Acute Disease ; Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Male ; Neurotoxicity Syndromes ; therapy

Objective To evaluate the effects of dexmedetomidine-propofol-fentanyl combined anesthesia on somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in patients undergoing cervical spine surgery. Methods Thirty-six patients undergoing cervical spine surgery were randomly divided into 2 groups (n = 18 each): propofol-fentanyl combined anesthesia group (group C) and dexmedetomidine-propofol-fentanyl combined anesthesia group (group D). Anesthesia was induced with TCI of propofol and iv injection of fentanyl.After the consciousness disappeared, a laryngeal mask airway was placed and the patients were ventilated. In group D, dexmedetomidine 0.5 μg/kg was injected over 10 min after the consciousness disappeared, followed by an infusion at a rate of 0.5 μg·kg-1 ·h-1 until the end of surgery. In group C, the equal volume of normal saline was administered instead of dexmedetomidine. SEPs (P15-N20) amplitudes and latency were measured and recorded before dexmedetomidine administration and at 10 min of dexmedetomidine infusion. The no-elicitation of MEPs was recorded. Results Compared with group C, there was no significant difference in P15-N20 amplitudes and latency in group D. The no-elicitation rate of MEPs in two groups was 0. Conclusion Dexmedetomidine-propofol-fentanyl combined anesthesia does not affect SEPs and MEPs in patients undergoing cervical spine surgery.

Cell Differentiation ; drug effects ; Cell Separation ; Endothelial Cells ; cytology ; Fibronectins ; pharmacology ; Humans ; Leukocytes, Mononuclear ; cytology ; Stem Cells ; cytology

Astragalus adsurgens seed is one of the most common adulterants of Astragali Complanati Semen in the market, whose morphological characteristics are very similar with A. complanatus seeds (Astragali Complanati Semen). Many identification methods have been reported, such as morphological identification, fluorescence method, ultraviolet spectrophotometry, TLC, HPLC, protein electrophoresis and so on, but there's no much about microscopic identification. In the present study, the morphological characteristics and microscopic characteristics of these two seeds were investigated, which could provide scientific evidence for the identification and classification of Astragali Complanati Semen. Our results showed that these two seeds were slightly different in the color and the appearance, but significantly different in the microstructure of the seed coat and the hilum, and the distribution of fat droplets in the cotyledon cells. So these microscopic characteristics can be applied for the identification of Astragali Complanati Semen.
Astragalus Plant ; anatomy & histology ; chemistry ; Color ; Discriminant Analysis ; Microscopy ; methods ; Quality Control ; Seeds ; anatomy & histology ; chemistry

OBJECTIVETo evaluate in vitro effect of abnormal savda munziq (ASMq) on the proliferation and apoptosis of human hypertrophic scar fibroblasts (HSFs).

METHODSHSFs were divided into six groups to receive different treatments as group A (blank control group), group B-E (ASMq in different concentration), and group F(5-Fu). Each group contains six specimens. The HSFs were cultured in vitro. After culture for 48 hours, the CCK8 test and flow cytometry methods were used to detect the proliferation, cell cycle and apoptosis.

RESULTSThe proliferation of HSFs in the B, C, D and E groups was inhibited at G2/M period, while it was inhibited at G0/S period in group F (P < 0.05). The inhibition effect of ASMq (0.1-1.0 mg/ml) on the fibroblasts enhanced in a concentration-dependent manner. Flow cytometry analysis with annexin V-FITC and PI staining confirmed the apoptotic. When HSFs were exposed to ASMq at 1.0 mg/ml (group E) for 48 h, the percentage of apoptotic cells increased to (43.7 +/- 2.58)%, which was significantly higher than that of blank control group (2.2 +/- 0.59)%. The induced apoptosis effect was also increased in a concentration-dependent manner.

CONCLUSIONASMq has a inhibitory effect on the proliferation and an enhancement effect on the apoptosis of fibroblast. ASMq could be used as an effective drug for treatment of hypertrophic scar.

Apoptosis ; Cell Cycle ; drug effects ; physiology ; Cell Division ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; pathology ; Fibroblasts ; cytology ; drug effects ; Flow Cytometry ; Humans ; In Vitro Techniques ; Medicine, East Asian Traditional

Objective To explore the related risk factors of cerebral hemorrhage complicated with stress ulcer (SU). Methods The clinical data of 1 185 patients with cerebral hemorrhage admitted to Department of Emergency Medicine of Nanjing General Hospital from March 2006 to March 2014 were retrospectively analyzed. Patients were divided into two groups according to whether patients complicated with SU or not. Data was collected within 8 hours after admission in two groups including gender,age,amount of bleeding,the bleeding site (basal ganglia,thalamus, brainstem,brain lobe,ventricle,subarachnoid,and cerebellum),disturbance of consciousness,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,systolic blood pressure(SBP),history of hypertension,and history of cerebral hemorrhage. The statistically significant risk factors found using univariate analysis was selected and was analyzed to find independent risk factors with multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve)was plotted to analyze the independent risk factors and evaluate their power of test. Results 1 185 patients with cerebral hemorrhage were enrolled in the study,293 cases occurred SU,accounting for 24.7%,and 892 cases without SU,which accounted for 75.3%. As shown by univariate analysis,risk factors for cerebral hemorrhage complicated with SU included age,amount of bleeding,the bleeding site,disturbance of consciousness,APACHEⅡscore,SBP. As to the site of bleeding,brain,thalamus,brainstem hemorrhage complicated with SU were higher proportion,45.3%(43/95),39.1%(63/161),36.9%(48/130),which were significantly higher than those of the lobes of the brain 〔26.2% (33/126)〕,cerebellum 〔18.8% (15/80)〕,basal ganglia〔16.1%(78/485)〕,arachnoid the inferior vena cava 〔12.0% (13/108)〕. Multivariate logistic regression analysis showed that amount of bleeding 〔odds ratio (OR)=3.305,P=0.001,95%confidence interval (95%CI)2.213-48.634〕,the bleeding site (OR=1.762,P=0.008,95%CI 0.123-2.743),SBP (OR=1.223,P=0.034,95%CI 0.245-2.812) were independent risk factors of cerebral hemorrhage complicated with SU. The area under the ROC curve (AUC)of amount of bleeding and SBP were 0.846 and 0.597,suggesting that amount of bleeding has moderate diagnostic value and SBP has low diagnostic value. Conclusions Cerebral hemorrhage patients with large amount of bleeding,the bleeding site in the ventricle,thalamus or brainstem,high SBP are of great risk. We should lower blood pressure and give preventive treatment for SU as soon as possible.

Background One of the features of the pathogenesis of primary angle-closure glaucoma(PACG) is anterior synechia of peripheral iris.Goniosynechialysis and combination of phacoemulsification and goniosynechialysis have been applied for the treatment of the disease recently,but the selection of operative types has great impact on clinical efficacy.Objective This study was to investigate the long-term efficacy of goniosynechialysis and combination of phacoemulsification and goniosynechialysis for the management of chronic PACG.Methods A non-randomized clinical controlled trial was designed.This clinical trial complied with Declaration of Helsinki and was approved by Medical Ethic Committee of Nanjing Medical University.Written informed consent was obtained from each patient.One hundred and ten eyes of 110 patients with chronic PACG were assigned to the goniosynechialysis group and combined operative group from March,2008 to February,2011 in Wuxi People's Hospital.180° goniosynechialysis was performed on 34 patients in the goniosynechialysis group,and phacoemulsifieation +intraocular lens (IOL) implantation + goniosynechialysis were carried out in 78 patients of the combination operative group.All the patients were followed-up for 2 years.Vision acuity,intraocular pressure (IOP),anterior chamber depth(ACD),unltrasound biomicroscopy and perimetry were recorded and compared between before and after operation.Results No significant difference was found in vision acuity between preoperation and postoperative 2 years in the goniosynechialysis group ([0.65 ± 0.15] vs.[0.45 ± 0.15]) (t =1.57,P＞0.05),but in the combination operative group,the vision acuity was significantly different between the before and after operation ([0.25±0.15] vs.[0.85 ±0.05]) (t =9.12,P＜0.001).The lOPs at 2 years after operation were (14.2±4.1) mmHgand(13.7±4.8) mmHg,respectively in the goniosynechialysis group and combination operative group and were significantly lower than(47.2 ±6.3) mmHg and(46.9±7.0) mmHg before operation(t =4.95,P＜0.001 ;t=5.03,P＜0.001).The ACD values in the goniosynechialysis group and combination operative group were(3.38±0.02)mm and (3.54±0.03) mm 2 years after operation,which were significantly increased in comparison with (1.33 ±0.24)mm and (1.56±0.37) mm before operation(t=7.65,P＜0.001;t=6.76,P＜0.001).Conclusions Both combination of phacomulsification with goniosynechialysis or 180° goniosynechialysis are effective for the treatment of PACG.Suitable operation should be alternated depending on the indicators of PACG patients.

Objective To explore influence of long-term inhaled glucocoticoids(IGS) on soluble intercellular adhesion molecule-1(sICAM-1)) in children with bronchial asthma.Methods Enzyme-linked immunosorbent assay(ELISA) method was used to detect the serum sICAM-1 level in 36 healthy children and 29 children with bronchial asthma(untreated and post-treated for 3,6 and 12 months).Results 1.Serum sICAM-1 level was significantly elevated in children with asthma and significantly higher than that in normal control group(P

Objective To study the clinicopathologieal features and expression of cyclin D1 and p53 in epithelial ovarian tumors,and to investigate the correlation between pathogenesis of ovarian cancer and epithelial borderline tumors.Methods Fifty four cases of ovarian borderline tumors and 45 cases of ovarian carcinomas from the People's Hospital,Peking University were reviewed retrospectively.The clinical data and pathological findings were analyzed.Immunohistochemical study of cyclin D1 and p53 was performed in all 99 cases.Results(1)In borderline tumors,the age of patients ranged from 14-82 (mean age=42.5)years.International Federation of Gynecology and Obstetrics(FIGO)stage of borderline tumors was stage Ⅰ in 48 cases,stage Ⅱ in 3 cases,and stage Ⅲ in 3 cases.In ovarian carcinomas,the age of patients ranged from 26-80(mean age=53.5)years.FIGO stage of carcinoma was stage Ⅰ in 6 cases, stage Ⅱ in 8 cases,stage Ⅲ in 26 cases,and stage Ⅳ in 5 cases.In follow-up of 54 cases with borderline tumors the 5-year survival rate was 98% and of 45 cases with carcinomas a 5-year survival rate of 51% was noted.(2)In 54 cases of borderline tumors,mucinous types accounted for 56%(30/54)and serous types accounted for 30%(16/54).There were 5 cases with micropapillary pattern,3 cases with peritoneal implants,3 cases with lymph node involvement,6 cases with microinvasion,one case with intraepithelial carcinoma,and one case with mural nodules.In 45 cases of carcinomas,serous carcinoma was the most (49%,22/45).The remainder included 3 cases of mucinous types,8 cases of endometrioid types,6 cases of transitional cell types,3 cases of mixed phenotype and 3 cases of undifferentiated types.(3) Overexpression of cyclin D1 and p53 was observed in 31%(14/45)and 56%(25/45)of ovarian carcinomas, respectively.There was a significant association between p53 overexpression and tumor grade.In the borderline tumor group,69%(37/54)had overexpression of cyelin D1 and 6%(3/54)had overexpression of p53.There were significant differences in expression of cyclin D1 and p53 between conventional serous borderline tumors and high-grade serous carcinomas(cyclin D1:91% vs 26%;p53:0 vs 58%).However, micropapillary serous borderline tumors and low-grade serous carcinomas showed remarkably similar expression of cyelin D1 and p53.Conclusions Epithelial ovarian borderline tumors are distinct from ovarian cancer in clinical progress and prognosis,and histological types.Overexpression of cyclin D1 is common in ovarian borderline tumors and low grade carcinomas.And overexpression of p53 is more common in high grade ovarian carcinomas.Conventional serous borderline tumors are distinct from high-grade serous carcinomas in pathogenesis.Micropapillary serous borderline ovarian tumors may be closely related to low grade serous carcinomas.

BACKGROUND: Three kinds of donor meniscus are commonly used at present, namely cryopreserved, fresh and deep-frozen meniscus, which,however, almost invariably give rise to degenerative changes of various degrees after transplantation.OBJECTIVE: To compare the outcome of transplantation of allograft deep-frozen meniscus and meniscal acellular matrix to determine the most preferable means of allograft meniscus preservation.DESIGN: Randomized controlled experiment with rabbits.SETTING: Department of Orthopedics, Second Hospital Affiliated to Harbin Medical University.MATERIALS: Sixty-four male Japanese white rabbits with body mass of 3.0 - 3.5 kg.METHODS: This experiment was carried out in the Animal Experimental Center, Second Hospital Affiliated to Harbin Medical University between September 2002 and September 2003. Totally 64 adult rabbits were assigned into 32 pairs according to the body weight to served as the donor and the recipient animals, respectively. The medial menisci was obtained from the bilateral knees of the donor animals with the right one cryopreserved at -80 ℃ and the left prepared into acellular matrix for deep-frozen preservation. The donor menisci were respectively transplanted into the corresponding knee joints of the recipient animal's hindlimbs, with the left side taken as the experimental side and right as control. Gross observation,X-ray examination, and histological examination of the tissues were carried out at postoperative 4, 8, 12 and 16 weeks, respectively.MAIN OUTCOME MEASURES: Findings in X-ray, gross observation and histological observation of the grafted meniscus with meniscal measurement and findings in abdominal aorta perfusion.RFSULTS: All the 64 rabbits were observed for result analysis. X-ray examination of the grafted meniscus revealed no obvious changes in either the experimental and control side at 4 and 8 weeks postoperatively, but mild changes occurred on the control side at 12 weeks, which became obvious at 16 weeks, presented by joint space narrowing, hyperostosis and osteosclerosis below the cartilage of varied severities (with scores of 1.3 and 0.6, respectively, P ＜ 0.05). By gross observation, meniscal atrophy on the experimental side was milder and slower than the control side, with al so lower atrophy rate [(15.14±4.62) % vs (20.97±4.72) % at week 4, P ＜ 0.001, and (19.23±11.27) % vs (32.74±10.43) % at week 16, P ＜ 0.05].Perfusion of the abdominal aorta revealed no revascularization in the surrounding tissues of the meniscus by gross observation in either groups, but histologically, the experimental side showed more favorable structure than the control side at postoperative weeks 4, 8, 12 and 16.CONCLUSION: Meniscal acellular matrix may produce better outcome than deep-frozen meniscus after transplantation and can be a more practical means for preservation of the meniscus.