Objective To evaluate the effects of different target effect-site concentrations (Ces) of sufentanil on the minimum alveolar concentration of desflurane inhibiting stress responses to skin incision (MACsAR) in 50％ of patients undergoing abdominal surgery.Methods Eighty-three patients,aged 20-60 yr,scheduled for elective abdominal surgery with an expected incision longer than 10 cm,were enrolled in the study.All the patients were randomly allocated to one of three groups using a random number table:control group (group C,n =28),sufentanil with target Ce of 0.1 ng/ml group (group S1,n =27),and sufentanil with target Ce of 0.3 ng/ml group (group S2,n =28).After tracheal intubation,desflurane inhalation was started,and sufentanil was infused at the preset target Ces in S1 and S2 groups.The initial end-tidal concentration of desflurane was 9.0％ in group C,and 6.0％ in S1 and S2 groups.The target concentration was maintained at least for 15 min.The modified up-and-down method was used to perform the test.The end-tidal concentration of desflurane was adjusted in the next patients according to the response to skin incision.The MACBAR and 95％ confidence interval of desflurane was calculated according to the up-and-down method.Mean arterial pressure and heart rate were monitored and recorded and rate-pressure product was calculated.Results The MACBAR (95％ confidence interval) ofdesflurane was 11.2％ (11.1％-11.3％),7.8％ (7.7％-7.9％),and 4.2％ (4.1％-4.3％) in C,S1 and S2 groups,respectively.MACBAR and rate-pressure product of desflurane were significantly lower in S1 and S2 groups than in C group,and in S2 group than in S1 group (P ＜ 0.05 or 0.01).Conclusion The optimum target Ce of sufentanil is 0.3 ng/ml when combined with desflurane in the patients undergoing abdominal surgery.

Objective To observe the research of the biologically performance,interface micro-structure and nano-indentation situation when polymethyl methacrylate bone cement-PMMA injected into rabbit in the near future and far future individually.Methods New Zealand white rabbits were used ovariectomy plus dcxamethasone intramuscular injection to establish osteoporosis animal model.All animal models were divided into 3 groups with 35 in each osteoporosis group,testing group,and normal group.Execute the lumbar centrum of New Zealand rabbit as osteoporosis bone defect model,injected bone cement,with the help of material dynamo experiment machine to do the axial compression tests,three point bending test,and torsion test in order to observe the biological dynamic changes.Optical microscope,fluorescence microscope and scanning electron microscope were used to observe the changes of micro bone cement and the changes of bone looseness.Nano-indentation testing was applied by the triboindenter to study the critical load.Results PMMA can rapidly establish the strong support with stable function in the near future.Biomechanical experiments showed that biomechanical properties of bone cement group was significantly higher than those in the other two groups.Biomechanical properties of bone cement group may decline with the time,but which were still better than those of OP in the control group.Histo-morphological observation result shows that under osteoporosis state the bone grows slower,bone's rebuilding time also extended.And in the later period,main bone's continuous osteoporosis had some impact on the interface.Nano-indentation testing showed that the young modulus and stiffness of the interface among bone,material and interface were significantly differences.Bone cement had showen the best nano indentation hardness,then was interface and bone tissue.Conclusion The polymethyl methacrylate bone cement llⅢ has a good effect in filling,on account of it has great plasticity and liquidity and can penetrate into the minuteness aperture between trabecula,then after solidifying,it will combine firmly with the host bone.PMMA can rapidly establish the strong support with stable function after operation.The performance is decreasing in the far future but still with satisfaction.

Objective This study combined genotyping with family doctors' contracting model to assess the application of precision medicine in rural patients with essential hypertension. Methods In this study, 209 hypertensive patients from 3 villages in Lujiang County, Hefei City, Anhui Province were selected as subjects and randomly divided into experimental group(n=105) and control group(n=104). The medication regimen of observation group was guided by genetic testing for gene sensitivity to antihypertensive drugs, and the control group was implemented routine pharmacy. All the patients were managed by family doctors. Adverse drug reaction rate, treatment compliance, blood pressure, body mass index (BMI), fasting blood glucose (FBG), cholesterol (TC), and triglycerides (TG) of the two groups were analyzed, respectively, during the 6-month intervention. Results After 6-month of intervention, the medication compliance of the experimental group were significantly higher than that of the control group, and the blood pressure and adverse drug reaction rate were significantly lower than that of the control group. After 3 months of intervention, there was no significant decrease in BMI, FBG, TC and TG in the two groups. After 6 months of intervention, the FBG, TC and TG of the experimental group were significantly decreased,while only the FBG value of the control group was significantly decreased. There were no significant changes in body mass index (BMI) values in both groups. Conclusions Individualized medication guided by genotyping can improve the treatment compliance, reduce the adverse drug reaction rate, and improve the treatment efficiency of patients with essential hypertension.

A case of ectodermal dysplasia syndrome was reported in this article. This case report and relevant literature of ectodermal dysplasia syndrome let us know the clinical symptom, etiology and effect factors of heredity of this disease.
Ectodermal Dysplasia ; Humans

Aneurysm, False ; etiology ; surgery ; Blood Loss, Surgical ; Carcinoma ; Carotid Arteries ; Carotid Artery Diseases ; etiology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Rupture

Adult ; Biopsy ; Cryptococcosis ; complications ; pathology ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Skin ; pathology ; Skin Diseases ; etiology ; pathology

BACKGROUNDThe non-hemodynamic effects of angiotensin receptor blocker (ARB) in the delay of progression of chronic kidney disease (CKD) remain unclear. In this study, we investigated the influence of irbesartan on the urinary excretion of cytokines in patients with CKD.

METHODSIn this randomized perspective clinical trial, different doses of irbesartan (150 mg/d and 300 mg/d) were given to two groups of patients in a cross-over design. Blood pressure (BP), creatinine clearance (Ccr) and 24-hour proteinuria were examined. Urinary excretion of cytokines was determined by human inflammatory cytokine antibody array. A two-fold change in spot intensity was considered significant.

RESULTSUrinary excretion of cytokines (granulocyte colony stimulating factor (GCSF), intercellular cell adhesion molecule-1 (ICAM-1), interferon γ (IFN-γ), interleukin 1β (IL-1b), IL-2, IL-6, IL-8, IL-11, IL-15 and macrophage inflammatory protein 1d (MIP-1d)) in group B (irbesartan 300 mg/d) was significantly decreased in comparison to group A (irbesartan 150 mg/d) after 8-week treatment. In group A, 8 weeks of treatment induced a two- to nine-fold reduction in urinary cytokine levels (GCSF, GM-CSF, IFN-γ, IL-1a, IL-11, IL-12p40, MCP-2, MIP-1a), while increasing the dosage to 300 mg/d further decreased the excretion of GCSF, GM-CSF, IL-12p40, MCP-2 and MIP-1a by week 18. There was no significant difference in BP or Ccr between the two groups. However, 24-hour proteinuria was significantly reduced in both groups, and in group A the reduction was dose dependent.

CONCLUSIONIrbesartan offers additional renoprotection in a dose-dependent manner by reducing pro-inflammatory cytokines excretion in the urine of CKD patients.

Angiotensin II Type 1 Receptor Blockers ; therapeutic use ; Biphenyl Compounds ; adverse effects ; therapeutic use ; Chronic Disease ; Creatinine ; metabolism ; Cross-Over Studies ; Cytokines ; urine ; Humans ; Kidney Diseases ; drug therapy ; immunology ; Prospective Studies ; Tetrazoles ; adverse effects ; therapeutic use

OBJECTIVEThe aim of this study was to evaluate the number of central cervical lymph node metastasis (CCLNM) in predicting lateral cervical lymph node metastasis (LCLNM) in patients with papillary thyroid carcinoma (PTC).

METHODSFrom January 2005 to October 2010, a total of 133 patients diagnosed as PTC underwent central and lateral cervical lymph node dissection were enrolled in this study. Quantitative analysis was performed to explore the correlation between the number of CCLNM and LCLNM.

RESULTSThe sensitivity of central cervical node metastasis to predict lateral cervical node metastasis was 84.7%(61/72), and the positive predictive value (PPV) was 66.3% (61/92). The incidence of lateral cervical LNM was correlated with the number of CCLNM (r=0.911, P=0.004). The LCLNM rates in patients with number of CCLNM <2 and ≥ 2 were 54.5% (12/22) and 70.0% (49/70), respectively, with a non-significant difference (P=0.181). The LCLNM rates in patients with number of CCLNM < 3 and ≥ 3 were 50.0% (19/38) and 77.8% (42/54), showing a significant difference (P=0.006). The LCLNM rates in patients with number of CCLNM <4 and ≥ 4 were 55.1% (27/49) and 79.1% (34/43), with a significant difference (P=0.015). The LCLNM rates in patients with number of CCLNM <5 and ≥ 5 with the LLNM rate were 57.6% (34/59) and 81.8% (27/33), showing a significant difference (P=0.019). The LCLNM rates in patients with number of CCLNM <6 and ≥ 6 were 60.0% (39/65) and 81.5% (22/27), showing a significant difference (P=0.047).

CONCLUSIONSCCLNM has a significant association with LCLNM in patients with papillary thyroid carcinoma. LCLNM is mainly observed in patients with ≥ 3 CCLNM. Therefore, the number of CLNM ≥ 3 may be a valuable predictor of lateral cervical lymph node metastasis, and lateral cervical lymph node dissection should be considered.

Axilla ; Carcinoma, Papillary ; secondary ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck ; Neck Dissection ; Sensitivity and Specificity ; Thyroid Neoplasms ; pathology

OBJECTIVETo study the cell biological mechanism of sodium selenite improving insulin sensitivity in pubertal rats with insulin resistance.

METHODSThe content of inositol 1,4,5-trisphosphate (IP3) was examined by anion resin chromatography, and mRNA levels of phosphatidylinositol 3-kinase regulatory subunits (PI3Kp85 alpha) and Se-P were detected by RT-PCR in hepatocyte isolated from pubertal rats with insulin resistance.

RESULTSThe mRNA levels of Se-P and PI3Kp85 alpha and content of IP3 in isolated hepatocyte decreased in pubertal male rats with insulin resistance. The above indices increased and reached normal level in rats supplied with selenium. The response to insulin stimulation in isolated hepatocyte in rats with selenium supply was similar to that in the control group, and both groups had higher response than those with high-fat diet. Alone when inhibited by wortmannin, the concentration of IP3 increased slightly in rats with selenium supply, but still was lower than that in the control group.

CONCLUSIONSThese results indicate that the effect of selenium improving insulin sensitivity may be related to phosphatidylinositol PI3K signalling pathway. The effect of regulation of IP3 by selenium is not as effective as that by insulin, which may explain the difference of effect between selenium and insulin.

Animals ; Cell Separation ; Hepatocytes ; cytology ; metabolism ; Inositol 1,4,5-Trisphosphate ; analysis ; Insulin ; pharmacology ; Insulin Resistance ; Male ; Phosphatidylinositol 3-Kinases ; analysis ; Proteins ; analysis ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Selenoproteins ; Signal Transduction ; Sodium Selenite ; pharmacology

OBJECTIVETo study the causes of chronic cough in children.

METHODSRetrospective analysis was carried out on the clinical data of 132 children with chronic cough from August 2010 to September 2011.

RESULTSSeveral conditions were found to contribute to chronic cough in children, including cough variant asthma (CVA, n=56), upper airway cough syndrome (UACS, n=44), infections/postinfectious cough (IC/PIC, n=22), allergic cough (AC, n=8), gastroesophageal reflux cough (GERC, n=5), and others (n=3). There was significant difference in the distribution of IC/IPC among an infant group (<1 year), a group of young children (>1 year), a group of preschool aged children (>3 years) and a group of school-age children (6-14 years) (χ2=11.638, P=0.001), and the infant group showed a significantly higher prevalence of IC/PIC than the other three age groups (P<0.05). IC/PIC was the main cause of chronic cough in the infant group, while CVA and UACS were the main causes in each of the other groups. A relatively large proportion of AC, CVA and UACS cases had a personal history of allergy, a family history of allergy/asthma and a history of exposure to harmful environments.

CONCLUSIONSCVA, UACS, and IC/PIC are main causes of chronic cough in children, varying among different age groups. Children with a personal history of allergy, family history of allergy/asthma and a history of exposure to harmful environment are more vulnerable to AC, CVA and UACS.

Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Cough ; etiology ; Female ; Humans ; Hypersensitivity ; complications ; Infant ; Infection ; complications ; Male ; Retrospective Studies