Objective To compare the feasibility and efficacy between dexmedetomidine and midazolam in herniorrhaphy surgery for older patients. Methods Sixty American Society of Anesthesiology (ASA) gradeⅠ~Ⅱpatients, treated by herniorrhaphy surgery under local anesthesia,were randomly divided into dexmedetomidine group (n=30) and midazolam group (n=30) .Patients in dexmedetomidine group were given dexmedetomidine at a loading dose of 1μg/kg for 10 min,then they were injected continuously by 0.4μg/(kg·h),whereas midazolam group were given midazolam at a loading dose of 0.06 mg/kg, then 0.04 mg/(kg·h) injected continuously.The mean blood pressure (MAP) and heart rate (HR) were recorded before infusion (T0),incision of skin (T1),15min (T2) and 30 min (T3) after administration and when sutured skin (T4), adverse reaction were also assessed. Results The difference of sedation level was not significant between the two groups (P>0.05) .Compared with T0 , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with midazolam group , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with dexmedetomidine group, the rate of respiratory depression and restlessness were more in midazolam group, but bradycardia was lower (P<0.05) .Conclusions Dexmedetomidine is a comparable alternative to midazolam for sedation in herniorrhaphy surgery under local anesthesia. It is associated with better respiration and lower restlessness but with a high incidence of bradycardia.

AIM: To investigate the relations between the proliferation and phenotype change of adventitial cells and the expression of T GF-?1 in adventitia after arterial injury. METHODS: After abdominal artery injury in rabbits, adventitial cel l proliferation and phenotype were identified by immunohistochemistry, transmissi on electron microscope and in situ Hybridization. RESULTS: Three days and 7 days after injury, the PCNA-positive ce lls were significantly increased. The previously weakly actin-positive adventiti al cells became strong-actin staining, the typical myofibroblast featurses of ad ventitial cells were detected by TEM 7 and 14 days after injury. Three days afte r vascular injury, there was a marked increase in the nu mber of cells that demonstrated the presence of TGF-?1 transcripts within the adventitia. Seven days after arterial injury, adventitial cells continued to ex press TGF-?1. on day 28, the number of TGF-?1-expressing cells was markedly r e duced in the adventitia. CONCLUSION: This study demonstrates that the proliferation and p henotype modulation of adventitial cells are associated with induction of TGF- ?1 expression in adventitia after arterial injury.

AIM: To observe the effect of AngⅡ on the ex pression of connective tissue growth factor (CTGF) in cultured cardiac fibroblas t (CFs), the antisense oligonucleotides (ASOND) was used to investigate whether CTGF is necessary for the proliferation and collagen synthesis of CFs. METHODS: CFs of SD rats were isolated and cultured. The proliferation and collagen synthesis of CFs were a ssessed by MTT assay and measuring hydroxyproline, respectively. The expression of CTGF mRNA and protein were detected by reverse-transcription PCR (RT-PCR) and Western blotting, respectively. RESULTS: AngⅡ could significantly increase the expression of CT GF both at mRNA and protein level in a dose and time-dependent manner (P0.05). CONCLUSION: It indicates that CTGF is involved in the process of myocardial fibrosis induced by AngⅡ, which may be a target for the treatment o f cardiac fibrosis.

OBJECTIVETo study the effection of suppression murine melanoma growth by Intratumor injection of recombinant attenuated salmonella carrying heat shock protein 70 and herpes simplex virus thymidine kinase genes.

METHODSPlasmids PCMV-mtHSP70-IRES-TK were electro-transferred into salmonella typhimurium SL7207 to construct recombinant salmonella typhimurium. In vivo, Recombinant bacteria were injected into the mouse melanoma and the antitumor effection was observed. The survival period was recorded and safety analysis for this vaccine in each group.

RESULTSIn vivo, the mtHSP70/HSV-tk recombinant bacteria can suppress tumor growth significantly and extend survival. After recombinant Salmonella, 10(9) CFU/mL, was administered as an intratumoral injection, No diarrhea were observed. During therapy, body weight did not change markedly.

CONCLUSIONResults of the animal experiment suggests intratumor injection of recombinant attenuated salmonella typhimurium containing mtHSP70 and HSV-tk genes, has targeting ability against B16 tumor cell and could significantly inhibit tumor growth .

Animals ; Bacterial Proteins ; genetics ; immunology ; Cancer Vaccines ; genetics ; immunology ; pharmacology ; Genetic Therapy ; methods ; HSP70 Heat-Shock Proteins ; genetics ; immunology ; Melanoma, Experimental ; microbiology ; pathology ; therapy ; Mice ; Mice, Inbred C57BL ; Mycobacterium tuberculosis ; genetics ; Salmonella typhimurium ; genetics ; immunology ; Simplexvirus ; enzymology ; genetics ; Skin Neoplasms ; therapy ; Thymidine Kinase ; genetics ; immunology ; Vaccines, Attenuated ; genetics ; immunology ; pharmacology ; Vaccines, DNA ; genetics ; immunology ; pharmacology

Objective To investigate the efficacy of levosimendan and dobutamine in the treatment of dilated cardiomyopathy combined with refractory end-stage heart failure. Methods A total of 90 patients with dilated cardiomyopathy and refractory end-stage heart failure in our hospital from February 2016 to February 2017 were enrolled and grouped according to digital table method. The control group received conventional anti-heart failure treatment and dobutamine treatment. The observation group received conventional anti -heart failure treatment and levosimendan treatment. The treatment effects of dilated cardiomyopathy and refractory end-stage heart failure, the symptom improvement time, heart failure correction time, left ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide, cardiac index before and after intervention and drug side effects rate between two groups were compared. Results The treatment effect of dilated cardiomyopathy and refractory end -stage heart failure was higher in the observation group than that in the control group(P＜0. 05). The improvement time of symptoms and the correction time of heart failure in the observation group were shorter than those in the control group(P＜0. 05). The ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide, and cardiac index in two groups were similar (P＞0. 05). After the intervention, the left ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide, and cardiac index in the observation group were superior to those of the control group(P＜0. 05). There was no significant difference in drug side effects between the two groups, both of which were mild(P＞0. 05). Conclusion Levosi-mendan has a better effect in patients with dilated cardiomyopathy and refractory end-stage heart failure than dobu- tamine does. Levosimendan can improve heart function and correct heart failure more quickly, with high drug safety, and is worth promoting.

PURPOSE: Elevation in serum alanine aminotransferase (ALT) levels is a biomarker for metabolic syndrome (MS); however, the relationship has not been fully investigated within the reference interval of ALT levels. Our objective was to explore the relationship between serum ALT levels within the reference interval and MS in Chinese adults. MATERIALS AND METHODS: This cross-sectional study included 16028 adults, who attended routine health check-ups at Shengli Oilfield Central Hospital from January 2006 to March 2012. The reference interval of serum ALT level was defined as less than 40 U/L. Logistic regression models and restricted cubic spline were used to evaluate the association of ALT with MS. RESULTS: The prevalence of MS in the total population was 13.7% (6.4% for females and 18.4% for males). Multiple logistic regression showed that ALT levels were positively associated with MS after adjustment for potential confounding factors. The odds ratio of MS in the top quartile was 4.830 [95% confidence interval (CI): 2.980–7.829] in females and 3.168 (95% CI: 2.649–3.790) in males, compared with the ALT levels in the bottom quartile. The restricted cubic spline models revealed a positive non-linear dose-response relationship between ALT levels and the risk of MS in women (p for nonlinearity was 0.0327), but a positive linear dose-response relationship in men (p for nonlinearity was 0.0659). CONCLUSION: Serum ALT levels within the reference interval are positively associated with MS in a dose-response manner. Elevated ALT levels, even within the reference interval, may reflect early dysmetabolic changes.
Adult ; Aged ; Alanine Transaminase/*blood ; Asian Continental Ancestry Group ; Biomarkers/blood ; Confidence Intervals ; Cross-Sectional Studies ; Dose-Response Relationship, Drug ; Female ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X/*enzymology/epidemiology ; Middle Aged ; Odds Ratio ; Prevalence ; Reference Values

Objective To evaluate the therapeutic effect of highly active anti-retroviral therapy (HAART) in treatment-na(i)ve Chinese patients with AIDS, to provide evidences for standardizing HAART.Methods Seventy-four treatment-naive AIDS patients were initiated with HAART and followed up regularly for 3 years. The clinical and laboratory data, side effects and drug resistance were observed and analyzed during the follow-up period. Results Of the 74 patients, 46 were males and 28 were females, with the average age being 42 years. The mean HIV viral load was ( 2. 2 ± 2.0 ) × 105 copies/ml and the baseline mean CD4+ T lymphocyte count was (62 ± 71 )cells/μl before treatment. After treatment for 3, 6, 12, 18,24, 30 and 36 months, the percentage of undetectable HIV viral road (less than 50 copies/ml ) was 71.6%, 83.8%, 75.7%, 77.0%, 82.4%, 81.1% and 79.7% respectively, and CD4+T lymphocyte count ascended to ( 167 ± 105), ( 177 ± 129), (238 ± 137), (290 ± 158), (304 ± 191 ), (331 ± 175) and ( 352 ± 202 ) cells/μl. The increase in amplitude of CD4+ T lymphocyte count in different periods examined was different, with the period of 0-3 months post-treatment demonstrating the most obvious augmentation ( P ＜ 0. 01 ) . The most common adverse reactions were liver function injury ( 52/74,70. 3% ), hyperlipemia (52/74, 70. 3%), hematopoietic inhibition of the bone marrow (33/74, 44. 6% ),peripheral neuritis (32/74, 43.2% ) and lipoatrophy (26/74, 35. 1%). Clinical drug resistance were found in nine patients and HIV gene mutations were detected in these patients. Conclusions Chinese treatment-naive AIDS patients have achieved good virological and immunological response to generic-drugpredominant HAART regimes with low drug resistance, but relatively more side effects.

Objective To investigate the association between serum direct bilirubin (DBIL) with metabolic syndrome (MS) and its components.Methods A dynamic health check-up cohort study was set up from 2006 to 2011.5 258 participants who satisfied the two basic rules:1) being free of MS at the 1st health check-up program;2) having at least two intact health checks were included in this study.With generalized estimating equation (GEE) model,after adjusting for items as age,gender,smoking,drinking,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,uric acid,blood urea nitrogen and white blood cells,the multivariable relative risks (RRs) of DBIL with MS and their components were analyzed.Results The RRs of DBIL for MS was 0.722 (95％ CI:0.654-0.797),which showing a dose-response.Serum DBIL was negatively associated with obesity and hyperlipidemia.Taking factors as gender and age into account,in the ＜45 years and 45-55 years groups,the RRs of DBIL for MS in females appeared as 0.516 (95％CI:0.349-0.761) and 0.435 (95％CI:0.256-0.740).And in males of ＜45 years and 45-55 years,the RRs of DBIL for MS were 0.738 (95％ CI:0.644-0.846) and 0.790 (95％ CI:0.667-0.937),respectively.Conclusions The elevated DBIL levels in serum appeared an early biomarker for MS and its components (obesity and hyperlipidemia).In particular,they may play a role in reducing the risk of MS in both females and males before 55 years of age.

Objective: To investigate hearing loss status of blasters, drillers mechanics and so on in underground mining, and put forward suggestion diagnosis of occupational explosive deafness and occupational deafness. Methods: Underground excavation workers in a metal mine were recruited in this study, those with a history of ear disease and non-occupational deafness were all excluded. Finally, the features of pure tone audiometry of 459 noise-exposed workers were analyzed. Results: High-frequency hearing loss occurred on 351workers and the positive detection rate was 74.29%, workers who had both high-frequency and linguistic frequency hearing loss were 51 and the positive detection rate was 11.11%. The positive detection of high-frequency hearing loss in right ear (χ²=9.427 and P= 0.024) and in left ear (χ²=14.375, P=0.002) was significantly different between different exposure age groups. The positive detection of high-frequency hearing loss of driving group was the highest, followed by blasting group, mining group and machine repair group. The characteristics of the hearing loss caused by drilling noise of the blasting workers with no accident occurred were in line with that of noise-induced hearing loss. Conclusion The diagnosis grading should be carried out according to the diagnostic criteria of occupational noise-induced deafness for the employees who engaged in the blasting operation with no record of blast accident.

Objective To explore the effect of Exendin-4 on dementia after traumatic brain injury (TBI) in rats and its related mechanism.Methods Thirty SD rats were randomly divided into sham group (n=10),TBI group(n=10) and Exendin-4 group(n=10).Cortical impact injury was used to construct the TBI model.Morris water maze test was used to test the memory function of rats one month after TBI.The beta-amyloid protein (Aβ1-42) and nuclear factor erythroid-2-related factor 2 (Nrf2) were detected by Western blot.Results One month after TBI compared with the sham group,the escape latency (EL) ((35.31 ± 13.23)s vs (8.79±9.71)s) was prolonged and the target quadrant stay time ((17.78±4.68)s vs (26.35± 5.83)s) was shortened,the number of crossing platforms ((1.40±1.75) vs (3.50±1.45)) decreased,the relative content of Aβ1-42 in hippocampus ((1.0140±0.0328) vs (0.4355±0.0152)) increased the relative content of tau protein ((0.8039±0.0251) vs (0.5170±0.0185)) increased,and Nrf2 expression levels ((0.3851±0.0188) vs (0.4901±± 0.0140)) decreased significantly,and the differences were statistically significant (t=5.110,3.625,4.068,16.010,9.208,4.474,all P＜0.01);Compared with TBI group,EL ((23.74±10.95) vs (35.31±13.23)) shortened,target quadrant dwell time ((24.28±5.37) vs (17.78±± 4.68)) shortened,the number of crossing platforms ((3.30±1.88) vs (1.40±1.75)) decreased,and the relative content of Aβ1-42 in hippocampus ((0.8370±0.0188) vs (1.0140±0.0328)) significantly decreased,the relative content of tau protein ((0.6693±0.0166) vs (0.8039±0.0251)) significantly decreased,and the expression level of Nrf2 ((0.4738 ± 0.0166) vs (0.3851 ± 0.0188)) significantly increased,and the differences were statistically significance (t=2.052,2.866,5.196,4.693,3.480,3.538,all P＜0.01).Conclusion Exendin-4 can significantly improve the learning and memory function of TBI rats,increase the expression of Nrf2,decrease the content of Aβ1-42 and tau in hippocampus,and improve the prognosis of neurological function of TBI rats.