Objective To observe the clilnical effect of treatment of chill by butorphanol after epidural anesthesthia. Methods One hundred patients under going epidural anesthesia , divided into two groups randomly, 50 in butorphanol group(B)were injected intravenously through upper limbs with 0. 04% butorphanol (diluted with normal saline)20 μg/kg; 50 in pethidine group(P) were injected intravenously through upper limbs with 1% pethidine ( diluted with normal saline )0. 75 mg/kg. The speed of the two injection was30 ml/min, after five minutes the patients who were still chilling were injected with midazolam 0. 05 mg/kg. Observe the effect and complications after one minute, three minutes and five minutes. Results After one minute and five minutes the effect of treating chill was no statistically difference ( P ＞ 0. 05 ).However, after three minutes the effect of the butorphanol group was obviously superior to the pethidine group ( P ＜0. 05) ,And the complications of butorphanol group was also less than pethidine group ( P ＜0. 01) . Conclusion Butorphanol display good effect on treating the chill after epidural anesthesia.

There are problems in traditional medical education in China. It is important to cultivate medical talents who are adaptable to social changes and medical advancement. However, the scientific quality and innovative medical students have long been neglected. This paper discussed the essence of scientific quality and innovative talents, and introduced the experience of the program of "long term clinical medicine education" at Peking University Health Science Center. We here delineateded the key points of the scientific quality and innovation education that may provide new ideas for the training of the medical talents.

Objective:To analyze the current status of frailty in elderly patients undergoing cardiac surgery, explore its risk factors, and establish a predictive model of frailty in order to provide targeted and predictive nursing programs.Methods:A total of 205 cardiac surgery patients admitted to the first affiliated hospital of Xinjiang Medical University from March 2015 to January 2019 were selected as the study subjects. Patients were divided into 2 groups according to whether they were frail: the frailty group ( n=78) and the control group ( n=127). Logistic regression was used to analyze the risk factors that affect the frailty of elderly patients undergoing cardiac surgery. The receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of model X [consisting of body mass index (BMI), Mini-Mental State Examination (MMSE) score, number of diseased patients, and number of drugs] in diagnosing frailty in elderly patients undergoing cardiac surgery. Results:Of the 205 patients, 78 (38.05%) showed frailty. The proportion of high school education level and above, Tinetti Gaitassessment (TGA) score≥24 and MMSE score≥27 in the frailty group was lower than that in the control group, and the proportion of Geriatric Depression Scale-15 (GDS-15) score≥7, the number of diseases≥3 and the number of drugs≥5 in the frailty group was higher than that in the control group ( χ2 value was 9.254-26.061, P<0.05). Logistic regression analysis showed that BMI, MMSE score, number of diseased, and number of medications were independent risk factors for frailty in elderly patients undergoing cardiac surgery ( OR value was 0.032-5.275, P<0.05). The area under the ROC curve, sensitivity and specificity of frailty in elderly cardiac surgery patients assessed by model X were 0.913, 75.61% and 96.77%, respectively. Conclusion:The incidence of frailty is higher in elderly patients undergoing cardiac surgery. Model X can diagnose the frailty of elderly patients undergoing cardiac surgery and help clinical nurses to carry out targeted care.

In this study, a platform for long-term and non-invasive blood pressure monitoring is proposed, Its software system and the functions of different program modules in the software system are introduced together with the development methods of the main modules.
Blood Pressure Determination ; instrumentation ; methods ; Blood Pressure Monitors ; Software Design

Objective To evaluate the potential value of IgG antibodies against recombinant PPE65 protein (rPPE65) of Mycobacterium tuberculosis in serodiagnosis of tuberculosis.Methods The gene encoding PPE65 protein of M.tuberculosis was cloned into the PET-28a vector and then expressed in Escherichia coli.The rPPE65 was purified with Ni-NTA affinity and ion exchange chromatography.After dialysis renaturation, the concentration of rPPE65 was determined using Lowry assay.ELISA was used to detect the levels of specific IgG against rPPE65 and recombinant PstS1 protein (rPstS1) in sera from 144 patients with pulmonary tuberculosis (PTB patients), 144 health controls, and 56 patients with non-tuberculosis pulmonary diseases.ROC curves were used to determine cut-off values with the results of IgG antibodies against rPPE65 and rPstS1 for 144 PTB patients and 97 controls with negative PPD skin test.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of rPPE65 and the combination of rPPE65 and rPstS1 were counted.Results The PPE65 protein of M.tuberculosis was successfully expressed in E.coli. The purity and concentration of rPPE65 were 95% and 0.5 mg/ml, respectively.ROC analysis showed that the cut-off of ELISA using rPPE65 was 0.64.The sensitivity, specificity, PPV, NPV, and accuracy of rPPE65 were 34.7%(50/144), 93.5%(187/200), 79.4%(50/63), 66.5%(187/287), and 68.9%(237/344), respectively.The sensitivity, specificity, PPV, NPV, and accuracy of the combination of rPPE65 and rPstS1 were 59.0%, 91.0%, 82.5%, 75.5%, 77.6%, respectively.Conclusions The rPPE65 of M.tuberculosis appears to be a candidate antigen for serodiagnosis of tuberculosis.Detection of IgG antibodies against the combination of rPPE65 and rPstS1 can increase the sensitivity of serological test for tuberculosis.

Objective To investigate the association of cysteine aspartic acid specific protease 8 (CASP 8) gene-652 6N Insertion/Deletion polymorphisms and susceptibility of type 2 diabetes mellitus (T2DM). Methods CASP 8 gene -652 6N I/D polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing in 414 controls and 410 patients with T2DM. Results I/I, I/D and D/D genotype frequency were 56.5%, 38.9%, 4.6%in controls and 58.0%, 32.9%, 9.0%in T2DM group respectively (P<0.05). The risk in D/D genotype people was 1.916 times than I/I genotype (adjusted OR=1.916, 95%CI=1.199~3.054, P<0.05). The fasting blood sugar of D/D genotype people was significantly higher than that of I/D and I/I genotype people (P<0.05). Conclusions CASP 8 gene-652 6N I/D polymorphisms are associated with T2DM outbreak.

Actins ; metabolism ; Animals ; Collagen Type III ; metabolism ; Collagen Type IV ; metabolism ; Desmin ; metabolism ; Diabetes Mellitus, Experimental ; complications ; Diabetic Nephropathies ; metabolism ; pathology ; HSP47 Heat-Shock Proteins ; metabolism ; Kidney Glomerulus ; metabolism ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Vimentin ; metabolism

OBJECTIVE To investigate the effect of ketoconazole on the pharmacokinetic (PK) behaviors of midazolam and its metabolite through intranasal and intragastric(ig) routes in rats. METHODS Twenty-four rats were evenly divided into 4 groups. Two groups of rats were administrated singly with midazolam (1 mg?kg-1) through intranasal or ig route. The other two groups were concomitant with CYP3A inhibitor,ketoconazole(30 mg?kg-1),midazolam(1 mg?kg-1)through the same two routes. Blood samples were collected from different time points. Plasma concentration of midazolam and 1′-hydroxymidazolam was determined. Major pharmacokinetic parameters were calculated and statistical tests were performed by using t test. RESULTS Tmax was about 2 and 25 min for rats administered singly with midazolam via intranasal or ig routes,respectively and AUC was 296 and 179 μg?L-1?h, respectively. When concomitant with ketoconazole,AUC increased to 2.1 and 3.3 folds the original value for intranasal and ig routes,respectively. However,the Tmax value of midazolam via intranasally didn′t change after being coadministrated with ketoconazole,but Tmax increased to 1.14 h via ig. CONCLUSION Compared with administration via ig,intranasal route administrated midazolam displays significant advantages of faster absorption and higher exposure,which are vital for the first aid. Concomitant with CYP3A inhibitor and midazolam via intranasal route,the absorption speed is not affected,but with the metabolism blocked,the systemic exposure is greatly elevated. While via ig,both absorption speed and metabolism are inhibited. The dose should be cut down or the dosing interval increased in clinic practice in this concomitant situation.

Objective To explore the diagnostic value of whole?body bone scan combined with SPECT/CT imaging for osteofibrous dysplasia( OFD) . Methods A total of 30 patients ( 14 males, 16 fe?males, age range 10-48 ( average age 29.2) years) with OFD confirmed by pathology from June 2007 to De?cember 2014 were included. The images of whole?body bone scan and SPECT/CT imaging were retrospec?tively analyzed. Results Nineteen patients (63.3%, 19/30) showed monostotic OFD, which mainly in?volved extremities (n=18), especially the femur. Eleven patients(36.7%, 11/30) showed polyostotic OFD, which frequently be seen unilaterally (n=7). Highly or obviously abnormal uptakes of radiotracer were shown in most lesions (95.3%, 81/85) on whole?body bone planar images, the ribs and extremities showed abnormal uptake along the backbone orientation, while the cranium, pelvis and spine showed irregu?lar bulky uptake of radioactivity. On SPECT/CT images, the lesions of high or obvious abnormal uptake of radiotracer mainly showed cystic expansion growth, ground glass, vegetable sponge and mixed appearance;and the higher the radioactive aggregation degree was, the more the morphological changes were. The density and morphological changes on CT were not obvious for lesions with moderately and mildly abnormal uptake of radiotracer. Conclusion The whole?body bone scan combined with SPECT/CT imaging is an effective diag?nostic method for OFD.

AIM:To investigate the protective effect of N-acetylcysteine (NAC) on H9c2 cells from injuries induced by methylglyoxal (MG) and the potential mechanism.METHODS:H9c2 cells were divided into control group, MG treatment group, NAC +MG treatment group, SP600125 pretreatment +MG group, NAC group and SP600125 group.The viability of the H9c2 cells was measured by CCK-8 assay.The protein levels of p-JNK and t-JNK were tested by Western blot .The changes of intracellular reactive oxygen species ( ROS) were evaluated by 2′, 7′-dichlorofluorescein di-acetate (DCFH-DA) staining.Mitochondrial membrane potential (MMP) was measured by rhodamine 123 (Rh123) stai-ning.The morphological changes in apoptotic cardiomyocytes were detected by Hoechst 33258 staining.RESULTS: Du-ring 100~800 μmol/L concentration range , MG caused significantly reduced viability of the H 9c2 cells in a dose-depend-ent manner.NAC had a protective effect on H9c2 cells against the injuries induced by MG during 500~1 500μmol/L con-centration range through raising cell viability , inhibiting cellular oxidative stress and improving MMP ( P <0.01 ) . SP600125,an inhibitor of JNK, showed the protective effect similar to NAC on H9c2 cells against MG-induced injuries, in-cluding attenuating oxidative stress , improving MMP and suppressing apoptosis .CONCLUSION: N-acetylcysteine offers obvious protective effect on H9c2 cells against the injuries induced by methylglyoxal .The underlying mechanisms may be associated with decreasing the production of ROS , ameliorating MMP , inhibiting the activation of JNK and suppressing ap-optosis.