Objective To investigate the effects of pretreatment with different inhalational anesthetic agents on myocardial Bcl-2, Bax and p53 gene expression during ischemia-reperfusion ( I/R) in rabbits. MethodsForty New Zealand white rabbits of both sexes were anesthetized with intramuscular ketamine 70 mg kg-1 tracheotomized and mechanically ventilated with 100% O2. PETCO2 was maintained at 4.0-4.5 kPa. Carotid artery and external jugular vein were cannulated for BP monitoring, fluid administration and medication. Anesthesia was maintained with midazolam 0.05-0.1 mg kg-1?h-1 , ketamine 2-5 mg? kg-1?h-1and vecuronium 0.05-0.1 mg? kg -1 ? h-1 . Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery. Ischemia was confirmed by cyanosis of local myocardium and elevation of S-T segment. The animals were randomly allocated to one of five groups with 8 animals in each group : group C sham operation; group I/R; group I isoflurane pretreatment; group S sevoflurane pretreatment and group D desflurane pretreatment. In guoup C animals underwent no I/R. In group I/R animals were subjected to 3h of ischemia followed by 3 h reperfusion. In group I, S and D animals inhaled 1.1% isoflurane or 2% sevoflurane or 6% desflurane for 30 min followed by 15 min of wash-out before I/R. Intravenous anesthetic infusion was suspended while inhalational anesthetic was being inhaled. Myocardium 100 mg was obtained from marginal zone of ischemic area and made into cell suspension for determination of apoptosis index ( AI) and expression of Bcl-2, Bax and p53 genes, using flow cytometry.ResultsAI was (14)% in group I/R and was significantly reduced to (6.7 ? 1.8)% ( group Ⅰ ), (6.7 ? 1.6)% ( group S) and (7.4?2.0)% ( group D) (P

Objective To study the protective effects of propofol against ischemia/reperfusion injury in rat lung. Methods Rat model of pulmonary ischemia/reperfusion injury was used in this study. Rats were randomly divided into three groups, including sham opera-tion group (group A), iachemia/reperfusion group (group B) and propofol group (group C), 15 rats in each group. The concentration of tumor necrosis factor -α and interleukin-6 in bronchoalveolar lavage fluid (BALF) were measured by enzyme linked immunosorbent assay (ELISA). Then blood gas analysis, lung wet/dry (W/D) weight ratio were detected in each group. Results Propofol could significantly improve PaO2, reduce the W/D value and the contents of TNF-α and IL-6 in BALF. Conclusion Propofol effectively suppressed the pro-duction and release of inflammatory cytokine, therefore it can protect the lung from isehemia/reperfusion injury.

To summarize the clinical experience of Prof. Yan Jun-bai in treating rheumatic arthritis (RA) with suppurative moxibustion and aim to guide acupuncture treatment for RA. Prof. Yan believes that contributing factors of RA include external contraction of pathogenic factors, obstructed flow of qi and blood, internal phlegm-turbidity (due to deficiency of healthy qi or improper diet), and obstruction or malnourishment of meridians. As a result, the treatment strategies are to warm yang, remove pathogenic factors, and tonify the liver, spleen and kidney. Suppurative moxibustion is a reliable therapy for RA.

Objective To detect anti-HCV in serum of hepatic disease patients by performing the confirmatory test, and further to confirm HCV infection. Methods Two recombinant immunoblot assays (CWT and CHIRON RIBA HCV 3.0 Strip Immunoblot Assay) were used respectively to detect anti-HCV in 477 human serum samples, which comprised 350 HCV-infected patients' specimens, 7 none-A none-E hepatitis specimens, 30 HBV-infected patients' specimens, 30 hepatitis E virus infected patients'specimens, and 60 specimens drawn from blood donors. The latter three groups served as controls. Results A total of 120 control non-HCV-infected patients' specimens were negative when tested by both assays. Among 350 HCV-infected patients, 341 were positive and 9 were indeterminated by CWT assay; 343 were positive and 7 were indeterminated by CHIRON RIBA HCV 3. 0 SIA. Seven none-A none-E hepatitis specimens tested by both assays turned out to be 2 positive, 4 negative and 1 indeterminate. The consistency rate of these two assays was 99. 16% (Kappa=0.98). Conclusion CWT assay is highly coherent with CHIRON RIBA HCV 3.0 SIA assay in the methodology of anti-HCV antibody detection, which can be applied in the determination of HCV infection among none-A none-E hepatitis patients.

[Objects]To isolate and identify the pathogen of the large outbreak of dengue in Guangdong province in 2014. To understand the origin and the phylogenetic characteristics of the isolates ,and provide scientific foundation for the surveillance and prevention of dengue fever.[Methods]Collected the patient serum samples over all the Guangdong province during the 2014 outbreakperiod,isolated and identified the virus from these samples. Amplified complete E gene and complete genome with certain primers and sequenced all the products. Then the Phylogenetic ,Bayesian phylogeography and mutations analysis were carried.[Results]40 DENV-1 strains were isolated and identified. 40 complete E gene sequences and 6 complete genome sequences of DENV-1 were obtained. Phylogenetic analysis with E gene sequences revealed that the 40 isolates were classified into two genotypes including 16 genotypeⅠ(Asia)and 24 genotypeⅤ(America/Africa). 14 genotypeⅠisolates were clustered closest with isolates from Guangdong province(2013)and Sigapore(2013)which share the nucletide identities of 99.6% ~ 99.9%,other two genotypeⅠisolates were clustered with strains from Malaysia (2013) and both share the nucletide identities of 99.7%;24 genotypeⅤisolates were all classified in one clade with striains from Bangladesh(2009),China(2009)and Bhutan(2013)which share nucletide identities of 99.0%-99.9%. Further analysis with six complete genome sequences showed that five isolates were clustered closest with strains isolated from Guangdong province(2013)share the nucletide identities of 99.6%-99.8% while the sixth stains closest with strains isolated from Myanmar(2002)share the nucletide identities of 98.8%. The isolates have five amino acid mutations compared with strains epidemic in Guangdong province in 2013,three mutations(S88V,E203G,T275R)are in the EⅡdomain and one mutation (S305P)is in the EⅢdomain which associated with virulence.[Conclusions]During the outbreak in Guangdong province in 2014, DENV-1 is the predominant causative serotype,and there are at least two different kinds of genotypes of DENV-1 largely epidemiced in the whole province. Evolution analysis reveals the multiple origins of the isolates which may origin from Guangdong province , Sigapore,Malaysia,Myanmar so that we should enhance the study and surveillance of autochthonous and vectors in order to understand the epidemic way of dengue in Guangdong province. The isolates have had four mutations in the domain associated with virulence which remain further study to know their biological effects.

Objective To investigate the analgesic effect and adverse reactions of patient-controlled intravenous analgesia (PCIA) in breast cancer patients with radical mastectomy.Methods A total of 210 breast cancer patients who underwent radical mastectomy was randomly divided into two groups,experimental (group A) and control (group B) groups (n =105 cases per group).Patients in group A was used PCIA for 48 hours analgesia,while group B weas applied routine intramuscular injections of pethidine.Visual analogue score (VAS) at 4,8,12,24,and 48 hours after operation were recorded.Pulse,respiration,and blood pressure were monitored and side effects e.g.existed skin itching,nausea,vomiting,and respiratory repression were observed.Results The VAS of group A patients on 4,8,12,24,and 48 hours were2.02 ± 1.47,1.73 ± 1.38,1.68 ± 0.91,1.44 ± 0.65,and 1.21 ± 0.61,respectively;and the VAS of group B patients were 6.95 ± 1.96,6.42 ± 1.57,5.63 ± 1.66,4.99 ± 1.62,and 3.72 ± 1.46,respectively.The VAS was significantly lower in group A patients than in group B (P ＜ 0.05).The incidence of skin itching,nausea,vomiting,and respiratory repression was also distinctly decreased in group A than in group B (P ＜0.05).The overall satisfaction of patients in group A (96.2％) was remarkably higher than in group B (67.6％) (P ＜0.01).Conclusions Patient-controlled intravenous analgesia pump can more effectively alleviate the degree of pain,reduce the incidence of skin itching,nausea,vomiting and respiratory repression,improve the satisfactory degree for analgesia in breast cancer patients with radical mastectomy compared to traditional intramuscular way.

[Objective]This study was designed to investigate the genetic evolution of the neuraminidase(NA)gene of seasonal A/H1N1 and 2009 novel A/H1N1 inflilenza virus,and discuss the genetic variation of influenza A virus.[Methods]The virus strains were separately isolated from the clinical samples collected in 2006 and 2009,and then identified as seasonal A/H1N1 and novel A/H1N1.The full length of the NA gene of these strains was amplified by RT-PCR.Then the genetic evolution and mutations of important functional sites were analyzed.[Results]The homology of NA gene between the 2009 novel A/H1N1 isolates and 2006 seasonal A/H1N1 isolates was low(77.9%～78.8%),so was the homology of NA gene between the 2009 novel A/H1N1 isolates and representative strains of different periods and 1979-2001 WHO recommended vaccine strains(78.1%～79.3%).But compared with the WHO recommended vaccine strains of 2009 novel A/H1N1,the homology reached more than 99%.The genetic evolution analysis revealed that NA gene of 2009 novel A/H1N1 had the closest genetic relationship with the swine influenza A virus(A/swine/Belgium/1/1983)from Eurasian Iineage,and some of the antigenic sites and neuraminidase active sites of NA gene of seasonal A/H1N1 were mutated after 2005.[Conclusion]The NA gene of 2009 novel A/H1N1 may originate from Eurasian Iineage of swine influenza virus.The variation of NA gene of seasonal A/H1N1 has occurred in a certain degree.Hence,it is very necessary to continuously monitor the variant of influenza A virus.

Objective:To investigate the clinical effect of repairing soft-tissue defect of foot weight-bearing area with the help of CT angiography (CTA) using medial plantar artery perforator (MPAP) flap.Methods:This was a retrospective study spanning over a period, from May 2011 to October 2019, conducted at the Yidu Central Hospital of Weifang. The data was focused on the cases of soft tissue defect in plantar bearing area repaired by fascial island skin flap containing a perforating branch of the medial plantar artery perforator. CTA of the foot was performed before procedure. The 3D digital model was reconstructed by computer software to explore the number, diameter, course, and distribution of perforating vessels in the donor site, and a personalized repair scheme was designed to match the shape and size of recipient site. The outcome of the flap repair, foot function, and sensory function were followed up. Pared-sample t-test was used to compare the difference of perforator vessel diameter and the distance from heel margin to perforator branch between preoperative and intraoperative actual measurement by CTA. Results:A total of 9 patients were enrolled, including 5 males and 4 females. The mode for age group were 41 (range, 16-65 years). The area of the wound defect was 2.0 cm×2.0 cm-4.0 cm×5.0 cm, and the size of perforator fascial skin flap was 6.0 cm × 4.0 cm -12.0 cm × 8.0 cm. All the 9 flaps were survived and followed up for half a year to 5 years. All the patients were satisfied with the outcomes, the satisfaction score of flap efficacy was 8.7±3.1. Outcomes were evaluated according to the foot function scoring criteria: 3 cases were excellent, 5 cases were good, and 1 case was medium. Sensory recovery reached S4 in 3 cases, S3 in 5 cases, and S2 in 1 case. There were 4 cases in R4, 4 cases in R3, and 1 case in R2. There was no significant difference between the preoperative measurement of perforator diameter and the distance between the heel edge and perforator ( P>0.05). Conclusions:The MPAP flap is simple, safe and easy to operate. It is one of the ideal methods to repair the soft tissue defects in small and medium-sized areas of the foot weight-bearing area.

Objective:To investigate the clinical effect of repairing soft-tissue defect of foot weight-bearing area with the help of CT angiography (CTA) using medial plantar artery perforator (MPAP) flap.Methods:This was a retrospective study spanning over a period, from May 2011 to October 2019, conducted at the Yidu Central Hospital of Weifang. The data was focused on the cases of soft tissue defect in plantar bearing area repaired by fascial island skin flap containing a perforating branch of the medial plantar artery perforator. CTA of the foot was performed before procedure. The 3D digital model was reconstructed by computer software to explore the number, diameter, course, and distribution of perforating vessels in the donor site, and a personalized repair scheme was designed to match the shape and size of recipient site. The outcome of the flap repair, foot function, and sensory function were followed up. Pared-sample t-test was used to compare the difference of perforator vessel diameter and the distance from heel margin to perforator branch between preoperative and intraoperative actual measurement by CTA. Results:A total of 9 patients were enrolled, including 5 males and 4 females. The mode for age group were 41 (range, 16-65 years). The area of the wound defect was 2.0 cm×2.0 cm-4.0 cm×5.0 cm, and the size of perforator fascial skin flap was 6.0 cm × 4.0 cm -12.0 cm × 8.0 cm. All the 9 flaps were survived and followed up for half a year to 5 years. All the patients were satisfied with the outcomes, the satisfaction score of flap efficacy was 8.7±3.1. Outcomes were evaluated according to the foot function scoring criteria: 3 cases were excellent, 5 cases were good, and 1 case was medium. Sensory recovery reached S4 in 3 cases, S3 in 5 cases, and S2 in 1 case. There were 4 cases in R4, 4 cases in R3, and 1 case in R2. There was no significant difference between the preoperative measurement of perforator diameter and the distance between the heel edge and perforator ( P>0.05). Conclusions:The MPAP flap is simple, safe and easy to operate. It is one of the ideal methods to repair the soft tissue defects in small and medium-sized areas of the foot weight-bearing area.

Objective:To explore the analysis of staging alteration and prognosis of 8th edition of the American Joint Committee on Cancer (AJCC) staging update for breast cancer with different molecular subtypes.Methods:The clinical data of 965 breast cancer patients treated in Xijing Hospital from January 2011 to December 2017 were retrospectively collected, and 103 patients met the inclusion criteria. The staging results between all the patients and patients with 4 different molecular subtypes were compared according to the 7th and 8th edition of the AJCC. Fisher's exact test was used for staging differences, Kaplan-Meier was used for survival analysis, log-rank test was used to compare survival rates of different groups, the prognostic judgement efficacy and staging alteration for all patients and cases with different molecular subtypes in the 8th edition was also compared.Results:Compared with the 7th edition, a total of 52 cases (50.5%) had staging declined and 8 cases (7.8%) had staging risen in the 8th edition, and there was a statistically significant difference in composition change ( P < 0.05). There was no rise in staging for Luminal subtype patients, but the decline in 34 cases, with the decline rate of 87.2% (34/39); no rise in staging for patients of HER2 + subtype, but the decline in4 cases, with the decline rate of 19.0% (4/21). No rise in staging for triple positive subtype patients, but the decline in 14 cases, with the decline rate of 82.4% (14/17). Oppositely, for the patients with previous subtypes, no decline in staging of patients with triple negative subtypes, but the rise in 8 cases with the rise rate of 30.8% (8/26). The difference in all the above staging changes was statistically significant ( P = 0.001). According to the 7th edition of the AJCC, the disease-free survival (DFS) time of all the cases and Luminal subtype patients had no statistical differences among different staging groups ( P > 0.05), but according to the 8th edition of the AJCC, the differences were statistically significant ( P < 0.05). DFS time was shorten with the increase of staging, indicating that the 8th edition of staging could more accurately assess the prognosis of patients. Conclusions:Compared with the 7th edition of the AJCC, for the staging changes determined by the 8th edition of the AJCC, the proportion of staging declined in all the cases is significantly higher than that of staging risen, and patients with different molecular subtypes has different staging changes, among which the patients with the triple negative subtypes have staging risen and the rest have staging declined. The DFS analysis for all the patients and patients with Luminal subtypes indicates that the 8th edition of the AJCC staging is a more accurate predictor of prognosis compared with the 7th edition of the AJCC.