25%, TCI of vecuronium was started at a target blood concentration of 0.3 ?g.ml-1 .Vecuronium was administrated by a specific TCI system incorporating the pharmacokinetic parameter set of Ruppy. Vecuronium target blood concentration was titrated to maintain T1/T2. at 25% .Results The average degree of NMB was 14.0%?2.2% in control group and 22.9%? 1.8% in TCI group. The difference was statistically significant ( P

Objective To assess the feasibility of using bispectral index (BIS) to guidance of desflurane or sevoflurane anesthesiaMethods Forty ASA Ⅰ-Ⅱ patients were randomly assigned to four groups, After a induction of propofol 2-2?5mg?kg -1 and fentanyl 2ug?kg -1, laryngoscopy and intubation were facilitated with intravenous vecuronium 01mg?kg -1,and anesthesia was maintained with either desflurane or sevoflurane in combination with 60% nitrous oxide In control groups, the anesthesiologists were blinded to the BIS value, and the volatile anesthetics were administered according to their clinical experience In BIS-titrated groups, the volatile anesthetics were titrated to maintain the BIS value at about 60Results During the maintenance period, the SBP in BIS-titrated groups was higher than that in control groups, while SBP fluctuation was less in control groups than that in BIS-titrated groups The requirements of volatile anesthetics were lower in BIS-titrated groups than those in control groupsConclusions In spite of predicting the sedative effect of desflurane or sevoflurane, BIS can not titrate desflurane or sevoflurane anesthesia

Objective:To compare the immediate therapeutic effect and safety between esmolol and lanatoside in con-trolling ventricular rate for patients with rapid atrial fibrillation.Methods:A total of 72 patients with rapid atrial fi-brillation (ventricular rate ≥120 beats/min)were randomly and equally divided into esmolol group and lanatoside group.Esmolol group received first dosage of 0.5 mg/kg intravenously for 1 min,then were observed for 5 min,if ventricular rate still >100 beats/min or decreased <20%,the 0.5 mg/kg esmolol was appended,meanwhile main-tained by 0.05mg·kg-1 ·min-1 via micro pump at first,maintenance dose can increase to a maximum 0.3mg· kg-1 ·min-1;lanatoside group received first dosage of 0.4mg or 0.2mg slow intravenous injection,if ventricular rate still >100 beats/min or decreased<20%,the another 0.2mg was appended.The onset time and adverse reac-tions were recorded after administration.Results:Compared with lanatoside group,there was significant reduction in mean onset time [(39.2±8.7)min vs.(5.6±3.1)min]in esmolol group,P<0.01;compared with before adminis-tration,there was significant decrease in ventricular rate in two groups after administration,P<0.05 or<0.01. On 2h af-ter administration,compared with lanatoside group,there was significant increase in decreasing range of ventricular rate (29% vs.39%)in esmolol group,P<0.05. The total effective rate and adverse reaction rate was no significant difference (P>0.05)between two groups.Conclusion:Intravenous using esmolol is efficient and safe,and it can be regarded as pre-ferred therapy to control ventricular rate in patients with rapid atrial fibrillation.

Objective To understand the life quality of elderly person in communities, nursing homes and elderly wards, and to find out the related influencing factors for providing references for policy-makers to improve the life quality of the elderly. Methods The senior citizens in 9 communities, 3 villages, 12 nursing homes and 5 elderly wards in Shanghai Minhang District were enrolled by stratified cluster sampling. And the life quality and its influential factors among the inhabitants in communities, nursing homes and elderly wards were compared by adopting Short-Form 36 (SF-36) questionnaire. Results Regarding to the life qualities of senior citizens, community showed that physical functioning was (71. 9 ± 23. 3)scores, role physical was (73. 6 ± 43. 0) scores, bodily pain was (80. 2±20. 3)scores, general health was (53. 2± 19. 1)scores, vitality was (70. 4± 15. 7)scores, social function was ( 83. 8 ± 20. 2) scores, role emotional was ( 81. 1 ± 37. 2 ) scores, mental health was (78. 1 ± 15. 4) scores, weighted average was (74. 1 ± 17. 5) scores. Nursing home showed that physical functioning was (42. 1 ±30. 7) scores, role physical was (57. 9 ±48. 1) scores, bodily pain was (78.0±23.0)scores, general health was (50. 2± 19. 5)scores, vitality was (66. 0± 19. 5)scores, social function was (70. 8 ± 26. 3) scores, role emotional was (66. 8 ± 45. 7) scores, mental health was (73. 6 ± 19. 6) scores, weighted average was (63. 2 ± 21. 0) scores. Elderly ward showed that physical functioning was (20. 4 ± 26. 0) scores, role physical was (36. 1 ± 47. 0) scores, bodily pain was (65. 4±29. 5)scores, general health was (43. 1±17. 1)scores, vitality was (59. 0± 18. 0)scores, social function was (57. 9 ± 25. 3) scores, role emotional was (49. 5 ± 48. 7) scores, mental health was (66. 2 ± 18. 3) scores, weighted average was (49. 7 ±18. 3) scores. The major influential factors on the life quality were gender, education, marriage, profession, age, disease, residence, entertainment, physical exercise for community; Age, disease, residence, entertainment, physical exercise for nursing home; Age, etc for elderly ward. Conclusions The influences of demographic factors on life quality of the senior citizens in communities are more significant than in nursing home and elderly wards. Variations on the degree of satisfaction (in residence, entertainment, health care and transportation) and the situation of physical exercise have made vast difference in the life quality of the senior citizens both in communities and nursing homes.

Objective To evaluate the effect of isoflurane or sevoflurane inhalation before and after gestation on the offspring brain development. Methods Thirty female adult Sprague Dawley rats were randomly assigned into 5 groups(n=6 each):control group(group C),group that ex?posed to isoflurane with the concentration of 1.6%for 6 hours before gestation(group BI),group that exposed to isoflurane with the concentration of 1.6%at the 6th,10th,14th and 18th day for 6 hours(group PI),group that exposed to sevoflurane with the concentration of 2.4%for 6 hours before gestation(group BS),and group exposed to sevoflurane with the concentration of 2.4%at the 6th,10th,14th and 18th day for 6 hours after gestation (group PS). Twelve offspring rats from pregnant rats in each group were chosen on the day of birth(T1),and 7th,14th and 28th days after birth(T2, T3 and T4)and sacrificed,and the hippocampi were then isolated. Hematoxylin and eosin stain were adopted to observe the tissue pathological change. Electron microscope was used to observe the neuron ultrastructure change of hippocampus. Immolunohistochemistry was used to detect cas?pase?3,the expression of growth associated protein?43(GAP?43)and neuronal nitric oxide synthase(nNOS). Results Compared with group C, no significant change was found in caspase?3,GAP?43 and nNOS expression in offspring rat hippocampus in groups BI and BS(P>0.05),and no damage change in hippocampal was seen by HE staining and electron microscopy. In group PI and PB,the expression of caspase?3 was significantly up?regulated,the expression of GAP?43 and nNOS was down?regulated at T1 to T3(P<0.01),and structural changes in cell were seen by electron microscopy. In group PI,significant pathological changes in hippocampal were seen by HE staining at T1 to T3. Compared with group PI,the expres?sion of GAP?43 and nNOS was significantly up?regulated(P<0.01),and the expression of caspase?3 was down?regulated at T1 to T3(P<0.01). Conclusion Isoflurane or sevoflurane inhalation before gestation does not affect the offspring brain development,while isoflurane or sevoflurane in?halation after gestation can induce transient abnormal change of offspring brain development,and isoflurane′s toxicity was greater than sevoflurane.

Objective To investigate the effects of simvastatin preconditioning on the pulmonary heme oxygenase-1 (HO-1) expression in rats with lung injury induced by ischemia-reperfusion (I/R) of hind limbs. Methods Forty-eight adult male SD rats weighing 250-300 g were randomly divided into 6 groups ( n = 8 each) : sham operation group (group S) ; I/R group; I/R + simvastatin 1,5, 10 mg/kg groups (S1 , S2, S3 groups) ; simvastatin control group (group SC) . I/R of hind limbs was produced by occlusion of bilateral femoral arteries for 2 h followed by 3 h reperfusion. Croups S1 , S2 , S3 received simvastatin 1, 5, 10 mg/kg respectively via an oro-gastric tube for 3 days before I/R. Group SC received simvastatin 10 mg/kg via an oro-gastric tube for 3 days. Arterial blood samples were taken at 3 h of reperfusion for blood gas analysis and PaO2 and PaCO2 were recorded. The animals were then sacrificed and the lungs removed immediately for pathologic examination and determination of the wet/dry lung weight ratio (W/D ratio), superoxide dismutase (SOD) activity and polymorphonuclear neutrophil (PMN) count . Hie expression of HO-1 mRNA and protein in lung tissues was detected using RT-PCR and Western blot analysis respectively.Results Alveolar edema, localized pulmonary atelectasis and large amount of PMN infiltration were found in I/R group and were ameliorated in S1, S2, S3 groups. Compared with group S, PaO2 and PaCO2 were significantly decreased in I/R group, W/D ratio and PMN count were increased and SOD activity was significantly decreased in I/R, S1 , S2 groups, and expression of HO-1 mRNA and protein was up-regulated in the other five groups ( P ＜ 0.05). PaO2, PaCO2 and SOD activity were significantly increased, W/D ratio and PMN count were significantly decreased, and HO-1 mRNA and protein expression was up-regulated in S1, S2 and S3 groups as compared with I/R group ( P ＜ 0.05 or 0.01). W/D ratio and PMN count were gradually decreased, SOD activity was gradually increased, and HO-1 mRNA and protein expression was gradually up-regulated in S1, S2 and S3 groups. Conclusion Simvastatin preconditioning has protective effect against lung injury induced by I/R of hind limbs in rats through up-regulation of HO-1 expression in the lung tissues and in a dose-dependent manner.

Objective To evaluate the effect of isoflurane or sevoflurane inhalation before and after gestation on the N-methyl-D-aspartate (NMDA) receptor expression in offspring rat hippocampus.Methods Thirty female adult Sprague-Dawley rats,aged 3 months,weighing 250-300 g,were randomly assigned into 5 groups (n =6 each):control group (group C),exposure to isoflurane before gestation group (group BI),exposure to isoflurane during gestation period group (group PI),exposure to sevoflurane before gestation group (group BS),exposure to sevoflurane during gestation period group (group PS).The rats inhaled 1.6％ isoflurane for 6 h at 1 day before gestation in group BI.The rats inhaled 1.6％ isoflurane for 6 h at 6,10,14 and 18 day gestation in group PI.The rats were exposed to 2.4％ sevoflurane for 6 h before gestation in group BS.The rats were exposed to 2.4％ sevoflurane for 6 h at 6,10,14 and 18 day gestation in group PS.Twelve offspring rats from pregnant rats in each group were chosen on the day of birth (T1),and 7th,14th and 28th days after birth (T2-4) and sacrificed,and the hippocampi were then isolated for determination of the expression NMDA receptor (NR1,NR2A and NR2B).Results Compared with group C,no significant change was found in NMDA receptor expression in off spring rat hippocampus in groups BI and BS (P ＞ 0.05),and the expression of NR1 and NR2A protein and mRNA was significantly up-regulated,and the expression of NR2B protein and mRNA was down-regulated at T1-3 (P ＜0.05),and no significant change was found in NMDA receptor expression at T4 in groups PI and PS (P ＞ 0.05).Compared with group PI,the expression of NRI and NR2A protein and mRNA was significantly up-regulated,and the expression of NR2B protein and mRNA was down-regulated at T1 3 (P ＜ 0.05 or 0.01),and no significant change was found in N MDA receptor expression at T4 in group PS (P ＞ 0.05).Conclusion Isoflurane or sevoflurane inhalation before gestation does not affect the NMDA receptor expression in offspring rat hippocampus,while isoflurane or sevoflurane inhalation after gestation can induce abnormal expression of the NMDA receptor in offspring rat hippocampus,which may result in apoptosis in hippocampal cells and abnormality in the development of nervous system and cognitive function.

Turnner syndrome is a common sex chromosome disorder. We reported a rare case with Turnner syndrome caused by abnormal number and structure of sex chromosomes. Hereby fluorescence in situ hybridization (FISH) and copy number variation by whole genome low depth sequencing (CNV-seq) were used to clarify the abnormal chromosome. This study provides a diagnostic strategy for clinicians and genetic researchers.

Objective:To analyze the applicability and feasibility of a cell-free DNA barcode-enabled single-molecule test (cfBEST) in non-invasive prenatal diagnosis of phenylketonuria.Methods:This study recruited four pregnant women who were prenatally diagnosed as heterozygous carriers of hot spot mutations in the PAH gene from pedigrees with phenylketonuria at the First Affiliated Hospital of Zhengzhou University from July to September 2019. The frequency of mutations in maternal plasma cell-free DNA and the fetuses' genotypes were analyzed by cfBEST. Nested polymerase chain reaction primers were designed to amplify the mutation sites in each pedigree. The results of cfBEST were compared with those of invasive prenatal diagnosis. Descriptive analysis was used for data analysis. Results:In pedigree 1, the frequency of c.603T>G and c.842+2T>A mutations in maternal plasma cell-free DNA were 48.40% (291/601) and 9.70% (61/628), which was detected by cfBEST. The fetus was diagnosed with phenylketonuria with two heterozygous mutations. In pedigree 2, the frequency of c.1238G>C and c.842+2T>A mutations in maternal plasma cell-free DNA was 43.70% (786/1 798) and 0% (0/1 550), respectively. Both mutations were wild-type, and the fetus was neither phenylketonuria nor a carrier. In pedigree 3, the frequency of c.1045T>G and c.728G>A mutations in maternal plasma cell-free DNA was 44.00% (930/2 112) and 0% (0/705), respectively, suggesting that both mutations in the fetus were wild-type, and the fetus was neither phenylketonuria nor a carrier. In pedigree 4, the frequency of c.755G>A and c.728G>A mutations were 45.40% (743/1 637) and 4.50% (28/849), respectively, which indicated that the former was wild-type, and the latter was heterozygous; namely the fetus was a carrier of phenylketonuria. The results of cfBEST were consistent with those of invasive prenatal diagnosis. Three pedigrees (Pedigree 2, 3 and 4) continued the pregnancy to full-term, and the phenylalanine levels in the neonates were all below 120 μmol/L. No abnormalities were reported in those three infants during follow-ups at one, three, and six months after birth.Conclusions:The cfBEST could be used for non-invasive prenatal diagnosis of phenylketonuria caused by PAH gene mutation, but further studies with a larger sample size are needed.

OBJECTIVE: To assess the value of copy number variation sequencing (CNV-seq) for the diagnosis of children with disorders of sex development (DSD). METHODS: Five children with DSD who presented at the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2020 were enrolled. In addition to chromosomal karyotyping, whole exome sequencing (WES), SRY gene testing, and CNV-seq were also carried out. RESULTS: Child 1 and 2 had a social gender of female, whilst their karyotypes were both 46,XY. No pathogenic variant was identified by WES. The results of CNV-seq were 46,XY,+Y (1.4) and 46,XY,-Y (0.75), respectively. The remaining three children have all carried an abnormal chromosome Y. Based on the results of CNV-seq, their karyotypes were respectively verified as 45,X[60]/46,X,del(Y)(q11.221)[40], 45,X,16qh+[76]/46,X,del(Y)(q11.222),16qh+[24], and 45,X[75]/46,XY[25]. CONCLUSION CNV-seq may be used to verify the CNVs on the Y chromosome among children with DSD and identify the abnormal chromosome in those with 45,X/46,XY. Above results have provided a basis for the clinical diagnosis and treatment of such children.
Humans ; Child ; Female ; DNA Copy Number Variations ; Chromosome Aberrations ; Karyotyping ; Exome Sequencing ; Disorders of Sex Development/genetics*