Objective To investigate the effectivity of bispectral index(BIS)and auditory -evoked potentials index(AEP index)in monitoring the depth of desflurane anesthesia in the elderly. Methods Sixty patients(ASA gradeⅠ～Ⅱ)without obvious auditory and psychiatric dysfunction undergoing general anesthesia were enrolled in this study,and they were devided into the elderly group (n=30)and the non-elderly group(n=30)according to the age.After the endotracheal intubation,the lungs were ventilated with desflurane in oxygen.End-tidal concentrations of desflurane were maintained at 0.6,1.0 minimum alveolar concentrations(MAC)and 1.3 MAC for 20 minutes, respectively.The changes of BIS,AEP index,mean arterial blood pressure(MAP)and heart rate (HR)were recorded simultaneously.Results In the elderly and non-elderly groups,BIS were 94.14?6.5 and 94.5?4.6(P＞0.05),and AEP index at pre-anesthesia were 87.2?11.7 and 89.2?6.9(P＞0.05)respectively,which showed no statistic difference between two groups.BIS and AEP index decreased significantly in each time point at pre-anesthesia compared with those during anesthesia in two groups (P＜0.05).In the periods of increasing concentration of desflurane,BIS decreased gradually in two groups(P＞0.05),but BIS in the elderly group were higher than in the non-elderly group at the same end-tidal desflurane concentration(P＞0.05),and BIS negatively correlated with the end-tidal desflurane concentration in two groups.In the elderly group,AEP index decreased significantly at the concentration of 1.0 MAC and 1.3 MAC of desflurane compared with that of 0.6 MAC(P＜0.05),but there was no difference in AEP index with increasing end-tidal desflurane concentration from 1.0 MAC to 1.3 MAC(P＞0.05).At every concentration of desflurane,AEPindexintheelderlygroupwaslessthaninthenon-elderlygroup(P＜0.05).Conclusions BIS and AEP indexes correlate well with the end-tidal desflurane concentration,and are valuable for monitoring the depth of desflurane anesthesia in the elderly.AEP index can predict the difference in depth of anesthesia at the same end-tidal desflurane concentration between the elderly and the non-elderly.

OBJECTIVETo study the clinical effects of integrative Chinese and Western medicine in treating chronic urticaria and its impact on peripheral blood content of interleukin-10 (IL-10) and IL-8.

METHODSPatients were assigned to the treatment group and the control group according to their sequence of visiting. They were treated orally with levocetirizine hydrochloride 5 mg once a day, but additional Kangqian Decoction (a self-formulated Chinese herbal preparation consisted of thorowax root 15 g, divaricate saposhnikovia root 9 g, licorice root 15 g, moutan bark 15 g, red sage root 15 g, milkvetch root 30 g, and schisandra fruit 12 g, etc. ) was given to the treatment group one dose per day, for 2 weeks as one therapeutic course. The efficacy was evaluated after two courses of medication, and patients' IL-10 and IL-8 levels in the peripheral blood were determined before and after treatment.

RESULTSThe total effective rate in the treatment group and control group was 93.75% and 56.66% respectively with significance difference between them (P <0.01). After treatment, the level of serum IL-10 was significantly lower while that of IL-8 was significantly higher in the treatment group (2.96 +/- 1.66, 50.17 +/- 32.35) than that in the control group (4.77 +/- 2.99, 29.44 +/- 17.62) respectively (P < 0.01).

CONCLUSIONChronic urticaria was related to the immune unbalance of body. Integrative medicine could adjust immune function to display a quick, potent anti-inflammatory and anti-anaphylactic actions in treating chronic urticaria with less adverse reaction and low recurrent rate.

Adolescent ; Adult ; Cetirizine ; therapeutic use ; Chronic Disease ; therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Interleukin-10 ; blood ; Interleukin-8 ; blood ; Medicine, Chinese Traditional ; Middle Aged ; Urticaria ; blood ; drug therapy ; immunology ; Young Adult

OBJECTIVETo investigate the clinical indications of asthma control test (ACT).

METHODSA total of 120 asthmatic patients with a diagnosis in line with the American Thoracic Society criteria and treated for over a month were enrolled in this study. The patients were asked to complete a survey to assess their symptoms and asthma attacks, and ACT evaluation was conducted by physicians familiar with ACT evaluation. The patients were classified into two groups based on the pulmonary function test (positive for bronchodilator test and provocation test) or based on disease severity (mild and moderate-to-severe asthma groups). The effect of ACT evaluation was graded as good (no less than 4 item available for evaluation), fair (2-3 items available) and poor (no more than 1 item). To further analyze the ACT sensitivity in relation to different disease severity, 29 asthmatic patients with an initial diagnosis and BDT positivity were included, and the ACT score of the patients with mild, moderate and severe asthma based on FEV1% were compared.

RESULTSIn patients positive for bronchodilator test, good, fair and poor evaluation effects were found in 48, 15, and 5 cases, as compared to 10, 15, and 27 in those positive for provocation test, respectively, showing significant differences between the two groups (P < 0.001). In mild asthma group, good, fair and poor evaluation effects were found in 12, 15, and 18 cases, respectively, significantly different from those in moderate-to- severe asthma group (50, 21, and 4 cases, P < 0.001). ACT scores showed a positive correlation to FEV1% in 29 patients with positive BDT (r = 0.55, P = 0.003). ACT scores had no significant difference between mild and moderate asthma groups (P > 0.05), but showed significant differences between mild and severe groups (P = 0.009) and between moderate and severe groups (P = 0.008).

CONCLUSIONACT is more suitable for evaluating patients positive for bronchodilator test or with moderate to severe asthma.

Adolescent ; Adult ; Aged ; Asthma ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Predictive Value of Tests ; Respiratory Function Tests ; Sensitivity and Specificity ; Severity of Illness Index ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo approach the treatment efficiency of replication defective adenovirus carrying HSV-tk gene under control of the human telomerase reverse transcriptase (hTERT) promoter in a mouse xenografts model of prostate cancer.

METHODSIt was erected that the model of human prostate cancer in BALB/C nude mouse followed by locally injecting Ad-hTERT-HSV-tk and peritoneal injection of GCV. The anti-tumor efficacy was evaluated by index of tumor volume, tumor weight, relative tumor curative, and tumor growth curve. Afterwards, the TUNEL and transmission electron microscope to overview apoptosis of tumor cells were used. Finally, immunohistochemistry for detecting PCNA of tumor cells were applied.

RESULTSCompared with the control group, all viruses treatment groups demonstrated tumor growth inhibition. Among 3 treatment groups, antitumoral effect of Ad-hTERT-HSV-tk/GCV was much stronger than other two groups (P < 0.05). Obvious necrosis and apoptosis was observed by TUNEL, and PCNA was detected by immunohistochemistry in tumor tissues in all viruses treatment group.

CONCLUSIONSAd-hTERT-HSV-tk/GCV system is highly efficacious to inhabit the growth of human prostate cancer.

Adenoviridae ; enzymology ; genetics ; Animals ; Female ; Genetic Therapy ; methods ; Genetic Vectors ; administration & dosage ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Promoter Regions, Genetic ; genetics ; Prostatic Neoplasms ; pathology ; therapy ; Recombination, Genetic ; Telomerase ; genetics ; Thymidine Kinase ; genetics

OBJECTIVEIt is to study the effect of tripterygium (TW) on the plasma IL-18 content in patients with lupus nephritis (LN) and its treatment value.

METHODThe patients with LN treated with prednisone were divided into active groupand inactive group with active index. The active group was given tripterygium additionally. The changing of plasma IL-18 and release of nephritis were observed after treatment for three months.

RESULTThe level of plasma IL-18 lowered down obviously, urinary protein decreased, LN activity index, hematuria and renal function improved.

CONCLUSIONTripterygium caninhibitroduction of plasma IL-18. It has definite treatment value on controlling LN activity.

Adolescent ; Adult ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Interleukin-18 ; blood ; Lupus Nephritis ; blood ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Tripterygium ; chemistry ; Young Adult

OBJECTIVETo examine the effect of trastuzumab on cell proliferation, colony formation and changes of HER-2 proteins in human breast cancer cell line SKBR3 and human ovarian cancer cell line SKOV3 cells which overexpress p185 HER-2 but shed high or low HER-2 extracellular domain (ECD) levels.

METHODSSKBR3 cells and SKOV3 cells were treated with or without trastuzumab. Cell number and the rate of colony formation were calculated. Western blot analysis was used to detect p185 HER-2, HER-2 ECD and phospho-HER-2. Two-site ELISA assay was used for the detection of HER-2 ECD.

RESULTSTrastuzumab inhibited cell proliferation, colony formation, and decreased or eliminated the levels of two uncharacterized phospho-proteins (molar weight about 90 000 and 40 000) in SKBR3 cells shedding high level of HER-2 ECD expression. These responses were not observed in SKOV3 cells shedding low level of HER-2 ECD expression. But total p185, phospho-p185 and phospho-p95 proteins did not appear to change in SKBR3 and SKOV3 cells after treatment with trastuzumab. Trastuzumab reacts not only with proteolytic cleavage HER-2 ECD containing HER-2 ECD I , II , III and IV subdomains of p185 HER-2 extracellular domain, but also with the secreted autoinhibitor p68/ECD III a specifying 340 residues, identical to subdomains I and II from the extracellular domain of p185 HER-2, followed by a unique C-terminal sequence of 79 aa encoded by intron 8, which suggested that there may be a trastuzumab binding site on p68/ECD III a protein. Comparing with HER-2 ECD levels of the same number of SKBR3 cells, there was no significant decrease of HER-2 ECD shedding level after treatment with or without trastuzumab for 4 days in serum-free medium.

CONCLUSIONAntitumor effects of trastuzumab may be related to the two uncharacterized phospho-p90 and/or phospho-p40 proteins. There is probably a trastuzumab epitope on p68/ECD III a. The decrease of HER-2 ECD levels may be positively correlated with the number of SKBR3 cells.

Antibodies, Monoclonal ; pharmacology ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; pharmacology ; Blotting, Western ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Ovarian Neoplasms ; metabolism ; pathology ; Phosphorylation ; Receptor, ErbB-2 ; metabolism ; Trastuzumab

AIM: To explore and analyze the image features, diagnosis and treatment of the central serous chorioretinopathy ( CSCR) fundus.
METHODS:From May 2008 to May 2014, 97 cases of 121 eyes with central serous chorioretinopathy were treated in in our hospital. The imaging features were compared and analyzed through different methods.
RESULTS:Sixty-one cases (61 eyes) were ≤45 years, including 13 case with disease in both eyes, single stove leak accounted for 48. 6%, multifocal leakage (25. 7%), atypical leakage accounted for 25. 7%. Thirty-six cases (47 eyes) were >45 years, 11 cases with disease in both eyes, single focal leakage ( 8. 5%), multifocal leakage (48. 9%), atypical leakage accounted for 42. 6%. FFA results showed acute hairstyle at the beginning of 89 eyes, chronic deferment type 32 eyes. OCT examination showed that the main features were neuroepithelial detachment, as well as the change of the retinal pigment epithelium ( RPE) layer, which was divided into RPE layer detachment 93 eyes, accounting for 76. 9%, rough and RPE little ridges in 28 cases, accounting for 23. 1%. The average thickness of macular center concave on the cortex of microns was 137. 87 ± 19. 21μm, and there was no significant difference conpared with normal ( 137. 32 ±4.98μm) microns (t=0. 30, P>0. 05). The closer leakage area to macular fovea, the worse of eyesight. .
CONCLUSION: Different imaging examination on central serous chorioretinopathy can show different features. For clinical diagnosis and treatment it had different and complementary roles, but were given significant help for diseases treatment.

OBJECTIVE: To observe the changes of auditory evoked potentials (AEP) index, mean arterial blood pressure (MAP) and heart rate (HR) undergoing desflurane anesthesia in the elderly and to evaluate the use of AEP index for monitoring the depth of desflurane anesthesia in the elderly. METHODS: Forty patients classified as ASA physical status I-III undergoing general anesthesia were divided into 2 groups with 20 patients in each group: Group elderly (> or =65 years) and Group youth (18-55 years). Anesthesia was induced with propofol and vecuronium. After the endotracheal intubation, the lungs were ventilated with desflurane in oxygen. End-tidal concentration of desflurane was maintained at 0.6 MAC, 1.0 MAC and 1.3 MAC for 20 min, respectively. The changes of MAP, HR and AEP index were recorded simultaneously. RESULTS: During the anesthesia of desflurane, MAP decreased significantly compared with those at preanesthesia in both groups. And HR decreased significantly compared with those at preanesthesia only in Group elderly (P < 0.05). The changes of MAP and HR had no statistical difference with increasing end-tidal desflurane concentration from 0.6 MAC to 1.3 MAC in both groups (P > 0.05). During the anesthesia of desflurane, AEP index decreased significantly compared with those at preanesthesia in both groups (P < 0.05). In the periods of increasing concentration of desflurane, AEP index decreased gradually. In Group elderly, AEP index decreased significantly 1.0 MAC and 1.3 MAC of desflurane compared with those of 0.6 MAC (P < 0.05). In Group youth, the changes of AEP index had no statistical difference with increasing end-tidal desflurane concentration from 0. 6 MAC to 1.3 MAC (P > 0.05). At the same concentration of desflurane, AEP index in the Group elderly were less than those in Group youth (P < 0.05). AEP index correlated with the end-tidal desflurane concentration significantly. The coefficient of product-moment correlation (r) were -0.983 and -0.980, respectively in Group elderly and Group youth (P < 0.05). CONCLUSION AEP index correlates well with the end-tidal desflurane concentration which is valuable for monitoring the depth of desflurane anesthesia in the elderly. AEP index can show the different depth of anesthesia at the same end-tidal desflurane concentration between the elderly and youth.
Aged ; Anesthetics, Inhalation ; Desflurane ; Evoked Potentials, Auditory ; Female ; Humans ; Isoflurane ; analogs & derivatives ; Male ; Monitoring, Intraoperative ; methods

OBJECTIVE: To evaluate the effect of intrathecal pumping tramadol on cell-mediated immunity in rats with formalin inflammatory pain. METHODS: Thirty-two Sprague-Dawley adult male rats weighting 250 approximately 300 g were randomly divided into 4 groups (n=8 in each group):Saline group (NS) and 3 tramadol groups (T1,T2,and T3). The rats were anesthetized with intraperitoneal chloral hydrate (300 approximately 350)mg/kg. Microspinal catheter was inserted into the subarachnoid space at the lumber region according to modified Yaksh techniques. In the tramadol groups,after 5 days tramadol was continuously infused through the spinal catheter at 50 (T1),25 (T2), and 12.5 microg/h (T3) for 7 days. In the NS group normal saline was continuously infused instead of tramadol. On Day 7 formalin (5%, 50 microL) was injected into the plantar surface of the left hindpaw. The number of flinches, lickings and total time of licking was recorded for 60 min.Pain intensity scoring(PIS)(0 approximately 3;0= no pain, 3=severe pain) was used to assess the antinociceptive effect of intrathecal tramadol. The rats were killed after the evaluation of pain intensity. Body weight and spleen weight were measured and spleen index (spleen weight/body weight) was calculated. T-lymphocyte function was evaluated based on Concanavalin-A(ConA) induced splenocyte proliferation. A modified lactic acid dehydrogenase(LDH) release assay was done to assess the NK cell activity. Phenotypic expressions of cell surface markers of T lymphocyte subsets (CD3+, CD3+ CD4+, CD3+ CD8+, and CD4+/ CD8+) and NK cell(CD161+) in the spleen were analyzed by flow cytometry. RESULTS: The PIS scores were significantly lower in the T1,T2,and T3 groups than those in the NS group. The spleen index and splenocyte proliferation induced by ConA were significantly suppressed in the T1 group,and the phenotypes of T lymphocyte subsets were significantly changed,but no significant difference was found in the T2 and T3 groups compared with the NS group. There were no differences in NK cell activity in the 3 tramadol groups from the control group. CONCLUSION Intrathecal pumping tramadol has significantly antinociceptive effect. Intrathecal pumping higher dosage tramadol (50microg/h) suppresses T lymphocyte proliferation and alteres T lymphocyte subset phenotype but does not affect NK cell activity. General analgesic dosage tramadol (25 and 12.5 microg/h) has no effect on the immune function.
Analgesics, Opioid ; pharmacology ; Animals ; Dose-Response Relationship, Drug ; Formaldehyde ; Injections, Spinal ; Killer Cells, Natural ; immunology ; Male ; Pain ; chemically induced ; immunology ; Pain Measurement ; drug effects ; Rats ; Rats, Sprague-Dawley ; T-Lymphocyte Subsets ; immunology ; Tramadol ; administration & dosage ; pharmacology

OBJECTIVE: To evaluate the immunological function in rats with formalin inflammatory pain through intrathecal pumping different dosages of morphine. METHODS: Thirty-two Sprague-Dawley rats were randomly divided into 4 groups (n = 8 in each group): saline group (NS) and morphine group included M1 group (10 microg/h) , M2 group (5 microg/h), and M3 group (2.5 microg/h). Chronic intrathecal catheterization was performed under anesthesia with 10% chloral hydrate (300-350) mg/kg according to M2 group (5 microg/h) and M3 group (2. 5 microg/h). Chronic intrathecal catheterization was modified Yaksh's. After 7 days, pain intensity scoring (PIS) was utilized to assess antinociceptive effect of morphine. And spleens were aseptically removed to obtain splenic cells. T lymphocyte function was evaluated based on Concanavalin-A induced splenocyte proliferation. A modified lactic acid dehydrogenase release assay was used to assess NK cell activity. Phenotypic expression of cell surface markers of T lymphocyte subsets (CD3+, CD3+ CD4+, CD3+ CD8+, and CD4+ / CD8+ ) and NK cell ( CD161+) in the spleen were analyzed by flow cytometry. RESULTS: Compared with the NS group, PIS of morphine group decreased obviously (P < 0.01) and was dose-dependent in the early and late phase of formalin pain, but there were no significant differences among morphine groups. Spleen index, splenocyte proliferation and NK cell activity were significantly suppressed by intrathecal pumping morphine. Phenotypic expression of T lymphocyte subsets and NK cell assessed by flow cytometry were different from the control group in all morphine groups. CONCLUSION There was significant antinociception of intrathecal pumping morphine. After intrathecal pumping different dosages of morphine (10 microg/h,5 microg/h, and 2.5 microg/h), the function of cellular immunity was suppressed and was dose-dependent.
Analgesics, Opioid ; administration & dosage ; pharmacology ; Animals ; Dose-Response Relationship, Drug ; Formaldehyde ; Immunosuppressive Agents ; administration & dosage ; pharmacology ; Injections, Spinal ; Killer Cells, Natural ; immunology ; Male ; Morphine ; administration & dosage ; pharmacology ; Pain ; chemically induced ; immunology ; Pain Measurement ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; T-Lymphocyte Subsets ; immunology