Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia.Methods Sixty parturient women,ASA grade Ⅰ-Ⅱ grade,scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group.All patients underwent combined spinal-epidural anesthesia.Spinal anesthesia consisted of isobaric bupivacaine 0.5％ (10 mg) in the standard group (group A),isobaric bupivacaine 0.5％ (10 mg) plus 5 mg meperidine in group B,isobaric bupivacaine 0.5％ (10 mg) plus 10 mg meperidine in group C,isobaric bupivacaine 0.5％(10 mg) plus 15 mg meperidine in group D.The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively.Results All patients were successfully operated,not unexpected.Four groups at each time point of vital signs,nausea and vomiting,and the number of cases of neonatal 1,5 min Apgar scores was no significant difference (P ＞ 0.05).Group A of shivering and the third grade shivering were significantly more than the number of group B,C,D(11 cases vs.2,1,1 cases;4 cases vs.0,0,0 cases,P＜ 0.01).Conclusion Epidural anesthesia,intrathecal meperidine 5-15 mg can effectively prevent shivering in cesarean section.

Objective To explotr clinical application of impulse oscillation system(IOS)determining bronchodilator reversibility test and the impact of age factor on positive values of bronchoddilator reversibility test in children.Methods Two hundred and fifteen patients during asthma attack were recruited randomly for this study.They were divided into three groups according to their age(4-7 year-old group,8-11 year-old group and 12-16 year-old group).Mensurated MEFV and IOS lung function.Carried on the bronchial dilation test with the results.Forced expiratory volume in first second(FEV1),the sensitivity and specificity of IOS parameters,total respiratory impedance(Zrs),respiratory resistance at 5 Hz(R5)and 20 Hz(R20),reactance at 5 Hz(X5)and resonant frequency(Fres)for diagnosing asthma at different improvement levels after inhalation of bronchedilator were calculated respectively through using FEV1 as a "sold standard"in the different age groups.Results After inhalation of bronchodilator,Fres,Zrs,R5,X5 and R20 of IOS were improved significantly.The improvement of X5 was the most obvious,however the decline of R20 was the lowest.The improving rate of Fres,Zrs,R5 had very significant difference in the three age groups(P＜0.01).It displayed that the age factor was very important impact factor on the improving rate of Fres,Zrs,R5,however the improving rate of X5 was on difference in the three age groups(P＞0.05).In the three age groups,there were significantly positive correlations between X5,R5,Zrs and FEV1(P＜0.01).there wash't correlations between R20 and FEV1 in the 4-7 year-old group and the 12-16 year-old group(P＞0.05).Furthermore,when an increase of FEV1 equaling to or greater than 15% was used as reference for positive bronchial reversibility,the improve rate of Fres,Zrs,R5,and X5 equaled to or greater than 13%,23%,17%,31%,respectively in 4-7 year-old group,18%,26%,25%,32%,respectively in 8-11 year-old group,25%,28%,28%,36%,respectively in 12-16 year-old group. Conclusions IOS can be used to assess bronchodilator reversibility test in children,and age factors should be paid attention.

Objective To evaluate the effectiveness of noninvasive positive pressure ventilation(NPPV) as a weaning strategy in patients with acute respiratory failure after failure to wean from invasive positive pressure ventilation(IPPV). Method A prospective randomized and controlled clinical trial of weaning of IPPV was carried out in patients mechanically ventilated in mode of IPPV for more than 48 hours with failure in a spontaneous breathing trial(SBT: PSV 6 cmH_2O). Patients with contraindications to NPPV were excluded. After failure the SBT, patients were randomly divided(random number) in two groups. Patients in NPPV group were extubated after being ventilated with high pressure support for 30 minutes and then placed on NPPV. Patients in IPPV group were weaned following conventional procedure. Arterial blood gases, maximal inspiratory pressure, respiratory rate,tidal volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured before and after failing the SBT. The rate of complications, including pneumonia and tracheotomy duration mechanical ventilation, days of hospital stay and outcome were observed. Findings of the two groups were vompared using the Student t test and the chi-square test. Results The percentage of complications in the NPPV group was lower(22.9% versus 72.2%, P <0.01) ,with lower incidences of pneumonia(6.1%,36.1%; P <0.01) and tracheotomy. Compared between the two groups, days of ICU stay( 14.16(3.45) d vs. 22.57( 7.71 ) d; P <0.01) and total days of mechanical ventilation(14.88±3.76 days vs. 20.68± 2.79 days, P <0.01) of NPPV group are shorter than IPPV group. Conclusions NPPV is a good alternative to the mechanically venti-lated patients who fail in initial weaning attempts. The key to successful NPPV weaning is the proper selection of weaning candidates and using NPPV as soon as possible after extubation.

AIM:To clarify if interferon-?(IFN-?), tumor necrosis factor-?(TNF-?)and interleukin-1?(IL-1?)can induce apoptosis of human airway smooth muscle cells (ASMCs) in vitro. METHODS: Human ASMCs were isolated and cultured in DMEM containing 10% fetal bovine serum. Passage 4-6 cell was used in the experiment. IFN-?,TNF-? and IL-1?, were used separately or together in the treatment of human ASMCs. The effects of IFN-?,TNF-? and IL-1? on the growth of the cells was detected by MTT method at the hour 0,24,48 and 72. Light microscopy and electron microscopy were used to examine the morphological change. DNA fragmentation was analyzed by agarose gel electrophoresis. SP immunohistological staing method was performed to detect the change of expressions of p53 , bcl-2 and bax gene. The apoptosis cell percentage were detected by in situ end labeling technique (TUNEL)of fragmental DNA. RESULTS: (1)IFN-? or IFN-? together with TNF-? and IL-1? decreased the number of viable cells in a time dependent manner. (2) Light and electron microscopic examination showed cell shrinkage, membrane blebbing, nuclear contraction, chromatin condensation and nuclear fragmentation in human ASMCs. (3) Agarose gel electrophoresis showed a characteristic"ladder"of DNA bands representing integer multiples of the internucleosomal fragments (about 180-200 bp) in cytokine cotreated human ASMCs. (4)The expression of p53 and bax gene in cytokine cotreated group was significantly higher than in control group, but the expression of bcl-2 gene was lower than in control group. (5)Stimultaneous treatment with IFN-?(4?10 5 U/L),TNF-?(4?10 5 U/L)and /or IL-1? (10?10 4 U/L) induced apoptosis of human ASMCs. Apoptotic index of human ASMCs in cytokine co-treated group was significantly higher than in control group ( P

Objective To explore the reference values of peak expiratory flow (PEF) for 4.0-14.0 years old children in Chengdu.Methods From November 2011 to May 2012,a total of 446 healthy children were enrolled in this study.PEF was measured using expiratory peak velocimeter and lung function meter.Children's age,sex,height and weight were recorded.Impact factors for PEF were investigated by multiple stepwise regression analysis.Results The PEF detected by expiratory peak velocimeter and lung function meter had a good correlation (r =0.920,P ＜ 0.01).Boys own higher peak expiratory flow rate than girls.The level of PEF had the best correlation with height,next was weight and age.The level of PEF increased with the increase of height,age.Some children PEF value was less than 80％ lower limits of lower limits of normal.The PEF could be obtained from height and age.Conclusions Males and females PEF can be calculated according to children's height.Set up the PEF equation about the expiratory peak velocimeter and lung function meter.

ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.

Objective To explore the CT and MR imaging features of nodular fasciitis(NF), which will in return improve the standard and quality of diagnosis. Methods CT (n = 4) and MRI (n = 5) findings of pathologically proved nodular fasciitis in 9 patients were retrospectively analyzed. Results Of 9 NF, 5 were located in the lower extremities, 2 in the abdominal wall, and the others in the acoustic duct. The resected tumor size vary from 1.1 to 9. 5 cm in the largest diameter and mean (3.7±0.3) cm. All lesions appeared as a discrete solid mass on imaging. The CT value of lesions was similar to muscle. MR imaging manifested as a hypo to isointense lesion on T_1WI and hyperintense signal intensity on T_2WI. There was homogeneous or heterogeneous moderate to significant enhancement in the lesions. Conclusion CT and MRI can provide helpful information for the clinical and differential diagnosis of NF.

Objective:To investigate plasma levels of fibrinopeptide A(FPA)and platelet alpha-granule membrane glycoprotein 140(GMP-140), and to analyze the changes of coagulation activity in elderly patients with primary microvascular angina(PMVA).Methods:In this prospective case-control study, a total of 45 elderly patients(aged 60-80 years, 27 males and 18 females)admitted to our hospital from Jan.2019 to Dec.2020 were diagnosed as PMVA(as microvascular angina group)by clinical symptoms, electrocardiogram, dynamic electrocardiogram and coronary angiography.Forty-three age-and sex-matched elderly subjects who took a medical check-up and had no primary microvascular angina were included as the control group.Plasma levels of FPA, GMP-140 and high-sensitivity C-reactive protein were determined.The levels of systolic blood pressure, diastolic blood pressure, platelet, fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein, uric acid, renal function and liver function were detected.Results:The FPA level was higher in the PMVA group than in the control group[(430.32±364.05)μg/L vs.(263.73± 118.29)μg/L, t=2.913, P<0.01]. There was no difference in GMP-140 level between the PMVA group and the control group[(5.78±3.92)μg/L vs.(6.95±1.91)μg/L, t=-1.790, P>0.05]. The high-sensitivity C-reactive protein level was higher in the PMVA group than in the control group[(3.33±5.70)mg/L vs.(0.81±0.86)mg/L, t=2.927, P<0.01]. Conclusions:Compared with the control group, the FPA level is significantly increased with elevated coagulation activity in patients with primary microvascular angina.The increased inflammatory state in the PMVA group might promote the occurrence and development of microvascular angina, but whether the inflammatory state promotes the enhancement of coagulation activity needs further study to confirm.

Objective To construct the lentiviral vector of RNA interference(RNAi) for DEK,and to detect its effect on breast cancer cell growth.Methods The DEK siRNA was designed and constructed based on DEK sequence using a lentiviral vector.The lentivirul vector containing DEK siRNA was named PSIH-H1-DEK as confirmed by PCR and sequenceing.PSIH-H1-DEK was then packaged with accessory plasmids into lentivirus in 293T cells and selected for 2 weeks with puromycin ( puro ) before the mixed colonies stably expressing DEK siRNA were obtained and the DEK expression was detected by real time PCR( RT-PCR) and Western blotting.The effect of DEK siRNA on ZR75-1 cell growth was determined by cell counting kit.Results Western blot and RT-PCR showed that PSIH-H1-DEK siRNA could suppress DEK gene expression.Suppression of DEK could markedly inhibit the growth of ZR75-1 cells.Conclusion The lentivirus-mediated DEK siRNA is obtained,which will facilitate further research on DEK function in breast cancer development.

AIM:This study was performed to investigate the feasibility and efficiency of exogenous mesenchymal stem cells(MSCs) transplantation on post-infarction ventricular remodeling and heart function in rats and compare the effects between adult rat MSCs and neonate rat MSCs transplantation.METHODS:1-2 hours after left coronary artery ligation,MSCs cultured in ex vivo,marked with BrdU,were injected directly into the border of infarcts in exogenous rats.6 weeks after transplantation,rat' heart function,ventricular remodeling and pathological results were measured.RESULTS:MSCs transplantation decreased LV end-diastolic diameter and end-systolic diameter,limited LV chamber dilatation and reduced collagen content significantly.The numbers of blood vessels and cardiomyocytes were increased.BrdU-labelled MSCs with oval nucleus were widely distributed.There were no significant difference between adult rat MSCs and neonate rat MSCs transplanted groups.CONCLUSION:MSCs can survive and home in exogenous host infarct hearts without addition of any immunosuppressant.MSCs transplantation has benificial effects on remodeling processes and contributes to improvement of cardiac function,which may be related with the reduction of the amount of the collagen,promotion of myogenesis and angiogenesis.