Apoptosis ; drug effects ; Asparaginase ; pharmacology ; HL-60 Cells ; Humans ; K562 Cells ; U937 Cells

Objective To investigate the effect of circadian rhythm on the duration of neuromuscular blockade (NMB) elicited by atracurium. Methods Sixty-one ASA Ⅰ or Ⅱ patients aged 18-55 yr with body mass index of 18-24 kg/m2 undergoing general anesthesia were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg. Atracurium 0.75 mg/kg was injected iv as soon as the patients lost consciousness . NMB was assessed by TOF-stimulation of ulnar nerve using TOF-Watch(R) SX. Tracheal intubation was performed as soon as the first twitch (T1) disappeared. The patients were mechanically ventilation (VT 6-8 ml/kg, RR 12 bpm, I ∶ E 1.0 ∶1.5). PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with continuous infusion of propofol 6-8 mg·kg-1·-1·-1and remifentanil 0.25-0.50 μg·kg-1·min-1 . Anesthesia was performed at 5 time periods: (1) 8:00-11:00, (2) 11:00-14:00, (3) 14:00-17:00, (4) 17:00-20:00 and (5) 20:00-23:00. The duration of NMB produced by atracurium was defined as the interval between the end of atracurium injection and 3% recovery of T2 . The data were analysed using generalised linear models (GLMs) and cosinor method. Results Fifty-three cases completed the study. GLM analysis showed that the duration of NMB was longest at 20:00-23:00 (53 min (95% confidence interval 50-56 min)) and shortest at 11:00-14:00 (43 min (95% confidence interval 39-46 min)), suggesting that there is a significant diurnal variation in the duration of NMB elicited by atracurium. Cosinor method analysis showed that equation of the duration of NMB and time point of atracurium administration was y = 48.05 + 15cos( 15t + 52.66). Conclusion Circadian rhythm can affect the duration of NMB elicited by atracurium, which shows that the duration of NMB is longest at 20:00-23:00 and shortest at 11:00-14:00.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

To investigate the clinical significance of serum soluble programmed cell death ligand-1 (PD-L1) in adult patients with community-acquired pneumonia (CAP). A total of 44 CAP patients, 54 severe CAP patients and 30 healthy volunteers were recruited in this study. Serum soluble PD-L1 were detected. Univariate and multivariate regression analyses were used to assess the influence of multiple clinical variables on prognosis. Serum soluble PD-L1 level in severe CAP group was 98.20(57.94, 128.90) ng/L, which was significantly higher than that in the CAP group [59.32(33.55, 92.58) ng/L] and healthy controls [20.44(12.15, 36.20) ng/L] (all P<0.001). PD-L1 level was positively correlated with CRUB-65( r=0.481, P<0.001) and the pneumonia severity index (PSI) score ( r=0.442, P<0.001). Univariate regression analysis showed that CURB-65 ( HR=2.544, 95% CI 1.324-4.889, P=0.005), PSI score ( HR=1.036, 95% CI 1.012-1.061, P=0.004), soluble PD-L1( HR=1.013, 95% CI 1.001-1.026, P=0.041) were risk factors of mortality during hospitalization. Multivariate regression analysis suggested that PSI score ( HR=1.042, 95% CI 1.012-1.073, P=0.005), soluble PD-L1 ( HR=1.011, 95% CI 1.002-1.071, P=0.020) were independent predictors for mortality risk in CAP patients. CAP patients with soluble PD-L1≥98.20 ng/L had a significantly lower survival rate than those with soluble PD-L1<98.20 ng/L ( P=0.033). In conclusion, this study indicates that serum soluble PD-L1 level in CAP patients is correlated with the survival prognosis.

Acute Disease ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Humans ; Infant ; Inpatients ; Insecticides ; poisoning ; Middle Aged ; Organophosphorus Compounds ; Pesticides ; poisoning ; Poisoning ; etiology ; mortality ; therapy ; Risk Factors ; Survival Rate

Objective To investigate the supply of iodized salt in non-excessive iodine counties and iodine-free salt in excessive iodine counties at household level in Jiangsu Province so as to provide a basis for the prevention and control of iodine deficiency disorders(IDD).Methods According to the National Iodine Deficiency Disorders Monitoring Program(Trial),county(city,district) was taken as a elementary sampling unit in Jiangsu Province.Townships(towns) and administrative villages were selected by systematic sampling and random sampling in every county and households were chosen by random sampling to collect their edible salt samples.The salt iodine content in non-and excessive iodine regions was detected by direct titration method and semi-quantitative method,respectively.Results All 30 840 salt samples were collected from 106 non-excessive iodine counties,and qualified iodized salt was 30 303 copies,iodine-free salt 199 copies.Weighted by the population of counties,the rate of iodine-free salt was 0.71％,the coverage rate of iodized salt accounted for 99.29％,out of which,98.93％ was qualified and the consuming rate of qualified iodized salt was 98.23％.All 1296 salt samples were collected in 5 counties with excessive water iodine content and the coverage rate of iodine-free salt was 98.99％ (1283/1295).Conclusions The national targets for preliminary elimination of IDD have been achieved in regions of nonexcessive and excessive iodine of Jiangsu Province.But it still should be strengthen the management work of iodinefree salt in excessive iodine counties and iodine saft in non-excessive iodine counties.

Objective To investigate the expressions of transforming growth factor beta receptors (TGF beta R), receptor-activated Smads and common-partner Smad in condylomata acuminata. Methods Tissue samples were collected from 20 patients with condylomata acuminata and 15 normal human controls.EliVisionTM plus immunohistochemical technique was used to detect the distribution and expression of TGF beta R Ⅰ , TGF beta R Ⅱ, Smad1/2/3, phosphorylated Smad2/3 and Smad4 in condylomata acuminata and normal control skin. Results Positive immunohistochemical staining for TGFbeta R Ⅰ , TGFbeta R Ⅱ,Smad1/2/3, p-Smad2/3 and Smad4 was detected in the epidermis of normal control skin. The intensity of im-munohistochemical staining was significantly lower for TGFbeta R Ⅰ , TGFbeta R Ⅱ, Smad1/2/3, p-Smad2/3and Smad4 in the epidermis of condylomata acuminata than in that of normal control skin (P < 0.05 or < 0.01). Conclusion The expressions of TGF beta R, receptor-activated Smads and common-partner Smad are decreased or absent in the epidermis of condylomata acuminata, which might interfere with TGF be-ta/Smad signaling and contribute to the development of epidermal hyperplasia in condylomata acuminata.

Autopsy ; Fetus ; Heart Neoplasms ; pathology ; Humans ; Rhabdomyoma ; pathology ; Tuberous Sclerosis ; pathology

Human immunodeficiency virus(HIV) infection may result in serious impairment of the immune system in HIV-posi-tive patients. Both HIV productions and highly active antiretrovi-ral therapy (HAART) drugs can cause neuropathy, including the HIV associated neurocognitive disorders (HAND) and the peripheral neuropathy. Several animal models have been devel-oped in an attempt to study the mechanisms of HIV relative neu-ropathies. This review focuses on researching HIV-1 associated neuropathies by application of HIV-1 animal models.

Objective To evaluate the clinical efficacy and safety of tacrolimus capsules combined with prednisolone acetate tablets in the treatment of systemic lupus erythematosus.Methods A total of 54 patients with systemic lupus erythematosus were randomly divided into control group and treatment group with 27 cases per group.Control group was treated with prednisolone acetate tablets 40 mg qd,oral.Treatment group was given tacrolimus capsules 1 mg per time bid,oral,on the basis of control group.The clinical efficacy,interleukin-4 (IL-4),monocyte chemoattractant protein-4 (MCP-4),white blood cell (WBC),platelet (PLT),erythrocyte sedimentation rate (ESR) and adVerse drug reactions were compared between two groups.Results After treatment,the total effective rates in treatment and control groups were 92.59％ (25/27 cases) and 70.37％ (19/27 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:IL-4 were (135.67 ± 16.88),(165.47 ±23.22)ng · L-1;MCP-4 were (3.17 ± 0.46),(4.98 ±0.71)ng· L-1;WBC were (4.83 ±0.58) ×109,(3.67 ±0.46) × 109/L;PLT were (153.22±18.85) ×109,(113.22 ± 16.26) × 109/L;ESR were (15.26 ± 3.14),(23.65 ± 3.58)mm · h-1,the differences were statistically significant (P ＜ 0.05).The adverse drug reactions in two groups were based on leukopenia,gastrointestinal discomfort and infection,and the incidences of adverse drug reactions in treatment and control groups were 18.52％ and 14.81％,without significant difference (P ＞ 0.05).Conclusion Tacrolimus capsules combined with prednisolone acetate tablets have a definitive clinical efficacy in the treatment of systemic lupus erythematosus,which can significantly reduce the serum levels of IL-4 and MCP-4,improve clinical efficacy,without increasing the incidence of adverse drug reactions.