Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.

Budd-Chiari Syndrome ; complications ; Humans ; Seizures ; complications

Objective To certify insuline resistance in nonobese patients with essential hypertension(EH) and observe effect of imidapril.Methods An oral glucose tolerance test(OGTT) and insulin releasing test(IRT) were performed on 40 nonobese EH patients before and after imidapril treatment,the plasma levels of glucose and insulin were tested and compared with those of 16 normal subjects.Results The insuline level of fasting or 30,60,120 min after OGTT were significantly higher than those in normal group(P

Objective To investigate the prevalence of hypertension in patients with obstructive sleep apnea hypopnea syndrome (OSA) and the relationship between blood pressure (BP) with respiratory ventilation function. Methods Patients with OSA (n=3 607) were included in this study and divided into 4 groups based on their apnea-hypopnea index (AHI) scores:control group (control, n=354) with AHI<5;mild OSAHS (mild, n=658) with 5≤AHI<15;moderate OSAHS (moder?ate, n=753) with 15≤AHI<30;and severe OSA (severe, n=1 842) with AHI≥30. BP were measured at 4 time points (daytime, evening, midnight, and morning). The midnight/ daytime average BP (RN/D) and morning/evening average BP (RM/E) ratios were calculated. Finally, the general profiles, prevalence of hypertension and average BP of 4 time points were compared among 4 groups. The correlations of MBP with AHI and LSaO2 were also analyzed. Results The prevalence of hypertension as well as MBP at daytime and in the morning in the mild group (34.65%), moderate group (39.04%) and severe group (55.37%) were all higher than that in control group (22.32%)(all P<0.05). The prevalence of hypertension as well as MBP at daytime and in the morning were both higher in severe group than those in mild and moderate groups. MPB in the evening and at midnight was higher in severe group than that in moderate group than that in mild group than in control group (P<0.05). Average MBP of all four time points rise with increasing AHI (all P<0.05). The ratios of nighttime to daytime MBP (RN/D) and of morning to evening MBP (RM/E) increased with the severity of the illness (F=9.821, 18.957;P<0.001). The day? time BP correlated well with AHI and lowest oxygen saturation (LSaO2;systolic BP, r=0.195,-0.206;diastolic BP, r=0.248,-0.251, P<0.01). Daytime MBP increased gradually with increasing AHI until MPB reached 61-65, at which point it either plateaued or dropped slightly. Conclusion OSA patients have a significant increase in midnight and morning BP and lose normal BP nycterohemeral rhythm. OSA is an independent risk factor for hypertension.

Objective To analyze the histopathology of patients with atypical squamous cells of undetermined significance (ASCUS),and provide evidence for further classification and clinical treatment of ASCUS.Methods The histopathology of cervical biopsy specimens from 249 patients with ASCUS diagnosed by liquid-based cervical cytology examination was analyzed retrospectively. Results Among the 249 ASCUS patients, the proportion of patients with inflammation was 34.14% (85/249), morphological change by human papillomaviral infection was 19.28%(48/249), CIN I was 32.53%(81/249),CIN II was 8.84%(22/249),CIN III was 3.21%(8/249), infiltrating squamous cell carcinoma was 1.20%(3/249),and endometrioid adenocarcinoma was 0.80%(2/249) . Conclusion It is very important to to further definitude the diagnosis of ASCUS, because a certain proportion of cervical cancer and precancerous leisions woud be confirmed.

The paper analyzes and discusses the necessity of integrating computational thinking into basic computer teaching by combining characteristics of medical undergraduates and the current situation and tendency of basic computer teaching,and states the thought and method of solving problems with the computational thinking by taking mind mapping and program design thought as the teaching cases,in order to cultivate the consciousness and ability of students in constructing problem solutions by taking advantage of the computational thinking.

objective To determine the existence of virulence-associated invA gene in different genospeeies of Leptospira interrogans reference strains in China.and to understand the alterations of invA gene transcription and expression of L.interrogans strain Lai before or after infecting cells.Methods PCR was applied to detect the invA gene of four L.interrogans strains belonging to four different genospecies and L.biflexa strain Patoc Ⅰ.The entire invA genes from the L.interrogans strains were cloned and then sequenced.The prokaryotic expression system of invA gene of L.interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai was constructed.Using Ni-NTA affinity chromatography,the target recombinant protein rInvA was extracted and purified.Rabbits were immunized with rInvA to obtain antiserum and the titer of antiserum was determined by immunodiffusion test.A model of L interrogans strain Lai infecting human embryo kidney cell line HEK293 was established to detect the alterations of invA gene transcription and expression of the leptospiral strain before or after infecting the host cells by real-time fluorescent quantitative RTPCR and western blot assay.Results All the four tested L.interrogans strains had invA gene whereas L.biflexa strain Patoc Ⅰ not.The similarity of nucleotide and putative amino acid sequences of invA genes from the four L.interrogans strains belonging four different genospecies were 99.33%-100%and 98.66%-100%,respectively.The constructed prokaryotic expression system could efficiently express rInvA and the immunodiffusion titer of rabbit anti-rInvA serum was 1:16.After L.interrogans strain Lai infecting HEK293 cells for 30 min or above,the microbe could adhere the surface of the cells.On the 30 min after the infection,the mRNA level of invA gene of L.interrogans strain Lai was remarkably upregulated,and on the 45 min after infection the mRNA level presented a peak value and then graduated decreased.On the 45 min or 60 min after L.interrogans strain Lai infecting HEK293 cells,InvA protein could be detectable but before infection or after infection for over 90 min the InvA protein expression was negative.Conclusion The invA gene is a unique gene for pathogenic L.interrogans.The invA gene of L interrogans has characteristics of cell-touched expression and transient expression,which may have a close correlation with adhering and invading host cells.

Objective To investigate the effects of p38 mitogen-activated protein kinase (MAPK) short hair RNA (shRNA) delivered by lentiviral vectors (pGLV) on cardiac function after myocardial infarction (MI) in aldosterone overload rats and to explore the mechanism.Methods Aldosterone overload rat myocardial infarction model was obtained by ligating the left anterior descending coronary artery.The pGLV-shRNA was constructed,sequenced and injected into rats via tail vein.Rats were divided into 3 groups:pGLV-shRNA group (n=6),pGLV-shRNA-NC group (n=6,contained a nonsense shRNA) and the sham-operation group (n=6).Cardiac function was measured by cardiac ultrasound.Apoptosis was assessed by transferase (TdT)-mediated biotin-16-dUTP nick-end labelling (TUNEL).The p38 MAPK mRNA expression was analyzed by RT-PCR.The protein expressions of p38 MAPK and caspase-3 were detected by Western blot.Results Compared with the sham-operation group,cardiac systolic function was reduced and myocardial apoptosis index was significantly increased [(31.26 ± 4.45) ％ vs.(15.20 ± 2.18) ％,P ＜ 0.01] in pGLV-shRNA-NC group.The mRNA and protien expressions of p38MAPK and caspase 3 protein expression were significantly increased in pGLV-shRNA-NC group (all P＜0.01).Compared with pGLV-shRNA-NC group,cardiac function was improved,myocardial cell apoptosis index was reduced [(22.35±3.59)％ vs.(31.26±4.45)％,P＜0.05],and the mRNA and protien expressions of p38MAPK and caspase 3 protein expression were decreased in pGLV-shRNA group (all P＜0.05).Conclusions Cardiac dysfunction is associated with p38MAPK-mediated myocardial apoptosis in aldosterone overload MI rats.pGLV-shRNA may inhibit cardiomyocyte apoptosis and improve postMI cardiac function.

Objective To explore the relationship between brain-derived neurotrophic factor (BDNF)gene polymorphisms and the susceptibility to pediatric epilepsy.Methods BDNF polymorphisms in 128 patients with pediatric epilepsy and 132 healthy controls were analyzed with polymerase chain reaction restriction and fragment length polymorphism (PCR-RFLP).Results There were significant differences between pediatric epilepsy and controls on genotype frequency of BDNF-270C/T (X2 =7.08,P =0.03 ).The CC genotype was positively associated with pediatric epilepsy (OR =3.91,95％CI =1.26 ～ 12.14).No differences in genotype or allele frequencies of the other polymorphisms were found between patients and controls.The frequencies of haplotypes did not show significant differences between patients and controls.Conclusion These findings support the hypothesis that BDNF-270C/T polymorphism may contribute to the risk of developing pediatric epilepsy.

Objective To construct a plasmid DNA encoding G glycoprotein of respiratory syncytial virus(RSV) and investigate the protective immune response against RSV infection. Methods Recombinant plasmid DNA of pcDNA3.1~G was constructed by standard RT-PCR based cloning procedure. The immunogenicity of recombinant G protein transiently expressed in HEK293 cells was detected by Western blot. BABL/c mice were intramuscularly immunized with pcDNA3.1~G. Samples of lung, sera, bronchoalveolar lavage fluid(BALF) were collected before and after RSV challenge; virus titer in lung was detected by viral titration; sections of paraffin embedding lung tissues were stained by haematoxylin and eosin(HE) for histological analyses; sera anti-RSV IgG levels were examined by ELISA; Th1/Th2 cytokine were detected by ELISA kit, the T lymphocyte subsets of BALF was determined by immunefluorescence staining followed by flow cytometry. Results Plasmid DNA of pcDNA3.1~G was successfully constructed. The expressed target protein possesses immunogenicity. After challenge, pcDNA3.1~G immunized mice presented relieved pathological changes in lung as well as reduced lung viral titers. The RSV specific IgG was detected in sera of immunized mice. There was significantly increased number of CD25~+CD4~+ T cells in mice BALF. Conclusion We constructed a pcDNA3.1~G plasmid DNA vaccination which can induce evident protective cellular immunity against RSV infection in mice with the increased number of CD25~+CD4~+ T cell subpopulation.