Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.

Adolescent ; Adult ; Audiometry, Pure-Tone ; Ear Protective Devices ; utilization ; Humans ; Middle Aged ; Noise, Occupational ; prevention & control ; Young Adult

Objective To observe the expression of zinc finger protein A20(A20), NF-κB and related inflammatory factors before and after lipopolysaccharide (LPS) stimulates degeneration of rabbit intervertebral disc nucleus pulposus cells.Methods The normal and degenerative nucleus pulposus cells were isolated and cultured, then divided into normal group,degenerative group,LPS stimulation group and NF-κB inhibition group.HE staining observe the morphological changes of nucleus pulposus and annulus fibrosus,immunohistochemistry was used to detect the expression of A20,NF-κB/p65 and COL-Ⅱ.Real-time PCR was employed to analyze the expression of A20,IL-1β,TNF-α,NF-κB and COL-Ⅱ,Western blot was used to observe the A20 protein,p65 and COL-Ⅱexpression in the four groups, and TNF-α, IL-1β in cell supernatant was determined by ELISA.Results The number of nucleuspulposus cells significantly decreased, aggregation occured in the degenerative group.COL-Ⅱ was obvious lower and A20, p65 significantly higher than that in normal group by immunohistochemical staining.Compared with the normal group,A20,TNF-α,IL-1β,p65 expression was significantly increased and COL-Ⅱ decreased in the mRNA and protein levels in degenerative group.Above indexes changed more significant in LPS stimulation group than in degenerative group.The expression of A20, TNF-α, IL-1β, p65 in the NF-κB inhibitor group was lower than that in the LPS group, and the expression of type Ⅱ collagen increased(P<0.05).Conclusions Intervertebral disc inflammatory response is closely related to the development of intervertebral disc degeneration, A20 may play an important role.

Spinal biomechanics, especially the range of spine motion,has close connection with spinal surgery. The change of the range of motion (ROM) is an important indicator of diseases and injuries of spine, and the essential evaluating standards of effect of surgeries and therapies to spine. The analysis of ROM can be dated to the time of the invention of X-ray and even that before it. With the development of science and technology as well as the optimization of various types of calculation methods, diverse measuring methods have emerged, from imaging methods to non-imaging methods, from two-dimensional to three-dimensional, from measuring directly on the X-ray films to calculating automatically by computer. Analysis of ROM has made great progress, but there are some older methods cannot meet the needs of the times and disappear, some classical methods such as X-ray still have vitality. Combining different methods, three dimensions and more vivo spine research are the trend of analysis of ROM. And more and more researchers began to focus on vivo spine research. In this paper, the advantages and disadvantages of the methods utilized recently are presented through viewing recent literatures, providing reference and help for the movement analysis of spine.
Animals ; Humans ; Imaging, Three-Dimensional ; instrumentation ; methods ; trends ; Radiography ; Spine ; diagnostic imaging

Objective To evaluate neurofunctional and radiographic results of transpedicular screw fixation reduction and anterior column fixation with use of screw-red system in treatment of multiple segment lumbar pedicle and vertebral body fractures combined with spondylolisthesis. Methods A consecutive series of 12 patients with unstable multiple segment lumbar pedicle fracture, vertebral body fracture, spondylolisthesis and neurologic deficit were managed with posterior transpedicular screw fixation including fractured pedicle and anterior screw-rod fixation instrumentation from January 2002 to December 2007. Results Patients were followed up for 24-30 months (mean 26 months). All the patients with incomplete neurologic deficits got improvement by at least one Frankel grade. Transpedicular screw brought satisfactory reduction. At the time of the latest follow-up, no screw breakage occurred. Con-clusions Excellent reduction of unstable multiple segment lumbar pedicle fractures combined with spon-dylolisthesis can attain better reduction and maintenance by means of selective pedicle screw fixation via fractured pedicle and anterior screw-rod instrument.

Objective To evaluate the development of cerebral sulci and gyrus in fetuses with conotruncal defect(CTD) at the second and third trimester by ultrasound,and to improve clinician′s understanding of the cerebral cortical development in fetuses with CTD.Methods The study was conducted at Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medicial University from December 2015 to January 2017,enrolled 180 women with single fetus,among whom 60 fetuses with CTD and gestational age between 20 weeks to 33+6 weeks were diagnosed by echocardiographic examination.CTD included persistent truncus arteriosous,tetralogy of fallot,transpofition of the great arteries and double outlet of right ventricle.Evaluation indexes of cerebral sulci and gyrus included depth and angle of parietooccipital sulcus,width and depth of sylvian fissure,uncovered width of insular,uncovered insular ratio,depth of calcarine sulcus,head circumference;evaluation indexes of hemodynamics included umbilical artery resistance index,umbilical artery pulsation index,middle cerebral artery resistance index,middle cerebral artery pulsation index,the cerebral-to-placental resistance ratio and the cerebroplacental pulsation ratio.Above indexes were measured for statistical analysis.Results At the whole gestational age in the study,depth of parietooccipital sulcus and width of sylvian fissure in CTD fetuses were smaller than those in the control group,uncovered insular ratio was larger than that in the normal group(P<0.05);middle cerebral artery resistance index,middle cerebral artery pulsation index and the cerebroplacental pulsation ratio in CTD fetuses were lower than those of the control group (P<0.05).Conclusions The change of hemodynamics in fetuses with CTD may be one of the reasons that fetuses with CTD have cerebral cortical hypoevolutism.

Objective To find the relationship between nuclear factor kappB (NF-κB) activation and cell apoptosis.Methods Degenerative human nucleus pulposus cells were cultured in vitro.Useing CCK-8 to observe the proliferative effect of LPS on the nucleus pulposus cells in vitro, in the concentration of 100, 200, 500 and 1 000 μg/mL and choose the most apropriate concentration.The experiment was divided into blank control group, LPS(500 μg/mL)groups, and NF-κB inhibitor(BAY11-7082)plus LPS(500 μg/mL)group,Annexin V-FITC/PI flow cytometry and Hoechest33258 staining was used to analyze apoptosis.The expression of cleaved caspase-3,PARP,P65,P-P65 proteins were detected by Western blot respectively.Results When LPS was 500 μg/mL, the cell vitality was obviously declined.Compared with the blank control group, cell apoptosis rate of the LPS group is increasing (P<0.05), and the expression of P-P65,cleaved caspase-3, cleaved PARP were alsohigher (P< 0.05).Compared with the LPS group, cell apoptosis rate of the NF-κB inhibitor plus LPS group is significantly lower (P<0.05) and the expression of P-P65,cleaved caspase-3,cleaved PARP were also lower (P< 0.05).Conclusions NF-κB signaling pathway may be associated with the nucleus pulposus cell apoptosis in disc degeneration.

CD38 is a multifunctional enzyme expressed in a variety of mammalian tissues, its catalytic activity was involved in a wide range of physiological processes. Based on the reported inhibitor of human CD38 NADase, 33 purine derivatives were designed and synthesized. The biological activity assay showed that compounds 20 and 38 exhibited almost the same extent of inhibitory activities on human CD38 NADase as the lead compound H2. The results also revealed that small substituents at C-6 of purine ring gave no obvious effect on inhibitory activity, but phenylpropionyl moiety at N-2 could affect the binding mode of the compound with CD38. This study provides a reliable basis for future rational design of inhibitors for CD38.
ADP-ribosyl Cyclase 1 ; antagonists & inhibitors ; Enzyme Inhibitors ; chemical synthesis ; chemistry ; Humans ; Purines ; chemical synthesis ; chemistry

Objective: To evaluate the application of panning axial turnover in placement of surgical positions before thoracic surgery. Methods: From June 2017 to September 2017, altogether 140 patients who underwent thoracic surgery were enrolled in and randomly divided into two groups: the observation group and the control group. The control group was treated with traditional turnover method, while the observation group were treated with axial turnover. Results: No significant changes were found in blood pressure, heart rate and respiratory rate (P>0.05) after turning over. There was no significant difference between the observation group and the control group about turn over time, (7.06±0.78)s vs. (7.01±0.81)s (P>0.05). The subjective evaluation results of the medical staff in the observation group were significantly better than those of the control group (Z=-7.111, P<0.01) and the shift rate of double-lumen endotracheal tube in the observation group was 3.7% (2/54), which was significantly lower than 21.6% (11/51) of the control group (χ²=6.158, P<0.05). Conclusions The panning axial turnover properly guided the turn-over work with the principle of human body mechanics, which was more labor-saving and requires less operators. Besides, the panning axial turnover effectively reduced the double-lumen tracheal intubation shift rate. It′s worthy of clinical promotion.

BACKGROUNDMacro- and microvascular diseases are the leading cause of morbidity and mortality in diabetic patients, but their mechanisms remain unclear. Recent reports provide evidence that the levels of CD55 and CD59 are decreased in diabetic microvascular diseases. However, very little is known about the levels of CD55 and CD59, the relationship between them and carotid artery intima-media thickness, and the effects of statins on CD55 and CD59 in diabetic macrovascular diseases.

METHODSThe mean fluorescence intensity (MFI) of CD55 and CD59 expression on peripheral blood leucocyte subsets (lymphocytes, monocytes and neutrophils) was studied using flow cytometry, and carotid artery intima-media thickness was measured using B-mode ultrasonography in 23 healthy subjects (controls), 19 patients with type 2 diabetes (T2DM), and 43 patients with type 2 diabetes and macrovascular diseases (T2DM-M). The patients with T2DM-M were assigned to two subgroups based on whether statins were used: group with statins (n = 23) and group without statins (n = 20).

RESULTSCompared with the controls and T2DM, the MFI of CD55 positive neutrophils was significantly lower in T2DM-M (P = 0.049 vs controls and P = 0.033 vs T2DM); similarly, the MFI of CD59 positive monocytes was also lower in T2DM-M (P = 0.038 vs controls and P = 0.043 vs T2DM). The MFI of CD59 positive neutrophils in T2DM-M was lower than in T2DM (P = 0.032). The levels of CD55 and CD59 were negatively associated with age and blood pressure (r = -0.245 - -0.352, P = 0.041 - 0.003), but not acute-phase reactants and carotid artery intima-media thickness. The levels of CD55 and CD59 increased after treatment with statins, but the results were not significantly different (P > 0.05).

CONCLUSIONSCD55 and CD59 expressions on peripheral blood leucocytes are decreased in T2DM patients with macrovascular diseases. The results suggest that the decreased levels of complement regulatory proteins might play an important role in diabetic macrovascular diseases.

Aged ; Aged, 80 and over ; CD55 Antigens ; immunology ; CD59 Antigens ; immunology ; Diabetes Mellitus, Type 2 ; immunology ; Diabetic Angiopathies ; immunology ; Female ; Flow Cytometry ; Gene Expression Regulation ; Humans ; Leukocytes ; immunology ; Male ; Middle Aged