Objective To determine the ED50 of remifentanil needed for tracheal intubation without neuromuscular relaxant in children when combined with sevoflurane inhalation.Methods Twenty-five ASA Ⅰ or Ⅱ children of both sexes,aged 4-9 yr,scheduled for elective surgery under general anesthesia were enrolled in this study.Anesthesia was induced with inhalation of 5% sevoflurane in 100% oxygen and PETCOM2was maintained at 30-35 mm Hg.Remifentanil was injected intravenously over 30 s after 3 min inhalation of sevoflurane.Tracheal intubation was performed 90 s after the completion of remifentanil injection.The experiment was performed using the modified Dixon's up-and-down method.The initial dose of remifentanil was set at 1.2 μg/kg and the ratio between two successive doses was 1.2.Intubation conditions were assessed by a blinded observer using Viby-Mogensen scale.If the conditions were not good,roenronium 0.3 mg/kg was then injected intravenously to facilitate intubation.The ED50 of remifentanil and 95% confidence interval (95% CI) were calculated.Results The ED50 of remifentanil combined with inhalation of scvoflurane required for successful intubation was 0.68 μg/kg in the absence of neuromuscular relaxant,and 95% CI was 0.65-0.71 μg/kg.Conclusion The ED50 of remifentanil required for tracheal intubatiun without neuromuscular relaxant drug is 0.68 μg/kg (95% CI 0.65-0.71 μg/kg) when combined with 5% sevoflurane inhalation in children.

Objective To breed a guinea pig inbred strain and set up a method for detection of the microsatellite markers of genetic structure in guinea pigs. Method Using inbreeding methods we try to breed the Zmu-1:DHP inbred strain. With 15 pairs of polymorphism microsatellite primers, the genetic homozygosity of Zmu?1:DHP inbred strain,Zmu?1:DHP outbred strain and Zmu?2:DHP inbred strain ( as control) were examined by PCR. Results After breeding for 13 years, 8 sublines of Zmu?1:DHP inbred strain ( >20 generations) were bred. After identification, the gene frequency of the second subline of Zmu?1:DHP inbred strain was 86. 7%,higher than Zmu?1:DHP outbred strain (6. 7%) and Zmu?2:DHP inbred strain (66. 7%). The average number of loci of Zmu?1:DHP inbred strain was 1. 13,lower than that of Zmu?1:DHP outbred strain (2. 47%) and Zmu?2:DHP inbred strain (1. 33%). The genotypic frequency of Zmu?1:DHP in?bred strain was also higher than that of the other strains. The gene types of Zmu?1:DHP inbred strain were included in the genes of Zmu?1:DHP outbred strain, but Zmu?1:DHP inbred strain was short of 2 characteristic genes. The gene homozy?gous rates of 8 sublines of Zmu?1:DHP inbred strain were different with each other,among them, those of the 2nd and 8th sublines were higher than others. Conclusions There are both homozygosity and specificity in the Zum?1:DHP inbred strain and Zum?1:DHP outbred strain. The second Zum?1:DHP subline becomes a new inbred strain guinea pig. It is es?sential that the subline with the characteristic property is screened from these sublines. The guinea pigs of black Zmu?2:DHP inbred strain carrying microsatellite markers not present in the white strains, may carry optimal genes related with hair color properties.

Objective To explore the effects of Helicobacter pylori (H.pylori) on the expression of catalytic subunit of the DNA-dependent protein kinase (DNA-PKcs) and Ku70/Ku80 heterodimer in gastric mucosa epithelial cells in vivo and in vitro.Methods After treated with H.pylori for one,three,six,12 and 24 hours,the expressions of DNA-PKcs and Ku70/Ku80 heterodimer in gastric epithelial cells (GES) 1 and gastric adenocarinoma cells (AGS) were detected by Western blot.Mongolian gerbils were gavaged with H.pylori,and were sacrificed after infected for six and 12 months.The gastric mucosa tissues were taken for immunohistochemistry to detect the expressions of DNA-PKcs and Ku70/Ku80 heterodimer at protein level.The data were analyzed by t test and chi-square test.Results After H.pylori infection for one hour,the relative quantity of the expression of DNA-PKcs in GES-1 was 1.16±0.09,which was higher than that of non infected group (1.04±0.31) and the difference was statistically significant (t=4.67,P＜0.05).After infected by H.pylori for one,three,six,12 and 24 hours,the relative quantities of the expressions of Ku70/Ku80 heterodimer in GES-1 were 1.58±0.32,1.84±0.40,1.97±0.35,3.72±1.42 and 3.74±1.56,respectively,all were higher than that of non infected group (1.24±0.31) and the differences were statistically significant (t=3.57,4.20,5.03,8.11 and 8.14,all P＜0.05).The relative quantities of the expressions of Ku70/Ku80 heterodimer in AGS were 4.69 ± 0.87,3.67 ± 0.67,2.41±0.24,1.35±0.35 and 1.32±0.10 after H.pylori infected for one,three,six,12 and 24 hours,respectively,all were lower than that of no H.pylori infected group (4.84 ± 0.76) and the differences were statistically significant (t=34.13,27.68,19.81,4.47 and 5.69,all P＜0.05).In Mongolian gerbil models,DNA-PKcs did not express in H.pylori negative group (0/25),the total positive rate of H.pylori infected group was 98.1％ (53/54),the difference between the two groups was statistically significant (x2 =74.55,P＜0.01).The total positive rate of Ku70/Ku80 heterodimer in H.pylori negative group was 92.0％ (23/25) and in H.pylori infected group was 68.5％ (37/54),the difference between the two groups was statistically significant (x2=5.16,P＜0.05).Conclusion H.pylori infection affected cellular DNA damage repair through changing the expression of DNA-PKcs and Ku70/Ku80 heterodimer in gastric mucosa in vivo and in vitro,which may cause gastric mucosal lesions.

Objective To evaluate the reliability of Amsterdam Preoperative Anxiety and Information Scale (APAIS) score in evaluating the preoperative anxiety of Chinese people.Methods One hundred sixty Chinese patients of both sexes, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective surgery, were enrolled.Preoperative anxiety of the patients was assessed with APAIS score and Spielberger's State-Anxiety Inventory (S-AI) questionnaire during the preoperative interview.Cronbach's alpha of total anxiety and need for information scores was calculated.Four thresholds of total anxiety score in identifying preoperative severe anxiety was set as 10, 11, 12 and 13.S-AI questionnaire was considered as the standard, and the correlation between total anxiety score and S-AI questionaire was tested.Results The Cronbach's alpha of total anxiety and need for information scores was 0.84 and 0.71, respectively.When the threshold of total anxiety score in identifying preoperative severe anxiety was 12, the total anxiety score was highly correlated with S-AI questionnaire, the Kappa value was 0.62, 95％ confidence interval was 0.46-0.78, the sensitivity was 0.71, the specificity was 0.90, and the positive predictive value was 0.78.Conclusion APAIS score can be used to assess the preoperative anxiety of Chinese people.

Objective To discuss the imaging technology and characteristic of perfusion-weighted imaging in rabbit models of hepatic VX2 tumors. Methods Twenty-eight New Zealand rabbits were implanted in liver with VX2 tumor by tissue block. After routine scans were performed on 1.5 T MR scanner, 28 New Zealand white rabbits with VX2 carcinoma were divided randomly into treatment group and control group. Treatment group was divided randomly into group A, group B and group C, 7 animals per group. Perfusion weighted imaging(PWI) was performed in day 14, 25 and 35, respectively, after tumor implantation in all animals. Select the regions of interest (ROI) of the VX2 tumor center, tumor border and pars-tumor parenchyma. Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were created as quantitative variable, and the parameters were calculated and compared in all groups. Results Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were studied in 4 groups, 23 VX2 rabbits,7,5 and 6 in group A , B and C, respectively. The SRSmax of tumor center were ( 12. 6 ± 3.4), ( 9. 8 ± 2. 6 ) and ( 1.0 ± 0. 4 ), the difference was significant ( F = 10. 855, P < 0. 05 ). The SRSmax of tumor border were(48. 3 ± 2.4), (46. 2 ± 1.5 ) and (43. 6 ± 1.8 ) ( P > 0. 05 ). The SRSmax of para-tumor parenchyma were ( 14.4 ± 3.0 ), ( 12. 2 ± 1. 4 ) and ( 14. 8 ± 5.0 ) ( P > 0. 05 ). The difference was significant in different ROI in treatment groups( F value was 7. 435,8. 625 and 12. 595, respectively, P < 0. 05 ). Conclusion PWI can be used in evaluating the liver tumor angiogenesis and angio-degeneration with the treatment of HIFU. It will be possible for qualitative analysis of rabbit models of hepatic VX2 tumors by different treatments.

Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer.Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination.All patients were divided into two groups,group Ⅰ were the patients with the lung cancer after tuberculosis or both found simultaneously (group Ⅰ a with peripheral lung cancer and group Ⅰ b with central lung cancer),group Ⅱ with tuberculosis during lung cancer chemotherapy (group Ⅱ a with peripheral lung cancer and group Ⅱ b with central lung cancer).Imaging characteristics of tuberculosis and lung cancer were compared.x2 test and t test were used for the statistical analysis.Results Of 104 patients,there were 92 patients (88.5％) in group Ⅰ and 12 patients (11.5％)in group Ⅱ.Seventy patients (76.1％) of lung cancer and tuberculosis were located in the same lobe and 22 patients (23.9％) in the different lobes in group Ⅰ.There was no significant difference in distribution of tuberculosis between group Ⅰ and group Ⅱ (x2 =4.302,P =0.507).The fibrous stripes,nodules of calcification and pleural adhesion of tuberculosis were statistically significant between the two groups (x2 =22.737,15.193,27.792,P ＜0.05).There were 33 central lung cancers and 71 peripheral lung cancers.In group Ⅰ a (64 patients of peripheral lung cancers),39 patients (60.9％) had typical manifestations and most of the lesions were ≥ 3 cm(n =49,76.6％),solid lesions showed variable enhancement.Conclusions Secondary tuberculosis during lung cancer chemotherapy has the same CT characteristics with the common active tuberculosis.The morphology,enhancement pattern of lesion and follow-up are helpful for the diagnosis of lung cancer after tuberculosis.

Objective To establish a rat model of coal-burning-borne fluorosis,and to observe the expression changes of bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-3 (BMP-3) in the serum of rat treated with different dose of fluoride and different treatment duration.Methods A total of 120 clean grade SD rats(body mass between 80 to 120 g) weaned for 4 weeks were randomly assigned into four groups,which were control,low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,respectively,and 30 rats in each group (female 15,male 15).All of the rats were fed with coal drying corn from fluorosis area.Ten rats were killed by femoral artery bleeding 30 d,90 d and 180 d after exposed to fluoride,respectively.Serum BMP-2 and BMP-3 level was tested by enzyme-linked immunosorbent assay (ELISA).Results ①Results of BMP-2:after exposed to fluoride for 90 d and 180 d,the differences of serum BMP-2 level between groups were statistically significant(F=385.08,173.98,all P ＜ 0.01).In low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,the expression of serum BMP-2 at 90 d[(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] and 180 d[(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89)μg/L] was higher than that of control group[(12.54 ± 1.29),(7.53 ± 0.97)μg/L,all P ＜ 0.05],and the level of BMP-2 increased with increasing dose of fluoride (all P ＜ 0.05).Within each group,the difference of serum BMP-2 was statistically significant(F =55.42,511.58,686.35,671.64,all P ＜ 0.01).The expression of BMP-2 in each group at 90 d [(12.54 ± 1.29),(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] was higher than that at 30 d[(11.75 ± 1.15),(11.42 ± 1.07),(11.38 ± 0.92),(11.15 ±1.03)μg/L,all P ＜ 0.05].The expression of BMP-2 in each group at 180 d[(7.53 ± 0.97),(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89) μg/L] was lower than that at 90 d.②Results of BMP-3:the difference between groups was not statistically significant at every experimental stage(F =0.7215,1.2951,0.0964,all P ＞ 0.05).Conclusions Longer excessive fluoride intake stimulates the expression of BMP-2 in rats,but with prolonged fluoride intake,the stimulation becomes weak.The effect of fluoride on BMP-3 is not as sensitive as that on BMP-2.

Objective To observe the effect of enhanced external counterpulsation (EECP) on diabetic retinopathy (DR). Methods 179 patients who accepted EECP combined with medication were as group A and the other 190 patients who accepted medication only were as group B. Their visual acuity, fundus fluorescein angiography (FFA) and optical hemodynamics were compared. Results There was significant improvement in group A with visual acuity, FFA and optical hemodynamics (P<0.05), and the incidence of improvement was more in group A than in group B (P<0.05). Conclusion EECP is effective on diabetic retinopathy.

OBJECTIVETo investigate the significance of detecting specific serum IgG antibodies in clinical diagnosis of SARS as well as affecting factors.

METHODSEnzyme-linked immunoassay kit for SARS coronavirus antibodies developed by HuaDa Biological Company was applied to detect specific serum IgG from SARS patients and the production of SARS specific antibodies among patients of different age groups, sex and with or without steroid treatment were statistically compared.

RESULTSOut of 121 patients studied, 71.1% were SARS specific IgG positive. Patients younger than 15 years, between 15 to 59 years, older than 59 years had positive rates of 60.0%, 70.2%, and 85.7%, respectively with no statistically significance (P=0.766); patients with or without steroid treatment showed positive rates of 70.6% and 72.4%, respectively (P=0.84); patients exhibiting either severe or light syndromes showed positive rates of 78.1% and 67.4%, respectively (P=0.493); both male and female patients showed the same positive rate of 71.1%.

CONCLUSIONThe sensitivity of the SARS specific IgG kit utilized needs to be further improved. The production of SARS IgG is not notably correlated with sex, age, seriousness of symptoms, and steroid treatment.

Adolescent ; Adult ; Aged ; Antibodies, Viral ; blood ; Child ; Female ; Humans ; Immunoglobulin G ; immunology ; Male ; Middle Aged ; SARS Virus ; immunology ; Sensitivity and Specificity ; Severe Acute Respiratory Syndrome ; diagnosis ; immunology

OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry