Objective To investigate the effects of sevoflurane combined anesthesia on the early cognitive function of the elderly patients.Methods 120 patients underwent laparoscopic surgery in our hospital from August 2014 to August 2016 were selected and randomly divided into two groups:sevoflurane group 60 cases, sevoflurane anesthesia during operation and propofol anesthesia 60 cases, propofol anesthesia during operation.MMSE was used to detect the cognitive function at one day before operation, one day, three days and seven days after surgery respectively.The blood samples were taken from the patients of the two groups at the time of one day before operation, one hour after operation and one day after operation, the levels of serum TNF-αand IL-6 were measured by enzyme-linked immunosorbent assay ( ELISA ) . The recovery time and adverse reactions were observed after operation.Results The average recovery time was (18.94 ±3.32) min in the propofol group and (10.62 ±2.31) min in the sevoflurane group, the sevoflurane group was better than the propofol group, the difference was statistically significant (P<0.05).The scores of MMSE were significantly lower in the sevoflurane group one day after operation than those in the one day before operation, the difference was statistically significant (P<0.05).The scores returned to the preoperative level three days and seven days after operation.In the propofol group, the MMSE score was significantly lower at one day after operation than that before operation, the difference was statistically significant (P<0.05), but increased three days after operation but did not reach the preoperative level, and sevoflurane group, the difference was statistically significant.After treatment, the levels of TNF-and IL-6 in serum of two groups increased, the level of TNF-αand IL-6 in the propofol group one hour after operation and one day after operation were significantly higher than those in the sevoflurane group, the difference between the two groups was statistically significant ( P <0.05 ).Conclusion The sevoflurane compound anesthesia in patients after surgery, the recovery of cognitive ability faster, fewer side effects in patients.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

Objective To study the influence of herbal decoction Shuxin Yin(SXY)on platelet activation of rats and mice with a- cute myocardial ischemia in order to explain its possible mechanism for treating coronary heart disease.Methods The rat model with acute myocardial ischemia and the mice model with acute myocardial ischemia and reperfusion were established.The male SD rats and ICR mice,51 each,were randomized into 5 groups respectively:sham operation group,model group,low dose SXY group,high dose SXY group,ticlopidine groap.Made models and collected blood Sample after 30 days gastric infusion in succession.The flow cytome- try technique and the monoclonal antibody examination were adopted to test the mice platelet glycoprotein CD_(62)P;the radioim- munoassay was used to test rat platelet aggregation rate(PAR),fibrinogen(Fg),thromboxane B_2(TXB_2)and 6-keto-PGF_(1?) and their ratio.Results Shuxin Yin can,inhibit the high expression of CD_(62)P of mice with acute myocardial ischemia and reperfusion,and de- crease PAR,Fg and TXB_2/6-keto-PGF_(1?) of rats with acute myocardial isehemia.Compared with the effect of ticlopidine,the differ- ence was not significant.Conclusion Shuxin Yin could effectively inhibiting platelet activation in rats anel mice with acute myocardial ischemia,and its effect in preventing and treating coronary heart disease might be related to the inhibition of platelet activation.

Objective To investigate the charateristics and prognostic value of computed tomography (CT) of retropharyngeal lymphadenopathy (RLN) in nasopharyngeal carcinoma (NPC).Methods From 1991 to 2006, CT images were analyzed for 588 patients with histologically proven NPC treated with radiation therapy in our hospital.The survival rate was evaluated by Kaplan-Meier method.Results RLN metastases were presented in 392 patients, with unilateral side in 254 patients and bilateral sides in 138 patients.The 5-year distant metastasis-free survival (DMFS) rate of patients with and without RLN metastasis was 66.6% and78.6%(χ2 = 10.78,P=0.005) ,with 69.7% and 62.2%(χ2 =2.31,P=0.129) for patients with unilateral and bilateral sides involvement.The DMFS rate was similar between the mild and moderate enhancement of RLN (67.6% and 58.9% ,χ2=2.77,P =0.096).The survival rate of RLN with homogeneous density was better than heterogeneous density (71.5%, 53.3% and 32.5%,respectively, χ2= 10.51, P = 0.001, χ2= 24.28, P = 0.000).The survival rate of patients with well boarded RLN was better than those with ill boarded RLN and obviously adjacent tissue involvement (65.5%, 51.8%and 50.0% , χ2 =8.20,P=0.004, χ2 =5.31 ,P=0.021).Conclusions The prognosis is poor with RLN metastasis, lymph node enhancement, heterogeneous density in nodes and ill boarded RLN.

Objective To assess the functional restoration in patients with developmental dysplasia of the hip (DDH) who underwent hip resurfacing arthroplasty and to determine whether greater abduction angle of the acetabular component is relat?ed to larger diameter of femoral head component. Methods We reviewed 34 DDH cases (9 hips of 8 males and 25 hips of 24 fe?males, mean age 44.6±11.85 years at the time of surgery) on whom we performed hip resurfacing arthroplasty (HRA) from October 2006 to September 2009. The total hip Arthroplasty (THA) group was consisted of 35 DDH cases (8 hips of 8 males and 27 hips of 25 females, mean age 43.7±10.4 years at the time of surgery). All operations were performed by the same doctor over the same peri?od. Assessment of the functional hip scores was conducted by Harris Hip Scores. A radiographic study was also performed to evalu?ate the implants stability and abduction angle of the acetabular components. All the data was analyzed with Kolmogorov?Smirnov method. Results The mean follow?up was 6.2 years in the HRA group. The Harris Hip Score improved from 54.9±13.2 to 97.3± 6.2 after the surgery. The mean abduction angle of the acetabular component was 51.6° ± 5.33°, hip flexion was 127° ± 6.9° and mean diameter of femoral head was 46.5±1.5 mm. The mean follow?up was 5.9 years in the THA group. The Harris Hip Score im?proved from 51.6±19.7 to 95.6±7.9 after the surgery. The mean abduction angle of the acetabular component was 43.9°±4.90°, hip flexion was 117°±4.2°. There was no failure of the prosthesis, peri?prosthetic fracture and infection in either group. There was sig?nificant difference in the abduction angle of the acetabular component (P<0.05) and flexion of the hip between the two groups (P<0.05). Conclusion Patients in the HRA group had a better functional restoration and larger range of motion. Furthermore, a larger diameter of femoral head component could be achieved by placing the acetabular component in a greater abduction angle, which may contribute to a better long?term stability.

Homocysteine (Hcy) is a sulfur-containing metabolic intermediate of methionine,which is normally at a lower level in the blood.Recent studies have shown that the elevated blood level of Hcy is an independent risk factor for ischemic stroke and increases the risk of occurrence of cerebral small vessel disease (CSVD).This article reviews the relationship between Hcy and CSCD.

We transformed the fip-fve gene into Pichia pastoris GS115 for inducible and constitutive expression to obtain feasible bioactvie recombinant Fip-fve. The fip-fve gene was cloned from Flammulina velutipes fruting body by PCR and ligated to pPIC9 to construct inducible expression vector pPIC9-FIP-fve, and promotor pgap was used to replace the paox1 to construct constitutive expression vector pPIC9-PGAP-FIP-fve. These two vectors were used to transform P. pastoris by PEG method. The fip-fve was expressed after histamine-absence screening and yeast colony PCR. The inducible expression level reached 158.2 mg/L at the fourth day and the constitutive expression level was 46.3 mg/L and 29.5 mg/L using glucose and glycerol, respectively. The SDS-PAGE and Western blotting both proved the correctness of rFip-fve, and the hemagglutination test indicats the rFip-fve's bioactivity.
Electrophoresis, Polyacrylamide Gel ; Flammulina ; chemistry ; Fungal Proteins ; biosynthesis ; Genetic Vectors ; Pichia ; metabolism ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Recombinant Proteins ; biosynthesis

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

OBJECTIVETo establish a new method for the identification of Schisandra sphenanthera and S. chinensis.

METHODRandom amplified polymorphic DNA-Sequence characterized applied region (RAPD-SCAR) method was applied to screen primers.

RESULTScreening from 100 primers, only 2 random primers, which can be used to identify S. sphenanthera and S. chinensis accurately with a good reproducibility. It worked to fit them into sequence characterized applied region.

CONCLUSIONRAPD-SCAR can be used to identify S. sphenanthera and S. chinensis accurately.

Objective To analyze the relationship between the serum B-cell activating factor (BAFF) levels and clinical characters and pathological features in children with lupus nephritis (LN). Methods ELISA was used to detect the serum BAFF (sBAFF) levels of the 54 LN children diagnosed in the First Affiliated Hospital, Sun Yat-sen University during October 1, 2014 to December 31, 2016 and with complete clinical data. According to whether glucocorticoid or immunosuppressive agents has been used at their first admission, patients were divided into treated group (n=44) and non-therapy group (n=10). According to the renal response after induction treatment for 6 months, patients were divided into remission group (n=20) and non-response group (n=34). According to whether there was renal recurrence, they were divided into recurrence group (6 cases) and non-recurrence group (48 cases). According to renal biopsy, patients were divided into class-Ⅲ, class-Ⅳ and class-Ⅴ group. Another 15 healthy children were taken as a control group. The correlations between sBAFF and clinical manifestation, laboratory examination, renal biopsy and clinical outcome were analyzed. Results (1) Compared with the control group, the sBAFF was significantly increased in LN group (t=3.821, P<0.001). Compared with the non- neuropsychiatric systemic lupus erythematosus (NPSLE) group, sBAFF was significantly increased in NPSLE group (t=2.202, P=0.032). (2) Compared with that in treated group, sBAFF was significantly higher in untreated group (LSD - t=2.309, P=0.025). Compared with non-response group, sBAFF was significantly decreased in response group (LSD-t=2.035, P=0.046). (3) No significant difference was observed between class-Ⅲ, class-Ⅳ and class-Ⅴpathological classification group (F=1.080, P=0.459). sBAFF in LN children was not significantly correlated with the active index (AI) or chronic index (CI) of Austin index (r=-0.273, P=0.063; r=0.150, P=0.314). (4) In LN children, sBAFF has positive correlation with ESR and IgG level (r=0.289, P=0.036; r=0.340, P=0.017) and negative correlation with WBC (r=-0.337, P=0.013). Multiple linear regression model showed that serum IgG level (β'=0.517, P=0.001) and renal response (β'=-0.271, P=0.037) were independent influencing factors of sBAFF level. Conclusions Renal remission and serum IgG levels in LN children are influencing factors of sBAFF levels. sBAFF is helpful to clinical assessment on renal response of LN children.