Objective To investigate correlation between genetic polymorphisms of CDHR3 (rs6967330),GSDMB (rs2305480),IL-33 (rs928413),RAD50 (rs6871536) and IL1RL1 (rs1558641) and occurrence and severity of allergic asthma in Han population.Methods Genotype and allele frequencies were compared between 516 patients and 552 controls by Chi-square test.Correlation between genotype and FEV1,total IgE was analyzed.Results Compared with the controls,the allergic patients had significantly higher allergic G of rs928413 and allergic C of rs6871536 (P ＜0.001).Besides,allergic patients were found to have significantly lower frequency of allergic A of rs1558641 (P =0.007).Compared with other genotypes,patients with rs928413 genotype GG and rs1558641 genotype GG were significantly correlated with low FEV1％ and high level of serum total IgE.Conclusion Gene IL-33,IL1R1,and RAD50 are correlated with the risk of asthma in Han population.

Objective To investigate correlation between genetic polymorphisms of CDHR3 (rs6967330),GSDMB (rs2305480),IL-33 (rs928413),RAD50 (rs6871536) and IL1RL1 (rs1558641) and occurrence and severity of allergic asthma in Han population.Methods Genotype and allele frequencies were compared between 516 patients and 552 controls by Chi-square test.Correlation between genotype and FEV1,total IgE was analyzed.Results Compared with the controls,the allergic patients had significantly higher allergic G of rs928413 and allergic C of rs6871536 (P ＜0.001).Besides,allergic patients were found to have significantly lower frequency of allergic A of rs1558641 (P =0.007).Compared with other genotypes,patients with rs928413 genotype GG and rs1558641 genotype GG were significantly correlated with low FEV1％ and high level of serum total IgE.Conclusion Gene IL-33,IL1R1,and RAD50 are correlated with the risk of asthma in Han population.

Objective:To investigate the effect of acute hypervolemic hemodilution (AHH) with 6% hydroxyethyl starch 130/0.4 on pharmacodynamics of propofol during successful laryngeal mask airway (LMA) implantation.Methods:American Society of Anesthesiology physical status Ⅰ or Ⅱ patients, aged 30-60 yr, with body mass index of 18.5-25.0 kg/m 2, undergoing elective extensive total hysterectomy under general anesthesia, were divided into 2 groups: AHH group (group A) and control group (group C). In group A, 6% hydroxyethyl starch 130/0.4 was infused at a rate of 20 ml/min for AHH, and the target hematocrit was 30%.In group C, lactated Ringer′s solution was infused according to the " 4-2-1" rule to supplement physiological requirements, and anesthesia induction was performed after 10 min of stabilization.Sufentanil was administered by target-controlled infusion using Bovil pharmacokinetic model with effect-site concentration (Ce) of 0.25 ng/ml, 3 min later propofol was given by target-controlled infusion using Schnider model.The Ce of propofol in the first patient was set at 5.0 μg/ml.Each time the concentration of propofol was increased/decreased by 0.5 μg/ml according to the sequential method.LMA was inserted following 1 min equilibration between plasma concentration and Ce of propofol.The trial was terminated when 8 consecutive inflection points of failed/successful LMA insertion occurred.The EC 5, EC 50, EC 95 and 95% confidence interval (95% CI) of propofol were calculated by probit regression analysis. Results:In group A, the EC 5 (95% CI), EC 50 (95% CI) and EC 95 (95% CI) of propofol when LMA was successfully placed were 4.237 (3.090-4.514) μg/ml, 4.802 (4.500-5.078) μg/ml and 5.443 (5.125-7.304) μg/ml, respectively.In group C, the EC 5 (95% CI), EC 50 (95% CI) and EC 95 (95% CI) of propofol when LMA was successfully placed were 2.408 (1.190-2.756) μg/ml, 3.120 (2.690-3.472) μg/ml and 4.042 (3.582-7.431) μg/ml, respectively.There was significant difference in EC 5, EC 50 and EC 95 between the two groups ( P<0.01). Conclusion:AHH with 6% hydroxyethyl starch 130/0.4 can decrease the efficacy of propofol when LMA is successfully implanted.

Objective To investigate the role of human umbilical cord mesenchymal stem cell-derived extracellular vesicle (hUC-MSC-EV) in the regeneration of fibrotic liver. Methods C57BL/6 mice were randomly divided into the 70% normal liver resection group (Oil+PHx group), 70% liver fibrosis resection group (CCl₄+PHx group) and 70% liver fibrosis resection+mesenchymal stem cell-derived extracellular vesicle (MSC-EV) treatment group (CCl₄+PHx+MSC-EV group), with 8 mice in each group. LX-2 cell lines were assigned into the phosphate buffer solution (PBS) group, transforming growth factor (TGF)-β group and TGF-β+MSC-EV group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in mice after partial liver resection were detected in each group. The expression levels of liver fibrosis and proliferation-related parameters were analyzed in each group. The messenger RNA (mRNA) expression levels of epidermal growth factor (EGF), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in LX-2 cells were detected in each group, and their effects on HGF expression in mouse liver were observed. Results Compared with the Oil+PHx group, the serum levels of AST, ALT and LDH were up-regulated, and the degree of fibrosis was more severe, the positive area of Sirius red and α-smooth muscle actin (α-SMA) staining was larger, and the expression level of α-SMA protein was up-regulated in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the serum levels of AST, ALT and LDH were decreased, the degree of fibrosis was slighter, the positive area of Sirius red and α-SMA staining was decreased, and the expression level of α-SMA protein was down-regulated in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the Oil+PHx group, the protein expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) were lower in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the protein expression levels of Ki67 and PCNA were increased in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the PBS group, the expression level of CollagenⅠ mRNA in LX-2 cells was increased, the expression level of α-SMA protein was up-regulated and the expression level of HGF protein was decreased in the TGF-β group. Compared with the TGF-β group, the expression level of CollagenⅠ mRNA in LX-2 cells was decreased, the expression levels of HGF mRNA and protein were increased, and the expression level of α-SMA protein was decreased in the TGF-β+MSC-EV group, the differences were statistically significant (all P < 0.05). The expression level of HGF protein in the CCl₄+PHx group was lower than that in the Oil+PHx group, whereas the difference was not statistically significant (P > 0.05). The expression level of HGF protein in the CCl₄+PHx+MSC-EV group was higher than that in the CCl₄+PHx group, and the difference was statistically significant (P < 0.05). Conclusions The regenerative capacity of fibrotic liver is weaker than that of normal liver. hUC-MSC-EV may alleviate liver fibrosis and improve liver regeneration by promoting HGF secretion from actived hepatic stellate cells and effectively enhancing the regenerative capacity of fibrotic liver.

Purpose: Microtubule-associated protein 1 light chain 3B (LC3B) serves as a key component of autophagy,which is associated with the progression of carcinoma. Yet, it is still unclear whetherLC3B is also an independent risk factor for intrahepatic cholangiocarcinoma (ICC). We aimto explore the predictive value of LC3B on prognosis of ICC, and to establish a novel andavailable nomogram to predict relapse-free survival (RFS) and overall survival (OS) for thesepatients after curative-intent hepatectomy. Materials and Methods: From August 2004 to March 2017, 105 ICC patients were eligibly enrolled in the ThirdAffiliated Hospital of Sun Yat-sen University. Preoperative clinical information of enrolledpatients was collected. Expression LC3B in the ICC specimen was detected by immunohistochemistry. Results: The 5-year RFS and OS in this cohort were 15.7% and 29.6%, respectively. On multivariateCox regression analysis, independent risk factors for 5-year OS were cancer antigen 125,microvascular invasion, LC3B expression and lymph node metastasis. Except for the above4 factors, neutrophil/lymphocyte ratio and tumor differentiation were independent factorsfor 5-year RFS. The area under the curve of nomograms for OS and RFS were 0.820 and0.747, respectively. Conclusion The nomograms based on LC3B can be considered as effective models to predict postoperativesurvival for ICC patients.

Objective:To discuss the improvement effect of Shenshuai Yingyang Capsule in the renal osteodystrophy model rats and its effect on the bone morphogenetic protein(BMP)-7/Smads signaling pathway,and to clarify the relationship between renal function and bone metabolism in the renal osteodystrophy model rats.Methods:Fifty SPF SD rats were selected,and 10 of which were randomly chosen as control group,and the remaining 40 rats were used to establish the renal osteodystrophy model.Thirty successful modeling rats were divided into model group,positive control group,and Shenshuai Yingyang Capsule group,and there were 10 rats in various groups.The rats in control and model groups were given saline,the rats in positive control group were given 0.01 mg·kg-1 calcitriol,and the rats in Shenshuai Yingyang Capsule group were given 1.2 g·kg-1 Shenshuai Yingyang Capsule,all the rats were treated for 12 weeks.HE staining was used to observe the pathomorphology of femur tissue of the rats in various groups;automatic biochemical analyzer and chemiluminescence were used to detect the kidney function and calcium-phosphorus metabolism indicators in serum of the rats in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in various groups;Western blotting method was used to detect the expression levels of BMP-7,phosphorylated BMP-7(p-BMP-7),Smad1/5/8,and phosphorylated-Smad1/5/8(p-Smad1/5/8)proteins in femur tissue of the rats in various groups.Results:The HE staining results showed that there was normal trabecular arrangement in control group with unchanged osteoblasts and osteoid area.In model group,the trabecular width and average osteoid area were increased,while the number of osteoblasts was decreased.In positive control and Shenshuai Yingyang Capsule groups,the trabecular width and average osteoid area were decreased,and the number of osteoblasts was increased.Compared with control group,the levels of blood urea nitrogen(BUN)and serum creatinine(Scr)of the rats in model group were increased(P<0.05);compared with model group,the levels of BUN and Scr of the rats in positive control and Shenshuai Yingyang Capsule groups were decreased(P<0.05);compared with positive control group,the levels of BUN and Scr of the rats in Shenshuai Yingyang Capsule group were decreased(P<0.05).Compared with control group,the level of calcium ion(Ca2+)in serum of the rats in model group was decreased(P<0.05),and the levels of phosphorus ion(P3-),parathyroid hormone(PTH),and alkaline phosphatase(ALP)were increased(P<0.05);compared with model group,the levels of Ca2+in serum of the rats in positive control and Shenshuai Yingyang Capsule groups were increased(P<0.05),and the levels of P3-,PTH,and ALP were decreased(P<0.05);compared with positive control group,the level of Ca2+in serum of the rats in Shenshuai Yingyang Capsule group was increased,and the levels of P3-,PTH,and ALP were decreased(P<0.05).The RT-qPCR results showed that compared with control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7 and Smad1/5/8 mRNA of the rats in positive control drug group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).The Western blotting results showed that compared with control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in positive control group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).Conclusion:Shenshuai Yingyang Capsule can improve the kidney function and calcium-phosphorus metabolism disorders in the renal osteodystrophy model rats,promote the proliferation of the bone marrow stromal cells,and enhances the bone metabolism;its mechanism may be related to the activation of BMP-7/Smads signaling pathway.

OBJECTIVETo analyze the correlation between the genotype and phenotype of 18q deletion syndrome with chromosome microarray analysis (CMA).

METHODSEight cases with 18q deletion syndrome were selected, including two affected fetuses and six children patients. DNA was extracted and hybridized with Affymetrix CytoScan TM 750K arrays following the manufacturer's standard protocol. The data was analyzed with a special software package.

RESULTSCMA analysis identified pathogenic copy number variations (CNVs) on 18q in all cases, which ranged from 6.612 Mb to 22.973 Mb. NFATC1, GALR1, MBP, SALL3 and TSHZ1 are likely to be causative genes for congenital heart disease, psychological, growth retardation, and cleft palate.

CONCLUSIONCMA can precisely locate the breakpoints of 18q and facilitate definition of the genotype-phenotype correlations, which is useful for prognosis.

Child, Preschool ; Chromosome Deletion ; Chromosome Disorders ; genetics ; Chromosomes, Human, Pair 18 ; genetics ; DNA Copy Number Variations ; Female ; Humans ; Infant ; Male ; Microarray Analysis

Objective:To evaluate the effect of esketamine combined with ultrasound-guided dorsal penile nerve block (DPNB) on negative postoperative behavioral changes (NPOBCs) in pediatric patients undergoing circumcision under general anesthesia.Methods:One-hundred and ninety-five pediatric patients, aged 4-8 yr, with body mass index of 10-35 kg, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, undergoing elective circumcision under general anesthesia, were selected and divided into 3 groups ( n=65 each) using a random number table method: esketamine group (group E), DPNB group (group D) and esketamine combined with DPNB group (group ED). Propofol 1.5 mg/kg was intravenously injected, and the patients were admitted to the operating room after consciousness disappeared in the 3 groups. Esketamine 0.5 mg/kg was intravenously injected in E and ED groups, and the equal volume of normal saline was given in group D. D and ED groups underwent bilateral DPNB with 0.25 % ropivacaine 0.15 ml/kg under ultrasound guidance, with the maximum total amount of the drug not exceeding 10 ml. Fentanyl 1.0 μg/kg and propofol 2.0 mg/kg were intravenously injected prior to the skin incision in the three groups. If intraoperative body movement occurred, propofol 10 mg was added, which could be repeated. The occurrence of intraoperative body movement, respiratory depression and amount of propofol added was recorded. When postoperative pain (FLACC score >4) occurred, flurbiprofen 1 mg/kg was intravenously injected for analgesia, and the usage of flurbiprofen was recorded. When emergence agitation(PEAD score>10) occurred, propofol 1 mg/kg was intravenously injected for sedation, and the occurrence of emergence agitation was recorded. Parents were followed up by telephone at 1, 7 and 30 days postoperatively to assess the occurrence of NPOBCs using the PHBQ scale. Results:Fifty-six patients in group E and 59 patients in D and ED groups finally completed the study.Compared with group E, the incidence of intraoperative body movement was significantly decreased, the amount of additional propofol was reduced, the emergence agitation score, incidence of emergence agitation and severe agitation and usage rate of postoperative flurbiprofen were decreased, and the incidence of separation anxiety at 7 and 30 days postoperatively was decreased in D and ED groups, and the incidence of intraoperative respiratory depression was significantly decreased, and the incidence of NPOBCs at 7 and 30 days postoperatively was decreased in group ED ( P<0.05). Compared with group D, the incidence of intraoperative respiratory depression was significantly decreased, the amount of additional propofol was decreased, the usage rate of postoperative flurbiprofen and incidence of sleep anxiety at 1 day postoperatively were decreased ( P<0.05), and no significant change was found in the incidence of NPOBCs at each time point after operation in group ED ( P>0.05). Conclusions:Esketamine combined with ultrasound-guided DPNB can reduce the occurrence of NPOBCs in pediatric patients undergoing circumcision under general anesthesia.

Objective To explore the value of postoperative prognostic nutritional index (post-PNI) in the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy. Methods Clinical data of 316 patients receiving HCC hepatectomy in the Third Affiliated Hospital of Sun Yat-sen University between January 2009 and December 2014 was analyzed retrospectively. There were 289 males and 27 females, with a mean age of (50±12) years. The informed consents of all patients were obtained and the local ethical committee approval was received. Post-PNI was calculated using value of ALB and lymphocyte count of the first examination after operation. The optimum cut-off value of post-PNI was defined according to receivers' operating characteristic (ROC) curve, and the patients were divided into high post-PNI group and low post-PNI group. Survival analysis of two groups was conducted using Kaplan-Meier method and Log-rank test, and the influencing factors for survival and prognosis were analyzed by Cox proportional hazard model. Results The optimum cut-off value of post-PNI was 36.4 by ROC curve. There were 165 cases in high post-PNI group, and 151 cases in low post-PNI group. The 1-, 3- and 5-year recurrence-free survival rate and overall survival rate of the high post-PNI group were respectively 74.4%, 55.5%, 50.3% and 93.8%, 85.9%, 78.7%, and were respectively 60.9%, 32.5%, 27.1% and 91.3%, 72.0% and 62.9% in low post-PNI group were, where significant differences were observed (χ2=16.939, 8.428; P<0.05). Multiple-factor analysis showed that post-PNI≤36.4 was the independent risk factor for the recurrence-free survival and overall survival of HCC hepatectomy patients(HR=1.705,1.771;P<0.05).Conclusions Post-PNI is an influencing factor for the recurrence-free survival and overall survival of HCC hepatectomy patients. Low post-PNI patients have worse prognosis.