OBJECTIVE:To evaluate the postoperative analgesic effects and side effects of buprenorphine versus ketamine for patients with patient-controlled epidural analgesia(PCEA).METHODS:60 patients withⅠ～Ⅱ grade in physical status evaluated by American society of anesthesiologists(ASA)scheduled for lower abdomen surgery by lumbar anesthesia combined epidural anesthesia were divided into three groups by a randomized double blind method to be treated with Buprenorphine + Droperidol(Group A),Buprenorphine + Droperidol + Bupivacaine(Group B),or Ketamine + Droperidol+ Bupivacaine(Group C).The visual analogous scale(VAS),Ramsay scale,frequency to press the analgesia pump was recorded at 0～48 h after operation,the time spent for the recovery of intestinal functions;score for nausea vomiting and other adverse drug reactions were observed.RESULTS:Frequency to press the analgesia pump,VAS score and Ramsay score in Group A in different period of time were all significantly different from those in Group B and Group C(P

Objective To evaluate the clinical features and guanosine triphosphate cyclohydrolase 1 (GCH-1) gene mutation in a family with dopa-responsive dystonia (DRD).Methods The clinical features of this family were collected and their peripheral blood samples were screened for mutation in GCH-1 gene using PCR and DNA direct sequencing.Results The clinical features among each patient in this family were different.But all affected family members had quite a good response to levodopa treatment without significant adverse reactions.DNA test showed an AT deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene in 5 affected members and 1 asymptomatic immediate family member.Conclusions Clinical heterogeneity is an important characteristic of DRD and clinical symptoms vary intra-families.Same gene type may cause different phenotype and not all carriers are patients.The deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene should be considered as a pathogenic mutation for DRD.

Objective To detect the ERCC1 expression in nasopharyngeal cancer(NPC),to analyze its relationship with concurrent chemo-radiotherapy.Methods The biopsy specimens were obtained through nasopharyngeal endoscopy from patients with NPC in the Fourth Affiliated Hospital of Guangxi Medical University from January 2008 to December 2008.The ERCC1 expression in the cancer tissue was detected using MaxVision immunohistochemistry.Eight weeks after the chemo-radiotherapy,MRI was performed,The MRI results were used to assess the efficacy according to RECIST 1.1 standard,with sensitive group including complete relief (CR) and partial relief (PR) and insensitive group including stable disease(SD) and progress disease (PD).MRI was re-performed every three months with follow-up 3 years.The relationships between ERCC1 expression and concuTent chemo-radiotherapy in the short-term sensitivity and overall survival in patients with nasopharyngeal cancer were analyzed.Results 76 cases were collected.All cases were evaluable for the short-term sensitivity,and only 72 cases were evaluable for progression-free rate and overall survival (OS).In 76 short-term curative effect evaluable cases,CR was 56 cases (73.68 ％),PR was 11 cases (14.47 ％),SD was 3 cases (3.95 ％),PD was 6 cases (7.89 ％),respectively.RR (effective efficiency) was 88.16 ％ and DCR (disease control rate) was 92.1％.The positive rate of ERCC1 expression was 42.1％ (32/76),with 37.3 ％ (24/67) in the sensitive group (CR+PR) and 88.8 ％ (8/9) in the non-sensitive group (SD+PD).RR and DCR in the negative ERCC1 expression group were higher (97.7 ％,97.7 ％) than those in the positive expression group (75 ％,81.3 ％,x2 =7.119,P ＜ 0.05).Of 72 case,twelve month progression-free survival (PFS) rate was 91.7 ％ (66/72),with 95.5 ％ (39/41) in the negative ERCC1 expression group and 87.1％ (27/31) in the ERCC 1 positive group,and there was no significant difference between the 2 groups (x 2 =0,623,P =0.430).Of 72 cases,one year OS rate was 93.0 ％ (67/72),two years OS rate was 84.7 ％ (61/72),three years OS rate was 72.2 ％(52/72).Of 31 ERCC1 positive cases one year OS rate was 90.6 ％(28/31),two years OS rate was 77.4 ％ (27/31),and three years OS rate was 61.3 ％ (19/31).Of 41 ERCC1 negative eases one year OS rate was 95.5 ％(39/41),two years OS rate was 90.2 ％ (37/41),and three years OS rate was 82.9 ％ (34/41).The ERCC1 expression demonstrated significant correlation with the short-term sensitivity and OS (x2 =4.192,P =0.041).Conclusion The ERCC1 expression in NPC has negative correlation with the chemo-radiotherapy and short-term sensitivity,which may predict the chemo-radio therapy sensitivity in NPC.The ERCC1 expression in NPC has significant correlation with OS.It may predict the prognosis of NPC.

Objective To research etomidate or propofol in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods Ninety patients undergoing abdominal surgery patients with coronary heart disease were randomly divided into etomidate group (E group, 45 cases) and propofol group (P group, 45 cases). In pre-anesthesia, after the induction of anesthesia and after intubatiou with power spectral analysis of heart rate variability (HRPSA) observed in patients with heart rate variability (HRV) changes. Results After the induction of anesthesia, the low frequency(LF)[(316±301) ms2/Hz] end total power(TP)[(756±535) ms2/Hz] decreased significantly in E group(P<0.05) and LF, high frequency (HF), LF/HF ratio(LF/HF)and TP decreased significantly in P group [ (187±168) ms2/Hz, (89±48)ms2/Hz, 2.3±1.6 and (616±462) ms2/Hz] (P<0.05). The duction degree of LF, HF, TP and LF/HF in E group was more significant than that in P group (P<0.05). After intubation, LF, HF, LF/HF and TP increased significantly in both groups and no significant difference of HRV was observed between the two groups (P>0.05). Conclusions Propofol decreases the activity of autonomic nervous system, wherea etomidate produces minimal changes under anesthesia induction in elderly coronary heart disease patients.There is no remarkable difference in cardiovasological changes induced by etomidate and propofol during tracheal intubation.

Objective To evaluate the protective effect on the pulmonary micmvascolar permeability and thereby to ameliorate the lungs injury attributed to cardiopuimonary bypass(CPB).Method Twenty-four adult hybrid health dogs were randomly divided into three groups(8 in each group):group C(normal saline given after CPB),group N1(NAC given intravenously just before CPB)and group N2(NAC given just after CPB).The changes of respiratory index(RI)and malondialdehyde(MDA)content in lung tissue were observed.Samples were taken three times,before CPB(T0),30 min after CPB surned off(T1)and 60 min after CPB sumed off(T2).The leucocyte count and slbumin content in bronchoalveolar lavage fluid(BAlF),the pulmonary micmvascular permeability index(PMPI),and the histological changes of lung under light microscope and electromicroscope in 3 groups were examined.Results No significant differences were found in the levels of Ri and MDA content of lung tissue between groups before CPB.However,they gradually reduced after CPB(P<0.05)in the three groups,but they still were significantly lower in group N1 and group N2 compared with those in group C at,T1 and T2(P<0.05)and those in group N1 were significantly lowere than those in group N2 at T1 and T2(P<0.05).MDA gradually increased after CPB in three groups(P<0.05),but it was still significantly lower in group N1 and group N2 than that in group C at T1 and T2(P<0.05).The leucocyte count and albumin content in BALF were significantly lower in group N1 and group N2 in comparison with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).The PMPI were significantly lower in group N1 and sroup N2 compared with those in group C(P<0.05)and they were significantly lower in group N1 compared with those in group N2(P<0.05).By using electromicroscope,the apparent inflammatory change of lung with endothelium cellular swelling,inter-endothelial cells spaces widened,and the indistinctness,deformation or decurtation of microfilarnent were observed.And the dissolution of laminated body,swollen mitochondria and plasmolysis were found in alveolar epithelial cell Ⅱ in group C.However,these changes were markedly alleviated in group N2 and group N1.Conclusions The results clearly demonstrate that NAC could protectie effect on the CPB injured lung and reduce the pulmonary microvascalar permeability,and the protetive effect is better in group N1 than that in group N2.

Objective To explore the relationship between TGF-?, P21ras, c-fos and the apoptosis of human embryonic pancreatic islet cells. Methods Semi-quantitative RT-PCR and immunohistochemistry (SABC method) were used to detect TGF-?, P21ras, c-fos expression at different growth periods of the primary human embryonic pancreatic islet cells and human fibroblast cells. Results P21ras expression was weak in every period of the pancreatic islet cells and significantly weaker than the fibroblast cells at exponential growth period and was stronger than in incubation period and retention period (P

During the course of the investigation of the antifungal metabolites against Peronophythora litchii from the fermentation broth of Streptomyces sp SC120, an antibiotics that exhibited the cytotoxicity to CNE 2 was isolated By spectral (UV, IR, HRMS, 1H NMR, 13 C NMR, 1H 1H COSY, HMQC and HMBC) analyses, its structure was identified as pimprinine The cytotoxicity of pimprinine to CNE 2 was reported for the first time

Objective To determine the in vitro antibacterial activity of levornidazole against 375 anaerobic isolates.Methods Agar dilution method was used to determine the minimum inhibitory concentrations (MICs)of levornidazole,3 comparators (metronidazole,ornidazole and dextrornidazole)against 375 anaerobic isolates.Results For anaerobic gram-negative and gram-positive bacilli,and anaerobic gram-positive cocci,levornidazole displayed activity similar to or slightly higher than that of met-ronidazole,ornidazole and dextrornidazole.Levornidazole showed good activity against B.fragilis,Bacteroides thetaiotaomi-cron ,Clostridium difficile ,Clostridium perfringens ,and Peptostreptococcus magnus .The MIC90 value of levornidazole a-gainst the above-mentioned anaerobes was 0.5,1,0.25,2 and 1 mg/L,respectively.However,levornidazole and the compa-rators had poor antibacterial activity against Veillonella spp.among anaerobic gram-negative cocci.Conclusions The in vitro anti-anaerobic activity of levornidazole is similar to or slightly higher than that of metronidazole, ornidazole and dex-trornidazole.Levornidazole has good activity against both gram-negative and gram-positive anaerobic bacilli,and gram-positive anaerobic cocci,suggesting its promising clinical use.

Objective To investigate the whole genomic expression profiles of chronic atrophic gastritis with interleukin(IL)-1β-31CC/-511TT genotype as measured by oligonucleotide microarray technique.Methods Genomic RNA was extracted from gastric biopsies of 12 patients with chronic atrophic gastritis(6 with IL-1β-31CC/-511TT and 6 with IL-1β-31TT/-511CC).The genomic profiles of IL-1β gene polymorphisms 31CC/-511TT and 31TT/-511CC were compared and tested for differential expressed genes associated with 31CC/-511TT using Agilent human whole genomic oligonucleotide microarrays.The results were further analyzed in terms of gene ontology(GO).Results There were 200 differentially expressed genes associated with IL-1β-31CC/-511TT,159 of which were up-regulated and 41 were down-regulated.These genes mainly involved in macromolecule metabolic process,post-translational protein modification,ubiquitin cycle,and protein kinase cascade.Five genes had biological activities,one of which was down-regulated gene(PCSK5)and 4 were upregulated genes(PRKCA,NPLOC4,TRIB3 and MAPKAPK3).Conclusions The chronic atrophic gastritis with IL-1β-31CC/-511TT genotype has molecular phenotypes which is associated with malignance and inflammation.These individuals are needed more intensive preemptive treatment and dynamic surveillance.

Objective To investigate the role of spo0A gene in growth and sporulation of Clostridium difficile clinical isolates. Methods ClosTron gene knock-out system was used to knock out the spo0A gene of C. difficile strain C25. Bacterial growth curve was plotted by measuring D600 with spectrophotometer in different phases of bacterial growth. Malachite green staining technique was used to count the number of vegetative cells and spores under optical microscope. The sporulation rate was calculated. Results The spo0A mutant and its C25 parental strain showed similar patterns of growth. However, after knock-out of spo0A gene, an asporogenous phenotype was built, while the parental strain could produce spores as usual.Conclusions The spo0A gene plays a key role in sporulation but not growth of C. difficile strain.