Objective To evaluate the effects of different doses of fentanyl on the median effective target plasma concentration (EC50) of propofol inhibiting body movement evoked by gastroscopy in the elderly patients.Methods Ninety patients of both sexes,aged 75-89 yr,with a body mass index of 19-25 kg/m2,of ASA physical status Ⅱ or Ⅲ,scheduled for elective gastroscopy,were randomly divided into 3 groups (n =30 each):control group (group C) and different doses of fentanyl groups (F0.5 and F1.0 groups).Fentanyl 0.5 and 1.0 μg/kg were injected intravenously in F0.5 and F1.0 groups,respectively.Propofol was then administered by target-controlled infusion.The initial target plasma concentrations (Cps) of propofol were 2.0,1.5 and 1.0 μg/ml in C,F0.5 and F1.0 groups,respectively.Gastroscopy was performed after the target effect-site and plasma concentrations were balanced.Body movement was defined as movement in head or four extremities during gastroscopy.The target Cp of propofol was determined by up-and-down sequential trial.Each time the Cp increased/decreased by 0.5 μg/ml in the next patient depending on whether or not body movement developed.The EC50 and 95 ％ confidence interval (CI) of propofol inhibiting gastroscopy-evoked body movement were determined using Probit analysis.Results The EC50 (95 ％ CI) of propofol was 2.24 ng/ml (1.67-2.47 ng/ml) in group C,1.79 (1.55-1.95) μg/ml in group F0.5,and 1.13 (1.08-1.62) μg/ml in group F1.0.There was no significant difference in the EC50 of propofol between F0.5 and C groups.The EC50 of propofol was significantly lower in F1.0 group than in C and F0.5 groups.Conclusion When combined with propofol,fentanyl 1.0 μg/kg is recommended for gastroscopy in the elderly patients.

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Objective To evaluate the effect of age on the median-effective target plasma concentration (EC50) of propofol inhibiting body movement evoked by gastroscopy in the patients.Methods Ninety adult patients of both sexes,of ASA physical status Ⅰ or Ⅱ,with body mass index 19-25 kg/m2,scheduled for elective gastroscopy,were divided into 3 groups according to age (n =30 each):18-39 yr group (Ⅰ group),40-64 yr group (Ⅱ group) and 65-85 yr group (Ⅲ group).In Ⅰ,Ⅱ,Ⅲ groups,propofol was given by target-controlled infusion with the initial target concentrations of 2.5,2.0 and 1.5 μg/ml,respectively,and gastroscopy was performed when the target concentration was achieved.Body movement was defined as the directional movement in head or four extremities during gastroscopy.The target plasma concentration of propofol was determined by up-and-down sequential trial.Each time the plasma concentration of propofol increased/decreased by 0.5 μg/ml in the next patient depending on whether or not body movement developed.The EC50 and 95 ％ confidence interval of propofol inhibiting gastroscopy-evoked body movement were determined using Probit analysis.Results The EC50 (95 ％ confidence interval) of propofol was 4.2(3.8-4.5),4.1(3.7-4.4) and 2.4(1.8-2.7) μg/ml in Ⅰ,Ⅱ and Ⅲ groups,respectively.There was no significant difference in the EC50 of propofol between group Ⅱ and group Ⅰ.The EC50 of propofol was significantly lower in group Ⅲ than in Ⅰ and Ⅱ groups.Conclusion Age affects propofol-induced analgesia in patients with visceral pain,and the potency of propofol inhibiting visceral pain during gastroscopy in the elderly patients is significantly enhanced as compared with that in the young and middle-aged patients.

Objective To investigate the preventive and therapeutic effects of vesiculation moxibustion on rat hepatic fibrosis (HF).Methods Thirty rats were randomly allocated to treatment, model and control groups, 10 rats each. A rat model of HF was made by intraperitoneal injection of carbon tetrachloride. At three weeks after model making, the treatment group was treated by vesiculation moxibustion 6 hrs twice a week, for a total of 4 weeks. Body weight, liver wet weight, liver index, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) contents, and serum and liver typeⅢ procollagen (PCⅢ), typeⅣ collagen (Ⅳ-C), hyaluronic acid (HA) and laminin (LN) contents were measured in every group of rats.Results There were statistically significant differences in HF severity grade and HF tissue collagen analysis indices between the model group of rats and the treatment group or the control group (P<0.01,P<0.05). There were statistically significant differences in body weight, liver wet weight and liver index between the model and control groups of rats (P<0.01). There were statistically significant differences in liver wet weight and liver index between the treatment and model groups of rats (P<0.01). There were statistically significant differences in serum ALT and AST contents, and serum and liver PCⅢ,Ⅳ-C, HA and LN contents between the model and control groups of rats (P<0.01,P<0.05). There were statistically significant differences in serum ALT and AST contents, and serum and liverⅣ-C, HA and LN contents between the treatment and model groups of rats (P<0.01,P<0.05). There was a statistically significant difference in serum PCⅢ content between the treatment and model groups of rats (P<0.01).Conclusion Vesiculation moxibustion has some preventive and therapeutic effects on rat hepatic fibrosis.

Objective To compare the effect of oxycodone,sufentanil and fentanyl on immune function in patients with colon cancer under postoperative analgesia,provide guidance and basis for clinical medication.Methods Ninety patients 49 males and 41 females,aged <65 years,ASA physi-cal status Ⅰ or Ⅱ,were enrolled and randomly divided into 3 groups using a random number table (n=30):oxycodone group (group O),sufentanil group (group SF)and fentanyl group (group F).All patients underwent the same way to maintain anesthesia.The PCIA pump recipe were as follows:group O,oxycodone 2 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group SF,sufen-tanil 0.002 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group F,fentanyl 0.02 mg/kg+granisetron 3 mg,added normal saline to 100 ml;The background volume of PCIA electronic pump was 2 ml/h,the amount of each press was 2 ml,the lock time was 1 5 min,the pump time lasted for 24 h and maintained for 2 days after operation.The percentage of CD4+,CD8+and NK cells in venous blood were recorded at the end of surgery,6 h,12 h,24 h and 48 h after surgery.Results In CD4+,in the time points of 6 h,12 h,24 h after surgery,it was significantly higher in group O than that in groups SF and F (P<0.05);CD8+in group O was higher than that of group F,and CD8+in group F was higher than group SF at the time of 6 h after surgery.The group O was significantly higher than that of the groups SF and F at the times of 12 h,24 h after surgery (P<0.05);In NK cells,at the time points of 12 h,24 h and 48 h after surgery,it was significantly higher in group O than in groups SF and F (P<0.05).Conclusion Three analgesic drugs caused decline in immune function.Sufentanil and fentanyl have the similar effects on immunity,but oxycodone have a relatively small effect on immunity.Oxycodone is a more appropriate analgesic drug for colon cancer under postoperative analgesia.

Background: Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. Methods: Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. Results: Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. Conclusion Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.

The traditional primary culture methods of human normal epithelial cells have disadvantages of low activity of cultured cells,the low cultivated rate and complicated operation.To solve these problems,researchers made many studies on culture process of human normal primary epithelial cell.In this paper,we mainly introduce some methods used in separation and purification of human normal epithelial cells,such as tissue separation method,enzyme digestion separation method,mechanical brushing method,red blood cell lysis method,percoll layered medium density gradient separation method.We also review some methods used in the culture and subculture,including serum-free medium combined with low mass fraction serum culture method,mouse tail collagen coating method,and glass culture bottle combined with plastic culture dish culture method.The biological characteristics of human normal epithelial cells,the methods of immunocytochemical staining,trypan blue exclusion are described.Moreover,the factors affecting the aseptic operation,the conditions of the extracellular environment,the conditions of the extracellular environment during culture,the number of differential adhesion,and the selection and dosage of additives are summarized.

Objective To observe the effect of ultrasound-guided transversus abdominis plane block combined with diclofenac sodium suppository in anus on postoperative analgesia and early recov-ery after laparoscopic hysterectomy.Methods Sixty-six patients of laparoscopic hysterectomy,aged 40-60 years,were randomly divided into group T and group D,33 cases in each group.Group T used ultrasound-guided bilateral transversus abdominis plane (TAP)block after surgery.Group D used TAP block and diclofenac sodium suppositories in anus.All patients received PCIA.Postoperative 24 h sufentanil dosage out of analgesia pump and the effective press times were recorded.The incidence of dysphoria,nausea and vomit within postoperative 24 h,the time of first out-of-bed activity,the time of first anal exhaust and the time of removing urine tube were measured.The plasma concentra-tion of interleukin-6(IL-6),C reactive protein (CRP)and cortisol (Cor)were recorded at the follow-ing four time points:before anesthesia,just postoperative moment,8 and 12 h after surgery. Results Compared with group T,the sufentanil dosage [(18.6±3.2)μg vs (40.8±5.1)μg]and the effective press times [(9.3±2.2)times vs (20.4±3.5)times]were fewer in group D (P<0.05).The incidence of dysphoria,and nausea and vomit were less in group D compared with group T (P<0.05).The IL-6,CRP and Cor of group D at 12 h were lower than those of group T (P<0.05). But the times of first out-of-bed activity,anal exhaust and removing urine tube in two groups were not significantly different.Conclusion Transversus abdominis plane block combined with diclofenac sodium suppositories in anus can provide safe and effective postoperative analgesia for laparoscopic hysterectomy,and promote the early fast recovery.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.