Objective To evaluate the effects on mechanical ventilation in ICU patients with dexmedetomidine merely and combined with dezocine, fentanyl, respectively.Methods Fifty-seven patients with mechanical ventilation in ICU were collected during Jun till Dec in 2016, 35 males and 22 females, aged 18-75 years, and classified into three groups with random number table method, among whom there were 17 patients treated with dexmedetomidine, 20 patients treated with dexmedetomidine combined with dezocine and 20 with dexmedetomidine plus fentanyl, the general condition, pain score, MAP and HR were compared before and after the treatment, ideal treatment time and mechanical ventilation time were also compared among the different groups.Results There were no statistical differences in the general condition, CPOT score, MAP and HR at different points and mechanical ventilation time.Whereas, the time of ideal sedation and analgesia was significantly faster in group C than that of groups A and B (P<0.05).Conclusion Dexmedetomidine combined with dezocine can reach the ideal analgesic effect more rapidly than dexmedetomidine solely or combined with fentanyl.

Single nucleotide polymorphisms (SNP) is an important molecular marker in traditional Chinese medicine research, and it is widely used in TCM authentication. The present study created a new genotyping method by combining restriction endonuclease digesting with melting curve analysis, which is a stable, rapid and easy doing SNP genotyping method. The new method analyzed SNP genotyping of two chloroplast SNP which was located in or out of the endonuclease recognition site, the results showed that when attaching a 14 bp GC-clamp (cggcgggagggcgg) to 5' end of the primer and selecting suited endonuclease to digest the amplification products, the melting curve of Lonicera japonica and Atractylodes macrocephala were all of double peaks and the adulterants Shan-yin-hua and A. lancea were of single peaks. The results indicated that the method had good stability and reproducibility for identifying authentic medicines from its adulterants. It is a potential SNP genotyping method and named restriction endonuclease digest - melting curve analysis.

Objective To study the effect of NS398, an inhibitor of cyclooxygenase 2 (COX2), on the growth and apoptosis of human squamous cell carcinoma cell line Tca8113. Methods Cultured Tca8113 cells were incubated with NS398 (0, 6.25, 12.5, 25, 50, 100 μmol/L) for 24, 48 and 72 hours, respectively. Thereafter, MTT method, flow cytometry and transmission electron microscopy were applied to detect the proliferation, cell cycle and apoptosis of Tca8113 cells, respectively. Results The proliferation of Tca8113 cells was inhibited by NS398 in a dose- and time-dependent manner (both P<0.05). FCM analysis showed the appearance of a typical hypodiploid apoptotic (Sub-G1) peak, an increase in the percentage of cells at G0/G1 phase and a decrease in that at S and G2/M phases in NS398 ( 100 μmol/L) -treated Tca8113 cells. Moreover, the cell proliferation index was significantly downregulated by NS398 of 100 μmol/L from 41.03 to 24.33 (P<0.05). Under an electron microscope, morphological changes characteristic of apoptosis were observed in NS398-treated Tca8113 cells. Conclusion NS398, an inhibitor of COX2, could effectively inhibit the growth of Tca8113 cells in vitro by induction of apoptosis.

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effect of brucella in=nfection, and to provide practical foundation and valuable experience for clinical treatment and prevention of brucellosis.Methods One hundred and nineteen patients with brucella infection hospitalized at the First Hospital of Lanzhou University from January 1st 2011 to July 30th 2011 were enrolled.Clinical data including gender, age, contact history with bovine and clinical manifestations such as fever, sweating and joint and muscle pain were extracted.Diagnosis and treatment effect of these patients were all recorded.The epidemiological characteristics and clinical manifestations were analyzed.Results The majority of patients were middle-aged male, and the number of male cases were 2.5 times of female cases.The brucella infections were observed all seasons in Lanzhou, while most cases were observed between May and July.A total of 78 cases had clear animal contact history.Among them, 53 cases (44.54%) had contact history with bovine.Main clinical manifestations included fever (n=84, 70.59%), muscle and joint pain (n=93, 78.15%), sweating (n=52, 43.70%), fatigue (n=29, 24.37%), and the most common clinical symptoms was joint and muscle pain.Blood routine test showed neutropenia (n=25, 21.01%), increase in blood sedimentation (n=34, 28.57%) and blood coagulation dysfunction (n=30, 25.21%).Liver function examination showed increase in ALT (n=37, 31.09%) and AST (n=43, 36.13%).Other examination showed that splenomegaly (n=28, 23.52%) was the most common finding, and liver diffuse lesions (n=22, 18.49%) ranked second.The most common drugs were doxycycline (n=79, 66.39%), rifampin (n=60, 50.42%) and cephalosporins (n=50, 42.02%).Among them, 45 cases (37.82%) were treated with combination therapy of rifampin and doxycycline, and 31 cases were treated with combination therapy of doxycycline and rifapentine or cephalosporins.Totally 112 cases (94.12%) recovered.Conclusions The majority of patients with brucellosis are male.The clinical manifestations of brucellosis are varied.Clinicians should pay attention to identify and prevent misdiagnosis.The timely and effective treatment should be provided according to patients' conditions.The relevant departments should also strengthen supervision and education of brucellosis.

Objective To investigate the effects of acitretin on T helper cell (Th) 1/Th2 balance and Th17 cells in psoriasis vulgaris (PV) patients. Methods A total of 13 men and 17 women with PV were investigated. 10 mg of acitretin was administered twice a day for 8 weeks for intervention therapy. Serum levels of interferon-gamma (IFN-γ), interleukin (IL)-4 and IL-17 were measured by enzyme-linked immunosorbent assay. T, Th1, Th2 and Th17 cells in skin biopsies were counted with double-labeled immunofluorescence. Psoriasis Area and Severity Index (PASI) score was calculated before and 8 weeks after treatment. Results Before treatment PV patients had higher serum levels of IFN-γ and IL-17, and increased T, Th1 and Th17 cells in skin biopsies. After treatment, both serum levels of IFN-γ and IL-17, and T, Th1 and Th17 cells infiltrating in PV skin decreased significantly. Th1/Th2 balance was restored to normal. However, their IL-4 and Th2 cells showed no significant change throughout the therapy. Conclusion Acitretin exerts influence on dermal Th1/Th2 balance and Th17 cell infiltration, so does it on production of systematic inflammatory cytokines IFN-γ and IL-17 in PV patients. However, Th2 cells and its derivative cytokine-IL-4 are not affected.

Objective To investigate the expression levels of somatostatin (SST) gene in endometrial adenocarcinoma tissues and cell lines,and the effects of over-expression of SST gene on the proliferation and invasion of endometrial cancer cell line Ishikawa in vitro.Methods Tissue sections of normal endometrium,endometrioid adenocarcinoma and uterine papillary serous carcinoma were selected to detect the expressions of SST by immunohistochemical method.The total RNA was extracted from fresh specimens that were confirmed as endometrioid adenocarcinoma.According to FIGO staging,samples included G1 (7 cases),G2 (6 cases) and G3 (5 cases) of endometrioid adenocarcinoma.The SST expression levels were detected by real-time PCR.Three endometrial cancer cell lines,Ishikawa,HEC-1A and KLE,were selected and the expression levels of SST were detected by real-time PCR and Western blot assay.Transfection was performed with pLVX-SST and pLVX.The transfection efficiency was observed by fluorescence confocal microscopy.The protein levels of SST were detected by Western blot assay.The assays of CCK-8 and transwell were applied to examine variations in cell proliferation and invasion.Results Immunohistochemical results showed that SST expression was increased in endometrioid adenocarcinoma and uterine papillary serous carcinoma compared with that of normal endometrium.Real-time PCR showed that SST expression was significantly increased in G3 compared with that of G1 and G2 in endometrioid adenocarcinoma (P ＜ 0.05).No matter mRNA or protein,SST levels were significantly increased in endometrial cancer cell line KLE compared with those of Ishikawa and HEC-1A,and the expression levels of SST mRNA and protein were significantly increased in HEC-1A group than those of Ishikawa group (P＜0.05).The expression of SST protein was significantly higher in the group of Ish-SST after 2 generations compared with that of Ish-ctr group.There were no significant differences in cell proliferation and invasive ability after over-expression of SST between Ishikawa cell group and control group (P ＞ 0.05).Conclusion SST is highly expressed in poorly differentiated endometrial cancer cells.The proliferation and invasion are not increased after the over-expression of SST in Ishikawa cell line of endometrial cancer.

Objective To investigate and analyze the mineral and bone disorder (MBD) in the patients with chronic kidney disease (CKD),reveal the change of related indexes of CKD-MBD.Methods A cross-sectional study was carried out in the First Affiliated Hospital of Harbin Medical University.From October 2011 to May 2014,1318 inpatients and hemodialysis outpatients were enrolled.Parameters related to MBD,including serum phosphorus (P),total calcium (t-Ca),intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed.Last,it was analyzed with multiple regression analysis to related factors of the secondary hyperparathyroidism (SHPT) in patients with CKD.Results Serum calcium,phosphorus and iPTH had no obvious abnormalities at the early stages of CKD [GFR ＞ 60 ml· min-1· (1.73 m2)-1],and relatively stable before GFR ＞ 30 ml· min-1· (1.73m2)-1.After entering the CKD4 stage,serum phosphorus,iPTH increased sharply and serum calcium decreased obviously along with the decreased glomerular filtration rate (GFR).Serum P,t-Ca and iPTH levels were statistically significant in CKD 1 to 5D patients,respectively,serum P:(1.13±0.20) mmol/L,(1.14±0.22) mmol/L,(1.26±0.23) mmol/L,(1.48±0.34) mmol/L,(2.05±0.61) mmol/L and (2.08±0.58)mmol/L;serum t-Ca (mmol/L) (2.35±0.13) mmol/L,(2.35±0.12) mmol/L,(2.35±0.15) mmol/L,(2.26± 0.18) mmol/L,(2.07±0.29) mmol/L and (2.31±0.26) mmol/L;iPTH:57.8(45.6,91.8) ng/L,54.1(37.8,74.6) ng/L,71.6(45.8,102.2) ng/L,131.1(81.7,205.1) ng/L,277.5(173.6,395.3) ng/L and 354.9 (194.4,720.3) ng/L;The stepwise logistic regression analysis showed:hypocalcemia (OR=3.32,P ＜ 0.01) and decreased GFR (OR=5.28,P ＜ 0.01) were independent risk factors of iPTH elevation at stage CKD3～ 5.Conclusions From the beginning of the CKD3 stage,serum t-Ca,P,iPTH level began to be relatively abnormal as renal function declined.Hyperphosphatemia,SHPT has not been improved significantly in CKD5D stage patients even with hemodialysis.The regulation of hemodialysis on serum calcium showed overcorrecting phenomenon.

Along with the continuous renewal of computer technology, artificial intelligence (AI) has been widely and gradually applied in the medical field of medicine.Research concerning machine learning and deep learning for making ophthalmological diagnosis is expanding.As glaucoma is an irreversible, blinding disease, early diagnosis and treatment are extremely important for improving patients' prognosis.Currently, AI is mainly combined with several auxiliary examinations (fundus photography, visual field tests, optical coherence tomography, etc.) to diagnose and treat glaucoma.AI models are built to segment, classify, and predict the results of image examinations, which is helpful for making diagnoses and predicting glaucoma progression.With the development of algorithms and technologies, the accuracy, sensitivity, and specificity of diagnosis gradually improve.Diagnosing and treating glaucoma require comprehensive consideration of multiple auxiliary examination results, so screening high-quality data and developing more systematic and comprehensive AI models remain to be explored.Currently, only several AI models are associated with glaucoma in the anterior examinations, so it is possible to begin studying the machine and deep learning models associated with ultrasonic biological microscopy and anterior segment optical coherence tomography.This paper, therefore, reviews the application of AI in glaucoma diagnosis.

This paper is a follow-up study of 329 children in factory-run nurseries in urban Shanghai. The investigation lasted for a period of one year for each index-child, focusing on the conditions of nutrition, development and diseases of the children of various ages.Comparison between nutritionl findings and RDA of China disclosed that calorie intake of most of the index-child groups were 80-85% of RDA, the only exception being the 6-12 months group where the average calorie intake showed 90%. Protein intake of all groups was over 80% of RDA. Fe intake was lower than RDA, except for 18-month-old and over.Weight and height of the children were compared with the anthropo-metric data established in 1985 (1985 data) for Shanghai children under six years of age. It was found that the average weight and height appeared differently according to their age. Average weight of children under one year old was slightly higher than 1985 data, while average height was lower than 1985 data once the children reached 10 months old. Average weight, however, became lower than the 1985 data after the children were two years old. Over 60% of the index between 6-18 months old suffered from anemia (IDA).Accordingly, it is requested that calorie and iron intake should be supplemented.

OBJECTIVETo investigate the histological typing and differentiation as well as clinical manifestation and prognosis in pineal parenchymal tumors (PPTs).

METHODSThe histological typing of 21 PPTs were made by using HE staining. Synaptophysin (Syn), neuron special enolase (NSE), neurofilament (NF), neuroblastoma (NB), glial fibrillary acid protein (GFAP), cytokeratin (CK), desmin (Des) were detected in 20 cases with SP immunohistochemical staining methods. Analysis of the clinical data and follow-up were performed.

RESULTS9 pineocytomas, 4 pineoblastomas, 8 pineal parenchymal tumors of intermediate differentiation were found in 21 PPTs. Immunoreactivity to Syn, NSE, NF, GFAP, NB were in 20, 20, 14, 15, 2, while Des and CK were negative in all cases.

CONCLUSIONSPineal parenchymal tumors of intermediate differentiation were characterized by a distinctly biphasic pattern, including areas of pineocytoma and pineoblastoma, or with intermediate differentiation and transitional feature. PPTs expressed neuronic differentiation. Death rate of PPTs were higher inside 1 year after the operation.

Adolescent ; Adult ; Brain Neoplasms ; metabolism ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Immunohistochemistry ; methods ; Male ; Middle Aged ; Pineal Gland ; metabolism ; pathology ; Pinealoma ; metabolism ; pathology