Objective To evaluate the analgesic effect of dexmedetomidine on the ultrasonic guidance brachial plexus block.Methods Sixty patients who underwent elective for one-side upper limb or forearm surgery were selected,they were received ultrasonic guidance brachial plexus block.The patients were divided into observation group and control group by random digits table method with 30 cases each.The observation group received 0.5％ ropivacaine 100 mg and dexmedetomidine 0.75 μg/kg,and the control group received 0.5％ ropivacaine 100 mg alone.The heart rate,mean arterial pressure (MAP),pulse oxygen saturation (SpO2) at the time of entering operating room,brachial plexus block completed,incision and the end of surgery were recorded.After brachial plexus block completed,the visual analogue score (VAS) at the time of incision,1 h during surgery and 1,2,6,12,24,48 h after surgery was recorded.Morphine was given the patients when VAS ＞ 4 scores,and the time to first prescription of morphine and total morphine consumption dose within 48 h after surgery were also detected.The adverse reaction was recorded.Results There were no statistical differences in heart rate and MAP at the time of entering operating room and brachial plexus block completed between the 2 groups (P ＞ 0.05).The heart rate and MAP at the time of incision and the end of surgery in observation group were significantly lower than those at the time of entering operating and the same time of control group,there were statistical differences (P ＜ 0.05).There was no statistical difference in SpO2 between the 2 groups (P ＞0.05).The VAS at the time of 6,12,24 and 48 h after surgery in observation group were significantly lower than those in control group [(3.0 ± 0.9) scores vs.(4.9 ± 0.5) scores,(3.0 ± 0.7) scores vs.(5.6 ± 1.2) scores,(2.2 ± 0.9) scores vs.(4.8 ± 1.8) scores,(1.7 ± 0.5) scores vs.(3.2 ± 1.0) scores],there were statistical differences (P ＜ 0.05).The time to first prescription of morphine in observation group was significantly longer than that in control group [(450 ± 37) min vs.(368 ± 42) min],the total morphine consumption dose was significantly lower than that in control group [(8.3 ± 2.8) mg vs.(15.5 ± 4.5) mg],there were statistical differences (P ＜ 0.05).There was no adverse reaction found.Conclusion Ropivacaine plus 0.75 μ g/kg dexmedetomidine for ultrasonic guidance brachial plexus block may prolong the duration of analgesia,thus reduce morphine consumption within 48 h after surgery without severe adverse reaction.

Objective To investigate dynamic change of anterior pituitary hormones (APHs), thyroid func-tion (TF) and genital hormones (GnHs) in patients with traumatic brain injury (TBI) and their clinical signifi-cance. Method APHs, TF and GnH were tested in 93 patients with TBI,who were admitted to Zhejiang Provin-cial People's Hopital from March 2006 to June 2007. Patients with primary injury in the hypothalamic and pituitary regions, as detected by CT and/or MR/examination, as well as those with tumors or immune diseases in the CNS,endocrine or urinogenital systems, were excluded. The clinical data were analyzed according to Glasgow coma scores (GCS), type and degree of injury, and whether there was any secondary cerebral injury. Twenty healthy people acted as controls. The data were analyzed by the Hotelling T2 test and t-tests using SAS 11.5. A P value of less than 0.05 indicated statistical significance. Results The levels of adrenocortieotropic hormone (ACTH),luteinizing hormone (LH) and prolactin (PRL) were markedly higher in all 93 TBI patients than controls, while those of thyroid-stimulating hormone (TSH), thyroid hormone T3,T4 and FT3 were significantly lower in TBI pa-tients in the early stage after injury than in those at follow-up and controls (P<0.05). The ACTH and PRL val-ues reached (33.33±6.86) and (31.74±5.51), respectively, and the LH value was (9.48±1.14) in the secondary cerebral injury group.The TSH value (1.26±0.17) in the brain injury group was significantly lower than those in controls (P<0.05). With the exception of TSH, PRL, testosterone (T) and E2, other APHs were markedly lower in TBI patients at following-up than in controls (P<0.05). The incidence of traumatic hypothala-mus-pituitary insufficiency (THPI) associated with low levels of more than three APHs was 3.2%, while 13.8% of THPI patients showed low levels of at least one APH. The ratio of sick euthyroid syndrome (SETS) was 14.0%. Conclusions A low level of a single APH is the prevalent pattern in THPI patients. Secondary cerebral injury, such as acute high intracranial pressure, brain edema and ischemia after TBI, may be the chief causes of THPI. Early hyperprolactinemia is an important indication for presaging THPI. The dynamic levels of neurcen-docrine hormones can serve as an important index for determining the suitability of TBI patients for treatment with hormone therapy.

Objective:To investigate the effect of nimodipine liposomes for injection(NOLI)on focal cerebral ischemia/reperfusion(I/R)injury in rats.Methods:Seventy SD rats were divided into NDLI 1.00 mg/kg,NDLI 0.50 mg/kg,NDLI 0.25 mg/kg,nimodipine 1.00mg/kg,solvent 10 mL/kg,sham-operation and ischemic model groups.The model of middle cerelral artery occlusion in rat was replicated.The behavioral scores in rats were assessed in all groups.The infarct volume,brain water content,biochemical indices of brain homogenate and histology were detected.Results:1he NDLI 1.00mg/kg,0.50 mg/kg and 0.25 mg/kg groups could significantly improve the behavior scores in focal cerebral ischemic rats,reduce the volume of cerebral infarction,decrease the brain water content,improve the activities of Na+,K+-ATPase,Ca2+-ATPase,glutathione(GSH)and superoxide dismutazse(SOD)in brain tissues,reduce conteras of malondialdehyde(MDA),lactic acid(LA)and nitric oxide(NO),and improve histo logical injury.Conclusions:NDLI has the protective effect on focal cerebral ischemia/reperfusion injury in rats.

Objective: To study the relationships between the expressions of E-cadherin and ki-67 in the tissues of heatocellular carcinoma(HCC)and the prognosis of HCC patients after hepatectomy as well as their clinical pathology. Methods: We examine the expressions of E-cadherin and ki-67 in 255 HCC tissues by tissue microarray and PV-6000 two-step method of immunohistochemistry and analyze the correlations between their expressions and clinical pathological data, 1-year recurrent rate and overall survival time after hepatectomy. Results: The expression of E-cadherin correlated with the tumor size and the 1-year recurrent rate of positive group was higher than that of the negative group. The expression of ki-67 correlated with vascular invasion and differentiation of the tumor, the positive group showed a higher 1-year recurrent rate and a shorter overall survival time. Multivariate Cox regression analysis indicated that the expression of ki-67 was an independent risky factor. Conclusions: The negative expression of E-cadherin and the positive expression of ki-67 predict a higher recurrent rate of early stage. The expression of ki-67 is an independent risky factor which can be used to evaluate the prognosis of patients with HCC after hepatectomy.

Aim To investigate the protective effects of on focal cerebral ischemic-reperfusion(I/R)injury in rats.Methods The model of rat middle cerebral artery occlusion(MCAO)was induced to observe the change of praxiology of rats,infarction percentage,water content,histology of the rat brains.The levels of superoxide dismutase(SOD),malondialdehyde(MDA),reduced glutathione hormone(GSH),Na+,K+-ATPase,Ca2+-ATPase,nitric oxide(NO)were also measured.Results Salidroside at different dosages(24,12,6 mg?kg-1)could obviously decrease cerebral function score,cerebral infarct size and water content,and repair pathological injury of focal cerebral I/R in rats.MDA,LD,NO contents in brain tissue were significantly decreased and activities of GSH,SOD were significantly improved.Na+,K+-ATPase,Ca2+-ATPase at dosages of 24,12 mg?kg-1 were also significantly improved.Conclusion Salidroside had protective effects on injuries of cerebral I/R.

AIM:To study the effect of Exendin-4 on the glucose tolerance and serum glucose level in normal animals. METHODS: The fasting blood glucose concentration was tested at 0,1,2,3,4 h and 2,4 week after the first administration of Exendin-4 (0.1, 0.3, 0.9 g/kg, 4 weeks, qd) in Wistar rats ,taking insulin as positive control. Before intragastric administration 2.5 g/kg glucose, Exendin-4 (0.2, 0.6, 1.8 g/kg) were subcutaneously injected, then the fasting blood glucose concentration was tested at 0.5, 1, 2 h after the glucose loading. After hypodermic administration of Exendin-4 (0.2, 0.6, 1.8 g/kg), half of the mice were subcutaneously administrated 2.5 g/kg glucose 15 min later, and the insulin was tested at the end of the experiment. RESULTS:Exendin-4 could not significantly change the fasting blood glucose concentration at different times. The fasting blood glucose concentration was significantly decreased after glucose loading by administration Exendin-4. Exendin-4 could increase the serum insulin concentration remarkably after glucose loading and could not change much without glucose loading. CONCLUSION: The results suggest that the blood glucose regulation of Exendin-4 was related to the concentration of glucose.

Objective To explore the application value of platelet parameters detection in early diagnosis of breast cancer.Methods Platelet parameters of intravenous blood from 103 breast cancer patients and 117 fibroadenoma patients within 24 hours of admission between January 2015 and December 2015 were collected and retrospectively analyzed,including platelet count(PLT),plateletcrit(PCT),mean platelet volume(MPV),mean platelet component concentration(MPC),mean platelet component mass (MPM),platelet distribution width(PDW),and compared with control group of 100 healthy women.The diagnostic efficiency of platelet parameters were assessed using receiver operating characteristic(ROC) curve.Results PLT and PCT in breast cancer group and fibroadenoma group were significantly higher than those in control group(P＜0.01);MPC,PMM and PDW were significantly lower than those in control group(P＜0.01);MPV had no significant statistically difference(P＞0.05).The levels of MPC in breast cancer group were obviously lower than that in fibroadenoma group(P＜0.01).The diagnostic efficiency of MPC in breast cancer had the highest area under curve(AUC=0.835).While the cutoff value of MPC was 249.5 g/L,sensitivity and specificity were 82.5 ％ and 73.6 ％,respectively.Conclusion The detection of platelet parameters,especially MPC,have certain application value in early diagnosis of breast cancer.

Objective To design a portable vital signs monitoring system to monitor and analyze severe patient vital signs in field conditions.Methods The communication protocols of all medical devices were analyzed.The information on the vital signs were acquired periodically from medical devices with the signal transducer based on embedded technique,and then sent to the computer for analysis.The abnormalities were displayed on the portable terminal.Results The system met the desired requirements,and facilitated the medical personnel dedicated to treatment.Conclusion The system contributes to information sharing for the changes of vital signs in field conditions,so that the doctor can take measures in time to enhance the efficiency and reliability of the treatment.

Objective To study the effect of cyclosporine combined with eleven acid testosterone on serum T helper cells in patients with chronic aplastic anemia.Methods A total of 86 patients with chronic aplastic anemia received treatment in our hospital were collected as the research objects,and divided into experimental group and control group,patients in the experimental group received eleven acid testosterone combined with cyclosporine therapy,patients in the control group received eleven acid testosterone therapy.Blood routine indexes,Th1,Th2,Th17 and Treg cells contents of the two groups before and after treatment were compared.Results Before treatment,hemoglobin content,leukocyte count,platelet count,peripheral blood Th1,Th2,Th17 and Treg cells contents of the two groups had no significant difference(P>0.05).After two courses of treatment,hemoglobin content,leukocyte count,platelet count of the experimental group were significantly higher than those of the control group.After two courses and four courses of treatment,peripheral blood Th1 and Th17 contents of experimental group were significantly lower than those of the control group,Th2 and Treg contents were significantly higher than those of the control group.Conclusion Eleven acid testosterone combined with cyclosporine treatment could be more effective to stimulate hematopoiesis,regulate immune function and T lymphocyte subsets content,it′s an effective method for the treatment of chronic aplastic anemia.

Objective To evaluate the effects of nicotine or electric vagal stimulation on injury to transplanted lungs in rats.Methods Twenty-four male Wistar rats with transplanted lung,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),nicotine group (group NI) and electric vagal stimulation group (group VS).Nicotine 2 mg/kgwas injected intraperitoneally at 15 min after lung transplantation in group NI.Right cervical vagus nerve trank was stimulated for 20 min with continuous electric rectangular pulses (5 V,2 ms,1 Hz) at 10 min interval twice in total starting from 15 min after lung transplantation in group VS.Arterial blood samples were then collected for blood gas analysis at 15,30,45,75,105 and 135 min after lung transplantation.Arterial blood samples were then collected at 135 min after lung transplantation for determination of the plasma concentration of interleukin-6 (IL-6),IL-8 and tumor necrosis factor-α (TNF-α) by ELISA.The rats were sacrificed at 135 min after lung transplantation and the tissue of transplanted lung was removed for determination of lung injury score (LIS) according to the pathological changes obtained with light microscope,and of wet/dry lung weight ratio (W/D ratio).Results Compared with group C,PaO2 and pH value were significantly increased,and LIS,W/D ratio,and the concentrations of plasma IL-6,IL-8 and TNF-α were decreased in NI and VS groups.Conclusion Nicotine or electric vagal stimulation can attenuate injury to transplanted lungs in rats.