Objective To determine the half-effective target effect-site concentration (EC50 ) of sufentanil inhibiting the urethroscope insertion response when combined with propofol by target-controlled infusion (TCI) in the elderly patients undergoing transurethral resection of prostate (TURP) . Methods Twenty-two ASA Ⅰ- Ⅲ patients, aged 65 -79 yr, weighing 47-81 kg, undergoing TURP, were enrolled in the study. Anesthesia was performed with TCI of propofol and sufentanil. The target plasma concentration of propofol was 4 μg/ml. The target effect-site concentration of sufentanil was determined by up-and-down sequential trial. The initial target effect-site concentration of sufentanil was 0.3 ng/ml and the ratio of the target concentrations between the two consecutive patients was 1.1. The ECW and 95% confidence interval of sufentanil required to inhibit the response to urethroscope insertion were calculated. Results The EC50 of sufentanil required to inhibit the urethroscope insertion response was 0.23 ng/ml (95% confidence interval 0.12-0.44 ng/ml). Conclusion When combined with propofol by TCI (target plasma concentration 4 μg/ml), the EC50 of sufentanil inhibiting the response to urethroscope insertion is 0,23 ng/ml in the elderly patients undergoing TURP.

[Abstract ] Objective To evaluate the inhibitory effect of chlorogenic acid on senescence of human skin fibroblasts (HSFs). Methods Fibroblasts isolated from human foreskin were treated with 1 mmol/L glyoxal in vitro to develop a model for cellular senescence. In order to select effective concentrations of chlorogenic acid, some HSFs were treated with 1 mmol/L glyoxal alone or in combination with chlorogenic acid at different concentrations (5, 10, 20, 40, 80 μmol/L)for 3 days, with those receiving no treatment serving as the blank control group. Then, methyl thiazolyl tetrazolium (MTT)assay was performed to evaluate the proliferative activity of HSFs. Some HSFs were divided into 5 groups to be cultured alone(blank control group), or treated with 1 mmol/L glyoxal(glyoxal group)or the combination of 1 mmol/L glyoxal and chlorogenic acid at effective concentrations of 10, 20 and 40 μmol/L (glyoxal + chlorogenic acid groups). Senescence associated β-galactosidase (SA-β-gal)staining and real-time fluorescence-based quantitative PCR were conducted to determine the percentage of senescent cells and expression level of p16INK4a mRNA respectively. Statistical analysis was carried out by one-way analysis of variance followed by the least significant difference(LSD)-t test. Results Compared with the blank control group, the glyoxal group showed significantly decreased cellular proliferative activity of HSFs (55.65% ± 2.00% vs. 100% ± 6.90%, P < 0.01), while chlorogenic acid increased the proliferative activity of HSFs in a dose-dependent manner, and the increase reached a peak at 40 μmol/L. Concretely speaking, the glyoxal + 10-, 20-, 40-, 80-μmol/L chlorogenic acid groups all significantly differed from the glyoxal group in cellular proliferative activity (60.75% ± 1.32%, 67.65% ± 1.90%, 75.71% ± 3.25% and 75.69% ± 2.38% vs. 55.65%± 2.00%, all P < 0.05), but no significant difference was observed between the glyoxal group and glyoxal + 5-μmol/L chlorogenic acid group or between the glyoxal + 40-μmol/L chlorogenic acid group and glyoxal + 80-μmol/L chlorogenic acid group (both P > 0.05). Therefore, 10 - 40 μmol/L was selected as the effective concentrations of chlorogenic acid. The glyoxal group showed significant increases in the percentage of senescent (SA-β-gal-positive)cells (35.65% ± 2.24% vs. 13.00% ± 2.22%, P < 0.01)and expression level of p16INK4a mRNA (2-ΔΔCt: 1.00 ± 0.06 vs. 0.26 ± 0.05, P <0.01)compared with the blank control group, while the glyoxal + 10-, 20-, 40-μmol/L chlorogenic acid groups showed significantly decreased percentage of senescent cells (31.50% ± 2.13% , 22.31% ± 3.11% and 19.32% ± 3.01%respectively)and expression level of p16INK4a mRNA (2-ΔΔCt: 0.88 ± 0.08, 0.73 ± 0.06 and 0.68 ± 0.04 respectively) compared with the glyoxal group (all P < 0.05). Additionally, the percentage of senescent cells decreased with the increase in chlorogenic acid concentrations in the glyoxal + chlorogenic acid groups. Conclusion Chlorogenic acid can protect HSFs from glyoxal-induced senescence.

Objective To assess the efficacy and safety of 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type.Methods A total of 114 patients were treated with 800 nm diode laser on 234 sites.Four sessions were performed at an interval of 6-8 weeks.Percentage of hair reduction was evaluated 3 months after each session by comparing the terminal hair count to the baseline values.Follow-up was performed 6-8 months after the last session.In addition,subjective satisfaction of physicians and patients was evaluated according to a four-grade scale and the satisfaction rates were calculated.Results After fouth session,97.01％ of patients had more than 40 ％ hair reduction,and 83.33 ％ patients had more than 60 ％ hair reduction.Hyperpigmentation was observed on 15 (6.41％) sites,and disappeared after 6-8 months follow-up.The satisfactory rates of the physicians and the patients were 98.25 ％ and 96.12 ％,respectively,with no statistical difference (x2 =3.33,P＞0.05).Conclusions 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type is a safe and effective treatment option for hair removal,with relatively less side effect.

Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

Baculoviruses produce two viral phenotypes, the budded virus (BV) and the occlusion-derived virus (ODV). ODVs are released from occlusion bodies in the midgut where they initiate a primary infection. Due to the lack of an in vitro system, the molecular mechanism of ODV infection is still unclear. Here we present data demonstrating that Helicoverpa armigera nucleopolyhedrovirus (HearNPV) ODV infected cultured Hz-AM1 cells in a pH dependent manner. The optimal pH for ODV infection was 8.5, which is same to that in the microvilli of midgut epithelial cells, the ODV native infection sites. Antibodies neutralization analysis indicated that four HearNPV oral infection essential genes p74, pif-1, pif-2 and pif-3 are also essential for HearNPV ODV infection in vitro. Thus, HearNPV-HzAM1 system can be used to analyze the mechanism of ODV entry.

Adult ; Arsenic ; pharmacology ; Chromosome Aberrations ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Humans ; Lymphocytes ; drug effects ; metabolism ; Male ; Middle Aged

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

Objective To explore the scanning technology of head-neck-coronaryone-stop-shopCT angiography using 256-slice iCT and complete image quality analysis.Methods 106 consecutive patients underwent 256-slice iCT head-neck-coronaryone-stop-shop CT angiography.According to the average heart rate,patients were divided into three groups,the 1ow heart rate group with the average heart rate ranged from 40 to 60,medium heart rate group with heart rate from 60 to 80 beats per minute and high heart rate group with heart rate more than 80 beats per minute.The volume rendering (VR),maximum intensity projection (MIP), multi-planar reformation (MPR)and curved planar reconstruction (CPR)were employed for three-dimensional reconstruction after the original image reached to the iCT post-processing workstation.The image quality of head-neck artery and coronary artery were assessed by two senior radiologists individually .Results The image quality scores in the three groups show statistic significance (F=14.886 , P =0.000).The difference between low heart rate group and medium heart rate group show statistic significance (P =0.031).The difference between low heart rate group and high heart rate group was statistical significant (P = 0.026 ).There was no statistic difference between medium heart rate group and high heart group.The excellent rates of coronary artery image quality reached to 100%,96.6%,92.6% in low,medium and high heart rate group respectively.The rates of excellent about head-neck vascular im-age quality in the three groups reached to 100%.Conclusion 256-slice iCT head-neck-coronaryone-stop-shopCT angiography can obtain satisfactory image.The image quality does not decrease in patients with high heat rate.

Objective To explore the optimal diagnosis and treatment strategy of tumors at the foramen magnum,the clinical characteristics were analyzed retrospectively.Methods The clinical data of 58 cases with foramen magnum tumors treated with microsurgery in our department were collected and analyzed retrospectively.And intraoperative neurophysiological monitoring was employed in later 21 cases.Results Gross total resection was achieved in 48 of the 58 cases ; Five of the 10 patients with VA encased by tumors were totally resected.Full resection was achieved in 43 of the last 48 cases.Forty-three of the 47 cases with intradural tumors got complete resection,and total resection was achieved in 3 and 2,respectively,in 9 intra-extradural communicated tumors and 2 extradural ones.Symptoms were significantly improved in 50 cases,worsened in 5 patients,and maintained stable in the last 3 patients.Post-operative symptoms were obviously improved in the later 21 cases with intraoperative neurophysiological monitoring employed and the therapeutic effect of the treatment was much better than the former cases.Three patients died postoperatively.Fifty cases got complete follow-up from 6 months to 3 years.Among them,forty-four patients had a KPS score of 80-100,but the other 6 patients less than 80.Conclusion Microsurgical treatment for foramen magnum tumors is effective.Optimal surgical approaches and precise micro-operative techniques are crucial for the tumor removing.It is quite difficult and risky to fully resect the intra-extradural communicated tumors and the ones encasing vertebral artery.Preoperative evaluation should be profound.The application of intra-operative electrophysiological monitoring and the timely management of post-operative complications can improve the prognosis obviously.

Objective To investigate the expression of serum soluble cytotoxic T lymphocyte associated antigen 4 (sCTLA4), the association of sCTLA4 level with erythrocyte sedimentation rate (ESR) and C reactive protein (CRP), as well as its role in patients with Crohn's disease (CD). The relationship-1661A/G and -1722T/C polymorphisms of CTLA4 gene and between disease susceptibility and phenotype of CD was analyzed. Methods A total of 126 CD patients and 300 healthy controls were enrolled in the study. Serum sCTLA4 level was determined by enzyme-linked immunosorbent assay. The concentrations of ESR and CRP were analyzed by automatic ESR Analyzer SRS 100/Ⅱ and rate nephelometry, respectively. The polymorphisms of CTLA4-1661A/G and -1722 T/C were genotyped by DNA sequencing. Results Serum sCTLA4 level was higher in CD patients than in healthy controls [(18. 70±3. 72) ng/ml vs (1.72±0. 32) ng/ml, P＜0. 01)]. Among CD patients, sCTLA4 level was higher in patients with active disease when compared to those with inactive disease [(19.83±4.35) ng/ml vs (18. 02±3.14) ng/ml, P=0. 015)]. sCTLA4 level was positively correlated with ESR and CRP levels (r=0. 267, P=0. 003; r=0. 524 P ＜0.01, respectively). In CD patients, serum sCTLA4 level was significantly higher in those with stricturing disease behavior than that in those without stricturing and penetrating or with penetrating disease behavior (P= 0.021; P=0. 015, respectively). Detection of CTLA4 -1661A/G and -1722T/C polymorphisms showed no significant difference between CD patients and healthy controls. Conclusions The high level of serum sCTLA4 in CD patients is correlated with disease activity, CRP levels and disease behavior. It suggests that sCTLA4 may play an important role in pathogenesis of CD.