AIM: To investigate the feasibility of early reversal of vecuronium with neostigmine. METHODS: 48 patients (ASA class I or II) scheduled for elective surgery undergoing general anaethesia were randomly assigned to vecuronium group (n=16) and vecuronium+ neostigmine group (n=32). Furthermore, the latter was divided into two groups according to the time of reversal. In vecuronium+ neostigmine group 1, the patients received neostigmine antagonization within 10 min after vecuronium administration,and in vecuronium+neostigmine group 2, time of reversal within 11-30 min after vecuronium administration. All patients received vecuronium 1.5 mg?kg -1 after general anesthesia. Neostigmine 0.05 mg?kg -1 +atropine 0.5 - 1.0 mg+saline 8 ml was administered to vecuronium+ neostigmine group and recovery was compared with that of vecuronium patients who received 8 ml saline. The time from vecuronium administration to recovery of?TOF? 0.25 ?and? 0.7 ?was recorded.?RESULTS: In vecuronium group, the recovery time to TOF 0.25 and 0.7 was ( 45.58 ? 8.88 ) min, and ( 67.59 ? 5.60 ) min, respectirely; in vecuronium+ neostigmine group 1,it was ( 23.45 ? 2.82 ) min, and ( 31.86 ? 3.36 ) min, respectirely; and in vecuronium+neostigmine group 2, it was ( 28.70 ? 4.13 ) min,and ( 38.86 ? 2.10 ) min, respectirely. The recovery time in vecuronium+neostigmine group was evidently shorter than that in vecuronium group (P

Objective To investigate the effects of minocycline,a selective microglia inhibitor on dorsal GABAB receptor expression in the spinal cord in a rat model of neuropathic pain and the possible mechanism.Methods Forty-eight male SD rats weighing 220-260 g were used in this study.Neuropathic pain was induced by ligation of L5 spinal nerve(SNL).The animals were randomly divided into 4 groups(n=12 each):Ⅰ sham operation;Ⅱ SNL;Ⅲ sham operation+intrathecal(IT)minocycline 50 μg;IV SNL+IT minecycline 50 μg.Paw withdrawal threshold to von Frey hair stimulation was measured before operation(baseline)and at post-surgery days 1,2,4,6,8,10,12,14,16,18 in 6 animals in each group.The GABABR2 expression in dorsal horn of spinal cord was detected by Western blot at the time point when paw withdrawal threshold to mechanical stimulation was the lowest in another six animals which did not undergo yon Frey hair stimulation test.Results The paw withdrawal threshold to mechanical stimuli and the GABABR2 expression in the dorsal horn of spinal cord were significantly lower in SNL group than in sham operation group.The decreased paw withdrawal threshold to von Frey hair stimulation and the down-regulated GABABR2 expression in the spinal cord induced by SNL were ameliorated by intrathecal administration of micmglia inhibitor- minocycline in group Ⅳ.Conclusion The mechanism of neuropathic pain mediated by microglia activation may be related to the inhibition of GABAB receptor activation.

ObjectiveTo explore the influence of narcissism of mothers of middle school students on maternal consciousness and their rearing patterns,and to provide theoretical support for family education.Methods361 pairs middle school students and their mothers were sampled randomly and tested by middle school students' mother maternal consciousness scale and the narcissistic personality Inventory for the mothers,and the mother's subscale of EMBU for the students respectively.The data were analyzed by ANOVA,product-moment correlation and path analysis.Results 1 ) Overt narcissism had significant differences among different levels of income(F=6.501,P＜0.001 ); 2)overt narcissism was correlated positively with emotional warmth and understanding of mother and mother' s over-interference,over-protection ( r =0.121,0.126,P ＜ 0.05 ) ; covert narcissism was correlated negatively with maternal consciousness and emotional warmth and understanding of mother,and positively with over-protection,refusal and deny,and severe punishment; 3 )narcissism of mothers not only would influence their rearing patterns through maternal consciousness indirectly( β=0.319,P=0.000),but would influence that directly ( covert narcissism:β =0.281,P =0.000 ; overt narcissism:β =- 0.278,P =0.000) ; and overt narcissism had positive effect,while covert narcissism had negative effect.ConclusionNarcissism of mothers of middle school students influences maternal consciousness and rearing patterns,and effect of overt narcissism is positive,and that of covert narcissism is negative.So it is important to perfect mother's character for ameliorating their rearing pattern.

To comparatively investigate ultrastructural characteristics and expressions of AFP (alpha-fetoprotein) and Tn (Thomsen-Friedenreich-related antigen) protein in AFP negative (AFP-) and AFP positive (AFP+) primary hepatocellular carcinoma. Fourty-three cases of AFP- and AFP+ hepatocellular carcinoma (HCC) tissues and five cases of normal liver tissues were divided into three groups: control group (normal liver tissue, n=5); AFP+ HCC group (the serum AFP level was higher than 10 ng/ml, n = 22); AFP- HCC group (the serum AFP level was lower than 10 ng/ml, n=21). The ultrastructural morphology was studied by transmission electron microscopy, the expressions of AFP and Tn protein were detected by immunohistochemistry and cell image analysis. 1. The immunohistochemical study showed that (1) the expression intensity and positive rate of Tn protein in AFP- HCC group were markedly higher than that in AFP+ HCC group (P<0.01); (2) The expression intensity of AFP in AFP- HCC group was lower than that in AFP+ HCC group (P<0.01). 2. The transmission electron microscopy demonstrated that some AFP- HCC cells linked closely with each other, others dispersed loosely just as cultured cells, the remarkable morphologic features in AFP- HCC cells were simple organelles, but they were abundant in the free polyribosomes. In AFP+ HCC group, all the HCC cells linked closely together and were rich organelles in their cytoplasm, especially the rough endoplasmic reticula. In addition, mitochondria and Golgi complex were obviously observed. (1) The AFP and Tn protein had discrepancy distribution in AFP- and AFP+ HCC tissues, Tn protein may be one of the early diagnostic indicators in AFP- HCC; (2) The synthetic locations of the AFP and Tn protein were different in hepatocarcinoma cells by ultrastructural observation.

Objective To investigate the influence factors of chronic hepatitis B virus(HBV) infection complicated with chronic liver failure.Methods One hundred and eighty-six chronic HBV infection patients with chronic liver failure were selected as our subjects,who were hospitalized in the Affiliated Hospital of Hebei United University from Jul.2008 to Dec.2013 and they served as case group.Meanwhile,186 patients with chronic HBV infection were selected and served as control group,who were hospitalized during the same period.A self-mad questionnaire was used to collect the information.The influence factors related to HBV infection complicated with acute on chronic liver failure were recorded.Results Multivariate conditional Logistic regression analysis showed that 8 variables were risk factors in terms of chronic HBV infection complicated with acute on chronic liver failure and they were virus overlap infection (OR =6.523,95％ CI:2.034 -10.030),drug application (OR =9.012,95％ CI:3.018-13.241),alcohol (OR =7.2520,95％ CI:1.985 -11.247),bacterial infection(OR =4.378,95％ CI:2.032-5.648),surgical operation (OR =8.514,95％ CI:2.114-17.253),emotional stress and fatigue (OR =2.217,95％ CI:1.729-5.648),genetic (OR =11.124,95％ CI:2.168-13.429),high PCR-HBVDNA quantity (OR =1.628,95％ CI:1.504-3.282).And one protective factorwas the usage of antiviral drug(OR=0.163,95％CI:0.085-0.417).Conclusion The risk factors include virus over infection,application of hepatotoxic drugs,disease before drinking,bacterial infection,surgical operation,emotional stress and fatigue,the genetic parents and high PCR-HBVDNA quantification;and antiviral drugs application is the protective factor in terms of Chronic HBV infection complicated with acute-on-chronic liver failure.

Objective To investigate the association of red cell distribution width (RDW) with outcome in patients with septic shock.Methods A retrospectively study was performed on a total of 156 cases with septic shock who hospitalized in the Affiliated Hospital of North China University of Science and Technology from January 2012 to December 2014.All cases were divided into two groups according to the outcome:survivor group and non-survivor group.The data of general information,combined disease,RDW,acute physiology and chronic health score(APACHE Ⅱ) were collected and compared between the two groups.All cases were divided into three subgroup in regard of RDW,group A was ≤ 14.0％,group B was 14.1％-15.9％,group C was ＞16.0％.Multiple Logistic regression analysis was performed to analyze the related factor of mortality.ROC analysis was used to test the predictive effect of RDW for the outcome of septic shock.Results Sixty-nine cases died in 156,with a mortality rate of 44.2％(69/156).The RDW in non-survivor group was significantly higher than that of survivor group((15.79±2.64) ％ vs.(12.69±3.09) ％,P＜0.001).Mortality rate in each sub-group were 21.5％ (14/65) in group A,49.0％ (25/51) in group B,75.0％ (30/40) in group C,respectively,and the difference among the three groups was statistically significant (x2 =29.396,P ＜ 0.001).Logistic regression analysis showed RDW was independently associated with mortality of septic shock.In reference with group A,the risk of mortality was 3.504 (95％ CI:1.563-7.858,P =0.002) in group B and 10.924 (95％ CI:4.314 -27.661,P＜0.001) in group C.Conclusion Red cell distribution width is a risk factor of mortality in patients with septic shock.

Objective:To determine the effects of FL,rIL 6,rIL 6R in vitro expansion and differentiation of human cord blood CD34 + cells.Methods:Human cord blood CD34 + cells were enriched by magnetic cell isolation system CD34 + cells were incubated in the presence of FL,rIL 6,rIL 6R and their various companision.The total number of cells and colonies were counted at various time intervals.Results:The expanded cells by FL,rIL 6,rIL 6R showed colonies were CFU GM mainly but rIL 6+rIL 6R and FL+rIL 6+rIL 6R,showed some BFU E and CFU Mix but no CFU MK.Erythrocyte cells were conformed and total cells were increased 6.4 folds by FL+rIL 6+rIL 6R.Conclusion:Human cord blood CD34 + cells could expanded and differentiated by FL+rIL 6+rIL 6R.

Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.

Objective To establish case database of critical illness and explore the effect of critical case-based learning in the anesthesia teaching program as well as its influence on clinical thinking ability of students. Methods Case database of critical illness was built with foxtable software and ASAⅢ~Ⅴpatients undergoing anesthesia were included in the case database. Patients' information were recorded according to the sequence of pre-operative evaluation,intra-operative management and post-operative recovery. We designed a student questionnaire to investigate the effect of critical case-based learning. And we also compared the effect of critical case-based learning and traditional teaching on undergraduate interns, residents, and graduate students by scores of case analysis test. Data analysis used t test. Results The critical cases database is characterized by authenticity, hierarchy and for-wardness. Survey result of questionnaire shows that the proportions of students who believe critical case-based learning helps to strengthen the links of theory and clinical practice, to improve expression skills, and to promote active classroom atmosphere, solidarity and cooperation are 80%, 71.6% and 68.3%respectively. Compared with those who received traditional teaching, the residents and graduate students who received critical case-based learning get significantly higher scores in case analysis test. However, the difference of scores between undergraduate interns receiving traditional teaching or criti-cal case-based learning has no significance. Conclusion The establishment of critical cases database and its application in anesthesia teaching program have effectively improved clinical thinking ability of anesthesia residents and graduate students.

Objective To investigate the pathogenic constitution of thyroid nodular diasease and it' s di-agnosis and treatment.Methods A retrospective analysis was performed on data of 576 patients accepted hospi-tal therapy with thyroid nodular diasease from January 2004 to June 2008.Results Definite diagnosis of all easeswere made by surgery biopsy or fine needle aspiration-cytology.529 eases were benign lesions, another 47 eases were malignant lesions.Condusions Ultra-sound , FNAC and frozen sections have important value in differenti-al diagnosis for the thyroid nodules, nodular goiter is most common, and which have a close relationship with thy-roid carcinoma.Regular surgical resection would reduce the recurrence of thyroid nodular diasease and avoid missed diagnosis for thyroid carcinoma.