ve In order to improve the reliability of somatosensory evoked potentials (SSEP) monitoring during anesthesia, we compared the effects of three commonly used volatile anesthetics on SSEP to choose suitable volatile anesthetic and determine the appropriate end-expiratory concentrations which have least effects on SSEP monitoring. Methods Sixty ASA I - II patients undergoing elective intracranial surgery were randomly divided into three groups: group A received enflurane; group B isoflurane and group C desflurane. The demographic data including age, body weight, height and sex were not significantly different between the three groups. In addition to SSEP, ECG, BP, SpO2, PET CO2 and end-tidal concentration of inhalation anesthetic were monitored. The SSEP electrodes were placed on N13 on the neck and N20 on the scalp. Before experiment the patient was asked to lie quietly for 10 min, then the patient started breathing 100% O2 and fresh-gas-flow (FGF) was set at 5 L/min. Median nerve on one side was stimulated and SSEP waves from cortex and cervical spinal cord were recorded as baseline tracing before anesthesia. The concentration of inhalation anesthetic was gradually increased from 0 to 0.3, 0.5, 0.75, 1.0 and 1.5 MAC. Each concentration was maintained for 15 min and SSEP waves were recorded. During experiment if the patient developed respiratory depression, oral airway was inserted and assisted ventilation was performed to maintain PETCO2 at 35-45minHg. If the patient developed hypotension, fluid was infused at an increased rate and vasopressor was given if necessary to maintain normal BP (baseline ? 20 % ) . Results The three volatile anesthetics did not change N13 latency and amplitude. Increasing concentrations of enflurane, isoflurane and desflurane were associated with graded reduction in N20 amplitude and increase in N20 latency and N13-N20 interpeak latency. Conclusions The results suggest (1) cortical SSEPs are moresensitive to the volatile anesthetics than subcortical SSEPs, (2) end-tidal concentration of enflurane less than 0.75 MAC is compatible with effective SSEP monitoring, whereas the end-tidal concentration of isoflurane or desflurane compatible with effective SSEP monitoring was less than 1.0 MAC. Enflurane has greater effect on SSEP than isoflurane and desflurane.

Objective To explore the key factors which affect maintenance cost of large-scale medical equipment. Methods The basic factors which affect maintenance cost of medical imagining equipment were summarized. The relationships of them are analyzed and then an interpretative structure mode of each factor was set. Additionally, the multiple relationship and controllability between each factor were also analyzed and the judging standard of key factors was set. Results The maintenance policy and mode were the key factors which affect maintenance cost of medical imagining equipment. Conclusion High quality maintenance for equipment condition and scientific optimization of the maintenance policy are necessary to fundamentally reduce the maintenance cost of large-scale medical equipment.

PAC1 is the neuropeptide pituitary adenylate cyclase activating polypeptide (PACAP) preferring receptor, which belongs to class B G protein-coupled receptors (GPCR) family. PAC1 mediates the most effects of PACAP as neurotransmitter, neuroregulator and neuroprotectant, while its high expression has close relationship with some physiological and pathological processes such as nerve-injury and tumor. To further understand the function of PAC1, a cell line that expressed inducible PAC1 was constructed to achieve Doxycycline (Dox) dependent expression of PAC1 in CHO (Chinese hamster ovary) cell using the improved Tet (tetracycline)-on Advanced System. First, the PAC1-EYFP fusion gene composed of PAC1 gene and gene encoding EYFP (enhanced yellow fluorescent protein) was sub-cloned to the tetracycline response element pTRE-Tight vector to construct the recombinant vector pEYFP-PAC1-EYFP by double enzyme digestion. Second, the tetracycline regulation components pTet-On advanced vector and the response element pTRE-PAC1-EYFP vector were both introduced into CHO cells successively and the positive clones were screened with G418 and hygromycin respectively. Third, the controlled expression of PAC1-EYFP in CHO was induced by tetracycline analogues Dox in different concentrations and the different levels of receptor PAC1-EYFP were detected. The results of fluorescence analysis and western blotting show that the cell strain with Dox dependent expression of PAC1-EYFP named PAC1-Tet-CHO was obtained. Moreover, in PAC1-Tet-CHO cells the expression of PAC1-EYFP was induced by Dox in a dose-dependent manner. The inducible expression of PAC1 still was stable after sub-culturing for more than 10 passages. It was also found by MTT assay that the higher expression level of PAC1 endowed the cells with higher proliferative viabilities. The construction of controlled expression system of PAC1 will lay a foundation for the further research on PAC1 profiles.
Animals ; Blotting, Western ; CHO Cells ; Cloning, Molecular ; Cricetinae ; Cricetulus ; Genetic Vectors ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I ; biosynthesis

Objective:To analyze the wall thickness of C-shaped canals in permanent mandibular second molars.Methods:40 ex-tracted permanent mandibular second molars with C-shaped root were collected from native Chinese and were scanned by micro-CT scan-ner.The specimens were reconstructed three-dimensionally by software Mimics 10.01.The roots were sliced from cemento-enamel junc-tion (CEJ)to apex with 1 mm intervals.The cross-sectional root canal configurations were classified into 5 types according to the Fan's Classification.The minimum buccal wall thickness (MBWT),minimum lingual wall thickness(MLWT)and their locations,as well as the wall thickness at the mesial and distal reference sites were detected.Two-way ANOVA and post hoc LSD-t tests were used to com-pare the mean thickness at 4 sides.Results:Among 370 cross-sections of 40 C-shaped roots,C1,C2 and C3 canals were observed on 126(34.1%),46 (12.4%)and 160 (43.2%)sections respectively.Except at the 10 mm level,the mean MLWT was always lower than MBWT;and the MLWT and MBWT were always lower than the wall thickness at the mesial and distal reference sites.The differ-ence was statistically significant (P <0.05)along the root length above the 12 mm level.The MBWT of the C2 and C3 canals was more likely located at the mesial region,and the MBWT of the C1 and the MLWT of C1,C2 and C3 was more frequently located at the center region.Conclusion:The lingual wall of C-shaped canal in mandibualr second molars was the thinnest zone among four sides,and care should be taken during root canal instrumentation and post space preparation to avoid perforation.

Objective To investigate the effect of endometrial ablation combined with mifepristone in the treatment of abnormal uterine bleeding after renal transplantation .Methods Eighty patients with abnormal uterine bleeding after renal transplantation were selected .According to the random number table method , the patients were divided into study group and control group ,with 40 cases in each group .The control group was treated with endometrial radiofrequency ablation .The study group was treated with mifepristone on the basis of the control group .The therapeutic effects of the two groups were compared ,included vaginal bleeding and complications in 3 months,6 months and 1 year.Results The effective rate of the study group was 92.5%,which was significantly higher than 65.0%of the control group(χ2 =7.935,P<0.05).The incidence rate of complications in the study group was 5.0%,which was significantly lower than 30.0%in the control group (χ2 =7.935,P<0.05).Conclusion The effect of endometrial radiofrequency ablation combined with mifepristone in the treatment of abnormal uterine bleeding after renal transplan -tation is significant ,which is worthy of further popularization and application in clinical practice .

Objective:To investigate the predictive value of fasting blood glucose on clinical outcome after intravenous thrombolysis in patients with severe acute ischemic stroke (AIS).Methods:From January 2016 to November 2020, consecutive patients with severe AIS receiving intravenous thrombolysis in the Department of Neurology, Shengli Oilfield Central Hospital were enrolled retrospectively. Severe AIS was defined as the baseline National Institutes of Health Stroke Scale (NIHSS) score ≥15. The primary endpoint was the clinical outcome evaluated according to the modified Rankin Scale at 90 d after onset. 0-2 was defined as a good outcome and a score of >2 were defined as a poor outcome. The secondary endpoint events were any intracranial hemorrhage and symptomatic intracranial hemorrhage (sICH). Intracranial hemorrhage was defined as any local or distant parenchymal hemorrhage shown by craniocerebral imaging during the hospitalization. sICH was defined as any intracranial hemorrhage and the NIHSS score increased by ≥4 within 7 d after treatment. Univariate and multivariate logistic regression analysis were used to determine the independent influencing factors of various endpoint events. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of fasting blood glucose levels for endpoint events. Results:A total of 113 patients with severe AIS treated with intravenous thrombolysis were included, and 73 (64.6%) had a poor outcome; 29 (25.7%) had intracranial hemorrhage, of which 10 (8.8%) were sICH. Multivariate analysis showed that fasting blood glucose was the independent risk factors for poor outcome (odds ratio [ OR] 1.451, 95% confidence interval [ CI] 1.053-2.000; P=0.023) and sICH ( OR 1.235, 95% CI 1.013-1.504; P=0.036). The ROC curve analysis showed that the area under the curve of fasting blood glucose predicting poor clinical outcome at 90 d after onset was 0.731 (95% CI 0.637-0.824), the optimal cut-off value was 6.25 mmol/L, and the corresponding sensitivity and specificity were 63.0% and 82.5% respectively. The area under the curve of fasting blood glucose predicting sICH was 0.728 (95% CI 0.577-0.878), the optimal cut-off value was 7.98 mmol/L, and the corresponding sensitivity and specificity were 70.0% and 77.7% respectively. Conclusion:Fasting blood glucose is an independent predictor of sICH and poor outcome at 90 d after onset in patients with severe AIS receiving intravenous thrombolysis.

Sodium glucose cotransporter 2 inhibitor (SGLT2i) emerged as a new hypoglycemic agent, which can inhibit glucose reabsorption and thus play a hypoglycemic role. Recent studies have shown that SGLT2i not only lowers blood glucose, but also has a protective effect on the cardiovascular system, which may benefit patients with heart failure.The specific mechanism of action is still not fully elucidated. This paper aims to summarize the latest research results of SGLT2i in the treatment of heart failure, and analyze the possible mechanisms for clinical guidance.

Objective The purpose of this research is to use modern statistical methods,to analyze the rules of cointment by Prof.Yang Zhimin treating yang deficiency and fatigue state patients,to increase the pertinence and to improve the clinical efficacy.Methods This paper analyzed 62 cases of Prof.Yang Zhimin in the treatment of the patients with yang deficiency and fatigue state from October 2010 to January 2013.The analyses were frequency analysis and association rules.Results Among the patients with yang-deficiency and fatigue,193 Chinese medicine were used.The monkshood was the highest frequency.Dampness-transforming medicine accounts for about 22.2％ in the top 36 frequency of medicine.Based on analyzing association rules,we found that the compatibility of medicine which were used more frequently came from Sini decoction,Danggui Sini decoction and Jinkui Shenqi pills,such as "monkshood and dried ginger","monkshood and roasted liquorice","dried ginger and roasted liquorice","monkshood and angelica","monkshood and comel","monkshood and prepared rehmannia root" and "monkshood and yam".Futhermore,we found two new core prescription.One was Qian Yang Dan combined with Sini decoction consist of "monkshood,roasted liquorice,dried ginger,fructus amomi".The other one was Tu Si Jian consist of "yam,semen cuscutae,angelica,roasted liquorice".Conclusions "Invigorating spleen and kidney","warming yang and dissipating dampness" and "hiding yang and Seeking Yang in Yin" are the habits and rules of the ointment medication by Prof.Yang Zhimin treatingyang deficiency and fatigue state patients.

Objective To construct the recombinant pMD19-exon18-exon20 plasmid containing locus G719S and T790M of EGFR gene associated with cervical cancer,which may provide a template for preparing the mutant recombinant vector of EGFR gene.Methods Using the healthy human genome DNA as templates,the segments of exon 18 and exon 20 of EGFR gene were amplified by two pairs of specific primers which were designed based on the sequences of overlapping and complementary area.The amplified segments were linked by overlap PCR.The products of linked exon18-exon20 were further inserted into the vector pMD19-T.The constructed recombi nant pMD19-exon18-exon20 plasmid was finally transformed into competent cells E.coli DH5α and then identified by PCR with bacterial solution and genome sequencing.Results The amplified fragments of exon18 and exon20 were clearly appeared at 778 bp and 596 bp and the fused product of exon18-exon20 was showed at 1 374 bp on agarose gel electrophoresis.The recombinant plasmid of fusion EGFR gene was consistent with the expected results via bacterial PCR assay and DNA sequencing.Conclusion We successfully fused the segments of exon18 with exon20 and constructed the recombinant expression vector of EGFR gene by using overlap PCR method.

Objective To construct mutant recombinant vector of epidermal growth factor receptor ( EGFR) gene G719S and T790M sites associated with cervical cancer, lay the foundation for the detection of EGFR gene mutation in cervical cancer. And using it to es-tablish a molecular switch platform to detect cervical cancer EGFR gene mutations. Methods Using the wild-type recombinant plasmid as template, the mutant fusion target fragment were amplified by overlap PCR, then connect this target fragment into the vector pMD19-T. The constructed mutant recombinant plasmid was finally transformed into competent cells E.coli DH5αfurther identified by PCR with bacterial solution and genome sequencing. Establishing the molecular switch for the detection of clinical cervical cancer samples. Re-sults The G719S and T790M mutations were successfully certified by genome sequencing, and the site-directed mutant vector was successfully constructed. In addition, a molecular switch detection platform was also successfully established for the detection of cervical cancer tissue DNA. Conclusion We successfully constructed an EGFR gene mutant recombinant vector by overlap PCR technique, which providing a new technical means for gene site-directed mutagenesis. And the molecular switch detection platform was successfully established based on it, which furnishing a new method for clinical detection of EGFR gene mutations.