Objective To compare the anesthetic efficacy of dexmedetomidine and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer.Methods Forty ASA Ⅱ male patients (aged 35-62 years and weighing 45-70 kg) scheduled for percutaneous microwave coagulation therapy were randomly divided into two groups (n =20 each):midazolam group (group Ⅰ) and dexmedetomidine group (group Ⅱ).A loading dose of midazolam 40 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by midazolam infusion at 40 μg·kg-1 · h-1 in group Ⅰ.And a loading dose of dexmedetomidine 1 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by dexmedetomidine at 0.5 μg· kg-1 · h-1 in group Ⅱ.At 5 minutes after administration of the loading dose of midazolam or dexmedetomidine,a loading dose of sufentanil 0.2 μg/kg was given,and then patient-controlled intravenous anesthesia (PCIA) with sufentanil (with the background infusion of 0.1 μg·kg-1 · h-1,bolus dose of 0.1 μg/kg and lockout interval of 3 minutes) was used.The operation was started 2 minutes after administration of the loading dose of sufentanil.The incidences of bradycardia,tachycardia,hypotension,hypertension and respiratory depression were recorded.The total attempts and effective pressing times of PCIA were also recorded.Results There was no significant difference in the incidences of bradycardia,tachycardia,hypotension,and hypertension between the two groups (P ＞ 0.05).The incidence of respiratory depression was significantly lower,and the total attempts and effective pressing times were smaller in group Ⅱ than in group Ⅰ (P ＜ 0.05).Conclusion The anesthetic efficacy of dexmedetomidine and sufentanil is better than that of midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.

Objective To evaluate the efficacy of thracheal extubation-insertion of the nasopharyngeal airway for preventing the response to extubation under anesthesia in patients with hypertension. Methods Eighty ASA Ⅱ or Ⅲ patients with hypertension, scheduled for laparoscopic cholecystectomy under general anesthesia were randomly allocated into 2 groups with 40 patients in each group: tracheal tube group (group Ⅰ ) and tracheal tube-nasopharyngeal airway group (group Ⅱ). Anesthesia was induced with midazolam 0.05 mg/kg, sufentanil 0.4 μg/kg, cisatracurium besylate 0.15 mg/kg and propofol 2 mg/kg. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol (target plasma concentration 3-4 μg/L) and sufentanil (target plasma concentration 0.2-0.4 μg/L). BIS was maintained at 40-50. Target plasma concentrations of propofol and sufentanil were adjusted to 1 μg/L and 0.1 ng/L respectively after operation and the infusion was stopped after recovery of breathing. In group Ⅱ, extubation was performed, and then the nasopharyngeal airway was inserted and oxygen was inhaled by mask, and the airway was removed after recovery of consciousness. In group Ⅰ , extubation was performed after recovery of cousciousness. The SP, DP, HR and SpO_2 were recorded immediately before anesthesia induction (T_0), immediately and 2 min after insertion of the nasopharyngeal airway (T_(1,2)), and immediately and 2 rain after removal of the tube or airway (T_(3,4)). The maximal value of SP (SP_(max)), DP (DP_(max)) and HR (HR_(max)) were also recorded during extubation. The differences in SP (△SP), DP (△DP) and HR (△HR) before and after extubation were calculated. The plasma concentrations of AD and NE were determined. The coughing and restlessness were observed. Results The SP, DP, HR and plasma concentrations of AD and NE were significantly higher at T_(3,4) in group Ⅰ and the SP, DP at T_(1,3,4) and HR at T_(2,3) were significantly lower in group Ⅱ than those at T_0 (P<0.05). The SP, DP, HR and plasma concentrations of AD and NE were significantly lower at T_(2-4) in group Ⅱ than in group Ⅰ (P<0.05). The SP_(max), DP_(max), HR_(max), △SP, ADP and △HR were significantly lower in group Ⅱ than in group Ⅰ (P<0.05). The incidence of coughing and restlessness was obviously lower in group Ⅱ than in group Ⅰ (P<0.05). Conclusion Thracheal extubation-insertion of the nasopharyngeal airway under anesthesia can effectively prevent the patients' response to extubation during emergence from anesthesia.

Objective To evaluate the preventive effect of different portal vein flush solutions in no heart beating donor harvest on biliary cast syndrome (BCS) after orthotopic liver transplantation (OLT), and the application of choledochoscopy in treating BCS. Methods The incidence of biliary complications in 137 consecutive recipients undergoing OLT in our liver transplant center from May. 2002 to Dec. 2003 was retrospectively analyzed. The incidence and risk factors of BCS were compared in 2 groups with different types of portal vein flush solution in no heart beating donor liver harvest: group 1 (n = 65). University of Wisconsin (UW) solution; and group 2 (n = 72), hypertonic citrate adenine ( HCA) solution combined with UW solution. Therapeutic experience and clinical value of choledochoscopy for BCS were summarized. Results Seventeen out of 137 cases (12.4 %) developed BCS in the first three months after operation. In the group 1, the incidence of BCS was 20. 0 % (13/ 65), while that in the group 2 5. 56 % (4/72) with the difference being significant (P

Objective To compare the efficacy of anesthesia with dexmedetomidinc and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer. Methods Forty ASA Ⅱ male patients, aged 35-62 yr, weighing 45-70 kg, scheduled for percutaneous microwave coagulation therapy,were randomly divided into 2 groups ( n = 20 each): midasolam group ( group Ⅰ ) and dexmedetomidine group ( group Ⅱ ). A loading dose of midazolam 40 μg/kg ( in normal saline 20 ml) was given intravenously over 10 min,followed by midasolam infusion at 40 μg·kg-1 ·h-1 in group Ⅰ . A loading dose of dexmedetomidine 1 μg/kg (in normal saline 20 ml ) was given intravenously over 10 min, followed by dexmedetomidine infusion at 0.5 loading dose of sufentanil 0.2 μg/kg was given, and then patient-controlled intravenous anesthesia with sufentsnil (background infusion 0.1 μg·kg-1 ·h-1 , bolus dose 0.1 μg/kg, lockout interval 3 min) was used. The operation was started 2 min after administration of the loading dose of sufentanil. Bradycardia, tachycardia, hypotension, hypertensinn and respiratory depression were recorded. The number of attempts and successfully delivered doses was also recorded. Results There was no significant difference in the incidence of bradycardia, tachycardia, hypotension and hypertension between the two groups ( P ＞ 0 .05). The incidence of respiratory depression was significantly lower, and the number of attempts and successfully delivered doses was smaller in group Ⅱ than in group Ⅰ ( P ＜ 0.05). Conclusion The efficacy of anesthesia with dexmedetomidine and sufentanil is better than that of anesthesia with midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.

ObjectiveTo compare the efficacy of laryngeal tube-suction airway (LTSA) and SLIPA laryngeal mask airway (SLIPA) in obese patients undergoing laparoscopic cholecystectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 40-60 yr,with body mass index ＞ 30 kg/m2,undergoing laparoscopic cholecystectomy,were randomly into 2 groups ( n =30 each):group LTSA ( group Ⅰ ) and group SLI PA ( group Ⅱ ).Anesthesia was induced with target-controlled infusion (TCI) of propofol with the target plasma concentration (Cp) of 3-5 μg/ml and remifentanil (target Cp =4-6 ng/ml ).Rocuronium 0.6 mg/kg was injected intravenously as soon as the patients lost consciousness.LTSA and PLMA were inserted when BIS value was 50-60.HR,mean arterial pressure (MAP),SpO2,peak airway pressure(Ppeak) and PETCO2 were monitored during operation.Fiberoptic bronchoscopy was performed and the placement was scored.The placement time,the rate of successful placement at first attempt,airway sealing pressure,the failure of airway management and side effects were recorded.ResultsThere was no significant difference in HR,MAP,the fiberoptic bronchoscopy scores,the airway sealing pressure,and the incidence of side effects between the two groups.The placement time was significantly shorter in group Ⅰ than in group Ⅱ (P ＜ 0.05).The rate of successful placement at first attempt was more than 90％ and no failure was found in airway management in both groups.The SpO2,Ppeak,and PET CO2 were within the normal range during operation in both groups.ConclusionBoth LTSA and SLIPA can be safely and effectively used in obese patients undergoing laparoscopic cholecystectomy,however,LTSA placement is more easier.

Objective To investigate and analyze the usage of expensive outpatient prescriptions in different hospitals in Longgang area,Shenzhen,and to discuss and provide reference for the rational usage of expensive pre-scriptions.Methods Two primary hospitals,two secondary hospitals and one tertiary hospital in the Longgang area, Shenzhen,were chosen as the research targets.The expensive outpatient prescriptions,defined as the amount of pre-scription was over 150,200 and 300 yuan for primary,secondary and tertiary hospital respectively,were randomly selected and evaluated using international standards for the rational use of drugs.Results The average prescription items for primary,secondary and tertiary hospitals were 2.96,2.61 and 2.61.The largest proportions of prescription costs were 150 to 200 yuan,200 to 250 yuan and 300 to 350 yuan,which were respectively accounted for 49.6%, 56.6% and 37.7%.The frequency of using proprietary Chinese medicine,was 60.08%,68.18% and 41.62%respectively,which was not reasonable.The clinical diagnosis for the prescriptions of primary and secondary hospitals was mainly composed of trauma,bronchitis and vaginitis.The usage of drugs was not reasonable about the use of anti-biotics and infusion.In addition,the clinical diagnosis for the prescription of tertiary hospital was mainly diabetes, hypertension and cerebral infarction,where the abuse of using large dose of adjuvant drug was observed.Conclusion The frequency of using proprietary Chinese medicine is higher at all levels of hospital.In order to reduce the propor-tion of expensive prescription,the medicine institution should establish a sound system for drug use management and strengthen supervision and verification for western medicine physicians using proprietary Chinese medicine in their prescription.Furthermore,we should intervene and restrict the abuse usage of the adjuvant medicine.

Objective To investigate the effect of drug dependence severity on the relationship between impulsivity and craving.Methods 36 abstiuent drug-dependent individuals were recruited in the study.The participants were divided into the heavy depeudence group (HDG) or the low dependence group (LDG) according to the scores of Addiction Severity Index (ASI).The Barratt Impulsiveness Scale (BIS-11) and classical Stroop task were used to measure the trait impulsivity and state impulsivity.Block designed cue-induced craving paradigm was presented to measure cue-elicited craving.Results For the HDG,a significant positive correlation was found between trait impulsivity (the mean value of BIS-11-CI scale was (39.03± 16.50)) or state impulsivity (the difference of reaction time between congruent and incongruent situation was (87.77±36.95)ms)and cue-elicited craving (0.83± 1.91)(r=0.487,0.500,P＜0.05).However,for the LDG subjects,the impulsivity was not found significantly correlated with the cue-elicited craving(r=-0.261,0.081,P＞0.05).Conclusion The addiction severity influences the relationship between impulsivity and craving,and impulsivity can only be used as a predictor of relapse in HDG.The findings suggest that the drug may influence the shared brain mechanism between impulsivity and craving.

Abstract: To investigate the distribution of avian influenza virus in environmental samples from live poultry markets (LPM) in China, samples were collected and tested by nucleic acid during 2009-2013 season. Each sample was tested by real-time RT PCR using flu A specific primers. If any real-time PCR was positive, the sample was inoculated into specific-pathogen-free (SPF) embryonated chicken eggs for viral isolation. The results indicated that the positive rate of nucleic acid in enviromental samples exhibited seasonality. The positive rate of nucleic acid was significantly higher in Winter and Spring. The positive rate of nucleic acid in LPM located in the south of China was higher than in northern China. Samples of Sewage for cleaning poultry and chopping board showed that higher positive rate of nucleic acid than other samples. The Subtype identification showed that H5 and H9 were main subtypes in the enviromental samples. Viral isolation indicated H5 subtypes was more than H9 subtypes between 2009 and 2013 while H9 subtypes increased in 2013. Our findings suggested the significance of public health based on LPM surveillance and provided the basis of prevention and early warning for avian flu infection human.
Animals ; China ; Feces ; virology ; Fresh Water ; virology ; Influenza A virus ; classification ; genetics ; isolation & purification ; Influenza in Birds ; virology ; Poultry ; Poultry Diseases ; virology ; Public Health ; Seasons ; Sewage ; virology

Objective To investigate the expression profile of cancer-related genes in human bone marrow-derived neural stem cells (Md-NSCs) to determine whether there are any characteristics that could help the evaluation of their tumorigenic potentials.Methods Md-NSCs were cultured in vitro and identified (experimental group);fresh human adult bone marrow cells were used as control group (sifting erythrocytes).The expression profiles of 440 cancer-related genes in cells from the two groups were analyzed by Oligo GEArray Human Cancer Microarray OHS-802;real-time quantitative PCR was performed to detect the expressions of oncogene MYC,matrix metalloproteinase 2 (MMP2),Notch congener 2 (Notch2),stanniocalcin 1 (STC1),integrin α3 (ITGA 3),signal transduction and transcriptional activation factor 5b (STA T5b),Ras congene gene family C (RhoC),and wingless-type MMTV integration site family member 1 (Wnt1).Results As compared with those in the control group,the Md-NSCs from experimental group had 66 tumor-related genes with high expressions (＞3 folds).MYC,MMP2,Notch2,STCI,ITGA3,STA T5b,RhoC and Wnt1 expressions in the Md-NSCs from experimental group were significantly higher than those in the control group (P＜0.05),whose results were accorded with genechip detection results,enjoying the folds of 4.35×100,2.84×100,2.87×100,3.41 ×102,2.22×102,6.99× 100,4.92 × 100 and 3.64 ×100,respectively.Conclusion A number of cancer-related genes are over-expressed in Md-NSCs,and the activations of some of these important oncogenes have been proved to promote human tumorigenesis.

OBJECTIVE:To establish a method for the determination of brucine concentration in plasma of rats,and to compare the pharmacokinetic differences between brucine and its nanostructure lipid carrier (NLC) in rats. METHODS:Sixteen male SD rats were randomly divided into brucine NLC solution group and brucine solution group(using normal saline as solvent, and containing brucine 1.28 mg/mL),with 8 rats in each group. They were given relevant solution 10 mg/kg via tail vein. Blood sample 0.5 mL was collected from fundus venous plexus capillary before medication and 15,20,30,40,45,60,90,120,150, 180,210,240,480 min after medication. HPLC method was adopted. The determination was performed on Dikma C18column with mobile phase consisted of methanol-water containing acetic acid and triethylamine(30∶70,V/V)at the flow rate of 1 mL/min. The detection wavelength was set at 265 nm,and column temperature was 30 ℃. Sample size was 10 μ L. Pharmacokinetic parameters of rats in 2 groups were calculated by using DAS 2.0 software,and the difference of them were compared by F test. RESULTS:The linear range of brucine plasma concentration were 1.03-66.00 μg/mL(R2＝0.999 6);the limit of quantitation was 1.03 μg/mL,and lowest detection limit was 0.515 μg/mL. RSDs of intra-day and inter-day were lower than 5%;method recoveries were 84.90%-100.88%, extraction recoveries were 80.60%-91.98%(all RSDs were lower than 10%). Average plasma concentration-time curve of single administration of brucine NLC solution and brucine solution were all in line with two-compartment model after medication via tail vein. The pharmacokinetic parameters included t1/2αwere(0.24±0.11)and(0.06± 0.03)h;t1/2 βwere (2.90 ± 0.22) and (0.57 ± 0.32)h;AUC0-twere (88.00 ± 6.98) and (28.50 ± 5.87)μg·h/mL;AUC0-∞were (109.96±7.99)and(45.06±6.66)μg·h/mL. Compared with brucine solution group,t1/2 α,t1/2 β,AUC0-tand AUC0- ∞of brucine NLC solution group were increased significantly;while CL, k10and k12were decreased significantly, with statistical significance (P＜0.05 or P＜0.01). There was no statistical significance in k21between 2 groups (P＞0.05). CONCLUSIONS: Established HPLC method is simple, specific,sensitive,precise and highly recoverable. It can be used for the determination of plasma concentration and phamacokinetic study of brucine in rats. After brucine NLC is prepared,the pharmacokinetic parameters of brucine change significantly;retention time of brucine is significantly prolonged and the clearance rate decreases significantly.