Objective To determine the median effective target effect-site concentration (EC50) of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index ＜ 30 kg/m2,scheduled for scoliosis surgery under sevoflurane and sufentanil anesthesia,were randomly divided into Ⅰ-Ⅵ groups (n =15 each).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with sevoflurane,sufentanil and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Before the wake-up test,infusion of cisatracurium was stopped and the end-tidal concentration of sevoflurane was adjusted to 0.The EC50 was determined by the K(a)rber method.The target effect-site concentration of sufentanil was set at 0.19 ng/ml in group Ⅰ,0.18 ng/ml in group Ⅱ and gradually decreased in decrements of 0.01 ng/ml.The wake-up test was performed 5 min later.The EC50 and 95 ％ confidence interval of sufentanil were calculated by the K(a)rber method.Results EC50 of sufentanil obtained was 0.164 ng/ml and 95％ confidence interval of sufentanil obtained was 0.157-0.172 ng/ml when the wake-up test was successful.Conclusion The EC50 of sufentanil is 0.164 ng/ml when the intraoperative wake-up test is successful in the patients undergoing scoliosis surgery.

Objective To observe the effect of treadmill training on metabotropic glutamate receptor of a middle cerebral artery occlusion model in rat and its underlying mechanisms. Methods Sprague-Dawley male rats of 2 or 3 months old were randomly divided into 3 groups: a sham operation group, an iscbemia-reperfnsion group and a treadmill training group (subject to 2 weeks of training after the ischemia-reperfusion). All the animals were sacri-ficed after 2 weeks of training and their brains were sampled for measurement of the expression level of the striatum mGluR Ⅰ-mRNA, using RT-PCR technique. Results The striatum mRNA of mGluR1 and mGluR5 was signifi-cantly elevated in the ischemia-reperfusion group(P<0.01), but treadmill training significantly suppressed the ele-vation of the expression of mRNA of mGluR1 and mGluR5 (P<0.01). Conclusions Treadmill training can signif-icantly downregulate mGluR Ⅰ-mRNA expression. This might be one of the important mechanisms for inhibition of the excitatory glutamate production.

Objective To investigate the effect of position ventilation(PPV) on oxygenation,the airway sputum drainage and hemodynamic of acute respiratory distress comprehensive syndrome(ARDS).Methods From June 2015 to April 2016,13 cases with moderate or severe ARDS were researched.The changes of PaO2,PaCO2,SpO2,PaO2/FiO2 and airway sputum drainage were observed as well as HR,MAP,CVP,CO,CI,SVV,etc.Results Totally 56 PPV were taken.Compared with pre-treatment of PPV,the number of PaO2 and PaO2/FiO2 increased from (74.7±13.18) mm Hg and 168.65±22.12 to (92.13±17.82) mm Hg and 208.80±24.04(P<0.05) respectively;SpO2 and airway sputum drainage increased from (95.32±2.76)% and (7.84±1.68)mL to (97.04±1.84)% and (13.25±3.55)mL(P=0.000).However,there were no significant differences in HR,MAP,CVP,CO,CI and SVV(P>0.05).Conclusion PPV can effectively improve oxygenation in patients with ARDS and promote airway sputum drainage,and hemodynamic effects are not obvious.However,nursing intervention still should be strengthened.

Bariatric surgery is one of the most effective way to lose weight,which suppresses appetite through the central nervous system. The mechanisms of appetite change may include gut hormones, adipokines, as well as microbiota in the intestine.

Background Several cytokines,especially interleukin-1β (IL-β) involve in the breakdown of blood-retina barrier,and the signal of cytokine is transduced through protein tyrosine kinase (PTK) pathway.Objective This study was to investigate the effects of PTK inhibitor,Genistein,on IL-1β-induced blood-retinal barrier breakdown and possible mechanism.Methods The animal models of blood-retinal barrier breakdown were induced through intravitreal injection of IL-1β(10ng) in 24 clean healthy SD rats and assigned to IL-1β group and Genistein group.5μl IL-1β+1μl Genistein with 0.2,1,5μg were intravitreally injected in 12 model rats and 5μl IL-1β (2mg/L)+1μl DMSO was used at the same way in other 12 models.Evans Blue was injected in rats via jugular vein in 1 hour before sacrifice of animals and the arterial blood was collected for the detect of serum Evans Blue.The retinas of the rats were obtained in 4 and 48 hours after injection of vitreous cavity to assay the content of Evans Blue in retina.The changes of vessels and infiltration of inflammatory cells were observed with hematoxylin-eosin stain.RT-PCR was employed to determine the expression of IL-8 and MCP-1mRNA in neuroretina after intravitreal injection.Expression of MCP-1 protein was localized by immunohistochemistry.Results The ratio of retinal Evans Blue and plasma Evans Blue was significantly decreased after intravitreal injection of different doses of Genistein among Genistein groups and IL-8 group with a statistical difference (4 hours:F=7.510,P=0.010;48 hours:F=5.960,P=0.019).With the increase of time after injection of Evans Blue,the ratio of retinal Evans Blue and plasma Evans Blue was gradually reduced in comparison to IL-1β group (P＜0.05).After injection of IL-1β,the dilation of retinal vessel and adhesion of leukocyte to vessel wall were seen under the light microscope,but infiltration of less inflammatory cells was found in Genistein group.The expressions of IL-8 and MCP-1mRNA were obviously declined in retina of rats in Genistein groups compared with IL-8 group (P＜0.05).Immunochemistry indicated that the expression of MCP-1 protein in neuroretina tissue was weaker in Genistein group compared with IL-8 group.Conclusion PTK inhibitor,Genistein,can decrease IL-1β-induced permeability of vessel and maintain the integrity of blood-retinal barrier by downregulating the expression of chemokines and infiltration of leukostasis in retinal vessels.This study imply that PTK pathway plays an important role in IL-1β-induced blood-retinal barrier breakdown.

As the actual clinical reflecting of transform Chinese medicine special curative effect, Chinese medicine preparation not only satisfies the need of hospital clinic, scientific research and teaching, but also plays an important role in deepening medical and health system reform, improving people's health level and contributing to the economic growth. However, some problems about administration and approval (tending to western medicine), contraction of the scale, lack of synchronization for clinic and scientific research, and the imbalance of regional development make Chinese medicine preparation move forwards slowly in contradiction. It has not only reduced the effectiveness of the Chinese medicine preparation in hospital clinic, but also brought bad effect on modernized development of Chinese medicine preparation. Research shows that main influencing factors of status quo of Chinese medicine preparation in medical institution include imperfect laws and regulations, high cost than income, and shortage of talents in preparation research. The analysis indicated that the necessary measures to break the contradiction, improve clinical effect of Chinese medicine, and promote the modernization development of Chinese drugs preparation were as follows: government and related departments should strengthen the supporting force in policy by adjusting the examination and approval policy, speeding up dispensing use, reforming pricing system, including into medicare reimbursement, integrating advantage resources and so on; medical institution should actively carry out research and development of traditional Chinese Medicine through drawing the traditional and modern essence, reserving professional talents, and developing characteristic preparation; companies cooperate with hospitals for complementary advantages, which can rapidly transform Chinese medicine preparation into clinical practice.
Chemistry, Pharmaceutical ; economics ; methods ; trends ; China ; Drug Discovery ; economics ; trends ; Drugs, Chinese Herbal ; chemistry ; economics ; pharmacology ; Humans ; Medicine, Chinese Traditional ; economics ; trends

Objective To randomly compare the therapeutic effect and safety between Levetiracetam (LEV) and Phenobarbital (PB) in the treatment of neonatal seizures.Methods A total of 61 infants with acute convulsion were randomly divided into 2 groups:LEV group (n =30) and PB group (n =31) during January 2013 to December 2014 in Urumqi Children's Hospital.All neonates received routine management including etiology treatment and adverse drug reaction monitoring.In the LEV group,subjects received oral formulation of LEV with initial loading dose 30 mg/kg,followed by 15 mg/kg twice a day.If the seizures were not controlled completely,PB treatment was added until seizures were completed controlled.If seizures were controlled quickly,the dose of PB was gradually reduced and LEV was used as monotherapy.The subjects in PB group received intramuscular or intravenous injection of PB with 10 mg/kg as the first dose,then 5 mg/(kg · d) oral PB was administered,if seizures were not controlled,LEV treatment was added,then dose of PB was gradually reduced until seizures were controlled completely,and then patients were switched to LEV monotherapy gradually.The drug adverse reactions were observed.Results (1) After LEV or PB monotherapy,66.7％ (20/30 cases) and 54.8％ (17/31 cases) of the subjects obtained sustainable seizure free respectively.Although,there was a higher control ratio in LEV group,but no significant difference was observed between the 2 groups (P ＞0.05).(2) LEV group (16/30 cases,53.33％) had higher rapid seizure control ratio with seizure controlled within 24 h after first dosage administration than that of PB group (8/31 cases,25.80％),and there was significant difference (x2 =4.841,P =0.028).Further more,if adding the cases who had to change to use another comparative one (LEV or PB) due to their seizures failure control with the first one treated,LEV group (21/44 cases,47.72％) still had higher rapid seizure control ratio in total patients than that of PB group(10/41 cases,24.39％),and there was significant difference (x2 =4.988,P =0.026).(3) Eight cases who changed to LEV after PB as the first treatment drug failed obtained sustainable seizure free.(4) One case in PB group with transient urinary retention was observed but the symptom disappeared 36 h after PB withdrawal,and no significant drug adverse reaction was observed in LEV group.Conclusion LEV is more rapid and safe for seizure control of neonates than PB.

To train the talents of clinical laboratory for the demand of clinical jobs,it is necessary to make the experimental teaching reform of clinical laboratory hematology.Comprehensive experimental teaching,which centers on case,has been explored in many ways like prefessional teachers' training,cases' choose,teaching method and experimental examination.And the practice has proved that the reform of comprehensive experimental teaching can give full play to the students' initiative and creativity,foster the students' ability to analyze and diagnose hematopathy.

Objective To explore the effect of cutting biopsy needle on decompression for lumbar disc prolapse and nursing measures? Method One hundred and twenty patients with lumbar disc prolapse were managed with intervertebral disc decompression as well as perioperative nursing? Results All of them had their pains significantly relieved one or two days after decompression? The follow-ups for 3 months to 1 year confirmed the effectiveness rate of 96?7%,excellent effectiveness rate of 89?2% and no complication?Conclusions The decompression by cutting needle biopsy,is advantageous for its operative simplicity,alleviation of pains,fewer adverse reactions and lower rate of complications? The perioperative nursing strategy and recovery instruction are critical for improved curative effect and prevention of relapse?