Objective The purpose of this study was to determine and compare the effect of patient controlled analgesia(PCA) with tramadol and fentanyl on postoperative sleep pattern in patients with severe obstructive sleep apnea syndrome(OSAS) Methods Forty five ASA Ⅱ patients with severe OSAS undergoing uvula palate pharyngoplasty(UPPP) were randomly divided into 3 groups of 15 patients each according to the postoperative PCA the patients received: 1) tramadol group; 2) fentanyl group and 3) control group The patients were premedicated with intramuscular atropine 0 01mg?kg -1 .The patients were adequately sedated (Ramsay Ⅱ Ⅲ) with midazolam 0 03 mg?kg -1 and fentanyl 2?g?kg -1 Awake intubation was performed under topical anesthesia Anesthesia was then induced with propofol 1 5 2 0 mg?kg -1 and maintained with inhalation of 1 0% 1 5% isoflurane and 60% N 2O and intermittent intravenous boluses of vecuronium PCA was started when the patients were awake Tramadol 500mg (tramadol group) and fentanyl 500?g (fentanyl group) were diluted to 100ml(tramadol 5mg?ml -1 , fentanyl 5?g?ml -1 ) A loading does of 10ml was given followed by continuous intravenous infusion at a rate of 3ml?h -1 PCA bolus does was 1 5ml and lock out time 10 min Polysomnography(PSG) was continuously monitored and recorded the first night after operation from 10 pm to 6 am next morning According to Rechtschaffen standard sleep was divided into 6 stages: stage Ⅰ, stage Ⅱ, slow wave sleep(SWS)(stageⅢ+Ⅳ), stageV (rapid eye movement REM) and stage Ⅳ(awake) Results During the 480 min of PSP monitoring, SWS was (13 06?7 56) min in tramadol group, (9 2?7 26) min in fentanyl group and (6 33?4 68)min in control group and the total sleep time (TST) was (197 4?84 48) min in tramadol group, (148 33?72 73)min in fentanyl group and (124 13?61 38)min in control group SWS and TST were significantly longer in tramadol group than those in control group(P

Acute cartilage injury is one of the most common disorders in orthopaedic clinics.Articular cartilage is known to have a limited capacity to repair or regenerate itself. The disorder is difficult to be dealt with, usually affects the function of joint and may induce the onset of osteoarthrosis.This will result in great economic burdens on the patients and their family and greatly degrade the patient s quality of life. The recent progress in researches on seed cells, culture methods, biological material has provided a new method to repair the acute injury of articular cartilage and thus may solve many problems. The article introduces new advances in seed cells and their culture methods in cartilage tissue engineering.

Objective To explore the inhibition of fusing antimicrobial peptides humanβ-defensin 3 and carbohydrate binding do-main on Staphylococcus aureus N315 and Staphylococcus epidermidis 35984.Methods The direct bactericidal test and other molec-ular biology methods were adopted to detect the inhibition role on Staphylococcus aureus strain N315 and Staphylococcus epidermi-dis strain 35984 and the influence on the key genes expression.Results The direct bactericidal test demonstrated that antimicrobial peptides hBD3 and hBD3-CBD had significantly inhibitory effects on staphylococcus aureus N315 and staphylococcus epidermidis 35984;the inhibitory effects of hBD3-CBD was stronger than that of hBD3;the stability of the inhibitory effects of hBD3-CBD also stronger than that of hBD3.In the key gene expression test,there were significant inhibitions on the agr and mecA gene expressions in Staphylococcus aureus N315 and Staphylococcus epidermidis 35984 by hBD3-CBD.At the same time,hBD3-CBD could inhibit the icaA gene expression and promote icaR gene expression in Staphylococcus epidermidis 35984,which indicated that hBD3-CBD could inhibit the biofilm formation of Staphylococcus epidermidis.Conclusion The fusion strategy of antimicrobial peptide has very important significance for improving the antibacterial efficacy of antimicrobial peptides and brings more hope in their future applications.

Objective To produce bioactive human bone morphogenetic protein-4 by Escherichia coli genetic engineering and investigate the effect of the product, recombinant BMP-4, on the bone marrow stem cells. Methods cDNA of human morphogenetic protein-4 mature peptide was obtained by RT PCR from tissue of human placenta. The gene was constructed in the pET-22b(+) expression vector and expressed in Escherichia coli BL-21 after transformation and induction by IPTG. The harvested protein was proved to be bioactive by inducing ectopic bone information in mouse thigh. The protein was applied to induce the cultured bone marrow stem cell. Shape change of the cell, ability of ALP (alkaline phosphatase) and concentration of OC (osteocalcin) were investigated. Results SDS-PAGE revealed a new protein band that located in position of 14?103 after 4 hours induction, the new protein made 15% of total bacteria protein, the rhBMP-4 could induce the cultured bone marrow stem cell of New Zealand rabbit to differentiate into osteoblasts and form calcified node. The ability of ALP and concentration of OC of tested group increased significantly than that of the control group. Conclusion The bioactive rhBMP-4 can be produced by Escherichia coli genic engineering, this protein can induce bone marrow stem cells to differentiate into osteoblast cells.

HIS constitutes part of the technical support and infrastructure indispensable for the running of a modemized hospital. At present, more than 50% of hospitals at or above prefecture and city levels in China have set up HIS. However, because of the lack of reliability of facilities and man-made factors, HIS is apt to break down, which greatly hinders the normai activities of the hospital. The authors argue that wriat affects outpatient service the most in case of a network failure is the charging subsystem for outpatient service and thus offer an emergency charging plan for outpatient service as well as a method for putting it into effect. The workstation in charge of charging regularly downloads relative data on charging for outpatient service from the netvvork, and in case of a netvvork failure, the stan-dalone computer takes over, and when the network retums to normal, the computer then uploads the data it collected during the failure period to the database server, thus ensuring the integrity of the data.

Since the emergence in 1980s,community-associated methicillin-resistant Staphylococcus Aurues (CA-MRSA) has caught great attention of the researchers and clinical practitioners all over the world. In recent scientific papers,people found that CA-MRSA's capability to adapt itself to the hostile environment and to colonize is a kind of important virulence factor. A newly unveiled gene,designated arginine catabolic mobile element (ACME),in USA300 stains contributes much to this sort of ability. The arginine deiminase encoded by ACME plays an important role in colonization.

OBJECTIVE To find the safer anesthesia induction methods in children with laryngeal papilloma combined by dyspnea.METHODS 50 laryngeal papilloma children with II degree laryngeal obstruction were randomly divided into 2 groups:inhalational group and intravenous group,no muscle relaxant was used in either of the groups.MAP,and SpO2 were observed at one minute before and after induction.The intubation condition was also assessed and compared between the 2 groups.RESULTS MAP and HR in intravenous group were significantly higher than those of inhaled group after intubation [(68.7?6.4)mmHg vs.(64.0?8.0)mmHg;(142.6? 13.8)bpm vs.(124.6?12.5)bpm;P0.05].For the intubation condition,the satisfactory rate in inhaled group was higher than that of intravenous group,P

Objective To explore the clinical effects of pyloroplasty on proximal gastrectomy in patients with lesions in cardia of the bottom of stomach.Methods One hundred cases of the proximal gastric diseases who were enrolled in the second affiliated hos-pital of Chongqing medical university from the January 2010 to December 2013 were selected in this prospective randomized con-trolled experimental study.Among them,6 cases were excluded,and the other 94 cases were divided into two groups:the experimen-tal group (A),in which 54 patients were underwent additional pyloroplasty surgery;the control group (B),in which 40 patients were underwent with no strings attached pyloroplasty.All patients were followed up.Then,the clinical indicators during hospitaliza-tion,term complications and repeated endoscopy prompted pyloric stenosis and reflux esophagitis situation three months after dis-charged from hospital were observed.Results There was no significant difference in the incidence rate of gastroplegia (P >0.05);there were significant differences in other clinical indicators during the postoperative hospitalization and the incidence rate of compli-cations (P <0.05).Conclusion Proximal gastrectomy additional pyloroplasty could reduce gastric retention,decrease the incidence of reflux esophagitis,shorten the hospital period and could be helpful for recovery,thus it is recommended to be further promoted.

BACKGROUND:Carrier material provides an essential part of microenvironment for seed cell culture. There are some investigations analyzing the long-term in vitro culture of cartilaginous cell in calcium alginate gel matrix.OBJECTIVE: This study was designed to investigate the activity, morphology and microstructure of cultured in vitro bone marrow stromal cells (BMSCs) immobilized in calcium alginate beads.DESIGN: Single sample studySETTING: It was conducted at the Orthopaedic Institute of Zhengzhou University and Orthopaedic Laboratory of Shanghai Second Medical University.MATERIALS: The experiment was conducted at the Orthopaedic Laboratory of Shanghai Second Medical University from September 2001 to March 2002. Eight New Zealand white rabbits, with an age ranging from 4 to 6weeks, were used for collecting BMSCs.METHODS: Eight rabbit were anaesthetized and 1.0-2.0 mL bone marrow was aspirated from the humerus of femur using a 16-gange biopsy needle pretreated with heparin for primary and passage culture of BMSCs.Sodium alginate solution was prepared. The sodium alginate-BMSCs composite formed calcium alginate beads, with a cell density of 1×109 L-1 and tology characteristics of BMSCs were examined using toluidine blue staintron microscope (TEM).scope, many aggregate cells with round shape, in all sizes, occasionally characteristics of BMSCs: Cells and matrix materials were well-mixed, with no materials stained. The cells were equably stained, in all sizes, with large nuclei and little plasma, and occasionally having two or more nuclei and cell division. These cells had an intact structure, well-defined border, and tures of BMSCs: The cells had normal structures, with no mitochondrion swelled and no degranulation in ribosomes. They had a continuous nuclear membrane, with babyhood morphology, round shapes,oval shapes or irregular shapes, and occasionally having two nuclei.CONCLUSION: BMSCs-calcium alginate beads exhibit advantages including a good hydrophilicity, easiness for nutritive matter to penetrate and proliferating actively. It is feasible to amplify BMSCs through in vitro cullage repair by tissue engineering (TE) method.

BACKGROUND: Seed cells and supporting materials are two key problems for cartilaginous tissue engineering. Enough functional cells in supporting materials is the foundation in the formation of bone and cartilaginous tissue in vivo.OBJECTIVE:To perform a morphological study on the tissue engineered bone and cartilage constructed with calcium alginate, in vitro cultured bone marrow stem cells(BMSCs) and growth factors.DESIGN:Morphological comparative study with the results observed for 12 weeksSETTING:Orthopaedic Institute of Zhengzhou University and Orthopedic Laboratory of the Second Affiliated Hospital of Shanghai Medical University.MATERIALS:This experiment was completed from September 2001 to June 2002 in the Orthopedic Laboratory of the Second Affiliated Hospital of Shanghai Medical University. Nine New Zealand male rabbits at the age of 3 months were selected, their mean body mass was 3.2 kg.METHODS: Rabbits received dorsal subcutaneous injection of five kinds of the following combinations at two points for each combination and in the Ⅰ+TGF-β. Totally ten points were marked. Three rabbits were put to death at the 4th, 8th, 12th weeks after injection respectively and dorsal subcutaneous hyperplasia tissues were collected for observation by using hematoxylin and eosin (HE), toluidine blue, Masson, tomato red-O staining techniques.MAIN OUTCOME MEASURES: Histological observation of dorsal subcutaneous hyperplasia tissues.RESULTS: At the fourth week, cartilaginous like tissues island could be observed in calcium alginate+ BMSCs + IGF-Ⅰ group, calcium alginate+BMSCs +TGF-β group and calcium alginate + BMSCs + IGF-Ⅰ +TGF-βgroup, with chondrocblasts surrounded by alkaline matrix; A great deal of cartilaginous-like tissue appeared at the eighth week with part of it transforming into bone, and cells secrete much matrix, part of the chondroblast clustered. At the 12th week, approximately all of the cartilaginous tissues turned into bone in calcium alginate+ BMSCs + IGF- Ⅰ +TGF-β group, and began to absorb.CONCLUSION: The compound composed of calcium alginate, BMSCs and growth factor might form bone and cartilaginous tissue. Calcium alginate is suitable for the growth of BMSCs and is believed to be an optimal bone and cartilaginous engineering carrier.