Objective To explore the effect of ProSeal laryngeal mask airway and endotracheal tube on analepsia stage of general anesthesia in geriatric patients undergoing radical mastectomy.Methods Thirty geriatric females with breast cancer of American Standards Association (ASA)Ⅰ-Ⅱscheduled for selective radical mastectomy under general anesthesia were randomly allocated to two groups: ProSeal laryngeal mask airway group(PLMA group, n=15) and endotracheal tube group (ET group, n=15). The patients were put on PLMA or were intubated with ET under general anesthesia in the two groups, respectively. The heart rate (HR), systolic blood pressure(SBP)and diastolic blood pressure (DBP) were recorded at the time points of 5 min after entering operation room (T0), end of surgery (T1), opening eyes (T2), after extubation (PLMA) immediately (T3) and 3 min after extubation (PLMA) (T4). The numbers of patients who were given antihypertensive agent,showed bucking, agitation or sore throat, nausea and vomiting after extubation were recorded during the analepsia stage of general anesthesia. Results The blood pressure (BP) and HR were mildly.increased in PLMA group at T2, and there was no significant difference compared with T0(P＞0.05). But the BP and HR were significantly higher at T3 than at T0 (P＜0.05). In ET group, the BP and HR were both significantly elevated at T2 and T3 than at T0 (P＜0.05), and reached the peak at T3. The increased levels of BP and HR were significantly lower in PLMA group than in ET group at T2 and T3 (P＜0.05). The quantities of patients who were given antihypertensive agent, showed bucking and sore throat were less in PLMA group than in ET group(P＜0.05). No differences in incidence rate of agitation, nausea and vomiting after extubation between the two groups were observed(P＞0.05). Conclusions PLMA can obviously reduce the occurrence of complications in analepsia stage of general anesthesia in geriatric patients scheduled for selective radical mastectomy,and is beneficial to provide much safer anesthesia.

BACKGROUND:Mesenchymal stem cells are capable of self-renew,a high degree of proliferation,with multi-differentiation potential,low immunogenicity and immunomodulatory properties.Both in vivo and in vitro it is able to regulate allogeneic immune response,to induce immune tolerance.In the solid organ transplantation it is playing an increasingly important role.OBJECTIVE:To summarize the research progress on the immunomodulatory mechanism and application of mesenchymal stem cells in solid organ transplantation.METHODS:An online search of Pubmed was undertaken by using the key words of "Mesenchymal Stem Cells,Mesenchymal Stem Cell Transplantation,Organ Transplantation,Transplantation Immunology,Immunologic Graft Enhancement,Graft vs.Host Disease" in Mesh to identify the relevant articles published in English from January 1994 to October 2009.At the same time,Wanfang database was screened to identify the relevant articles published between January 1994 and October 2009 with the key words of "Mesenchymal Stem Cells,Organ Transplantation,Transplantation Immunology" in Chinese.Inclusive criterion:The articles related to the immunomodulatory properties,transplantation immunology and application of mesenchymal stem calls in the solid organ transplantation were included.Exclusive criterion:The articles with repetitive research or Meta analysis were excluded.RESULTS AND CONCLUSION:Totally 200 relevant articles were selected and 86 of them met the inclusive criterion.Mesenchymal stem cells exhibit low immunogenicity and immunomodulatory properties,have an indispensable advantage about inducing graft tolerance and repairing tissue in solid organ transplantation.The mechanism of inducting immune tolerance may be related to soluble factors,regulatory T cells,tolerant dendritic cells,bone marrow chimerism,anti-inflammatory and tissue repair,dose and time of injecting MSCs.

Objective To assess the efficacy and safety of target-controlled infusion of propofol and remifentanil in geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation. Methods Thirty geriatric patients with primary hepatocellular carcinoma of ASA Ⅱ-Ⅲ scheduled for percutaneous radiofrequency ablation under monitored anesthesia care (MAC) were randomly allocated to two groups: target-controlled infusion of propofol and remifentanil group (PR group, n= 15) and intravenous injection of midazolam and fentanyl group (MF group. n= 15). The mean arterial blood pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) of patients were recorded during the treatment. The Ramsay Score, Patient Cooperation Score, VAS Score and postoperative Patient Satisfaction Score were recorded as well. Results The Ramsay Score, Patient Cooperation Score, VAS Score and Patient Satisfaction Score were all higher in PR group than in MF group (all P<0.05). The maximum values of MAP and HR [( 108.7± 8.6) mm Hg, (83.8±7.1) times/min] were significantly higher than the baseline values [( 99.3 ± 8.5) mm Hg, (76.3±7.1) times/min] in MF group, and the degree of increment of MAP and HR were significantly greater in MF group than in PR group (both P<0.05). The minimum values of MAP and HR [(84.5±6.5) mm Hg, (66.6 ± 6.6) times/min] were significantly lower than the baseline values [(97.7±6.5) mm Hg, (75.4±7.3) times/min] in PR group, and the degree of decrement of MAP and HR were significantly greater in PR group than in MF group (both P<0.05). SpO2 of both groups decreased significantly (the minimum values of PR and MF groups were 95.1±2.0 and 95.5± 2.2, respectively), but there was no statistical difference between two groups (P>0.05) . Conclusions MAC with target-controlled infusion of propofol and remifentanil is more suitable for geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation, as it can provide ideal analgesia and sedation, but the respiration and the change of hemodynamics of patients must be observed seriously.

Objective To observe the clinical efficacy of breeze heat treatment with site blood circulation for abdominal purpura allergic acupoint application therapy. Methods 96 patients were randomly divided into treatment and control group ,with 48 people in each. Both groups received traditional Chinese medicine with conventional therapy. Control group was given oral medicine treatment and acupoint application while the treatment group was given enema treatment. Clinical parameters observed includes degree of symptoms released ,the number of days in hospital and laboratory test results. Results The number of days in treatment group and hospital stay significantly decreased compared with control group (P<0.05). In terms of laboratory tests,the degree of improve?ment of the treatment group than the control group was statistically significant (P<0.05). Conclusions Treatment of dispersing heat blood circulation acupoint sticking with the treatment for abdominal type allergic purpura can sig?nificantly improve symptoms and laboratory tests ,with no obvious adverse reactions.

OBJECTIVE:To establish a method to determinate the content of paeoniflorin in Bailing tablet,and to evaluate the uncertainty of results. METHODS:HPLC was performed on the column of Platisil C18 with mobile phase of water- acetonitrile(87:13,V/V) at a flow rate of 1 ml/min,the detection wavelength was 230 nm,the column temperature was 25 ℃ and the injection volume was 10 μl. Quantitative analysis was conducted for the processes and procedures and the uncertainty was evaluated. RESULTS:The linear range of paeoniflorin was 0.100 1-2.502 8 μg;RSDs of precision,stability and reproducibility tests were lower than 2.0%,recovery rate was 98.7%-100.9%(RSD=0.86%,n=6). Reference substance amount,elution produce and the accuracy of method had great effect on the uncertainty. CONCLUSIONS:The established method can be used for the content determination of paeoniflorin in Bailing tablet,and the uncertainty evaluation provides reliability for the method.

Objective To make a qualitative and a quantitative control on the Calculus Bovis in Houzao Niuhuang Powder.Methods Hyodeoxycholic acid and bilirubin in Calculus Bovis were separately identified by TLC,and the cholic acid content was determined by TLCS with the scan wavelength of ?s=380 nm,?R=650 nm.Results TLC can be used for the identification in-vitro cultured Calculus Bovis and artificial Calulus Bovis,the samples containing cultured Calulus Bovis showed the specific spots of bilirubin but no hyodeoxycholic acid spot while the samples containing artifical Calulus Bovis showed the hyodeoxycholic acid spot but no bilirubin spot.TLC-scanning can be used to measure the quantity of cholic acid,with the linear range being 0.2～1.8 ?g,average recovery rate of 99.5 %,and RSD being 3.3 %(n=6),and the results accorded with the criterion of the cultured Calculus Bovis in Chinese pharmacopoeia.Conclusion The methods can effectively control the quality of Calculus Bovis in Houzao Niuhuang Powder.

Objective To investigate the relationship between the expression of Toll-like receptor 4 (TLR4) on mononuclear cells in peripheral blood and changes of serum vitamin D level in children with bronchiolitis.Methods The children who were diagnosed as bronchiolitis and received treatment in the Second Affiliated Hospital of Harbin Medical University from October 2013 to January 2014 were chosen as the pre-treatment group,and then divided them into moderate group and severe group according to the clinical symptoms,20 cases for each group.Then the cases in pre-treatment group who recovered after treatment were recruited as the after-treatment group,and the children who were healthy and medical examination in the Second Affiliated Hospital of Harbin Medical University in the same period were recruited as the healthy control group.The expressions of TLR4 on CD14 labeled mononuclear cells in the periphera were measured by flow cytometry.The level of 25 (OH) D in serum was detected by enzyme linked immunosorbent assay (ELISA).Results (1) The expression level in children with bronchiolitis of TLR4:the mode-rate group [(18.98 ±2.29)％] and severe group [(30.13 ±2.13)％] increased significantly (P ＜0.05) compared with control group [(1.17 ± 0.57) ％].And the expression level of moderate group [(2.02 ± 0.48) ％] and severe group [(11.43 ± 1.52) ％] decreased significantly after treatment (P ＜0.05).(2) Serum vitamin D level in children with bronchiolitis of the moderate group[(17.16 ± 3.34) μg/L] and severe group [(6.56 ± 2.28) μg/L] were lower than healthy control group [(53.69 ± 20.18) μg/L] before treatment (P ＜ 0.05),especially the severe group [(6.56 ±2.28) μg/L].The level of moderate group [(9.59 ± 2.31) μg/L] and severe group [(4.70 ± 0.67) μg/L] became lower after treatment (P ＜ 0.05).(3) Both severe group (r =-0.491,P ＜ 0.05) before treatment and moderate group (r =-0.436,P ＜ 0.05) after treatment showed negative correlation between TLR4 on mononuclear cells in peripheral blood and serum 25 (OH)D level in children with bronchiolitis.And no correlation was found among healthy control group,moderate group before treatment and severe group after treatment (P ＞ 0.05).Conclusions The conditions of children with bronchiolitis was positively correlated with the expression level of TLR4,and negatively correlated with the vitamin D level.The serum 25 (OH) D decreased steadily during the treatment.The expression of TLR4 in monocytes has a certain correlation with the level of vitamin D in children with bronchiolitis.

Objective To investigate the effect of high-mobility group box protein1 (HMGB1) on the expression of TNF-αand its mechanism in 16HBE in vitro. Methods groups with different HMGB1 (0, 100, 500, 2 000 ng/mL) concentration was set; RAGE antagonizing groups were as control, HMGB1-2000ng, anti-RAGE and anti-RAGE+HMGB1. The changes of TNF-αmRNA and secretion were determined by quantitative PCR and ELISA. RAGE protein level was measured by western blotting. Results HMGB1 intervention and TNF-α expression of 16HBE presented a positive dose-dependent relationship. Thechanges of RAGE was HMGB1positively concentration dependent. In comparison with HMGB1 2 000 ng/mL group, anti-RAGE+HMGB1showed a remarkable reduction of TNF-α secretion. Conclusion In vitro, HMGB1 increases TNF-α expression in 16HBE with a dose-dependent manner through RAGE.

Objective To seek a scalp venipuneture method with high success rate and less pain for patients. Methods Taking the rapid parallel straight method as the control group, and the rapid vertical straight method as the experimental group, 400 patients were randomly divided into the control group and the experimental group with 200 patients in each group. The success rate of two groups were counted, pain scores were got by VAS visual imitation assessment and the results undergoing statistical analysis. Results The success rate was 91.5% in the control group, and 99.5% in the experimental group. Distinguished sig-nificance existed in VAS visual imitation score. Conclusions The rapid vertical straight method is supe-rior to rapid parallel straight method in scalp venipuncture.