OBJECTIVE: To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy. METHOD: Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep. If not, double the injection dose of the two group. Observe and record the patient vital signs, EEG and sleep time, and handle the complications. RESULT: The study was successfully completed both in group A and B. Mean arterial pressure (MAP) in group B was lower than group A during the examination significantly (P < 0.05). The time falling to sleep in two groups were (13.4 +/- 2.5) min and (6.6 +/- 1.2) min, and the time in group A was much longer than that in group B. The lowest oxygen saturation during the examination in two groups were 0.835 +/- 0.096 and 0.691 +/- 0.095, and the difference was statistically significant. There was no incidence of adverse reactions in two groups. CONCLUSION Compared with propofol, Dexmedetomidine is a safer sleep-inducing drug, and it can be used for clinical sleep endoscopy.
Adult ; Dexmedetomidine ; therapeutic use ; Endoscopy ; Feasibility Studies ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Propofol ; therapeutic use ; Sleep

Objective To prepare an occupation well-being scale for nurses, and test its reliability and validity. Methods After literature review and semi-structured interviews, the item pool of the occupation well-being scale for nurses was created based on theory of structure of the subjective well-being. After group discussion, and evaluation by the specialists, a pilot scale was obtained. A total of 350 clinical nurses were selected by using stratified sampling method, and their occupation well-being were surveyed by the scale. The data were used to assess the reliability and validity of the scale. Results The occupation well-being scale for nurses had 3 dimensions, including 8 exploring factors. The values of Cronbach Alpha and the split half reliability coefficient of the total scale, endogenous exogenous satisfaction, satisfaction of nurses occupation happiness were all larger than 0.9, which meaned the internal consistency was good. In the emotion dimension, the value of Cronbach Alpha and the split half reliability coefficient were less than 0.7, which meant the internal consistency was not so good. The reliability coefficient of repeated measurement of the whole scale and each dimension were greater than 0.7, suggesting the external consistency of the scale was good. The content validity index of 3 dimensions were all larger than 0.9,and the cumulative ex-planatory variables were all larger than 55%. Conclusion The occupation well-being scale for nurses proposed in this study has good reliability and validity, and can be used to evaluate the occupation well-being of the nurses.

Objective To evaluate the radical effect and prognosis of laparoscopic resection for colorectal cancer in China.Methods Articles of non.randomized comparative studies(NRCs)of laparoscopic resection and open Burgery for colorectal cancer which were published before October 2007 were retrieved,and correlated indexeswere extraeted for meta.analysis.Results The mean quality score of the 14 articles selected was 18.92±1.27.The basic characteristics of patients in laparoscopic resection group were similar to those in open surgery group.Compared with open surgery group,the incised length of the intestine in the laparoscopic resection group was shorter by 0.66 cm.and the distance between distal margin of resection and tumor was farther by 0.26 cm.The 2-year survival rate of patients in laparoscopic group Was 1.67 times higher than that of open surgery group.There was no significant difference upon follow-up rate,tumor diameter,number of resected lymph nodes,local recurrence rate and distal metastasis rate between the 2 groups.Conclusions The results of meta-analysis show that laparoscopic resection has the sanle radical effect as open surgery for colorectal cancer.but the 2-year survival rate of patients treated by laparoscopic resection is comparatively higher.

Objective To evaluate the strategies and effect of surgical treatment for concomitant abdominal aortic aneurysm (AAA) and colorectal cancer (CRC). Methods Literatures on concomitant AAA and CRC published from January 1988 to December 2008 were retrieved from Pubmed, Sciencedirect, Ovid, CBMdisc, CNKI and et al, and correlated indexes were extracted for analysis. Differences among the groups were analyzed using the t test, chi-square test and fisher's exact test. Results A total of 367 cases of concomitant AAA and CRC treated by operation were retrieved. The length of operation delay of patients who received radical resection of CRC first was (115 ± 21 )days, which was significantly longer than (42 ± 8 )days of patients who received open abdominal aortic aneurysm repair (OAAR) first (t = 18. 9, P <0.05). The 30-day complication rate and accumulative length of hospital stay of patients who received one-stage radical resection of CRC + OAAR were 10.5% ( 12/114 )and (23 ±6) days, and 26.0% (47/181) and ( 16 ±4)days of patients who received two-stage radical resection of CRC + OAAR, with a significant difference ( χ2 = 10.42, t = 12. 01, P <0.05 ). The accumulative length of hospital stay of patients who received radical resection of CRC + endovascular aneurysm repair (EVAR) was (12 ±4) days, which was significantly shorter than that of patients who received radical resection of CRC + OAAR [ ( 19 ±5 ) days ] ( t = 9.48, P < 0. 05 ). The 4-year survival rate of patients who received two-stage radical resection of CRC + OAAR was 43.5% (27/62), which was significantly lower than that of patients who received two-stage radical resection of CRC + EVAR [69.2% (18/26) ] or one-stage radical resection of CRC + OAAR [73.7%(14/19) ] (χ2 =4.83, 5.28, P<0.05). Conclusions If the diameter of AAA is under 5 cm, radical resection of CRC should be firstly carried out; but if the diameter of AAA is above 5 cm, OAAR should be firstly carried out to prevent the rapture of tumors. One-stage surgery is better than two-stage surgery if patients could tolerate it.

Objective To observe the effect of DPC4 gene transfection on the chemotherapy sensitivity of pancreatic carcinoma cells. Methods The human DPC4 complementary DNA was subcloned to the retroviral vector pLXSN to obtain recombinant pLXSN/DPC4 with direct inserting potential. The daughter cell BxPC-3/DPC4 which had DPC4 stable expression was acquired after the pancreatic carcinoma BxPC-3 cells had been transfected with pLXSN/DPC4. The sensitivity of the carcinoma cells for 5-Fu and gemcitabine was observed. Meanwhile, the mRNA level of Mdr-1 and Chk1was detected by semi-quantity PCR assay. Results The 50% inhibiting concentrations (IC50)of 5-Fuand gemcitabin4e for BxPC-3 (culturing for 72 h) were rather lower than those of BxPC-3/pLXSN and BxPC-3/-cells. Moreover, the semi-quantity PCR assay revealed that the mRNA level of Mdr-1 and Chk1 was down-regulated. These findings indicated that pLXSN/DPC4 vector, 5-Fu and gemcitabine could inhibit the growth of pancreatic cancer cells. The combined therapy with pLXSN/DPC4 vector and chemotherapeutic drugs could further inhibit the growth of cancer cells. Conclusion The DPC4 gene transfection could enhance the sensitivity of pancreatic cells to chemotherapy, which may be realized through the down-regulation of Mdr-1 and Chk1 gene expression.

Objective To investigate the diagnosis and treatment of splenic space occupying lesions associated with comorbidity.Methods The clinical data of 5 patients from Jiangyin People' s Hospital and 9 patients from Wuxi People's Hospital from January 2002 to June 2012 were retrospectively analyzed.All the patients suffered from splenic space occupying lesions associated with comorbidity.Splenectomy or multi-visceral resection were selected according to the results of preoperative B sonography and computed tomography examination.Chemotherapy regimes were selected based on postoperative pathological examination.All the patients were followed up till June 2013.Results The symptoms of patients with splenic space occupying lesions were non-specific.The first symptoms of 4 patients were discomfort or distending pain of left upper abdomen,and the other 10patients had no symptoms.The coincidence rate of preoperative diagnosis was 10/14,and the coincidence rate of preoperative diagnosis for patients with malignant tumors was 2/5.Fourteen patients received preoperative B ultra-sonography,and 9 were definitively diagnosed.Nine patients received computed tomography,and 7 were definitively diagnosed.Of the 14 patients,right ovarian cancer,bilateral ovarian cancer and sigmoid colon cancer were correlated with solitary splenic metastasis,and the main lesions of the other 11 patients were not correlated with splenic space occupying lesions.The main lesions of patients with left colon carcinoma,type 2 diabetes and vascular tumor of the spleen,patients with renal carcinoma and splenic sclerosing hemangioma,and patients with hypertension,cholecystolithiasis and splenic lymphangioma were diagnosed simultaneously with the splenic space occupying lesions,and the main lesions of theother 11 patients were diagnosed separately with the splenic space occupying lesions.Ten patients underwent simple splenectomy and 4 patients received multi-visceral resection.Chemotherapy regimens were selected according to the type of main lesions for 5 patients who were diagnosed by pathological examinations.All the patients were recovered smoothly with no occurrence of severe infections.Two patients with splenic sarcoma had tumor metastasis at postoperative 6 months and 1 year,respectively.One patient with right ovarian cancer and solitary splenic metastasis had transverse colonic metastasis at postoperative 3 years.One patient with bilateral ovarian cancer and solitary splenic metastasis had peritoneal metastasis at postoperative 2 years.One patient with sigmoid colon cancer and solitary splenic metastasis died of peritoneal tumor recurrence at postoperative 4 years.One patient with left colon carcinoma,type 2diabetes and vascular tumor of the spleen survived for 6 years and was still sound and well.The other 9 patients with benign disease survived within the period of follow-up.Conclusions The definitive diagnosis for patients with splenic space occupying disease associated with comorbidity depends on the preoperative imaging examination and postoperative pathological examination.Surgical treatment is safe when operative contraindications are excluded.The prognosis of patients is determined by the progress of main lesions and the character of splenic space occupying lesions.

Objective To explore the multi-modal MRI characteristics of breast cancers in dense breasts.Methods 120 patients with breast cancer shown on mammography underwent breast MRI,which were solitary and confirmed by pathological examination. According to the BI-RADS classification of breast,the 120 cases were divided into two groups including dense type breast and non-dense type one.The differences in morphological features,ADC values (b=1 000 s/mm2 )and time-signal intensity curve (TIC)of the lesions between two groups were analyzed and compared.Statistical analysis was performed using SPSS1 6.0.Results The breast cancers in dense breast were vulnerable to have a spiculated margin (44/68 in the dense breast group vs.1 6/52 in the non-dense breast group,P =0.000).The size of the lesion in dense breast (1.83 ±0.98)cm was bigger than that in non-dense breast (1.40±0.46)cm (P =0.005).The non-mass-like enhancement of the lesion in dense breast was much more than that in non-dense breast (P =0.000).In addition,the average ADC values of the lesion in dense breast (0.89±0.12)×10 -3 mm2/s were lower than in non-dense breast (0.95±0.10)×10 -3 mm2/s(P =0.01 6).Conclusion The breast cancer in the dense breast has different MRI findings in comparison with non-dense breast.

Objective To investigate the effects of recombinant adeno-associated virus-mediated myostatin propeptide (MPRO) on uptake and oxidation of glucose,and glycogen synthesis in C2C12 myotubes,as well as the associated molecular mechanism.Methods Mature C2C12 myotubes were assigned to the following 6 groups:control,insulin,green fluorescent protein (GFP),insulin + GFP,MPRO,and insulin + MPRO groups.Glucose uptake,glucose oxidation,and glycogen synthesis were detected by counting radioactivity of 14CO2 or 14C labeled glycogen derived from 2-deoxy-[1-14 C] glucose.The activity of insulin signal pathway was evaluated by Western blot.Results Compared with control group,glucose uptake and glycogen synthesis were significantly increased in insulin and insulin+GFP groups,and further increased in insulin+MPRO group as compared with insulin alone(all P＜ O.05).However,MPRO and insulin had no effect on glucose oxidation.The phosphorylations of insulin receptor (IR) β,insulin receptor substrate 1 (IRS-1),protein kinase B (Akt),glycogen synthase kinase-3 β (GSK-3β),and the expressions of phosphatidylinositol 3-kinase (PI3K) and glucose transporter 4 (Glut4) in membrane were significantly increased in insulin and insulin+GFP groups compared with control group(all P＜0.05),and were further increased after MPRO transfection (all P ＜ 0.05).Conclusion MPRO may increase insulin-stimulated glucose uptake and glycogen synthesis in C2C12 cells by activating the IRS/PI3K/Akt signal pathway.

Objective To analyze the endemic situation of schistosomiasis after its interruption of transmission in Xiuzhou District,Jiaxing City,Zhejiang Province,so as to provide the references for future surveillance work. Methods The data of schistosomiasis and Oncomelania hupensis snails in Xiuzhou District were collected and analyzed statistically. Results From 1994 to 2015,totally 975 village?times were investigated for O. hupensis snails,and the accumulated area of 4 385.31 hm2 was surveyed. Twenty former snail sites were reoccurring,with an area of 32.61 hm2. An area of 57.71 hm2 was supplied with snail eradication measures. Totally 11 941 snails were dissected and no schistosome infected snails were found. The serum and stool tests were performed to 221 794 and 3 731 residents respectively,and no local infection cases but four imported cases were found. Conclusion The endemic situation of schistosomiasis in Xiuzhou District is stable after the transmission was interrupt?ed. However,there are imported schistosomiasis cases,and therefore,the prevention of imported infection source is the focus of surveillance work.

Objective To explore the effect of ciliary,neurotrophic factor (CNTF)-coated polyglycolic and polylactic acid (PGLA) nerve conduits treated by pulsed plasma to repair canine tibial nerve defects. Methods A 2.5 cm long tibial nerve defect was made in eighteen cross-bred dogs.The nerve defects were re- constructed by three different methods:group A:pulsed plasma treated and CNTF coated PGLA nerve conduits (n=6);group B:PGLA nerve conduits alone (n=6);group C:nerve autografts (n=6).HE staining, Massons' trichrome staining,S-100 immunostaining,electrophysiological test and axon counting were used to evaluate the results of nerve regeneration in three groups.In addition,the dynamic walking pattern was recor- ded individually.The observation period lasted for three months.Results All nerve conduits were well vas- cularized and mostly degraded as well as absorbed.It was found that the regenerating axons could traverse all nerve conduits.In regard to nerve conduction velocity and axon counting there was no significant difference be- tween group A and group C (P＞0.05),while the data of group A and group C were significantly better than those of group B(P＜0.05).The dogs in group A and C recovered nearly normal walk pattern while those in group B were still crippled.Conclusion Pulsed plasm-treated and then CNTF-coated PGLA nerve conduits could effectively repair 2.5-cm-long canine tibial nerve defects,and the effect is similar to that of autografts.