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 the effects of lipopolysaccharide(LPS) on the expression of hypoxia inducible factor-1?(HIF-1?) and its target gene glucose transpoter-1(GLUT-1)in human monocyte lines THP-1. Methods THP-1 cells were stimulated with 1 ?g/mL LPS for 0,2,4,6 or 8 h.The expression of HIF-1? protein of THP-1 cells was detected by Western blotting,and RT-PCR was employed to detect the expression of HIF-1? mRNA and GLUT-1 mRNA.THP-1 cells were exposed to different concentrations of LPS(0,0.01,0.1 and 1 ?g/mL) for 6 h,and the expression of HIF-1? protein of THP-1 cells was detected by Western blotting. Results The expression of HIF-1? protein of THP-1 cells began to increase 2 h after being treated with 1?g/mL LPS,significantly increased after exposure for 4 h(P

Objective To evaluate the clinical application of GlideScope~ video laryngoscope in anesthetic endotracheal intubation.Methods Two hundred patients who received surgery under general anesthesia with ASA I or II were involved in this study.One hundred patients were assigned to be intubated with GlideScope~(GS group) and the other 100 with size 3 Macintosh laryngoscope(ML group).The following data were recorded and analyzed: noninvasive blood pressure(NBP),heart rate(HR) at the different time points of intubation process,glottic exposure time,CormarkLehane grade,tracheal intubation time and total intubation attempts. Results The rise of NBP and HR in ML group were significantly higher than those in GS group(P

Objective To investigate the apoptosis response to mechanical stretch in human alveolar type Ⅱ epithelial cells A549.Methods First,A549 cells were given different stretch(0%,5%,15%,30%) at frequency of 0.5 Hz for 4 h.Then,A549 cells were stretched for different periods(0 h,2 h,4 h,8 h) at stretch 15%,0.5 Hz.Last,A549 cells were stretched for different frequency(0 Hz,0.2 Hz,0.5 Hz and 1 Hz) at stretch 15% for 4 h.The early apoptosis was detected by flow cytometry. Results A549 cells submitted to cyclic stretch caused the early apoptosis in a time-,stretch-and frequency-dependent manner.In details,at 0.5 Hz and 4 h stretch-dependence occurred,at 15% stretch and 0.5 Hz time-dependence occurred,and at 15% stretch and 4 h frequency-dependence occurred. Conclusion Mechanical stretch can induce the early apoptosis in human alveolar type Ⅱ epithelial cells A549,which may be one of the mechanisms of ventilator-induced lung injury.

Objective To observe the hemodynamic effects of open-loop target controlled infusion (OLTCI) and closed-loop target controlled infusion (CLTCI) of propofol and fentanyl for general anesthesia induction. Methods Twenty-four female patients with ASA grade I-II who were performed thyroidectomy were randomly allocated into two groups: OLTCI group and CLTCI group(n=12). In OLTCI group, anesthesia induction and maintenance were performed with propofol and fentanyl at the target concentrations of 3 ?g/mL and 3 ng/mL, respectively. In CLTCI group, double CLTCI were performed. Titrations of propofol and fentanyl were guided with bispectral index (BIS) and product of systolic pressure and heart rate (HR). Initiative concentrations of this closed-loop system were 3 ?g/mL and 3 ng/mL, step-up or step-down concentrations were 0.5 ?g/mL and 0.5 ng/mL, and the highest concentrations were 6 ?g/mL and 5 ng/mL, respectively. HR, mean arterial pressure (MAP), HR variability, BIS value and the dosages of propofol and fentanyl in various time of the two groups were recorded. Results One min after intubation and simulative incision stimulation, BIS value of both groups were increased, but the BIS value in CLTCI group was less increased than OLTCI group(P

Objective To investigate the effect of Huangqi four Decoction in treating gestational diabetes mellitus (GDM) and its effect on the levels of Mg2+,CRP,adiponectin and complications.Methods In our hospital from August 2015 to January 2017 were 130 cases of gestational diabetes patients as the research object,the patients were randomly divided into observation group and control group with 65 cases in each group,the control group was given conventional treatment,patients in the observation group in the conventional treatment based on the use of Astragalus four gentleman decoction,observe two groups of patients before and after fasting blood glucose (FPG),2h postprandial blood glucose (2 hPG),glycosylated hemoglobin (HbA1c),and Mg2+,CRP and serum adiponectin levels and occurrence of complications after treatment and the curative effect.Results After treatment,the observation group FPG[(5.30±0.3)mmol/L],2 hPG[(5.36±0.27)mmol/L],HbA1c[(5.58±1.29%)]levels were lower than those of control group[(5.68±0.38)mmol/L,(6.01±0.33)mmol/L,(6.86±1.35)%],the two groups was statistically significant (P<0.05).In the observation group,Mg2+ [(1.25±0.36)mmol/L] and adiponectin[(35.24±5.18)μg/L] levels were higher than those of the control group [(0.91±0.30)mmol/L and (30.76±4.85)μg/L],while CRP [(1.59±0.35)mg/L] was lower than control group[(2.21±0.46)mg/L],the difference was statistically significance(P<0.05);observation group of adverse reactions in patients with abdominal pain,abdominal distension,the incidence of hypoglycemia (9.23%) than in the control group (38.46%),the two groups was statistically significant (P<0.05);the patients in observation group after treatment The total effective rate (96.92%) was higher than that of the control group (n=87.69%),and the difference between the two groups was statistically significant (P<0.05).Conclusion Astragalus four Decoction in the treatment of gestational diabetes can effectively reduce blood glucose,improve Mg2+,CRP,adiponectin and other related indicators,reduce the incidence of complications,the effect is significant,worthy of clinical application.

Objective To identify the nursing interventions and activities for hemiplegic patients in various functions suffered from stroke,and guide clinical practice.Methods Review rehabilitation of evidence-based clinical practice and literature of hemiplegic patients,stroke patients in different functional states were continuously cared and recorded by a researcher.Nursing program was identified according to patients' functions and the sixth edition of Nursing Interventions Classification,8 experts were consulted by a questionnaire survey,which was based on the initial screened nursing interventions and activities,30 nurses and 41 experts were consulted then.Results The established nursing program included 20 interventions and 307 activities.80％-100％ nurses' opinions culminated in consensus on the selected interventions.The selected activities scored 4.00-5.00 in average,with the coefficient of variations ranging from 0.00 to 0.25.Conclusions The established nursing program is convenient to communication and could be a tool to guide the clinical nursing practice.

Objective To explore the feasibility of blood oxygen level-dependent (BOLD) MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group (n=7) and stage 2 kidney injury group (n=10). All of the enrolled subjects underwent BOLD examination and T2* relaxation rates (R2*) of renal cortex and medulla of split kidney, and the ratio between them (R2*med/cor) were measured separately. One-way analysis of variance (ANOVA) were performed on the control group and chronic hepatitis b patients group (kidney injury stage 1 and stage 2 group) to compare the difference of renal cortical and medullary R2*values and R2*med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2* values and R2*med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were(16.87 ± 0.74)/s,(17.88 ± 0.73)/s,(20.29 ± 2.87)/s, respectively;the medullar R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were (28.07±1.03)/s,(31.14±2.49)/s,(32.81±3.28)/s, respectively;R2*med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant (F values were 17.779, 19.170 and 3.439 , all P<0.05). Furthermore, the renal cortical and medullary R2* values of chronic hepatitis b patients were significantly higher than the control group, and the the renal cortical R2* value of the patients in stage 2 kidney injury group was also higher than the stage 1 kidney injury group. The area under curve (AUC) of ROC of the renal cortical and medullary R2*values and R2*med/cor to diagnose chronic HBV hepatitis-induced early kidney injury were 0.903, 0.949 and 0.526, respectively. Conclusion It's feasible and has great value to use renal BOLD MRI for the diagnosis of chronic hepatitis b-induced early kidney injury, and the renal cortex is more sensitive than the medulla to the kidney injury.

Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into group B (≤5 years),group C (6-10 years),group D (11-20years) and group E (＞ 20 years).Face-to-face surveys were conducted in all the subjects by trained physicians using Mini-Mental-State-Examination (MMSE) and Clock-Drawing-Test (CDT).The incidences of cognitive impairment were compared among the five groups and the relationship between duration of hypertension and cognitive function were analyzed by SPSS 18.0 software.Results (1) Compared with the normotensive group,the hypertensive group performed worse in the scores of MMSE,CDTs,the memory type cognitive function and the non-memory type cognitive function (MMSE:Z =-2.585,P =0.010;C DTs:Z =-3.689,P ＜ 0.001 ; memory type cognitive function:Z =-2.718,P =0.007 ; non-memory type cognitive function:Z =-1.994,P =0.046).(2) The incidences of cognitive impairment in the five groups were 3.6％ (8/224),6.6％ (26/393),16.6％ (72/433),19.7％ (55/279) and 33.5％(64/191),respectively.(3) Compared with the group A,the cognitive function was significantly worse in the group E (MMSE:Z =61.314,P ＜ 0.001 ; CDTs:Z =44.642,P ＜ 0.001 ; memory type cognitive function:Z =35.703,P ＜ 0.001 ; non-memory type cognitive function:Z =54.440,P ＜ 0.001).Conclusions Hypertension is a risk factor for the cognitive dysfunction.The incidence of cognitive dysfunction and the severity are positively associated with the duration of hypertension.In those with hypertension over 20 years,the cognitive dysfunction occurs much more obviously.

Objective To investigate the effect of diaphragm training on respiratory function and the activities of daily living after cerebral apoplexy.Methods Seventy-eight patients with post-stroke fatigue were randomly divided into a treatment group and a routine therapy group,each of 39.Both groups were given conventional rehabilitation treatment,while the treatment group was additionally provided with diaphragm muscle training.Before and after 4 weeks of treatment,both groups were evaluated using pulmonary function tests,a fatigue severity scale (FSS),Fugl-Meyer motor function assessment (FMA) and the modified Barthel index (MBI).Results Vital capacity,forced vital capacity,forced vital capacity during the first second,and especially the maximum ventilatory volume of the treatment group were all significantly improved after the treatment.There was also significant improvement in that group's average FSS score,but not in that of the control group.The average FMA and MBI scores for both groups had improved significantly after the intervention,with the average FMA score of the treatment group significantly higher than that of the control group.However,no significant differences in the average MBI score were observed after the treatment.Conclusion Diaphragm training can significantly improve motor function and the daily life of stroke survivors.The mechanism may be related to improved respiratory function and decreased severity of fatigue.