Objective To compare the effects of target-controlled infusion(TCI) of remifentanil in three different doses in thoracic patients undergoing total intravenous anesthesia.Methods Forty-five ASA Ⅰ～Ⅱ patients aged 40～60yr undergoing thoracic surgery were randomly divided into three groups.The patients were given midazolam 0.05mg/kg and artropine 0.5 mg/kg i.m.before anesthesia.Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously.The target concentration of propofol was set at 3?g/ml and remifentanil at 4,6,8ng/ml(groupⅠ,Ⅱ,Ⅲ).When the patients lost conscionsness,rocuronium 0.6mg/kg was given i.v.to facilitate intubation.Anesthesia was maintained with TCI of propofol-remifentanil and intermittent i.v.boluses of rocuronium.Remifentanil target concentration maintained unchanged during anesthesia.BIS index was controlled at 45～55 by modify propofol target concentration.SBP,DBP,MAP,HR and BIS index was recorded in baseline(T0),before intubation(T1),intubation(T2),skin incision(T3),the opening of the chest(T4),skin closuer(T5),extubation(T6).Vein blood samples were taken for determination of plasma concentration of epinephrine(E) and norepinephrine(NE) by ELASA.Results SBP,DBP,MAP,HR and plasma NE concentration at T2,T3,T4,T5 were higher than T0 in group Ⅰ(P

Objective · To evaluate the clinical characteristics of endometrial pathology in postmenopausal women with asymptomatic thickened endometrium. Methods · A retrospective review was conducted of the patients between October 2013 and October 2015 in the International Peace Maternity & Child Health Hospital. The postmenopausal women with asymptomatic thickened endometrium of 5 mm or more found by transvaginal ultrasonography were recruited. They underwent hysteroscopy and endometrial sampling to analyze the relationship between endometrial pathology and endometrial thickness. Results · A total of 257 patients were recruited. The average age was 61.3 years old, the average menopause period was 122 months, and the average endometrium thickness was 8.6 mm. The endometrial pathology included normal atrophic endometrium, endometrial polyp, submucous myoma, intrauterine adhesion, uterine septum, endometrial hyperplasia and endometrial cancer. The most common pathological type was endometrial polyp, accounting for 66.9% of the all patients and 83.9% (172/205) of all pathological types. Three cases of adenocarcinoma (1.2%) were diagnosed. There was significant difference in endometrial thickness among normal endometrium, endometrial polyp and endometrial cancer (P<0.05). The endometrium in endometrial cancer was the thickest, which was (13.20±5.38) mm averagely. There was significant difference in ages among the pathological types (P=0.004). Conclusion · There are few patients of malignancy among asymptomatic postmenopausal women with thickened endometrium. Follow-up visits were recommended to these women.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Fracture Fixation ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Humans ; Intraoperative Period ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Recovery of Function ; Smell ; Young Adult

Objective To investigate the effects of robot-assisted walking training after total knee replacement (TKR).Methods Forty TKR patients at 1 week post-operation were randomized into a control group (n =20) and a treated group (n =20).For 2 weeks the control group accepted routine rehabilitation therapy.The treated group received the same treatment as the control group,but also walking training using a robot-assisted walking training system.The results were evaluated using the Hospital for Special Surgery knee rating scale (HSS),knee proprioception grading,Berg scores,and 6 minute walking distance in both groups.All the analyses were administered before the operation and 2 weeks,l month,3 months and 12 months after the operation.Results The treated group had significantly better HSS scores,Berg scores,and 6 minute walking distances than the control group on average.However,there was no significant difference in average knee proprioception between the two groups.Conclusion Robot-assisted walking training was significantly more effective than conventional rehabilitation alone in improving knee joint function,balance ability and walking after TKR.

Objective Detecting the level of IDO and KYN in ulcerative colitis (UC) patients; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of dis-ease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent (ELISA) methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression (P<0.05). There was a positive correlation between KYN level and IDO expression (P<0.05). ②The levels of IDO and KYN in UC group were higher than those of disease control group and health control group (P<0.05). ③The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC (P<0.01), and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels (P<0.05). ⑤The IDO,KYN and CRP area under ROC curve were 0.976, 0.856 and 0.864;best cut-off point were 53.66 U/L, 2.34 nmol/L and 1.75 mg/ml;sensitiv-ity were 90.5%, 78.65% and 100.0%; specifity were 94.4%, 83.3% and 61.1%; Youden index were 0.839 2, 0.619 0 and 0.611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

Objective To screen the mimic epitopes of Rh(D)blood group antigens and identify their immunity from phage display peptide library.Methods A twelve mer phage peptide library was biopanned with anti-Rh(D)monoclonal antibody immobilized on plastic surface.After three round panning,thirty-five clones were randomly selected and positive clones were identified by ELISA and cross-reaction,followed by antibody competition inhibition assay and DNA sequencing to obtain the mimic epitopes of Rh (D)blood type antigens.The target phage clones were characterized and the antigenicity was analyzed by Western blot.Results After the third round screening,phages were enriched,and eleven positive clones were obtained.According to sequencing and competition inhibition analysis,the same"-WP-Q-"structure existed in seven of the eleven clones,and they had more than 40%inhibition ratio.The other clones had no same characteristics with low inhibition ratio possibly due to non-specific binding.Western blot analysis indicated that these phage clones could be specifically recognized by the anti-Rh(D)serum and they shared the same antigenicity of Rh(D)protein.Conclusions Rh(D)mimotope of"-WP-Q-"structure is successfully obtained by phage peptide library screening with anti-Rh(D)monoelonal antibody.The results lay the foundation for further exploration of pathogenesis and vaccine development of Rh(D)hemolytic diseases of newborn.

Objective To identify the imbalance of T cell-specific transcription factors T-bet/GATA-3,and to explore the modulation with dexamethasone and imiquimod in CD4+T cells from ovalbumin (OVA)sensitized mice.Methods CD4+T cells were obtained fromsingled-cell suspension of spleen(after lysis of RBC).ELISA assay was used to detect the concentrations of IL-4,IL-5 and IFN-γin superna tants and cell pellets,and the expression of T-bet and GATA-3 was detected by Western blot.Resuits In the control group,tIle low levels of IFN-γ were detected in the supernatants during 24 h.In OVA treatment group,the concentrations of IL-4,IL-5 were increased significantly,and the concentrations of IFN-γ were always low in the supernatants.In the dexamethasone treatment group,the concentrations of IFN-γ,IL-4 and IL-5 were all low in the supernatants during 24 h.In the imiquimod treatment group,the concentrations of IFN-γ were increased significantly,and the concentrations of IL-4 and IL-5 were decreased in the super natants.It worked at 6 h,and achieved the peak at 12 h,lasted over 24 h.In the control group,the expres sions of T-bet and GATA-3 were detected in CD4+T cells during 24 h.In OVA treatment group,the expressions of T-bet were decreased,and that of GATA-3 were increased rapidly in CD4+T cells.In dexam ethasone treatment group,the expressions of T-bet were always low in CD4+T cells,and that ofGATA-3 were no change during 24 h.In imiquimod treatment group,the expressions of T-bet were increased,andthat of GATA-3 were decreased in CD4+T cells.The protein expressions worked at 6 h.and achieved the peak at 12 h,lasted over 24 h.Conclusion The imbalance T cell-specific transcription factors T-bet/GA-TA-3 contributes to both high expression of GATA-3 and low expression of T-bet in CD4+T cells from OVA sensitized mice.Dexamethasone treatment inhibits the expression of T-bet in CD4+T cells and has no func tion in GATA-3.Imiquimod treatment modulates key master switches GATA-3 and T-bet that results in com mitting T helper cell to a TH 1 phenotype and imiquimod may play a key role in the regulation of TH2 cytokine responses in asthma.

Objective To approach the guide of ultrasound-guided minimally invasive biopsy technique in diagnosis and treatment of thyroid diseases. Methods One hundred and seventeen cases (a total of 131 nodules, nodules 0. 5-1.5 cm in diameter, with an average diameter of approximately 0. 8 cm) with thyroid nodules , under Ultrasound-guided minimally invasive biopsy techniques from October 2008 to July 2009 were analyzed. Result One hundred and seventeen cases of patients with biopsy derived satisfaction were not ap-parent discomfort and complications after biopsy. Across 59 cases of surgical treatment in patients with biop-sy, and preoperative biopsy and postoperative pathologic is not fully consistent in only two cases, 58 patients without surgical treatment, who is combined with symptoms, palpation, serum thyroxine and color Doppler ultrasound and other laboratory examinations, and regularly review treated with symptomatic treatment, the symptoms, and color Doppler ultrasound imaging were much better under the treatment. 8 cases of patients in 117 cases of minimally invasive biopsy have cervical lymph node biopsy at the same time, biopsy patholo-gy and postoperative results are consistent with postoperative pathologic (7 cases of metastatic carcinoma, 1 case of reactive hyperplasia), accuracy was 100%. Conclusion Uhrasound-guided minimally invasive bi-opsy technique have important guiding for diagnosis and treatment of thyroid diseases, consistent with the high rate of clinical, especially for the preoperative diagnosis of small nodules, to avoid unnecessary over-treatment, can also reduce the misdiagnosis of thyroid cancer. While this technology is simple, safe and ac-curate, which have clinical value in the thyroid surgery.