Objective To investigate the effect of general anesthesia of laryngeal mask airway in laparoscopic appendectomy;Methods 106 cases of laparoscopic appendectomy patients in the informed consent were randomly divided into LMA group and intubation group by odd and even numbers of hospital,53 cases per group,all patients were used of rapid induction of general anesthesia,oxygen 3 ～ 5min,laryngeal mask insertion laryngeal mask anesthesia,intubation group received tracheal intubation under general anesthesia,then compared of both groups in vital signs and complications; Results HR and MAP of intubation group 5min after intubation was statistically significant from during anesthesia and anesthesia stopped 5 min ( t = 7. 823,6. 849,15. 331,17. 636, all P ＜ 0. 05 ), MAP and HR of other point had no significant difference ( P ＞ 0. 05 ). Regurgitation and aspiration, and complications such as nausea and vomiting had not been observed,emergence agitation in the LMA group was 5.7% ,cough was 9. 4% ,hoarseness was 1.9% all were significantly lower than the intubation group( x2 = 10. 415,7. 996,5. 410, all P ＜ 0. 05 ). Conclusion Laryngeal mask airway under general anesthesia with intubation in the laparoscopic appendectomy had the same anesthetic effect and it's impact on vital signs were small ,and it had a lower incidence of complications.

Lysosomal storage disorders (LSDs) are genetic defects caused by lysosomal hydrolase deficiencies. These deficiencies lead to substrate accumulation affecting cells, tissues and organs. Detecting abnormal compound excretion and deficient enzymes assist diagnosis of these disorders for treatment and prevention. This mini review summarizes clinical presentations and diagnostic workup of LSDs and updates the new development in the area.

ObjectiveTo explore the application value of repaglinide combined with metformin in type 2 diabetes therapy.Methóds92 patients with type 2 diabetes were randomly divided into study group and control group.Two groups of patients were given repaglinide treatment,patients in study group given metformin treatment.The blood lipid,glucose metabolism,body weight change and clinical outcomes were compared belween the groups.ResultsCompared with the control group,study group the cure rate and total effective rate was significantly increased,as high as 58.7％ and 97.8％,the ineffective rate was significantly decreased,only 2.2％,there were significant differences ( x2 =2.64,3.59,3.59,P ＜ 0.05 ).The fasting and 2h postprandial blood glucose and glycated hemoglobin and other indicators of glucose metabolism in the study group were significantly decreased,there were also significant differences(P ＜ 0.05 ).The triglycerides and cholesterol and other lipid levels and body mass index in the study group were significantly decreased,there were significant differences ( P ＜ 0.05 ).ConclusionRepaglinide combined with metformin in type 2 diabetes treatment was remarkable for type 2 diabetes to further improve the clinical efficacy.

Objective To evaluate the effect of dexmedetomidine on p38 mitogen -activated protein kinase (p38MAPK)signaling pathways in ventilator -induced lung injury of rats.Methods 100 SD rats were divided into 5 groups(n =20)by random number table.The control group(Group C),mechanical ventilation(Group H)and different dosage of dexmedetomidine group (Group DEX1 -3 ).Group C:no mechanical ventilation with natural breathing air for 4h;Group H:high tidal volume ventilation for 4H,inhaled oxygen concentration was 21%;Group DEX1 -3:20min before mechanical ventilation,infusion of dexmedetomidine(0.5,1.0,and 2.0μg/kg)with loading dose (5mL,0.5,1.0,and 2.0μg·kg -1 ·h -1 )for 4 hours.Femoral arterial blood were collected after mechanical ventilation for 1h,2h and 4h(T1 -4 )in basic status,the arterial blood gas and the PaO2 were analysized and recorded. concentration of total protein,TNF -αand macrophage inflammatory protein -2(MIP -2)in bronchoalveolarlavage fluid(BALF)were detected in rats after ventilation for 4h;myeloperoxidase(MPO)activity in lung tissue was deter-mined;intercellular adhesion molecule -1(ICAM-1)expression and lung wet/dry weight(w/d)ratio were detected;p -p38MAPK protein expression was detected by Western blot;pathological changes of lung tissue in each group and cell apoptosis were observated.Results Compared with the group C,expression of P -p38MAPK(5.4 ±0.5)and p38MAPK/p -p38MAPK(1.64 ±0.17)increased in Group H(F =3.22,3.28,all P <0.05),accompanied by the increased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -αand MIP -2 concentration in the BALF[(6.4 ±1.1),(1.95 ±0.16)U /g,(1 459.39 ±0.29)mg/L,(182 ±9)ng/L,(436 ±31)ng/L](F =3.53, 3.66,3.21,3.32,3.43,all P <0.05);.And compared with group H,expression of p -p38MAPK and p38MAPK/p -p38MAPK in DEX2 groups and DEX3 fell(F =3.22,3.28,all P <0.05)accompanied by decreased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -a and MIP -2 concentration in the BALF(F =3.53,3.66, 3.21,3.32,3.43,all P <0.05).Compared with the group H,PaO2 at each point showed no statistically significant difference in group DEX1 -3(F =1.43,P >0.05),and no significant difference of W/D in group DEX 2 ~3(F =2.89,P >0.05 ).Heavy pathological damage of lung tissue and significant apoptosis were observed in group H. Conclusion Dexmedetomidine can inhibit the development of ventilator -associated lung injury.The mechanism may associated with the inhibition of phosphorylation of p38MAPK,thereby inhibiting the expression of downstream inflam-matory factors.

Objective: To construct an adenoviral vector containing cDNA of EWS-FLI1 and detect its expression in peripheral blood mononeuclear cell(PBMC).To Investigate the antitumor immunity in vitro of the EWS-FLI1 gene modified-dendritic cells.Methods: The EWS-FLI1 cDNA in plasmid Pec1/ EWS-FLI1 was digested and subcloned into the shuttle plasimid padtrack-cmv.The shuttle plasmid and the bone plasmid pADeasy-1 were cotransformed into BJ5183 cells.The recombinant plasmid was generated by homologous recombination in BJ5183 cells.The positive clone was obtained by digestion and electrophoresis.Transforming the recombinant plasmid into "293 cells" by lipofectamine method.Adenoviruses with high titer and purity were obtained by amplifying in the"293 cells" on a large scale and ultra-centrifugation in CsCL step gradient solutions.The cytotoxic activity of stimulated T cells to Ewing sarcoma cells was detected by ~(51)Cr release assay.Results: PCR showed that the adenovirus contained EWS-FLI1(cDNA.) After the PBMC were transfected by Ad EWS-FLI1,the EWS-FLI1 mRNA was detected by(RT-PCR.) The antigen-specific CTL was induced successfully by the EWS-FLI1 gene modified-DC.The vigorous antigen-specific CTL response against A673 cells was detected by ~(51)Cr release assay.The killing percentage was 35.18%?0.0128% at effector-target ratio 40∶1,which was more efficient than that of the control.Conclusion: The recombinant adenovirus was successfully constructed and could efficient express EWS-FLI1 in PBMC.After T lymphocytes were stimulated by DCs modified with EWS-FLI1 gene,the specific CTL response against Ewing's sarcoma cell line A 673 in vitro was observed successfully.~(51)Cr release assay showed that there was significant difference between the experimental group and the control group.

Effects of cutting the ventral trunk of abtominal vagus nerve of rats. and stimulating its central end on the somatostatin concentration in amygdala, hy-pothalamic nuclei and stomach were studied by radioimmunoassay.Following section of the vagus nerve, the somatostatin concentration of amygdaloid nuclei was not changed, that of lateral preoptic area, hyopthalamic ventromedial nuclei and paraventricular nuclei was reduced, and that of mucosal and muscular layers of antrum and corpus of stomach was also decreased, indicating the tonic influence of the vagus nerve impulses on hypothalamic and gastric somatostatin concentration. Electrical stimulation of the central end of the vagus nerve decreased the somatostatin concentration of medial, lateral and central amygdala, increased that of lateral preoptic area, hypothalamic ventromedial and paravcntricular nuclei, and also increased that of mucosal and muscular layers of gastric antrum, suggesting that somatostatin in amygdala and hypothalamic nuclei plays a role in central integration of visceral afferent information.

The effects of somatostatin and cysteamine injccted into the ventromedial nucleus of the hypothalamus (VMH) on somatostatin-like immunoreactivity (SLI) concentration in the gastric antral mucosa and portal vein plasma as well as the gastric acid secretion were studied in anesthetized rats. The SLI concentration in the gastric antral mucosa and portal vein plasma and the gastric acid output were significantly increased one hour after injection of somatostatin (o. 5 ?g/0.5 ?l) into the VMH. Four hours later, the SLI concentration in the mucosa was still higher than the control level, while the SLI level in the plasma and the acid secretion were close to those of controls. On the contrary, the SLI concentration in the mucosa and plasma and the acid output were markedly decreased at four hours after injection of cysteamine (15?g/0.5?l) into the VMH. The present results suggest that both exogenous and endogenous somatostatin in the VMH have a facilitory action on the gastric somatostatin concentration and its release as well as on the gastric acid secretion, thus providing evidence for hypothalamic control of gastric somatostatin and acid secretion.

OBJECTIVE: To analyze the highly cited papers in China Pharmacy so as to provide reference for drug research and application in China.METHODS: A bibliometric analysis was conducted to study the highly cited papers in China Pharmacy from 1990 to 2008 using Chinese Journal Full-Text Database(CJFD) and Chinese Science Citation Database(CSCD).RESULTS: Of all those papers,32 papers had a citation frequency of 30,being highly cited 2 to 6 years after their publication.349 papers had a citation frequency of 10,and their publishing time was mainly from 1996 to 2005.These highly-cited papers were mostly related to hospital pharmacy,followed by pharmacy administration and pharmaceutics as well as review articles.CONCLUSIONS: The focuses and hot topics of present pharmacy research in China Pharmacy were rational drug use,pharmaceutical care,the methodology and application of pharmacoeconomics etc.

Objective To analyze the efficacy of modified epley maneuver associated with betahistine for treating posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods 78 cases with unilateral PC-BPPV were divided into complexed therapy group(39 cases)and control group(39 cases)randomly.The complexed therapy group was treated by modified epley maneuver associated with betahistine 6mg per time,3 times daily for successive 1 month.the control group was treated by modified epley maneuver only.Results 78 patients after first treatment,56 cases were cured,control group(28 patients),complexed therapy group(28 cases),no statistically significant difference between the two groups.After 1 month of treatment,the control group were cured 30 cases,effective 3 cases,invalid 6 cases;the complexed therapy group were cured 37 cases,effective 1 case,invalid 1 case;complexed therapy group,the cure rate was 94.9％,significantly higher than the 76.9％ of control group(x2=4.3365,P＜0.05).Conclusion The modified epley maneuver associated with betahistine is effective to treat PCBPPV,which is worth being promoted.

Objective To investigate the surgical treatment and prognostic factors in elderly patients with thyroid cancer.Methods The surgical treatment and prognostic factors of 96 patients over the age of 60 years with thyroid cancer were analyzed retrospectively in our hospital from January 2001 to December 2010.The Kaplan-Meier method was applied to analyze survival rates,Log-rank test was used in the univariate analysis and multivariate Cox model was applied for the independent prognostic factors analysis.Results The 5 year survival for elderly patients was 73.6％ and median survival time was 68 months.Univariate analysis indicated that sex,age,lymph node metastases,distant metastasis,clinical stage,extent of tumor invasion and modified cervical lymph node dissection were prognostic factors (all P＜0.05).Multivariate analysis showed that age,clinical stage,extent of tumor invasion and distant metastasis were independent prognostic factors(P＜0.05).Conclusions The elderly patients with thyroid cancer are in poor prognosis.Age,clinical stage,extent of tumor invasion and distant metastasis are independent important prognostic factors.Individualized surgical treatment should be made on the basis of correct assessment of prognosis.