ObjectiveTo analyze the influence of different anesthesia methods on the stress response and hemodynamic of elderly patients undergoing laparoscopic cholecystectomy(LC).Methods Fifty-eight elderly patients who needed LC were selected and divided by random digits table method into GAEA group received general anesthesia combined with epidural anesthesia and GA group received general anesthesia with 29 cases each.The stress response and changes of hemodynamic were observed.Results Blood pressure and heart rate (HR) were elevated during pneumoperitoneum in both groups.Blood pressure and HR returned to normal at 30 minutes after pneumoperitoneum in GAEA group,which were recovered more slowly in GA group.There was no significant difference in systolic blood pressure (SBP),diastolic blood pressure (DBP),HR between two groups before and after anesthesia (P＞0.05).SBP,DBP,HR of GAEA group were ( 123.8 ± 25.9) mm Hg ( 1 mm Hg =0.133 kPa),(85.9 ± 8.4) mm Hg,(83.2 ± 7.4) times/min during pneumoperitoneum,respectively,(118.2 ±21.1) mm Hg,(84.4 ±8.3) mm Hg,(82.8 ±7.5)times/min at 10 min after pneumoperitoneum,( 114.9 ± 20.7) mm Hg,(80.2 ± 7.6) mm Hg,(78.5 ± 10.4)times/min at 30 min after pneumoperitoneum.SBP,DBP,HR of GA group were (138.3 ±26.7) mm Hg,(91.2 ± 8.8) mm Hg,(89.3 ± 10.1 ) times/min during pneumoperitoneum,( 130.3 ± 21.3) mm Hg,(89.2 ±8.6) mm Hg,(88.2 ± 9.7) times/min at 10 min after pneumoperitoneum,( 126.2 ± 20.7) mm Hg,(85.2 ±8.4) mm Hg,(84.9 ± 9.6 ) times/min at 30 min after pneumoperitoneum,respectively.SBP,DBP,HR during pneumoperitoneum,at 10 min and 30 min after pneumoperitoneum in two groups had significant differences (P ＜0.05).The anesthesia onset time in GAEA group was(73.2 ±24.9) s,and the awake time after operation was (31.6 ± 10.2) min,while those in GA group were (78.1 ± 22.4) s and (35.9 ± 14.3) min.The anesthesia onset time and awake time after operation in GAEA group were shorter than those in GA group,but had no significant difference (P＞ 0.05 ).Postoperative visual analogue score of GAEA group [ ( 13.4 ± 8.2)scores] was obviously lower than that of GA group[(26.3 ± 10.1) scores] (P ＜0.05).The incidence of adverse reactions between GAEA group [27.59％(8/29)] and GA group [6.90％(2/29)] had statistical difference (P ＜ 0.05).ConclusionsCompared with general anesthesia,general anesthesia combined with epidural anesthesia during LC for elderly patients can reduce the occurrence of intraoperative stress responses and have more steady hemodynamic,better anesthetic effect and faster recovery.But it may cause the incidence of nausea,headache and other postoperative adverse reactions increase.

Objective To compare the therapeutic effects of different doses of pioglitazone, a kind of peroxisome proliferator-activated receptor γ (PPARγ) agonist, on vascular dementia and explore how pioglitazone affects cerebral ischemia. Methods Modified Pulsinelli's vessel ligation was used to establish a vascular dementia model in rats. Recognition, learning and memory were evaluated by Morris's water maze test. Immunoenzyme staining was used to determine the number of nerve cells. Immunofluorescence double-staining was used to examine the expression of PPARγ/nerve cells and PPARγ/astrocytes in different groups. Results Both in pioglitazone groups and sham-operation group, the latency was reduced significantly compared to that in control group (P<0.01). Sham-operation group had the largest number of neurons in the cortex, followed by low-dose pioglitazone group and high-dose pioglitazone group, and control group came last. Compared with control group, pioglitazone groups had more PPARγ expression in nerve cells, and the fluorescence intensity of PPARγ was stronger. Conclusion Pioglitazone can induce the expression of PPARγ in neuron endochylema and astrocyte endochylema to protect nerve cells, and then to improve spatial learning and memory function in VD rats.

AIM: To establish the quality standard for Qidan Granules(Radix et Rhizoma Salviae Miltiorrhizae,Radix Astragali,Myrrha,Rhizoma Curcumae;Faeces Togopteri). METHODS: Myrrh,Rhizoma Curcumae and Faeces Trogopteri in Qidan Granules were identified by TLC.The content of tanshinone Ⅱ_A was determined by HPLC.The astragaloside content was determined by HPLC-ELSD. RESULTS: Myrrh,Rhizoma Curcumae and Faeces Trogopteri could be identified by TLC.There was a good linear relationship between the peak area and quantity of tanshinone Ⅱ_A at the range of 2.98-953.6 ng,r=0.999 9,and the recovery was 100.6%,RSD was(0.5%.) Also,there was a good natural logarithm linear relationship between the peak area and quantity of astragaloside at the range of 2.05-40.92 ?g,r=0.999 8,and the recovery was 102.0%,RSD was 1.8%.(CONCLUSION:) The method can be used to set up the quality standard for Qidan Granules.

Objective: To analyze the expression of CMTM1-v17 in normal prostate tissue and prostate carcinoma originated cell lines, and study its impact on the transactivation of androgen receptor and the possible mechanism. Methods: The expression of CMTM1-v17 in normal prostate tissue was analyzed with immunohistochemistry method. In immounocytochemistry was used to analyze the expression of CMTM1-v17 in prostate carcinoma originated cell lines. Luciferase assay was used to study the impact of CMTM1-v17 on the transactivation of AR and its mechanism. Results: The results of immunohistochemistry showed that CMTM1-v17 was highly expressed in prostate. In prostate cancer originated cell lines, CMTM1-v17 could also be detected in prostate cancer originated cell lines PC3, Du145 and LNCaP. And the results of luciferase implied that the relative luciferase activity of the PC3 cells transfected with 1 ?g and 2 ?g pCDI-CMTM1-v17 plasmids separately were 70.8 and 34.7, compared with the control set as 100. When trichostatin A, the inhibitor for histone deacetylase, was used, the repression of androgen receptor could be recovered with trichostatin A treatment,for the relative luciferase activity of the PC3 cells transfected with 1 ?g and 2 ?g pCDI-CMTM1-v17 plasmids and treated with 100 nmol/L trichostatin A rebound to 90.9 and 86.4. Conclusion: CMTM1-v17 is highly expressed in both normal prostate and prostate carcinoma originated cell lines. It may recruit histone deacetylas to inhibit the function of androgen receptor.

Calcium Channel Blockers ; pharmacology ; Cell Survival ; drug effects ; Drug Antagonism ; Humans ; Kidney ; cytology ; drug effects ; Lead ; toxicity

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

Background: Studies showed that aberrant activation of JAK/STAT3 signaling pathway promoted the tumorigenesis and progression of hepatocellular carcinoma (HCC), and transforming growth factor-β1 (TGF-β1) has either tumor-suppressing or tumor-promoting effect in regulation of tumor progression.Aims: To investigate the effect of specific inhibition of JAK/STAT3 signaling pathway on HCC and whether TGF-β1 signaling pathway is involved in this process or not.Methods: Thirty Wistar rats were randomly divided into three groups: control group, HCC group, and HCC+AG490 group.In the latter two groups, diethylnitrosamine was administered in drinking water to induce HCC model, and in HCC+AG490 group, AG490, a specific inhibitor of JAK was injected intraperitoneally in the first week of model establishment.At the end of the 16th week, all rats were sacrificed.The maximum diameter of tumor nodules in the liver was recorded and the number of tumors with maximum diameter greater than 1 cm was counted.Expression and distribution of STAT3 and TGF-β1 in liver tissue were determined by real-time PCR, immunohistochemistry, and immunofluorescence.Results: Compared with the control group, expressions of STAT3 and TGF-β1 mRNA in liver tissue were significantly increased in HCC group (P<0.05).Phosphorylated STAT3 (p-STAT3) and TGF-β1 proteins were absent in liver tissue in control group, and both were up-regulated and co-expressed in HCC group.While in HCC+AG490 group, expressions of STAT3 and TGF-β1 mRNA were significantly lower than those in HCC group (P<0.05);the liver tissue was weakly positive for p-STAT3 and TGF-β1 proteins, and the number of tumor nodules greater than 1 cm and the maximum diameter were markedly reduced when compared with the HCC group [1.20±1.03 and (1.14±0.18) cm vs.4.30±1.06 and (1.78±0.27) cm, P all<0.05].Conclusions: Specific inhibition of JAK/STAT3 signaling pathway may restrain the tumorigenesis and progression of HCC partially by interfering TGF-β1 signaling pathway.

Objective To investigate the distribution and antibiotic resistance of isolated pathogens in neonatal sepsis. Methods The results of blood culture and drug susceptibility test in neonates sepsis from January 2012 to June 2013 were retro-spectively analyzed. Results One hundred and thirty-two strains were detected in the blood samples, with 100(75.76%)Gram-positive bacteria, 30 (22.73%) Gram-negative bacteria and 2 (1.52%) fungus. Staphylococcus epidermidis, Escherichia coli and Staphylococcus aureus were the three most common pathogens. Gram-positive cocci was strongly resistant to penicillin (100.00%), erythromycin, selectrin and ampicillin/sulbactam (62.50%-100.00%), but still sensitive to vancomycin and teico-planin. The resistance rate of Gram-negative bacilli to ampicillin was 100.00%, and the resistance rate to cefatriaxone, selectrin and cefuroxime was 61.54%-100.00%. The resistance rate to imipenem and piperacillin/tazobactam was lower. Conclusions The selection of sensitive antibiotics should be based on the pathogens and drug resistance testing for the treatment of neonatal sepsis.

Anti-tumor necrosis factor-α(anti-TNF-α)agents have been widely used in the treatment of inflammatory bowel disease(IBD)in children.Anti-TNF-α therapy can effectively induce and maintain disease remission, promote intestinal mucosal healing, and prevent long-term end-stage organ damage and growth retardation in pediatric IBD patient.Anti-TNF-α agents can significantly impair the human immune function, which may increase the infection risk of IBD children, including the infection of bacteria, viruses, fungi and mycobacteria.This study summarizes the current published literature regarding infections in pediatric patients with IBD receiving anti-TNF-α therapies, which can help to improve the cognition of pediatric medical staff on opportunistic infection of pediatric IBD patients following anti-TNF-α treatment.

This paper reviewed the practice of Handicap International (HI) in China and discussed the HI localized action plan using current theories and approaches of community-based rehabilitation.