Objective To investigate the changes in BIS values induced by TCI of sufentanil at different target concentrations (Cr) during propofol anesthesia. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective surgery under general anesthesia were randomly divided into 5 groups (n = 10 each) based on CTof sufentanil: 0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml. BIS, ECG, HR, MAP, SpO2, PET CO2 were continuously monitored. Anesthesia was induced with propofol TCI. The initial target plasma concentration (Cp) was set at 3.0 μg/ml. If the patient remained conscious 5 rain after the equilibrium between Cp and target effect-site concentration (Ce) was achieved, the Cp of propofol was increasing in increments of 0.3 μg/ml until consciousness was lost (LOC). Propofoi TCI was maintained at this level and Cp and Ce were recorded. TCI of safentanil was then started at the different Cp set in the 5 groups. When the equilibrium between Cp and Ce of safentanil was achieved, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg and the patients were mechanically ventilated (VT= 8-10 mi/kg, RR = 8-12 bpm, PETCO2 = 30-35 mm Hg). BIS value, HR, MAP, SP and DP were recorded before induction of anesthesia at LOC (T0) and 1,2, 3, 4, 5 and 6 min after sufentanil TCI was started. Results There was no significant difference in Cp and Ce of propofol at LOC (T0) among the 5 groups. BIS value was decreasing after the beginning of TCI of sufentanil and was significantly lower than the BIS value at T0. The changes in BIS value was negatively correlated with the Cp and Ce of sufentanil. Conclusion TCI of sufentanil can decrease BIS value further during propofol anesthesia.

Objective To observe the curative effect of pulmicort aerosol combined with terbutaline aerosol in the treatment of infants with mycoplasma pneumonia (MP).Methods 240 children with MP were selected and according to the different treatment method,they were divided into the observation group and control group.120 cases in the observation group were treated with pulmicort combined with terbutaline inhalation therapy.120 cases in the control group received budesonide inhalation therapy.Immunological parameters of IgG,IgE and TNF-α level,the main clinical symptoms and clinical efficacy were compared between the two groups.Results Compared with before treatment,IgG significantly increased,IgE and TNF-α level significantly decreased after treatment in the two groups,the differences were statistically significant (t =19.965,10.780,3.468,6.002,5.440,4.885,all P ＜ 0.05).And those in the observation group were better than the control group (t =13.920,4.523,2.729,all P ＜ 0.05).The remis sion time of clinical symptoms such as body temperature,wheezing,cyanosis,cough and pulmonary rales in the observation group were significantly shorter than those of the control group (t =2.991,6.034,4.623,8.562,7.113,all P ＜ 0.05).The obvious effective rate of the observation group was 93.3％,which was higher than 79.2％ of the control group (x2 =8.140,P ＜ 0.05).There were no significant adverse reactions in two groups.Conclusion Budesonide combined with terbutaline atomization inhalation in the treatment of infants with mycoplasma pneumonia has short remission time of clinical symptoms,good efficacy and less adverse reactions,it is worthy of promotion.

This study was aimed to observe the effect of Sang-Ji (SJ) mixture in the treatment of Toll-like receptor 4 (TLR-4) expression on peripheral blood monocytes (PBMCs) in hypertensive patients. A total of 60 cases of hyper-tensive cases with overabundant liver-fire and phlegm syndrome were randomly divided into the treatment group and the control group with 30 cases in each group. Both groups received Felodipine and/or Benazapril treat-ment. The treatment group was added with SJ mixture. The observation duration was 28 days. The detection was made on indicators such as blood pressure , traditional Chinese medicine ( TCM ) syndrome scores and TLR-4 ex-pression on PBMCs before and after treatment. The results showed that after treatment, the blood pressure, TCM syndrome scores and TLR-4 expression on PBMCs of both groups decreased compared with that of the pretreat-ment . Changes on TCM syndrome scores and TLR-4 expression of the treatment group were more significant than that of the control group ( P < 0 . 05 ) . It was concluded that SJ mixture improved clinical symptoms in pa-tients with overabundant liver-fire and phlegm syndrome , decreased TLR-4 expression on PBMCs , in order to inhibit the immune response to a certain extent .

Objective To investigate the pharmacodynamics of sufentanil required to inhibit the body movement induced by tetanic stimulation and skin incision when combined with propofol in patients undergoing thoracic or abdominal surgery. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective thoracic or abdominal surgery were randomized into 5 groups sufentanil target effect-site concentration (Ce) (n = 10 each):0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml groups. Anesthesia was induced with TCI of propofol at the target plasma concentration of 3.0-3.2 μg/ml. As soon as the patients lost consciousness, infusion of sufentanil with the corresponding Ce was started in the each group. One tetanic stimulus (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) was given after the target effect-site and plasma concentrations were balanced. Tracheal intubation was facilitated with succinylcholine 1.5 mg/kg. The concentrations of propofol and sufentanil were maintained until 4 min after skin incision. The body movement was observed during tetanic stimulation and skin incision. The effective effect-site concentration (EC50, EC94) of sufentanil and 95% confidence interval (CI) were calculated using probit regression analysis. Results The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation when combined with propofol were 0.12 (95% CI 0.09-0.14) ng/ml and 0.20 (95% CI 0.17-0.31) ng/ml respectively. The EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 (95% CI 0.11-0.16) ng/ml and 0.21 (95% CI 0.17-0.29) ng/ml respectively. There was no significant difference in the EC50 and EC95 of sufentanil between the two different stimuli (P ＞ 0.05). Conclusion The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) when combined with propofol were 0.12 and 0.20 ng/ml respectively, the EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 and 0.21 ng/ml respectively and there was no significant difference in the pharmacodynamics between the two different stimuli, indicating that tetanic stimulation as an alternative to skin incision can be used to evaluate the pharmacodynamics of anesthetics.

OBJECTIVE: To establish the reference panel of methamphetamine (MET) Kits. METHODS: After determining the cut-off value of MET kits, selecting the raw material, and determining the component of reference material, MET kits reference material was prepared. The reference material was characterized by verified LC-MS method, and also tested for the stability. RESULTS: The national reference material of MET kits consists of one positive sample, 12 negative samples, three LOD samples, and one repeatability sample. This reference material passed the co-characterization of five companies. CONCLUSION: The developed national reference material of MET kits meets the corresponding requirement. The establishment of the national reference material of MET kits may help regulate the development and production process of the drug kits.

Objective To compare the EC50 ～ EC95 for propofol and remifentanil targetcontrolled infusion(TCI)at loss of consciousness (LOC) and without response to a standard Hoxious painful stimulus in elderly and young adult patients.Methods A total of 102 (American society of anesthesiologists) ASA Ⅰ-Ⅱ patients undergoing elective surgery under general anesthesia were enrolled in this study and divided into control group (aged 18-64 years,n=52) and elderly group (aged≥65 yrs,n=52).Propofol TCI was started at target plasma concentration (Cp) of 1.2 mg/L and the Cp increased by 0.3 mg/L every 30s until loss of consciousness (LOC),kept the target effectsite concentration (Ce) of propofol at LOC.Remifentani TCI was started at Cp of 2.0 μg/L,increased by 0.3 μg/Levery 30s until loss of somatic response to a tetanic stimulus (50Hz,80mA,0.25ms,4s) Cp,Ce,systolic blood pressure (SBP),diastolic blood pressure (DBP),mean artery pressure (MAP) and heart rate(HR) were recorded.The Ce of propofol at LOC,the Ce of remifentanil at loss of somatic response to noxious stimulus in 50％-95％ of the patients (EC50-EC95),and 95％ confidence interval were determined by probit method.The adjustment required for TCI propofol with remifentanil in elderly patients was explored.Results In elderly group,the propofol Ce at LOC was (2.0±0.3) mg/L,significantly lower than that in control group (2.9±0.2) mg/L (t=6.168,P＜0.01) and EC50-EC95 of remifentanil at loss of somatic response to noxious stimulus in elderly group (3.5-5.4) μg/L was similar to that in control group (3.7-5.9) μg/L.Conclusions For TCI propofol and remifentanil in elderly patients,the requirement of Ce of propofol is significantly decreased and Ce of remifentanil required in elderly patients is similar to adult patients.

Objective:To investigate the possibility of miR-125b in serum as a novel tumor marker for primary hepatocellular car-cinoma (HCC) and the diagnosis value of combined detection of miR-125b and alpha-fetoprotein (AFP) for HCC. Methods:We detected serum miR-125b expression of 65 cases of HCC patients and 30 cases of healthy controls by real-time quantitative PCR. Moreover, we analyzed the significance of miR-125b and explored the relationship between miR-125b and clinical pathological factors. Results:The level of miRNA-125b was down regulated in serum of HCC patients compared with healthy controls which showed significant differences (P<0.05). Furthermore, the expression of miRNA-125b has no distinct correlation with sex, age, HbsAg, AFP, ALT andα-GGT, which had no significant differences (P>0.05). The expression level of miRNA-125b correlated the difference with liver Cirrhosis, tumor size and tumor node metastasis (TNM) stages, which were considered significant differences (P<0.05). The receiver operating characteristic (ROC) curve analysis of serum miR-125b for the diagnosis of HCC yielded AUC of 0.917(95%CI:0.851~0.960, P<0.001)with 85.9%sensitivity and 93.5%specificity. The ROC curve analysis of combined miR-125b and AFP for HCC detection yielded AUC of 0.951(95%CI:0.894~0.982, P<0.001)with 92.9%sensitivity and 93.5%specificity. The ROC curve analysis of serum miR-125b as biomarkers for the group (AFP<20μg/L) of HCC yielded AUC of 0.889(95%CI:0.776~0.957, P<0.001)with 84.0%sensitivity and 87.1%specificity. Conclusion:Serum miRNA-125b combined with AFP has considerable clinical value for the early diagnosis of primary HCC.

Objective To study whether suprachiasmatic nucleus (SCN) slices are able to induce the molecular oscillations in NIH/3T3 fibroblast. Methods SCN slices from 10-day-old SD rat and NIH/3T3 cells were co-cultured in a serum-free condition. 24h mRNA profiles of Per1 and Rev-Erbα were measured in NIH/3T3 cells using real-time PCR. Results After co-cultured for 6 days, ten SCN slices can induce the significant daily oscillation of Per1 and Rev-Erba mRNA expression in NIH/3T3 cells (P<0.01). The peak time Rev-erbα and Per1 were at CT5 and CT11 respectively. Rev-Erbα oscillations were significant even with two SCN slices and 2 days co-culture (P<0.05). In contrast, Per1 expression fluctuation was not observed until more than 6 days of co-culture and with six SCN slices (P=0.031). Conclusion Diffusible signals release from SCN slices can regulate molecular rhythms in cultured fibroblasts. Rev-Erbα and Per1 don't start to oscillate at the same time, and Rev-Erbα is more sensitive to SCN signal.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Ⅰ-gel for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients,aged 26-64 yr,weighing 54-90 kg,of ASA physical status Ⅰ-Ⅲ (Mallampati Ⅰ-Ⅲ),scheduled for elective laparoscopic surgery,were randomly divided into Ⅰ,Ⅱ and Ⅲ groups (n =20 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA I-gel.In group Ⅱ,the nasogastric tube was inserted through the nostril before surgery.In group Ⅲ,the nasogastric tube was inserted through the nostril before surgery,and another nasogastric tube was inserted through the drain tube of LMA I-gel after induction of anesthesia.The hemodynamic parameters,SpO2,PET CO2 and peak airway pressure were monitored during surgery.The fiberoptic laryngoscopy scores were assessed and the development of nasogastric tube displacement was recorded after successful LMA placement.The LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,and occurrence of air leakage of LMA and nasogastric tube drainage were recoded.The bloodstains and gastroesophageal reflux were observed after removal of LMA Ⅰ-gel.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA by using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after surgery.Results The hemodynamics was stable and SpO2,peak airway pressure and PETCO2 were all within the normal range during surgery,and Ppeak was lower than airway sealing pressure in the three groups.There were no significant differences between the three groups in LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,incidence of air leakage of LMA,fiberoptic laryngoscopy scores,time for removal of LMA I-gel,incidences of adverse reactions in the oropharynx,bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA.There was no nasogastric tube displacement in Ⅱ and Ⅲ groups.There were 7 patients developing gastric juice outflow from drainage tube of the LMA I-gel and 2 patients developing gastric juice outflow from the nostril gastrictubes in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA I-gel is easy,and I-gel LMA can assure good airway sealing and adequate ventilation.