ObjectiveTo study the anesthesia effect,safety and reliability of etomidate combined with remifentanil in elderly patients. Methods40 patients scheduled for abdominal operation were divided into two groups with 20 cases each: etomidate group(group A)and propofol group(group B).Anesthesia induction: midazolam 0.04mg/kg,remifentanil 1.5 μg/kg(time＞60s),atracurium 0.6mg/kg,group A to etomidate 0.2mg/kg(30 ～ 60s),(T1),1 min before trachea intubation(T2),1 min after trachea intubation(T3),5 min after cutting skin(T4),5 min after exploration(T5),5min after cutting ill focus(T6),3min after tracheal extubation(T7),30min after operation(T8).At the same time,observed analepsia condition. ResultsIn group B,SBP and DBP were lower than those in group A at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than those in group A at T6 and HR was lower than those in group A at T3 and T7(all P＜0.05).In group B,SBP and DBP were lower than before anesthesia at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than before anesthesia at T6 and HR was lower than before anesthesia at T2(all P＜0.05).In group A,HR was faster than before anesthesia at T7(P＜0.05).The time of openingeyes,remove-tracheal tube in B group was less than those in A group(all P＜0.05).Both groups without memory about operation,anesthesia was content. ConclusionEtomidate combined with remifentanil anesthesia was milder than propofol group to elderly patients ardiovascular effects.It was better than propofol group for elderly patients.

Objective To establish a method of HPLC for determination of rhamnocitrin in Oxytropis falcate Bunge.Methods The HPLC method was used.Chromatographic column:Lichrospher C18(4.6 mm? 250 mm,5 ?m) reversed-phase column;mobile phase:0.4% phosphoric acid in water-methanol(20∶80);flow rate:1.0 mL/min;detective wavelength:350 nm.Results Rhamnocitrin was liner at the range of 4～ 30 ?g(r =0.999 8),and its average recovery rate was 99.7%,RSD=1.4%.Conclusion The method was simple and accurate,so it can be used for the quality control of Oxytropis falcate Bunge.

Objective To summarize the clinical features,diagnosis and surgical strategies of the acute and subacute nontraumatic spinal cord injury.Methods We analyzed retrospectively 46 cases of patients with acute and subacute nontraumatic spinal cord injury,who were admitted in the southwest hospital between January 2010 and december 2015.We summarized the clinical data and the effects of the surgical treatments.Results Among the 46 patients,There were 27 males and 19 females with mean age of 40.7 years (10-70).They were followed up for more than 3 months.Neurological function of ASIA at the initial admission included A in 9 cases,B in 6,C in 12 and D in 19.There were 5 hematoma patients (10.9％),11 neurilemmoma cases(23.9％),4 cases of acute disc herination (8.7％),Vascular Malformation 7 cases (15.2％),5 meningioma patients (10.9％),glioma 10 cases(21.7％) and enterogenous cyst 1 case(2.2％).46 patients underwent preoperative MRI examination,followed by spinal canal exploration,lesion resection and/or decompression.Operation within 8 hours,the signs and symptoms were improved in 6 cases.Operation within 8-24 hours were improvement in 2 cases,Operation after 24 hours improvement in 25 cases.Conclusion Early MR imaging and emergency spinal canal exploration and lesion resection with or without lamina decompression surgery is effective for the treatment of patients with acute and subacute nontraumatic spinal cord injury.

Objective To explore the mechanism of VEGF treating cerebral ischemia. Methods A rat model of middle cerebral artery occlusion (MCAO) was set up by nylon suture embolization. The naked plasmid DNA encoding vascular endothelial growth factor(pUCCAGGS/hVEGF 165 ) was directly injected through skull into the ischemic areas of brain. After seven days the rats were killed. RT-PCR was used to measure the expression of VEGF mRNA in the brain tissues, and immunohistochemistry was appllied to detect the expression of VEGF, Fas and Fas L in the brain tissues. Results Compared with control group, VEGF expression significantly increased in the therapeutic group(P

Objective To evaluate renal vascular damage (RVLs) and detect the expression of miR-145 in children with lupus nephritis (LN).Methods Clinical data of 41 cases of LN diagnosed by renal biopsy from the children with systemic lupus erythematosus (SLE) were collected. Glomerular damage score and RVLs were evaluated. The children were divided into groups according to RVLs score and pathological pattern. In situ hybridization was performed to detect the expression of miR-145 in kidney blood vessel. Differences in RVLs, miR-145 expression in the renal blood vessels and glomerular damage score were observed among the groups with different renal pathological pattern. Differences in clinical parameters, glomerular damage score and miR-145 expression in the renal blood vessels were investigated among groups with different RVLs. Results Among the groups with different pathological pattern, there was no difference in RVLs (P>?0.05) while signiifcant different were found in the expression of miR-145 and glomerular damage score (P??0.05) while a statistical different was found in the expression of miR-145 (P?

The strain Streptomyces sp.,nominated IMB-14,was isolated from the soil sample of WuDang Mountain by the method of cellulose ester membrane filter.The studies on antibiotic activities,morphological characteristics,cultural characteristics,physiological characteristics,16S rDNA sequence analysis and the metabolite of strain IMB-14 showed that the strain IMB-14 was accordance with Streptomyces xanthoci-dicus.The study on the isolation and identification of strain Streptomyces xanthocidicus establishes a foundation on screening of novel antibacterial and antitumor agents.

BACKGROUND: Delirium is an acute organic brain syndrome caused by various reasons, and it is common in elderly patients. Antipsychotics treatment is an important method to control delirium.OBJECTIVE: To observe the efficacy of new antipsychotic agent of olanzapine and the traditional antipsychotic agent of haloperidol in treating senile delirium.DESIGN: A randomized controlled observation. SETTING: Mental Health Center, the First Affiliated Hospital of Chongqing University of Medical Sciences.PARTICIPANTS: Totally 175 inpatients with senile delirium were selected from the First Affiliated Hospital of Chongqing University of Medical Sciences from September 2001 to September 2003, they were randomly divided into olanzapine treatment group (n=74), haloperidol treatment group (n=72) and a control group(n=29). There were 111 males (63.4%) and 64 females (36.6%). Delirium had occurred for a duration of 30 minutes to 17 days, with an average of (3.02±2.71) days. The enrolled patients were classified according to the etiological factors of delirium: metabolic (n=68), toxic (n=47), structural (n=25) and infectious (n=35).METHODS: Different treatments were used in different groups. Control group (n=29): The patients were only given somatic treatment aiming at delirium, and not any drug for central nervous system was used. Olanzapine group (n=74): Besides the somatic treatment aiming at delirium, the patients were given olanzapine (Zyprexa, produced by Eli Lilly and Company,5 mg/tablet) taken orally or sublingually (fasted patients), the initial dosage was 1.25-2.5 mg per day, and then adjusted to 1.25-20 mg per day. Haloperidol group (n=72): Besides the somatic treatment aiming at delirium, they were treated with intramuscular injection of haloperidol (2.5-10 mg per day). The effects were prospectively observed for 1 week.The scores were observed before enrollment and at 1-7 days respectively,the severity of mental disorder and amelioration were evaluated by the clinical global impression scale-severity of illness (CGI-SI) and global improvement item of clinical global impression scale (CGI-GI). The dosage and time of administration was taken as the dosage and time to take effect when the CGI-SI baseline scores decreased by more than 1 point.MAIN OUTCOME MEASURES: The severity of mental disorder and amelioration were observed.RESULTS: ① The scores of CGI-SI after treatment were significantly decreased in the olanzapine group, haloperidol group and control group, and there were significant differences (P ＜ 0.01). ② The rates of marked effect in the three groups were 82.4%, 87.5% and 31.0%, respectively, and those in the two treatment groups were significantly different from that in the control group (P ＜ 0.01). ③ Both olanzapine and haloperidol began to take effect at small dosages, and it was the fasted in the olanzapine group, followed by the haloperidol group, and slowest in the control group.CONCLUSION: Olanzapine and haloperidol have similar effects in treating senile delirium. However, olanzapine is faster to take effect than haloperidol.

Objective To explore the safety and effectiveness of transurethral resection of the prostate (TURP) for large benign prostatic hyperplasia.Methods A total of 56 cases of patients with large benign prostatic hyperplasia were analyzed retrospectively.Results The weight of prostate tissue resected with TURP was 60.2 g (48-122 g).The resection rate was 60％,operation time 113.4 min (70-180 min).The lower urinary tract symptoms (LUTS) after TURP was improved significantly.The international prostate symptom scores (IPSS) of 38 cases were decreased from (25.6±1.5) before operation to (6.0± 2.0) after operation.The maximum urine flow rate were increased from (5.0±1.9) ml/s to (18.0±4.5) ml/s.The mean residual urine volume of 22 cases were reduced from 95 ml (40-250 ml) to 10 ml (0-60 ml).Conclusions Skilled TURP technology for large benign prostatic hyperplasia is a safe treatment with good effect and low complications rates.

This study is to determine the preventive effect and mechanism of targeting IL-17A on pulmonary inflammation and fibrosis after acute lung injury. Mice were treated with anti-IL-17A antibody on the day 7 and sacrificed on the day 14 after bleomycin lung injury. The pulmonary inflammatory status and the deposition of collagen were measured by HE and Sirius stains staining. The contents of hydroxyproline and collagen were measured by using commercial kits. The survival rate of mice was calculated by Kaplan-Meier methods. The inflammatory cytokines in bronchoalveolar lavage fluid were measured by ELISA and the expressions of inflammation-related molecules were detected by Western blotting assay. Targeting of IL-17A could prevent the development of lung inflammation, decrease collagen deposition and the contents of hydroxyproline, and protect against the development of pulmonary fibrosis, which together led to an increase in the animal survival. Moreover, blocking IL-17A decreased the expression ofpro-fibrotic cytokines such as IL-17A, TGF-beta1 and IL-13; increased the expression of anti-fibrotic or anti-inflammatory factors such as IFN-gamma, COX-2, 5-LOX, 15-LOX. Indeed, IL-17A antagonism suppressed the activation of pro-inflammatory p65NF-kappaB but enhanced the activation of pro-resolving p50NF-kappaB. In conclusion, that blockade of IL-17A prevents the development of pulmonary fibrosis from acute lung injury, is because blocking IL-17A may prevent acute inflammation converting to chronic inflammation.

Objective To study the use of ultrasound-guided percutaneous transhepatic cholecystostomy (PTGD) followed by selective minilaparotomy cholecystectomy (MC) for acute obstructive cholecystitis in the high-risk elderly.Method A retrospective study was conducted on 120 patients who received ultrasound-guided PTGD followed by selective MC from January 2008 to December 2010.Results PTGD+ MC were performed successfully on 120 patients with acute severe obstructive chole cystitis.In all the patients,the abdominal pain was relieved within 2-3 h of operation,and the temperature decreased to normal from 24- 48 h after operation.The average time of drainage was 10 days.In 97 patients MC was performed 1 week after PTGD,and in 23 patients 2 weeks after PTGD.Bleeding from gallbladder bed occurred in 1 patient.No patient suffered from bile leak.There was no major complication or death after PTGD+ MC.Conclusion PTGD followed by selective MC is a simple,efficacious and minimally invasive treatment for high-risk elderly patients with acute obstructive cholecystitis.