Objective To compare the clinical effects of remifentanil combined with sevoflurane or with isoflurane in elderly patients undergoing radical gastrectomy for cancer and their recovery.Methods Sixty-two patients,who scheduled for radical gastrectomy for cancer was randomly divided into remifentanil combined with sevoflurane group ( SR group,n =31 ) and remifentanil combined with isoflurane group ( IR group,n =31 ).They were classified into American Society of Anesthesiology(ASA) physical status Ⅱ and ,The procedure of two Anesthesia was same,in which remifentanil was continually pumped into at the same velocity using micro pump immediately after intubation,tili the target density in plasma increased to 6 μg/L.Sevoflurane at 1.5％ to 2.0％ was inhaled in the SR group,whereas isoflurane at 1％ to 2％ in the IR group.The inhalation was ended at 5 mins before the surgery was completed,Remifentanil was stopped while stuturing,and 0.1 mg of Remifentanil was injected at 20 mins before the surgery was completed.The heart rate(HR) and blood pressure were recorded at before induction of anesthesia (T0),after induction of anesthesia ( T1 ),immediate intubation ( T2 ),surgery after the start of 5 min ( T3 ),30 min (T4) and the time of surgery ( T5 ),respectively.The recovery time and extubation time,and quality score for awakening after extubation (OAAS) were also recorded.Results There were no significant differences in HR,SBP and DBP at every time points observed between the two groups.The recovery time( 10.4 ± 3.9)mins and extubation time(5.9 ± 3.1 )min in SR group was significantly shorter than that of(16.3 ± 5.8) min and (9.7 ±2.5) min in the IR group(t =6.25 and 4.19,P =0.02 and 0.01,respectively ).The OAAS after extubation in the two groups gradually increased,and immediately after extubation and extubation after 10 min,OAAS in the SR group was(4.1 ± 1.2),which was significantly higher than that of (2.9±1.0)in the IR group(t =3.27,P =0.03).Conclusion Either stevoflurane-remifentanil or isoflurane remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Anesthesia with Sevoflurane-remifentanil provides better faster recovery than isoflurane- remifentanil in elderly patients.

s Objective To assess the correlation between the features of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) in clinically significant diabetic macular edema. Design Prospective case series. Participants 102 patients(177 eyes) with clinically significant diabetic macular edema. Methods Optical coherence tomography and fluorescein angiography typing were done separately in a double-masked manner in each case of clinically significant macular edema. The correlation between FFA types and OCT types were analyzed, and their associations with the best visual acuity, central foveal thickness were evaluated. Main Outcome Measures The FFA features and OCT features of clinically significant diabetic macular edema, central foveal thickness, best visual acuity. Results The prevalence of focal leakage type was higher in the OCT type 1 (70.6%) than in the diffuse leakage type (27.2%) and diffuse cystoid leakage type (2.2%) of fluorescein angiography (P

This paper analyzed the necessity of training of interdisciplinary and innovative think-ing for medical postgraduates and proposed many specific programs for interdisciplinary training con-struction including the building of interdisciplinary curriculum system,comprehensive experiment and communication platform,construction of interdisciplinary innovative tutor team,double or multi-tutorial system,interdisciplinary projects,et al.

Objective By comparing the biological characteristics among Lewis lung cancer cells ( LLC) , LLC or-thotopic transplantation derivative cells ( R1-LLC) and R1-LLC orthotopic transplantation derivative cells ( R2-LLC) , we e-valuate their invasion and metastatic abilities in orthotopic transplantation models.Methods In vitro, we applied CCK8, clonogenic assay, and Transwell invasion assay to detect the proliferation ability, invasion ability and morphologic structures of LLC,R1-LLC, R2-LLC cells respectively, meanwhile observing morphologic structures by transmission electron microsco-py.In vivo, we constructed LLC, R1-LLC and R2-LLC orthotopic transplantation models.Herein, we observed their tumor growth and metastasis.The tumor formation rate and tumor-forming time were recorded for statistic analysis.Results In vitro:LLC, R1-LLC and R2-LLC cells showed no significant difference in proliferation ability ( P>0.05 ) , but significant differ-ences in invasion ability:R2-LLC>R1-LLC>LLC(P<0.05).In vivo:In the orthotopic group, the tumor formation rates of LLC, R1-LLC and R2-LLC cells were 66.67%、80%、93.33%(P <0.05).Conclusions In orthotopic implantation mouse models, R2-LLC cells present higher invasion and metastatic ability than R2-LLC and LLC cells.

OBJECTIVE:To observe the clinical efficacy and safety of pregabalin assisting anti-histamine drugs in the treat-ment of secondary skin pruritus in uremic patients underwent maintenance hemodialysis. METHODS:140 uremic patients with sec-ondary skin pruritus underwent maintenance hemodialysis were randomly divided into control group and treatment group,with 70 cases in each group. Control group was given loratadine orally,10 mg,qd. Treatment group was additionally given pregabalin on the basis of control group,75 mg,po,at night of hemodialysis end,increasing by 75 mg every week if no obvious relief was found,maximal dose of 300 mg. Both group received 3 months of treatment. Clinical efficacy,VAG itching score,modified Duo score,PSQI score before and after treatment and the incidence of ADR were compared between 2 groups. RESULTS:Total effec-tive rate of treatment group (90.00%) was significantly higher than that of control group (71.43%),with statistical significance (P<0.05);VAG itching score,modified Duo score and PSQI score of treatment group after treatment were significantly lower than control group and before treatment,with statistical significance(P<0.05). There was no significant difference in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Pregabalin assisting anti-histamine drugs in the treatment of secondary skin pruritus in uremic patients with maintenance hemodialysis can efficiently relieve the itching symptoms,improve sleep quality,and not increase the risk of ADR.

Objective To observe the correlation between nuclear factor ?B(NF-?B) expression and apoptosis after hypoxia-ischemia brain damage(HIBD).Methods Forty-eight 7-day newborn Sprague-Dawley(SD) rats were randomly divided into 2 groups: control group (n=24) and HI group (n=24).The expression of NF-?B in the hippocampus was detected by immunohistochemical techniques.The apoptosis of the hippocampal cells was detected by terminal deoxynucleotidyltransferase-mediated 2-deoxyuridine 5′-triphosphate-biotin nick end labeling(TUNEL)straining.Results The expression of NF-?B in hippocampal cells increased at 6 h after HIBD,peaked at 48 h,and lasted till 72 h when compared with control group(Pa

ObjectiveTo investigate the effect of comprehensive rehabilitation therapy on movement function of stroke patients.Methods121 cases of acute stroke were randomly divided into the rehabilitation group (n=59) and control group (n=62). Patients of the rehabilitation group were treated with Bobaths and motive relearning method. Cases of the control group were treated with ordinary rehabilitation. All patients were assessed by the clinical neural function-defect assessment, concise Fugl-Meyer assessment (FMA) and modified Barthel index (MBI).ResultsThe scores of the clinical neural function-defect assessment set, FMA, and MBI of two groups were not different before treatment (P>0.05), while there was a significant improvement after treatment (P<0.01), and scores of the rehabilitation group was significantly higher than that of the control group.ConclusionComprehensive rehabilitation therapy can facilitate the function recovery, and gain a good functional prognosis to the stroke patients.

Epidemics of hand, foot and mouth disease (HFMD) have mainly been caused by Coxsackievirus A16 (CVA16) and Enterovirus A 71 (EV-A71), which circulated alternatively or together in the affected area. CVA16 has caused numerous outbreaks and epidemics in multiple countries and geographical regions, and has become an important public health problem. Based on an analysis of the complete VP1 coding region, all CVA16 strains can be divided into genotypes A, B1, and B2. Furthermore, genotype B1 can be divided into subgenotypes B1a, B1b, and B1c. After 2000, no reports of genotype B2 virus strains have been reported. All of the CVA16 strains reported in mainland China have belonged to subgenotypes B1a and B1b. Most CVA16-associated infections cause only mild symptoms; however, some CVA16 infections can lead to severe complications and even death. Vaccination is considered to be the most effective method to control the transmission and infection rate of this virus. A number of research groups are studying various vaccine types, including inactivated vaccines, genetic engineering vaccines, and DNA vaccines, amongst others. In this review, an overview is provided of the research advances in molecular epidemiology and vaccines of CVA16.
Animals ; China ; Coxsackievirus Infections ; epidemiology ; immunology ; prevention & control ; virology ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Humans ; Molecular Epidemiology ; Viral Vaccines ; administration & dosage ; genetics ; immunology

The clinical data of patients with hypoparathyroidism accompanied by elevated and normal muscle enzymes were analyzed retrospectively.The results showed that there were no differences in age,gender,pathogenesis,etiology,and parathormone level between groups with elevated muscle enzyme and normal muscle enzyme.Serum calcium concentration in the group with normal muscle enzyme was within normal range.Serum calcium concentration in the group with elevated muscle enzyme was significantly lower than that in the group with normal muscle enzyme (P＜0.01).As the serum calcium concentration rose,the elevated enzyme level gradually returned to normal range,suggesting that the decrease of serum calcium concentration resulted in the elevated muscle enzyme levels in patients with hypoparathyroidism.

Objective To investigate the effect of chronic intermittent hypoxia(CIH)on serum high-density lipoprotein cholesterol(HDL-C)and the changes of HDL-C metabolism-related indicators such as the expressions of peroxisome proliferators-activated receptor a (PPARα)and adenosine triphosphate binding cassette transporterA1(ABCA1)in liver in male SD rats.Methods Obstructive sleep apnea syndrome(OSAHS)-induced CIH rats were randomly allocated into 6 groups:10％CIH-3 weeks,5％CIH-3 weeks,5％CIH-3 weeks +RH(Removal of hypoxia-3 weeks),10％CIH-3 weeks + RH(Removal of hypoxia-3 weeks),control group-3 weeks,and control group-6 weeks.Serum lipids were measured and compared.To observe and compare the liver pathology,the expression levels of PPARα and ABCA1 in liver tissue of CIH rats were detected by immunohistochemical method.Results The levels of serum TC,TG and LDL-C was significantly higher in CIH rats than in control group.The levels of TC,TG and LDL-C were significantly lower in reoxygenation groups than in CIH groups.There was no significant difference between experiment groups and correspondent control groups(all P＞0.05).Compared with control group,CIH rats had significantly lower levels of serum HDL-C;Compared with CIH groups,the levels of HDL-C were significantly higher in reoxygenation groups.There was no significant difference between experiment groups and correspondent control groups(all P＞0.05).Compared with control group,the expression of PPARα and ABCA1 of CIH group was significantly lower;Compared with CIH groups,the expression of PPARα and ABCA1 was significantly higher in reoxygenation groups;There was no significant difference in the expression of PPARα and ABCA1 between reoxygenation groups and correspondent control groups,in which the oxygen level was recovered to normal.Conclusions The serum HDL-C level was obviously decreased in OSAHS-induced CIH rats,and the decreased serum HDL-C can be effectively improved by reoxygenation intervention.OSAHS-induced CIH may lead to the dyslipidemia through PPARα-ABCA1 pathway,and reoxygenation intervention for three weeks can effectively recover the expression levels of PPARα and ABCA1 to normal levels,which suggests that if CIH is effectively intervented,the change of PPARα and ABCA1 of liver can be reversed,thereby reversing dvslipidemia.