ObjectiveTo evaluate the efffects dexamethasone (DEX) administration at different times on intestinal ischemia-reperfusion(I/R) injury and inducible nitric oxide synthase(iNOS) activity in mice.Methods Tirty-five healthy male Kunming mice weighing 20-24 g were randomly divided into 5 groups( n =7 each): Sham operation group (group Ⅰ ); intestinal I/R group (group Ⅱ ); DEX administration before ischemia group (group Ⅲ ); DEX administration during ischemia group ( group Ⅳ) and DEX administration at the begining of reperfusion group (group Ⅴ ).Intestinal I/R injury was induced by clamping the superior mesenteric artery for 30 min.Normal saline10 mg/kg,DEX 10 mg/kg was injected iv at 30 min before ischemia in groups Ⅱ and Ⅲ respectively.DEX 10 mg/kg was injected iv at 5 min of ischemia in groupⅣ and immediately at the begining of reperfusion in group Ⅴ.The mice were sacrificed at 3 h of reperfusion,and then the small intestinal tissues were taken for determination of intestinal pathological score( Chiu score),iNOS activity and nitric oxide (NO) content.ResultsChiu score was significantly higher in groups Ⅱ - Ⅴ,and iNOS activity and NO content were sinificantly higher in groups Ⅱ,Ⅳ and Ⅴ than in group Ⅰ ( P ＜ 0.05).Chiu score,iNOS activity and NO content were sinificantly lower in group Ⅲ,and were higher in group Ⅴ than in group Ⅱ ( P ＜ 0.05).There was no significant difference in the indexes mentioned above between groups Ⅱ and Ⅳ ( P ＞ 0.05).ConclusionDEX administration before ischemia can reduce intestinal I/R injury by inhibiting iNOS activity; DEX administration during ischemia has no effcet on intestinal I/R injury and iNOS activity; DEX administration at the begining of reperfusion aggravates intestinal I/R injury by enhancing iNOS activity.

AIM: To investigate the effect of rosiglitazone , a peroxisome proliferators-activated receptor γ(PPARγ) agonist, on the expression of PPARγ, the activation of NF-κB and intestine injury in the rats undergoing ortho-topic autologous liver transplantation ( OALT ) .METHODS: Sprague-Dawley male rats were randomly divided into 4 groups:control group, sham group, OALT group and rosiglitazone (0.3 mg/kg, iv) pretreatment (ROS+OALT) group. The OALT model was established , and the intestinal tissues were collected 8 h after the liver reperfusion .The intestinal tis-sue sections were stained to visualize the damage .The expression of PPARγand NF-κB in the tissues, the concentrations of diamine oxidase (DAO) and fatty acid-binding protein 2 (FABP2) in the serum and the concentration of TNF-αand IL-6 in the tissues were measured .RESULTS:Compared with sham group , the intestinal mucosa of the rats showed obvious pathological injury after liver reperfusion in OALT group and ROS group , the Chiu’s scores of intestinal mucosa was signifi-cantly higher , and the serum concentrations of DAO and FABP 2 increased ( P<0.05 ) .After rosiglitazone pretreatment , the injury of intestinal mucosa of the rats was alleviated , the Chiu’s scores was lower and the serum concentrations of DAO and FABP2 decreased (P<0.05), the PPARγexpression was obviously up-regulated in the intestinal tissues, the nuclear translocation of NF-κB was reduced and the concentrations of IL-6 and TNF-αwere decreased .CONCLUSION: During perioperative period of OALT in rats , the inflammatory responses are obvious .Furthermore, obvious intestinal injury oc-curs .PPARγagonist rosiglitazone obviously up-regulates PPARγexpression and inhibits the inflammation in the intestines , thus protecting against intestinal injury in rats undergoing OALT .

Objective To explore the changes of plasma fibrinogen ,plasminogen and D-dimmer before and after thrombolytic therapy in patients with acute myocardial infarction (AMI) ,to provide the evidence for treatment and prognosis AMI .Methods 93 cases of patients with AMI were divided into twe groups ,reperfusion group of 77 cases ,obstract group of 16 cases .At the same pe-riod ,30 cases myocardial infarction of patients with non thrombolytic therapy were selected as control group .The levels of plasma Fib ,Plg and D-dimer in each group were detected at different times .Results The levels of Fib and D-D in AMI patients were higher than those in the control group before thrombolysis therapy (P<0 .05) .Compared with before thrombolysis therapy ,the Fib and Plg levels of AMI patients were decreased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 48 h .The D-dimmer level of AMI patients was increased significantly after thrombolytic therapy 6 h(P<0 .01) ,and returned to the normal level after 7 d .After thrombolytic therapy 6 h ,the levels of Fib and Plg of reperfusion group were decreased signifi-cantly(P<0 .05) ,the level of D-dimmer was increased significantly (P<0 .05) .Conclusion The levels of plasma fibrinogen ,plas-minogen and D-dimmer have important reference value for monitor the thrombolytic therapy effect in patients with AMI .

0.05). The bone graft rate was 13% in senile group and 9% in non-senile group( P

AIM: To investigate the effects of non-ventilated lung with N_2O on systemic oxygenation and lactic acid level in arterial blood during one lung anesthesia. METHODS: Twenty-two patients, ASA Ⅰ-Ⅲ, scheduled for selective pulmonary surgery, were randomly divided into two groups: control group (group A, n=11) and observation group (group B, n=11). Group A: the non-ventilated lung was kept open to the air; group B: N_2O 2 cmH_2O through CPAP system was insufflated into the non-ventilated lung during one lung ventilation. The anesthesia was induced with intravenous midazolam (0.05 mg?kg~(-1)), propofol (0.5-1.0 mg?kg~(-1)), fentanyl (4 ?g?kg~(-1)), and vecuronium (0.1 mg?kg~(-1)) and was maintained with inhaling isoflurane. Blood gas analysis and lactic acid was recorded 20 min after two-lung ventilation (TLV) in the supine position, 20 min after one-lung ventilation (OLV) in the supine position, 20 min and 40 min after OLV in the lateral position and at the end of operation and the shunt fraction was calculated. RESULTS: PaO_2 in group B was significantly higher than that in group A (P

Objective To investigate the effect of hypothermia on the learning and memory a-bility of neonatal rats during anesthesia and its possible mechanism.Methods Forty SD rats aged 7 d were randomly divided into 4 groups (n=10):control group (group C),anesthesia group (group A),anesthesia and hypothermia group (group AH),hypothermia group (group H).Group C was in-jected intraperitoneally with 0.1 ml of saline and equipped with heating pad to keep the rectal temper-ature at 38-39℃.Group A was injected with propofol 0.1 ml at 25 mg/kg intraperitoneally with 1/2 of the initial dose,and anesthesia was maintained for 2 h.The same method to maintain the rectal temperature at 38-39℃;Group AH of anesthesia and time and Group A of the same,rats in the anes-thesia process is not insulation,control room temperature of 23℃,allowing the body temperature de-creased;Group H rats intraperitoneal injection of 0.1 ml saline,the same control room temperature of 23℃,so that the natural temperature drop.Anesthesia in the process of continuous oxygen,inter-mittent monitoring of body temperature.Immediately after awake,5 rats in each group were randomly selected to detect the content of p-ERK and p-CREB in hippocampus by Western blot.The spatial learning and memory ability and p-ERK and p-CREB contents in hippocampus were measured by water maze test.Results The rectal temperature in group AH and group H decreased to (25.38± 0.22)℃ and (25.54±0.20)℃ in 1 h respectively,and the body temperature decreased significantly compared with group C(38.36±0.24)℃ and group A(37.40±0.29)℃ (P<0.05).Compared with group C and group A,the expression of group AH and group H was decreased (P<0.05).At the end of the water maze test,the expression of protein in the four groups was not statistically signifi-cant.There was no significant difference between the four groups in the escape latency,the number of crossing the platform and the quadrant of the original platform quadrant.Conclusion The expression of p-ERK and p-CREB in neonatal rats hippocampus can be short-term inhibition in the period of hy-pothermia at 25℃,but no significant effect on the long-term learning and memory ability.

ObjectiveTo observe the pharmacodynamic effect of propofol by target controlled infusion (TCI) in patients with different liver functions during surgery.MethodsSixty patients undergoing laparotomy under general anesthesia with endotracheal intubation in the Third Affiliated Hospital of Sun Yat-sen University between June 2013 and June 2014 were enrolled in this prospective study. Among the 60 patients, 51 were males and 9 were females with the age ranging from 18 to 70 years old and the median of 48 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into 4 groups according to the Child-Pugh liver function grading, the normal liver function group (N group,n=7), grade A group (A group, n=21), grade B group (B group,n=20) and grade C group (C group,n=12). TCI propofol were given to all patients during the operation with the target plasma concentration of 3 μg/ml. Bispectral index (BIS) and hemodynamic parameters of the 4 groups during the anesthesia induction period (within 30 min of TCI) were recorded. The percentage of patients with BIS dropped below 40 and the incidence of hemodynamic events in each group were compared. The comparison was conducted using Chi-square test or Fisher's exact test.ResultsDuring the anesthesia induction period, BIS of the 4 groups dropped with time and was stable at 20 min. The percentage of patients with BIS below 40 in N, A, B and C group was respectively 9.2%, 11.2%, 20.4% and 26.8%, C group was signiifcantly higher than N and A group (χ2=12.28, 18.81;P<0.05). During the anesthesia induction period, the incidence of hypotension in N, A, B and C group was respectively 0, 5%, 8% and 16%, C group was signiifcantly higher than N, A and B group (P<0.0001, P<0.0001,P=0.0195). The incidence of bradycardia in N, A, B and C group was respectively 15%, 5%, 3% and 0, C group was significantly lower than N, A and B group (P<0.0001,P=0.0003,P=0.0085). ConclusionsSimilar trends of change in anesthesia depth are observed in patients with different liver function when using propofol TCI, but patients with severe hepatic dysfunction may more likely to develop fulminant suppression of brain wave and hypotension.

Objective:To analyze the dynamic changes of T lymphocytes in patients with COVID-19.Methods:Blood samples were collected from 40 COVID-19 cases and 40 healthy controls in Beihai People′s Hospital from January to February, 2020. The counts of CD4 + T and CD8 + T lymphocytes were detected by flow cytometry. Moreover, the T lymphocyte counts in 24 convalescent patients with two consecutive negative nucleic acid test results were also detected. Results:The leukocytes and lymphocytes in the patients with acute COVID-19 were significantly lower than those in the healthy controls [(4.71±1.54)×10 9 cell/L vs (6.26±1.44)×10 9 cell/L, (1.13±0.41)×10 9 cell/L vs (1.51±0.39)×10 9 cell/L; both P<0.05]. The counts of CD4 + T and CD8 + T lymphocytes in the patients with acute COVID-19 were significantly lower than those in the healthy controls [(447.15±144.42) cell/μl vs (592.83±146.76) cell/μl, (309.35±173.05) cell/μl vs (397.20±136.94) cell/μl; both P<0.05], while no significant difference was observed in the CD4 + /CD8 + T cell ratio ( P>0.05). In the 24 convalescent COVID-19 patients, the counts of CD4 + T and CD8 + T lymphocytes were higher during convalescence than in the acute phase [(598.08±138.71) cell/μl vs (420.67±147.38) cell/μl, (439.08±166.94) cell/μl vs (296.67±151.06) cell/μl; both P<0.05], but there was no significant difference in the T lymphocyte counts between the convalescent patients and the healthy controls ( P>0.05). Conclusions:A transient immune deficiency occurred in patients with acute COVID-19, but the impaired immune function could restore to normal level during recovery.

OBJECTIVE: To explore the genetic basis for a child with Aspartylglucosaminuria (AGU). METHODS: Clinical data of the patient was analyzed. The child was subjected to trio-whole exome sequencing (WES) and copy number variation sequencing (CNV-seq), and candidate variant was verified by Sanger sequencing. RESULTS: The child was found to harbor homozygous c.319C>T (p.Arg107*) nonsense variant of the AGA gene, for which both of his parents were heterozygous carriers. No abnormality was found by CNV-seq analysis. The c.319C>T (p.Arg107*) variant was not found in population database, HGMD and other databases. Based on guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be pathogenic (PVS1+PM2+PP3). CONCLUSION The c.319C>T variant of the AGA gene probably underlay the autosomal recessive AGU in this child. Above finding has enabled genetic counseling and prenatal diagnosis for his parents.
Female ; Pregnancy ; Humans ; Child ; Aspartylglucosaminuria ; DNA Copy Number Variations ; Genetic Counseling ; Genomics ; Heterozygote ; Mutation

Objective:To compare the effects of five different types of videolaryngoscopes in patients with a simulated difficult airway.Methods:575 patients who needed endotracheal intubation in Nanjing Hospital Affiliated to Nanjing Medical University from May 2021 to September 2021 were randomly divided into 5 groups [UE videolaryngoscope group (U group), GlideScope videolaryngoscope group (G group), C-MAC videolaryngoscope group (C group), Airtraq videolaryngoscope group (A group) and A. P.advance videolaryngoscope group (AP group)], with 115 patients in each group. They all wore cervical collar to simulate difficult airway. The main observation index was the success rate of first endotracheal intubation. Secondary observation indicators included overall success rate, laryngoscope exposure field, intubation time, operator′s subjective score, cause of failure, adverse events, and complications of intubation.Results:The patients′ mouth opening degree was reduced from (46±6)mm to (24±4)mm ( P<0.05) after wearing the cervical collar; The success rate of the first endotracheal intubation were 96%(UE), 92%(C-MAC), 86%(GlideScope), 85%(Airtraq), and 60%(AP.Advance) respectively, with statistically significant difference ( P<0.05); Compared with AP group and G group, the incidence of soft tissue injury or bleeding in U group and C group were lower ( P<0.05); There were significant difference in the overall success rate of videolaryngoscopes, laryngoscope visual field exposure, intubation time, the subjective score of the operator and adverse events ( P<0.05); There was no significant difference in the complications of intubation among the groups ( P>0.05). Conclusions:Among 575 patients with a simulated difficult airway with limited neck mobility and limited mouth opening, there were significant differences in the use of five videolaryngoscopes. Among them, UE video laryngoscope had the highest first intubation success rate and lowest tissue trauma rate, C-MAC video laryngoscope, GlideScope video laryngoscope and Airtraq video laryngoscope followed in performance, while A. P.Advance video laryngoscope performed the worst.