Objective To discuss the influence of intravenous anesthesia with procaine on the release of central nervous Ach. Methods 50 samples of plasma were collected from healthy people, and 30 samples of plasma from cases prior to surgical operation, during anesthesia and after operation respectively. The activity of Ach in the plasma was measured. Then observe the dropping speed and concentration of procaine at different time during anesthesia, and the subsequent changes of the activity of plasma Ach and the slowdown of its activity. Results The data showed that the activity of plasma Ach prior to operation was considerably lower than that of the control group (P

Objective To construct the stably over-expressing hB7-H3 gene human pancreatic cancer cell line PANC1,and provide tools for further investigating the function of hB7-H3.Methods hB7-H3 gene fragment was inserted into lentiviral plasmid GV287 carrying GFP to construct recombinant hB7-H3-GV287 plasmid vector.293T cells were transfected,and the GFP expression was evaluated under fluorescence microscopy.Western Blot wasused to detect the expression of hB7-H3 protein.Lentiviral vectors were packaged and the titer was determined.The recombinant hB7-H3 expressed lentivirus was used to infect PANC1 cell.Flow cytometry was applied to detecte the percentage of GFP and hB7-H3 positive cells.Real-time PCR and Western Blot was used to verify the mRNA and protein expression of hB7-H3.Self-cyclizing GV287 plasmid served as negative control (NC).Results PCR amplified fragment of recombinant plasmid was around 1 368 bp,and no amplified production of NC plasmid was observed.The DNA sequencing of recombinant plasmid was completely consistent with the designed fragment,indicating that hB7 H3-GV287 plasmid was successfully constructed.293T cells transfected with recombinant plasmid expressed hB7-H3 protein,while those cells transfected with NC plasmid did not express hB7-H3 protein.The virus titer of lentiviral packaged recombinant hB7-H3 plasmid was 2 × 108 TU/ml.The percentage of hB7-H3 positive cells,hB7-H3 mRNA and protein expression in PANC1 cells infected with cells infected with hB7-H3 lentivirus was 94.3％,5.09 ± 0.24 and 2.85 ± 0.27,respectively,which was obviously higher than 18.5％,1.28 ± 0.53 and 0.44 ± 0.69 in cells infected with NC lentivirus,and the differences were statistically significant (P value ＜0.01).Conclusions A human pancreatic cancer cell line PANC1 stably over-expressing hB7-H3 was successfully constructed.

Objective To observe the clinical effects of different doses of Xuebijing injection in the treatment of sepsis. Methods Eighty patients with sepsis from First Center Clinical College of Tianjin Medical University were selected and randomly divided into four groups:the control group,Xuebijing small,middle and large dose groups(each, 20 patients). All patients in the four groups were given Western medicine conventional treatment,whereas in the Xuebijing small,middle and large dose groups,additionally they were intravenously dripped with Xuebijing injection 50 mL, 2 times a day,100 mL,2 times a day and 100 mL,4 times daily respectively. The patients' vital signs,blood routine, interleukin-18(IL-18),procalcitonin(PCT)and C- reactive protein(CRP)were detected before treatment(0 d)and 3,7 and 14 days after Xuebijing injection,28-day and 60-day death rate were observed. Results With prolonged treatment,the body temperature,heart rate(HR),respiratory rate(RR),white blood cell count(WBC),IL-18,PCT, CRP levels were all decreased in each group(all P<0.05),and on 14 days they reached the valley;when compared with middle,small dose Xuebijing groups and control group,in the Xuebijing large dose group they were decreased the most significantly over the same period〔temperature (℃):36.22±0.55 vs. 36.55±0.99, 36.87±1.05, 36.93±1.07,HR(beats/min):82.11±8.99 vs. 93.45±10.02,109.02±11.44,113.13±10.34,RR(breaths/min):15.48±6.45 vs. 17.33±6.94,20.35±7.19,22.34±6.67,WBC(×109/L):5.35±1.37 vs. 8.35±2.98,10.54±3.22, 13.33±4.78,IL-18(ng/L):107.36±55.89 vs. 136.55±80.19,177.78±102.32,193.93±98.07,PCT(μg/L):0.33±0.19 vs. 0.66±0.22,1.62±0.44,2.78±0.34,CRP(mg/L):15.40±1.37 vs. 48.34±8.98,100.45±30.67, 131.92±49.53〕,the differences all being statistically significant(all P<0.05). The 28-day and 60-day death rate in Xuebijing large dose group were significantly lower than those in control group,Xuebijing small,middle dose groups (28-day:25% vs. 40%,40%,45%;60-day:30% vs. 45%,40%,50%). Conclusion The time for onset of therapeutic effect in large dose Xuebijing group is short,and reduce the levels of inflammatory mediators significantly, and improve the prognosis of patients with sepsis,therefore it can be used clinically.

Objective To assess the factors affecting survival of malignant pheochromocytoma/malignant paraganglioma.Methods The clinical data of 85 malignant pheochromocytoma/malignant paraganglioma patients were analyzed retrospectively.All the patients were followed up,the duration from 2 months to 283 months,the median time was 48 months.The overall survivals of 5 years and 10 years were calculated.The possible affecting factors,such as gender,age,tumor function,metastatic sites,metastatic fields,incipience or recurrence,the time to recur,were analyzed.Survival differences between groups were compared with the log rank test.Multivariate analysis was performed by using Cox regression analysis to detect variables independently associated with survival.All P values were 2 tailed with P ＜ 0.05 considered statistically significant.All statistical analysis was done by SPSS 17.0 software package.Results The overall median survival time was 62 months,5-year survival rate was 44.7％,10-year survival rate was 11.8％.Gender (P =0.649),age (P =0.228),incipience or recurrence (P =0.217) had no significant effect on the survival time.Significance was found in tumor function (P =0.034),metastatic sites,metastatic fields (P =0.009),the time to recur (P =0.003).The median survival time of patients with nonfunctioning tumor and functioning tumor was 90 months and 37 months.The median survival time of patients with multiple system metastases and single system metastasis was 37 months and 117 months.For the patients with single system invaded,there were 15 cases (26.8％) of bone metastasis,10 cases (17.9％) of lymph node metastasis,8 (14.3％) of liver metastasis,7 (12.5％) of lung metastasis,6 (10.7％) of renal metastasis,6 (10.7％) of intestine metastasis and 4 (7.1％) of brain metastasis.The median survival time was 110,77,28,14,26,8 and 19 months.The median survival time of patients with lung,liver,intestine metastasis were shorter than the other patients (P ＜ 0.05).Fifty-five patients were found recurrence after operation,recurrent time was from 4 to 65 months,and the median time was 22 months.The survival time of patients with recurrence within 2 years was shorter than patients above 2 years (P =0.003).Conclusions The prognosis of malignant pheochromocytoma/malignant paraganglioma is poor.Gender,age,incipience or recurrence could not affect the overall survival time.The survival time has relationship with the function of tumor,metastatic field,metastatic sites and time to recurrence.The patients with nonfunctioning tumor have longer survival time than those with functioning tumors.The survival time of patients with single system invaded is longer than ones with multiple systems invaded.The common metastatic sites are bone,lymph node,liver,lung,kidney,intestine and brain.Patients with intestine metastasis have worst prognosis.The patients with only bone and lymph node metastasis have best prognosis.Patients with recurrence above 2 years have a better prognosis than those within 2 years.

Objective To improve the diagnosis and treatment of von H ippel-Lindau (VHL) disease.Methods The clinic data of one kindred with VHL disease type Ⅱ B was reviewed including clinical manifestation,imaging,pathology and therapy.A 40-year-old male complained of the left upper extremity numbness for 6 months,and a variety of visceral tumors were found 3 months ago.Contrast-enhanced MR imaging showed multiple brain tumors.CT showed left kidney tumor,pancreatic tumor,pars-aortic tumor and left adrenal tumor.Fundoscopy showed multiple retinal hemangioblastoma.PET-CT discovered abdominal multiple tumors.And pedigree analysis was to determine the family medical history,and 6 members got genetic screening.Results In the kindred with VHL disease type Ⅱ B,9 members (30％) out of 40members in 4 generations got the disease.Six members got genetic screening,and the result showed 5 (5/6) members had mutation.Three (3/5) members with 3 sites genetic mutation showed clinical manifestation,1 (1/5) members with 3 sites genetic mutation without clinical manifestation found brain tumors by MRI,and 1 ( 1/5 ) member with 1 site genetic mutation did not find disease by comprehensive checkup.The main mutation located at exon 1 in chromosome 3p25 of VHL gene.All mutation was hetcrozygous mutation.The 295,337 and 337 nucleotide thymine of the VHL gene were substituted by cytosine,cytosine and adenine,which made the 98th,112th and 112th tyrosine substituted by histidine and asparagines.One member with 1 site mutation had 98th tyrosine substituted by cytosine.The first operation was to remove brain tumor,and the second operation was to remove adrenal tumor,para-aortic tumor and renal tumor.Pathology of the brain tumors showed hemangioblastoma,and the retroperitoneal tumors were clear cell carcinoma,paraganglioma and pheochromocytoma.Followed up for 6 months after operation,no relapse occurred.Conclusions VHL disease is a relatively rare autosomal dominant disorder.Comprehensive management of patients should also include genetic counseling and screening for other manifestations of the disease process.Genetic testing might be helpful in early detection of asymptomatic VHL patients.Members having gene mutation should be followed up strictly.Surgical management of VHL disease should be decided on the base of comprehensive assess.Multiple lesions could be cut off in one operation.For patients with pheochromocytoma,pheochromocytoma shuld be handled first.

Objective To observe the inhibition effect of selective cyclooxygenase-2 inhibitor (celecoxib) on the experimental choroidal neovascularization (CNV).Methods Thirty 8-10 weeks old healthy male Brown-Norway(BN) rats were randomly divided into the control,laser and celecoxib group,with 10 rats in each group.At the dosage of 50 mg/kg,celecoxib was garaged twice per day.After 7 days,experimental CNV was induced by Krypon laser on laser group and celecoxib group.Fundus fluorescein angiography (FFA) was performed on days 3,7,14,21,30 after laser photocoagulation.On days 21 after photocoagulation,5 rats in each group were sacrificed and the relative thickness of CNV membranes,the expression of COX-2,vascular endothelial growth factor(VEGF) and matrix metalloproteinase-2 (MMP-2) Were studied by histopathologic or immunohistochemistry examination.Results On days 21 after photocoagulation,the incidence of CNV in the celecoxib group is significantly lower than that in the laser group (X~2=7.1068,P=0v0077);the relative thickness of the CNV membranes in the celecoxib group is reduced 41.38% compared to the laser group,the difference is statistically significant (t=16.7600,P=0.0000).COX-2,VEGF and MMP-2 expression in the CNV membrane of celecoxib group were significantly lower than in control group (t=5.7100,5.8400,8.0200;P=0.0000);the COX-2,VEGF and MMP-2 expressions in choroid and retina of control group were weak.Conclusion Prophylactic celecoxib can reduce the expression of VEGF and MMP-2 by inhibiting COX-2,and prevent the CNV induced by laser photocoagulation.

Objective To evaluate the effect of azithromycin on mycoplasmal pneumonia (MP).Methods We divided 90 MP cases into azithromycin and erythromycin treatment groups. In azithromycinThe pyretolysis time, cough improvement time, the disappearing time and the mean length of hospitalization of azithromycin group were shorter than that of erythrornycin group. The local ache, stomach and intestinal tract adverse reaction, and damage of hepar function were less than these in erythromycin group. ConclusionAzithromycin is an effective and safe drug to MP.

Based on the high solubility of azodicarbonamide (ADC) in hot solution and its electrostatic interaction with Nafion film,a new electroanalytical method was developed for the determination of ADC by using Nafion film electrode.The effect of temperature on the solubility of ADC and the mechanism of the reduction reaction of ADC on Nafion film electrode were investigated.Under the experimental conditions such as water bath at a constant temperature of 80 ℃,pH 6.0 and optimal test parameters,the differential pulse voltammetric response was proportional to the concentration of ADC in the range of 0.93-10.5 μg/L,and the detection limit was estimated to 0.58 μg/L.The relative standard deviation was less than 5.86 ％ and the recovery was 95.8％-104.0％ for the determination of the ADC in flour samples.The semicarbazide and nitrofurazone did not interfere with the determination of ADC.

Objective To investigate the values of computed tomography(CT) and endoscopic retrograde cholangiopanc reatography(ERCP) in acute biliary tract obstruction associated with Clonorchiasis. Methods The image features of 47 patients with acute biliary tract obstruction associated with Clonorchiasis proved by operation (27 cases) and ERCP (20 cases) were reviewed retrospectively. Results Fourty-three cases showed equal intrahepatic bile duct diffuse dilatation from porta hepatis to capusle with different levels in CT, and 39 cases showed extrahepatic bile duct dilatation. There was no significant relationship for the extent of intra and extrahepatic bile duct dilatation. It showed the end of intrahepatic bile duct shaped like a bag in 41 cases, a enlarged gallbladder in 38 cases, and 9 cases with a soft intralumenal masses. There were 13 patients with pancreas swelling and 8 with pancreatic duct dilatation. Of the 20 patients underwent ERCP, eighteen cases showed intrahepatic bile duct diffuse dilatation with the end shaped like a bag, and 16 showed extrahepatic bile duct dilatation. Irregular filling-defect was seen in the common bile duct in 9 cases. The obstruction were relieved after Oddi's muscle endoscopic sphincrectomy(EST). Conclusion The patients with acute obstructive jaundice can be diagnosed as Clonorchiasis, if CT or ERCP showed equal intrahepatic bile duct diffuse dilatation with the end shaped like a bag and with extrahepatic bile duct dilatation, which can be confirmed by the worms and eggs found in the drawing-out bile, and the obstruction can be relived by EST.

Objective To investigate the CT imaging feature of EHCC associated with Clonorchiasis. Methods The CT image features of 18 patients with EHCC associated with Clonorchiasis proved by operation and pathology were reviewed retrospectively. Results CT depicited the level and cause of obstruction in all eigthteen patient. Most tumors( n =14,77.8%)were located in the proximal third of the extrahepatic bile duct. The gross morphologic pattern was an intraluminal soft tissue mass leision in 14 patients(77.8%), infiltrating in two patients and exophytic types in two patients. Contrast enhancement of the tumors relative to the liver parenchyma showed isoattenueation in 10 tumors(55.6%), hyperattenuation in seven tumors(38.9%) and hypoattenuation in one tumor(5.6%). Severe,uniform dilation of the intrahepatic bile duct was identified in 14 patients (77.8%) and central dilation was seen in four patients (23.2%).Male preponderance was found( n =15,83.3%). Conclusion It is concluded that the EHCC associated with Clonorchiasis is located predominantly in the proximal third of the extrahepatic bile duct and detected more readily than non Clonorchiasis-associated cholangiocacinoma.