Objective To discuss the feasibility and safety of propofol used in senile patients undergoing minor surgery including gastroscopy and colonoscopy.Methods 40 patients aged 80-88 years old were randomly divided into two groups with 20 cases for each group.Group P received only propofol by intravenous injection in a speed of 1ml/s till eyelash response disappeared.In patients of group F fentanyl was first given at 0.5?g/kg,and 1 minute later,the patients were given propofol by intravenous injection in a same speed as in group P if there was no discomfort until eyelash response disappeared.MAP,HR,SpO2 and RR were determined before induction of anesthesia,beginning of operation,and 1st,3rd and 5th minute after operation.The onset time of anesthesia,total dosage of propofol used,time of palinesthesia and follow-up results were recorded.Results MAP was significantly decreased in both groups at the beginning of operation,and more stable in group F at the 3rd and 5th minute after operation.There were significant differences between two groups in amount of propofol used,and the dosage in group F was less than that used in group P(P

Objective:To evaluate a Meta-analysis of randomized controlled trials ( RCTs) in multiple sclerosis ( MS) patients to evaluate the efficacy of vitamin D as add-on therapy. Methods: Searched Pubmed,EMbase,the Cochrane Library,CNKI,Wanfang Data base and so on up to february 2016 using the keywords:multiple sclerosis or MS and the drug names:vitamin D orCholecalciferol. Two authors independently selected the articles and extracted the data. We performed meta-analysis using Review Manager ( RevMan) version 5. 3 software. Results:Four RCTs with a total of 247 patients were selected.①Compared to the placebo, the EDSS score[MD=-0. 33,95% Confidence interval (CI)= (0. 68,0. 01),P=0. 05],the annual relapse rate[MD=-0. 08, 95%CI=(-0.37,0.21),P=0.60]and the number of gadolinium-enhancing lesions[MD=-0.16,95%CI=(-0.57,0.25),P=0. 45] showed no significant difference at 12 months,meanwhile the EDSS score[MD=-0. 48,95%CI=(0. 87,-0. 09),P=0. 02] and the annual relapse rate[MD=-0. 27,95%CI=(-0. 52,-0. 02),P=0. 03] were significantly less in the vitamin D group at 24 months.②Safety evaluation:There was no hypercalcaemia in vitamin D treated patients in each studies,main adverse events reported were diarrhoea, fever, constipation, dyspepsia, headache and so on. These symptoms were mild, after stopping drug can relieve the general. Conclusion: Vitamin D as an added in the treatment of MS showed as same as the placebo in some clinical indicators. However,after a longer treatment, the clinical indicators were significantly lower in the vitamin D group. Due to limited quantity and quality of the included studies,further larger and more prolonged studies are merited to verify the above conclusion.

AIM:To investigate the protective effect of somatostatin (SST) and octreotide (OCT) on rat hepatocytes. METHODS: The primary hepatocytes were pretreated with different concentrations of SST and OCT. The levels of alanine minotransferase (ALT) and aspartate aminotransferase (AST) in culture supernatant were analyzed by the model of ethanol/carbon tetrachloride (CCl4)-induced hepatocyte injury. Additionally, 75 Sprague-Dawley rats were divided into 5 groups at random, including normal control, model control, SST-treated model groups at high, medium and low doses (200 ?g?kg-1?d-1, 100 ?g?kg-1?d-1 and 50 ?g?kg-1?d-1, respectively). Except for the normal controls, all rats were injected with 40% CCl4 subcutaneously for 8 weeks to establish hepatic fibrosis. Meanwhile, rats of SST-treated model groups were given at different doses of SST twice a day in the same way. Thereafter, the liver function and apoptosis index of hepatocytes were detected by standard enzyme method, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), respectively. RESULTS: Compared with those of injury model group, the hepatocytes pretreated with SST (10-8-10-6 mol/L) and OCT (10-7-10-5 mol/L) exhibited significantly decreased levels of ALT and AST in the culture supernatant. Furthermore, most indices of liver function including ALT, AST, alkaline phosphatase (ALP), total bilirubin (TBIL) and albumin (ALB) improved obviously in all SST-treated groups, especially in the group treated with low dose of SST. The apoptosis index of hepatocytes in the fibrotic liver was also reduced greatly by the treatment with low dose of SST. CONCLUSION: SST and OCT may protect hepatocytes against CCl4-induced injury, inhibit hepatocyte apoptosis, and improve the liver function. These findings suggest them a potential efficiency in the prevention of hepatic fibrosis.

AIM:To evaluate the negative regulatory effects of somatostatin(SST) and octreotide(OCT) on the extracellular matrixes(ECM) metabolism in rat hepatic stellate cells(HSCs).METHODS:HSCs were treated with different concentrations of SST or OCT.The mRNA levels of collage type I,III and the intracellular expression of collagen,matrix metalloproteinase-1(MMP-1),tissue inhibitor of metalloproteinase-1(TIMP-1) in activated HSCs were assessed by in situ hybridization(ISH),[3H]-proline incorporation and immunocytochemistry,respectively.In addition,levels of hyaluronic acid(HA),laminin(LM),and procollagen type III(PCIII) in the culture supernatant of HSCs were also detected by enzyme-linked immunosorbent assay.RESULTS:Both SST(10-7 mol/L-10-6 mol/L) and OCT(10-7 mol/L-10-5 mol/L) markedly down-regulated the transcription of collagen type I,III,and the production of collagen,HA,LM,PCIII in HSCs in a dose-dependent manner.Furthermore,HSCs treated with SST(10-6 mol/L) and OCT(10-6 mol/L-10-5 mol/L) significantly reduced TIMP-1 level,which resulted in an elevated ratio of MMP-1/TIMP-1.CONCLUSION:SST and its analogy inhibit the synthesis of ECM and enhance its degradation both at transcriptional and translational levels.

Objective To evaluate the application values of two kinds of single-platform flow cytometric methods,the Volumetric method based on flow sensor and the Trucount method based on Trucount beads,in the counts of T-lymphocyte subsets in peripheral blood of patients after transplantation.Methods The absolute number and percentage of CD4 +,CD8 +,and CD3 + T cells in peripheral blood samples from 107 patients after liver or renal transplantation were determined by the Trucount method and the Volumetric method,respectively,and their results were compared using paired t-test and linear regression analysis.Five samples with low CD3 + counts were selected and the precisions of the absolute number of CD4 +,CD8 + and CD3 + T ceils detected by the Volumetric method were evaluated.Results There was no significant difference in the levels of CD4+,CD4+/CD3+,CD8+,CD8+/CD3+,and CD4+/CD8 + in peripheral blood between the Trucount method and the Volumetric method (P ＞ 0.05),and the linear regression coefficients between them were from 0.9 to 1.1.When the concentration of CD3 + was equal or more than 40/μL,the coefficients of variation (CVs) were below 5.5％ for the Volumetric method.When the concentration of CD3 + was 20/μL,the CVs of CD3 +,CD4 +,and CD8 + were 5.19％,10.28％ and 6.48％,respectively.Conclusion The single-platform method based on flow sensor is accurate and reproducible for counting T-lymphocyte subsets in peripheral blood,which may be used to monitor the immune state of the patients after liver or renal transplantation.

Objective To silence the beclin1 gene expression by using RNA interference technology in AR42J rat pancreatic acinar cells,and build a stable AR42J line silencing beclin1.Methods Three kinds of shRNA targeting rat beclin1 mRNA and negative control shRNA were designed and synthesized,and were inserted into the plasmids GV112,respectively.The recombinant plasmids were named as p-sh-Beclin1-1,psh-Beclin1-2,p-sh-Beclin1-3 and p-shRNA-NC.Lipo3000 was used to transfect the recombinant plasmid into AR42J cells,the expression of beclin1 mRNA were detected by RT-PCR to screen for the most efficient silencing plasmid,and then it was packaged into lentiviral (LV).AR42J cells were infected with LV and screened by puromycin.Beclin1 mRNA and protein expression was determined by RT-PCR and Western blot.Results The recombinant plasmid was confirmed by agarose gel electrophoresis and sequencing showed that shRNA sequences were in line with expectations.The beclin1 mRNA inhibition rates of AR42J cells after p-sh-Beclin1-1,p-sh-Beclin1-2,p-sh-Beclin1-3 and p-shRNA-NC transfection were (17.8 ± 4.0) ％,(30.6 ± 2.8) ％,(45.8 ± 7.7) ％,(7.0 ± 11.8) ％,respectively.The inhibition rates of three p-sh-Beclin1 transfection cells were significantly higher than that in non-transfection cells,and the difference was statistically significant (P ＜ 0.05).While the inhibition rate of p-shRNA-NC transfection cells was not significantly different from that of non-transfection cells,p-sh-Beclin 1-3 with highest rate of inhibition was packaged by LV,and infected AR42J cells,then puromycin was applied to screen,inhibition rate of beclin mRNA expression in LV infection cells was (86.1 ± 1.2) ％,and the protein expression inhibition rate was (87.9 ± 2.8) ％,and the difference between infection and non-infection groups was statistically significant (P ＜ 0.05).Conclusions The stable AR42J line silencing beclin1 is successfully established,which can provide a new cell model for future research of the role of beclin1 in the pathogenesis of acute pancreatitis.

Objective To establish a stable AR42J cell line expressing EGFP LC3.Methods The EGFP LC3 overexpressed Lentivirus was constructed and transfected into pancreatic acinar cells (AR42J) of rats.The rats with Lentiviral EGFP transfection were treated as negative control.The transfection efficiency was detected by inverted fluorescence microscope and flow cytometry.The EGFP LC3 protein expression in the stable cell lines were analyzed by Western blot.The cells were treated with thapsigargin to establish endoplasmic reticulum stress model,and the LC3,PERK protein expressions were detected by Western blot.Results The transfection efficiency of Lentiviral EGFP LC3 of AR42J cell was ＞ 85％,which could achieve stable passage.The expression of LC3 mRNA of AR42J cells transfected with Lentiviral EGFP LC3 was 9.14 ±0.32 folds higher than that of negative control,which had no expression of LC3 protein,only EGFP expression.However,compared with non-transfection group,the LC3 mRNA expression in EGFP group was not significantly different.Conclusions A pancreatic acinar cell line (AR42J) of rat stably expressing EGFP LC3 protein is successfully constructed.And it may provide a new model for further research of the relationship between acute pancreatitis and autophagy.

Objective To investigate the electrocardiographic characteristics and assess the efficiency of ra-diofrequency catheter ablation(RFCA) in ventricular arrhythmia arising from the aortic sinus of Valsalva. Methods Eighteen patients(6 males and 12 females)were selected to undergo RFCA for ventficular arrhythmia originating from the left aortic sinus of Valsava. All of them were symptomatic,but without evidence of structural heart disease. Activation mapping was performed in the endocardium of the aortic sinus of Valsalva,then ablation was performed at the site with the earliest ventricular wave in endocardium electrograms. At the same time, coronary and aortic angiog-raphy were performed to assess the anatomic relationship between the ventricular tachycardia (VT)/ventricular pre-mature contraction (VPC) origin and coronary arteries and aortic valve before the RF energy delivery. Results Eighteen patients were successfully managed, with no major complications related to the procedure. VT eliminated and VPC counts on 24-hour ECG monitoring decreased significantly after the ablation[18 474(12 399,26 812)/24h vs 4 (1,7)/24 h, Wilcoxon signed-rank test, P<0.05]. During a follow-up period of 6 monthes, there was no recur-rence. Conclusions Ventricular arrhythmia arising from the aortic sinus of Valsalva has specific electrocardiograph-ic characteristics, and it can be successfully and safely treated under the guidance of activation mapping.

Objective To explore the relation of early time secretion function of Beta cell in newly diag-nosed type 2 diabetic patient and the changes of body weight following intensification therapy of insulin. Methods 237 newly diagnosed type 2 diabetic patients were divided into 1 kg lower group, the 1-5 kg group, the 5 kg above group. The maximum body weight and waist circumference were recorded. The present body weight and waist circum-ference were measured according to OGTT study, meanwhile,30 minuets blood sugars, the insulin and the C-peptide (C-P) level and the blood pressure(BP) and the insulin resistance index (HOMA-IR), the early insulin secretion index (△I30/△G30) was calculated. All cases were treated for 14 days. Results Early time secretion function of Beta cell in the group keeping above lose weight 5 kg was the worst, after treatment insulin secretion level were in-creased 1.12 times and 1.86 times in 1 kg lower group than in the 1-5 kg group and above 5 kg group. Conclusions Early time secretion function of Beta cell in newly diagnosed type 2 diabetic patient is correlated with the maxi-mum body weight decrease.

Objective To evaluate the effects of pacing in right ventricular septum (RVS) on hemodynamics among atrioventricular sequential dual chamber pacing Methods Twenty patients with high grade or complete atrioventricular block received permanent dual chamber pacemaker ( DDD ),were randomized into right ventricular septum pacing group (RVS)and right ventricular apex pacing group (RVA)according to the ventricular leads position.The QRS duration of the ECG,the left ventricular ejection (LVEF),the interventricular mechanical delay( IVMD )and the plasma levels of brain natriuretic peptide (BNP)were compared before and after operations.Results Compared with the preoperation,the mean QRS duration ( ( 187.00 ± 15.67 ) ms and (94.00 ±9.17 ) ms),the IV MD ( (43.20 ± 6.79 ) ms and ( 15.00 ± 4.08 ) ms ),the level of BNP ( ( 89.70 ± 8.30) ng/L and (40.00 ± 4.73 ) ng/L) increased( P ＜ 0.05 ) and LVEF decreased significantly ( (53.70 ± 1.34) % and (58.60 ±1.65 )% ,P ＜ 0.05 ) in RVA group,but didn't change in RVS group (P ＞ 0.05 ).After three months following up,the mean QRS duration and the IVMD in RVS group( (119.00 ±7.38 )ms,(19.00 ±4.59)ms) were shorter than that of RVA group( ( 187.00 ± 15.67) ms,(43.20 ± 6.79) ms) ( P ＜ 0.05 ),the LVEF was higher and the plasma level of BNP was lower than that of RVA group ( (57.00 ± 2.00) % and ( 53.70 ± 1.34) %,(44.20 ± 9.18 ) ng/Land ( 89.70 ±8.30) ng/L,P ＜0.05).Conclusions The RVS pacing could keep the normal ventricular activation sequence and biventricular contraction synchrony farthest without side effects on hemodynamics in comparison with the RVA pacing.The RVS pacing is more approaching physiological rhythm than the RVA pacing.