Objective To observe the patients hemodynamic reactions to the different stimula-tions under different blood concentrations of propofol with remifentanil.Exerting the response surface methodology,the half of the maximum effective concentration of propofol and the interaction index of propofol with remifentanil were calculated.Methods A total of 120 patients for scheduled abdominal surgery,randomly divided into 12 groups(n = 10).TCI 12 different concentration combinations of propofol with remifentanil,also the the hemodynamic reactions to harmful stimulations of intubation and incising were observed.The data were analyzed by responding surface analysis.Results The in-teraction index of propofol and remifentanil under intubation was 0.523 0±0.223 7,that under inci-sing 0.361 3±0.148 4,half of the maximum effective concentration of propofol for intutation and in-cising was (6.878 7 ± 1.832 1 ) μg/ml and (4.41 1 6 ± 0.902 5 ) μg/ml respectively. Conclusion Propofol and remifentanil have a synergistic inhibitory effect on harmful cardiovascular reaction among Chinese.During the endotracheal intubation,the requirements of half of the maximum effective concentration of propofol and intensity of the synergy with remifentanil are greater than those during the incising.

Through the comparative analysis of undergraduate specialty settings of medical colleges and universities in minority areas in the different periods,this paper reveals the characteristics of undergraduate specialty settings.It is necessary to follow the demand for social and economic development,and adhere to the medical and national characteristics,promoting the durable development of undergraduate specialty settings of medical colleges and universities in minority areas.

Objective To investigate the relationship between serum 25-hydroxycholecalciferol [25(OH)D3] deficiency and the risk of peritoneal dialysis associated peritonitis.Methods Baseline clinical data (before the peritoneal dialysis catheter insertion) of peritoneal dialysis patients treated with CAPD in the First Affiliated Hospital of Guangxi Medical University from May 1,2013 to February 1,2016 were retrospective analyzed.All the patients were followed-up until July 31,2016.According to the baseline serum 25(OH)D3 levels,patients were divided into deficiency group (25(OH)D3 ＜ 15 ng/ml) and non deficiency group (25(OH)D3 ≥ 15 ng/ml),the baseline clinical data of the two groups were also analyzed.Kaplan-Meier method was used to compare the time-to-peritonitis of two groups.Cox proportional hazard model was used to analyze the relationship between the 25(OH)D3 deficiency and the risk of peritonitis.ROC curve was used to analyze the predictive value of the baseline serum 25(OH)D3 for the risk of PDAP in peritoneal dialysis patients.Results Compared with the 25(OH)D3 non deficiency group,25(OH)D3 deficiency group had a significant increase incidence of peritonitis,high diastolic blood pressure and mean arterial pressure,but serum albumin,total serum protein decreased significantly (P ＜ 0.05).Kaplan-Meier survival analysis showed that,compared with 25(OH)D3 non deficiency group,the time-to-peritonitis episode of patients with 25(OH)D3 deficiency were shorter (P ＜ 0.05).Cox proportional hazard model showed that after adjusting for age,sex,hemoglobin,serum albumin,C-reactive protein,total Kt/V,eGFR,diabetes or not,25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis (HR 5.247,95％CI 1.180-23.340,P ＜ 0.05).ROC curve showed the area under the curve that baseline serum 25(OH)D3 deficiency predict the occurrence of PDAP was 0.714,and the best cut-off point of baseline serum 25(OH)D3 was 11.35 ng/ml (sensitivity 75％,specificity 63％).Conclusions Peritoneal dialysis associated peritonitis occurred earlier in peritoneal dialysis patients whose baseline serum 25(OH)D3 deficiency.Baseline serum 25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis,which may predict the incidence of peritoneal dialysis associated peritonitis.

To play the best role of medical ethics education to people,medical ethics teaching forms and methods should be reformed with the specific conditions,the establishment of new student performance assessment appraisal mechanism should be mobilized,the enthusiasm and initiative of students studying medical ethics should be mobilized,and the effectiveness of teaching should be continually enhanced.

Objective To study the clinical effect and application value of micro-plasma beam joint radiofrequency treatment for the striae of pregnancy.Methods 21 female patients with the striae of pregnancy were included in this study,treated from the July 2012 to March 2014,aged 25-37 years;and time of the striae was from 3 months to 7 years.Micro-plasma radiofrequency technology was used to treat the striae,with interval of 30 days each time for total seven months.The total effective rate,satisfaction,and the adverse reaction were evaluated after the treatment.Results 21 patients included grade 4 in 6 cases,grade 6 in 10 cases,grade 2 in 4 cases and grade 1 in 1 case;the total effective rate was 95.2％ (20/21).Satisfactory degree was for the level C in 6 cases,B in 14 cases,and A in 1 case,with total satisfactory rate of 95.2％ (20/21).Adverse reactions included mild pigmentation in 2 patients after scab skin falling off,and disappeared at the end of the treatment course.Conclusions Micro-plasma beam combined with radio frequency in treating the striae of pregnancy has clear curative effect and good clinical application value.

OBJECTIVETo study the relationship between gene p53 codon 72 polymorphism and pathological scar formation occurrence after caesarean section.

METHODSThe method of molecular beacon with real-time PCR was applied to detect gene polymorphism of p53 codon 72 in blood samples taken from 303 pregnant women (within a week after caesarea section). The clinical visits were taken 3 times for 12th to 18th months to ascertain clinical formation of pathological scar and its relationship to genotype of p53. The chi-square method was used to analyze the relationship of p53 gene polymorphism and abnormal scar formation occurrence by statistical software SPSS 13.0.

RESULTSTotal of 303 pregnant women were assayed. 30 patients were found with pathological scar by clinical visit in the total 303 pregnant women. The genotype frequencies of total three types (C/C, C/G and G/G) of p53 gene codon 72 in patients with pathological scar are significantly different from that of normal pregnant woman. The frequency of C/C genotype in patients are higher than that of normal pregnant women (P < 0.01). The frequency of C/C genotype in these patients with pathological scar is higher (46.7%, 14/30) than C/G (33.0%, 10/30, P < 0.01) or G/G (20%, 6/30) genotype (P < 0.01). The C allele frequency in the patients is 63.7%. It is also higher than G allele (36.7%, P < 0.01). The OR value is 2.30. Therefore the C allele of p53 gene codon 72 is a risk factor for pathological scar.

CONCLUSIONSThere was a certain relationship between p53 gene codon 72 C allele and pathological scar formation after caesarean section.

Alleles ; Cesarean Section ; Cicatrix ; genetics ; Codon ; Female ; Gene Frequency ; Genes, p53 ; Genotype ; Humans ; Polymorphism, Genetic ; Pregnancy ; Risk Factors

OBJECTIVETo establish a method based on molecular beacon real-time PCR for detecting single nucleotide polymorphisms (SNP) in codon 72 of scar-related p53 gene.

METHODSTwo fluorescence-labeled molecular beacon probes were synthesized targeting CCC/CGC SNP of p53 codon 72. The genomic DNA was extracted from the peripheral blood of 28 patients with keloid, and the CCC/CGC SNP of P53 gene codon 72 were assayed with molecular beacon real-time PCR. The results of SNP typing were compared with the results of reverse dot hybridization and confirmed by direct DNA sequencing.

RESULTSThe goodness of fit of this method was 100% in comparison with direct DNA sequencing, higher than that of reverse dot hybridization.

CONCLUSIONMolecular beacon real-time PCR is suitable for rapid clinical detection of SNPs in p53 gene.

Base Sequence ; Codon ; genetics ; Humans ; Keloid ; genetics ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Real-Time Polymerase Chain Reaction ; methods ; Tumor Suppressor Protein p53 ; genetics

OBJECTIVETo investigate the changes of neutrophils in airway inflammation in children with severe asthma.

METHODChildren with mild to moderate asthma (n=23), severe asthma (n=16) and healthy control subjects (n=16) underwent lung function tests and sputum induction. The sputum specimens were assayed for cellular differential count, the supernatant and peripheral blood were assayed for the concentrations of IL-8 by "sandwich" enzyme linked immunosorbent assay (ELISA). Sputum supernatant, IL-8 and mifepristone were assessed for their abilities to prolong the in vitro survival of blood-derived neutrophils.

RESULTThe percentage of sputum neutrophils was significantly higher in severe asthmatics [59.54 (41.99-74.65)%] than mild-moderate asthmatics [30.03 (15.94-47.71)%] and healthy control subjects [29.72(16.53-45.74)%] (P < 0. 01); the level of IL-8 in sputum was significantly higher in severe asthmatics [2907.78 (331.67 - 3457.93) ng/L] than mild-moderate asthmatics [287.58 (130.75-656.84) ng/L] and healthy control subjects [179.2 (58.55-346.59) ng/L] (P < 0.01); the percentages of neutrophilic apoptosis respectively cultured with LPS [(10.57 +/- 1.97)%], severe asthmatics supernatant [(11.82 +/- 2.96)%], IL-8 [(10.47 +/- 1.93)%], dexamethasone [(9.93 +/- 1.95)%], severe asthma supernatant + mifepristone [(12.15 +/- 2.86)%] in vitro were lower than that cultured with PBS [(17.98 +/- 2.27)%], healthy control supernatant [(17.37 +/- 2.50)%], mild-moderate asthmatics supernatant [(16.35 +/- 3.26)%], mifepristone [(17.89 +/- 2.38)%], and dexamethasone + mifepristone [(17.06 +/- 2.59)%] (P < 0.01).

CONCLUSIONSuppression of neutrophilic apoptosis seems to play a potential role in airway neutrophilic inflammation in severe asthmatics, and the level of IL-8 in sputum was significantly higher in patients with severe asthmatics.

Adolescent ; Apoptosis ; Asthma ; metabolism ; pathology ; physiopathology ; Case-Control Studies ; Child ; Female ; Humans ; Inflammation ; Interleukin-8 ; metabolism ; Leukocyte Count ; Male ; Neutrophils ; cytology ; Respiratory System ; metabolism ; pathology ; Sputum ; metabolism

BACKGROUNDPlatinum-based chemotherapy has been proved effective in patients with advanced non-small cell lung cancer (NSCLC). This study evaluated the effectiveness and safety of first-line chemotherapy with gemcitabine plus cisplatin (GEM-Cis) 3-week regimen in routine care of Chinese patients with advanced NSCLC.

METHODSTwo hundred and twenty-one patients with NSCLC stage IIIb or IV were enrolled and 209 were eligible for effectiveness and safety analysis. The median age was 58 (range 29 to 79) years. The percents of cases in stage IV and stage IIIb were 52.2% and 47.8%; of Karnofsky performance score (KPS) less than 80 and 80 - 100 were 37.3% and 62.7% and of adeno-cancer and non-adeno-cancer were 59.8% and 40.2%. The average number of completed chemotherapy cycles was three. Measures of effectiveness included clinical benefit, significant clinical response (SCR) and adverse effects of GEM-Cis in the treatment of NSCLC at stages IIIb/IV.

RESULTSKPS increased from 79 +/- 9 at baseline to 86 +/- 10 after chemotherapy (P < 0.01). Lung cancer symptom scale (LCSS) score of pain, dyspnea and cough increased from 77 +/- 24, 74 +/- 22 and 63 +/- 19 to 92 +/- 15, 90 +/- 14 and 86 +/- 15, respectively (P < 0.01). The clinical benefit rate was 85.2% [95% confidence interval (CI) 80.3% - 90.0%]. The SCR was 89.5% (95% CI 85.3% - 93.7%). Median survival time was 7.8 months (95% CI 7.1 months-9.1 months). Sixty-four patients (30.6%) experienced an adverse effect that was deemed clinically significant. Only one patient (0.5%) was hospitalized due to chemotherapy related adverse effects. Life-threatening toxicity was observed in two patients (1.0%).

CONCLUSIONFirst-line chemotherapy with GEM-Cis in the routine care of Chinese patients with advanced NSCLC is effective and safe.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; pathology ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prospective Studies