Objective To investigate the impact of the COX-2 specific inhibitor parecoxib on postoperative serum cytokines and early cognitive function in the elderly patients undergoing knee replacement.Methods Seventy-two elderly patients undergoing knee replacement were divided into a control group (group Ⅰ)and parecoxib group (group Ⅱ).MMSE score were compared at preoperative 1 d and postoperative 1 d,3 d,7 d.Before induction of anesthesia (T1 ),postoperative 6 h (T2 ),1 d (T3 ),3 d (T4 ),7 d (T5 ),the serum IL-1β,IL-6 concentrations were measured,meanwhile the serum S-100βwere measured in T2 .Results At postop-erative 1 d,3 d,the MMSE score in group Ⅰ was significantly lower compared with the preoperative (P <0.05).IL-6 in T2 ,IL-1βin T3 increased in both group.In group Ⅱ,three days later,the exaltation of plasma inflammatory factors returned to the preopera-tive level,but this process last untill T5 in group Ⅰ.The plasma concentration of IL-6 in T2 ,T3 ,T4 and IL-1βin T3 ,T4 in group Ⅰwere higher than group II (P <0.05).At T2 ,the serum S-100βin group Ⅰ was (1 625 ± 364)pg/mL higher than group Ⅱ(1 263 ±174)pg/mL(P <0.05).Conclusion The protective effection of COX-2-specific inhibitor parecoxib upon postoperative cognitive decline in elderly patients undergoing orthopedic surgery may be related to inhibition of peripheral cytokine release.

Objective To evaluate the relationship between airway inflammation before treatment and asthma status and response to inhaled corticosteroids treatment in children with mild or moderate asthma. Methods Eighty-seven children diagnosed with mild or moderate asthma were enrolled as study group, 20 healthy children as control group. Sputum induction, cellular differential count, and the assaying of mediators in sputum supernatant were performed before treatment with corticosteroids. Eosinophil cationic protein were measured by enzyme-linked fluorescent assay, interleukin-8 and transforming growth factor-β_1 (TGF-β_1) were measured by enzyme linked immunosorbent assay. Pulmonary function tests were performed for small airway function on the baseline and methacholine bronchial provocation tests were performed to screen airway hyperresponsiveness. SPSS13.0 software was used to analyze the data. Results (1) Among the 87 patients, 64 patients were studied as eosinophil asthma (EA) group, 23 patients as non-eosinophil asthma (NEA) group according to the ratio of eosinophils in sputum. The percentages of inflammatory cells and level of ECP, IL-8 were of significant difference between the two groups (P < 0.05), other indexes as FEV_1% pred, PEF% pred, moderate-severe AHR%. small airway function were also of significant difference between the two groups (P < 0.05). (2) Patients in EA group showed significant improvement in pulmonary function, bronchial hyperresponsiveness and small airway function after treatment with inhaled corticosteroids compared with NEA group. (3) Multiple stepwise regression analysis showed that among the different baseline variants considered only baseline FEVl%pred, sputum eosinophil percentages (EOS%), sputum TGF-β_1 significantly correlated with the response to inhaled cortieosteroids, moreover, sputum eosinophil percentages had the closest correlation (β= 0.583, t = 6.214, P < 0.05). Conclusions There were different patterns of airways inflammation in children with mild or moderate asthma. Sputum eosinophilia was associated with asthma status. Low sputum eosinophils, low FEV_1%pred, high sputum TGF-β_1 before treatment predict poor response to treatment with inhaled corticosteroids. Evaluation of those baseline indexes may be helpful to an individualized therapeutic regime.

Objective To investigate the protective effect of NS398,a specific cyclooxygenase-2 inhibitor,on microglial activation-mediated neuronal damage.Methods The microglia of neonatal SD rat were isolated and cultured in the medium containing 1 μg/ml of LPS.The morphological changes of microglial were observed.The IL-1β and TNF-α levels were detected by Western blot in LPS group (group L) and control group (group C).The hippocampal neurons of neonatal SD rats were cultured in the control medium (group C),LPS-activated microglial conditioned medium (group L) and LPS-activated microglial conditioned medium with NS398 (group N),respectively.The survival rate of neurons were detected by MTT.The respiration of hippocampus neurons was determined by detecting the ratio of lactic acid/pyruvic acid.Results LPS-induced microglial activation was characterized by the morphological change and increased secretion of IL-1β and TNF-α.The survival rate of neurons cultured by microglia activated conditioned medium was 64.37％,while the group N was 80.25％ (P＜0.01).In group L,the ratio of lactic acid/pyruvic acid (27.34±8.53) was significantly higher than that of group N (20.32±6.05,P＜0.01) and group C (14.95±4.72,P＜0.01).Conclusion NS398,a specific cyclooxygenase-2 inhibitor,has a protective effect on rat hippocampus neuron damaged by activated microglia.

Objective To investigate the diagnosis and treatment of Mirizzi syndrome.Methods 6 cases of Mirizzi syndrome were analyzed with review of the latest literatures on its diagnosis and treatment.Results None of the 6 cases were definitely diagnosed by ultrasonography and CT.All of them underwent operations,five of them were cured and one died.Conclusions Ultrasonography and CT can give a hand to diagnosis.Definite diagnosis depends on ERCP and PTC.The specific conditions of the patients and the experience of surgeon decide the selection of treatment.Subtotal cholecystectomy and hepaticojejunostomy are the basic choices.

[Objective]To evaluate the inhibiting affection of Ad-BMP-7 to osteoporosis of ovariectomized rats.[Method]Mice model of osteoporosis was made by surgical ovariectomy,and divided into 4 groups:A.group of vertebral body intramedullary injection of normal saline;B.injection of Adovirus(Ad)-GFp;C.injection of Ad;D.injection of Ad+BMP(bone morphogenetic protein),the bone losing of whole body were monitored by measuring dry bone weight after 1 month,the osteoporosic condition of bone trabecular were observed by histology,and bone histomorphometry of vertebral bodies were carried to quatitatively measure the dynamic and static indexes of osteoporosic bone.[Result]The dry bone weight of AdBMP-7 rats werehigher than that of other groups.Under the microscope,the bone trabecula form of the Ad BMP-7 groups were more integrity,however,the bone trabecular of the other groups showed sharpen and ruptured.In the bone histomorphomitry,the numbers of the osteoblasts,the thickness of osteoid of group D were obviously higher than other groups.[Conclusion]Ad BMP-7 injected into the vertebral bodies of ovariectomized rats may secrete BMP-7,and inhibits the osteoporosis of ovariectomized rats in the early stage.The protective effect of this gene was not restricted to bones receiving intramedullary injection of the vector,but occurred in all bones that were evaluated.This proof of concept encourages further development of gene therapy approaches to the treatment of osteoporosis.

Object To study the pharmacological effects of CH 2Cl 2 extract of Flos Magnoliae.Methods Anti inflammatory and antiallergic effects of CH 2Cl 2 extract of Flos Magnoliae were studied on various experimental models. Results The extract remarkably inhibited the contraction caused by histamine and acetylcholine, as well as the ovalbumin sensitized allergic constriction of isolated ileum smooth muscle of guinea pigs. It could inhibit the increase of capillary permeability induced by acetic acid in mice, inhibit the mice paw edema produced by carrageenin and reduce the production of PGE 2 in inflammatory tissues. Conclusion CH 2Cl 2 extract of Flos Magnoliae showed remarkable anti inflammatory and antiallergic effects.

Objective To investigate whether I198T gene polymorphisms and Lp-PLA2 activity were the risk factors of CAD.Methods A case-control study was conducted in 398 people with coronary heart disease and 396 controls whose ages and sex were matched with coronary heart disease from Peking University People's Hospital in October 2009 to May 2010.The Il98T gene polymorphisms were detected by the amplification refractory mutation system (ARMS-PCR) using TaqMan probe.Lp-PLA2 activity,CHO,GLU,TG,HDL,LDL,hs-CRP,Lp (a) were investigated at the same time.The data were analyzed by Independent-samples T Test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results LpPLA2 activity was significant higer in CAD group than that in the control group (31.51 nmol · ml-1 · min-1＞21.31 nmol · ml-1 · min-1,F =16.40,P ＜0.05).Adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,quartiles of Lp-PLA2 activity were associated with risk of CVD with a OR of 7.5 (95％ CI:2.34-24.05) for comparison of the top to bottom quartile.Lp-PLA2 activity was the highest (22.68 nmol · ml-1 · min-1,P ＜ 0.05) in genotype Ⅱ and the lowest (11.35 nmol · ml-1 · min-1,P ＜ 0.05) in genotype TT,the association between I198T and coronary artery disease was not significant (P ＞ 0.05).Conclusions Lp-PLA2 activity was significantly higher in CAD group and was a risk factor for CAD.There was no significant association between I198T polymorphism and CAD.

Purpose To analyze and summarize morphological characteristics, the immune phenotype, diagnosis and differential diag-nosis, clinical features and prognosis of epithelioid angiomyolipomas retrospectively, to deepen understanding of EAML and improve the diagnostic accuracy. Methods The pathological morphology was observed and immunohistochemistry of phenotypic characteristics were analyzed in 7 cases of epithelioid angiomyolipomas. Results Seven cases of epithelioid angiomyolipomas had similar morphology:larger tumor cells, ovoid, fusiform or polygonal, with abundant and eosinophilic cytoplasm, a big nucleus of different size with obvious nucleoli, polynuclear and gaint tumor cells, with a few mitotic figures. The tumor cells arranged in nests or sheets, cuff-shaped around the blood vessels. Immunohistochemistry showed that the tumor cells were positive for HMB-45, Melan-A, vimentin and SMA, but negative for EMA, CK, and CD10. All of them underwent radical surgery or surgical resection, and were followed up for 3~56 months after operation. 6 cases were alive, without recurrence and metastasis, while 1 case died of gastrointestinal stromal sarcomas 3 months later. Conclusion Epithelioid angiomyolipomas belong to mesenchymal tumors with malignant potential, pathological morphology would be easily misdiagnosed as malignant tumors. Immunohistochemistry plays an important role in the differential diagnosis. Surgical treatment is the main method at present, with possibility of recurrence or metastasis.

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.