Objective To compare the feasibility and efficacy between dexmedetomidine and midazolam in herniorrhaphy surgery for older patients. Methods Sixty American Society of Anesthesiology (ASA) gradeⅠ~Ⅱpatients, treated by herniorrhaphy surgery under local anesthesia,were randomly divided into dexmedetomidine group (n=30) and midazolam group (n=30) .Patients in dexmedetomidine group were given dexmedetomidine at a loading dose of 1μg/kg for 10 min,then they were injected continuously by 0.4μg/(kg·h),whereas midazolam group were given midazolam at a loading dose of 0.06 mg/kg, then 0.04 mg/(kg·h) injected continuously.The mean blood pressure (MAP) and heart rate (HR) were recorded before infusion (T0),incision of skin (T1),15min (T2) and 30 min (T3) after administration and when sutured skin (T4), adverse reaction were also assessed. Results The difference of sedation level was not significant between the two groups (P>0.05) .Compared with T0 , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with midazolam group , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with dexmedetomidine group, the rate of respiratory depression and restlessness were more in midazolam group, but bradycardia was lower (P<0.05) .Conclusions Dexmedetomidine is a comparable alternative to midazolam for sedation in herniorrhaphy surgery under local anesthesia. It is associated with better respiration and lower restlessness but with a high incidence of bradycardia.

AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema.METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion (n=54 eyes) or diabetic retinopathy (n=39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender.RESULTS: IOP increased significantly (P＜0.001) at 14 days 16.02± 2.45mmHg after injection and peaked at 18.80± 6.20 at 2 months post-injection (P＜0.001) from 14.85 ± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18(19.5%),9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5,and 6 months after injection. One eye (0.01%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22 mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, P ＜0.05), high baseline IOP (correlation coefficient 0.52-0.79, all P ＜0.001),and the presence of diabetes mellitus (correlation coefficient 023, P＜0.001) but independent of gender (correlation coefficient -0.002-0.04, all P ＞0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes.CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

AIM: To investigate the expression of peroxisome proliferator-activated receptors (PPARs) in human endothelial cells, and their effects on plasminogen activator inhibitor-1 transcription. METHODS: The expression of three types of PPARs in mRNA level were detected in human umbilical vein endothelial cells(HUVECs) by using RT-PCR. Cultured endothelial cells line-ECV304 were transfected with PAI-1 promoter controlling CAT reporter gene and co-transfected with varying doses (250, 500, 1 000 ng) of expression vectors PPAR? or PPAR?.The transcripton activity of PAI-1 promoter were detected with ELISA. RESULTS: There were all three types of PPARs mRNA expression in HUVECs, while the expression of PPAR? was less than that of PPAR?( P

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Styrenes ; analysis ; Workplace

Objective To analyze the status, changing trends and determinants of mental health of migrant adolescents in junior high schools. Methods All of the data came from China Education Panel Survey (CEPS). CEPS baseline survey was conducted during the 2013-2014 school year by using a stratified multistage probability sampling design. 10 279 nationally representative adolescents from the seventh grade in junior high schools were enrolled in the base school year of data collection and 9 449 participants were followed up at the second wave of data collection during the 2014-2015 school year. Our analytic sample (n=1 645) included all the migrant adolescents who had valid data on mental health. Based on CEPS self-reported mental health scale, t-test method and multivariate linear regression model were used to examine the determinants of mental health of migrant adolescents by performing univariate analysis and multivariate analysis. Results The baseline mental health score of migrant adolescents was (8.33±3.31), higher than that of non-migrant adolescents, and significantly increased to (8.60±3.79) in the follow-up school year. 43.3% of participants had negative mental status at higher frequency as time went on. Sex, cognitive skills, co-residence arrangements, numbers of siblings and school rankings were significant influencing factors for mental health score of migrant adolescents. Conclusions The mental health status of migrant adolescents are more vulnerable than that of non-migrant adolescents and continue deteriorating. Among migrant adolescents, female, those with weak cognitive skills, those who do not live with both parents, those who are not only children and those in schools ranking medium and above are more likely to have a poor mental health state.

AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy ( PPV ) combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. ·METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity ( BCVA ) , intraocular pressure (IOP), counting of corneal endothelial cells ( CEC) and central retinal thickness ( CRT ) were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution ( LogMAR ) visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy ( AVE) and effective phacoemulsification time ( EPT ) were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d. ·RESULTS:The mean operation time for vitrectomy were 12. 57± 1. 35min in 23G group and 17. 30 ± 1. 19min in 20G group. The difference was statistically significant ( t =-12. 488, P<0. 01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups ( t=-0. 68,-1. 186,-0. 737, P=0. 500, 0. 242,0. 465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant (t= -2. 345, P=0. 024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT ( F = 0. 465, 1. 895, 0. 689; P = 0. 499, 0. 176, 0. 411). IOP, BCVA and CRT were significant statistical different in different time-point within each group ( F=291. 245, 103. 06, 665. 402, P<0. 01 ). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points ( F = 13. 245, P<0. 01 ), but different surgeries had no interactive effects on BCVA and CRT with different time points (F=1. 212, 2. 293;P=0. 283, 0. 129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant (t=2. 049, P=0. 048). ·CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery

Objective To establish a method for detecting HBV cccDNA in hepatocytes of chronic hepatitis B patients.Method 21 liver biopsies from the hepatic operation patients in the hospital of jiangsu province,concluding 19 HBV chronic infected patients (10 HBeAg positive patients and 9 HBeAg negative patients) and 4 uninfected patients,HBV DNA(+) serum of hepatitis B patients was thought as rcDNA.To use proteinase K to release HBV cccDNA and genomic DNA,then divide the cell lysis solution into two parts,one for detecting HBV cccDNA,the other for detecting the number of ?-Globin as internal control. Nucleic acid for detecting HBV cccDNA extracted by phenol-chloroform was digested by plasmid-safe ATP dependent DNase which was applied to digest the single strand DNA in rcDNA and ssDNA,then was quantitated by the primers spanning across the nick and SYBR Green Ⅰ dye.The specifity of PCR production was confirmed by the sequence analysis and rcDNA comparison.The significance of the difference of HBV cccDNA level between HBeAg(+) and HBeAg(-) group was analyzed by two group t test.Results The agarose gelelectrophoresis showed the molecular weight of the PCR production was about 350bp.The coincidence rate of PCR production and goal fragement was nearly 99% by sequence analysis.The result of PCR detection of rcDNA group was negative.The positive rate of HBV cccDNA of liver biopsies of HBeAg (+) patients detected by this method was 100%,the level of HBV cccDNA in the liver biopsies of HBeAg (+) patients was higher than HBeAb(+) patients.Conclusions The specificity of the method is proved by agarose electrophoresis,gene sequencing of the PCR product and rcDNA comparison.The quantitative method that use SYBR Green Ⅰ dye and ?-Globin as internal control is more specific,sensitive and economical,and more suitable for clinical purpose.

Objective To evaluate the immediate and short term therapeutic efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to investigate the prevention of the related complications. Methods PTSMA was conducted in 3 patients with HOCM refractory to medication. The immediate effect was evaluated by pressure monitor, but the follow up effect by observation of the clinical symptoms and ultrasonic cardiogram. Results The left ventricular outflow tract gradients triggered by ventricular premature beats decreased from 143 mmHg (ranging from 70 to 180 mmHg) to 53 mmHg (ranging from 30 to 80 mmHg). Complete atrioventricular block (Ⅲ?AVB) with atrioventricular node rhythm was found in 1 case, and complete right branch bundle block (CRBBB) in another one. Follow up of the 3 cases at 6 months after operation revealed remarkable improvement of the patients' cardiac function (NYHA), disappearance of angina pectoris, and obvious attenuation of ventricular septal hypertrophy and SAM (systolic anterior motion of mitral) phenomenon. Conclusion PTSMA is an effective method with satisfactory short term effect for the patients with HOCM refractory to medication.

Objective: To construct the expression plasmid of a novel gene human NBEAL1 (neurobeachin like 1), and to study its relationship with the pathological grades of glioma. Methods: Total RNA of human glioma cell line U251 was extracted. NBEAL1 expression plasmid pGEX-KG/NBEAL1 was constructed and transferred into E. coli BL21. Recombinant NBEAL1 protein was induced by IPTG and further purified by GST affinity chromatographic column. The purity of recombinant NBEAL1 protein was examined by Western blotting analysis. A NBEAL1 protein specific monoclonal antibody was prepared and was used to study the relationship of NBEAL1 expression with pathological grades of glioma. Results: The NBEAL1 gene fragment was successfully cloned into pGEX-KG expression plasmid and verified by DNA sequencing. The recombinant NBEAL1 protein was expressed in inclusion bodies, with a yield of more than 30% of total bacterial proteins; the purity of purified NBEAL1 protein was above 95%. Western blotting analysis confirmed that the purified protein containing GST tag and NBEAL protein. NBEAL1 protein was lowly expressed in normal brain tissues and highly expressed in low grade glioma tissues; and the expression of NBEAL1 decreased with the increase of glioma malignancy. Conclusion: The NBEAL1 protein has been successfully cloned, expressed and purified. NBEAL1 protein expression in glioma tissues is negatively associated with the pathological grades of glioma.

Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.