Objective To investigate the influence of balanced anesthesia(BA)versus total intravenous anesthesia(TIVA)on the hemodynamics and respiratory function of patients undergoing laparoscopic hysterectomy.Methods Two groups of patients undergoing elected laparoscopic hysterectomy received balanced anesthesia(BA group,20 cases)or total intravenous anesthesia(TIVA group,20 cases)respectively.Data of hemodynamics and respiratory system were recorded and the compliance of respiratory system was calculated.Results The MAP at 10 minutes after pneumoperitoneum(PP)was elevated significantly than that before-induction in BA group(P

Objective To investigate the influence of balanced anesthesia(BA) and total intravenous anesthesia(TIVA) on the hemodynamics and respiratory function in elderly patients undergoing laparoscopic hysterectomy.Methods Fifty elderly patients undergoing elective hysterectomy.Their mean age was 62.7?1.8 years.ASA Ⅰ-Ⅱ class.They were randomly divided into two groups: balanced anesthesia group and total intra-venous anesthesia group.The perioperative data of hemodynamics,respiratory system and arterial blood gas were recorded,and the compliance of respiratory system was calculated.Results The MAP at 10 minutes after pneumoperitoneum(PP) was greatly higher than that of the pre-induction period in BA group(P

Objective To explore the effect of lidocaine, the sodium channel blocker, on electrical physiological changes in the circumstances of hypoxia. Methods The effects of different doses of lidocaine (10~ -5 mol/L, 10~ -4 mol/L and 5?10~ -4 mol/L) on the changes in voltage-dependent sodium currents in hippocampal neurons of the rat induced by 10~ -5 mol/L DNP (2,4-dinitrophenol) were recorded by whole-cell configuration of the patch clamp. Results DNP could increase the spike amplitude of sodium currents significantly. With the application of 10~ -5 mol/L and 10~ -4 mol/L lidocaine in advance, the spike values of each group were not significantly different from that of the contral after the administration of DNP, but the spike values after 5?10~ -4 mol/L lidocaine were lower than that of the control after the administration of DNP. Conclusion With the use of DNP, lidocaine can achieve the effect of brain protection through inhibiting the voltage-dependent sodium channel.

Objective:To identify HLA-A2-restricted CTL epitope of breast cancer differentiation antigen NY-BR-1.Methods:The HLA-A2-restricted CTL epitope of breast cancer differentiation antigen NY-BR-1 is predicted by combination quantitative motif method and the molecular dynamics.The three epitope were assayed their affinity to HLA-A2.Results:The affinity to HLA-A2 of NY-BR-1_ 1043-1051 is a best.Conclusion:NY-BR-1_ 1043-1051 is a HLA-A2 restricted epitope.

Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.

Capillary Leak Syndrome ; complications ; Cholestasis, Intrahepatic ; complications ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications

Objective To investigate the effects and mechanisms of G protein-coupled receptor 91 (GPR91) on blood-retinal barrier (BRB) in diabetic rats.Methods A lentiviral vector of shRNA targeting rat GPR91 and scrambled shRNA were constructed.Healthy male Sprague-Dawley (SD) rats were selected in this study.The 60 rats were randomized into 4 groups and treated as follows:(1) control group (Group A,n=15),the rats received injections of an equal volume of 0.1％ citrate buffer;(2) streptozocin (STZ) group (Group B,n=15),the rats received injections of STZ;(3) LV.shScrambled group (Group C,n=15),diabetic rats received an intravitreal injection of 1 μl 1 × 10s TU/ml scrambled shRNA lentiviral particles at 2 weeks after the induction of diabetes;(4) LV.shGPRg1 group (Group D,n=15),diabetic rats received an intravitreal injection of 1 μl 1 × 108 TU/ml pGCSIL-GFP-shGPR91 lentiviral particles.At 12 weeks after intravitreal injection,immunohistochemistry and Western blot were used to assess the expression of GPRg1,p-extracellular signal-regulated kinase(ERK)1/2,t-ERK1/2,p-Jun N-terminal kinase (JNK),t-JNK,p-p38 mitogen-activated protein kinase (MAPK) and t-p38 MAPK.Haematoxylin and eosin (HE) staining and Evans blue dye were used to assess the structure and function of the retinal vessel.Immunohistochemistry enzyme-linked immunosorbent assay (ELISA) was used to test the protein level of VEGF.Results Immunohistochemistry staining showed that GPR91 was predominantly localized to the cell bodies of the ganglion cell layer.Western blot showed that GPR91 expression in Group D decreased significantly compared with Group C (F=39.31,P＜0.01).HE staining showed that the retina tissue in Group B and C developed telangiectatic vessels in the inner layer of retina,while the telangiectatic vessels attenuated in Group D.It was also demonstrated in Evans blue dye that the microvascular leakage in Group D decreased by (33.8±4.11)％ compared with Group C and there was significant difference (F =30.35,P＜0.05).The results of ELISA showed the VEGF secretion of Group B and C increased compared with Group A and the VEGF expression in Group D was significantly down regulated after silencing GPR91 gene (F=253.15,P＜0.05).The results of Western blot indicated that compared with Group A,the expressions of p-ERK1/2,p-JNK and p-p38 MAPK were significantly upregulated (q=6.38,2.94,3.45;P＜0.05).Meanwhile,the activation of ERK1/2 was inhibited by GPR91 shRNA and the difference was statistically significant (F=22.50,P＜0.05).Conclusions The intravitreal injection of GPR91 shRNA attenuated the leakage of BRB in diabetic rats.GPR91 regulated the VEGF release and the leakage of BRB possibly through the ERK1/2 signaling pathway.

Objective To explore the correlation among serum immunoglobulin G4 (IgG4),transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF) and Hashimoto thyroiditis (HT) thyroid fibrosis.Methods Case-control study.A total of 159 patients with HT visiting the Wuhan Union Hospital were collected from May 2013 to March 2015.All patients were divided into IgG4 HT group (IgG4≥1.35 g/L,n =39) and non-IgG4 HT group (IgG4 ＜ 1.35 g/L,n =120).The serum IgG4,TGF-β1 and CTGF were determined by enzyme-linked immunosorbent assays.The levels of serum thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured by electrochemiluminescence immunoassay.Meanwhile,ultrasound of the thyroid gland was performed.Statistical analysis was performed by use of SPSS 17.0 software.The Mann-Whitney U test was used to compare two independent samples of non-normal distribution data,Fisher's exact test was employed to analyze thyroid imaging differences,correlation test was performed to examine various correlations,multivariate Logistic regression analysis was used to evaluate thyroid fibrosis risk factors.Results Compared with that of non-IgG4 HT group,IgG4 HT group:TPOAb [(455.2 ± 169.7) vs.(186.5 ± 102.3),U =27.0,P=0.003],TgAb [(984.6±452.7) vs.(289.3 ±245.1),U=30.5,P=0.017],TGF-β1 [(1.45±0.97) vs.(0.30±0.22),U=119.0,P=0.035] andCTGF [(88.65±14.39) vs.(62.21± 8.76),U =69.0,P =0.039] were significantly higher,thyroid ultrasound showed obvious fibrosis (35/4 vs.32/88,x2 =48.03,P =0.000);significant positive linear correlation between IgG4 and TPOAb (r =0.719,P =0.000),CTGF and TGF-β1 (r =0.500,P ＜ 0.01) respectively.Logistic regression analysis indicated that all the serum IgG4,TPOAb,TGF-β1 and CTGF were independent risk factors of thyroid fibrosis [IgG4,odds ratio (OR) =1.968,P =0.014,95％ confidence interval (CI) =1.287-2.041;TPOAb,OR =2.537,P =0.012,CI =1.322-2.869;TGF-β1,OR =1.549,P =0.023,CI =1.105-1.498;CTGF,OR =1.185,P =0.046,CI =1.204-1.625].Conclusion The highlevel of circulating antibodies,IgG4,TGF-β1 and CTGF were significantly associated with thyroid fibrosis,and were independent risk factors of HT fibrosis.

Objective To analyze electrophysiology of peripheral nerve in uremic patients. Methods 24 uremic patients and 19 normalvolunteers were included, surface electrodes were used to observe the electrophysiology performance, including tibial nerve, peroneal nerve,sural nerve and skin sympathetic response. Results The motor conduction, sensory conduction and skin sympathetic response were significantlydifferent between uremia patients and normal volunteers (P<0.05). The electrophysiology performance showed that F wave latencyprolonged, nerve conduction slowed, distal latencies prolonged, sensory fibers damaged more serious than motor fibers. Conclusion Peripheralneuropathy is one of the most common complications in uremia patients, neural electrophysiological abnormalities are significantly earlierthan clinical symptoms, nerve electrophysiological examination is of great significance in diagnosis and evaluation uremic peripheralneuropathy.

Objective To investigate the renoprotective effects of autologous transplantation of adipose-derived mesenchymal stem cells (ADMSCs) in diabetic rats. Methods Sprague-Dawley (SD) rats were injected intraperitoneally with 40 mg/kg streptozotocin (STZ) for 5 consecutive days to induce type 1 diabetes. Four weeks following STZ injection, eighteen SD rats were randomized into two groups: the diabetic group (n = 9) and the ADMSCs group (n = 9). Normal nondiaetic rats were set as the normal control (n = 9). Autologous ADMSCs were cultured and identified in vitro , which were intravenously injection to the ADMSCs group rats via the tail vein. At 8 weeks after transplantation, levels of blood glucose, insulin, serum urea nitrogen, serumcreatinine and urine protein were measured. Meanwhile the body weight and kidney weight were examined. Results Mesenchymal cell surface markers were expressed in the cultured ADMSCs. The ADMSCs could differentiate into the adipogenic and osteoblastic lineages. Both the diabetic group and the ADMSCs group rats had higher levels of blood glucose , urea nitrogen , serum creatinine , urine protein and higher ratio of the kidney weight/body weight than those in the normal control group (P < 0.05, respectively). Blood glucose, urea nitrogen and the ratio of kidney weight/body weight in the ADMSCs group rats were significantly decreased compared with the diabetic group (P < 0.05, respectively). The decreased insulin level was attenuated after transplantation of ADMSCs (P < 0.05). Besides, levels of serum creatinine and urine protein in the ADMSCs group were lower than those in the diabetic group with no significant difference. Conclusion Autologous transplantation of ADMSCs can improve metabolic disorder and relieves diabetic renal damage.