Objective To evaluation the efficacy of dexmedetomidine mixed with dezocine and levobupivacaine for patient-controlled epidural analgesia (PCEA) after cesarean section.Methods A total of 300 patients, aged 23-35 yr, with body mass index of 24-28 kg/m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective cesarean section under epidural anesthesia, were randomly divided into 3 groups (n =100 each) according to the random number table: morphine and levobupivacaine group (ML group), dezocine and levobupivacaine group (DL group), and dexmedetomidine, dezocine and levobupivacaine group (DDL group).In group ML, the loading dose included morphine 2 mg + levobupivacaine 10 mg + 5 ml normal saline, and PCEA solution contained morphine 5 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DL, the loading dose included dezocine 3 mg+ levobupivacaine 10 mg+ normal saline 5 ml, and PCEA solution contained dezocine 15 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DDL, the loading dose included dezocine 2 mg+ levobupivacaine 10 mg + dexmedetomidine 0.5 μg/kg + normal saline 5 ml, and PCEA solution contained dezocine 7.5 mg+ levobupivacaine 150 mg + dexmedetomidine 1.5 μ g/kg + normal saline 100 ml.At 10 min before the end of operation, the loading dose was given via the epidural catheter, and the PCEA pump was connected and set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Analgesia was maintained until 42 h after operation.Visual analog scale score was main-tained ≤ 3, and (or) visual analog scale for fatigue score ≤ 2.When PCEA failed, morphine 2 mg was injected epidurally as rescue analgesic.At 4, 8, 24 and 42 h after operation, the modified Bromage score and Ramsay sedation score were recorded, and patients' satisfaction with analgesia was evaluated.The occurrence of epidural analgesia-related adverse reactions was recorded.Results The consumption of PCEA solution and requirement for rescue analgesics were significantly lower in group ML than in group DL.Compared with group ML, Ramsay sedation score was significantly decreased at 4 and 8 h after operation, the degree of patients' satisfaction with analgesia was increased, and the incidence of nausea, vomiting, dizziness and pruritus was decreased in DL and DDL groups, and the incidence of urinary retention was decreased in group DDL.The degree of patients' satisfaction with analgesia was significantly higher, and the incidence of dizziness and urinary retention was lower in DDL group than in group DL.No patients developed epidural analgesia-relatcd hypotension, bradycardia, or respiratory depression in the three groups.Conclusion The efficacy of dexmedetomidine mixed with dezocine and levobupivacaine is good when used for PCEA after cesarean section, and the adverse reactions are fewer.

A new steroid with a long cross-conjugation structure, 15a-hydroxy-(22E, 24R)-ergosta-3, 5, 8 (14), 22-tetraen-7-one (1), was isolated from the marine-derived fungus Aspergillus aculeatus. Its structure was established by the extensive spectroscopic analyses, and its cytotoxicities against P388, HL-60, and PC-3 cell lines were measured in vitro.
Animals ; Aspergillus ; chemistry ; Cell Line, Tumor ; drug effects ; Cholestenones ; chemistry ; isolation & purification ; pharmacology ; HL-60 Cells ; drug effects ; Humans ; Inhibitory Concentration 50 ; Molecular Structure ; Seawater ; microbiology

Objective To investigate the method and clinical outcome of partial nail carried by great toe fibular flap for repairing the defect of fingertip soft tissue and nail bed.Methods From June,2016 to October,2017,12 cases suffered the defect of fingertip soft tissue and nail bed.The injury fingers included 5 index fingers,6 mindle fingers and 1 ring finger.All cases were complicated with nail bed defect of different degrees.The nail matrix was intact.The area of fingertip defect ranged from 1.0 cm×1.0 cm to 1.5 cm×2.5 cm.The area of nail bed defect ranged from 0.2 cm×0.8 cm to 0.5 cm×1.5 cm.Great toe fibular flap combine with partial nail was harvested.Donor site was directly sutured or skin grafting according to the size.The regular preoperative followed-up was performed.Results All flaps survived with donor sites healing good.The average followed-up time was 7 (ranging from 2 to 10) months,and cosmetically acceptable results were achieved for all patients.The mean static 2-PD in the flaps was 7.5 (range,6.0 to 8.0) mm.No obvious deformity of the great toe nail.Conclusion Findings proved that using partial nail carried by great toe fibular flap is a beneficial microsurgical alternative for reconstructing defect of fingertip soft tissue and nail bed.

Objective To describe the characteristics of sexual debut among college students in China to provide appropriate sex education in that population. Methods An anonymous questionnaire survey was conducted among 33 653 college students selected by multi-stage stratified cluster sampling method in 18 provinces and cities of China. Results The percentage of students who had initiated sexual intercourse before age 14 was 1.9%. Overall, male students (2.8%) were significantly more likely to have initiated sexual intercourse before age 14, than female students (1.1%). The percentage of students who had initiated sexual intercourse from age 15 to 18 was 6.4% in males versus 2.1% in females. while the rates of students who had initiated sexual intercourse after age 19 were 6.9% in males and 2.6% in females. The first sexual intercourse was significantly associated with parental educational attainment, geographic location and family structure. Students whose parents were relatively well educated, living in the western areas of the country China, or with nucleus/extensive families were more likely to have early sex in their puberties. Conclusion Sexual education should be strengthened especially in the western areas, and targeted on the students whose parents with relatively higher educational background or who were from extensive families.

OBJECTIVETo identify the current epidemiological situation of injuries among adolescents in China and to provide basis for prevention and control.

METHODSAn anonymous questionnaire survey was conducted among 170 602 middle school students in 18 provinces and cities of China.

RESULTSThe overall incidence of injuries among middle school students was 43.7% while the incidence of recurrent injuries was 20.9%. The incidence of boys was higher than that of girls mainly because of the difference of the recurrent injuries incidence. The incidence of injuries decreased with age in our investigation, especially the recurrent injuries. The main causes of injuries were fall and collision, and the most frequent results of injuries were cut and bone-joint injuries among boys and girls. Key school, nucleic family and higher education level of mothers were protective factors to injuries.

CONCLUSIONAdolescents seemed high-risk population for injuries. Some preventive measures should be carried out to decrease the incidence of injuries especially on recurrent injuries.

Adolescent ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Risk ; Students ; Wounds and Injuries ; epidemiology

OBJECTIVETo study the metabolites of marine fungus Alternalia sp.

METHODCompounds were separated by column chromatography and their structures were elucidated by means of chemical and spectral analysis.

RESULTSix compounds were isolated from the ethyl acetate and n-butanol extracts of the fermentation of marine fungus Alternalia sp. Their structures were elucidated as p-benzyloxy-phenol ( I ), p-hydroxy phenyl ethylamine( II ), 3-hydroxymethyl-8-hydroxyl-pyrrolopiperazine-2, 5-dione ( III ), 3-isobutyl-6-secbutyl-piperazine-2, 5-dione (IV), 5alpha, 8alpha-epidioxy-ergosta-6, 22-diene-3beta-ol (V), 3beta-hydroxxy-cholesta-5-ene (VI).

CONCLUSIONCompounds I , II, III, IV have the activity of inducing morphological deformation of mycelia germinated from conidia of Pyricularia oryzae. Compounds I , II , III were isolated from the genus Alternalia for the first time.

Antifungal Agents ; isolation & purification ; pharmacology ; Ascomycota ; drug effects ; Fermentation ; Fungi ; chemistry ; Molecular Structure ; Phenethylamines ; chemistry ; isolation & purification ; pharmacology ; Phenols ; chemistry ; isolation & purification ; pharmacology

BACKGROUNDBone morphogenetic protein (BMP) is a member of the superfamily of transforming growth factor-beta. Recent studies show that it is an indispensable factor in hematopoiesis. To better characterize the effect of recombinant human BMP (rhBMP)-2 in hematopoiesis, we set out to determine whether rhBMP-2 could promote the proliferation of mesenchymal stem cells (MSCs) and increase the levels of hematopoietic cytokines in MSCs.

METHODS2, 3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-((phenylamino) carbonyl)-2H-tetrazolium hydroxide (XTT), real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) were used to detect the effects of rhBMP-2 on the proliferation and hematopoietic cytokine levels of MSCs. In addition, MSCs marked with Hoechst33342 were transplanted into BALB/c mice by the intravenous route or intra-bone marrow transplantation, and cluster numbers were counted.

RESULTSThe XTT test revealed that rhBMP-2 significantly induced proliferation of MSCs in doses ranging from 10 ng/ml to 0.1 mg/ml in a dose-dependent manner. The experiments in vivo showed that there were more clusters of donor cells in bone marrow, spleen, liver and lung of the BMP group than those in the control group after both intra-bone marrow transplantation (P < 0.001, P < 0.001, P < 0.001, and P = 0.001, respectively) and intravenous transplantation (P < 0.001, P < 0.001, and P < 0.001 respectively). The results of real-time PCR and ELISA revealed that rhBMP-2 significantly increased mRNA expressions and protein levels of IL-6, IL-7, IL-11, G-CSF, M-CSF and SCF.

CONCLUSIONSThe treatment with rhBMP-2 promotes the proliferation of MSCs in vivo and in vitro and increases the levels of hematopoietic cytokines in MSCs, which may contribute to the improvement of hematopoietic function.

Animals ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Dose-Response Relationship, Drug ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor ; genetics ; Humans ; Interleukin-11 ; genetics ; Interleukin-6 ; genetics ; Interleukin-7 ; genetics ; Macrophage Colony-Stimulating Factor ; genetics ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Mice ; Mice, Inbred BALB C ; Polymerase Chain Reaction ; Recombinant Proteins ; pharmacology ; Stem Cell Factor ; genetics ; Transforming Growth Factor beta ; pharmacology

Criminal responsibility is divided into three types: full criminal responsibility, diminished criminal responsibility and criminal irresponsibility in China. In forensic psychiatric expertise, doctors often have different opinions about the responsibility in a given case because of lacking objective criteria. The evaluation of criminal responsibility is always unresolved problem in forensic psychiatric expertise. Application of these evaluation tools in forensic psychiatric expertise were reviewed in this article. The value of the tools were still controversial in the reliability and validity, but it is clear that these tools have the positive roles in ensuring the standardization and the uniformity of the forensic investigation.
Crime/psychology* ; Expert Testimony/legislation & jurisprudence* ; Forensic Psychiatry ; Humans ; Liability, Legal ; Mental Competency ; Mental Disorders/psychology* ; Psychiatric Status Rating Scales ; Social Responsibility

Appearance of proteomics technology can fleetly filt and reveal specificity biomarkers of disease, this will help to reveal the pathogenesis of femur head necrosis and help early diagnosis, find more effective methods and therapeutic targets. At present, they are hot spots that find out the occurred mechanism,related proteins of early diagnosis and early treatment and its functional identification; set up the early related database; optimize the protein extraction methods for research of femur head necrosis. This article reviews the application of study technology of related proteins of femur head necrosis on bone tissue, serum,related animal model,and in order to provide further research ideas.
Early Diagnosis ; Femur Head Necrosis ; diagnosis ; metabolism ; Humans ; Proteomics ; methods

OBJECTIVETo verify the hypothesis that selected nestin positive cells derived from human fetal pancreas (according as medical ethnics) have surface markers similar to bone marrow mesenchymal stem cells (MSCs), and that these cells have multilineage potential.

METHODThe cell surface markers were determined by flow cytometry, and then the potential that these cells might be differentiated into adipocytes and osteoplasts were explored.

RESULTThese cells have similar surface markers as MSCs of bone marrow origin. These cells was induced to differentiate into adipocytes and osteoplasts.

CONCLUSIONSelected nestin positive cells derived from human fetal pancreas have certain characteristics of MSCs.

Adipocytes ; cytology ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Separation ; methods ; Cells, Cultured ; Fetal Stem Cells ; chemistry ; cytology ; metabolism ; Flow Cytometry ; Humans ; Intermediate Filament Proteins ; Mesenchymal Stromal Cells ; metabolism ; Nerve Tissue Proteins ; Nestin ; Pancreas ; cytology ; embryology