Objective To compare the effectiveness of patient-controlled propofol sedation (PCS) against propofol sedation with TCI during epidural anesthesia. Methods Thirty-two ASA Ⅰ -Ⅱ patients (18 male , 14 female) aged between 23-71 years, undergoing lower abdominal surgery or surgery on lower limb were randomly divided into two groups: PCS group ( n =16) and TCI group ( n = 16). Propofol sedation was started when epidural anesthesia was shown to be satisfactory. In PCS group a loading dose of propofol 0.5?g?kg-1 was given. The bolus dose was 0.3mg?kg-1 and the lock-out interval 2 min. There was no background infusion of propofol. In TCI group the initial target concentration of propofol was set at 1. 5?g?kg-1 target concentration was adjusted according to OAA/S score which was maintained at 3 during operation. Radial artery was cannulated and arterial blood samples were taken for determination of blood propofol concentration before and 5, 15, 30, 45 min after incision. OAA/S score was evaluated every 5 min and at the same time BIS and 95% SEF were recorded. The total amount of propofol infused during operation was recorded and whether the patient was satisfied with sedation was inquired. Results All patients expressed great satisfaction with the sedation in both groups. In PCS group the level of sedation was lighter and less propofol was consumed than in the TCI group. (2.5mg?kg-1 ?h-1 vs 3.8mg?kg?h-1, P

Objective To investigate the changes in pharmacokinetics of propofol and propofol concentration in the brain induced by normovolemic hemodilution ( NHD) . Methods Thirteen healthy male mongrel dogs weighing 10-15 kg were randomly divided into 2 groups: control group ( n = 7) and NHD group ( n = 6). The animals were anesthetized with intravenous diazepam 0.5 mg?kg-1 and ketamine 5 mg?kg-1 . The femoral artery and vein were cannulated. Lactated Ringer's solution was infused at 5-7 ml ? kg-1 ? h-1 . 30 min after induction of anesthesia NHD was conducted by removing blood from femoral artery and replacing it with 6% hydroxyethyl starch (HES) until Hct was reduced to 25% . Propofol was then infused at 10 mg?kg-1 ?h-1 for 30 min after NHD. Arterial blood samples were taken immediately before and at 1, 2, 5 , 10, 15, 20, 30, 31, 32, 35, 40, 50, 70, 90, 120, 150, 180, 240 and 300 min after propofol infusion was started for determination of plasma propofol concentrations. One week later the same NHD was repeated. Propofol was administered by TCI via Graseby 3500 infusion pump incorporated with Stanpump TCI software. Target plasma propofol concentration was set at 5 ?g?ml-1 . Arterial blood and CSF samples were obtained at 5, 15, 30, 45 and 60 min after the start of propofol infusion for determination of plasma propofol concentration ( bound and free) , plasma free propofol concentration and CSF propofol concentration. At the end of 60 min, after the collection of blood and CSF samples, brain tissue was obtained from the cerebral cortex of right frontal lobe for determination of brain propofol content. ECG, BP, arterial blood gases and body temperature were monitored during experiment.Results The plasma propofol concentrations were significantly lower during and after propofol infusion at 10 mg? kg-1 ? h-1 in NHD group than in control group ( P

Objective To investigate the expressions of claudin-5 and claudin-10 in colorectal carcinoma(CRC) and its significance.Methods Pathological verified 50 colorectal tissue (CRT),25 colorectal adenoma (CRA),25 non lymph node metastasis CRC (non-LNM CRC) and 25 lymph node metastasis CRC (LNM CRC) were detected for the expression of claudin-5 and claudin-10 by immunohistochemical SP(streptavidin perdcidase) method.Results The positive expression rate of Claudin-5 was 82%,76%,68% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-5 in different groups was not significantly different(X~2 =2.638,P＞0.05).claudin-5 expression was correlated with LNM (P＜0.05),but was not correlated with gender,age,tumor,location,differentiation,tumor diameter and serous membrane invasion(P＞0.05).The positive expression rate of claudin-10 was 54%,56%,72% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-10 in different groups was not significantly different(X~2 = 3.839,P＞0.05).claudin-10 expression was correlated with tumor diameter,serous membrane invasion and LNM (P＜0.05),but was not correlated with gender,age,location and differentiation (P＞0.05).There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC (r = 0.050,P = 0.732).Conclusions claudin-5 and clandin-10 are expressed in CRT,CRA,and CRC.They are not involved in CRC occurrence,claudin-5 and clandin-10 abnormally expressions are significantly associated with the incidence of LNM.Meanwhile,claudin-10 expression is correlated with tumor diameter and serous membrane invasion.There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC.

Hoxa3-Pax1/Pax9-Eya1-Six1/4 regulatory pathway seems to be operating during forming the bilateral parathyroid/thymus common primordial in early embryonic development.The specification of the parathyroid domain in the parathyroid/thymus primordial is regulated through a Shh-Tbx1-Gcm2 pathway.Gcm2 also may play roles in later steps of parathyroid development,including CaSR and PTH gene expression.MafB and Gcm2 interact with each other and synergistically activate PTH transcription.Genetic basis and the etiology of some hypoparathyroid disorders in man are involved defects in transcription factors that include GCMB,GATA3,Tbxl,SOX3 and GNA11.This marker expression in thymus and parathyroid primordium includes HoxA3,Pax1,Eya1,and Six1;and expression of parathyroid cell-like cells includes Gcm2,CaSR,and PTH.These expressions may serve as markers of stem cell differentiation into parathyroid cell-like cells.

Objective: To investigate the prevalence of osteoporosis (OP) and its influencing factors among people aged 60 years and above, so as to provide insights into OP prevention and treatment among the elderly. Methods: People aged 60 years and above who underwent physical examinations were selected from Hangzhou First People's Hospital from January to October 2023. Demographic information, lifestyle and physical examination data were collected through field surveys and hospital information systems. Bone density was measured by dual-energy X-ray densitometer, and OP was diagnosed with reference to the Guidelines for the Diagnosis and Treatment of Primary Osteoporosis (2022). Factors affecting the OP were identified using a multivariable logistic regression model. Results: A total of 482 participants were included and had a mean age of (69.10±6.52) years. There were 217 men (45.02%) and 265 women (54.98%). The prevalence of OP was 43.36%. Multivariable logistic regression analysis identified gender (women, OR=3.791, 95%CI: 1.726-8.314), age (70 to 79 years, OR=1.260, 95%CI: 1.018-1.559; 80 years and above, OR=3.083, 95%CI: 1.546-6.147), body mass index (≥24 kg/m2, OR=0.358, 95%CI: 0.205-0.626), family history of fracture (OR=1.475, 95%CI: 1.073-2.030), diabetes (OR=1.626, 95%CI: 1.109-2.382), regular exercise (OR=0.457, 95%CI: 0.287-0.726), intake of milk products (OR=0.511, 95%CI: 0.335-0.780), intake of calcium supplements (OR=0.473, 95%CI: 0.287-0.778) and vitamin D deficiency (OR=2.132, 95%CI: 1.309-3.473) as factors affecting OP. Conclusion The prevalence of OP is associated with gender, age, body mass index, family history of fracture, diabetes, diet and vitamin D deficiency.

Objective:To retrieve and analyze the relevant literatures on vancomycin added into bone cement to provide the evi-dence for the treatment of osteomyelitis and other orthopedic infections. Methods:Search strategy and criteria of inclusion and exclu-sion for literatures were designed. PubMed, SCI, Embase, CNKI, VIP and the other databases were searched, and the articles from the establishment date to February 2014 were statistically analyzed using bibliometric methods. The final included documents were sta-tistically analyzed in respect of the article type, year, contents, citation frequency and the maln contents of the study. Results:A total of 1 941 articles were searched, and 430 of them were in the final inclusion. The total number of the articles in every year was in an es-calating trend. The paper focused on the research and analysis of clinical studies, and there were 74 clinical studies among the includ-ed literatures, which accounted for 17. 2% of all the included literatures. The highest citation frequency was 97 for one literature. The research included the overall situation, year distribution, publishing country, research type analysis, corresponding author and their in-stitutions, journals, citation frequency, and the maln content of work and clinical studies on vancomycin added into bone cement. The analysis could provide reference for the clinical treatment of orthopedic diseases. Conclusion: The results of the analysis show that vancomycin added into bone cement in the treatment of chronic osteomyelitis is effective with high security, and the technology is ma-ture.

BACKGROUND: At present, osteoarthritis of knee is mainly treated with non-steroid drug in medication, but resulting in the side effects on gastrointestinal tract. The research indicates that bushen yiqi huoxue formula, with litter side effect, improves remarkably pain and motor function of patients with osteoarthritis of knee.OBJECTIVE: To probe into the effect of bushen yiqi huoxue formula on pathological process of the cartilage of knee joint by setting up ostoarthritis of knee in rabbt.DESIGN: Randomized controlled study by observation in which the experimental animals were taken as the objects.SETTING: Animal experimental center of a university.MATERIALS: Totally 36 New Zealand normal male rabbits, weighted varied from 2.0 to 3.0 kg.METHODS: The experiment was performed in Animal Experimental Center of Guangzhou University of Chinese Medicine from January 2002 to January 2003. Thirty-six New Zealand rabbits were involved to set up Hulth knee osteoarthritis model. After operation, they were randomized into 3 groups,named as model group, acetaminophen group and bushen yiqi huoxue formula group (formula group). Adopted corresponding managements in each group,the materials were collected at the 4th, 8th and 12th week after operation for histological pathological assess.MAIN OUTCOME MEASURES: Primary results: integrals of pathological changes in cartilage of joint in every group. Secondary results: ①Naked-eye observation of cartilage of joint in every group. ② Optic microscopic observation of cartilage of joint in every group.RESULTS: The total integrals of pathological changes in cartilage of joint in model group, acetaminophen group and bushen yiqi huoxue formula grcup (formula group) at the 4th week were 18.50±1.00, 14.25±1.26,11.75±2.22 respectively, and 30.75±1.26, 22.00±3.16, 17.75±2. 21 at the 12th week respectively. The total integrals of pathological changes in cartilage of joint, in chondrocyte and in cartilage surface layer are in the sequence of model group ＞ acetaminophen group ＞ formula group successively. The significant or very significant differences present in the comparisons between groups.CONCLUSION: Bushen yiqi huoxue formula delays pathological progression of osteoarthritis of knee so that it can treat and prevent the disease.

A full-length cDNA sequence encoding for the precursor of a venom peptide (named BmKCT) with homology to chlorotoxin has been isolated from a cDNA library made from the venom glands of the Chinese Scorpion Buthus martensii Karsch. The sequence of BmKCT is similar (68 % identities) to that of chlorotoxin isolated from Leiurus quinquestriatus quinquestriatus. To understand the biological function of BmKCT, this peptide was expressed using pGEX expression system and purified using GST affinity column and gel filtration.Whole cell patch-clamping recording showed that BmKCT could significantly inhibit chloride currents of gliomas cells, and the inhibitory effect was reversible. These results suggested that BmKCT might belong to the class of short chain toxins blocking the chloride ion channels.

Objective To analyze laparoscopic lymphadenectomy and the safety of gastrectomy for gastroesophageal junction cancer.Methods From Jan 2011 to Dec 2012 72 gastroesophageal junction cancer patients were enrolled, including 46 patients in laparoscopic group, and 26 in open surgery group.Results There was no significant difference in the numgbers of lymph node dissection between the two groups and nor difference in the number of positive lymph node dissection.Esophagus resection length in open group was (2.0 ± 1.0) cm, while that was (3.0 ± 0.8) cm in laparoscopic group (t =0.471, P ＜ 0.001).5 (19％)patients in open group had positive margins compared to six in laparoscopic group (13％), x2 =0.491, P =0.483.7 patients in the open group underwent thoracoabdominal resection, while in laparoscopic group 3 patients did, x2 =5.781, P =0.016.Laparoscopic splenic hilar lymphnodes dissection harvested more lymph nodes (t =0.260, P =0.011).Laparoscopic gastrectomy used less operation time (t =0.237, P =0.021) experinced less blood loss (t =0.451, P ＜ 0.01) than open group.There was no difference in major complications between the two groups.Conclusions Laparoscopic splenic hilar lymphnodes dissection in gastroesophageal junction cancer surgery is superior to open surgery, with more lymph nodes harvested, longer esophageal cutting distances, lower incidence of thoracoabdominal surgery, shorter operation time, and less blood loss.

To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.