Objective To determine the median effective dose (ED50 ) of ropivacaine for spinal anesthesia when combined with sufentanil in patients undergoing caesarean section. Methods Twenty-eight ASA Ⅰ or Ⅱ parturients, aged 18-40 yr, weighing 50-110 kg, undergoing cesarean section under combined spinal-epidural anesthesia, were enrolled in this study. Combined spinal-epidural anesthesia was performed at L2,3 interspace. The mixture of ropivacaine and 5 fig sufentanil was injected into the subarachnoid space over 30 s. The initial dose of ropivacaine was 11 mg. The dose was increased/decreased by 1 mg in the next patient. The ED50 and 95% confidence interval were calculated by up-and-down method. Results The ED50 of ropivacaine was 7.780 mg (95% confidence interval 6.850-8.836 mg). Conclusion When combined with sufentanil 5 μg, the ED50 of ropivacaine for spinal anesthesia is 7.780 mg in patients undergoing caesarean section.

Lymphocyte function associated antigen-1 (LFA-1) is a member of integrin family, that plays an important role in the adhesion of lymphocytes with other cells and matrix. To investigate the role of LFA-1 in collagen-induced arthritis (CIA), the incidence of CIA, histological and radiological assessments in the LFA-1 deficient (LFA-1~ -/- ) mice and control mice were examined. LFA-1~ -/- mice and control mice were immunized with 100?g collagen type II(CII) emulsified with an equal volume of Freund’s complete adjuvant (CFA), followed by the booster injection of the same amount of CII in CFA on day 21. Then, clinical, histological and radiological assessments were done. It showed that 57% control mice developed arthritis and apparently changed in the histological and radiological assessment, whereas the all of LFA-1~ -/- mice had the normal histological and radiographic response and none developed arthritis. These results suggeste that LFA-1 is indispensable for the onset of CIA.

Objective To study the COLIXA3 gene polymorphism of patients with fluorosis and to explore the pathogenesis of COLIXA3 gene in endemic fluorosis.Methods Fifty one cases of patients with drinking-water borne fluorosis were selected as the case group in Xinzhou city,Shanxi province and 28 cases of healthy people were as the control group.Dental fluorosis was detected by Dean method and skeletal fluorosis was examined by X-ray.COLIXA3 of exon 5 gene product of 103 points was amplified by PCR and the gene locus genotype was sequenced.Results Ten cases of mild dental fluorosis,14 cases of moderate dental fluorosis,15 cases of severe dental fluorosis were detected among the 51 patients.The control group was free of dental fluorosis.All the 51 cases of patients with fluorosis had varying degrees of skeletal fluorosis,mainly osteosclerosis lesions,accounting for 86.27％(44/51 ),and mild skeletal fluorosis patients were all osteosclerosis lesions,and osteosclerosis lesions and multiple skeletal lesions were found among moderate and severe skeletal fluorosis patients in the case group,while control group had no skeletal fluorosis.The differences between genotypes of frequency distribution of AA,Aa,aa of COLIXA3 of case and control groups were not statistically significant [96.08％(49/51 ),3.92％(2/51 ),0.00％(0/51) and 96.43％(27/28),3.57％(1/28),0.00％(0/28),x2 =0.94,P ＞ 0.05].ConclusionsCOLIXA3 gene polymorphism is not significantly correlated to fluorosis.

OBJECTIVETo study the histopathological changes of livers in idiopathic portal hypertension (IPH).

METHODSLiver specimens from 29 cases with idiopathic portal hypertension were studied. Histological preparations of the livers were stained with haematoxylin eosin and Masson's trichrome; reticular fibers in the liver tissues were demonstrated. The slides were also stained using some immunohistochemistry methods, and the pathological changes of the livers were analyzed.

RESULTSThe characteristic changes found in these IPH livers were dense portal fibrosis; obliteration, with or without phlebitis, of the branches of the portal vein; dilatation of the sinusoids; atrophy and nodular hyperplasia of liver cells.

CONCLUSIONSHistopathological changes of the livers in IPH are dense portal fibrosis, portal vein branch obliteration and nodular hyperplasia of liver cells. These are the main features for a histopathological diagnosis of IPH.

Adolescent ; Adult ; Female ; Fibrosis ; pathology ; Humans ; Hypertension, Portal ; pathology ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

Objective To evaluate the effect of nimodipine on postoperative delirium (POD) in elderly patients with lacunar infarction. Methods Sixty patients with lacunar infarction of both sexes, aged 65-80 yr, of American Society of Anesthesiologists physical status Ⅱor Ⅲ, scheduled for elective spinal surgery under general anesthesia, were divided into 2 groups (n= 30 each) using a random number table: control group (group C) and nimodipine group (group N). Nimodipine 7. 5 μg·kg-1 ·h-1 was in-travenously infused starting from 30 min before anesthesia induction until the end of surgery in group N, while the equal volume of normal saline was given in group C. At 30 min before infusing nimodipine (T1 ), immediately after tracheal intubation (T2 ), at 1 h after skin incision (T3 ) and at the end of surgery (T4 ), blood samples were taken from the radial artery and jugular bulb for blood gas analysis. Jugular bulb oxygen content, arterial-jugular bulb oxygen content difference, cerebral oxygen uptake rate and jugular-arterial lactate concentration difference were calculated. The concentrations of S100β protein and brain-derived neurotrophic factor (BDNF) in serum of the jugular bulb were measured by enzyme-linked immunosorbent as-say. The occurrence of POD was recorded within 3 days after operation. Results Compared with group C, jugular bulb oxygen content was significantly increased, and arterial-jugular bulb oxygen content difference and cerebral oxygen uptake rate were decreased at T3,4 , the concentrations of serum S100β protein were de-creased and the concentrations of brain-derived neurotrophic factor were increased at T2-4 , the incidence of POD was decreased (P<0. 05), and no significant change was found in jugular-arterial lactate concentra-tion difference at each time point in group N (P>0. 05). Conclusion Nimodipine can reduce the devel-opment of POD, and the mechanism may be related to improving intraoperative cerebral oxygen metabolism and reducing brain injury in elderly patients.

OBJECTIVETo discuss the surgical skill, treatment effect and indications for reconstruction of vertebral lamina with skull titanium plate and autograft in the treatment of thoracolumbar vertebrae fracture.

METHODSFrom March 1999 to April 2007, 33 patients with thoracolumbar vertebrae fracture combined nerve injury were treated by reconstruction of vertebral lamina with skull titanium plate and autograft including 30 males and 3 females with an average age of 41 years ranging from 21 to 66. The fracture involved 3 cases in T11, 9 in T12, 16 in L1, 3 in L2 and 2 in L3. There were 12 cases with flexion fracture, 8 with extension fracture, and 13 with burst fracture. Five cases performed emergency operation and in the others the time from injury to operation was 5 to 12 days. GSS fixation was applied in 25 cases and AF in 8. The volume of vertebral canal, the stability of the spine, the height of vertebrae, and the nerve function were observed before and after operation.

RESULTSThese 33 patients were followed up for 1 to 3 years (means 25 months). The height of anterior column of the involved vertebrae changed from 58% to 96%, the cobb angle return from average of 26 degree to 2 degree, the volume of vertebral canal extended from 43% to 92%, respectively, when compared between preoperatively and postoperatively.

CONCLUSIONReconstruction of vertebral lamina with skull titanium plate and autograft which is a simple and safe treatment for thoracolumbar vertebrae fracture can increase the stability of spine and avoid second canal stenosis.

Adult ; Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Titanium ; pharmacology ; Transplantation, Autologous ; methods ; Young Adult

OBJECTIVETo explore the value of (18)F-FDG PET/CT in the diagnosis and treatment evaluation in patients with pretreatment or recurrent extranodular natural killer/T-cell lymphoma nasal type (ENTCL).

METHODS(18)F-FDG PET/CT images and clinical records of 35 cases (67 scans) of pathologically confirmed ENTCL treated in our hospital within the last 9 years were analyzed. The imaging characteristics of the upper aerodigestive tract (UAT) and the non-aerodigestive tract (NUAT) lesions were analyzed. Lesion distribution, clinical stages, SUVmax and patient survival data were compared between pretreatment and recurrent cases.

RESULTSs All the ENTCL lesions were hypermetabolic. The UAT lesions involved mainly the nasal cavity and pharynx, while the NUAT lesions may involve the lymph nodes and all the organs. UAT lesions were more common in pretreatment cases while NUAT lesions tended to increase in recurrent cases. The SUVmax of pretreatment and recurrent lesions were 10.4∓4.4 and 9.6∓5.2, and showed no significant difference among patients with different lesion distribution patterns, clinical stages, or treatment history. The tumor remission rate evaluated by PET/CT were higher in cases with an initial diagnosis than in those with recurrence [(89.5% (17/19) vs 33.3% (5/15), P<0.005)]. Cox regression analysis revealed no significant differences in the survival rates among patients with different treatment history, clinical stages, lesion distribution patterns, or SUVmax levels (P>0.05).

CONCLUSION(18)F-FDG PET/CT can sensitively detect the pretreatment or recurrent lesions in ENTCL patients and helps in accurate tumor staging and curative effect evaluation.

Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnostic imaging ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography

The genetic diversity of 279 indivdiuals from 10 populations in Shandong Province was investigated using inter-simple sequence repeat (ISSR) markers. As a result, 116 bands were amplified by 10 informative and reliable primers, of which 101 were polymorphic loci. A relatively high level of genetic diversity was revealed: PPL = 87.07, He = 0.2697, H0 = 0.3999 (at the species level); PPL = 64.58, He = 0.2004, H0 = 0.3010 (at the population level). A higher level of genetic differentiation was detected among populations with Nei's G(ST) analysis and the analysis of molecular variance (AMOVA; G(ST) = 0.2414, F(ST) = 0.2224). Habitat fragmentation and gene flow may result in genetic differentiation. UPGMA cluster analysis indicated that the four populations from Linshu, Junan, Tancheng and Feixian grouped together, whereas Laiyang populations clustered in an isolated clade. The results showed that a mixed mating system was possibly the main factor influencing the genetic structure of this species. These results, combined with other information about Castanea mollissima, may provide a valuable basis for proposing conservation strategies.
China ; Fagaceae ; genetics ; Genetic Markers ; genetics ; Genetic Variation ; Genetics, Population ; Microsatellite Repeats

By electrophysiological methods, cultured Drosophila embryonic and larval central neurons have been widely used to study ion channels, neurotransmitter release and intracellular message regulation. Voltage-activated K(+) channels play a crucial role in repolarizing the membrane following action potentials, stabilizing membrane potentials and shaping firing patterns of cells. In this study, a mechanical vibration-isolation system was used to produce a sufficient number of acutely dissociated larval central neurons, of which the majority were type II neurons (2~5 microm in diameter). Using patch clamp technique, the whole-cell K(+) currents in type II neurons were characterized by containing a transient 4-AP-sensitive current (I(A)) and a more slowly inactivating, TEA-sensitive component (I(K)). According to their kinetic properties, five types of whole-cell K(+) currents were identified. Type A current exhibited primarily fast transient K(+) currents that activated and inactivated rapidly. The majority of the neurons, however, slowly inactivated K(+) currents with variable inactivation time course (type B current). Type C current, being present in a small number of the cells, was mainly composed of noninactivating components. Some of the neurons expressed both transient and slow inactivating components, but the slowly inactivating components could reach more than 50% of the peak current (type D current). Type E current showed distinct voltage-dependent activation properties, characterized by its bell-shaped activation curve. Type E current was inhibited by application of Ca(2+)-free solution or 0.1 mmol/L Cd(2+). Moreover, this novel current ran down much more rapidly than other types. These results indicate that different K(+) channels, which have different kinetic and pharmacological properties, underlie the whole-cell K(+) currents in type II neurons of Drosophila larval central nervous system.
Action Potentials ; Animals ; Cell Separation ; methods ; Drosophila ; metabolism ; physiology ; Larva ; cytology ; Membrane Potentials ; Neurons ; metabolism ; physiology ; Patch-Clamp Techniques ; Potassium ; physiology

Objective To assess the risk factors for carbapenem-resistant Acinetobacter baumannii(CRAB)bloodstream infection(BSI)and 28-day short-term mortality in elderly patients,and provide reference for the pre-vention and treatment of CRAB BSI.Methods Clinical data of patients aged ≥60 years and diagnosed with AB BSI in a hospital in Yulin City from January 2013 to December 2022 were retrospectively analyzed,including demogra-phic and microbiological characteristics,as well as clinical outcomes of the patients.Variables which were significant in univariate analysis were selected for multivariate analysis using binary logistic regression model and Cox propor-tional hazards model.Independent risk factors for infection were further determined,and survival analysis was per-formed using Kaplan-Meier curve.Results A total of 150 patients were included in the study,out of which 16 pa-tients(10.7％)had CRAB BSI and 134 had carbapenem-sensitive AB(CSAB)BSI.The 28-day short-term mortali-ty of AB BSI in elderly patients was 15.3％(23/150,95％CI:9.6％-21.1％),and the short-term mortality of CRAB BSI was higher than that of CSAB([56.3％,9/16]vs[10.4％,14/134]).Deep venous catheterization(OR:15.598,95％CI:1.831-132.910)and combined infections of other sites(OR:15.449,95％CI:1.497-159.489)were related to CRAB BSI in elderly patients.The independent risk factors for 28-day mortality in elderly patients with AB BSI were hemodialysis(OR:11.856,95％CI:2.924-48.076),intensive care unit admission(OR:9.387,95％CI:1.941-45.385),and pulmonary infection being suspected source of bacteremia(OR:7.019,95％CI:1.345-36.635).Conclusion The occurrence of CRAB BSI in elderly patients is related to the combined infection of other sites and deep vein catheterization.Hemodialysis,admission to ICU,and pulmonary infection being suspected source of bacteremia are independent risk factors for the prognosis of AB BSI in elderly patients.