Objective To compare the effects of electroacupuncture at points Shangjuxu(ST37), Zusanli(ST36), Xiajuxu(ST39) and Yanglingquan(GB34) on colonic expressions of interleukin-1b (IL-1b) and nicotinic acetylcholine receptor a7 mRNA (nAchRa7mRNA) in ulcerative colitis rats and investigate if large intestine lower He-Sea point Shangjuxu has relative specificity to fu organ diseases. Method Seventy healthy SD rats were randomized into blank, model, Shangjuxu, Zusanli, Xiajuxu, Yanglingquan and Chengjin groups, 10 rats, half male and half female, each. A rat model of ulcerative colitis was made by induction of 2-4-6 three nitrobenzene sulfonic acid/ethanol solution enema in every group except the blank group. After successful model making and ten days of treatment, rat colonic mucosal ulcers and inflammation were observed macroscopically, colonic IL-1bcontent was measured by ELISA and the expression of nAchRa7mRNA was determined by RT-PCR. Result Compared with the model group, colonic lesions were reduced in varying degrees, colonic IL-1b content was significantly lower and the expression of nAchRa7mRNA was higher in every acupoint group (P<0.05, P<0.01);the colonic ulcer score was lower in the Shangjuxu and Zusanli groups (P<0.05, P<0.01). Compared with the Shangjuxu group, colonic expression of nAchRa7mRNA was lower in the other four acupoint groups (P<0.01); colonic mucosal ulcers and inflammatory lesions were more severe and the colonic ulcer score and the IL-1bcontent were higher in the Xiajuxu, Yanglingquan and Chengjin groups (P<0.05, P<0.01). Conclusion The mechanism of electroacupuncture treatment for ulcerative colitis may be that it regulates abnormal immunologic function by modulating IL-1b and nAchRa7mRNA and reduces mucosal lesions. The overall therapeutic effect of Shangjuxu is better than those of Zusanli, Xiajuxu, Yanglingquan and Chengjin, indicating that Shangjuxu has relative specificity to fu organ large intestine.

OBJECTIVETo evaluate the safety and efficacy of oral endotracheal intubation in the patients with difficult laryngoscopy undergoing general anesthesia.

METHODSA total of 1 683 patients with difficult laryngoscopy, aged 1.5-67 yr, and scheduled for the elective plastic surgery were observed in this study from 1989-1997. All these patients were at American Society of Anesthesiologist physical status I. According to the preoperative predictive results for difficult laryngoscopy, we classified these patients into two groups: Group I included 1 375 patients, whose epiglottis could be viewed (laryngoscopic view grades II and III); and Group II, included 308 patients, whose epiglottis could not be viewed (laryngoscopic view grade IV). For group I, anesthesia was induced with thiopentone 4-5 mg/kg and succinylcholine 1 mg/kg; Laryngoscopy was carried out using modified Macintosh method. For Group II, anesthesia was induced with a total intravenous anesthesia or inhaled anesthesia; anesthetic depth was required to effectively inhibit laryngeal reflexes with reservation of spontaneous breathing. Tracheal intubation was performed by fiberoptic stylet laryngoscope (FOSL). During anesthesia induction and tracheal intubation procedures, electrocardiogram, arterial pressure, heart rate and pulse oxygen saturation (SpO2) were continuously monitored. Complications of intubation (arrhythmia, and so on) were observed and recorded. Immediately after laryngoscopy and successful intubation, patients were examined for any traumatic injuries at teeth, lips, tongue, and oropharyngeal tissues.

RESULTSIn group I, tracheal intubation was accomplished by the first attempt in 1 279 cases (93.0%) and the intubation time was less than 3 min in 1 304 cases (94.8%). In group II, tracheal intubation was accomplished by the first attempt in 114 patients (37.0%), and 123 patients (39.9%) had the intubation time of less than 3 min. Tracheal intubation was successful by the second or third attempt in 96 patients of group I and 156 patients of group II, respectively. Thirty-eight patients required four or more attempts, which only occurred in group II. Of all the complications of tracheal intubation, the traumatic complications were most common. The incidences of traumatic complications in the patients with laryngoscopic view grade II, III (group I ) and IV (group II) were 0.7%, 3.9% and 14.3%, respectively. Other complications such as respiratory depression were only seen in group II. A pooled incidence of the intubation complications was 6.7% (113/1 683).

CONCLUSIONAn anesthesiologist who is skillful in difficult airway management may safely manage the airway in the patients with difficult laryngoscopy under general anesthesia.

Adolescent ; Adult ; Aged ; Anesthesia, General ; Child ; Child, Preschool ; Dyspnea ; etiology ; Female ; Humans ; Infant ; Intubation, Intratracheal ; adverse effects ; methods ; Laryngoscopy ; Lip ; injuries ; Male ; Middle Aged ; Mouth Mucosa ; injuries

Host genetic factors, such as human leukocyte antigen (HLA) alleles, are important in Human immunod-eficiency virus (HIV) infection and its progression to AIDS. HLA class I genes, especially highly polymorphicHLA-B genes, are involved in the activation of HLA-restricted cytotoxic T lymphocytes (CTLs) against HIV, andthus control susceptibility to or protect against this virus. The present study was aimed to determine the distributionof HLA-B alleles in the Chinese Uygur ethnic group and its association with HIV infection. One hundred ten healthycontrol (HIV negative) and 128 HIV positive Chinese Xinjiang Uygur ethnic individuals were used in this study.HLA typing for B allele was performed by polymerase chain reaction (PCR) with sequence-specific primers (SSP).Hardy-Weinberg equilibrium was calculated using POPGENE software for the healthy control group. The HLA-Bfrequency of each allele was compared between the patients and the controls using the chi-square test. In HIV-1-pos-itive group, gene frequency of allele B * 4901 was significantly higher compared to the healthy control subjects (P=0.02, OR=3.06, 95%CI=1.16～8.10 forB*4901). In contrast, the gene frequency of B * 40 in healthy controlswas significantly higher than in the HIV-positive patients (P=0.02, OR=0.39, 95%CI=0.07～0. 92 for B* 40).In this study, HLA allele B * 4901 may be associated with increased susceptibility to HIV-1 infection, whereas the B* 40 allele may be associated with resistance to H HIV-1 infection.

OBJECTIVETo observe the effect of small interfering RNA (siRNA) targeting multidrug resistance-related protein (MRP) and bcl-2 genes in modulating drug resistance and apoptosis of K562 and K562/ADM cells.

METHODSTwo siRNA constructs targeting respectively bcl-2 and MRP genes, were synthesized and transfected either alone or in combination into K562 and K562/ADM cells via lipofectamine2000. MTT assay was used to evaluate the viability of the transfected cells at 24, 48 and 72 h Post-fransfection, and RT-PCR was performed to determine the mRNA levels of bcl-2 and MRP. The effects of MRP siRNA and bcl2 siRNA on the apoptosis and the protein expression of Bcl-2 and MRP were evaluated with flow cytometry.

RESULTSIn K562/ADM cells, the IC (50) decreased from 12.81 microg/ml (ADM group) to 3.74 microg/ml (ADM+MRP siRNA group), 6.82 microg/ml (ADM+bcl2 siRNA group) and 2.51 microg/ml (ADM+MRP siRNA+bcl2 siRNA). Similarly, in K562 cells, the IC50 decreased significantly from 6.75 microg/ml (ADM) to 3.22 microg/ml (ADM+MRP siRNA), 3.56 microg/ml (ADM+bcl2 siRNA) and 1.84 microg/ml (ADM+MRP siRNA+bcl2 siRNA) (P<0.05). Flow cytometry demonstrated significantly increased apoptosis of the cells following MRP siRNA and bcl2 siRNA transfection, which also resulted in significantly decreased expressions of MRP and bcl-2 proteins (P<0.05).

CONCLUSIONTreatment with both MRP and bcl-2 siRNAs inhibits the target gene expression, and increases the drug sensitivity and apoptosis of K562 and K562/ADM cells.

ATP Binding Cassette Transporter, Sub-Family B ; genetics ; Apoptosis ; genetics ; Doxorubicin ; pharmacology ; Drug Resistance, Neoplasm ; genetics ; Humans ; K562 Cells ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo explore the characteristics of the whole genome of the influenza H1N1 virus of the mild and severe cases in Beijing.

METHODSA total of 21 samples of throat swabs were collected from surveillance-designated hospitals between June and December in 2009, including 10 severe cases (4 death cases) and 11 mild cases. RNA of the virus were extracted,and the amplified primers of the whole genome were designed.Reverse transcription and PCR were performed to the RNA and then the PCR product was sequenced by software to analyze the evolution of the viral genes and the variation of the amino acids.

RESULTSCompared with the reference vaccine strain A/California/07/2009 (H1N1), the genetic nucleotide homology in the eight segments of the pandemic H1N1 virus in Beijing in 2009 was higher than 99%, without significant variation. Among them,the genetic distance of hemagglutinin (HA), neuraminidase (NA) and nucleoprotein (NP) was comparatively far, separately 0.0050, 0.0040 and 0.0040.The gene of HA, P83S, the gene of NA, N248D, the gene of polymerase (PA), P224S and the gene of NP, V100I and L122Q were found to mutate in all the samples. Genes of HA, NA, NP, PA, PB 2 and nonstructural protein (NS1) in severe cases showed obviously clustered evolution. The mutation of gene S128P and S203T of HA, gene R269R and D547E of PA, gene T588I of PB 2 and gene I123V of NS mainly happened in severe cases, separately counting 6, 9, 6, 7, 9 and 6 cases. The relevance between the mutation happened in S203T of HA, R269K and D547E of PA and the severeness of the cases showed statistical significance (P < 0.05). The mutations of HA gene were mainly on the Ca and Cb antigene domains. No drug resistant mutation was found on NA gene but happened on matrix protein 2 (M2 gene). None of the mutations were found on the virulence related genes.

CONCLUSIONA high homology was found between the pandemic H1N1 virus in Beijing in 2009 and the reference vaccine strain A/California/07/2009(H1N1). Mutational sites related with the severe and fatal cases were found, but not the virulence related mutation.

Base Sequence ; China ; epidemiology ; Genes, Viral ; Genetic Variation ; Genome, Viral ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; Influenza, Human ; epidemiology ; virology ; Neuraminidase ; genetics ; RNA-Binding Proteins ; genetics ; Viral Core Proteins ; genetics

OBJECTIVETo evaluate the feasibility of the fibreoptic intubating laryngeal mask airway (LMA) CTrach (CTrach) in anticipated difficult airway caused by face and neck scar contracture.

METHODSTotally 33 patients undergoing selective face and neck scar plastic surgery and requiring general anesthesia were enrolled in our study. After anesthesia induction, the CTrach was inserted and the viewer was attached, which allowed fibreoptic visualization of the larynx before and during passage of the tracheal tube through the vocal cords. The duration and the success rates of CTrach insertion, tracheal intubation, and CTrach removal were recorded. The view of glottis on viewer and the adjusting maneuvers for improving the laryngeal view were recorded. Noninvasive blood pressures and heart rates were recorded before and after anesthesia induction and at CTrach insertion, tracheal intubation, and CTrach removal.

RESULTSThe CTrach was successfully inserted in all patients, among whom 4 patients succeeded at the second attempt. The full view of glottis were shown in 10 patients, while partial view and no view of glottis were shown in 8 and 15 patients, respectively. The good view of glottis was achieved by adjusting manoeuvres. Tracheal intubation via the CTrach was successful in 27 patients at the first attempt and in 6 patients at the second attempt. Hemodynamic changes during the performance with the CTrach were minimal.

CONCLUSIONSThe CTrach can be easily inserted, with clear view and high success rate of tracheal intubation. Therefore, it is an effective way to resolve difficulty intubation caused by face and neck scar contracture.

Adolescent ; Adult ; Cicatrix ; complications ; surgery ; Contracture ; etiology ; surgery ; Face ; Female ; Fiber Optic Technology ; methods ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngeal Masks ; Male ; Middle Aged ; Neck ; Young Adult

OBJECTIVETo observe the clinical effectiveness of inductions and tracheal intubating conditions with 3% sevoflurane and different doses of remifentanil without muscle relaxant in children.

METHODSTotally 120 peadiatric patients (aged 4-10 years, American Society of Anesthesiologists grade I for inhalational induction) were randomly allocated into group I (remifentanil 1 microg/kg), group II (remifentanil 2 microg/kg), group III (remifentanil 3 microg/kg), and control group (vecuronium bromide 0.1 mg/kg). After inhalational induction with 3% sevoflurane and 60% nitrous oxide in 40% oxygen for 2 minutes, remifentanil 1 microg/kg, 2 microg/ kg, and 3 microg/kg were intravenously injected over 1 minute into patients in group I , group II, and group III, respectively. After remifentanil administration and manual ventilation for 1 minute, the trachea was intubated. In the control group, 2 minutes after intravenous administration of vecuronium bromide 0.1 mg/kg, tracheal intubation was attempted. Agitation, intubating satisfactoriness, and the circulation changes after tracheal intubation and anesthesia induction were observed.

RESULTSIn these four groups, agitation occurred in 37.5% of patients during sevoflurane induction. Satisfactory intubation rate was 70.0% in group I, 86.7% in group II, 90.0% in group III, and 93.3% in the control group. Compared with the control group, the impact of tracheal intubation on the circulatory system was smaller in group I , II , and III.

CONCLUSIONSInduction with 3% sevoflurane combined with remifentanil can be smoothly performed, followed by the successful tracheal intubation. The intubating conditions are more satisfactory with 3% sevoflurane combined with remifentanil 2 microg/kg or 3 microg/kg.

Anesthesia, Inhalation ; Anesthetics, Inhalation ; administration & dosage ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Methyl Ethers ; administration & dosage ; Piperidines ; administration & dosage

OBJECTIVETo observe the safety and feasibility of tracheal intubation by target-controlled infusion of propofol and remifentanil without muscle relaxant in children.

METHODSTotally 100 4-10-year-old pediatric patients (ASA1) who had been scheduled for plastic surgery were equally divided into remifentanil group and control group through computer-generated randomized grouping. In all patients, five minutes after intravenous administration of atropine 0.01 mg/kg and midazolam 0.1 mg/kg, propofol was infused at the targeted effect-site concentration (Ce of 6 μg/ml. When the intended target Ce of propofol was reached, the remifentanil group began to be infused with remifentanil at a Ce of 5 ng/ml, and normal saline (0.1 ml/kg) was injected simultaneously. In the control group remifentanil was replaced by normal saline and rocuronium (0.8 mg/kg) was injected together with the normal saline. After the equilibration of plasma and the Ce of remifentanil were reached, tracheal intubation was attempted. The complications during the induction and tracheal intubation were recorded. The intubating conditions were assessed using a five-point scoring system based on ease of laryngoscopy, vocal cords position, coughing, jaw relaxation and limb movement.

RESULTSThe success rate of tracheal intubation was in 90% in remifentanil group and 98% in the control group (P=0.122).CONCLUSION Target-controlled infusion of propofol and remifentanil at Ce of 6 μg/ml and 5 ng/ml is feasible for the induction and tracheal intubation without muscle relaxant in children.

Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Intubation, Intratracheal ; Male ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

Accidents, Traffic ; statistics & numerical data ; Adult ; China ; epidemiology ; Female ; Humans ; Male ; Wounds and Injuries ; epidemiology ; surgery

OBJECTIVETo determine the distribution of HLA-B alleles in the Chinese Yi ethnic group and its association with HIV infection.

METHODSOne hundred and six unrelated healthy HIV negative and 73 HIV positive Chinese Yi ethnic individuals were typed by PCR-SSP.

RESULTSThe frequency of alleles B*07, Bx 35, and B*46 were increased in HIV-1-positive subjects, whereas the alleles B*55, B*44 and B*78 were absent in the HIV-infected persons studied. The B*46 allele was present in a significantly higher gene frequency among HIV-1-positive individuals (P=0.02, OR=3.32, 95% CI=1.13-9.78) compared with control subjects.

CONCLUSIONHLA-B*46 may be associated with its susceptibility to HIV-1 infections.

Case-Control Studies ; China ; ethnology ; DNA ; analysis ; Ethnic Groups ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; HIV Infections ; blood ; genetics ; HIV Seropositivity ; blood ; HIV-1 ; pathogenicity ; HLA-B Antigens ; genetics ; Humans ; Polymerase Chain Reaction ; methods ; Surveys and Questionnaires