, but no significant correlation between hepatitis C virus genotypes and viral load.