Objective To investigate the effect of dexmedetomidine on postoperative cognitive function in elderly patients undergoing general anesthesia.Methods A total of 100 elderly patients undergoing elective surgery were enrolled.The patients were randomly divided into observation group and control group,with 50 patients in each group.The observation group was given dexmedetomidine + 0.9％ sodium chloride injection before induction anesthesia.The control group was given 0.9％ sodium chloride injection.The remaining anesthesia induction and maintenance time were same in the two groups.The cognitive function and postoperative cognitive dysfunction(POCD) were evaluated by MMSE scale.The blood pressure and heart rate before and after operation and at the end of the operation,the levels of serum tumor necrosis factor α(TNF-α) before operation,at the end of the operation and postoperative 3,7 days were measured.Results At postoperative 1 day and 3 days,the MMSE scores of the observation group were (24.6 ± 0.7) points and (27.2 ± 1.1) points,respectively,which were significantly higher than those of the control group [(22.4 ± 0.6) points,(27.2 ± 1.1) points,t =3.64,3.97,all P ＜ 0.05].And 6 cases in the observation group occurred cognitive dysfunction,which was significantly lower than 20 cases of the control group (x2 =5.38,P ＜0.05).At the end of the operation and postoperative 3 days,the serum levels of TNF-α in the observation group were (28.52 ± 3.73) ng/L,(28.82 ± 4.13) ng/L,respectively,which were significantly lower than those in the control group[(37.14 ± 3.62) ng/L,(38.27 ± 3.47) ng/L,t =5.21,4.89,all P ＜ 0.05].At the beginning of the operation,the systolic blood pressure,diastolic blood pressure,heart rate of the observation group were (124.53 ±3.84) mmHg,(79.32 ± 4.38) mmHg,(70.45 ± 5.32) times/min,respectively,which were significantly lower than those of the control group [(145.36 ± 4.72) mmHg,(93.17 ± 3.82) mmHg,(86.79 ± 4.26) times/min],the differences were statistically significant(t =5.83,4.97,4.58,all P ＜ 0.05).Conclusion In the elderly patients undergoing general anesthesia,the use of pumped dexmedetomidine has little effect on the postoperative cognitive function.The mechanism may be related to stabilizing the blood flow dynamics,decrease the high expression of TNF-α,which is worthy of clinical application.

Objective:To investigate the analgesic effects of butorphinol used in intravenous patient-controlled analgesia after laparoscopic gynecological surgery.Methods:Ninety-eight patients who underwent laparoscopic gynecological surgery in Linhai First People's Hospital between March 2018 and November 2019 were included in this study. They were randomly divided into control and observation groups, with 49 patients per group. After surgery, intravenous patient-controlled analgesia with either ondansetron (control group) or ondansetron combined with butorphanol (observation group). At 2, 12 and 24 hours after surgery, visual analogue scale score and Ramsay sedation scale score were compared between the two groups. Heart rate, systolic blood pressure, and respiratory rate at 0 and 30 minutes after surgery were compared between the two groups. The incidences of postoperative adverse reactions were compared between the two groups.Results:At 2, 12 and 24 hours after surgery, visual analogue scale scores in the observation group were (1.27 ± 0.50) points, (2.24 ± 0.63) points, and (1.71 ± 0.55) points respectively, which were significantly lower than (1.52 ± 0.47) points, (3.20 ± 0.58) points, (2.23 ± 0.59) points in the control group ( t = 2.55, 7.84, 4.51, all P < 0.05). At 2, 12 and 24 hours after surgery, Ramsay sedation scale scores in the observation group were (4.22 ± 0.41) points, (3.22 ± 0.43) points, and (3.02 ± 0.31) points, respectively, which were significantly higher than (4.02 ± 0.32) points, (3.01 ± 0.27) points, (2.73 ± 0.35) points in the control group ( t = -2.69, -2.89, -4.34, all P < 0.05). There were no significant differences in heart rate, systolic blood pressure, and respiratory rate measured at 0 and 30 minutes after surgery between the two groups (all P > 0.05). There were no significant differences in use of pethidine and the incidence of adverse reactions between the two groups (both P > 0.05). Conclusion:Butorphinol helps improve the analgesic and sedative effects after laparoscopic gynecological surgery and has little impact on patient's breathing and circulation.

OBJECTIVETo study the relative expression of the genes involved in artemisinin biosynthesis in different tissues including roots, stems, leaves and flowers of Artemisia annua, and establish the relationship between gene expression and artemisinin accumulation, eventually leading to discover the mainly effective genes involved in artemisinin biosynthesis.

METHODThe 7 functional genes involved in artemisinin biosynthesis were detected at the level of expression by using qRT-PCR, and simultaneously the content of artemisinin in the 4 investigated tissues was detected in parallel.

RESULTThe 3 genes including HMGR, DXR and FPS which were involved in the upstream pathway of artemisinin biosynthesis showed the highest expression levels in flowers, and the 4 functional genes including ADS, CYP71AV1, CPR and AAR which were involved in the artemisinin-specific biosynthetic pathway were found to be expressed in all the 4 detected tissues. The highest expression level of ADS was found in leaves, then followed by flowers, and the lowest expression level of ADS was found in roots and stems. CYP71AV1 had highest expression level in flowers and lowest in leaves. CPR showed highest expression level in flowers, and AAR had lower expression levels in the other 3 artemisinin-specific pathway genes in all the tissues. The highest content of artemisinin was found in leaves (0.343 mg x g(-1)), then followed by flowers (0.152 mg x g(-1)), roots (0.062 mg x g(-1)) and stems (0.060 mg x g(-1)).

CONCLUSIONIn the biosynthesis of artemisinin, the upstream genes including HMGR from the MVA pathway, DXR from the MEP pathway and the checkpoint gene FPS were much more active in flowers, and this suggested that flowers might be the tissues of artemisinin precursor biosynthesis, and further DXR contributed more to artemisinin biosynthesis. The positive correlation of ADS expression and artemisinin content in tissues demonstrated that ADS played a very important role in artemisinin biosynthesis, which was the ideal target for engineering the artemisinin biosynthetic pathway. In summary, the functional genes involved in artemisinin biosynthesis do not express at the same level but synergistically.

Artemisia annua ; chemistry ; genetics ; metabolism ; Artemisinins ; metabolism ; Plant Proteins ; genetics ; metabolism ; Polymerase Chain Reaction

Objective:To evaluate the effect of Parkinson′s disease factor on the sedative efficacy of dexmedetomidine.Methods:The patients of either sex, aged 45-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, with body mass index of 18.5-30.0 kg/m 2, undergoing non-intracranial space-occupying lesions in neurosurgery, were selected.Patients were divided into control group (group C) and Parkinson′s disease group (group P) according to whether they had Parkinson′s disease or not.The ED 50 of dexmedetomidine was determined by using the Dixon′s up-and-down method.The initial dose of dexmedetomidine was 0.5 μg/kg in both groups, and each time the concentration increased/decreased by 0.05 μg/kg in the next patient, which was repeated until 7th independent crossover pair (loss of consciousness) appeared, and then the test was ended.The ED 50 and 95% confidence interval of dexmedetomidine inducing loss of consciousness were calculated using the probit test in a Logistic regression model.Hypertension, hypotension, bradycardia and nausea and vomiting were recorded. Results:Compared with group C, the ED 50 of dexmedetomidine inducing loss of consciousness was significantly increased in group P ( P<0.05), and no significant change was found in the incidence of adverse reactions in group P ( P>0.05). Conclusions:Parkinson′s disease factor can decrease the sedative efficacy of dexmedetomidine.

Objective: Schizophrenia (SCZ) is one of the most common and severe mental disorders. Modified electroconvulsive therapy (MECT) is the most effective therapy for all kinds of SCZ, and the underlying molecular mechanism remains unclear. This study is aim to detect the molecule mechanism by constructing the transcriptome dataset from SCZ patients treated with MECT and health controls (HCs). Methods: Transcriptome sequencing was performed on blood samples of 8 SCZ (BECT: before MECT; AECT: after MECT) and 8 HCs, weighted gene co-expression network analysis (WGCNA) was used to cluster the different expression genes, enrichment and protein-protein interaction (PPI) enrichment analysis were used to detect the related pathways. Results: Three gene modules (black, blue and turquoise) were significantly associated with MECT, enrichment analysis found that the long-term potentiation pathway was associated with MECT. PPI enrichment p-value of black, blue, turquoise module are 0.00127, <1×10-16 and 1.09×10-13, respectively. At the same time, EP300 is a key node in the PPI for genes in black module, which got from the transcriptome sequencing data. Conclusion It is suggested that the long-term potentiation pathways were associated with biological mechanism of MECT.

Objective: Schizophrenia (SCZ) is one of the most common and severe mental disorders. Modified electroconvulsive therapy (MECT) is the most effective therapy for all kinds of SCZ, and the underlying molecular mechanism remains unclear. This study is aim to detect the molecule mechanism by constructing the transcriptome dataset from SCZ patients treated with MECT and health controls (HCs). Methods: Transcriptome sequencing was performed on blood samples of 8 SCZ (BECT: before MECT; AECT: after MECT) and 8 HCs, weighted gene co-expression network analysis (WGCNA) was used to cluster the different expression genes, enrichment and protein-protein interaction (PPI) enrichment analysis were used to detect the related pathways. Results: Three gene modules (black, blue and turquoise) were significantly associated with MECT, enrichment analysis found that the long-term potentiation pathway was associated with MECT. PPI enrichment p-value of black, blue, turquoise module are 0.00127, <1×10-16 and 1.09×10-13, respectively. At the same time, EP300 is a key node in the PPI for genes in black module, which got from the transcriptome sequencing data. Conclusion It is suggested that the long-term potentiation pathways were associated with biological mechanism of MECT.

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.