Objective To evaluate the efficacy and safety of dexmedetomidine combined with propofol for gastroscopy in elderly patients.Methods Ninety ASA physical status Ⅰ-Ⅲ patients,aged 65-80 yr,weighing 45-80 kg,scheduled for elective gastroscopy,were randomized to receive either dexmedetomidine combined with propofol (group DP,n =45) or propofol (group P,n =45).In group DP,dexmedetomidine 0.4 μg/kg was infused over 5 min and propofol 1.0 mg/kg was injected intravenously 25 min later.Propofol 2.0 mg/kg was injected intravenously in group P.When body movement occurred during operation,additional propofol 0.2 mg/kg was given intermittently.Mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2) and Narcotrend index were monitored during the whole procedures.The consumption of propofol and vasoactive agents,adverse cardiovascular events,and respiratory depression were recorded.Results Compared with group P,the consumption of propofol,incidences of respiratory depression and tachycardia,and degree of body movement were significantly decreased (P ＜ 0.05),Narcotrend index was increased during operation (P ＜ 0.01),and no significant change in the incidence of circulatory depression was found in group DP (P ＞ 0.05).Conclusion Small dose of dexmedetomidine 0.4 μg/kg combined with small dose of propofol 1.0 mg/kg provides good efficacy and safety for gastroscopy in elderly patients.

Recent in vitro and in vivo experiments have revealed that ellagic acid and its metabolites can inhibit the growth of digestive system malignant tumor cells by inhibiting tumor cell proliferation,inducing apoptosis,breaking DNA binding to carcinogens,blocking virus infection,disturbing inflammation,angiogenesis and drug-resistance processes required for tumor metastasis.Ellagic acid and its metabolites are potential chemoprevention and therapeutic drugs against human cancers.

Objective To compare the clinical effects of transurethral plasmakinetic resection(TUPR) with transurethral resection of the prostate(TURP) for benign prostatic hyperplasia.Methods From October 2003 to July 2006,a total of 127 patients with benign prostatic hyperplasia was divided the into the TURP Group(n=62) and the TUPR Group(n=61) according to random number table by computer.1 case of neurogenic bladder and 3 cases of TURP failure were ruled out the study.Results As compared with the RTRP Group,the TUPR Group had less intraoperative blood loss[(78.5?46.2)ml vs(115.0?43.5)ml,t=4.511,P=0.000] and more weight of resected prostate[(60.5?29.3)g vs(45.9?30.5)g,t=2.709,P=0.008].The operation time in the two groups was similar[(93.4?35.5)min vs(81.3?46.3)min,t=1.629,P=0.106].There were no statistic differences in international prostate symptom score,quality of life,Qmax,residual urine and complication rate(2/61 vs 5/62).Conclusions Compared with TURP,transurethral plasmakinetic resection of the prostate has the advantages of less blood loss and more entire resection of the prostate,so it might be more effective.

Objective To investigate the effectiveness and safety of the slender external biliary drainage tube (F5 ureter catheter) inserted into the common bile duct via the cystic duct in laparoscopic choledochotomy with primary closure.Methods Clinical data of 59 patients with cholecystolithiasis and choledocholithiasis treated in our hospital between Feburary 2013 and March 2016 were retrospectively analyzed.The patients were treated with laparoscopic common bile duct exploration followed by primary duct closure,and bile duct drainage with a slender catheter through cystic duct after closure of the choledochotomy.Results All the cases underwent surgery successfully.The postoperative output of bile drainage was 30-570 ml/d.There were no complications such as biliary leakage,cholangitis or biliary pancreatitis.The catheter was withdrawn in 6-8 d in 57 patients after the operation,and was withdrawn in 10-11 d in 2 patients after the operation.There was no discomfort after removing the catheter.Postoperative hospitalization time was (9.1 ± 2.0) d.All patients were followed up for 5 months to 3 years,with an average of 16 months.The B ultrasound examinations showed no residual bile duct stones and liver functions were normal.Conclusions External biliary drainage using a slender ureter catheter via the cystic duct is safe,effective and easy to perform.It may reduce postoperative potential complications,especially bile leakage.

early lithagogue rate.

Objective To construct h n bone marrow mesenchymal stem cell line genetically modified with human proenkephalin gene. Methods The packaging cell line Phoenix-293T was transfected with the recombinant pBABE-PENK vector to aquire virus. The recombinant virus was then collected and used to infect hMSCs. Stable expression of proenkephalin gene and leucine enkephalin protein and the concentration of leucine enkephalin protein were detected by RT-PCR, immunofluorescence and ELISA respectively. Results The expression of proenkephalin gene and leucine enkephalin protein were significantly up-regulated in the hMSC-PENK cells, and the concentration of leucine enkephalin protein was also increased in the culture medium. Conclusion A human mesenchymal stem cell line that expresses proenkephalin gene and secrets enkephalin was successfully established.

Tuberculous meningitis is an important global medical problem which gives rise to high morbidity and mortality. It is the most severe form of extrapulmonary Mycobacterium tuberculosis. Comprehensive prevention effort, prompt diagnosis and rational treatment are all keys to improving treatment outcomes; yet many unsolved problems remain. On the other hand, the new problems, such as HIV co-infection and drug-resistance are posing important challenges. This review outlines the epidemiology, pathogenesis, diagnosis, management and prognosis of tuberculous meningitis. We mainly focus on research carried out in the recent decades, giving special attention to the work done among the Asian populations
Tuberculosis, Meningeal

Objective To assess the clinical outcomes in patients who underwent laparoscopic primary closure of common bile duct (CBD) with or without transcystic cholangiography and transcystic biliary drainage.Methods From June 2013 to March 2016,we operated on 46 patients who underwent primary closure of common bile duct after laparoscopic choledochotomy (group A).The results were compared with 51 patients who underwent primary closure of common bile duct after laparoscopic choledochotomy together with transcystic biliary drainage (group B) during the same study period.Results There was a significant difference in the incidence of postoperative bile leakage between the two groups.The risk in group A was sig nificantly higher than group B (8.7％ vs 0％,P ＜0.05).The duration of operation in group A was significantly shorter than in group B [(125.3 ± 28.3) min vs (131.3 ± 20.5) min].There were no significant differences in the duration of hospital stay between the two groups [(7.3 ± 2.4) days vs (7.8 ± 1.9) days,P ＞ 0.05].All patients were followed up (range 3 months to 29 months,average 8.4 months).B-ultrasound examination showed no residual bile duct stones and the liver functions were normal.Conclusions Laparoscopic primary closure of common bile duct was possible after choledochotomy.Transcystic cholangiography and transcystic biliary drainage after primary closure of common bile duct were safer and more reli able.

OBJECTIVE:To evaluate the medical orders in terms of the medication for the inpatients with tuberculosis in our hospital.METHODS:The medical orders for the inpatients in Tuberculosis institute from Dec.7th,2007 to Jan.6th,2008 were synchronously monitored and analyzed.RESULTS:Of the total 5 592 medical orders monitored,1 461 were warned by PASS,of which,562 were warnings about drug interactions,884 about dosage and 15 were about incompatibility.CONCLUSION:Medical orders synchronously monitored by PASS could help correct and monitor the irrational medication.But the function of PASS remained to be strengthened and the data base remained to be enriched and renewed in time.

Objective To examine the current situation of smoke-free policies and the support for comprehensive smoke free policies in Beijing, Shenyang, Shanghai, Changsha, Guangzhou, and Yinchuan. Methods Data from Wave 1 of the ITC China Survey (April 2006-August 2008) were analyzed. The ITC China Survey employed a multistage sampling design across 6 cities: Beijing, Shenyang, Shanghai, Changsha, Guangzhou, and Yinchuan. Face to face interviews were conducted with a total of 4 815 smokers and 1 270 non-smokers across the 6 cities to examine their support for smoke free policies. Multivariate logistic regression models were used to identify factors associated with support for comprehensive smoke free policies. Results None of the six cities had implemented comprehensive smoke free policies. Support for comprehensive smoke free policies in workplaces, restaurants and bars was relatively lower compared to hospitals, schools, and public transport vehicles. Support for comprehensive smoke free policies in workplaces, restaurants and bars were associated with knowledge about the adverse health effects of secondhand smoke (for workplaces OR=1.27, 95%CI: 1.08~1.49; for restaurants and bars OR=1.55, 95%CI: 1.17~2.05). Conclusion More comprehensive smoke free policies are needed in the 6 cities. To improve support for comprehensive smoke free policies, public knowledge about the adverse health effects of secondhand smoke needs to be strengthened.