Objective To evaluate the effects of dexmedetomidine on lidocaine-induced apoptosis in rat cortical neurons.Methods The cortical neurons obtained from Sprague-Dawley fetal rats were seeded in 24 multiwell plates at a density of 1 × 105 cells/ml,and the cortical neurons of 80 wells were randomly divided into 4 groups (n =20 each):control group (group C),lidocaine group (group L),dexmedetomidine group (group D) and lidocaine + dexmedetomidine group (group L+ D).The cells were cultured routinely in group C.The cells were exposed to lidocaine with a final concentration of 1 mmol/L in group L.The cells were exposed to dexmedetomidine with a final concentration of 3 μmol/L in group D.The cells were exposed to lidocaine and dexmedetomidine with the final concentrations of 1 mmol/L and 3 μmol/L,respectively,in group L + D.After 4 h incubation,the neurons were subjected to DAPI staining for detection of apoptosis,and the apoptosis rate was calculated.Western blot analysis was used to measure the expression of phosphorylated Akt (p-Akt),Akt and caspase-3.Results Compared with group C,the apoptosis rate was significantly increased,the expression of p-Akt was down-regulated,and the expression of caspase-3 was up-regulated in L and L + D groups (P ＜ 0.05),while no significant changes were found in the indexes mentioned above in group D (P ＞ 0.05).Compared with group L,the apoptosis rate was significantly decreased,the expression of p-Akt was up-regulated,and the expression of caspase-3 was down-regulated in L + D group (P ＜ 0.05).There was no significant difference in the expression of Akt between the four groups (P ＞ 0.05).Conclusion Dexmedetomidine can reduce lidocaine-induced apoptosis in rat cortical neurons,and activation of Akt may be involved in the underlying mechanism.

Objective To investigate the role of Akt signaling in the protective effect of dexmedetomidine preconditioning on the lipopolysaccharide(LPS)-induced acute lung injury (ALI) in rat .Methods Twenty-two SD rats were randomly divided into 4 groups:before LPS injection group(T0 group) ,1 h after LPS injection group(T1 group) ,3 h after LPS injection group(T2 group) and 6 h after LPS injection group(T3 group) ,the expression of Akt and p-Akt in the process of LPS-induced ALI was investigated . Another 54 rats were divided into 3 groups :control group(C group) ,6 hours of ALI group(ALI group) and Dexmedetomidine+ALI group(D+ ALI group) ,the expression of p-Akt in lung tissues ,the protein concentration in bronchoalveolar lavage fluid (BALF) ,apoptotic index and the pathological changes in the lung tissues were observed .Forty rats were divided into ALI group and ALI + D group to investigate the 48 h-survival ratio .Results Compared with T0 group ,the level of p-Akt expression in T1 ,T2 , T3 groups were deceased in a time-dependent manner(P<0 .05) .Compared with ALI group ,p-Akt in D + ALI group increased significantly(P<0 .05) but was still lower than that in C group(P<0 .05);the protein concentration in BALF and the apoptotic in-dex in D + ALI groups were significantly lower than those in ALI group(P<0 .05) ,but still higher than those in C group(P<0 .05) .The 48 h survival ratio was significantly decreased in D + ALI group comparing with ALI group(P<0 .05) .Conclusion Dexmedetomidine preconditioning might display protective effect via activating p-Akt signaling pathway in LPS-induced ALI .

OBJECTIVE: To analyze 113 patients with drug-induced liver disease(DILD) so as to clinically validate the international generally-accepted diagnostic criteria.METHODS: 113 DILD cases were reviewed and categorized according to international generally-accepted diagnostic criteria and then graded separately by Maria clinical scale and DDW-J scale to analyze the correlations.RESULTS: 113 out of 822 patients with liver diseases were DILD(13.7%),among whom 17 were of hepatocellular type(15.0%),92 cholestasis type(81.5%) and 4 mixed type(3.5%).Application of Maria clinical scale and DDW-J scale led to different number of DILD cases diagnosed.DILD were mostly induced by antihyperlipidemic drugs and immunosuppressants followed by anticoagulant drugs.CONCLUSION: DDW-J scale,which is more close to clinical diagnostic criteria,contributed to the standardization of the diagnostic criteria of DILD,yet it has its limitations as well.

【Objective】To explore the therapeutic effect of TCM syndrome differentiation and treatment for immunoglobulin A(IgA) nephropathy.【Methods】The selected 123 patients with IgA nephropathy were divided into two groups(in the proportion of 3∶1) by number randomization.Group A(n=86) was given Tripterygium Glycosides tablets and differential treatment according to syndrome patterns,and Group B(n=37) was given routine western medicine including anti-inflammation drugs,drugs for controlling blood pressure and glucocorticoid hormone.The two groups received a 3-month treatment course and received one more course according to individual cases.The total therapeutic effect,effect for TCM syndrome patterns,and toxic and side effects were observed.The changes of TCM syndrome scoring were compared before and after treatment.【Results】In group A,symptoms were completely relieved in 29,markedly relieved in 30,relieved in 15 and un-relieved in 12 patients,the total effective rate being 86.05%,while respectively in 4,5,10 and 18 of patients in group B,the total effective rate being 51.35%.The total effect was better in group A than that in group B(P0.05).The improvement on TCM syndrome scoring in group A was superior to that in group B(P

Objective To evaluate the efficacy of different doses of dexmedetomidine mixed with ropivacaine for brachial plexus block.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,weighing 40-70 kg,scheduled for upper extremity surgery under brachial plexus block,were randomly divided into 6 groups (n =20 each):ropivacaine group (group R) and different doses of dexmedetomidine groups (groups RD1-5).Brachial plexus block was performed using the interscalene approach.In group R,interscalene brachial plexus block was performed using 0.5 ％ ropivacaine 25 ml (single injection).In groups RD1.5,interscalene brachial plexus block was induced with a mixture (25 ml) of dexmedetomidine 0.25,0.50,0.75,1.00,1.25μg/kg and 0.5 ％ ropivacaine,respectively.The onset time and duration of sensory and motor block were recorded.The adverse effects such as adverse cardiovascular events,excessive sedation,and pneumothorax were also recorded.Results Compared with group R,the onset time was significantly shortened,and the duration of block was prolonged (P ＜ 0.05).Compared with groups RD1 and RD2,the onset time was significantly shortened,and the duration of block was prolonged in groups RD3 5 (P ＜ 0.05).There was no significant difference in the parameters mentioned above between groups RD1 and RD2 or among groups RD3,RD4 and RD5 (P ＞ 0.05).Some patients developed bradycardia,hypotension or excessive sedation in groups RD4 and RD5,while no adverse effects were observed in the other groups.Conclusion Dexmedetomidine 0.75 μg/kg mixed with 0.5 ％ ropivacaine 25 ml can be safely and effectively used for brachial plexus block in patients.

Objective:To prepare for mAb of progesterone receptor. It would provide support for the immunohistochemistry behind. Methods:Target gene connected together with a carrier by seamless cloning method. The target protein that expression by inducing was collected. And with cell fusion method , the monoclonal antibodies were preparation. Then the mAb were detected by IHC. Results: The mAb ( clone 7C7 ) was detected and it found positive for the breast, uterine fibroid tissue, showed negative in colorectal cancer tissue, smooth muscle tissue, the goal of the claim were achieve. Conclusion: Finally, we found the method that prepare for mAb was far beyond our imagination. The result of IHC on different samples about mAb(7C7)obtained compliance with an-ticipation. Study on the difference between the PR-A and PR-B had significance.

0.05).The results of electrocardiography and the laboratory ex-amination showed that neither ANWin cluding natural Calculus Bovis nor A NWincluding in -vitro cultured Calc ulus Bo-vis had obviously toxic and side effe cts in treating epidemic encephalitis B.Conclusion ANW including in -vitro cul-tured Calculus Bovis has an markedly effect in the treatment of epidemic e ncephalitis B.

Objective To investigate the association of serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) level with severity,progression and prognosis of traumatic brain injury (TBI).Methods Sixty TBI patients,admitted to our hospital from March 2012 to June 2013,were chosen in our study,and divided into moderate TBI group (Glasgow coma scale [GCS] scores:9-12,n=30) and severe TBI group (GCS scores:3-8,n=30);30 healthy controls were chosen.The serum UCH-L1 levels 12 and 24 h,and 2,3 and 5 d after TBI were detected using enzyme-linked immunosorbent assay (ELISA).Additionally,the correlations between serum UCH-L1 level and both imaging data and prognosis of TBI were analyzed.Results As compared with that in the control group,the mean serum UCH-L1 level in moderate TBI group and severe TBI group 12 and 24 h,and 2 and 3 d after TBI was significantly increased (P＜0.05);as compared with that in the moderate TBI group,the serum UCH-L1 level in severe TBI group 12 and 24 h,and 2 and 3 d after TBI was significantly increased (P＜0.05).The serum UCH-L1 level in the moderate TBI group reached the peak at 12 h after TBI,then gradually declined and presented no significant difference 5 d after TBI in comparison with controls.In severe TBI group,serum UCH-L1 level reached the first peak at 12 h,then gradually decreased,and rose again for the second peak 3 d after TBI.Serum UCH-L1 level was closely related with imageological changes and negatively correlated with prognosis of TBI (r=-0.412,P=0.030).Conclusion Serum UCH-L1 level appears to have potential clinical utility in providing valuable information about severity,progression and prognosis of TBI.

Objective To explore the reasons and influencing factors of unplanned removal of implantable venous access port (IVAP) in tumor patients, and analyze its influencing factors, so as to explore the corresponding clinical interventions. Methods A total of 1 029 cases of tumor patients who were implanted IVAP in Zhejiang Cancer Hospital from January 1st, 2009 to December 31st, 2016 were recruited by convenience sampling method. Univariate analysis and Logistic regression analysis were applied to analyze the influencing factors of unplanned port-taking. Results Finally 1 002 tumor patients were recruited excluding patients who died or lost follow-up. Excluding patient's subjective factors, catheter-related blood stream infection (CRBSI), catheter clamping syndrome, and pain around infusion seat were the main causes of unplanned removal of IVAP. Univariate analysis revealed that there were significant differences in unplanned port removal among patients with different catheterization veins, infection and coagulation function (χ2=15.691, 14.425, 16.732; P＜ 0.001). Logistic regression analysis showed that internal jugular vein catheterization (OR=8.272), infection (OR=2.592) and coagulation (OR=2.709) were the main factors. Conclusions Medical staff should strictly control the causes and influencing factors of unplanned removal of IVAP when implanting and maintaining the use of IVAP for patients, so as to prolong the use time of infusion port.

Objective To compare the difference in binocular visual function after implantation of different types of intraocular lenses(IOL).Methods A total of 63 patients(126 eyes)with age-related cataract who underwent phacoe-mulsification combined with IOL implantation in Yantai Affiliated Hospital of Binzhou Medical University from October 2021 to June 2023 were collected.Among them,22 patients(44 eyes)were implanted with monofocal IOL in both eyes(mono-focal group),21 patients(42 eyes)were implanted with monofocal and multifocal IOL in both eyes,respectively(mixed group),and 20 patients(40 eyes)were implanted with multifocal IOL in both eyes(multifocal group).Another 22 patients(44 eyes)with physiological presbyopia were selected from the medical examination center of the same hospital during the same period as the control group.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),defocus curve,amplitude of accommodation(AMP),positive relative accommodation(PRA),negative relative accommo-dation(NRA),binocular cross-cylinder(BCC),accommodative convergence/accommodation ratio(AC/A),rupture point at the near point of convergence(NPC),near-far distance positive fusional vergence(PFV)and negative fusional vergence(NFV)rupture points,and near-far distance stereopsis of patients in the four groups were recorded and compared during the 3-month follow-up.Results After three months of follow-up,there was no significant difference in UDVA among the four groups(P＞0.05),while the UNVA of patients in the multifocal group and the mixed group was better than that in the control group and the monofocal group(all P＜0.05).The defocus curves of patients in the mixed group and the multifocal group were bimodal.There were statistically significant differences in AMP,NRA,PRA,and BCC among the four groups(all P＜0.05).There was no statistically significant difference in the AC/A ratio and far-distance NFV and PFV rupture points among the four groups(all P＞0.05).There were statistically significant differences in NPC rupture point and near-distance NFV and PFV rupture points among the four groups(all P＜0.05).There was no statistically significant difference in the proportion of patients with normal far-distance stereopsis among the four groups(P＞0.05).The proportion of pa-tients with normal near-distance stereopsis in the mixed group was significantly lower than that in the other three groups(all P＜0.05).Conclusion Multifocal IOL can effectively improve postoperative UDVA and UNVA in cataract patients.Binocular implantation of multifocal IOL is beneficial to the reconstruction of binocular visual function in far-and near-dis-tance conditions after cataract surgery.The mixed implantation of monofocal and multifocal IOL affects the recovery of near-distance binocular stereopsis in the short term.