Objective To find a more suitable approach to pediatric anesthesia during laparoscopic operation to alleviate stress response.Methods Forty patients,1 to 3 years of age,ASA grade Ⅰ-Ⅱ,underwent general anesthesia(group GA)and combined general epidural anesthesia(group GEA)during their laparoscopic operation.Heart rate(HR),mean arterial pressure(MAP),ECG,SPO2,PETCO2,blood gas,plasma epinephrine,plasma norepinephrine,plasma IL-6 and IL-10 were monitered and recorded five minutes before anesthesia(T0),pre-pneumoperitoneum(T1),5 min after pneumoperitoneum(T2),30 min after pneumoperitoneum(T3),30 min after operation(T4)and 24 h after operation(T5).Results(1)HR,MAP of group GA were increased obviously at T2,T3,T4 compared to T0(P0.05).Significant difference was found at T1,T2,T3 and T4 between group GA and group GEA(t=4.749,10.349,13.632,10.051,P0.05).Plasma IL-10 at T1,T2,T3,T4 were higher than that at T0 in both groups(P

Based on the limitation of the segmental activityand signs of local tenderness,location diagnosis andtreatment for cervical pain and referred pain was per-formed with elevating—rotation reduction.Clinically, attention should be given to the combination of X—rayfilm and signs and symptom.The total effective ratefor 3687 eases thus treated was rather high.

ObjectiveTo study the MRI features of children with cerebral palsy(CP) resulting from anoxia.Methods The clinical and MRI findings in 83 premature or mature children affected by cerebral palsy resulting from PVL were reviewed retrospectively to search for the MRI features and the data were analyzed by statistic. Results1. MRI features of CP children resulting from anoxia were clearly demonstrated:1) MRI features of PVL: reduction of white matter ;T2W signal hyperintensity in white matter; ventricle enlarged or irregular appearance; lateral fissure;deepened or widened Sulci;and abnormal corpus callossum; 2) other abnormal MRI features: basal ganglion damaged; cerebral cortex atrophy or malacia. 2.Differences in MRI features between premature and mature CP children: there are significant differences between premature and mature children at malacia and cyst of deep white matter; enlargement and irregularity of the lateral ventricles. ConclusionsMRI examination can clearly display the level and scope of focus of PVL,and the differences in MRI features between premature and mature children.The level and degree of premature children are deeper and more extensive than those of mature children.Cyst and malacia in deep white matter,enlargement and irregularity of the lateral ventricles occur more frequantly in premature children.

ObjectiveTo study the MR images findings of acute spinal cord stab wound injury. MethodsThe clinical material and MRI findings of 12 patients with acute spinal cord stab wound injury within 7 days were reviewed retrospectively with 1.0 T magnet. Results4 of 12 patients had the Brown-Sequards's Syndrome, the locations of wound injury are mainly within T6-8 level. MRI findings of pathway of the stab wound were seen in all cases. Many other signals including artefact of knife track, spinal cord injury, edema, hemorrhage, and hematoma of subdural and epidural were also seen in some cases. The location relationship of the hematoma to dura in distinguishing a subdural hematoma from an epidural hematoma by MR images is important, injury of the ligamentum flavum and anterior and posterior longitudinal ligaments and spinal dura can be diagnosed by either absence or interruption of the normal linear low-signal-intensity band.Conclusions MR images allows vasualization of intramedullary injury, extramedullary injury and injury to spinal ligaments and dura. T 2 -weighted images can be helpful in visualization of the knife track extending from the skin surface to the spinal canal.

Objective To analyze and compare the clinical and laboratory features between patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA).Methods One hundred and forty-one patients with AS and 73 cases with nr-axSpA were recruited.Clinical and laboratory indexes of individuals were recorded in detail,Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) crp were calculated.Spondyloarthritis research consortium of Canada (SPARCC) score standard was used to evaluate the degree of bone marrow edema in sacr-oiliac joint under magnetic resonance imaging scanning.T test,rank test and x2 test were used for statistical analysis.Results The average age of patients with AS was obviously higher than that of patients with nr-axSpA (t=4.962,P＜0.01).Patients with AS were more often male,and those with nr-axSpA were more often female (82.0％ of the AS patients were men and 49.3％ of the nr-axSpA patients were men (x2=24.079,P＜0.01).Disease duration of AS was significantly longer than that of the nr-axSpA (Z=6.396,P＜0.01).The incidence of human leukocyte antigen (HLA)-B27 positive in AS was 89.4％,which was similar to that in patients with nr-axSpA (84.9％) (x2=0.884,P＞0.05).21.6％ (21 cases) of patients with AS had peripheral swollen joints,which was higher than that in nr-axSpA (2.2％,x2=8.861,P=0.003).Forty cases in AS had tender joints (41.2％),only 6 patients in nr-axSpA had tender joints (13.3％,x2=11.458,P＜0.01).Serum erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) levels in patients with AS were clearly higher than those in nr-axSpA (P＜0.01) patients.In AS,the patient global assessment (PGA),BASDAI and ASDAScrp value was significantly higher than that in nr-axSpA (P＜0.01).There were no differences in SPARCC score or incidence of bone marrow edema in sacroiliac joint in magnetic resonance imaging scanning between AS and nr-axSpA (P＞0.05).Percentage of patients with occipit-to-wall distance higher than 0 cm in AS was higher than that in nr-axSpA,and the mean distance of fingers to ground in AS was also higher than that in nr-axSpA (x2=19.844,P＜0.01;Z=5.724,P＜0.01).Chest expansion degree and Schboer's test in AS was much lower than that in nr-axSpA,respectively (Z=3.083,P=0.002;Z=5.103,P＜0.01).BASFI in AS was higher than that in nr-axSpA (Z=5.840,P＜0.01).The ratio of joint function in AS was obviously worse than that in nr-axSpA (x2=1 1.369,P=0.01).Conclusion Compared to patients with nr-axSpA,AS patients are male predominant,and have severer inflammation in clinical and laboratory findings and are worse in functional status.

Objective To investigate the effect of sarcopenia and vitamin D deficiency on osteoporosis (OP) in patients with rheumatoid arthritis (RA).Methods Six hundred and forty-eight patients with RA were enrolled into the study,while 158 normal subjects were recruited as the control group.Bone mineral density (BMD) at total hip and lumbar vertebra 2-4 were measured by dual energy X-ray absorptiometry (DEXA),limbs skeletal muscle mass was determined in 267 patients with RA and 156 normal subjects by bioelectrical impedance method.Serum 25-hydroxy vitamin D [25(OH)D] levels were determined by electrochemiluminescence in 234 RA patients and 68 normal subjects.Clinical and laboratory features,daily dosage and duration of glucocorticoid (GC) were recorded.Numerical data and categorical data comparisons were analyzed using t test,x2 test,linear correlation analysis,single factor analysis of variance test and Logistic regression analysis test.Results ① Incidence of OP in RA (37.8％,245/648) was significantly higher than that in the controls (13.9％,22/158)(x2=32.712,P＜0.01).Incidence of sarcopenia was evidently higher in RA,compared with normal subjects [55.8％(149/267),9.0％(14/156),x2=91.176,P＜0.01].Percentage of sarcopenia was higher in RA with OP compared with RA without OP group [76.6％(49/64),39.3％(35/89),x2=20.848,P＜0.01].②Compared to control group,serum 25 (OH)D levels were significantly lower in RA group [(13.4±9.7) ng/ml,(22.4±6.3) ng/ml,t=9.063,P＜0.01].Rate of vitamin D deficiency iu RA was also higher than that in controls [80.8％(189/234),36.8％(25/68),x2=49.412,P＜0.01].③The differences of serum 25 (OH)D levels among different bone metabolic state groups at lumbar vertebra in RA (normal bone mass,osteopenia,OP) were statistically significant (F=6.263,P=0.003),whichrepresented a clearly decreasing trend along with the decreasing of serum 25 (OH)D levels (P=0.001).④Linear correlation analysis found that skeletal muscle mass indexes at limbs in RA were positively correlated with BMD and serum 25 (OH)D levels (P＜0.05).⑥Logistic Regression analysis revealed that sarcopenia (OR=4.373,P=0.002),age (OR=1.083,P=0.001) and duration of disease (OR=1.074,P=0.029) were the risk factors for occurrence of OP in patients with RA.Conclusion Sarcopenia generally exists in patients with RA,which is correlated with decreasing of serum 25 (OH)D levels,and also is the risk factor for the occurring of OP in RA.

Objective To investigate the clinical value of serum 14-3-3η protein levels in patients with rheumatoid arthritis (RA) and secondary osteoporosis (OP). Methods 259 RA patients and 80 healthy controls were recruited. Serum 14-3-3η levels were determined by ELISA and bone mineral density (BMD) were detected by the DEXA. Results Firstly, the levels and the positive rate of serum 14-3-3η protein were significantly high-er in RA patients than healthy controls (P < 0.000 1). Secondly, ROC curve revealed that the sensitivity of 14-3-3η protein for diagnosis of early RA was 91.7% and its specificity was 99.6% when the cut-off point was 0.879 ng/mL (AUC = 0.917, P < 0.000 1). Finally, 14-3-3η protein concentrations revealed significant differ-ence among the groups of bone mass normal, osteopenia and osteoporosis in early RA (χ2=7.974, P = 0.019). Conclusion Serum 14-3-3η protein levels increase significantly in RA , especially in early RA , which is relat-ed to clinical symptoms and osteoporosis.

Objective To explore the effect of vitamin D deficiency and falls on osteoporotic fracture (OPF) in patients with rheumatoid arthritis (RA).Methods A total of 852 patients with RA were recruited, anteroposterior and lateral X-rays examination of vertebral column were conducted for every patient.Serum 25-hydroxy vitamin D [25(OH)D] levels and bone mineral density (BMD) of all the vertebrae of lumbar were exam-ined.Clinical and laboratory index of patients were recorded in details meanwhile.Data of 156 normal subjects during the same period were collected as the control group.Numerical data and categorical data comparisons were analyzed using t test, x2 test, single factor analysis of variance test, linear correlation and Logistic regression analysis test.Results ① The prevalence of vertebral OPF in RA was 16.1％(137/852).Compared to RA without OPF, patients with OPF had lower serum 25(OH)D levels [(14±4) ng/ml vs (18±7) ng/ml, t=2.898, P=0.004].② The occurrence rate of falls in RA patients was 19.7％(36/183).Patients with falls had lower serum 25(OH)D levels [(14±4) ng/ml vs (18±6) ng/ml, t=2.854, P=0.005].③ The prevalence of falls in RA with vertebral OPF was higher than that in RA without OPF (38.1％ vs 14.2％,x2=11.708, P=0.001).④ Linear correlation analysis found that serum levels of 25 (OH)D was positively correlated with total lumbar region BMD in RA patients.⑤ Logistic regression analysis revealed that age [OR=1.124, P=0.002, 95％CI: (1.045, 1.209)]and usage of glucocorticostroid (GC) [OR=6.724, P=0.031,95％CI: (1.196, 37.813)] were the risk factors for occurrence of OPF in RA, while serum 25 (OH) D level [OR=0.850, P=0.046, 95％CI: (0.725, 0.997)] was the protective factor.Conclusion Spinal OPF in patients with RA is clearly related with vitamin deficiency, falls and usage of GC.

To establish a LC-MS/MS method for quantification of chlorogenic acid, caffeic acid, 3,4-DCQA, ferulic acid and cinnamic acid in rats plasma and study its pharmacokinetics after administration of Mailuoning injection at a single dose to rats. Plasma samples were acidified with hydrochloric acid and extracted with ethyl acetate. The analytes were determined by LC-MS-MS using a ZOBAX SB C18 column with a mobile phase of methanol-water (containing 2 mmol x L(-1) ammonium acetic) (60:40)at a flow rate of 0.5 mL x min(-1) and detected using ESI with negative ionization mode. Ions monitored in the multiple reaction monitoring (MRM) mode were m/z 353.1/191.0 [M-H]- for chlorogenic acid, m/z 178.9/134.9 [M-H]- for caffeic acid, m/z 515.2/353.0 [M-H]-for 3,4-DCQA, m/z 193.0/133.9 [M-H]-for ferulic acid, m/z 146.9/102.9 [M-H]- for cinnamic acid and m/z 246.0/125.8 [M-H]- for tinidazole (IS). After administration of Mailuoning injection at a single dose to eight Sprague-Dawley rats, the concentrations of chlorogenic acid, caffeic acid, 3,4-DCQA, ferulic acid and cinnamic acid in plasma were determined by LC-MS/MS method. The main pharmacokinetics parameters of measured data were caluculated by using DASver 1.0 software. The linear concentration ranges of the calibration curves for chlorogenic acid, caffeic acid, 3,4-DCQA and cinnamic acid were 2.006-1,027 microg x L(-1) (r = 0.999 6), 1.953-1,000 microg x L(-1) (r = 0.999 7), 28.51-1.459 x 10(4) microg x L(-1) (r = 0.998 9), 1.836-940.0, g x L(-1) (r = 0.997 7) and 4.780-2,447 microg x L(-1) (r = 0.998 6) respectively. The inner and inter-days relative standard deviations were both less than 5.0%, indicating legitimate precise and accuracy to the requirement of biological sample analysis. For chlorogenic acid, the pharmacokinetic parameter t1/2, AUC0-t, and CL were (49.78 +/- 12.81) min, (123.55 +/- 14.82) mg x min x L(-1) and (0.004 3 +/- 0.000 5) L x min(-1), respectively. For caffeic acid, the pharmacokinetic parameter t1/2, AUC0-t, and CL were (36.65 +/- 10.59) min, (91.67 +/- 11.77) mg x min L(-1) and (0.005 7 +/- 0.000 7) L x min(-1), respectively. For 3,4-DCQA, the pharmacokinetic parameter t1/2, AUC0-t, and CL were (50.08 +/- 13.78) min, (278.34 +/- 31.82) mg x min x L-1 and (0.001 6 +/- 0.000 2) L x min(-1), respectively. For ferulic acid, the pharmacokinetic parameter t1/2, AUC0-t, and CL were (51.39 +/- 15.52) min, (34.72 +/- 4.67) mg x min x L(-1) and (0.000 4 +/- 0.0001) L x min(-1), respectively. For cinnamic acid, the pharmacokinetic parameter t1/2, AUCo-t, and CL were (74.42 +/- 18.32) min, (34.63 +/- 4.82) mg x min x L(-1) and (0.007 7 +/- 0.001 1) L x min-', respectively. The assay method is proved to be sensitive, accurate and convenient. It can be applied to the pharmacokinetic study of chlorogenic acid, caffeic acid, 3,4-DCQA, ferulic acid and cinnamic acid.
Animals ; Chromatography, Liquid ; methods ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Female ; Hydroxybenzoates ; blood ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; methods