Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

Objective To investigate the correlations of FcεRI-βgene polymorphisms with clinical manifestation and prognosis inwheezing infants. Methods One hundred and forty-six wheezing infants were recruited and divided into two groups by FcεRI-βdetection using Fluorescent quantitative PCR: Risk genotype group (n = 41) or normal genotype group (n = 105). The genotype distributions,clinical manifestation and asthma,and morbidity were analyzed and compared between the two groups. Results FcεR1 E237G AG/GG was more serious than FcεR1 AA in wheezing infants. (χ2 = 14.202; P = 0.003). No significant differences were found in AS morbidity between the two groups after two years follow-up (χ2 = 2.25;P = 0.13). Conclusion FcεRI-βgene polymorphisms are strongly related with infantile wheezing. Th risk genotype may be the severity of asthma but may not be the major influencing factor of asthma.

Objective To observe the clinical features and to identify γ-secretase gene mutations in a Chinese family with follicular occlusion triad (FOT).Methods Clinical evaluation was carried out in a family with FOT through field investigation.Peripheral blood samples were obtained from the family members and 100 unrelated healthy controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN1,PSENEN and NCSTN genes followed by DNA sequencing and comparative analysis.Results There were 14 members over 3 generations in this family,of whom,6 (4 males and 2 females) were affected by FOT.FOT was inherited in an autosomal dominant manner in this family.Clinical manifestations varied greatly among the 4 surviving affected members.DNA sequencing revealed a novel missense mutation,c.647A ＞ C (p.Q216P),in the exon 6 of NCSTN gene in the proband,which was cosegregated perfectly with affected,but not with unaffected,members in the family.The mutation was not found in any of the unrelated controls and had not been registered in the single nucleotide polymorphism (SNP) database in NCBI.Conclusions There is a novel heterozygous missense mutation,c.647A＞C in the exon 6 of NCSTN gene,which may be the molecular basis of pathogenesis of FOT in this family.

Objective To evaluate the feasibility and therapeutic efficacy of real-time virtual navigation system (RVS) combined with contrast-enhanced ultrasonography (CEUS) for hepatocellular carcinoma undetectable by conventional ultrasound and CEUS.Methods A total of 213 patients with 265 lesions (undetectable on conventional ultrasound but detectable by other imaging examinations) were enrolled in this study.CEUS was performed,and lesions which were detected with CEUS were given CEUS guided radio-frequency ablation (RFA) (CEUS group).RVS combined with CEUS was performed to locate the rest lesions and guide RFA (RVS + CEUS group).Diagnostic value and therapeutic efficacy of RVS + CEUS were assessed.Results In 256 lesions,174 (65.7％) could be detected with CEUS,and among the rest 91 lesions,82 (90.1％) lesions could be detected by RVS combined with CEUS.The technique effectiveness rate of RVS + CEUS was significantly higher than that of CEUS (x2 =18.85,P ＜0.0001).Complete ablation rate after one month in RVS+ CEUS group was 9t.5％ (75/82),which was significantly higher than that in CEUS group [86.2％ (150/174),P ＜0.05].Local progression in one year in CEUS group and RVS + CEUS group were 13.4％ and 10.9％,respectively.Conclusions RVS combined with CEUS is feasible for hepatocellular carcinoma undetectable by conventional ultrasonography and CEUS,and the therapeutic efficacy of RVS + CEUS guided RFA is satisfactory.

Objective To evaluate the efficacy profile of loading dose of anti-tumour necrosis factor (TNF)-α antibody infliximab in the treatment of ankylosing spondylitis (AS) and investigate the parameters that could be used as predicting factors for clinical response to infliximab in AS.Methods This was an open-labeled.mutticenter trial.Subiects eligible for this study were adults with a diagnosis of definite AS.Active disease was a Bath AS disease activity index(BASDAI)≥4 and spinal pain VAS≥4.Infliximab 5 md/kg was infused at weeks 0,2,6.All patients were followed for up to 10 weeks.Logistic regression likelihood ratio tests (univariate and multivariate) were performed to investigate which of the following parameters assessed before treatment were associated with ASAS 20,ASAS 40 and BASDAI 50 response:sex.age.disease duration,HLA-B27,BASDAI,spinal inflammatory (questions 5 and 6 of the BASDAI),spinal pain,night pain,patient global assessment,Bath AS functional index (BASFI),BASMI,enthesis index (EI),presence of peripheral arthritis,chest expansion,ESR,CRP,Bath AS radiology index (BASRI).Results Sixty-three patients (79% were males.90% were HLA-B27 postivie with a median age of 32 years and the median disease duration was 10 years) completed the treatment.The proportion of ASAS 20 responders.ASAS 40 responders and BASDAI 50 at week 10 was 84%,75%,70%,respectively.Univariate and multivariate Logistic regression analysis showed none of the 17 parameters evaluated at week 0 including ESR/CRP,disease duration were predictive for improvement.Conclnsion In this study,a loading regimen of infliximab has demonstrated consistent efficacy and none of the demographic parameters and baseline AS activity parameters are predictors for maior clinical response to infliximab in active AS.

ObjectiveTo investigate the expression of the long non-coding RNA (lncRNA) EXOC7 in serum and liver biopsy tissue of patients with nonalcoholic fatty liver (NAFLD) and its clinical significance. MethodsA total of 120 patients who underwent liver biopsy in The Affiliated Hospital of Southwest Medical University from January 1, 2013 to December 31, 2018 and were diagnosed with NAFLD based on imaging and histopathology were enrolled, among whom 47 had nonalcoholic fatty liver (NAFL) and 73 had nonalcoholic steatohepatitis (NASH). A total of 50 liver disease patients without steatosis or steatohepatitis were enrolled as control group. Real-time PCR was used to measure the expression of lncRNA EXOC7 in liver tissue and serum. The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups. A chi-square test was used for comparison of categorical data between groups. A Pearson correlation analysis was used to investigate the correlation between lncRNA EXOC7 and biochemical parameters. The receiver operating characteristic (ROC) curve was plotted to investigate the diagnostic value of lncRNA EXOC7. ResultsCompared with the control group, the patients with NAFL or NASH had significant increases in the expression of lncRNA EXOC7 in liver tissue and serum (all P＜0.05), and the level of such expression increased with the aggravation of hepatic steatosis and inflammation (F=19.96, P＜0.05). The correlation analysis showed that the expression of lncRNA EXOC7 was positively correlated with total triglyceride and low-density lipoprotein cholesterol (r=0.785 and r=0.847, both P＜0.001) and was negatively correlated with high-density lipoprotein cholesterol and insulin sensitivity index (r=-0.726 and -0.709, both P＜0.001). LncRNA EXOC7 had an area under the ROC curve of 0.812 (95% confidence interval: 0.599-0.915, P＜0001), a sensitivity of 8542%, and a specificity of 81.17% in the diagnosis of NAFLD. ConclusionLncRNA EXOC7 is highly expressed in patients with NAFLD, and the expression of lncRNA EXOC7 increases with the aggravation of hepatic steatosis and inflammation, suggesting that lncRNA EXOC7 may be a potential new target for the prevention and treatment of NAFLD.

Objective In this study,Knoevenagel derivatives of curcumin were synthesized,and their oil-water partition coefficient were determined.Our aim is to provide an experimental basis for further development of curcumin derivatives.Methods Two Knoevenagel derivatives of curcumin,including 4-(thiophen-2-ylidene)curcumin(3a)and 4-(pyridine-4-ylidene)curcumin(3b),were obtained by using the methylene group of curcumin as the modification site and purified by column chromatography.The structures of these derivatives were confirmed by nuclear magnetic resonance spectroscopy(NMR),infrared(IR)and high-resolution liquid mass spectrometry(HRLC-MS).The oil-water partition coefficient of the derivatives in n-octanol aqueous solution was determined by quantitative analysis using HPLC.Results Knoevenagel derivatives of curcumin were successfully synthesis.The oil-water partition coefficients(lgPap)of curcumin derivatives 3a and 3b are 0.96 and 0.82,respectively.Compared with the oil-water partition coefficient of curcumin(lgPap=3.85),it suggested that curcumin derivatives showed better water solubility than curcumin.Conclusion Compared to the curcumin prototype,Knoevenagel derivatives of curcumin increased water solubility and improved bioavailability.Thus,it may provide experimental basis for introducing heteroarylene moiety of the methylene position of curcumin to enhance pharmacological activity.

To investigate the effects of gossypol acetic acid (GA) on proliferation and apoptosis of the macrophage cell line RAW264.7 and further understand the possible underlying mechanism responsible for GA-induced cell apoptosis, RAW264.7 cells were treated with GA (25~35 micromol/L) for 24 h and the cytotoxicity was determined by MTT assay, while apoptotic cells were identified by TUNEL assay, acridine orange/ethidium bromide staining and flow cytometry. Moreover, mitochondrial membrane potential (DeltaPsi(m)) with Rhodamine 123 and reactive oxygen species (ROS) with DCFH-DA were analyzed by fluorescence spectrofluorometry. In addition, the expression of caspase-3 and caspase-9 was assessed by Western Blot assay. Finally, the GA-induced cell apoptosis was evaluated by flow cytometry in the present of caspase inhibitors Z-VAD-FMK and Ac-LEHD-FMK, respectively. GA significantly inhibited the proliferation of RAW264.7 cells in a dose-dependent manner, and caused obvious cell apoptosis and a loss of DeltaPsi(m) in RAW264.7 cells. Moreover, the ROS production in cells was elevated, and the levels of activated caspase-3 and caspase-9 were up-regulated in a dose-dependent manner. Notably, GA-induced cell apoptosis was markedly inhibited by caspase inhibitors. These results suggest that GA-induced RAW264.7 cell apoptosis may be mediated via a caspase-dependent mitochondrial signaling pathway.
Animals ; Antineoplastic Agents, Phytogenic/*pharmacology ; Apoptosis/*drug effects ; Cell Line ; Cell Proliferation/*drug effects ; Dose-Response Relationship, Drug ; Gossypol/*analogs & derivatives/pharmacology ; Membrane Potential, Mitochondrial/*drug effects ; Mice ; Mice, Inbred BALB C ; Reactive Oxygen Species/*metabolism ; Signal Transduction/*drug effects

Objective To carry out quality assessment and content analysis on guidelines on arteriovenous fistula (AVF) dysfunction monitoring in hemodialysis patients so as to provide a reference for building the localized clinical practice plan. MethodsDocuments were retrieved in guideline websites, professional society websites and electronic databases at home and abroad by computer. Quality assessment was carried out with the appraisal of guidelines for research and AGREEⅡ and JBI quality assessment tool on consensuses, and the recommendations of included guidelines were summarized. ResultsTotals of 4 evidence-based guidelines and one consensus were included with three of them in the level A and one in the level B of overall quality evaluation. A total of 12 items in 7 aspects were extracted including policy-making, team building, monitoring technology, training of personnel, continuous quality improvement, risk assessment and health education. Intraclass correlation coefficients of 4 evidence-based guidelines ranged from 0.866 to 0.935. Conclusions The guidelines have high levels of overall quality, but applicability needs to be improved. The recommendations are in general accord with each other, which can provide a basis for building the localized clinical practice plan.

Objective:To explore the current status and influencing factors of venous thromboembolism (VTE) knowledge among nurses of hospitals in Tibet, so as to provide guidance for VTE nursing in Tibet.Methods:From November to December 2019, convenience sampling was used to conduct a VTE knowledge survey of 1 117 nurses in 59 hospitals from 7 cities (regions) of the Tibet Autonomous Region using the VTE Knowledge Questionnaire for Clinical Nurses. Binary Logistic regression analysis was used to explore the influencing factors of VTE knowledge scores among nurses.Results:Among nurses of the Tibet Autonomous Region, the total VTE knowledge score was (36.70±15.17) , of which the basic knowledge dimension score was (7.13±2.99) , and the risk assessment dimension score was (14.75±7.61) , and the basic prevention dimension score was (3.92±1.99) , and the physical prevention dimension score was (4.73±2.62) points, and the drug prevention dimension score was (1.96±1.29) , and the VTE post-processing dimension score was (4.22±2.35) . The average score rate of VTE knowledge among nurses in Tibet was 48.94%, and the knowledge of nurses was at an intermediate to low level. In the use of preventive measures, nurses had insufficient knowledge, including physical prevention score rate of 36.38%, drug prevention score rate 39.20%. Logistic regression analysis showed that professional title, hospital level, and whether or not they had participated in training were independent factors influencing the qualification of nurses' VTE knowledge score ( P<0.05) . Conclusions:The nurses in Tibet have insufficient knowledge of VTE. Managers need to carry out targeted training for nurses with different characteristics and the deficiencies of knowledge, to promote nurses to apply what they have learned to clinical practice effectively, and to ensure the quality of VTE care.