ObjectiveTo investigate the effect of dexmedetomidine on the median effectivetarget effectsite concentration (EC50) of remifentanil required for preventing body movement in response to skin incision made under propofol sedation.MethodsForty ASA Ⅰ or Ⅱ patients aged 20-50 yr weighing 45-58 kg scheduled for elective breast tumor excision were randomly allocated into 2 groups ( n =20 each):group remifentanil (group R) and group remifentanil + demedetomidine ( group RD).Sedation was induced with propofol TCI at target plasma concentration of 3.0 mg/L in both groups.In group RD dexmedetomidine 1.0 μg/kg was infused iv over 10 min before start of propofol TCI,while in group R equal volume of normal saline was infused instead of dexmedetomidine.Remifentanil TCI was started with target effect-site concentration set at 3.0 and 2.5 μg/L in groups R and RD respective at 13 min after beginning of propofol TCI.Skin incision (3 cm in length) was made when the target concentrations of propofol and remifentanil TCI were reached.Body movement was assessed by a nurse not involved in this study.EC50 and 95％ confidence interval (CI) of remifentanil were determined by up-and-down technique.The target effect-site concentration was increased or decreased by 20％ depending on the response of the previous patient to skin-incision.ResultsThe EC50 of remifentanil for preventing body movement in response to skin incision performed under propofol sedation was 1.7 μg/L (95％ CI 1.5-1.9 μg/L) and 2.5 μg/L (95％ CI 2.2-2.7μg/L) in groups RD and R respectively.The EC50 of remifentanil was significantly lower in group RD than in group R.ConclusionDexmedetomidine 1.0 μg/kg can decrease EC50 of remifentanil for preventing body movement in response to skin incision made under propofol sedation.

35 patients with malignant lymphoma and 18 patients with multiple mycloma were investigated for expression of OKT10in pherpheral blood. A significant incresing of OKT 10 positive cells was found in most of patients (26/30, 16/18 cases respectively) with Non-Hodgekin's Lymphoma(NIIL) and Multiple myeloma(MM). The inereasing of OKT10 positive cells is related to the degrce of malignaency of patients with NIIL from low-grade to high-wade. No relationship between serum beta-2-microglobulin and OKT10 positive cells in patients with NIIL and MM was also found.

Objective To investigate the effect of dexmedetomidine on bispectral index (BIS) value at loss of consciousness (LOC) caused by propofol given by target-controlled infusion (TCI).Methods One hundred and twenty ASA Ⅰ or Ⅱ patients,aged 20-50 yr,weighing 41-68 kg,scheduled for general surgery were randomly divided into 3 groups (n =40 each):propofol group (group P),dexmedetomidine 0.5 μg/kg + propofol group (group D1P) and dexmedetomidine 1.0 μg/kg + propofol group (group D2P).The patients in each group were randomly assigned into 5 subgroups ( n =8 each):groups P0-4 receiving TCI of propofol with the target effect-site concentration (Ce) set at0,1,2,3 and 4 mg/L respectively.Groups D1P0-4 received iv infusion of dexmedetomidine 0.5 μg/kg at a rate of0.05μg·kg-1 ·min-1 and TCI of propofol with the target Ce set at 0,1,2,3 and 4 mg/L respectively at 5 min after the end of dexmedetomidine infusion.Groups D2 P0-4 received iv infusion of dexmedetomidine 1.0 μg/kg at a rate of 0.1μg· kg- 1· min- 1 and TCI of propofol with the target Ce set at 0,1,2,3 and 4 mg/L respectively at 5 min after the end of dexmedetomidine infusion.Three minutes after TCI of propofol was started,OAA/S score and BIS value were recorded.The OAMS score ≤ 2 was defined as LOC.The EC50 and 95％ confidence interval of propofol for LOC and BIS50 and 95％ confidence interval at LOC were calculated by Probit analysis.Prediction probability (Pk) of BIS value at LOC was calculated using Smith method.Results Compared with group P,EC50 was significantly decreased,BIS50 was significantly increased ( P ＜ 0.05 or 0.01 ),and no significant change was found in Pk in groups D2 P and D1 P ( P ＞ 0.05).There were no significant differences in EC50,BIS50 and Pk between groups D2 P and D1P ( P ＞ 0.05).Conclusion BIS value can accurately predict the level of consciousness during anesthesia with dexmedetomidine and TCI of propofol,but BIS value is increased at LOC.

Objective To investigate whether oral administration of probiotics can reduce complications induced by interventional therapy in patients with primary hepatic carcinoma and liver cirrosis.Methods Two hundred and sixty four patients with primary hepatic carcinoma and liver cirrhosis who underwent transarterial chemoembolization(TACE) were randomly divided into two groups.and patients in experimental group were given probiotics but not in control group.Shoa-term clinical manifestations.liver functions,blood routine and pain scores were compared between two groups.Results On the day 3 after therapy,the incidence of abdominal distension and constipation in experimental group were less than that in control group(x2=18.22 and 55.22,P=0.000);On the day 7 after therapy,the incidence of abdominal distension,constipation and infection in experimental group were less than that in control group(x2=5.35,13.5 and 19.14,P=0.021,0.000 and 0.000).There were no significant difference in other clinical manifestations,liver function,blood routine and pain scores between the two groups. Conclusion Oral administration of probiotics can reduce the incidence of some short-term complication induced by interventional therapy in patients with hepatic carcinoma and liver cirrhosis.

Objective To study the expression of interleukin-18(IL-18)during the progression of renal interstitial fibrosis in rat kidney after unilateral ureteral obstruction(UUO)and the effect of Shenfu injection.Methods The obstructive nephropathy model was established by unilateral ureteral obstruction(UUO).Fifty。Six rats were randomly assigned into shame operation group,operation group(UUOgroup)and treatment group(UUO+Shenfu).After 7 and 14 days,the renal function and histopathological changes were evaluated.Immunohistochemistry was used to examine the expression of IL-18 in renal tissue.Results In comparison with the shame opeartion group,the operation group showed obvious renal interstitial fibrosis.And the expression of IL-18 increased signifieantly(P<0.05).Compared with the operation group,the degree of interstitial fibrosis was obviously ameliorated in the treatment group,and the expression of IL-18 decreased significandy after treatment for 7 days(P<0.05),and decreased more after treatment for 14 days(P<0.05).Conclusions Shenfu injection may protect renal function by decreasing the expression of IL-18 in the progression of renal interstitial fibrosis.

BACKGROUND:Three-dimensional (3D) printing technology exhibits a broad future in the orthopedics,especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures.However,the related researches are few,and there is a lack of evidence-based medicine to confirm its application values.OBJECTIVE:To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of tibial plateau fractures through a meta-analysis.ME=THODS:MEDLINE,Cochrane library,Embase,CBM,CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually,to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures.Methodology quality of the trials was assessed critically and relative data were extracted,followed by analysis on Stata 11.0 (Stata Corporation,College Station,TX) software.RESULTS AND CONCLUSION:(1) Seven controlled trials involving 362 patients were included.(2) Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time (SMD=-2.411,95％C/=-2.718-2.104,P=-0.00) and less intraoperative blood loss (SMD=-1.579,95％C/=-1.842--1.316,P=-0.00) than those in the traditional surgery.The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps (P ＞ 0.05).(3) To conclude,compared with the traditional surgery,the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.

BACKGROUND: Osteoblasts have become a kind of important seed cells in bone tissue engineering. However, it is difficult to harvest osteoblasts, and the purity and calcification ability of osteoblasts isolated by different methods are inconsistent. OBJECTIVE: To compare the purity and calcification ability of osteoblasts induced from mouse bone marrow mesenchymal stem cells, MC3T3 cell lines, and cultured primarily from the neonatal mouse cranium. METHODS: Mouse bone marrow mesenchymal stem cells were isolated by differential adhesion method, and after passaing, passage 3 cells were cultured in osteogenic induction medium for 21 days. MC3T3 cell lines were cultured in osteogenic induction media 1 and 2 for 21 days. Osteoblasts were cultured primarily from neonatal mouse cranium by type Ⅰ coll agenase digestion method. Calcium nodules of osteoblasts obtained by three methods were observed by Alizarin red staining to detect osteogenic activity of cells. RESULTS AND CONCLUSION: (1) There were average 16.3 calcium nodules per low-power field after osteogenic induction of bone marrow mesenchymal stem cells. (2) There were sparsely distributed calcium nodules in MC3T3 cells after induction with osteogenic induction medium 1, accounting for 1.7 calcium nodules per low-power field, while there were dense calcium nodules in MC3T3 cells after induction with osteogenic induction medium 2, accounting for 44.6 calcium nodules per low-power field. There was a significant difference in the calcium nodule formation ability between the two groups (P < 0.01). (3) After primary culture, there was only 0.6 calcium nodule per low-power field. (4) Except for the insignificant difference between osteogenic induction medium 1 and primary culture groups, there were significant differences in pair-wise comparison of any other two groups. Except the insignificant difference between group I of MC3T3 inducing conditional media and primary culture osteoblasts, there were significant differences in the osteogenic ability between groups (P < 0.01). In conclusion, it is a better method to culture MC3T3 cells in osteogenic induction medium 2 containing dexamethasone, because many uncontrol able factors are involved in the isolation and culture of bone marrow mesenchymal stem cells.

ObjectiveThe aim of this study was to investigate the professional cognitive level and its influencing factors of fresh nursing students in Yunnan,in order to provide a basis for nursing education workers, improve the situation and put forward a series of interventions.MethodsA questionnaire survey was done among 623 fresh nursing students in 5 universities of Yunnan province,and the data were collected and analyzed using the descriptive analysis and chi-square test of software SPSS22.0.Results There were 313 peoples choose nursing for easy future employment in qualified 599 questionnaires. The professional cognitive level in Yunnan was not comprehensive compared with other provinces,and the ratio of the nursing mission and etc were lower than other provinces with statistical significance(P < 0.05). However,there were 50 people(40.98%)would like to choose other major of 122 people who come from other provinces,which was higher than that of Yunnan (34.98%). There were 324 students(63.11%)were proud of nursing,327 students(63.70%)think nursing have a good development prospect who received the freshmen entrance education,which were higher than 35.62% and 42.47% of who could not receive the freshmen entrance education,with a statistical significance(P < 0.05). ConclusionSchool should reinforce the new students entrance education and professional publicity to cultivate the professional emotion of nursing freshmen.

Objective To investigate the value of pulse-indicate continuous cardiac output(PICCO) in septic shock patients.Methods In a retrospective study,58 patients who were diagnosed to be suffering from septic shock in the intensive care unit (ICU) were enrolled,from January 2010 to December 2011,and were divided into two groups:PICCO group(n =28) and the conventional group (n =30).We compared their 6 h-EGDT compliance rate,the level of lactate and central venous pressure (CVP),the oxygenation index,the characteristics of fluid intake and balance within 72 hours,duration of mechanical ventilation,and ICU stay of the two groups.The incidence of MODS after 72 hours in ICU,28-day mortality were recorded and compared.Results (1) Fluid intake((9565 ±1623) ml vs (12245±2253) ml,t=2.673,P=0.021) and balance ((3656 ± 1904) ml vs (5465 ± 2765) ml,t =2.357,P =0.012) were significantly lower in PICCO group compared the conventional group within 72 hours.(2) The oxygenation index ((252.6 ± 87.4) vs (226.8 ± 69.4),P ＜ 0.05) in PICCO group increased significantly and duration of mechanical ventilation ((134.7 ±42.8) h vs (193.3 ± 92.4) h,t =1.356,P =0.023) reduced significantly compared with the conventional group after 72 hours.(3) There was no difference in the 6 h-EGDT compliance rate,the level of lactate and CVP,6 h EGDT,ICU stay,the incidence rate of MODS after 72 hours,28-day mortality in ICU(P ＞0.05).Conclusion In contrast with classic methods as CVP monitoring,PICCO catheter may assess more accurately the volume status and guide early fluid resuscitation in septic shock patients.

Objective To investigate the changes in the expression of neuromedin U receptor 2 (NMUR2) in spinal dorsal horn in a rat model of bone cancer pain (BCP).Methods Thirty-two female Sprague-Dawley rats,weighing 150-180 g,were randomly divided into 2 groups (n =16 each):sham operation group (group S) and BCP group.BCP was induced by inoculating Walker 256 mammary gland carcinoma cells (1 × 105) into the medullary cavity of left tibia.Heat-killed Walker 256 cells (1 × 105) were injected into the medullary cavity of left tibia in S group.Eight rats were chosen from each group and the paw withdrawal threshold (PWT) to yon Frey filaments was measured at 1 day before operation (baseline) and 1,3,6,9,12 and 15 days after operation.Bone destruction was shown by X-ray at 15 days after operation.At 1 day before operation and 15 days after operation,4 rats in each were chosen and sacrificed,and L4,5 segments of the spinal cord were removed for measurement of the expression of NMUR2 mRNA (by real-time PCR) and protein (using Western blot analysis) in the spinal dorsal horn.Results Compared with S group,the PWT was significantly decreased at day 6-15 after operation and the expression of NMUR2 mRNA and protein in the spinal dorsal horn was up-regulated at 15 days after operation in BCP group (P ＜ 0.05 or 0.01).Compared with the baseline value,the PWT was significantly decreased at day 6-15 after operation and the expression of NMUR2 mRNA and protein in the spinal dorsal horn was up-regulated at 15 days after operation in BCP group (P ＜ 0.05 or 0.01).X-ray showed defect of bone trabecula and cortical bone destruction in BCP group.Conclusion The expression of spinal NMUR2 is up-regulated in rats with BCP and this change may be involved in the development and maintenance of BCP.