Animals ; Animals, Newborn ; Cell Survival ; drug effects ; Cells, Cultured ; Cerebral Cortex ; cytology ; drug effects ; Dose-Response Relationship, Drug ; Neurites ; drug effects ; Neurons ; cytology ; drug effects ; Organometallic Compounds ; toxicity ; Rats ; Rats, Wistar

Objective To observe the effect of propofol target-controlled infusion on stress response during nasoscopic procedures.Methods Totally 40 patients with ASA gradesⅠ-Ⅱ scheduled for the nasoscopic operation ware randomly divided into two groups:Group A(propofol continuously injection,2.5 mg?kg-1,n=20)and Group B(propofol target-controlled infusion,4 ?g?ml-1,n=20).The operations were all performed under general anesthesia.Venous blood samples were taken to measure cortisol and blood glucose at three time points:before operation,at 30 min after the operation started,and 60 min after the endotracheal catheter was withdrawn.Meanwhile,HR and MAP of the patients were recorded.Results At both 30 min after the operation started and and 60 min after the endotracheal catheter was withdrawn,Group A showed significantly higher MAP and serum levels of glucose and cortisol than Group B.At 30 min after the operation started:HR:(73?8)/min vs(65?13)/min,t=2.344,P=0.024;MAP:(74?7)mm Hg vs(68?7)mm Hg,t=2.711,P=0.010;blood glucose:(6.28?0.11)mmol/ml vs(5.31?0.15)mmol/ml,t=23.321,P=0.000;cortisol:(125.3?11.5)ng/ml vs(89.6?9.9)ng/ml,t=10.521,P=0.000.At 60 min after the endotracheal catheter was withdrawn:MAP:(79?6)mm Hg vs(73?8)mm Hg,t=2.683,P=0.011;blood glucose:(6.18?0.09)mmol/ml vs(5.62?0.16)mmol/ml,t=10.082,P=0.000;cortisol:(169.1?16.3)ng/ml vs(149.5?15.3)ng/ml,t=3.921,P=0.000.Conclusion Propofol target-controlled infusion can inhibit the stress response caused by nasoscopic operation.

Objective To investigate the factors affecting the protective effects of morphine preconditioning on murine hippocampal neurons against anoxia/reoxygenation (A/R) injury and the underlying mechanisms.Methods Hippocampal slices (400 μm thick) were prepared using hippocampi isolated from decapitated mice. A/R injury was simulated in vitro using artificial cerebral spinal fluid (ACSF) deprived of O_2 and glucose for 20 min followed by reoxygenation and glucose supply for 2 h. The experiment was performed in 4 parts: I .The slices were incubated with 5 different concentrations of morphine (0.1, 0.3, 0.5, 1.0, 3.0, 10.0 /μmol/L) for 30 min at 30 min before A/R; Ⅱ. The slices were incubated with morphine 3.0 /μmol/L for 5 different periods of time (5, 15, 30, 45, 60 min) at 30 min before A/R; Ⅲ. The slices were incubated with morphine 3.0 μmol/L for 30 min followed by A/R at 6 different intervals (0, 5, 15,30,60, 120 min); Ⅳ. The slices were incubated with (a) chelerythrine (a non-selective PKC antagonist) 10 /μmol/L or (b) εVl-2 (a selective nPKCe isoform antagonist) 2 μmol/L or (c) AIP 2 μmol/L (a selective CaMK Ⅱ antagonist) or (d) MK-801 10 μmol/L (a non-competitive NMDA receptor blocker) for 30 min and then for another 30 min together with morphine 3.0 μmol/L before A/R at 30 min interval. The survival rates of the hippocampal neurons were assessed by TTC staining. Results Neuronal survival rates were significantly higher in morphine preconditioning groups which preconditioned with morphine (0.5-10.0 μmol/L) for 15-60 min at an interval of 0-60 min before A/R than in A/R group. Increase in neuronal survival rate induced by morphine preconditioning was partially blocked by chelerythrine or εV1-2 or AIP or MK-801. Conclusion Preconditioning with appropriate concentrations of morphine (0.5-10.0 μmol/L) for appropriate period of time (15-60 min) at appropriate interval (within 60 min) before A/R can protect hippocampal neurons against A/R injury through activation of nPKCε, NMDA receptor and CaMKⅡ.

Objective To observe the effect of propofol target controlled infusion with different blood plasma target concentration on stress reaction during the nasal endoscope operation. Methods Sixty patients with ASA Ⅰ - Ⅱ scheduled for the nasal endoscope operation were divided into three groups by random digits table: each group was 20 patients, group A, B, C was given propofol target controlled infusion with blood plasma target concentration 3,4,5 μ g/mi respectively. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), blood glucose, serum cortisol, bispectral index ( BIS ), extubation time were recorded before anesthesia,at 30 min after the operation starting and 60 min after the extubation.Results The descent degree of HR and MAP at 30 min after the operation starting were group C ＞ group B ＞ group A (P = 0.024,0.010 );the descent degree of MAP at 60 min after the extubation were group C ＞group B ＞ group A (P = 0.011 ). BIS and extubation time were 65 ± 8 and (25 ± 7) min in group A, 53 ± 11 and( 36 ± 13 ) min in group B, 45 ± 12 and(45 ± 9 ) min in group C, there were significant differences among three groups(t = 2.476,P= 0.023;t = 2.657,P= 0.012). The blood glucose was increased at 30 min after the operation starting and 60 min after the extubation, the ascensus degree were group A ＞ group B ＞ group C (P= 0.000、0.000);the serum cortisol was decreased at 30 min after the operation starting, the descent degree was group C ＞ group B ＞ group A (P= 0.000), increased at 60 min after the extubation, the ascensus degree was group A ＞ group B ＞ group C (P= 0.001 ). Conclusions Propofol target controlled infusion with blood plasma target concentration 4-5 μ g/ml can ensure eligible depth of anesthesia, decrease pain stimulus, remain stable vital sign,depress the stress reaction caused by nasal endoscope operation efficiently,with short extubation time. It is an eligible blood plasma target concentration.

Fatal Outcome ; Female ; Fever ; Humans ; Infant ; Purpura, Schoenlein-Henoch ; diagnosis ; therapy

Adhesives ; Anti-Bacterial Agents ; Dental Cements ; Dental Materials ; Humans

Bronchitis ; diagnosis ; Diagnostic Errors ; Humans ; Infant ; Male

Objective To observe the expression of Glu、mGluR 5 and EAAT 1 in bone tissues of ovariectomized osteoporotic rats and the effects of Total Flavonoids of Rhizoma Drynariae (TFRD) on it. Methods 45 SPF 3-month-old Sprague-Dawley (SD) female rats were randomly divided into sham operation (Sham, n=15) group and ovariectomized (OVX, n=30) group. The osteoporotic(OP) model was established by bilateral ovariectomy, 14 weeks later, we measured bone mineral density(BMD) by dual-energy X-ray and determined that OP model was successfully replicated, OVX group rats were then divided into OVX group (n=15) and OVX+TFRD group (n=15). The OVX+TFRD group was given TFRD for 12 weeks. Glutamate (Glu), metabotropic glutamate receptor 5 (mGluR 5), and Glutamate/Aspartate Transporter (GLAST/EAAT 1)’s expression of femur was examined in order to clarify the characteristics of bone glutamate signaling pathway and the effects of TFRD on it. Results Glu and ionotropic receptors mGluR 5 mainly distributed in bone marrow cells and osteoblasts closed to the bone marrow cavity walls. There were no significant differences in Glu expression among Sham group, OVX group and OVX+TFRD group. The mGluR 5 expression of OVX+TFRD group was significantly higher than that of Sham group and OVX group(P=0.009), while no significant difference was found between the latter two groups. In addition to large distribution in bone marrow cells, small amount of transporter EAAT 1 was noted to express in bone cells of the bone lacunae. There were no significant differences in EAAT 1 expression among the three groups. Conclusion In bone glutamate signaling pathway, this study demonstrated that TFRD could significantly improve the ionotropic receptor mGluR 5’s expression, but had no inlfuence for Glu and EAAT 1.

Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Objective To investigate the efficacy of sequential add-on of pegylated interferon α-2a (PEGIFN-α-2a) for 48 weeks in chronic hepatitis B (CHB) patients with low serum hepatitis B e antigen (HBeAg) titer after long term adefovir dipivoxil (ADV) monotherapy.Methods This was a randomized,open and prospective clinical trial.Patients who had been treated with ADV for 72 to 144 weeks,with undetectable serum hepatitis B virus (HBV) DNA level,low HBeAg titer (5 S/CO＜ HBeAg＜50 S/CO) and serum hepatitis B surface antigen (HBsAg) ＜5000 IU/mL were included.The patients were categorized into ADV monotherapy group and ADV plus PEGIFN-a-2a combination therapy group by random number table.Patients in ADV group continued ADV monotherapy and patients in combination therapy group added PEGIFN-α-2a to ADV for 48 weeks.After the treatment,efficacy of the two therapies were assessed by comparing the reduction of serum HBeAg reduction,HBeAg loss rate,HBeAg seroconversion rate,and reduction of intrahepatic HBV DNA and HBV covalently closed circular DNA (cccDNA).Pre-and post-treatment results were compared by paired samples t test.Comparison between groups was performed using indepedent samples t test.Comparison of rates between groups was performed using x2 test.Results The trial enrolled 55 CHB patients,and there were 27 patients in ADV monotherapy group,28 patients in combination therapy group.Baseline characteristics including age distribution,sex ratio,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil),serum HBeAg and HBsAg,hepatic HBV DNA and HBV cccDNA were all comparable (all P＞0.05).Twenty-five patients in ADV monotherapy group and 26 patients in combination therapy group completed 48 weeks treatment.HBeAg loss rates and seroconversion rates of combination therapy group were higher than those of ADV monotherapy group (x2 =5.38 and 4.69,respectively,both P＜0.05).HBeAg titers of both groups were significantly lower than those of baseline (t=8.43 and 8.50,respectively,both P＜0.05).The HBeAg titer of combination therapy group was lower than that of monotherapy group (t=5.60,P＜ 0.01).HBV DNA and HBV cccDNA in liver tissue of combination therapy group was (6.934±0.52) lg IU/mg and (5.63±0.54) lg IU/mg post-treatment,respectively,which were both lower than baseline (t＝7.12.6.67,respectively,both P＜0.01).HBV DNA in liver tissue of monotherapy group was (7.09＝0.43) lg IU/mg post-treatment,which was lower than baseline (t=2.67,P=0.02).After treatment,HBV cccDNA in liver tissue of combination therapy group was lower than that of monotherapy group (t =2.87,P=0.00).Conclusions Compared with ADV monotherapy,sequential add-on of PEGIFN-a-2a in combination with ADV can achieve higher serum HBeAg loss rate and seroconversion rate and facilitate the clearance of hepatic HBV DNA and HBV cccDNA in CHB patients with low HBeAg titer after long-term ADV monotherapy.