Objective To assess the anticonvulsant effect of midazolam, thiopental and propofol on the convulsion induced by ropivacaine in rats and the underlying mechanism.Methods Fifty male SD rats, 4-6 months of age, weighing 250-300 g were randomly divided into five groups of 10 animals each : (1) control group (C); (2) ropivacaine group; (R) (3) midazolam-ropivacaine group (MR); (4) thiopental-ropivacaine group (SR) and (5) propofol-ropivacaine group (PR) . In control group normal saline 2 ml was infused i.v. . In ropivacaine group (R) 0.75% ropivacaine was infused i.v. at 0.5 ml?min-1 until convulsion occurred. In midazolam - ropivacaine group (MR) midazolam 0.23 mg?kg-1 was injected i.v. 3 min before 0.75% ropivacaine infusion. In SR and PR groups thiopental 2 mg?kg-1 or propofol 1 mg?kg-1 was injected i.v. 1 min before 0.75% ropivacaine infusion. As soon as convulsion occurred ropivacaine infusion was stopped. The animals were decapitated and their brains were removed and kept in liquid nitrogen for determination of the contents of excitatory ammo-acids (aspartic acid and glutamic acid) and the inhibitory amino-acids [glycine and ?-amino butyric acid (GABA)] by high-performance liquid chromatography . The amount of ropivacaine infused in each group was recorded and calculated.Results The dose of ropivacaine needed to produce convulsion was 4.6?0.5 mg?kg-1 in group R and was significantly increased in the 3 groups pretreated with general anesthetics and was 2.96 times the dose in group R in MR group, 2.84 times in SR group and 1.54 times in PR group. The 4 amino-acid concentrations in the brain were significantly higher in group R than in control group. Compared to group R the Asp, Gly and GABA concentrations were significantly lower in group MR and PR but in group SR only Asp concentration was significantly lower. There was no significant difference in glutamic acid concentration among the4 roopivacaine groups (group 2-5).Conclusion Midazolam, thiopental and propofol can all increase the dose of ropivacaine needed to induce convulsion and midazolam and thiopental are more effective than propofol.

Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17％.Esophageal perforation occurred in 2 patients; the incidence was 0.09％.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management.

Objective To evaluate the training quality of anaesthesiology residents in different hospitals. Methods The scores of 125 residents,attending Shanghai resident clinic skill examination from 2005 to 2007,were analyzed. ResultsThe scores of examinees from municipal hospitals were higher than those from district hospitals,municipal specialized hospitals and traditional Chinese medicine hospitals.The scores of practice part were higher than those of theory part in all groups. Conclusion The training quality is related to the comprehensive strength of the hospital in which examinees work,but the training of theory knowledge still need to be strengthened.

AIM: To evaluate the preservation of anterior capsule during vitrectomy and lensectomy.ment (RD) and grade C proliferative vitreoretinopathy (PVR)underwent pars plana vitrectomy (PPV) and pars plana lensectomy (PPL) with preservation and polishing of the anterior capsule. Of the 15 eyes, 4 eyes had giant tear, 3 had recurrent rhegmatogenous retinal detachment (RRD), 2 had diabetic retinopathy. Totally 6 eyes had gas and 9 had silicone oil tamponade. The surgeries were evaluated according to the visual acuity (VA) and the postoperative complications during the follow-up of at least 3 months.in all eyes, improved by 3± 3 lines overall. Eight eyes were implanted posterior chamber intraocular lens (PCIOL) successfully at 2-3 months after operation, including 6 having gas and 2 having silicone oil tamponade. No eyes had central anterior capsule opacity, corneal decompensation, puplillary block, retina redetachment or other complications.an intact anterior capsule in eyes with RD and PVR. Preserving the anterior capsule can help preventing intraoperative and postoperative complications of gas or silicone oil, simplify future PCIOL placement, and maintaining a normal iris appearance.

Background Clinical researches showed that antimicrobial-resistance of bacterium is gradually serious.It is very important to master pathogen distribution and antimicrobial susceptibility after eye surgery.Objective This study was to investigate the distribution and drug sensitivity of pathogenic bacteria from ocular operative infection in 3-year duration to provide a reference for reasonable selection of antibiotics.Methods Sixtyfive positive specimens were obtained from 65 patients due to postoperative infection in Department of Ophthalmology of Shenzhou Hospital and Shengjing Hospital from 2009 January through 2011 December.The pathogenic bacteria were isolated and then the drug sensitivity test of conventional antibiotics was performed.Results Among the 65 ophthalmic specimens,35 strains of Gram-positive bacteria were isolated with the constituent ratio 53.8％,and 15 strains of Gram-negative bacteria accounted for 23.1％.Fungus was found in 15 cases with the constituent ratio 23.1％.Staphylococcus epidermidis accounted for 42.9％ in Gram-positive bacteria,and Pseudomonas aeruginosa accounted for 33.3％ in Gram-negative bacteria.Aspergillus was the main component of fungus,which accounted for 60.0％ of the proportion 3 strains of methicillin-resistant Staphylococcus aureus (MRSA) in 8 strains of Staphylococcus aureus,but no vancomycin-resistant Enterococcus (VRE) and vancomycin-resistant Staphylococcus (VRS) were seen.The in vitro drug sensitivity test showed that the main Gram-positive bacteria,Staphylococcus epidermidis and Staphylococcus aureus,were sensitive to linezolid,vancomycin,levofloxacin and ciprofloxacin with the sensitive rates ＞50.0％,and these bacteria were lowly sensitive to penicillin and erythromycin with the sensitive rates ≤30.0％.Pseudomonas aeruginosa appeared to be the main Gram-negative bacteria,showing a sensitive rate ≥ 80.0％ to tobramycin,amikacin,ceftazidime,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,imipenem and meropenem.Conclusions Staphylococcus epidermidis,Staphylococcus aureus,Pseudomonas aeruginosa and Aspergillus are primary pathogens in ocular infection after operation.Antibiotics such as penicillin,erythromycin,levofloxacin,cefotaxime seem to be relatively high resistant to eye infection.To choose sensitive antibiotics timely and reasonably is a key to the prevention and control of ocular infection after operation.

Objective To establish nursing intervention for patients with diabetes mellitus and discuss in-fluence of community nursing on rehabilitation of patients with diabetes mellitus. Methods Patients with con-finned diagnosis of type two diabetes mellitus (61 cases) were selected,individual health records were established and health education was given to them,including diet,exercises,psychological nursing,medication instruction and regular blood glucose monitoring. Patients compliance,control of fasting blood glucose and glycosylated hemoglobin were compared before and after nursing intervention. Results Patients compliance such as regular physical ex-amination,diet control,regular blood glucose monitoring and exercises treatment improved after intervention com-pared with those before community intervention (P<0.05). The control of fasting blood glucose and glycosylated hemoglobin was better after intervention compared with those before community intervention (P<0.01). Con-clusion Community nursing intervention for patients with diabetes mellitus proved to have good effect.

Adult ; Female ; Granuloma, Respiratory Tract ; pathology ; Humans ; Lung, Hyperlucent ; pathology ; Male ; Middle Aged

OBJECTIVETo explore the effect of Qingyi Granule (QYG) on high mobility group box-1 (HMGB1) expressions in liver and renal tissues of severe acute pancreatitis (SAP) rats.

METHODSFifty-four Sprague-Dawley (SD) rats were divided into the sham-operation (SO) group, the SAP group, and the QYG group according to random digits table. Rats in the SAP group were induced by injecting 5% sodium taurocholate (STC). Liver and renal pathological changes were observed by HE staining. Serum contents of amylase (AMS), MDA, IL-1, and HMGB1 were detected by ELISA. HMGB1 protein expressions in liver and renal tissues were tested by immunohistochemistry. HMGB1 mRNA expressions in liver and renal tissues were detected by reversed transcription PCR.

RESULTSThe pathological scores, serum levels of AMS, MDA, IL-1 and HMGB1, and protein and mRNA HMGB1 expressions in liver and renal tissues were increased more obviously in the SAP group than in the SO group (P < 0.05, P < 0.01). All of them could be down-regulated by QYG intervention, with the most significant effect seen at 72 h (P < 0.05, P < 0.01) in a time-effect relationship.

CONCLUSIONSHMGB1 participated in SAP complicated liver and renal injuries. QYG could effectively inhibit HMGB1 expressions, thereby attenuating SAP complicated liver and renal injuries.

Amylases ; Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; HMGB1 Protein ; metabolism ; Interleukin-1 ; Kidney ; metabolism ; Liver ; metabolism ; Pancreatitis ; drug therapy ; metabolism ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Taurocholic Acid

The purpose of this study was to investigate the cytotoxicity of the nickel ion and provide with basic data for the biological evaluation of those medical devices containing nickel. Seven cell lines were chosen. They were L929, h9c2(2-1), 293[HEK-293], hFOB1.19, THLE-3, H9 and IM-9 respectively. According to the principle of biological evaluation of medical devices, MTT method was chosen to test the cytotoxicity in different concentrations of nickel ion. For each cell line, the relative growth rate (RGR) was obtained and the cytotoxic grade was classified. Besides, IC50 values were calculated. As a result, it was found that the sensitivity was different among all cell lines. H9 was the most sensitive one, while the L929 was the most tolerant one. The concentration which is not above 1.25 mg/L was safe for all seven cell lines, because the cytotoxicity for all cells exposed in this concentration were not higher than grade 1. According to the criteria for medical devices, the concentrations not above 5 mg/L were safe for L929 cells. This result helps us to roughly assess the cytotoxicity and systematic toxicity caused by nickel contained in medical devices.
Cell Line ; Equipment and Supplies ; HEK293 Cells ; Humans ; Ions ; toxicity ; Nickel ; toxicity

Immunosuppressive tumor microenvironment is a part of the tumor microenvironment that plays an immunosuppressive function.It consists of suppressor cells and inhibitory cytokines.In recent years,be-cause of its important role in tumor immunity,CAR-T and PD-1/PD-L1 signal pathway has become a hot top-ic of immunotherapy, which can suppress immune through different mechanisms to promote tumor progression. Therefore,taking more effective anti-tumor therapies against the above mechanisms is possible to rescue the pro-gress of tumor.In this article,the influence of immunosuppression microenvironment in CAR-T cell therapy and PD-1/PD-L1 signaling pathway in the anti-tumor process is reviewed.