Objective To evaluate the efficacy of dexmedetomidine used to supplement lumbar plexus combined with sciatic nerve block for total hip arthroplasty in the elderly patients.Methods Fifty ASA Ⅱ or Ⅲ patients,aged 80-93 yr,with a body mass index of 17-25 kg/m2,scheduled for unilateral total hip arthroplasty,were randomly divided into 2 groups (n =25 each):normal saline group (group NS) and dexmedetomidine group (group D).Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups.After a loading dose of dexmedetomidine 0.5 μg/kg was infused over 10 min starting from 20 min after the block,dexmedetomidine was infused at 0.2 μg· kg-1 · h-1 until the end of surgery.While the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol 20 mg or ketamine 10 mg was infused intravenously when the efficacy of the block was inadequate.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory rate (RR),side effects during operation,requirement for propofol or ketamine and doctor' s satisfaction were recorded after admission to the operating room,immediately after iv administration,at 0,10 and 30 min after the beginning of surgery,and at the end of surgery (T0-5).Results Compared with the baseline value at T0,MAP and HR were significantly increased at T2-5 in group C (P ＜ 0.05),and no significant change was found in the hemodynamic parameters at each time point in group D (P ＞ 0.05).Compared with group C,the MAP,HR,incidences of respiratory depression and agitation and requirement for propofol or ketamine were significantly decreased,and the doctor's satisfaction was significantly increased (P ＜ 0.05).Conclusion Dexmedetomidine can increase the efficacy of lumbar plexus combined with sciatic nerve block when used for supplementation of total hip arthroplasty in the elderly patients,the hemodynamics is stable and side effects are fewer.

Nowadays,the incidence of intellectual disabilities(ID) increased in the elder,and they would meet the following problems:life transitions,future life planning and understanding emotions,etc.This paper discusses the measures to be made for ageing person with ID from three aspects:assessing and managing illness,caregiving stress and the role of psychologists.

OBJECTIVEThe aim of this study is to establish a transgenic mouse model for cleft palate relevant gene thyroid transcription factor-2 (TTF-2), which can be used to study palatal shelf development when the expression pattern and regular activation of TTF-2 is altered.

METHODSThe C57BL/6J mouse TTF-2 gene was cloned through polymerase chain reaction (PCR) from the mouse genomic DNA. The TTF-2 gene was inserted into the expression vector pBROAD3-mcs to construct the recombinant expression vector pBROAD3-TTF-2. This expression vector was then microinjected into the male pronuclei of the fertilized mouse ovum. Thus, the TTF-2 transgenic mice model was established. The genotype of the transgenic mice was identified by PCR and Southern blot analysis. Immunohistochemistry identified the consistent expression of TTF-2 gene during its palatal shelf development.

RESULTSTTF-2 genes were microinjected into 982 fertilized ova. A total of 580 two-cell-stage embryos cultured and transplanted into the oviducts of 48 pseudopregnant female mice. Overall, 68 embryos were obtained for analysis. The genotype of the mice was determined through PCR and Southern blot analysis using genomic DNA extracted from tail biopsies of the transgenic fetus. A total of 13 TTF-2 transgenic mice were detected. The expression of TTF-2 gene during the palatal shelf development of the transgenic mice was consistently detected by immunohistochemistry.

CONCLUSIONThe recombinant expression vector pBROAD3-TTF-2 was integrated into mouse genome through microinjection. The transgenic mouse in the palatal shelf that consistently expressed TTF-2 was successfully established and displayed a cleft palate phenotype.

Animals ; Cleft Palate ; Disease Models, Animal ; Female ; Forkhead Transcription Factors ; Genotype ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Thyroid Gland

The aim of this study was to propose an algorithm for three-dimensional projection onto convex sets (3D POCS) to achieve super resolution reconstruction of 3D lung computer tomography (CT) images, and to introduce multi-resolution mixed display mode to make 3D visualization of pulmonary nodules. Firstly, we built the low resolution 3D images which have spatial displacement in sub pixel level between each other and generate the reference image. Then, we mapped the low resolution images into the high resolution reference image using 3D motion estimation and revised the reference image based on the consistency constraint convex sets to reconstruct the 3D high resolution images iteratively. Finally, we displayed the different resolution images simultaneously. We then estimated the performance of provided method on 5 image sets and compared them with those of 3 interpolation reconstruction methods. The experiments showed that the performance of 3D POCS algorithm was better than that of 3 interpolation reconstruction methods in two aspects, i.e., subjective and objective aspects, and mixed display mode is suitable to the 3D visualization of high resolution of pulmonary nodules.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Lung ; pathology ; Multiple Pulmonary Nodules ; diagnosis ; Tomography, X-Ray Computed

Objective: To investigate the free radical scavenging properties of six aloe species and study its protective effect on red blood cells. Methods: Free radical scavenging properties were investigated in modified chemical system. The antioxidant was purified by silica column and thin layer chromatography and analyzed by HPLC. Its protection on red blood cells was studied with red blood cells culture system in vitro. Results: The extract from A. berebihoria showed the most effective scavenging activities on O - 2? and ?OH (32.19% and 26.05% respectively) in six aloe species. The fraction A with a Rf value of 0 497 was proved to be a pure antioxidant (Rt=15.956 min). It is an anthraquinone with phenol hydroxyls. Fraction A showed strong inhibitory activity on H 2O 2 induced hemolysis of red blood cells and its IC 50 was 0.856 g/L. Conclusion: Fraction A of the extract from A. berebihoria had strong scavenging activities of O - 2? and ?OH, thereby inhibiting the peroxidation of red blood cells and maintaining their functions.

Adult ; Altitude ; Chordoma ; surgery ; Endoscopy ; Female ; Humans ; Nasal Cavity ; surgery ; Paranasal Sinuses ; surgery ; Skull Base ; surgery ; Video-Assisted Surgery

Objective To investigate the association of C-reactive protein (CRP) gene polymorphisms and plasma hs-CRP level,and effect on the genetic susceptibility of ischemic stroke (IS).Methods A case-control study was conducted and 548 patients with acute ischemic stroke and 993 agematched controls from community-based population were included in this study.Epidemiological questionnaires were managed to collect for demographic information.Blood pressure was measured and blood glucose,triacylglycerol,cholesterol,and high sensitivity C-reaction protein (hs-CRP) were detected.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for genotyping of CRP gene in all participants.Results The levels of plasma hs-CRP and the proportion of elevated plasma hs-CRP (≥3.0 mg/L) in the ischemic stroke patients (3.534 ± 3.484) mg/L (43.1％) were significantly higher than those of controls (1.957 ±2.344) mg/L (16.6％),t =9.475,P ＜ 0.01,x2 =128.326,P ＜ 0.01.The results of association analysis indicated that rs3093059 and rs3091244 of CPR gene presented statistical associations with ischemic stroke.After correction for confounding factors,ORs (95％ CI) of additive model and dominant model of rs3093059 were 0.697 (0.528-0.921),0.671 (0.487-0.923) respectively.ORs 95％ CI) of dominant model of rs3091244 was 0.728 (0.536-0.988).Further analysis indicated the polymorphism of rs876537,rs3093059,rs3091244 of CPR genotyping were significantly associated with plasma hs-CRP elevation (≥ 3.0 mg/L) both in ischemic stroke patients and in controls (P ＜0.05).Conclusion The CRP genetic polymorphisms were negatively associated with ischemic stroke,and positively corrleted with plasma hs-CRP elevation.However,plasma hs-CPP was positively correlated with ischemic stroke.These results suggested that the plasma hs-CRP levels might be accompanied by ischemic stroke.

Objective To investigate the metabolite features of acute necrotizing pancreatitis in rats in vitro by high resolution magic angle spinning nuclear magnetic resonance spectroscopy (HR-MASNMR).Methods A total of 30 Wistar rats were randomized into ANP group ( n = 20) and control group ( n = 10).All the rats in ANP group were injected with L-arginine 2.5mg/g body weight twice, and the animals in the control group received same dose of saline. HR MASNMR was used to study the metabolic changes of acute necrotizing pancreatitis in rats in vitro. Results 12 hours after the ANP induction, the pancreas were more swelling, presented with bleeding points, with mild increase in liquefied change, coagulation necrosis could be found in parenchyma and a large number of fatty tissues could be seen around the pancreas. Serum amylase level was ( 3527 ± 429 ) U/L, which was significantly higher than ( 1250 ± 188 ) U/L in control group.Compared with those in the control group, the signal intensity of taurine ( Tau), acetic acid ( Ace), alanine (Ala) of the ANP group were significantly increased. While the signal intensities of phosphocholine (Pc),glycerophosphocholine (GPc) and betine (Bet) were significantly decreased. The signal intensities of choline (Cho), glutamic acid (Glu), lactate (Lac) were not significantly different. Conclusions There were obvious metabolic features of pancreatic tissues of ANP in rats, and it is useful for the application of magnetic resonance spectroscopy in AP in vivo in human studies.

Objective To explore the value of monitoring techniques of the external branch of superior laryngeal nerve (EBSLN) in thyroid surgery and to study its protective effects on vocal function after thyroid surgery.Methods We retrospectively analyzed the clinical data of 139 patients who underwent primary surgery of papillary thyroid cancer with neurological monitoring from Jun.2017 to Mar.2018 in the General Surgery Department of PLA General Hospital.The tumors of 31 cases were located in the upper pole of the gland and elsewhere in 108 cases.The patients' vocal function was assessed at one week and one month after surgery.The rate of EBSLN identified visually and by the intraoperative nerve monitoring (IONM) were counted.EBSLN recognition efficiency and prevalence of EBSLN damage during the operation of tumor in upper pole of thyroid and in other location were compared.Results In the 139 patients,there were 218 upper poles(218 EBSLN) treated intraoperatively,of which 145 were recognized visually (126(57.8％) confirmed by IONM,and 203(93.1％) were identified by IONM,OR=8.27(x2=59.345,P=0.00).The percentage of EBLSN located in the upper pole accurately identified by the naked eye was 20/46(43.5％) while by IONM was 43/46(93.4％).The percentage of EBSLN at the other position accurately identified visually was 106/172(61.6％),and by IONM was 160/172(93.0％).The number of visually identified cases in different locations showed significantly differences according to the chi-square test (x2=4.901,P=0.027),and no significant difference by IONM identification according to chi-square test (x2=0.012,P=0.914).Five patients had a low voice at one week postoperatively and low voice and vocalization change were not observed after one month.Conclusions IONM can effectively increase the proportion of intraoperative EBSLN identification to ensure the safety of surgery.The difficulty of visual identification of EBSLN during the surgery of tumor in upper pole is greater than that in other locations.IONM can provide more evidences for nerve protection and reduce the risk of injury.

Objective To investigate the diagnostic values of transcranial Doppler ultrasonography (TCD) for vertebral artery hypoplasia (VAH) and focal vertebral artery stenosis (fVAS) with CT angiography (CTA) finding as a standard.Methods Consecutive patient who underwent TCD and CTA were included.According to the findings of CTA,they were divided into 3 groups:a normal group,a VAH group,and a fVAS group.The TCD parameters included the mean flow velocity (MFV),peak systolic velocity (PSV),pulsatility index (PI),resistance index (RI) and asymmetry index (AI),and they were compared among the groups,respectively.The receiver operator characteristic (ROC) curves were used to evaluate the sensitivity and specificity of TCD parameters for diagnosis of VAH and fVAS.Results A total of 405 patients were enrolled,including 278 (68.6％) in the normal group,75 (18.5％) in the VAH group,and 52 (12.8％) in the fVAS group.There were significant differences in MFV,PSV,PI,and RI on the affected sides among different groups (the affected side in the normal group was defined as the right side).The blood flow velocity in the VAH group was the slowest,and that in the fVAS group was the fastest.Other parameters had the same trend.There were significant differences in MFV and PSV on the unaffected side among different groups.The blood flow velocity in the VAH group was significantly faster,the fVAS group was slightly faster,and the fVAS group was less than the VAH group.There were significant differences in AI among different groups,and it could be used as an indicator for diagnosis of VAH (the area under the curve 0.78,95％ confidence interval 0.72-0.84;P＜0.001).With the AI ＞33.7％ as a cut-off value,the sensitivity and specificity of VAH diagnosis were 74.7％ and 68.7％.Conclusions Attention should be paid to identifying VAH and fVAS when using TCD for evaluation of vertebral artery.AI ＞33.7％ can be used as a reference index for diagnosis of VAH.