Objective To investigate the clinical effects of continuous 3-in-1 femoral nerve block with stimulating catheters for patient controlled regional anesthesia(PCRA) in elderly patients after unilateral total knee replacement (TKR)surgery.Methods Thirty ASA Ⅰ - Ⅱ elderly patients wererandomly divided into two groups: FB group and Ⅳ group.FB group received continuous 3-in-1 femoral nerve block for postoperative analgesia with 0.2% ropivacaine plus 0.1 μg/ml sufentanil continuous infusion at 5 ml/h plus PCA boluses (1.0 ml/15 min).Ⅳ group received continuous intravenous analgesia with 1 μg/ml sufentanil plus 0.04 mg/ml tropisetron hydrochloride at 2 ml/h plus PCA boluses (0.5 ml/15 min).All patients were maintained analgesia for 48 hours.Results In FB group, the visual analogue scale(VAS) scores were 1.3 ±1.1, 1.2 ± 1.0, 1.1±0.9, 1.1 ± 1.0,1.0±0.9 at 4, 8, 12, 24, 48 hours after surgery under rest status respectively and were 3.04±1.4,2.3±1.3 at 24, 48 hours after surgery in active function training.These parameters in Ⅳ group were 4.0±1.6, 3.5±1.6, 3.2±1.4, 3.0±1.3, 2.5±1.2, 4.7±1.5 and 3.3±1.5 respectively, which were significantly different compared with FB group (t=5.358, 4.707, 4.852, 3.784, 3.743, 3.254,1.932,all P<0.05 or P<0.01).The incidence of nausea was higher in IV group than in FB group(P = 0.0022).Postoperative satisfaction ratings was higher (χ2 =41.1 ,P<0.01) and the total morphine use for 48 hours after operation was less(uc=2.412, P<0.01) in FB group than in Ⅳ group.Conclusions After TKR surgery, the continuous 3-in-1 femoral nerve block with stimulating catheters is an effective method with better pain relief,fewer side effects and higher satisfaction ratings in the elderly.

Objective To study the effect of small diameter graft (0.8 cm) splenocaval or mesocaval shunts combined with pericardial devascularization in the treatment of portal hypertensive variceal bleeding. Methods Splenocaval shunts were performed in 14 patients and mesocaval shunts were done in 24 patients, in combination with pericardial devascularization. Results The average decrease of free portal pressure was 6.6±1.2 cm. There was no significant changes in liver function postoperatively (P>0.05). Platelet counts and leukocyte counts were back to normal in splenocaval shunt patients postoperatively (P< 0.05). Operative mortality was 3%. Pyrexia developed in 4 patients, intractable ascites in 1 patient, chylons ascites in 1 patient, hepatic encephalopathy in 1 patient, intraabdominal infection in 1 patient and stress ulceration in 1 patient. All patients recovered after expectant treatment except one who died from severe intraabdominal infection. 35 patients received follow-up between 6 months and 3 years, total effective rate was 89%, 2 patients died from recurrent variceal bleeding, the shunt potency rate was 80% in 1 year and 75% in 3 years. Esophagogastric varices disappeared or alleviated as shown by endoscopy in 25 patients on 6 months postoperatively. Conclusions Small diameter portosystemic graft shunts combined with poricardial devascularization is an effective therapy for bleeding esophagogastric varices with a low rate of hepatic encephalopathy. Splenocaval shunt alleviates hypersplenism concurrently.

Objective To analyse the kidney damage situation of the elderly health examination people,and identify its characteristic.Methods A cross-sectional study was held which enrolled 1088 elderly health examination people.Urine routine,random urine albumin/creatinine ratio (ACR),serum creatinine,urea nitrogen were detected by biochemical analyzer,and estimated glomerular filtration rate (GFR) with CKD-EPI formula.Kidney structure change was examined by Color doppler ultrasound detector.Results The prevalence of hypertension,hyperlipemia,diabetes mellitus was 61.5％,62.1％,11.6％,respectively.The abnormal detection rate of urine routine was 19.0％,including 2.6％ proteinuria,14.1％ hematuresis and 5.4％ leucocyturia.The abnormal detection rate in the people with was higher than those without (P＜0.01).However,the albuminuria detection rate with random urine ACR was 25.1％,obviously higher than that of urine routine (P＜0.01).The ultrasound results showed that 6.8％ of the total were examined with elderly characteristic kidney change,the proportion of renal cyst was the highest,accounted for 21.8％.70.7％ of all people were in the level of eGFR more than 60 ml· min-1 · 1.73 m-2.The level of eGFR＜60 ml· min-1 · 1.73m-2 in the people with was higher than those without (P＜0.01).eGFR was declined with age.When age increased every 10 years,eGFR was decreased 7 ml · min-1 · 1.73 m-2.Conclusions No matter in structure or function,the elderly people's kidney damage has its characteristic.We should make it clear to correctly diagnose and cure elderly kidney disease.

Objective To investigate the effect of stage 1 acute kidney injury (AKI) on the prognosis of patients underwent cardiopulmonary bypass (CPB) cardiac operation. Methods A retrospective analysis was conducted. All patients aged ≥ 18 years who underwent cardiac operation with CPB admitted to Beijing Anzhen Hospital from July 1st, 2013 to December 31st, 2015 were enrolled. According to the standard of serum creatinice (SCr) of Kidney Disease Improving Global Outcomes (KDIGO) criteria, the AKI patients with stage 1 and non-AKI patients were served as the research objects. Perioperative clinical data of two groups were collected, and the prognosis was recorded during follow up to draw the Kaplan-Meier survival curve. Cox regression model was used to analyze the risk factors of prognosis in patients with stage 1 AKI experienced CPB during cardiac operation. Results A total of 5 823 patients were enrolled, of which 1 285 patients with AKI, and those in stage 1 was 998, accounting for 77.67% of total AKI patients; and 4 538 in non-AKI group. The mean follow-up period among survivors was (23.13±12.28) months. Compared with non-AKI patients, 30-day mortality of patients with stage 1 AKI was significantly increased [4.00% (40/998) vs. 0.40% (18/4 538), P < 0.01]. It was showed by Kaplan-Meier survival analysis that the cumulative survival rate of patients with stage 1 AKI was significantly lower than that of non-AKI patients (log-rank = 51.989, P < 0.001). It was showed by further subgroup analysis that the cumulative survival rate of patients with stage 1 AKI without serum creatinine (SCr) recovery was significantly lower than that of patients with SCr recovery from stage 1 AKI (log-rank = 43.580, P = 0.000). It was showed by Cox multivariate analysis that stage 1 AKI [hazard ratio (HR) = 2.725, 95% confidence interval (95%CI) = 1.810-4.230, P = 0.000] and prolonged CPB in patients undergoing cardiac operation (HR = 1.013, 95%CI = 1.001-1.017, P = 0.000), combined with coronary heart disease (HR = 1.046, 95%CI = 1.010-1.063, P = 0.005) and diabetes mellitus (HR = 1.060, 95%CI = 1.010-1.090, P = 0.002) were independent risk factors of death in patients undergoing CPB during cardiac operation. Conclusion Stage 1 AKI is the main stage of AKI and it is independently related to all-cause mortality in patients underwent cardiovascular operation using CPB.

Traditional Chinese medicine is a treasure of Chinese culture, absorbing the wisdom of the Chinese people. Continuous application of new technologies makes traditional Chinese medicine research advance with the times. After several years of development, high-throughput transcriptome study has become a mature research tool in biology. This paper reviewed the advances in medicine transcriptome study, and compared two sequencing platforms, Roche's GS FLX platform and Illumina's HiSeq 2000 platform. Moreover, this paper introduced medicine transcriptome analysis process, with Panax quinquefolius and Lonicera japonica for examples, showing the characteristics of traditional Chinese medicine transcriptome studies. High-throughput transcriptome studies facilitate traditional Chinese medicine research with overall understand of functional genes, give clear elucidation of metabolic pathways, lay molecular foundation for the traditional Chinese medicine research and offer modern interpretation for traditional Chinese medicine theory. However, the current study faces several difficulties, including weak molecular basis, high sequencing cost and staff shortages in data anaysis. In the future, with the development in sequencing technology, the combination of transcriptome and other genomics, such as proteome and metabolome, will lay a solid foundation for the new high-throughput screening and developing model for the traditional Chinese medicine industry.
Biomedical Research ; methods ; trends ; Forecasting ; Gene Expression Profiling ; methods ; Gene Expression Regulation, Plant ; Humans ; Lonicera ; genetics ; Medicine, Chinese Traditional ; methods ; trends ; Panax ; genetics ; Phytotherapy ; methods ; trends ; Transcriptome ; genetics

OBJECTIVETo compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.

RESULTSThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).

CONCLUSIONBoth HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

Aged ; Holmium ; Humans ; Laser Therapy ; adverse effects ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Middle Aged ; Penile Erection ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Retrospective Studies ; Thulium ; Transurethral Resection of Prostate ; Treatment Outcome ; Urine

Bel1, a transactivator of prototype foamy virus (PFV), plays pivotal roles in the replication of PFV. Previous studies have shown that Bel1 bears a nuclear localization signal (NLS), but its amino acid sequence remains unclear and the corresponding importins have not been identified. In this report, we inserted various fragments of Bel1 into an EGFP-GST fusion protein and investigated their subcellular localization by fluorescence microscopy. We found that the 215PRQKRPR221 fragment could direct nuclear localization, which accords with the consensus sequence K(K/R)X(K/R) of monopartite NLS. Point mutation experiments revealed that K218, R219, and R221 are essential for the nuclear localization of Bel1. The results of the GST-pulldown showed that the Bel1 fragment with residues 215-223, which bears the NLS, interacts with KPNA1, KPNA6, and KPNA7. This result suggests that KPNA1, KPNA6, and KPNA7 maybe involved in Bel1 nuclear translocation.
Cell Line ; Cell Nucleus ; genetics ; metabolism ; virology ; Humans ; Nuclear Localization Signals ; genetics ; metabolism ; Protein Binding ; Protein Transport ; Retroviridae Infections ; genetics ; metabolism ; virology ; Retroviridae Proteins ; chemistry ; genetics ; metabolism ; Spumavirus ; chemistry ; genetics ; physiology ; Trans-Activators ; chemistry ; genetics ; metabolism ; alpha Karyopherins ; genetics ; metabolism

OBJECTIVETo establish characteristic parameters of complex impedance spectrum of rabbit whole blood cells.

METHODSThe AC impedances of 30 blood samples from the 10 rabbits were measured with the Agilent 4294A impedance analyzer at frequency range of 0.01-100 MHz and its characteristic data were analyzed by the Bode plot, the Nyquist plot and the Nichols plot.

RESULTSThe impedance amplitude and phase angle of rabbit blood cells was frequency-dependent. The impedance spectrum of rabbit blood cells had two characteristic frequencies: the 1st one (f(C1)) was 2.58 MHz, the 2nd one (f(C2)) was 5.21 MHz.

CONCLUSIONThe frequency properties of whole blood cells can be obtained by the analysis of impedance spectrum.

Animals ; Blood Cells ; cytology ; physiology ; Electric Conductivity ; Electric Impedance ; Rabbits ; Spectrum Analysis ; methods

In the present study, the AC impedance of rat blood was measured with Agilent 4294A impedance analyzer in the frequency range of 10(4)-10(8) Hz, and the effect of simulated weightlessness (SWL)on electrical properties of rat blood was investigated by analyzing the data characteristics with the use of electrical impedance spectroscopy, the Bode diagram, the Nyquist diagram and the Nichols diagram. The results demonstrated 60 days SWL caused some changes: (1) the electrical impedance of rat blood were reduced, mainly in the real part of complex impedance (Z'o and Z'infinity), the electrical impedance modulus amplitude (|Z*|o and |Z*|infinity), the impedance relaxation strength (deltaZ', delta|Z*|) and the logarithm of impedance modulus amplitude at low frequency (Log |Z*|o) were lower than that in the control (CON) group; (2) the characteristic frequency of the electrical impedance spectrum of rat blood and the phase angle were increases, mainly in the characteristic frequency (fc1, fc2) and the phase angle [theta(p) (degree), theta(p) (radian)] increased compared with that in the CON group. These data indicate that SWL leads to reduced resistivity and enhanced conductivity of blood.
Animals ; Blood ; Blood Physiological Phenomena ; Dielectric Spectroscopy ; methods ; Electric Impedance ; Male ; Rats ; Weightlessness Simulation

BACKGROUND: Exercise has been proved to accelerate the proliferation of intervertebral disc cells and extracellular matrix production in healthy rats. For the degenerative intervertebral disc, whether exercise also has positive effects on its cell proliferation, extracellular matrix production or pain relief remains unclear. OBJECTIVE: To investigate the effect of exercise on the extracellular matrix production in a rat model of intervertebral disc degeneration.METHODS: A rat model of intervertebral disc degeneration was prepared by Freund's complete adjuvant injection into the intervertebral disc at L5-6 levels. Then, the model rats were allowed to have a rest for 2 weeks. All rats were then randomly divided into exercise and control groups. Rats in the exercise group were forced to run every day, while the controls allowed free activities in the cage. The behavioral tests were performed at 7, 14, 28, 42, 56 and 70 days after modeling; meanwhile, the intervertebral disc samples were collected used for alcian blue staining and immunohistochemical staining to detect the levels of proteoglycan, aggrecan and collagen type Ⅱ in the intervertebral disc cells, respectively.RESULTS AND CONCLUSION: Vocalization threshold on the rat back of punctured disc was significantly decreased, while grooming and wet-dog shaking were significantly increased at 7 days after modeling compared with the baseline (P < 0.05), suggesting that Freund's complete adjuvant injection successfully induces disc degeneration, hyperalgesia and abnormal behaviors. Further, the vocalization threshold and wet-dog shaking in the exercise group showed significant improvement compared with the control group after 14 days of exercise (P < 0.05), while the grooming was significantly reduced until the 28th day (P < 0.01), indicating that exercise can alleviate pain caused by disc degeneration in model rats. At 21 days after modeling, the levels of proteoglycan, aggrecan and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus were significantly decreased compared with the baseline (P < 0.01), indicating the occurrence of disc degeneration. After 14 days of training, the levels of proteoglycan, aggrecan, and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus in the exercise group were significantly increased compared with the control group (P < 0.01). Moreover, after 8-week exercise, the level of proteoglycan in the nucleus pulposus and annulus fibrosus in the exercise group was increased by 4-5 times compared with the control group, and levels of aggrecan and collagen type Ⅱ in the nucleus pulposus in the exercise group also was increased by 3-4 times compared with the control group. To conclude, exercise can promote extracellular matrix increased by production by increasing the levels of proteoglycan, aggrecan, and collagen type II in the degenerative intervertebral disc.