Objective To compare the effect of midazolam pretreatment on propofol sedation using closed-loop target-controlled infusion (TCI) between two age groups - the adult and the aged. Methods Forty-eight ASA Ⅰ-Ⅱ patients of both sexes weighing 45-81 kg undergoing elective lower abdominal or lower extremity operation under epidural anesthesia were divided into two age groups : (A) the adult group (18-39 yrs) and (B) the aged group (66-79 yrs). The two groups were further divided randomly into 2 subgroups : midazolam subgroup ( n=12) received midazolam 0.04 mg?kg-1 10 min before propofol TCI and placebo subgroup ( n = 12) received normal saline instead of midazolam 10 min before propofol TCI. The patients were unpremedicated. An intravenous line was established before operation, which was connected to a TCI system comprising a Graseby 3500 infusion pump and a closed-loop TCI automatic control system. BP, HR, SpO2 and BIS were continuously monitored during operation. During epidural anesthesia the patients were sedated with propofol administered by TCI. The initial target blood concentration of propofol was set at 1.5?g?ml-1 . The level of sedation was assessed by OAA/S scale (5 = alert,0 = no response to prodding). The target blood propofol concentration was then increased or decreased in 0.5?g?ml-1 increment to maintain OAA/S score at 3. The BIS value at this level of sedation (OAA/S=3) was used as feedback in controlling TCI of propofol. The induction dose and the total dose of propofol, induction time and emergence time (OAA/S=5) were recorded. Results Midazolam premeditation significantly reduced the induction dose and total dose of propofol, shorten the induction time and prolonged the emergence time compared with placebo in both groups, especially in the aged group (P

Objective To investigate the influence of motor impersistence on functional recovery and prog- nosis of patients with left hemiplegia. Methods A total of 64 in-patients with left side hemiplegia who were able to understand the oral instructions were assigned into a motor impersistence group (n = 31 ) and a control group (n = 34) , respectively, according to the assessment with Scale of Motor Impersistence developed by Joynt. Both groups were comparable in terms of the basic clinical characteristic and motor function of patients except motor impersis- tence. The conventional rehabilitation training programs were adopted for all patients in this study. Brunnstrom func- tional category, Ueda Satoshi hemiplegic finger function assessment scale, upper limb function assessment scale, Berg balance scale, Functional ambulatory category, Modified Barthel Index were employed to evaluate the subjects before and after 1 and 2 months of treatment, with regard to the motor function of their upper limbs, walking ability, activities of daily living performance and balance ability. Results After 1 month of treatment, the patients in the M1 group were significantly improved with regard to the motor function of upper limbs, hand function, standing ba- lance and activity of daily living performance( P0.05 ) , while those in the control group were improved with all the parameters except the lower limb function. After 2 months of treatment, patients in both groups were all significantly improved ( P

OBJECTIVETo observe the regulatory effects of electroacupuncture with different acupoints combinations on blood lipid and atherosclerosis index (AI) in rats with hyperlipemia, so as to make a preliminary screening for the optimal acupoints combination for hyperlipemia.

METHODSOne hundred and five clean-grade SD male rats were randomly divided into 9 groups, including a normal group, a model group, a Quchi group, a Zhongwan group, a Fenglong group, a Quchi+Zhongwan group, a Quchi+Fenglong group, a Zhongwan+Fenglong group and a Quchi+Zhongwan+Fenglong group (three acupoints group), 17 rats in the normal group and 11 rats in the rest groups. The normal group was fed with normal diet, while the rest groups were fed with high-fat diet for 3 weeks to prepare the hyperlipemia model. All the rats were given unlimited water. After the establishment of model, the normal group was fed freely without any treatment; the model group was bundled and immobilized everyday; the rest groups were bundled, immobilized and treated with electroacupuncture at corresponding acupoints with disperse-dense wave, 20 min per time, once a day. After 4 weeks, the blood examples were collected from abdominal aorta to measure the total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C), and analyzed the AI in each group.

RESULTSAfter the treatment, TC, TG, HDL-C, LDL-C and AI in each acupuncture group were all lower than those in the model group (P<0.05, P<0.01). Compared with single acupoint group and the Quchi+Zhongwan group, the content of TC in the three acupoints group was lower (P<0.01). The differences of content of TG among each acupuncture group were not significant (all P>0.05). Compared with the rest 6 acupuncture groups, the content of HDL-C and AI in the three acupoints group were significantly different (all P<0.05). The content of LDL-C in the three acupoints group was decreased as compared with the Quchi group and the Zhong-wan group.

CONCLUSIONThe electroacupuncture at "Quchi" (LI 11), "Zhongwan" (CV 12) and "Fenglong" (ST 40) has more advantages on regulating the content of HDL-C and LDL-C as well as improving AI in hyperlipemia rats, and it has superior effects on blood lipid metabolism.

Acupuncture Points ; Animals ; Electroacupuncture ; Humans ; Hyperlipidemias ; blood ; therapy ; Lipids ; blood ; Male ; Rats ; Rats, Sprague-Dawley

Objective To study the relationship between insulin induced gene 2 (INSIG2) variant and obesity or lipid metabolism in Chinese children and adolescents. Methods A total number of 2030 school students at the age from 7 to 18 years were selected in Beijing. Physical indicators, serum lipids and the rs13428113 polymorphism in INSIG2 gene were examined for all the subjects. Results The overall mutation rate of the rs13428113 polymorphism (T>C) was 49.3%.The differences of genotype and allele frequencies were not statistically significant among normal-weight, overweight and obesity groups (P>0.05). Among the overweight students, those with CC genotype had higher body mass index, waist-hip ratio, bronchial triceps skin-fold, and anterior superior lilac spine skin-fold than TT/TC carriers. Among the obese group, those with CC genotype had higher total cholesterol level than TT/TC careers (P<0.05). Conclusion The rs13428113 polymorphism in INSIG2 gene was associated with abnormal lipid metabolism in overweight and obese children, which increasing the degree of obesity and abnormal serum lipids.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; methods ; Combined Modality Therapy ; Embolization, Therapeutic ; Hepatectomy ; Humans ; Laser Coagulation ; Liver Neoplasms ; surgery ; Microwaves ; therapeutic use

OBJECTIVETo study the effect of Shumai Capsule (SMC) on angiogenesis and expression of relevant growth factor in rats with myocardial ischemia (MI).

METHODSModel rats of MI were duplicated and treated with SMC (SMC group), bFGF + calparine (positive control group) and normal saline (model group) respectively. Besides, a sham-operative group was set up and treated with normal saline. The rats were sacrificed in batches at the time after being medicated for 1, 2 and 4 weeks, for determining von Willebrand factor (vWF) and vascular endothelial growth factor (VEGF) protein expression in ischemic myocardium by immuno-histochemical staining, myocardial micro-vessel density (MVD) using digital analysis system, and the gene expression of VEGF by quantitative real-time PCR.

RESULTSCompared with the sham-operative group and the model group, levels of MVD, protein and gene expression of VEGF in the SMC group were higher respectively at three time segments (all P <0.01), but showed insignificant difference to those in the positive control group.

CONCLUSIONSMC could promote angiogenesis in ischemic myocardium of rats, the up-regulation on VEGF mRNA and protein expression might be one of the potential mechanisms of SMC in promoting angiogenesis.

Animals ; Capsules ; Coronary Vessels ; drug effects ; physiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gene Expression ; drug effects ; Male ; Myocardial Ischemia ; physiopathology ; Myocardium ; metabolism ; pathology ; Neovascularization, Physiologic ; drug effects ; Phytotherapy ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

OBJECTIVETo observe the effect of Ningdong Granule (NG) on serum levels of interleukin-12 (IL-12) and tumor necrosis factor-alpha (TNF-alpha) of children patients with Tourette's syndrome (TS).

METHODSTotally 90 TS children patients were randomly assigned to the NG group, the NG + Tiapride group (abbreviated as the combined treatment group), and the Tiapride group, 30 in each group. Besides,another 30 healthy children were recruited as the healthy control group. Patients in the NG group were treated with NG (consisting of all gastrodia rhizome, Codonopsis pilosula, Ophiopogon japonicus, white peony root, Rhinocerotidae, oyster, earthworm, licorice root, etc.), one dose daily, administered by dissolving it in boiled water, taken in two portions in the morning and in the evening respectively. Patients in the Tiapride group took Tiapride Tablet, 50 -100 mg each time, twice daily. The dosage was adjusted according to individual difference and changes of pathogenic conditions. The maximal dosage was 300 mg per day. Those in the combined treatment group were treated with equal dose of NG and Tiapride Tablet in combination. The treatment course was 3 months for all. Changes of pathogenic condition before and after treatment were assessed by Yale global tic severity scale (YGTSS). Serum levels of IL-12 and TNF-alpha were detected by enzyme-labeled immunosorbent assay (ELISA) before and after treatment.

RESULTS(1) The total effective rate of the NG group, the combined treatment group, and the Tiapride group was 79.3%, 83.3%, and 67.9%, respectively. It was the lowest in the Tiapride group (P < 0.05). It was significantly higher in the combined treatment group than in the NG group (P < 0.05). (2) The post-treatment YGTSS score was obviously lower in each group after treatment than before treatment (P < 0.05). The posttreatment YGTSS score was obviously lower in the NG group and the combined treatment group than in the Tiapride group (P < 0.05), but with no statistical difference between the fromer two groups (P > 0.05).(3) Compared with the healthy control group before treatment, serum levels of IL-12 and TNF-alpha (pg/mL) were 124.95 +/- 22.78 and 209.52 +/- 21.69 in the NG group, 126.14 +/- 25.65 and 208.97 +/- 22.46 in the combined treatment group, 123.00 +/- 24.26 and 205.10 +/- 26.16 in the Tiapride group, being higher than those in the healthy control group (64.56 +/- 27.59 and 78.13 +/- 33.42; P < 0.05). After treatment, serum levels of of IL-12 and TNF-alpha were 104.67 +/- 16.84 and 183.01 +/- 24.95 in the NG group, 109.04 +/- 16.81 and 179.87 +/- 23.45 in the combined treatment group, significantly lower than before treatment (P < 0.05). But there was no statistical difference in serum levels of IL-12 or TNF-alpha in the Tiapride group between before treatment (123.00 +/- 24.26 and 205.10 +/- 26.16) and after treatment (117.75 +/- 16.79 and 199.76 +/- 33.21; P > 0.05).

CONCLUSIONNG could modulate abnormal serum levels of IL-12 and TNF-alpha in TS children patients, which might be one of its pharmacodynamic mechanisms for treating TS.

Adolescent ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-12 ; blood ; Male ; Phytotherapy ; Tourette Syndrome ; blood ; drug therapy ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo observe the effects of panax quinquefolius saponin (PQS) of stem and leaf on glucose-lipid metabolism and insulin signal transduction in the insulin resistant model of adipocytes.

METHODSThe insulin resistant model of differentiated 3T3-L1 adipocytes was established in vitro with free fatty acid. After induction of insulin resistance, cells were treated with metformin or PQS for 2 days. The glucose consumption in culture fluid was detected by glucose oxidase method; the effects of PQS on the lipolysis induced by tumor necrosis factor (TNF-alpha) was observed using colorimetry; and the phospholation of signal proteins was detected by Western-blot.

RESULTSThe amount of glucose consumption (mmol/L) in the model group (5.250 +/- 2. 671) was significantly lower than that in the normal control group (14.133 +/- 1.305, P < 0.01), it increased in the meformin treated group (11.807 +/- 1.358), and the groups treated with high-, middle- and low-dose PQS dose-dependently (10.784 +/- 2.373, 10.217 +/- 1.237 and 9.984 +/- 2.006, respectively), significantly higher than that in the model group (P < 0.01). Upon TNF-alpha treatment, the concentration of free fatty acid (FFA) (nmol/ microg) in culture medium was 2.479 +/- 0.597, predominantly higher than that in the control group (1.320 +/- 0.538, P < 0.01), while it was 1.210 +/- 0.566 in the metformin group, 1.105 +/- 0.631 in high-dose PQS group, 1.108 +/- 0.260 in the middle-dose PQS group, 1.201 +/- 0.593 in the low-dose PQS group, all were lower than that in the TNF-alpha group (P < 0.05 or P < 0.01), and a dose-dependent tendency of PQS's action was seen. The tyrosine phosphorylation of insulin receptor and IRS-1 as well as Ser473 phosphorylation of PKB were lower in the model group than in the control group; they were insignificantly changed in the low-dose PQS group, but did show significant difference in comparing with those in the high-and middle-dose PQS groups or metformin group.

CONCLUSIONPQS can accelerate the glucose utilization and depress the lipolysis in adipocytes induced by TNF-alpha, which may be correlated with its promoting insulin signal transduction and improving insulin resistance in adipocytes.

3T3-L1 Cells ; Adipocytes ; drug effects ; metabolism ; Animals ; Glucose ; metabolism ; Insulin ; metabolism ; Insulin Resistance ; Lipid Metabolism ; drug effects ; Mice ; Saponins ; pharmacology ; Signal Transduction ; drug effects

Humans ; Nasal Obstruction ; surgery ; Treatment Outcome ; Turbinates ; surgery