Objective To evaluated the acccuracy of the two quantitative electroencephalographic parameters-bispectral index (BIS) and 95% specrral edge frequency (95% SEF) for measuring the depth of sedation induced by propofol, midazolam and ketamine. Methods Forty-five ASA Ⅰ - Ⅱ patients aged 30-59 yr weighing 46-80 kg scheduled for elective general thoracic or abdominal surgery were randomized to receive an infusion of propofol at a rate of 8 mg?kg-1?h-1 (group P , n = 15) or midazolam at 0.5 mg?kg-1?h-1 (group M, n = 15) or ketamine at 4 mg?kg-1? h-1 (group K, n = 15) . The patients were unpremedicated. The depth of sedation was assessed using OAAS scale (5 = wide awake , 1 = no response to prodding or shaking ) at 3 min intervals. BIS and 95 % SEF were continuously monitored. The BIS and 95% SEF values at each OAAS score (5-1) were recorded. The relations between BIS, 95 % SEF and sedation scores were determined in each group. The ED50 values of BIS and 95% SEF50 for loss of consciousness and their 95% confidence internals were calculated. Prediction probability(Pk) values for BIS and 95% SEF were compared among the drugs. Results There were no significant differences among the 3 groups with respect to age, body weight, sex and duration of drug infusion. With increasing sedation there was a progressive decrease in BIS and 95 % SEF values in group P and M but no significant changes in BIS and 95 % SEF values were seen in group K. The BIS and 95 % SEF positively correlated with OAAS score in group P and M but not in group K. The BIS50 was 65.9 in group P and 70.7 in group M,but inestimable in group K.The 95% SEF50 was 20.4 in group P and inestimable in group M and K. The Pk values for BIS and 95 % SEF were higher in P group than in M group and were not significantly different from 0.5 indicating a very poor predictive performance . Conclusion The accuracy of BIS and 95 % SEF for assessing the depth of sedation is greater with propofol. BIS is more sensitive than 95% SEF for the same anesthesia.

Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.

Purpose To construct expression vector of Fas extracellular region gene(eFas) ,to express and purify recombination protein and to prepare polyclonal antibody, which have laid a foundation of studying its function. Methods The eFas gene encoding sequence was acquired through overlapping PCR, and pET-22b ( + )/eFas expression vector was constructed. Then this vector was transformed into E. coli Rosetta-gami. Re-combinant protein was expression being induced by IPTG,and was purified using Ni-NTA matrix of affinity chromatograph. The purity of recombination protein was identified by SDS-PAGE. Hereafter, the purified eFas recombinant protein was immunized to New Zealand white rabbit in order to prepare polyclonal antibody. The titer of polyclonal antibody was determined by ELISA. Results The encoding sequence and expression vector of eFas was obtained while the interest protein was mainly expressed in the inclusion body. The eFas fusion protein's expression quantity accounts for more than 30% proportion of total E. coli protein. The eFas protein we obtained was provided with the purity of at least 95 % . Conclusion The successful constrution, expression and purification of FasL fusion protein and preparation of polyclonal antibody will provide some material for further studies of Fas.

Objective To further research the biological functions of PES1,the ovarian SKOV3 cell line with inducible stable PES1 expression is established by using Tet-on system.Methods PES1 was cloned into pTRE-Tight vector via PCR and its expression was identified. After transfected the regulating plasmid pTet-on,SKOV3 cells were screened with G418 and re-transfected pTRE-Tight-PES1.The positive cell clones were screened out with hygromycin and were induced by doxycycline (Dox) to definite the best induction concentration.Growth velocity of SKOV3 cells stably expressing PES1 induced by Dox was detected with viola crystallina.Results The SKOV3 cells with inducible PES1 expression were screened out after the cells were transfected pTRE-Tight-PES1 constructed.Dox could dose-dependently induce the PES1 expression with the concentration under 2 mg/L,and 2 mg/L of Dox induced the highest PES1 expression.Growth velocity of SKOV3 cells transfected pTRE-Tight has no significant difference between the SKOV3 cells transfected nothing induced with Dox.However,the SKOV3 cells transfected pTRE-Tight-PES1 grew faster than the cells transfected pTRE-Tight or without transfection in the fourth day (P =0.001 ).Conclusion The inducible stable PES1 expression SKOV3 cells are successfully established and could be used to be an effective cell model to research the biological functions of PES1.The expression of PES1 could promote the growth of SKOV3 cells.

Objective To investigate the effect of Jinqi Jiangtang tablet on the activation of T helper type 17 (Th17) and the expressions of interleukin (IL)-17 and IL-23 in kidney of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (NC, n=15) and experimental group (n=30). Diabetes was induced by tail vein injection with streptozotocin (STZ, 45 mg/kg). The well-established 28 diabetic model rats were then randomly divided into diabetes group (DM, n=14) and Jinqi Jiangtang tablet administration group (Jinqi, n=14). The rats in Jinqi group were given Jinqi Jiangtang tablet solution by gavage at a single dose of 2.1 g·kg-1·d-1 for 18 weeks, while NC group and DM group were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The circulating Th17 frequencies were assessed using flow cytometry. Serum IL-17 and IL-23 levels were measured by enzyme-linked immunosorbent assay. The pathological changes in kidney were studied by electron microscope. The expressions of IL-17 and IL-23 in kidney were detected using immunohistochemistry. Results (1) Compared with the group NC, the circulating Th17 frequencies were significantly increased in group DM and group Jinqi. The circulating Th17 frequencies were significantly lower in group Jinqi than those in group DM. (2) Compared with the group NC, the serum IL-17 and IL-23 levels were significantly increased in group DM and group Jinqi. The serum IL-17 and IL-23 levels were significantly lower in group Jinqi than those in group DM. (3) In group DM, irregular thickening of glomerular basement membrane, fusion of epithelial cell foot processes and mesangial expansion were observed by electron microscope. The above-mentioned pathological changes were improved inthe group Jinqi. (4) Compared with the group NC, the expressions of IL-17 and IL-23 in the renal cortex were significantly increased in group DM and group Jinqi, and those were significantly lower in group Jinqi than those in group DM. Conclusion The activation of Th17 and the increased expressions of IL-17 and IL-23 in kidney play a potential role in diabetic nephropathy. Jinqi Jiangtang tablet can improve diabetic nephropathy through inhibiting the activating Th 17 and decreasing the expression of IL-17 and IL-23 in kidney.

Objective To investigate the application of delayed sternal closure (DSC) following neonatal cardiac surgery.Methods We retrospectively analyzed clinical data of 360 neonatal patients underwent cardiac surgery through median sternotomy in Guangdong General Hospital between June 2009 and June 2014.These neonates were divided into 2 groups:DSC group (190 cases) and non-DSC group(170 cases).Comparing the differences between 2 groups,we analysed the application of DSC following neonatal cardiac surgery and the effect of DSC on surgical site infection.Results The cardiopulmonary bypass time,cross clamp time and mechanical ventilation time were longer in DSC group than in non-DSC group.The mortality rate in the DSC group(20.53％) was markedly higher than that in the non-DSC group(5.29％).However,there was no statistical difference in the incidence of sternal wound infection between 2 groups.Conclusion As an effective treatment for neonates with severe cardiac surgery,DSC doesn' t increase the incidence of surgical site infection.

Objective:The purpose of this study is to evaluate the effects of a single-chain antibody against death receptor 5 (ZF1) on tumor growth and survival in murine H22 hepatocellular carcinoma tumor model.Methods:Killing effect of ZF1 on H22 cells was analyzed by MTT assay in vitro. The apoptosis rate of H22 cells induced by ZF1 was detected using Flow Cytometry assay. The transplanted model of H22 tumor was developed in mice. The mice were randomly divided into four groups, PBS group, ZF1 group, EPI group and combined treatment group of ZF1/EPI. Tumor growth and body weight changes were observed. After treatment over 13 days, the tumor tissue for HE staining and TUNNEL assay was performed to detect apoptosis.Results:The results showed that ZF1 could inhibit growth of H22 cells in a dose dependent manner. The growth inhibition rate was up to 84.5%. The results showed that ZF1 alone or in combination with ZF1/EPI, the tumor growth was significantly inhibited. HE staining and TUNNEL analysis showed that ZF1 could effectively induce apoptosis of tumor cells without toxic effects, especially in ZF1/EPI combined treatment group.Conclusion:It is showed that ZF1 induces a good inhibition on the proliferation of H22 cell, especially in combined treatment group of ZF1/EPI.

Objective To investigate the prevalence of anti-endothelial cell antibody fAECA) in the sera of patients with connective tissue diseases(CTD)complicated with pulmonary arterial hyperten-sion (PAH)and to detect the specific antigens of AECA which may be related to clinical manifestations.Methods AECA was detected with Western blotting in 39 CTD patients with PAH.22 CTD patients without PAH and 30 healthy donors.Results The prevalence of AECA was 82%in CTD patients with PAH.73%in CTD patients without PAH and 20%in healthy donors.Anti-22 000 AECA was only detected in CTD patients with PAH(15%).Anti-75 000 AECA was more frequently detected in CTD patients with PAH than in thosewithout PAH(51%vs 23%.P＜0.05).In CTD patients complicated with PAH.anti-75 000 AECA was morefrequently detected in those with Raynaud's phenomenon or with positive anti-RNP antibody.Conclusion AECA can be more frequently detected in CTD patients with or without PAH.Furthermore,anti-22 000 and anti-75 000 AECA may play a special role in CTD patients with PAH.

Objective To investigate the clinical characteristics of Takayasu's arteritis (TA) with pulmonary hypertension (PAH) in order to improve the diagnosis and treatment earlier. Methods Twelve out of 191 patients with TA registered in Peking Union Medical College Hospital from 1987 to 2007 were diagnosed as PAH, the clinical data of 12 patients were analyzed. Results Ten patients were females. The range of age were from 14 to 47 years old, the average age was (27±10) years old. Eleven patients had the clinical manifestations or/and signs of pulmonary artery involvement. Seven patients presented with short breath after exercise or hemoptysis as the first manifestation, four patients with fatigue, four patients with intermittent claudication or pain or numbness of extremities, three patients with dizziness. Seven patients belonged to type Ⅰ+Ⅳ, one patient to type Ⅱ+Ⅳ, three patients to type Ⅲ+Ⅳ, one patient to type Ⅴ. Elevated ESR/CRP was found in ten patients. All patients took the glucocorticoid and DMARDs, stent implantation in pulmonary artery was done in one patient, Bentall was operated in another patient.The symptoms of all patients improved except one patient died for low cardiac output after operation. Conclusion PAH is one of the severe complications in late stage of TA, and other arteries are usually involved too. Because it is difficult to observe PAH in TA patients in early stage, CTA or pulmonary angiography and UCG should be taken in early stage. The stent implantation or dilating the artery should be considered aa a treatment, but at on the same time, glucocorticoid and DMARDs should be taken to avoid the relapse.

The clinical data were collected from medical record of 749 patients admitted into Peking Union Medical College Hospital from January 2008 to March 2013.They were diagnosed with primary Sj(o)gren's syndrome (PSS) at discharge.Clinical manifestations,laboratory results and outcomes were compared between PSS patients with pulmonary hypertension (PSS-PH) and those without (PSS-non PH).PSS-PH group had higher proportions of Renault phenomenon (36.8％ vs.20.0％,P =0.05),pericardial effusion (55.3％ vs.0.0％,P＜0.01),leukocytopenia (42.1％ vs.30.0％,P =0.03),elevated IgG level [(28.8 ±11.2) vs.(21.5 ±10.0) g/L,P=0.01] and hypothyroidism(34.2％ vs.12.5％,P=0.05) with significant significance.The PSS patients had leukocytopenia low thyroid function,rising IgG and pericardial effusion with pulmonary hypertension.