ObjectiveTo investigate the effect of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.MethodsNinety-six ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr weighing 50-80 kg undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate short-term sleep quality in hospital.The patients were divided into 4 groups according to the types of preoperative sleep disturbance ( n =24 each):group Ⅰ no sleep disturbance;group Ⅱ long-term sleep disturbance; group Ⅲ acute short-term sleep disturbance; group Ⅳ long-term + acute short-term sleep disturbance.Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with iv infusion of remifentanil and propofol.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-35 nun Hg.Controlled hypoteasion was performed with nicardipine,MAP was maintained at 50-70 mm Hg and HR at 60-90 bpm during operation.The patients received iv flurbiprofen 50 mg at 15 min before the end of operation for postoperative analgesia.When VAS score was more than 3 during the fnrst 6 h after operation,flurbiprofen 50 mg was given iv as rescue analgesic.ResultsThe incidence of rescue analgesic administered after operation was significantly larger in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesic administered during the first 6 h after operation between groups Ⅱ and Ⅲ.ConclusionPreoperative sleep disturbance has adverse effect on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Objective To study the expression of homocysteine in serum of patients with common malignant tumor,and initially investigate the possibility of serum homocysteine as cancer biomarker.Methods Expression levels of homocysteine and caner biomarkers (CEA,AFP,CA125,CA199) in serum of 180 patients with established malignant tumor and 30 healthy controls (control) were measured,the results of homocysteine were compared with that of the cancer biomarkers based on the cutoff value used in clinic.Results The expression levels of homocysteine was significantly higher in patients with malignant tumor than in controls [(13.89 ± 4.95) μmol/L-(21.40 ± 9.38) μ mol/L vs (11.40 ± 3.13) μmol/L,P ＜ 0.05)].Conclusions The positive predictive rate of homocysteine is higher than the four kind of cancer biomarkers in lung cancer,breast cancer,esophageal cancer.The increase of homocysteine in tumors may be universal,and Homocysteine may be used as cancer biomarker in lung cancer,breast cancer and esophageal cancer.

Objective To investigate the effects of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.Methods Ninety-six ASA Ⅰ or Ⅱ patients of both sexes (aged 20-60 years and weighing 50-80 kg) undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate the long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate the short-term sleep quality in hospital.The patients were divided into four groups according to the types of preoperative sleep disturbance (n =24 each):no sleep disturbance (group Ⅰ),long-term sleep disturbance (group Ⅱ),acute short-term sleep disturbance (group Ⅲ),and long-term + acute short-term sleep disturbance (group Ⅳ).Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with intravenous infusion of remifentanil and propofol.Then the patients received endotracheal intubation and mechanical ventilation.The end-tidal pressure of carbon dioxide was maintained at 30-35 mm Hg.Controlled hypotension was performed with nicardipine,and the mean arterial blood pressure was maintained at 50-70 mm Hg and heart rate at 60-90 bpm during operation.The patients received intravenous injection of flurbiprofen 50 mg 15 minutes before the end of operation for postoperative analgesia.When the visual analogue scale score was more than 3 during the first 6 hours after operation,flurbiprofen 50 mg was given intravenously as rescue analgesia.Results The incidence of rescue analgesia administered after operation was significantly greater in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and greater in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesia administered during the first 6 hours after operation between groups Ⅱ and Ⅲ.Conclusion Preoperative sleep disturbance has adverse effects on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

AIM: To investigate expression of CD44s in lung cancer and it's clinical significance. METHODS: A total of 117 primary lung cancer from patients were examined for CD44s expression by immunohistochemical staining. RESULTS: CD44s mostly expressed in non-small cell lung cancer (NSCLC) but not in small ecll lung cancer (SCLC), and squamous cell carcinoma(SCC) showed much stronger expression of CD44s than adenocarcinoma(ADC)(P

Objective: To investigate the association of calcium intake with bone mass in premenarche girls. Method: Bone mineral density (BMD) and bone mineral content (BMC) at the whole body, lumbar spine (L1-L4) and left hip of 194 premenarche girls (10?1 years old) were measured by dual-energy X-ray absorptiometry (DEXA). Dietary calcium intakes were assessed by food frequency questionnaire and 3d weighed diet records. Results: Statistically significant positive correlations between daily calcium intake and bone bone mineral density (BMD) were or bone mineral content (BMC) at all studied bone sites were found (P

0.05],while the RDW in CHD patients was significantly increased[(13.2?0.8)%,both P

Objective A novel high-speed three-way solenoid valve is developed, which is used for the common-rail injection system equipped on DME powered engine. In order to improve the dynamic response performance of the three-way solenoid. Methods Experimental studies have been conducted to investigate the effects of spool stroke, drive voltage, negative demagnetizing pulse and two drive schemes on the dynamic response performance of the three-way solenoid valve. Results The results show that the dynamic response performance of the three-way solenoid valve can be remarkably improved by shortening the spool stroke and increasing the drive voltage. Simultaneously, the difference between the response time of closing valve and that of opening valve decreases. At each different drive voltage, there exists an optimal negative demagnetizing pulse corresponding to the same positive exciting pulse. At this optimal pulse,the dynamic response performance of the three-way solenoid valve is the best. In addition, the high drive voltage can lead to the smaller optimal negative demagnetizing pulse. It is also indicated from the experiments that the dynamic response performance of the three-way solenoid valve is better when the NO. 1 drive scheme is adopted. The lower drive voltage results in the larger difference between the dynamic response performances for the two drive schemes.Conclusion The dynamic response performance of a novel three-way solenoid valve is good.

OBJECTIVETo determine the physiological role of D-bifunctional protein (DBP) in bile acid biosynthesis through investigating the effect of increasing activity of DBP on bile acid biosynthesis.

METHODSTwenty male Wistar rats were divided into two groups: diethylhexyl phthalate (DEHP) group (n = 10) and control group (n = 10). Serum triglyceride, total cholesterol, hepatic DBP activity, and fecal bile acids were assayed. The mRNA levels of hepatic peroxisome proliferator-activated receptor alpha (PPARalpha), DBP, and cholesterol 7alpha-hydroxylase (CYP7A1) were detected by RT-PCR.

RESULTSCompared with control group, serum triglyceride level was decreased significantly and PPARalphamRNA level was increased significantly in DEHP group (P < 0.01). Together with a sharp induction of DBP mRNA expression and DBP activity in DEHP group (P < 0.01), the levels of CYP7A1 mRNA and fecal bile acids were significantly increased by 1.9 times and 1.6 times respectively compared to control group (P < 0.01). There was a significantly positive correlation between DBP mRNA level or DBP activity and CYP7A1 mRNA level (r = 0.89, P < 0.01; r = 0.95, P < 0.01).

CONCLUSIONThe up-regulation of DBP mRNA and activity in liver can result in the increase in CYP7A1 mRNA expression and bile acid biosynthesis, suggesting that DBP may be involved in bile acid biosynthesis together with CYP7A1.

17-Hydroxysteroid Dehydrogenases ; metabolism ; Animals ; Bile Acids and Salts ; biosynthesis ; Cholesterol 7-alpha-Hydroxylase ; analysis ; Enoyl-CoA Hydratase ; metabolism ; Liver ; metabolism ; Male ; Multienzyme Complexes ; metabolism ; PPAR alpha ; analysis ; Peroxisomal Multifunctional Protein-2 ; RNA, Messenger ; analysis ; Random Allocation ; Rats ; Rats, Wistar

Objective To investigate surgical treatment and effect of secondary endocardial fibroelastosis,based on respective analysis of clinical data and follow-up data of patients with secondary endocardial fibroelastosis (SEF) between 2010 and 2012.Methods A retrospective analysis was performed including 10 patients with secondary endocardial fibroelastosis from January 2010 to December 2012 in Wuhan Union Hospital.All patients were diagnosed by Untrasonic Cardiogram and/or CT angiography of heart and great vessel,and had cardiac insufficiency in different degree [EF 0.37 ± 0.08 (0.26 ～ 0.48)].All patients except 2 patients with anomalous origin of the coronary artery received treatment of digitaloid drugs before operation,which promoted preoperative cardiac function.5 patients with SEF complicated with Congenital Coarctation of the Aorta (CoA),2 patients underwent correction of CoA,2 patients underwent correction of CoA and partial resection of endocardium,1 patient underwent correction of CoA,partial resection of endocardium and mitral vavuloplasty.2 patients with SEF complicated with anomalous origin of the left coronary artery from the pulmonary artery,who were underwent correction of anomalous origin of coronary artery.2 patients with SEF complicated with aortic stenosis,who were underwent aortic commissurotomy and partial resection of endocardium.1 patient with SEF complicated with mitral stenosis and insufficiency,who underwent mitral valve replacement.The intraopertive gross appearance of endocardium was opaque greyish-white not transparent pink.The postoperative pathological examination showed obviously positive dyeing of elastic fibers.In 3,6,12 and 24 months after operation,Untrasonic Cardiogram evaluated cardiac function and endocardium.Results one 6 months patients with origin of left coronary from pulmonary artery died of severe post-operative low cardiac output syndrome,while another 1 months patients with origin of left coronary from pulmonary artery obtained post-operative good recovery,and the Untrasonic Cardiogram show disappearance of endocardial fibroelastosis.The post-operative mean time of using respirator(4.0 ± 1.5) days (2-7 days).Compared with the preoperative data,the cardiac function index (EF) was not significantly better at 2 weeks and 3-6 months[0.38 ± 0.07 (0.28 ～ 0.48),P ＞ 0.05 ; 0.39 ± 0.08 (0.30 ～ 0.50),P ＞ 0.05],and the non-resected fibroelatic endocardium still existed and were not attenuated.But the cardiac function index (EF) significantly increased [0.44 ± 0.08 (0.38 ～ 0.55),P ＜ 0.05] than the pre-operative EF,and the 3 of 5 cases the fibroelatic endocardium were attenuated or disappeared,while 2 of 5 cases the fibroelatic endocardium still existed.Conclusion SEF is the important causes of the infant intractable heart failure,which has the characteristic of high mortality and limited therapy.For SEF patients with anomalous origin of the coronary artery,the SEF is completely reversed by early diagnosis and early correction of the malformation.For SEF patients with CoA or aortic stenosis,the surgical treatment could promote recovery of cardiac function,but whether the SEF were reversed is still subject to further follow-up.The heart transplantation is the best therapy for SEF with severse heart failure.

OBJECTIVE To detect ESBLs genes in 5 Shigella sonnei isolates.METHODS Susceptibility test to common antibiotics was performed through disk diffusion test,and ESBLs were confirmed according to CLSI.Conjugation experiment was performed to determine whether the resistance was transferable.The ESBLs gene was detected by PCR using universal primers for TEM,SHV,CTX-M,and the PCR products were also directly sequenced and analyzed.At the same time,the five isolates were analyzed by PFGE. RESULTS The five S.sonnei isolates were ESBLs producers and produced CTX-M-15 ESBLs,which were resistant to the most of the ?-lactams such as aztreonam,the first and second generation cephalosporins,cefotaxime,and non ?-lactam such as gentamicin,SF,but susceptible to ceftazidime,the 4th generation cephalosporins,Amikacin and meropenem.These strains were also intermediate to quinolones.CTX-M-15 gene could be transferred through conjugation.PFGE patterns of one isolate were different from the others.CONCLUSIONS Five S.sonnei isolates producing CTX-M-15 ESBLs are resistant to the most antibiotics.Clone spread is evident in these isolates.We should pay more attention to monitor these strains.