OBJECTIVETo compare the sedative effects of different doses of dexmedetomidine (DEX) and midazolam (MDZ) in dental implant surgery:

METHODSSixty patients undergoing dental implantation were selected and divided randomly into six groups (10 in each group). In group 1 (G1), a highdose of MDZ alone was administered intravenously. In group 2 (G2), a relatively low dose of MDZ and DEX was administered intravenously. In group 3 (G3), a highdose of MDZ and DEX was administered intravenously. In group 4 (G4), a lowdose of MDZ and a highdose of DEX were administered. In group 5(G5), a highdose of MDZ and a low dose of DEX were administered. In group 6 (G6), a highdose of DEX alone was administered intravenously. Blood pressure (BP), heart rate (HR), and arterial oxygen saturation values were measured. Sedation was assessed by determining the Ramsay sedation scores(RSS) during infiltration anesthesia (T1), incision (T2), cutting (T3), and suturing (T4). Before discharging from the hospital, patients were asked if they remembered the T1 to T4 procedures. The visual analogue scale (VAS) and the degree of patient satisfaction were assessed at the same time.

RESULTSIn T1 to T4, the systolic blood pressure (SBP) in G3 was the lowest and was significantly different from that in G1 and G2 (P < 0.05). In G1, the SBP was higher than that in G6 at the T3 and T4 points (P < 0.05). HR was below the preoperative (P < 0.05) in the G3 only. RSS was the lowest in G1 during the whole procedure. In G2, most patients obtained scores of 2-3. In G3, sedation was deeper, had more cases ofup to 5. In G4, most patients obtained scores of 3-4. In G5, some patients had a score of up to 5. The RSS in G6 was lower than that in G3 and G4 or G5 in T1 to T2, closer to G4 in T2. An evaluation of the VAS and the degree of patient satisfaction did not show any differences among the groups.

CONCLUSIONThe combination of DEX and MDZ is superior to a single intravenous injection. Low-dose MDZ combined with high-dose DEX achieved the highest quality of sedation in this study.

Anesthesia ; Blood Pressure ; Dental Care ; Dental Implants ; Dexmedetomidine ; therapeutic use ; Heart Rate ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Midazolam ; therapeutic use ; Pain Measurement ; Patient Satisfaction ; Prospective Studies

Objective To detect the microvessel density(MVD) marked by MIF protein in esophagus squamous cell carcinoma(ESCC), and to see if a relationship exists between microvessel density(MVD) and clinicopathologic features. Methods The expression of MIF in vascular endothelial cell in forty ESCC specimens was examined by immunohistocbemistry staining, calculated the mean of MVD and analysed the relationship with clinicopathologic features. Results The positive rate of MIF protein was 95.00 %(38/40) in ESCC vascular endothelial cell. Compared with the normal esophageal squamous tissue[32.50 %(13/40)], there was significant difference in statistics, the mean of MVD was 26.5±8.5. MVD was positively correlated with the tumor TNM stages and lymph node motastasis. Conclusion MIF can be used in tagging vascular endothelial cell, MVD of ESCC was positively correlated with the tumor TNM stages and lymph node metastasis. It might be an major prognostic factor in ESCC.

Objective To investigate the status of clinical blood transfusion from 2008 to 2014 in order to standardize clinical transfusion management and improve the clinical rational usage of various blood components .Methods By various blood compo‐nents transfusion ,the average quantity of clinical blood transfusion ,4 common blood types and the usage of red blood cells and platelet in different departments were analyzed and compared .Results The rate of blood component transfusion remained at 100%over the 2008 - 2014 year .The utilization of platelet was the highest ,followed by red blood cells and plasma ,and the amount of cryoprecipitate was the least from 2010 .The total consumption of blood was increasing each year ,but there was a downward trend at the average usage of clinical blood ,and also there were significant differences among 4 common blood types ,and the blood compo‐nent transfusion rate was different in different departments in hospital .Conclusion From 2008 to 2014 ,the blood transfusion is ap‐propriate and reasonable ,but still can be improved by effective means .

Objective To investigate the chemical constituents of red algae Hypnea charoides. MethodsThe constituents were isolated by column chromatography and their structures were elucidated by chemical properties and spectroscopic analyses. Results Three compounds were isolated and their structures were identified as 3, 6-dimethyl-8-(4-methyleneheptan-3-yloxy) octane-1-amine (Ⅰ), palmitate-K (Ⅱ), and (2R, 1′S, 2′S, 3′R)-N-(1′-hydroxymethyl-2′, 3′-dihydroxy-heptadecenyl)-2-hydroxy-12, 13-methylene-tetracosanamide (Ⅲ). Conclusion Compounds Ⅰ and Ⅲ are new compounds named as charoidesine and charoidesamide.

ObjectiveTo study the mechanism of nimodipine combined with electroacupuncture therapeutics protecting rats from cerebral ischemia and reperfusion injury.Methods60 rats were divided randomly into 3 groups, 24 rats in treatment group that accepted nimodipine combined with electroacupuncture therapy after middle cerebral artery occlusion (MCAO) for one hour, and 24 in control group,which acceptd normal saline after ischemia and reperfusion injury, and 12 rats in normal group. One or three days later, all rats were decapitated and their brains were extracted for superoxide dismutase(SOD) activity and malonaldehyde(MDA) concentration assay. And immunohistochemistry was used to detect the expression of growth associated protein 43(GAP-43),microtubule associated protein 2(MAP-2) and cyclin D1 protein.ResultsAfter ischemia and reperfusion injury,SOD activity markedly decreased in both treatment and control group while MDA concentration increased, compared with normal group(P<0.01).Level of MAP-2 expression in treatment and control group was markedly lower than normal group(P<0.01), while levels of GAP-43 and cyclin D1 expression were higher (P<0.01). Contrasted to control group, SOD activity was higher and MDA concentration was lower in treatment group. Level of GAP-43 and MAP-2 expression in treatment group were higher than those in control group, while level of cyclin D1 lower. Differences between treatment group and control group were significent(P<0.01).ConclusionsNimodipine combined with electroacupuncture therapeutics can prevent brains from ischemia and reperfusion injury. It's actions of wiping free radicals out, inhibiting apoptosis and protein hydrolysis and promoting nerve regeneration are involved in the mechanism.

Objective To evaluate the value of angled insonation technique in obtaining the volumes of the fetal palate and in three-dimensional post-processing.Methods Five hundred and sixty-six cases of 20~28 weeks fetuses with normal face were confirmed by systemic ultrasound examinations and post-natal examination.The volumes in the standard midsagittal plane and angled midsagittal plane were obtained,then post-processed these data by 4D-View software.The same technology was used for volume data acquisition and processing to 1 case of cleft lip and palate fetal.Results In 566 fetuses,two groups of volume data were successfully acquired in 458 cases (standard midsagittal plane group) and 411 cases (angled midsagittal plane group).Fetal primary palate in the standard group and the angled group can be both well visualized(100%).Axial plane of hard palate can not be reconstructed in the standard group.Only 36% of the fetal hard palate's coronal plane and transoral oblique coronal plane can be reconstructed.The visualization rate of soft palate was 87% in the standard group,which was slightly higher than the angled group (82%).The visualization rate of hard palate's axial plane,coronal plane and transoral oblique coronal plane was 100% respectively in the angled group.Cleft alveolar process involving the secondary palate can be clearly visualized in 1 case of cleft lip and palate fetus.Conclusions By using the angled insonation technique,which is based on clearly visualizing secondary palate to obtain volumes,using three-dimensional post-processing technique can obtain the conventional three orthogonal planes and any other section of the whole palate.By using it we can assess the integrity of fetal palate,diagnose cleft lip with or without cleft palate and classify the cleft palate,even make prenatal diagnosis of the isolated cleft palate possible.

Objective To review and sum up the experience of diagnosis and surgical treatment of cardiac myxoma. Methods 133 patients with cardiac myxoma of different locations from January 1990 to May 2007 admitted in Qilu Hospital of Shandong University and Department of Cardivovascular Affdiafed Zhong shan Hospital of Xiamen Unversity were clearly diagnosed by two dimensional echecardiography. The tumors of 109 patients were located in left atrium ,22 in right atrium and 2 in both cardiac atria. All the patients underwent tumor extirpation under extracor-poreal circulation. Atrioventricular valve plasty was performed when necessary. 11 underwent bicuspid valvuloplasty and 6 underwent tricuspid valvuloplasty at the same time. All the minors were sent to histopathology examination. Re-suits Two patients died of low cardiac output syndrome in early postoperative period. Cerebral embolism happened in 6 cases,left lower extremity embolism and pulmonary embolism in 1 ease respectively. Other patients' symptoms were improved and the physical sign disappeared. All the tumors were demonstrated to be benign cardiac myxoma. Conclusions Most cardiac myxoma is benign but its clinical consequence is severe. So tumor extirpation should be performed as soon as possible and the following-up is important after operation. Prevention of tumor defluvium is im-portant. Two dimensional echocardiography is preferred in the diagnosis of cardiac myxoma.

Objective：To study the toxicity mechanism(s) of ifosfamide(Ifo) in suspending cultured rat hepatocytes.Methods：Hepatocytes of adult rat were isolated using two-step perfusion method and cultured suspendingly. Cell viability,intracellular enzyme leakage, contents of sulfhydryl groups and MDA contents of hepatocytes were examined 3 hours after ifosfamide was administered at 5,10,20 mmol/L. Surface and ultrastructure of hepatocytes were also observed. Results：Cell viability and TSH,NPSH,PSH contents of hepatocytes significantly declined, and LDH,AST activities in media increased due to the leakage of intracellular enzymes. The decrease in PSH content was ascribed to depletion of TSH. The higher the dose was, the more serious these changes became. However, MDA contents of the hepatocytes were not found increased at any ifo dose groups. In pathological examination, “bulla" formation was found on the surface of the hepatocytes, deformation，swelling even vacuolation of mitochondria and dilation of rough，smooth endoplasmic reticulum were also observed. Conclusions：Ifo has toxic effect on suspending cultured rat hepatocytes. The decrease in sulfhydryl groups contributes to the hepatotoxicity induced by Ifo.

The present study examined the protective effect of the ethanol extract of Sarcopyramis nepalensis (EESN) on agents-induced hepatotoxicity in mice and the possible mechanism. Acute liver injury was induced by administration of either CCl(4) or D-GalN. The animals were divided into 5 groups in terms of different treatment: normal group, CCl(4) or D-GalN group, silymarin or bifendate group, low dose EESN group (10 mg/kg) and high dose EESN group (30 mg/kg). Liver function was evaluated by detecting the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The oxidize stress markers were measured, including malondialdehyde (MDA), glutathione peroxidase (GSH) and superoxide dismutase (SOD). Liver tissues were histopathologically examined by hematoxylin-eosin (H&E) staining. The acute toxicity study revealed that there was no toxicity of EESN at the dose of 5 g/kg in mice. The levels of ALT and AST in serum, and the MDA level in live tissues were significantly increased and the activities of SOD and GSH substantially decreased in mice after CCl(4) or D-GalN treatment. These biochemical and oxidize stress markers were profoundly improved after treatment with EESN at different doses, which was similar to the results of silymarin or bifendate treatment. The histophathological examination revealed the significant improvement in the pathological changes of the liver in EESN-treated mice as compared to those in CCl(4) or D-GalN group. It was concluded that EESN possesses potential antioxidant and hepatoprotective properties and has therapeutic potential for liver diseases.

To improve the water solubility of daidzein, solid inclusion complexes of daidzein with two amino-modified β-cyclodextrins (ACDs), i.e., mono-6-amino-6-deoxy-β-cyclodextrin (NCD) and mono-6-ethylenediamino-6-deoxy-β-cyclodextrin (ENCD), were prepared by the saturated solution method in water under the preparation conditions as follows: the ratio of daidzein/ACD was 3∶1 and the stirring time was 72 h (83% and 67% yields, respectively).The formation of two inclusion complexes was confirmed by x-ray diffractometry (XRD) and themogravimetric (TG) analysis.The inclusion stoichiometry of the inclusion complexes was 1∶1 from the Job plot and their complexation stability constants (KS) were 899.2 and 203.8 L/mol from fluorescence titration, respectively.After formation of inclusion complexes with NCD and ENCD, the water solubility of daidzein was dramatically raised from 8.31 μg/mL to 15.2 and 13.2 mg/mL at 25℃, increasing by 1800-fold and 1500-fold.