Objective To study the sedation efficacy of propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope. Methods Ninty outpatients were randomly divided into three groups. Group PF (n=31)was given fentanyl 0. 05 m.g plus propofol 1 mg/kg intravenously, group PM (n=29) midazolam 2 mg plus propofol 1 mg/kg, and group PMF(n=30) fentanyl 0. 05 mg, midazolam 2 mg and propofol 1 mg/kg. Propofol 20 mg was used when needed. HR,MAP,SpO_2,sedation scores and amnesia were recorded. Results All patients were awakened in 20 minutes after procedures. The recovery time was shorter in group PF than that in the other two groups. There were 21(67. 70%) patients in group PF, who were aware of surgery. Fifteen(48. 4%) patients were satisfied in group PF. Conclusion Propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope has better sedation without any obvious side effects.

Objective To investigate the protective effects of continuous norepinephrine infusion and its mechanism in early stage of lipopolysaccharide induced septic rats.Methods Forty SD rats were randomly divided into 5 groups (an external jugular vein catheterization was performed in every rat a day before intraperitoneal injection):saline control group (n =8),endotoxin group (n =8),low dose norepinephrine therepy group(n =8),middle dose norepinephrine therepy group (n =8),and high dose norepinephrine therepy group (n =8).Saline control group received intraperitoneal injection of 0.9％ saline 10 ml/kg,and then received an infusion of 0.9％ saline 1 ml/h.Endotoxin group animals were intraperitoneal injected with lipopolysaccharide 10 mg/kg,and then received an infusion of 0.9％ saline 1 ml/h.Therapy group animals received an infusion of norepinephrine solution 1 ml/h after being intraperitoneal injected LPS 10 mg/kg.The doses of norepinephrine were 0.06,0.3,0.6 μg/(kg· min) respectively.Blood samples were taken 2 h and 6 h later and the levels of serum TNF-α、IL-1β and IL-10 were detected by enzyme-linked immunoadsorbent assay.The membrane potential and three tricarboxylic acid cycle key enzyme activity [isocitrate dehydrogenase(IDH) and pyruvate dehydrogenase (PDH) activity] of isolated liver mitochondrion were detected 24 h later,and the morphologic changes of mitochondria in liver were observed by electronic microscopy.Results In endotoxin group,the levels of serum TNF-α JL-1 β and IL-10 all increased significantly(P ＜ 0.05) and liver mitochondrial membrane potential,PDH and IDH activity decreased significantly compared with control group(P ＜0.05,P ＜0.01).In the middle dose of norepinephrine therepy group,the levels of serum TNF-α and IL-1β all increased significantly (P ＜ 0.05,P ＜ 0.01),the level of serum IL-10 decreased significantly compared with endotoxin group (P ＜ 0.05) ; In the high dose norepinephrine therepy group,the liver mitochondrial membrane potential,PDH and IDH activity increased significantly compared with endotoxin group (P ＜ 0.05).The mitochondrial ultrastructural changes in every group were not obviously.Conclusion In the early stage of septic rats,reversible liver mitochondrion injury can be observed.Norepinephrine infusion can protect early septic rats through attenuating inflammatory reaction and enhancing tricarboxylic acid cycle key enzyme activity and mitochondrial membrane potential level.

Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy in childhood. Immune and genetic factors take part in the development of JIA and influence its consequence. Studies have identified association between JIA and genes encoding the human leukocyte antigens (HLA) . In this article we discuss the principles behind genetic studies of complex traits like JIA, and comprehensively catalog HLA candidate gene associated with JIA to date, and review several validated associations. Studies indicate that the HLA-Ⅰ, Ⅱ gene and their products play an important role in JIA pathogenesis, clinical course, hormonal effect and prognostic judgment. Studies in different ethnic groups indicate the main relationship between JIA and HLA is concentrated upon A, DR and DQ loci, especially the HLA-Ⅱ gene and some haplotypes. The different type of JIA is always with different HLA susceptible locus and protective locus. Different race, different region and different social environment also affect the JIA's susceptible gene polymorphism. Finally we discuss the problems existed in the study of JIA susceptibility and HLA polymorphism.

Objective To observe the clinical effect of Chi nese herbs Biejia Ruangan pill(BRP)on fibrosis in chronic hepatic B.Methods Ninety -eight patients with liver fibrosis of chronic hepatitis B were ra ndomly divided into two groups of BRP ,treatment group and co ntrol group,in which clinical manif estation scoring,liver function an d serum marker of hepatic fibrosis were obse rved.Results BRP could obviously improve the clin ical manifestation scoring,liver function and serum marker of hepatic fibrosis as compared with the contro l group.Conclusion Chinese herbs BRP could treat liver fibrosis of chronic hepatitis B effectively.

Objective To evaluate the application value of the hematology analysis combined with genetic diagnosis in the prena-tal diagnosis of thalassemia.Methods 2 368 parturients were performed the prenatal diagnosis of thalassemia in the prenatal diag-nosis center of our hospital from July 2010 to April 2013,and those with positive hematological screening detection were performed the genetic diagnosis.Results The hematology analysis results showed 124 parturients of abnormal HbA2.The hematology analy-sis results in the abnormal parturients had the statistical difference compared with those in the rest healthy parturients (P <0.01). Among 124 pregnant women of hematological positive phenotype,there were 16 couples with the same genotype,in these 16 preg-nant women,15 cases were performed the prenatal diagnosis of thalassemia,there were 7 cases of αthalassemia gene,2 cases of βgenotype,6 cases of normal genotype,3 cases of severe fetal thalassemia,including 2 cases of α-thalassemia(genotype--SEA/--SEA ),1 case ofβ-thalassemia(genotype 41-42/IVS-Ⅱ-654).All pregnant women terminated pregnancy after informing the patients.Conclu-sion The hematology analysis combined with genetic diagnosis plays an important role in the construction of perfect thalassemia prenatal detection and diagnosis intervention mode,and is worthy of popularization and application.

Objective To investigate the application value of fluorescence in situ hybridization (FISH)in prenatal diagnosis and compared with karyotype analysis of cells from amniotic fluid.Methods A total of 183 high-risk pregnant women received for a FISH and karyotype analysis who taken prenatal disgnosis in Meizhou people′s hospital between April 2012 and November 2013. Results According to the test results of karyotype analysis.There were 9 cases of chromosomal abnormality in 183 pregnant women.Among 9 cases,3 cases were trisomy 21,3 cases were trisomy 18,2 cases were XO and one case of XXY.One case of tri-somy 18 was showed normal using the FISH.Other cases were consistent with karyotype analysis result.Conclusion FISH is a rapid,reliable and prompt prenatal diagnosis method,combined with karyotype analysis will maximize the detection efficacy in pre-natal diagnosis of chromosome abnormalities.

This study is to investigate the effect of recombinant hFGF-10 adenovirus on the proteome of HaCat cells, and to speculate further the possible mechanism of the effect of hFGF-10 on HaCat cells via differentially expressed proteins identified. Two-dimensional gel electrophoresis (2-DE) combined with tandem time-of-flight mass spectrometry was applied to identify the differentially expressed protein spots on the 2-DE maps of the whole-cell proteins from Ad infected and rAd-hFGF-10 infected HaCat cells. The mRNA and protein levels of the differentially expressed proteins were confirmed with semi-quantitative RT-PCR and Western blotting. The results showed that the 2-DE maps with high resolution were obtained, and four selected differentially expressed proteins involved in cell apoptosis, cytoskeleton regulation and protein degradation were identified with MALDI-TOF/TOF. The mRNA and protein levels of one of the differentially expressed proteins, VDAC2, were up-regulated in HaCat cells infected with the recombinant hFGF-10 adenovirus. The differentially expressed protein, VDAC2, may be related to the bioactivities of hFGF-10.

This study is to investigate the effect of recombinant hFGF-10 adenovirus on the proteome of HaCat cells, and to speculate further the possible mechanism of the effect of hFGF-10 on HaCat cells via differentially expressed proteins identified. Two-dimensional gel electrophoresis (2-DE) combined with tandem time-of-flight mass spectrometry was applied to identify the differentially expressed protein spots on the 2-DE maps of the whole-cell proteins from Ad infected and rAd-hFGF-10 infected HaCat cells. The mRNA and protein levels of the differentially expressed proteins were confirmed with semi-quantitative RT-PCR and Western blotting. The results showed that the 2-DE maps with high resolution were obtained, and four selected differentially expressed proteins involved in cell apoptosis, cytoskeleton regulation and protein degradation were identified with MALDI-TOF/TOF. The mRNA and protein levels of one of the differentially expressed proteins, VDAC2, were up-regulated in HaCat cells infected with the recombinant hFGF-10 adenovirus. The differentially expressed protein, VDAC2, may be related to the bioactivities of hFGF-10.

Objective: To study the effects of the different doses of midazolam in fibreoptic gastroscopy on sedation, respiratory and circulatory function. Method: One hundred and four outpatients undergoing fibreoptic gastroscopy were randomly divided into four groups. The control group(N)was not given drugs, the other groups were intravenously given midazolam 0.07mg/kg(MS),0.05mg/kg(M),diazepam 10mg(D)respectively. The sedative scores, symptom, amnesia,HR,MAP and blood gases were observed. Result: The sedative scores of MS,M and D groups were much better than that of control group. There were significant differences in sedative scores,amnesia and sedative period between MS group and D group or M group. MAP decreased one minute after administering the drugs in MS,D and M groups significantly. The results of blood gases analysis of all groups were in normal ranges. Conclusion: Midazolam 0.07mg/kg can produce safe and effective sedation for fibreoptic gastroscopy.

Objective To investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention,evaluate intervention efficacy,and provide evidence for the rational clinical antimicro-bial application.Methods From August 2012,measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI)in 312 patients undergoing arthroscopic surgery be-tween September 2011 and August 2013 were retrospectively surveyed.Results A total of 312 patients were investi-gated,pre-and post-intervention were 150 and 162 cases respectively,SSI rates were both 0 before and after inter-vention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00% ,χ2=1.781,P<0.001). Irrational antimicrobial use dropped obviously;average expense of antimicrobial agents dropped from (1165.69±756.33)yuan (RMB)before intervention to (32.71 ±119.29)yuan (RMB)after intervention (t= 3.330,P<0.001).Conclusion Perioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention,rational use of antimicrobial agents has improved,SSI rate still remains zero.