Objective To explore the safety and the efficacy of the two-stage sedation administration method for the elderly in gastroscopic examination. Methods 128 elderly patients were divided into two groups according to age and body mass index (BMI), and were given sedation treatment before gastroscopic examination by two-stage administration method(group TSAM, n= 64)and continual administration method (group CAM, n= 64) of analgesics respectively. The following major data were recorded : ( 1 ) mean artery pressure (MAP) ;( 2 ) Blood oxygen saturation ( SpO2 ) ;(3)sedation level;(4) recovery time;(5) the amount of propofol used for sedation;(6) electrocardiogram (ECG) ;(7)the degree of pharyngeal malaise;(8) the oblivion degree of malaise. Results There was no significant difference in MAP alteration between two methods(P>0. 05). Compared with group CAM, the decreased degree of SpO2 was slighter and no patient's SpO2 was lower than 90% in group TSAM (P<0. 05). Fifty-seven patients in group TSAM fell into sedative state for gastroscopy with OAA/S score 2, while sixty patients in group CAM with OAA/S score 2, which represented a deeper sedation level in group CAM (P<0. 01). The recovery time was shorter and the amount of propofol used was significantly less in group TSAM than in group CAM (P<0. 01). During the process of gastroscopic exmaination, ST-T change and arrhythmia in ECG were not seen in either of these two groups. The pharyngeal malaise of patients in group TSAM was more severe than in group CAM (P<0. 01). However, there was no difference in the oblivion degree of malaise between two methods(P>0.05). Conclusions The two-stage sedative administration method is safer and more effective for gastroscopic examination for the elderly.

Objective To explore the application of propofol combined with midazolam intrave-nous anesthesia in pediatric upper gastrointestinal endoscopy, Methods A total of 497 ASA Ⅰ～Ⅱ patients who received sedative upper gastrointestinal endoscopy were assigned to a children group (2～14 years) and an adults group (18～65 years). The 2 groups were treated with midazolam (0.02～0.03 mg/kg, iv) and propofol (0.6～0.7 mg/s, iv) with an interval of 3～5 minutes. Enterseopy was inserted at light sleep, relaxing muscles, and disappearance of eyelash relaxation. Combining of pro-endoscopy, reaction to intravenous administration, dose of propofol, reaction to en-doscopy, time of returning to consciousness, changes of SpO2, R, HR, and BP, and sedative quali-ty were evaluated. Results Good sedation of the 2 groups after intravenous administration was ob-served. Rate of combining of pro-endoscopy in children was lower (42%) than that in adults (100%). The incidence of restlessness, hyperphasia, temporary decreasing of SpO2, dose of propofol of per kilogram weight, time of returning to consciousness in the children were 82.7%, 17%, 2.4 mg/kg, and (17.5±3.2)min, respectively, which were all higher in the adults [9%,4%,1.4 mg/kg, and (9.5±1.3)min, P<0.01]. HR and BP decreased in the 2 groups, and recovered rapidly after the endoscopy. There was no significant difference between the 2 groups (P>0.05). Conclusion It is safe and effective to use propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy.

Objective: To evaluate the effect of NGX6 with 5-Fu on the apoptosis of colon cancer cells. Methods: The NGX6-transfected HT-29 cell line with 5-Fu was used in the test group. HT-29 cell line with 5-Fu and PDTC was used in the control group. The expression of NF-κB was detected by EMSA. The proliferation of HT-29 cell line was assayed by MTT. The effect of NGX6 on the apoptosis was detected by FCM. HT-29 cells were double-stained by PI/Annexin-V and AO/EB and observed by fluorescence microscopy. Results: The expression of NF-κB was inhibited in NGX6 transfected colon carcinoma cell group and in colon carcino-ma cell group treated with PDTC. Treatment with the chemopreventive compounds 5-Fu and PDTC resulted in different responses in the effects of anti-proliferation and induced apoptosis of colon carcinoma cells. There was no significant difference in apoptosis between NGX6-transfected HT-29 call line with 5-Fu and the cells in the control group. NGX6 gene enhanced the effect of 5-Fu on the proliferation and apoptosis of colon carcino-ma cells. Conclusion: NGX6 gene can induce apoptosis and inhibit the proliferation of colon carcinoma cells. NGX6 gene can enhance the effect of 5-Fu on the proliferation and apoptosis of colon carcinoma cells through NF-κB pathway.

Objective] To evaluate effect of health literacy intervention in occupational groups , explore suitable ways and provide suggestions for workplace health promotion . [ Methods ] In application of convenience sampling , Minhang District , Hongkou District and Qingpu District each selected 2 enterprises respectively according to their type , scale and location , setting one as intervention enterprise and the other as control .Then a six-month comprehensive intervention was conducted among intervention groups .Two hundred employees in each enterprise were randomly investigated before and after intervention to evaluate the effect . [ Results ] The overall health literacy level of participants in the intervention group rose from 16.7% to 33.4%, with improvement on the literacy levels of scientific view , infectious diseases prevention and treatment , chronic disease control and prevention and the three aspects of health literacy content ( P<0 .05 ) , while such improvement was not reflected in the control group , and health skill literacy, safety and first aid literacy declined (P <0.05). [Conclusion] Comprehensive intervention based on health needs could improve the level of health literacy of occupational groups . Intervention in future should focus on improving the literacy of chronic disease control and prevention and basic medical care in occupational population .

To examine the self-association of CD4 molecules and preliminary studies on its biological function by several indirect methods. A series of CD4 chimeras were generated including truncated CD4 lacking the short cytoplasmic tail, deleted mutantsD1/D2 devoid of D3 and D4 and D3/D4 devoid of D1 and D2 by PCR techniques, as well as another three CD4 chimeric genes by fused human Fas cytoplasmic death domain to the downstream of the above chimeras respectively. All these molecules were subcloned into pEGFP-N1, forming the corresponding expression vectors. After introducing into HEK293 cells, gene-modified cell morphological changes and target protein subcellular localization were observed and analyzed by a confocal microscopy. Moreover, stable 293/CD4 clones were obtained by transfecting the truncated CD4 recombinant plasmid into the HEK293 cell line and selected by G418. The fluorescene intensity and rosette formation of different clones was each analyzed by a confocal microscopy and cell adhesive assays. It's seen that CD4-Fas fusion gene could induce approximately 80% cell apoptosis of transfected HEK293 cells, compared to FKBP12-Fas is about 30% and CD4 gene only is 7%. Furthermore, both D1/D2-Fas and D3/D4 Fas chimeras could trigger nearly all transfected HEK293 cells to death. Cell adhesion assays showed that neither the D1/D2 nor D3/D4 chimeras when expression in HEK293 cells binds to MHC class II + Raji B cells. Interestedly, there were two type stable clones among 293/CD4. Fluorescence intensity analysis displayed that one' mean fluorescence intensity value is about twice of the other while cell-cell binding examination showed that the former is capable of forming rosette with Raji cells but the latter. All these results suggest that CD4 molecules most likely could exist as a dimer or even an oligomer on transfected HEK293 cell surface, which constitute a functional form for stable binding to MHC class II molecules.
Antigen-Presenting Cells ; immunology ; metabolism ; CD4 Antigens ; chemistry ; genetics ; metabolism ; CD4-Positive T-Lymphocytes ; immunology ; metabolism ; Cell Line ; Dimerization ; Fas Ligand Protein ; metabolism ; Histocompatibility Antigens Class II ; genetics ; immunology ; metabolism ; Humans ; Mutagenesis, Site-Directed ; Protein Binding ; genetics ; Protein Multimerization

OBJECTIVE: To investigate the efficacy and security of different administrations of propofol on the sedation in upper gastrointestinal endoscopic procedures in snoring patients. METHODS: A total of 1,117 patients with snoring in ASA I-II level, who underwent gastroscopy and received propofol as sedation, were assigned to Group A, Group B, and Group C.These groups had different administration methods of propofol. The dose of propofol, response to endoscopic procedures, changes of oxygen saturation of arterial blood (SPO₂), incidence of severe respiratory depression and sedation quality assessed by operators were observed. RESULTS: The incidence of transient decline in SPO₂ in Group A, B, and C were 50.4%, 3.1%, and 18.5%, respectively. The doses of propofol of Group A, B, and C were (108.50±18.02) mg, (57.50±7.50) mg, and (79.80±10.02) mg, respectively, with significant difference (P<0.05). The incidence of severe respiratory depression in Group A was 1.2%, but Group B and C were 0%. Compared with Group A(100%) and C(100%), the satisfaction rate of sedation quality in Group B was 74%, with significant difference (P<0.05). CONCLUSION During the upper gastrointestinal endoscopic procedures, snoring patients are premedicated with propofol in various uses by steps or one slow administration. Both methods are safe and effective to reduce the incidence of severe respiratory depression, and patients have no memory of the procedure.
Adult ; Endoscopy, Gastrointestinal ; methods ; Female ; Gastrointestinal Diseases ; complications ; diagnosis ; Humans ; Hypnotics and Sedatives ; administration & dosage ; adverse effects ; Male ; Middle Aged ; Propofol ; administration & dosage ; adverse effects ; Snoring ; complications

OBJECTIVE: To determine the efficiency and safety of capsule endoscopy for patients with intestinal diseases. METHODS: Given M2A capsule endoscopy (CE) was performed on 81 patients with obscure gastrointestinal bleeding and obscure abdominal pain, and the clinical data were analyzed. RESULTS: In the 81 patients, 9 showed negative finding, CE didn't reach the small intestine in 1 patient. In the other 71 patients, 132 intestinal lesions were detected, and the total positive rate of CE for intestinal diseases was 88.75%. The findings consisted of 36 intestinal inflammation, 24 angiopathy, 16 protuberant lesions, 15 mutipolypi in the intestine, 12 blood in the intestine, 11 single or multiple ulcers, 6 ascarid in the intestine, 5 diverticula, 1 ankylostomiasis, 1 intestinal dysplasia with internal fistula, and the 5 intestinal Crohn's disease. Ten patients with protuberant lesion were verified by surgical operation and pathology, and the 5 stromal tumors diagnosed by CE were confirmed by pathological examination, while no one of Crohn's disease, lymphoma and angioma was diagnosed correctly by CE. All images of CE were good. All the patients had no complications. CONCLUSION Capsule endoscopy is a safe and effective procedure, with a high positive rate, but the diagnostic yield is limited, which can be used for intestinal diseases.
Abdominal Pain ; diagnosis ; Adult ; Aged ; Aged, 80 and over ; Capsule Endoscopy ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Humans ; Inflammatory Bowel Diseases ; diagnosis ; Intestinal Diseases ; diagnosis ; Intestine, Small ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

OBJECTIVE: To establish a liver metastasis model of nude mice in colon cancer so as to determine the function of NGX6. METHODS: The cells of Group HT-29, pcDNA3.1(+)/HT-29, and pcDNA3.1(+)/NGX6/HT-29 were implanted into the spleen of nude mice, respectively. Everyday we measured the weight of the nude mice and observed their ingestion, movement and mental status. The nude mice were killed after 45 days, and the effect of NGX6 on the malignant behavior of HT-29 was assessed by this experiment. RESULTS: In contrast to the other two groups, the metastasis in the liver and xenograft tumor in the spleen of pcDNA3.1(+)/NGX6/HT-29 group was significantly reduced (P<0.01). CONCLUSION The metastasis of HT-29 colon cancer cell line was significantly inhibited by NGX6 gene. This model of liver metastasis in the nude mice is a proper model to determine the anti-metastasis mechanism of NGX6 gene.
Animals ; Colonic Neoplasms ; genetics ; pathology ; Disease Models, Animal ; Gene Expression Regulation, Neoplastic ; HT29 Cells ; Humans ; Liver Neoplasms ; pathology ; secondary ; Male ; Membrane Proteins ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Metastasis ; Neoplasm Transplantation ; Splenic Neoplasms ; pathology ; Transfection ; Tumor Suppressor Proteins ; genetics

OBJECTIVE: To investigate the efficacy and security of different uses of propofol on the sedation during the upper gastrointestinal endoscopic procedures. METHODS: Four hundred patients who underwent gastroscopy received midazolam and propofol as sedation. Patients were divided to 4 groups with different intervals between midazolam and propofol: Group A and D with the interval of 30 seconds to 1 minute, Group B and C with 3 to 5 minute interval. All patients were premedicated with midazolam and propofol at 16 approximately 25 mg/10s (Group A and B) and 6 approximately 7 mg/10s (Group C and D). RESULTS: The doses of propofol of Group A,B,C, and D were (111.90+/-22.43),(102.20+/-15.99),(73.05+/-13.08) and (80.90+/-17.36)mg respectively, with significant difference(P<0.01). The time of return to consciousness decreased markedly in Group C and D [(9+/-1), (10+/-2)min ], and that of Group A and B was [(14+/-5), (13+/-3)min ]. There was significant difference between Group C, D and Group A, B(P<0.01). CONCLUSION The dose of propofol and the time of return to consciousness depend on the rate of administration and the interval between midazolam and propofol. Appropriate rate and interval can produce safer and more effective sedation for the upper gastrointestinal endoscopic procedure.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Dose-Response Relationship, Drug ; Endoscopy, Digestive System ; methods ; Female ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Infusions, Intravenous ; Male ; Midazolam ; administration & dosage ; Propofol ; administration & dosage ; Time Factors

OBJECTIVE: To explore the safety and the efficacy of two-stage administration sedation method (with propofol plus midazolam) in the analgesia gastroscopy for hypoxia predisposed patients. METHODS: Sixty-four hypoxia predisposed patients (with snore or expectoration) were divided into two groups and received sedation respectively with two-stage administration method and routine continuum administration method before gastroscopy. We analyzed the alteration of SBP, DBP, SpO2, sedation level, the degree of pharyngeal malaise, recovery time, dose of propofol,the lethe degree of upset, and procedure of gastroscopy to evaluate the safety and the efficacy of the two methods in the analgesia gastroscopy for hypoxia predisposed patients. RESULTS: Compared with routine continuum administration sedation method, two-stage administration sedation method had little influence on SpO2, so it reduced the accident of respiratory arrest (P < 0.01). The gastroscopy could be achieved at the lower sedation level with two stage administration method (P <0.01), so that the recovery time was shortened (P < 0.01). The degree of pharyngeal malaise in the patients with two-stage administration sedation method was higher than that of patients with routine continuum administrationsedation method (P < 0.01), and the dose of propofol used for sedation decreased (P < 0.01). While the lethe degree of gastroscopy upset and alteration of SBP, DBP were rated similarly in both groups (P > 0.05), and the lethe degree of gastroscopy procedure in two-stage administration method group was significantly lower than that of routine continuum adminis- tration method group (P <0.01). CONCLUSION The two-stage administration sedation method is a new effective and safe sedation method for gastroscopy in the hypoxia predisposed patients.
Adult ; Analgesia ; Female ; Gastroscopy ; methods ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage