Objective It has been shown that ketamine attenuates cytokine production and release induced by endotoxin. The purpose of this study was to investigate the effects of diazepam and ketamine on inflammatory responses during early stage of burn. Methods BALB/C male mice weighing 20-25 g were randomly divided into 5 groups : (1) normal control group (n = 10); (2) burn control group received Ⅲ degree bums covering 15%-20% of the body surface (n = 10); (3) D-K group received intramuscular diazepam 0.4mg?kg-1 and ketamine 10 mg?kg-1 ( n = 10); (4) D + K pretreatment group received D + K 15 min before burn ( n = 10) and (5) D + K post-treatment group received D + K 15 min after burn ( n = 10) . Four hours after burn or anesthesia (D + K) the animals were sacrificed and blood was collected for determination of serum TNF-?, IL-1? and IL-10 concentrations (ELISA) and peritoneal macrophages were isolated for detection of glucocorticoid receptor (GR) by Western blotting. In addition peritoneal macrophages isolated from normal animals (group 1) and bum animals (group 2) were cultured with diazepam-ketamine for 1 h befor detection of GR.Results Serum TNF-?, IL-1? and IL-10 levels in group 2 were significantly higher than those in group 1. In group 4 and 5 serum TNF-?, IL-l? and IL-10 levels were significantly lower than those in group 2. In group 4 only serum IL-10 level whereas both serum IL-1? and IL-10 levels in group 5 were significantly higher than those in group 1. GR of peritoneal macrophage was significantly down regulated 4 h after bum (group 2) as compared with group 1. The level of GR in group 4 was significantly higher than that in group 2 but not significantly different from that in group 1; whereas the GR level in group 5 was significantly higher than that in group 2 but lower than that in group 1 and 4. There was no significant difference in GR expression after macrophages were cultured in vitro with diazepam and ketamine between normal or bum groups. Conclusion Diazepam-ketamine pretreatment can suppress cytokine release induced by severe bum. The expression of GR in peritoneal macrophages is significantly reduced by bum. Diazepam-ketamine given before or after bum can suppress the inflammatory response but have no direct effect on peritoneal macrophages.

Dual material gate SOI MOSFET with asymmetrical halo can suppress short channel effect and increase carriers transport efficiency. The analytical model of its subthreshold drain current is derived based on the explicit solution of two-dimensional Poisson's equation in the depletion region. The model takes into consideration the channel length modulation effect and the contribution of the back channel current component. Its validation is verified by comparision with two dimensional device simulator MEDICI.

People departure from the treatment, prevention and health care purposes, intermittently or continuously excessive use of drugs with dependence, will cause serious mental and physical damage, while serious social harm.Opioids are the most commonly abused drug, abusers by taking an excess number of pills orally or by crushing the pills, followed by smoking, snorting, or injecting the new altered formulation to get euphoric.The escalating abuse of opioids has recently spawned the development of novel drug formulations resistant to various methods of tampering and misuse.This article discusses available opioids that include abuse-deterrent mechanisms as well as such agents currently in development.

Acute Disease ; Autonomic Nervous System Diseases ; Child ; Humans ; Male

Objective To explore the clinical efficacy and toxicity of idarubicin (IDA)-based IA regimen as induction chemotherapy in treating acute myeloid leukemia (AML) within different risk groups.Methods Data collected in 60 patients initially diagnosed and treated with one course of IA regimen were studied retrospectively.Results Efficacy were different for patients treatment with different prognosis after one course of IA chemotherapy,CR rates achieved in patients with favorable,intermediate and unfavorable prognosis were 83.3 ％ (10/12),73.1％ (19/26),59.1％ (13/22) respectively,PR rates were 16.7 ％ (2/12),19.2％ (5/26),13.6％ (3/22) while ORrateswere 100％ (12/12),92.3 ％ (24/26),72.7 ％ (15/22)respectively.After 2 years of follow-up,relapse free survival (RFS) rates were 100 ％ for patients with good prognosis,53.8 ％ for those with moderate prognosis,and 45.5 ％ for people with poor prognosis.The outcome showed that there were significant differences among these three group (P =0.042).Myelosuppression and infections due to neutropenia were the main adverse effects,and severe non-hematologic toxicities were not observed.Conclusion IA regimen as induction chemotherapy may be an efficacious and safe solution and achieve a higher CR rate and 2 years RFS rate for patients diagnosed as AML with good prognosis.Hematopoietic stem cell transplantation should be considered as soon as possible for patients with moderate or poor prognosis.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

Objective To evaluate the clinical effects of platelet-rich plasma in treatment of DeepⅡburn wounds. Methods Sixty eight cases of inpatients with Deep Ⅱburns were selected, whose age were from 1 to 65 years and their burn areas were between 5%~62%of total body surface area (TBSA). Deep gradeⅡburn of each sample was divided into two parts. Part A was the treatment group and part B was the control group.The burn wounds in the treatment group were treated with platelet-rich plasma and the counterpart in the control group were treated with SD-Ag. Healing time ,recovering rate and the frequency of dressing changes,frequency of changing the most innerlayer gauze and the rate of wound infection were also analyzed. Finally the laboratory abnormalities and adverse effect were monitored regularly. Results The healing time of the treatment group (16.5±3.1 ) d was shorter than that of the control group (19.5±3.8 ) d. The recovering rate of the treatment group was higher than that of the control group on the 14th and 17th day after treatment. There were statistically sig?nificant differences between these two groups (P<0.05). After two weeks’treatment, the internal and external dressing per?meability into wet gauze layers were 20.6 ± 1.7, which were significantly decreased than that in the control group 23.3 ± 5.9. The frequency of dressing changes was(7.2±1.1)times in treatment group versus(9.2±1.4)times in control group and the frequency of changing the inner most layer gauze was( 2.3±0.6)times in the treatment group versus(5.3±1.3)times in con?trol group. There were 5 inflammation reaction cases in the treatment group, but 13 cases in the control group. However, there was no statistic significance between the two group in the outcomes of bacterial culture, the laboratory abnormalities and the adverse effect. Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,re?duce frequency of dressing change and promote wound healing for deepⅡburn wound. PRP is a potential safety reagent in treating deepⅡburn wound.

Objective To investigate the effect of pelvic floor muscle exercise on perimenopausal female sexual dysfunction. Methods Forty six patients with perimenopausal female sexual dysfunction received pelvic floor muscle exercise. Sexual function and pelvic floor muscle strength were compared between pre-and post-exercises. Result The patients′pelvic floor muscle strength and sexual function after exercises were significantly better than those before the exercises (P<0.05). Conclusion Implementation of the pelvic floor muscles exercise in the patients with perimenopausal sexual dysfunction can strengthen pelvic floor muscle and thus alleviate their sexual dysfunction.

Objective To observe the effect of Shengxian Decoction (Decoction for lifting the depressed organs) in the treatment of 38 patients with obstructive sleep apnea hypopnea syndrome (OSAHS) in the TCM syndrome of qi deficiency of the lung and spleen. Methods Totally 68 patients were randomized into a control group (30 cases) treated by Duxil for oral taking and a treatment group (38 cases) treated by Duxil and Shengxian Decoction for 10 days. The changes in the symptom scores of both groups after treatment were observed. The polysomnogram (PSG) was applied before and after treatment to record the total sleep time,hypopnea total time,and average heart rate to calculate the times when oxygen saturation was less than 90% in each hour sleep time,the total continuous time when oxygen saturation was less than 90% in the whole night,apnea-hypopnea index (AHI),and hypopnea index (HI). Results After treatment,the main symptoms in the treatment group were significantly improved (P

Objective As estrogen increases visceral hypersensitivity induced by water avoidance stress in female rats,further experiment was designed to determine whether the influence of estrogen involves NR2B.Methods Healthy adult female Wistar rats were bilaterally ovariectomized,and then housed individually.Implantation of cannula into lateral cerebroventricle and electrodes into the abdominal muscle had been done.After 5 days recovery,rats with abnormal behavior and ehctromyography were excluded,finally a total of 48 rats were eligible,and were equipped for abdominal muscle electromyography and submitted to water avoidance stress(WAS).Visceromotor response(VMR)to 20,40,60 and 80 mmHg colorectal distension(CRD)was recorded in rats intracerebroventricular-infused with either 17β-estradiol,normal saline,AP5(NMDA receptor-antagonist)or Ro25-6981(NR2B antagonist).NR2B mRNA in anterior cingulate cortex or dorsal root ganglia were compared by real-time PCR between the rats treated with 17β-estradioI and that with normal saline.Results Bilaterally ovarieetomized rats treated with 17β-estradiol,exhibited more visceral hypersensitivity after WAS than that with normal saline on 40,60 and 80 mmHg CRD(P=0.039,P=0.033,P=O.001).The VMR on 40 and 60 mmHg CRD in 17β-estradiol treated group was not significantly different from that in 17β-estradiol plus Ro25-6981 treated group.Whilst,significant differences of VMR were noted between 17β-estradiol treated group and 17β-estradiol plus Ro25-6981 treated group on 80 mmHg CRD,17β-estradiol treated group and 17β-estradiol plus AP5 treated group on 60,80 nmmHg CRD,respectively.17β-estradiol increased NR2BmRNA in anterior cingulate cortex(0.57±0.41 vs 0.21±0.13,P=0.048),but not in dorsal root ganglia(0.35±0.45 vs 0.38±0.31,P=0.465). Stress-induced visceral hypersensitivity in the hormonally-restored visceral hyper-responsiveness of bilaterally ovariectomized rats was antagonized by AP5 or Ro25-6981.Conclusions Estrogen may be mediated through NR2B activation to enhance visceral sensitivity in female stressed rats,that probably related with the increased expression of NR2B mRNA in anterior cingulate cortex.