Objective To deter mine the effect-site concentration of sufentanil blunting responses to tracheal intubation with video laryngoscope during propofol target controlled infusion (TCI). Methods Twenty-three patients undergoing selective surgery under general anesthesia were enrolled in this study. Induction of anesthesia was initiated by TCI sufentanil at the target effect-site concentration 3 min later , TCI of propofol began at the target plasma concentration of 3 μg/mL. Cisatracurium 0.15 mg/kg was ad ministrated for video laryngoscope tracheal intubation after loss of consciousness. The target concentration of sufentanil for consecutive patients was deter mined using the modified Dixon′s up-and-down method by the intubation response of the previous patient , in an increment or decrement of 0.05 ng/mL. The initial concentration was set at 0.4 ng/mL. Results The EC50 of Sufentanil was 0.32 ng/mL with 95%confidence interval of 0.29~0.35 ng/mL; the EC95 was 0.38 ng/mL with 95%confidence interval 0.35-0.55 ng/mL during video laryngoscope tracheal intubation. Conclusion The EC50 and EC95of sufentanil blunting responses to tracheal intubation with video laryngoscope are 0.32 ng/mL and 0.38 ng/mL during propofol TCI.

Objective To evaluate the efficacy of closed-loop coadministration of propofol and remifentanil guided by Narcotrend index (NI) in laparoscopic cholecystectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 20-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective laparoscopic cholecystectomy,were randomized into 2 groups (n =30 each):program regulation group (group P) and artificial regulation group (group A).After the initial target effect-site concentration of propofol was selected,the target effect-site concentration of remifentanil was determined according to the formula.In group A,the target effect-site concentrations of propofol (2-4 μg/ml) and remifentanil (3-4 ng/ml) were adjusted artificially according to anesthesiologists' experience every 5 min to maintain NI value at 26-46.Induction time,anesthesia induction and mean maintenance doses and the initial,highest and lowest target concentrations of propofol and remifentanil,mean NI value,percentage of time with NI between 26 and 46,emergence time,and development of fluctuation in heart rate or mean arterial pressure ＞ 20％ of the baseline value and intraoperative awareness were recorded.Results No intraoperative awareness was found in the two groups.Compared with group A,the induction time was significantly shortened,the induction dose and initial target concentration of remifentanil were increased,the mean maintenance dose and lowest target concentration of propofol and remifentanil were decreased,the percentage of time with NI between 26 and 46 was increased,and the emergence time was shortened (P＜0.05 or 0.01),and no significant change was found in the induction dose and initial target concentration of propofol,the highest target concentrations of propofol and remifentanil,mean NI value,or incidence of fluctuation in heart rate or mean arterial pressure ＞ 20％ of the baseline value in group P (P＞ 0.05).Conclusion For laparoscopic cholecystectomy,NI-guided closed-loop coadministration of propofol and remifentanil produces safe and effective anesthesia,and the efficacy of precise administration is superior to that of artificially regulated target-controlled infusion.

OBJECTIVE:To study the accuracy of infusion of Midazoloam with plasma concentration as target. METHODS:The parameters of Midazoloam obtained from our researches were inputted into target-controlled infusion(TCI) system with C language. The clinical anesthesia of 12 patients undergoing selective operations was completed with plasma concentration as target-controlled infusion. Predicted value of plasma concentration of Midazoloam was compared with measured value. Parameters of Midazoloam sample were calculated such as performance error(PE),absolute performance error(absPE),median performance error(MDPE),median absolute performance error(MDAPE),constancy error(CE),absolute constancy error(absCE),median constancy error(MDCE) and median absolute constancy error(MDACE). RESULTS:PE,absPE,MDPE and MDAPE of plasma concentration were -2.57%,14.16%,-3.28% and 15.34%,respectively. CE,absCE,MDCE and MDACE were 0.06%,1.42%,0.03% and 1.21%,respectively. The measured values were in indirect relationship with predicated values(r=0.986,P

Objective To explore the correlation of patient-controlled sedation of dexmedetomidine and Narcotrend values. Methods Forty patients with lower limb surgery were enrolled. Until CSEA block fixed , the electronic pump ran the patient-controlled sedation of dexmedetomidine. The parameter of electronic pump was set as follows: load dose 2 mL + background dose 1.5 mL/h + single dose 0.5 mL + locktime 20 s. The heart rate , mean arterial pressure, pressing times, effective times, OAA/S sedation scores and NI values were determined. Results At T4 point, the patients reached appropriate sedation. At T4 ~ T9 OAA/S scores kept 3 to 4. From T5 point, NI values showed significant decrease. After the T7 point. OAA/S scores and NI values reached the plateau time of (7.5 ± 1.8) min and (13.1 ± 3.4) min, OAA/S scores of 1, 2, 3, 4, respectively, corresponding roughly with NI values 95 to 100, 90 to 94, 65 to 89, 40 to 64. The correlation coefficient was 0.58. The time of NI values significant decreased in the younger group and in the elderly group, with (10.2 ± 1.6) min and (14.4 ± 2.2) min. In T5~ T9 point, NI values of the younger group were significantly lower than those in the elderly group. Conclusion Relevant relationships are observed between dexmedetomidine patient-controlled sedation depth and the narcotrend values under CSEA.

OBJECTIVETo explore the effect of Qiling Decoction (QD) combined highly active antiretroviral treatment (HAART) on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients.

METHODSTotally 55 HIV/AIDS patients were randomly assigned to the treatment group (28 cases) and the combination group (27 cases). Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combination group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4+ T cell counts before treatment, HIV/AIDS patients were assigned to three subgroups. For patients in subgroup 1, 1 cells/microL < CD4+ T cell counts < or = 100 cells/microL; For patients in subgroup 2, 101 cells/microL < CD4+ T cell counts < or = 200 cells/lL; For patients in subgroup 3, 201 cells/microL < CD4+ T cell counts < or = 350 cells/microL. Expression of peripheral blood Th17 and Treg cells, and number of CD4+ T cell counts were detected using flow cytometry (FCM)in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group.

RESULTSCompared with the healthy control group, CD4+ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased P < 0.01). Compared with before treatment in the same group, CD4+ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference (P < 0.05, P < 0.01). There was no statistical difference in the effective rate at various CD4+ T cell levels between the two groups (P > 0.05). There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point (all P >0.05). The Th17/Treg ration significantly increased in the combination group after 24 weeks of treatment, showing statistical difference when compared with the treatment group (U = 2.135, P = 0.038).

CONCLUSIONQD could improve the immune balance of Th17/Treg cells, which might be one of its mechanisms for improving HIV/AIDS patients' immunity.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

Adenomatoid Tumor ; metabolism ; pathology ; surgery ; Adult ; Biomarkers, Tumor ; metabolism ; Female ; Humans ; Hysterectomy ; methods ; Keratins ; metabolism ; Lymphangioma ; pathology ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Experiment teaching is a most important item of college teaching, and plays a vital and unexchangeable role to train students for their ability to practice and to innovate. To construct a feasible and scientific examination system of experiment teaching, will significantly help deepen the reformation of experiment teaching and improve the teaching quality. So according to the request for cultivating qualified ap- plication person, we preliminarily constitute the valuation system throughout the whole course and in the final, of theoretic examination and practice examination, and combined with students’ self-valuation and valuation from teachers. In fact, the system works well with a perfect effect.

Objective To investigate the methods of rectifying the excessive width of fold line and conglutination of the upper eyelid following blepharoplasty. Methods The width of double eyelid was redesigned, ranging from 6 mm to 8 mm. Then the scar of upper eyelid was excised about 1 mm to 2 mm, and the orbital septum fat flap, orbicularis oculi flap, infraorbicularis oculi fat flap and injection of lipochondria were utilized to fill the depression of upper eyelid. Results In our series, there were 20 eyelids of 16 cases receiving rectification. Orbital septum fat flap was used to correct 2 eye-lids, orbicularis oculi flap 4 eyelids, infraorbicularis oculi fat flap 10 eyelids and injection of lipochon-dria 4 cases. Among 12 eases of following-up, 10 of them were satisfied with the postoperative effects. The results were acceptable in other 2 cases. Conclusion It is a good approach to correct the excessive width of fold line and conglutination of the upper eyelid with local flaps, including the orbital septum fat flap, orbicularis oculi flap, infraorbicularis oculi fat flap and injection of lipochondria.

AIM: To investigate the relationships between antiproliferative mechanisms of probucol and protein expressions of signaling molecules ERK1/2, MKP-1, HO-1 and Trx-1 in rat aortic smooth muscle cells (RASMCs) stimulated with ox-LDL. METHODS: The effects of probucol on cell cycle, cell proliferation and the expressions of ERK1/2, MKP-1, HO-1 and Trx-1 in the presence of ox-LDL were observed by means of MTT test, FCM and Western blotting. RESULTS: (1) Probucol significantly inhibited the proliferation of RASMCs stimulated with ox-LDL. A value in 100 μmol/L probucol+35 mg/L ox-LDL group was reduced by 34.9% as compared to ox-LDL group (P<0.01). (2) Probucol protected against ox-LDL-induced RASMCs proliferation through inducing cell growth arrest at G_0/G_1 phase and cell apoptosis. (3) ox-LDL increased the expression of p-ERK1/2 by 34.7% (P<0.01) and decreased MKP-1 by 60.0% (P<0.01), respectively, as compared to control. Probucol attenuated the increase in ox-LDL-stimulated p-ERK1/2 level by 15.7%, but increased MKP-1 expression by 2 times (P<0.01). (4)ox-LDL at concentration of 35 mg/L decreased the intracellular Trx-1 expression by 28.9% (P<0.05), and slightly increased the level of HO-1 expression as compared to control (P<0.05). Probucol enhanced the expression of Trx-1 by 91.6% (P<0.01) and HO-1 by 31.9% (P<0.01), respectively as compared to ox-LDL group. CONCLUSION: Probucol inhibits ox-LDL-stimulated the proliferation of RASMCs through increases in MKP-1/HO-1 expression, suppression of cell cycle progression and induction of cell apoptosis.

Objective To investigate the sedative and hypnotic interaction between remifentanil and propofol by target-controlled infusion (TCI) during induction of anesthesia.Methods Third-two ASA Ⅰ or Ⅱpatients,aged 22-63 yr,body mass index 18-25 kg/m2,scheduled for elective surgery under general anesthesia,were randomly divided into 4 groups(n=8 each).Group Ⅰ only received TCI pmpofol.GroupⅡ,Ⅲ,and Ⅳreceived a target concentration of 2,4 or 6 ng/ml remifentanil respectively.While the blood-effect site concentrations of remifentanil were equilibrated,patients received TCI of propefol,with an initial target concentration of 0.5μg/ml.After the blood-effect site concentrations of propofol were equilibrated then with 0.5μg/ml increments until the loss consciousness was achieved.The eyelash reflex and state of consciousness were assessed and radial arterial blood sample 6 ml was taken every 3 min to determine the remifentanil and propofol concentrations in blood.Propofol and remifentanil concentrations in blood were measured by reversed-phase high-performance liquid chromatography and high-performance liquid chromatography with ultraviolet detection respectively.The sedative and hypnotic interaction between propofol and remifentanil was determined with a pharmacodynamie interaction model by regression analysis and determined using the isobolographic method.Results Propofol concentrations in blood were lower in group Ⅱ,Ⅲ and Ⅳ than group Ⅰ(P<0.05).The propofol concentratopms in blood were significantly decreased in trun with the increase in the remifentanil concentrations in blood in group Ⅱ-Ⅳ(P<0.05).At loss of eyelash reflex and loss of consciousness of patients,the pharmacodynamic interaction model by curve fitting was superior to linear regression (P<0.05).At loss of eyelash reflex of patients,the curve fitting result showed EC50,prop=2.77μg/ml and EC50,rem=26.67 ng/ml,and the isobolographic method equation is ECprop/2.77+ECrem/26.67=0.69.At loss of consciousness of patients,the curve fitting result showed EC50,prop==3.76μg/ml and EC50,rem=31.56ng/ml,and the isobolographic method equation is Ecprop/3.76+Ecrem/31.56=0.65.Conclusion Remifentanil (Cp 2-6 ng/ml) and propofol by TCI shows a synergistic type of pharmacodynamic interaction on the sedative and hypnotic during induction of anesthesia.