Objective To study the effect of dexmedetomidine anesthesia on surgery condition, renin-angiotensin-aldosterone system (RAAS) activity and renal function of laparotomy patients.Methods 96 patients received laparotomy in our hospital during May 2012 to October 2015 were studied, which were divided into dexmedetomidine group (D group) and control group (C Group) by random number table method and received different anesthetic regimes.Then surgery condition, renal function indexes and plasma renin, angiotensin II levels of two groups were compared.Results The operation time, intraoperative blood loss, intraoperative transfusion volume and awakening time of D group and C group had no significant difference.10 min after opening abdomen and 10 min before closing abdomen, the plasma renin, angiotensin II, cystatin C (Cys-C),α1-microglobulin (α1-MG) contents were significantly lower than those of C group(P<0.05).Conclusion Dexmedetomidine anesthesia applicated in laparotomy could inhibit the RAAS activity, protect renal function, and its anesthesia effect is more precise.

Objective To compare the effect of sevoflurane and propofol in elderly surgery patients towards cardiac damage.Methods 45 elderly patients with hypertension were divided into Sevoflurane group and Propofol group,which were observed changes of their ECG ST-segment,Mb,CK-MB,cTnI.Results 24 hours after induction of anesthesia,cardiac damage could be observed;Compared with Sevoflurane group,levels of CK-MB,Mb and cTnI increased significantly 24 hours after induction of anesthesia(t =2.771,0.681,0.557,all P ＜ 0.05),ST-segment significantly depressed at the same time[(-1.96±0.06)mV,(-1.45±0.04)mV](P ＜0.05).Conclusion Elderly patients with hypertension show cardiac damage during pevi-operative stage;Compared with propofol,sevoflurane shows lighter damage to cardiac muscle.

Objective:To study the effect of sevoflurane inhalation anesthesia on stress reaction and kynurenic acid ( KYNA) level in serum of the patients with laparoscopic cholecystectomy .Methods:Totally 48 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups.Group S(n=24) received sevoflurane inhalation and group V (n=24) received intravenous general anesthesia.The levels of norepinephrine (NE), epinephrine (E), cortisol (Cor), KYNA and neutrophil and the neutrophil/lympho-cyte ratio were measured at five time points, namely T1(before the anesthesia), T2 (just after the surgery) , T3(in the morning of the first day after the surgery ) , T4 ( in the morning of the second day after the surgery ) and T5 ( in the morning of the third day after the surgery).The correlation of Cor, NE, E and NLR with KYNA was studied as well.Results:The levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group V were significantly higher than those before the surgery (T1) with statistically significant difference (P<0.05), while those in group S had no significant changes (P>0.05).And the levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group S were markedly lower than those in group V at the same time point (P<0.05).After the surgery (T2, T3, T4 and T5), KYNA levels in group V were significantly decreased and NLR values in group V were significantly increased when compared with those of T 1.In group S, KYNA levels and NLR values after the surgery (T2, T3, T4 and T5) were markedly increased , which were higher than those in group V at the same time point with statistically significant difference (P<0.05).The correlation analysis indicated the level of KYNA displayed positive correlation with the levels of NLR , Cr, Z and E (P<0.05).Conclusion:Sevoflurane inhalation anesthesia can inhibit the increase of stress reaction and KYNA level in the patients with laparoscopic cholecystectomy , which may be related with its anti-in ammatory properties .

Objective To analyze clinical results of newborn hearing concurrent genetic screening and to ex-plore the significance of genetic test and potential correlations between the genotype and clinical phenotype.Methods Newborns in Foshan born during May,2012 and September,2013 were recruited.Two-step hearing screening was carried out by using AABR (automated auditory brainstem response).Blood samples were collected with a standard protocol for testing hot-spot mutations of common deafness-susceptibility genes.ResuIts A total of 10 238 newborns,including 9 295 rooming-in infants and 943 NICU infants,received hearing screening and 99.16%of passed the initial screening.The passing rates of rooming-in and NICU infants were significantly different (χ2 =99.1,P<0.001),but the difference was not significant in the secondary screening (χ2 =0.26,P=0.61).Three hundred and fifteen out of 10 238 (3.08%)newborns who underwent genetic testing were found to have one or two allele mutations of deafness-susceptibility genes,and the positive rate of genetic screening was significantly higher than the referring rate of initial hearing screening (χ2 =123.9,P<0.001).Newborns with gene mutations had high-er referring rate of hearing screening than the general population (χ2 =72.4,P<0.001).GJB2 c.235delC heterozygous mutation frequency was 1.61% (165/10 238),while the homozygous mutation frequency was 0.04% (4/10 238);c.299 300delAT heterozygous mutation frequency was 0.20% (20/10 238);c.176 191del16 heterozygous mutation frequency was 0.06% (6/10 238);no c.35delG mutation was detected.SLC26A4 c.919-2A>G heterozygous mu-tation frequency was 0.80% (82/10 238)and the homozygous mutation frequency was 0.03% (3/10 238);c.2168A>G heterozygous mutation frequency was 0.12% (12/10 238).MTRNR1 1555A>G heteroplasmic mutation fre-quency was 0.04% (4/10 238)while the homoplasmic mutation frequency was 0.18% (18/10 238).1494C>T ho-moplasmic mutation frequency was 0.01% (1/10 238).GJB2 c.235delC and SLC26A4 c.919 -2A>G mutations were found to be the most recurrent mutations in participants,and finally eight infants aged 6 days to 25 months di-agnosed with moderate to very severe sensorineural hearing loss were correlated with these two mutations.ConcIu-sion Genetic screening is a potent strategy to complement the conventional hearing screening since it is helpful for determining high risk individuals and early discovering possible late-onset hearing loss.

Objective To establish a method of gold nanoprobe-based solution hybridization (GNBSH) to detect nucleic acid sequence-based amplification (NASBA) products for the rapid diagnosis of invasive aspergillosis (IA).Methods The Aspergillus specific 18S rRNA was amplified by NASBA and then the amplified products were hybridized with the gold nanoprobes which were modified with thiol compounds at the 5'end.Serum samples from 106 patients,including 14 with a definite IA,32 with suspected IA and 60 without IA,were detected by the established method,and the obtained results were compared with that of galactomannan (GM) test to evaluate its accuracy.Results The gold nanoprobes only hybridized with Aspergillus NASBA products but not other non-Aspergillus strains.The sensitivity,specificity and the area under the ROC curve (AUCROC) of the established GNBSH method for detecting 106 clinical samples were 82.61％ (38/46),81.67％ (49/60) and 0.890,respectively.The sensitivity,specificity and AUCROC of GM test were 56.52％ (26/46),83.33％ (50/60) and 0.723,respectively.Conclusion The established GNBSH method to detect Aspergillus NASBA products has high sensitivity and specificity and simple operation,which may be used to detect the infection of Aspergillus by clinical laboratories.

Objective:To explore the application effect of whole-course guided management under the concept of enhanced recovery after surgery (ERAS) in perioperative period of patients with acoustic neuroma.Methods:Retrospective analysis was performed on the patients with acoustic neuroma treated by inpatient surgery in our department from January 2018 to December 2019. The patients before January 2019 adopted the traditional outpatient and inpatient treatment management mode were in the control group. Patients admitted after January 2019 were in the observation group. The experimental group adopted the guided management mode under the concept of enhanced recovery after surgery. In other words, on the basis of the traditional management, the whole-course guided management under the concept of enhanced recovery after surgery was added, which mainly included outpatient documentation, introduction of basic disease knowledge, preoperative and postoperative life guidance, preoperative and postoperative psychological guidance and family follow-up. Patients in both groups were observed for their first medical contact-discharge time, medical and nursing satisfaction, and psychological status was assessed by self-rating depression Scale (SDS) and self-rating anxiety scale (SAS) before surgery, on the day of discharge, and 1 month after discharge.Results:The first medical contact discharge time of the whole-course oriented management group under the concept of accelerated rehabilitation surgery was significantly shorter than that of the traditional group, and its medical and nursing satisfaction was significantly improved ( P<0.05); the SDS score and SAS score before operation, on the day of discharge and 1 month after discharge in the observation group were significantly lower than those of the control group ( P<0.05). Conclusions:The whole-process guided management under the concept of enhanced recovery after surgery can significantly shorten the time of patients′ first medical contact and discharge, reduce anxiety and depression in patients with acoustic neuroma before and after surgery, and improve patients′ satisfaction with medical treatment and care.

OBJECTIVE: To investigate the differences of IL-4, IFN-gamma gene promoter methylation of allergic rhinitis patients between Uygur and Han people of Xinjiang. METHOD: Methylation-specific PCR (MSP) detected IL-4, IFN-gamma gene methylation of each of 50 patients with allergic rhinitis in Uygur and Han. RESULT: Complete IL-4 gene promoter methylation rate was 44% (22/50) and 48% (24/50) in Uygur and Han AR patients, un-methylation was 26% (13/50) and 22% (11/50), coexistence rate of methylation and un-methylation was 30% (15/50) and 30% (15/50). Complete IFN-gamma gene promoter methylation rate was 12% (6/50) and 16% (8/50) in Uygur and Han AR patients, un-methylation was 8% (4/50) and 10% (5/50), coexistence rate of methylation and unmethylated was 80% (40/50) and 74% (37/50). Distribution of IL-4 gene methylation between Han and Uygur AR patients had no statistically significant (P > 0.05). Distribution of IFN-gamma gene methylation between Han and Uygur AR patients had no statistically significant (P > 0.05). CONCLUSION There is no difference of IL-4, IFN-gamma gene methylation in patients between the Han and Uygur.
Adult ; China ; epidemiology ; DNA Methylation ; Epigenesis, Genetic ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Humans ; Interferon-gamma ; genetics ; Interleukin-4 ; genetics ; Male ; Promoter Regions, Genetic ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; epidemiology ; genetics

Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease.As a dengue non-endemic country,China has experienced several dengue outbreaks in recent years.However,dengue patients in China displayed distinct clinical characteristics compared to patients in endemic countries.To standardize the diagnosis and treatment of dengue fever,the experts of the Society of Infectious Diseases,Society of Tropical Medicine and Parasitology of Chinese Medical Association,and the Society of Emergency Medicine,China Association of Chinese Medicine have reached this guideline based on guidelines for diagnosis,treatment,prevention and control of dengue (World Health Organization,2009);guidelines for diagnosis and treatment of dengue (National Health and Family Planning Commission of the People's Republic of China,2014,Edition 2),health industry standard of the People's Republic of China "diagnosis for dengue fever (WS216-2018)" and systemic reports on dengue.The guideline includes 8 aspects:introduction,terminology,epidemiology and prevention,etiology and pathogenesis,clinical features,diagnosis,treatment and problems to be solved.

Objective To evaluate the application value of F wave by comparison with quantitative sensory testing(QST)and nerve conduction studies(NCS)in diabetes peripheral neuropathy (DPN). Methods Three hundred and fourteen diabetic patients with symptom of DPN were retrospectively analyzed, who were recruited and divided into four groups according the course of diabetes mellitus: ≤ 3 years group, 4-6 years group, 7-9 years group and >9 years group. The abnormal rates of QST, NCS and F wave were analyzed and compared. Results At earlier course of disease (≤ 3 years group, 4- 6 years group), the abnormal rate of QST [76.54%(62/81), 91.67% (88/96)]>F wave[(48.15%(39/81),64.58%(62/96)]>NCS[(32.10%(26/81),47.92%(46/96)], and there were significant differences(P<0.01).The abnormal rate of QST, F wave and NCS at 7-9 years group and>9 years group had no significant differences(P>0.05).The abnormal rate of QST in 4-6 years group[(91.67%(88/96)]was higher than that in≤3 years group[(76.54%(62/81)],and decreased in 7-9 years group and >9 years group. The abnormal rate of NCS was increased with course of disease, and the range was obviously between close together group. The abnormal rate of F wave was increased with course of disease,but in 4-6 years group the range was obvious and the range was slow down.At earlier course of disease (≤3 years group, 4-6 years group), the abnormal rate of only F wave significantly increased the abnormal rate of NCS + F wave from 30.86%(25/81), 44.79% (43/96)to 46.91%(38/81), 61.46%(59/96)respectively, but in 7-9 years group and>9 years group, the abnormal rate of only F wave increased the abnormal rate of NCS + F wave from 69.44%(50/72), 84.61%(55/65)to 72.22% (52/72),86.15%(56/65).Conclusions Although the abnormal rate of F wave is not as high as QST, it is still remarkable. Detection of F wave shows positive correlations with the course of disease, which can reflect the course of disease objectively and reliably.The added F wave detection can distinctly raise the abnormal rates on the base of NCS.

This paper aims to study the effects of traditional Chinese medicine on multidrug resistant human gastric cancer cells in the cell proliferation, migration, invasion and apoptosis, and to study the apoptosis-inducing pathway. Different dilutions of extract were used to process human multidrug resistant gastric cancer SGC7901/ADR cells. Cell proliferation inhibition phenomenon was determined by MTT experiment. Nuclear morphological changes of apoptotic cells and apoptotic indexes were observed and determined by Hochest33528 staining followed with fluorescence microscope observing. Flow cytometry was used to detect cell apoptosis rate. Cell migration and invasion ability were observed and determined by Transwell method. Spectrophotometry was used to detect caspase-3 and caspase-9 enzyme activity. Western blotting was used to detect subcellular distribution of cytochrome c. The results showed that extract had obvious inhibition effect on proliferation of gastric cancer multidrug resistant SGC7901/ADR cells, which was time- and concentration-dependent. After processing multidrug resistant gastric cancer SGC7901/ADR cells with extract, the apoptotic index and apoptosis rate were significantly increased than those in the control group, which showed a time- and dose-dependent mode; but if a caspase inhibitor was added, apoptosis index was not obviously increased. Transwell method showed that migration and invasion ability of the extract-processed SGC7901/ADR cells dropped significantly. Spectrophotometry showed that in extract-processed SGC7901/ADR cells, caspase-3 and caspase-9 expression were increased, which had significant differences with the control group. Western blotting test showed that the distribution of cytochrome c decreased in mitochondria, while increased in the cytoplasm (i.e., cytochrome c escaped from mitochondria to the cytoplasm). In conclusion, extract could inhibit the proliferation, migration and invasion, and induce apoptosis in human gastric cancer multidrug resistant SGC7901/ADR cells; and cytochrome c, caspase-9 and caspase-3 might be involved in cell apoptosis induced by extract, suggesting endogenous or mitochondrial apoptotic pathway.