Objective To evaluate the efficacy of dexmedetomidine combined with sufentanil for patientcontrolled intravenous analgesia (PCIA) after caeserean section. Methods One hundred and twenty parturients aged 18-40 yr undergoing caeserean section under spinal-epidural anesthesia were randomly assigned to one of 3 groups( n=40 each):group Ⅰ , group Ⅱ and group Ⅲ . During operation as soon as the baby was bom a bolus of dexmedetomidine 0.5 μg/kg was given iv in Ⅱ and Ⅲ groups while in group Ⅰ normal saline (NS) was given instead. Ⅰ and Ⅱ groups received PCIA with sufentanil (background infusion 0.015 μg·kg-1·h-1;bolus dose 0.023 μg/kg;lockout interval 8 min). Group Ⅲ received PCIA with sufentanil + dexmedetomidine (background infusion sufentanil 0.015 μg·kg-1 ·h-1 + dexmedetomidine 0.045 μg·kg· h-1;bolus dose sufentanil 0.023 μg/kg + dexmedetomidine 0.07 μg/kg;lockout interval 8 min) . Pain threshold and pain tolerance threshold were measured before caeserean section and 1 h after bolus dose of dexmedetomidine or NS. VAS, OAA/S and satisfaction scores and sufentanil consumption were recorded at 4, 8 and 24 h after operation.Blood samples were obtained before anesthesia,1 h after bolus injection of dexmedetomidine, and 24 h after operation for determination of serumcortisol concentration. Results Pain threshold and pain tolerance threshold at 1 h after bolus injection of dexmedetomidine were significantly increased as compared with the baseline before anesthesia in Ⅱ and Ⅲ groups and were significantly higher in Ⅱ and Ⅲ groups than in group Ⅰ . VAS scores and the consumption of sufentanil were significantly lower while the satisfactory score was significantly higher in group Ⅲ than in Ⅰ and Ⅱ groups. Serum cortisol concentrations were significantly increased at 1 h after iv dexmedetomidine or NS injection as compared with the baseline before anesthesia in all 3 groups, but there was no significant difference in serum cortisol levels among the 3 groups. Conclusion Addition of dexmedetomidine to sufentanil for PCIA can significantly reduce the consumption of sufentanil and improve parturient's satisfaction.

Objective:To investigate the application value of magnetic resonance dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) combined with microRNA-21 (miR-21) and miR-92a in the benign and malignant differentiation of bone tumors and the evaluation of their efficacy.Methods:A total of 120 patients with bone tumors were selected retrospectively from June 2018 to June 2019 in Panyu Hospital of Chinese Medicine, including 52 cases in the benign group and 68 cases in the malignant group. The DCE-MRI dynamic enhancement parameters and tumor tissue miR-21, miR-92a levels were compared between the two groups. The diagnostic value of DCE-MRI, miR-21, miR-92a levels of cancer tissue and their correlation were analyzed. Patients with bone malignant tumors were given comprehensive treatment. Six months after operation, according to the criteria of solid tumor curative effect, they were divided into good curative effect group and poor curative effect group. The DCE-MRI dynamic enhancement parameters [signal enhancement amplitude (SEE), early dynamic enhancement slope value (Slope), centripetal enhancement rate (DER)], miR-21, miR-92a levels of patients with different curative effects were compared.Results:The levels of SEE, Slope, DER and miR-21 a nd miR-92a in the malignant group were higher than those in the benign group ( P<0.05); The area under curve (AUC) of DCE-MRI, miR-21, miR-92a combined in the diagnosis of benign and malignant bone tumors (0.885)>Slope(0.808)>SEE(0.788)>miR-21(0.785)>miR-92a (0.740)>DER(0.660), with sensitivity 80.88%, specificity 88.46%, respectively; the DCE-MRI dynamic enhancement parameters SEE, Slope, DER were positively correlated with miR-21 and miR-92a ( P<0.05); the DCE-MRI dynamic enhancement parameters SEE, Slope, DER and miR-21, miR-92a of patients with good curative effect were lower than those with poor curative effect ( P<0.05). Conclusions:DCE-MRI dynamic enhancement parameters, miR-21, miR-92a levels are abnormally high expression in patients with bone malignant tumors, and combined detection is expected to become an important means to identify benign and malignant bone tumors and evaluate the efficacy.

Objective To examine the relationship between hematocrit and risk of long term mortality among patients with acute myocardial infarction. Methods A total of 274 patients with acute myocardial infarction were recruited and divided into two groups by death after long term follow-up, the relationship between hematocrit and mortality was evaluated through the methods of independent t-test,chi-square test and multivariate regression analysis. Results The mean age was 69. 79 ± 7.45 years, with 73. 0% of male. The average of followup was 44. 4± 10. 7 months, with mortality of 38.7% . Comparison of baseline data showed that NYHA classification, smoking history, hemoglobin, hematocrit, mean red cell volume, glomerular filtration rate, ejection fraction,left ventricular diastolic diameter and right ventricular diameter was significantly different between the two groups( Ps ＜ 0. 05), Multivariable logistic analysis showed that hematocrit ,glomerular filtration rate, ejection fraction and smoking history were independently predicted factors, with OR of 0. 904 (95% CI: 0. 832 - 0. 982,P =0. 016) ,0. 983 (95% CI: 0. 969 -0. 996,P =0. 014) ,0. 932 (95% CI: 0. 887 -0. 979,P =0. 005) and 3. 230 (95% CI: 1.468 - 7. 106, P = 0. 004), respectively. The power of hematocrit to predict mortality was examined by ROC curves, the area under the curve was 0. 669(P ＜ 0. 001,95% CI: 0. 603 - 0. 736) Conclusion Hematocrit is a significant independent predictor for long term death among patients with acute myocardial infarction.

BACKGROUND:In oral warm and moisture circumstance, al oy which contains Be is easily to be eroded to release Be2+. But there is stil no research focusing on beryl ium influence on genotype of Porphyromonas gingivalis fimbriae gene cluster. OBJECTIVE:To investigate Be 2+effect on genotype of Porphyromonas gingivalis fimbriae gene cluster. METHODS:The revived Porphyromonas gingivalis was resuscitated for 48 hours in the anaerobic culture medium with different concentration of Be 2+(10×10-6, 5×10-6, 1.25×10-6). Through PCR amplification and sequencing, we investigated the effects of Be2+RESULTS AND CONCLUSION:(1) When Be on genotypes of Porphyromonas gingivalis fimbriae gene cluster. 2+concentration was 5×10-6, we found the peak of 217 and 257 sites on DNA sequence expressing G/A overlap peak, different from G single peak of the other groups, suggesting the suspicious bases changes, part of the single base G mutated into A. (2) On al concentrations, we found a base group composed of seven A bases was inserted into the 101 site of DNA sequence. Up to now, there is no direct contacts of the mutations occurring to Be2+concentration. Changes of gene may lead to the shifting of the reading frame, the abnormal synthesis of proteins, the change of Porphyromonas gingivalis fimA gene toxicity, and lastly the unbalance of the micro-ecological environment.

AIM:To identify and quantify the expression of IL-1βand IL-17 in mast cells ( MCs) in different types of human pericapical diseases using double immunofluorescence staining .METHODS: The specimens ( n=102 ) , including healthy control ( n=35 ) , periapical cyst ( n=35 ) and periapical granuloma ( n=32 ) , were involved in the present study .The tissue samples were fixed in 10% buffered formalin for at least 48 h and then embedded in paraffin . Serial 5-μm-thick sections were deposited onto SuperFrost/Plus microscope glasses .Routine staining of the sections using hematoxylin&eosin ( HE) was performed for morphological evaluation .The number of IL-1βand IL-17 positive MCs was identified by double immunofluorescence staining .RESULTS:Compared with the healthy controls , the inflammation score of periapical lesions was significantly increased in the periapical patients (P<0.01).The density of IL-1βand IL-17 posi-tive MCs in the periapical lesions were obviously higher than that in the healthy controls (P<0.01).However, no signifi-cant difference between periapical cyst and periapical granuloma was observed .The Pearson correlation analysis showed that there was a positive correlation between the density of IL-1βand IL-17 double positive MCs and inflammation score in dif-ferent groups of specimens (P<0.01).CONCLUSION:There is significantly increased number of MCs , along with in-creased density of IL-1βand IL-17 positive MCs in human periapical lesions .The increased density of IL-1βand IL-17 positive MCs has the similar tendency as the severity of tissue inflammation in human periapical lesions , suggesting that IL-1βand IL-17 positive MCs may play an important role in the pathogenesis of human periapical diseases .

AIM: To investigate the expression of stem cell factor (SCF) in tryptase -positive mast cells ( MCs) in different types of human periapical diseases for determining the role of SCF and MCs in the pathogenesis of peria-pical diseases.METHODS: A total 50 cases of specimens were involved in this study, including healthy control (n=20), periapical cyst (n=15) and periapical granuloma (n=15).The tissue material was fixed in 10%formalin for at least 48 h, stained with hematoxylin and eosin for the observation of histopathology, stained with immunohistochemistry for identifying MCs and MCs degranulation, and stained with double immunofluorescence for identification of tryptase-SCF double positive MCs.RESULTS:Compared with healthy control, significantly higher densities of both total and degranu-lated MCs in human periapical lesions were observed.The densities of both total and degranulated MCs in the periapical cyst were significantly higher than that in the periapical granuloma.The density of tryptase-SCF double positive MCs in the periapical lesions was significantly higher than that in the healthy controls.The density oftryptase-SCF double positive MCs in the periapical cyst was significantly higher than that in periapical granuloma.No significant difference in the density of MCs between immunohistochemistry staining and double immunofluorescence staining was observed.CONCLUSION:The tryptase-SCF double positive MCs play an active role in the pathogenesis of the periapical inflammatory lesions, particularly in the formation of fibrous tissue in periapical cyst.The potential role of the tryptase-SCF double positive MCs relates with the initiation, development, and persistence of the periapical inflammatory process.

Objective To determine the effects of valsartan, a specific angiotensin Ⅱ type 1 receptor blockade, on arrhythmia in rabbits after myocardial infarction and to discuss the mechanism. Method Twentyfour rabbits were randomly (random number) divided into sham operated (SO) group ( n = 8), myocardial infarction (MI) group ( n = 8) and valsartan (VAL) group ( n = 8). The rabbits of SO group were operated upon with median stemotomy without left ventricular coronary artery hgature. The rabbits of MI group and VAL group had median stemotomy with left ventricular coronary artery ligature. After MI, the rabbits of VAL group were fed with border zone of infracted left ventricular wall and the L-type calcium current was recorded by whole-cell patch clamp technique. Results Ventricular tachycardia or fibrillation (VT/VF) episodes were markedly decreased in VAL group than that in MI group [(3.2 ± 0. 6) vs. ( 11.7 ± 1.8)] after 12 weeks. The density of Ica-L current was higher in MI group than that in SO group and VAL group [( - 9.12 ± 0.73) pA/pF vs. ( - 6.29 ± 0.65) pA/pF and ( - 6.75 ± 0.64) pA/pF], ( P ＜ 0.05), however, there were no significant differences in Ica-L current between So group and VAL group ( P ＞ 0.05). Conclusions Valsartan reduces the VT/VF episodes in rabbits after MI. The effects of valsartan may be attributed to the inhibited electrical remodeling after MI.

AIM: To investigate the effect of sucking porcine liver extracts (LE) and doxorubicin (DXR) on BEL-7402 hepatoma cells in the renal capsulae of BALB/c nude mice. METHODS: Histo-cellular morphology, mitotic counting, ultrastructural observation and in situ DNA labeling apoptotic detection were performed. RESULTS: Both LE and DXR can apparently inhibit the tumors' growth and induce the apotosis of hepatoma cells. LE exerted no apparent effect on the hepatoma cell mitosis, but DXR inhibited it. Electron-microscopic observations showed LE can induce the hepatoma cells to apoptosis. CONCLUSIONS: LE can induce the hepatoma cells to apoptosis, but has no apparent effect of their differentiation and proliferation. DXR can not only induce the hepatoma cells to apoptosis and inhibit their growth, but also can promote their differentiation.

Objective To investigate the prognostic value of right ventricular end-diastolic diameter (RVDD) in patients with chronic systolic heart failure (CHF).Methods A retrospective study was conducted with clinical data of inpatients from 12 third-grade class-A hospitals of Hubei Province between 2000 to 2010,followed up by phone calls.Based on RVDD,patients diagnosed with chronic systolic CHF were divided into four groups:＞38 mm,31-38 mm,25-30 mm and ＜25 mm groups;based on prognosis,patients were divided into the death group and the survival group.Of the death group,patients were further divided into the heart failure death subgroup and the sudden cardiac death subgroup.Single-factor and multi-factor Cox survival analyses were conducted to analyze the relationships between RVDD and mortality,including all-cause mortality,CHF mortality and sudden cardiac death (SCD).Results A total of 16681 patients were enrolled in this study.They were followed up for 1-4 years,during which 6453 died.Multivariate Cox survival analysis showed that the mortality risk for patients with RVDD between 25-30 mm,between 31-38 mm,and ＞38 mm groups was 1.87,2.41,3.95 times that for patients with RVDD＜25 mm,respectively (95％CI:1.64-2.13,2.06-2.80,3.61-4.32,all P＜0.01).The risk of sudden cardiac death for patients with RVDD＞38mm was 3.82 times that for patients with RVDD＜25 mm (95％CI:2.27-5.94,P＜0.01).The areas under the ROC curve for death by the best prediction model alone and RVDD combined with the best respectively.RVDD increased the areas under the ROC curve for all cause mortality,CHF mortality and sudden cardiac death.The best prediction model combined with RVDD could discriminate between total mortality,heart failure mortality and sudden cardiac death for patients with different causes of death in multivariate analysis.Conclusions RVDD has a predictive value in the prognosis of patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model for total mortality prediction in patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model to discriminate between all-cause mortality,heart failure mortality and sudden cardiac death in patients with different causes of death.RVDD＞38 mm can serve as an indicator for the assessment of sudden cardiac death in CHF patients.

Objective To investigate the prevalence and prognostic value of anemia in male and female patients with chronic systolic heart failure (CSHF).Methods Data of in-hospital patients with CSHF were investigated between 2000 and 2010 from 12 hospitals in Hubei Province.Patients were divided into normal hemoglobin (Hb) group,mild anemia group,moderate anemia group,severe and extreme anemia group.According to age,body mass index (BMI) and correction of glomerular filtration rate (GFRc),patients were divided into several subgroups,respectively.Multivariate logistic regression was performed to determinate the associated factors with anemia.Kaplan-Meier curve was performed to evaluate the difference in all-cause mortality in male and female patients with anemia.Univariate and multivariate Cox proportion hazard analysis was performed to determinate the risk of all-cause mortality among different anemia group in male and female patients.Results A total of 16681 patients were enrolled.Anemia accounted for 23.79％ and 27.29％,separately,in male and female patients with CSHF.BMI and GFRc were related to anemia in both male and female patients with CSHF,while only age was related to anemia for female patients with CSHF.The hazard ratio of all-cause mortality was 1.08 (P ＜ 0.01),1.13 (P ＜ 0.O1) and 1.02 (P =0.74),respectively,for all,male and female anemia patients with CSHF,compared to normal Hb group.Compared to normal Hb group,the hazard ratio of mild anemia group,moderate anemia group,severe and extreme anemia group was 1.05 (P =0.14),1.20 (P ＜0.01) and 1.36 (P ＜0.01),respectively,for all CSHF patients;1.11 (P ＜ 0.01),1.35 (P ＜ 0.01) and 1.37 (P ＜ 0.01),respectively,for male;0.96 (P=0.48),1.08 (P=0.40) and3.47 (P＜0.01),respectively,for female.Conclusions Compared to male,female patients suffer higher prevalence of anemia in patients with CSHF.There is a significant difference in risk factors and prognosis of anemia between male and female patients with CSHF.