Objective To determine the 95 ％ effective target plasma concentration (EC95) of remifentanil for tracheal tube tolerance during the recovery period from anesthesia following cervical spine surgery.Methods Thirty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,weighing 50-80 kg,scheduled for elective cervical spine surgery under total intravenous anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of propofol,sufentanil and rocuronium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol and target-controlled infusion of remifentanil.The target plasma concentration (Cp) of remifentanil was set at 4-6 μg/L.BIS value was maintained at 40-60.Infusion of propofol was stopped at the end of surgery.Participants were allocated to a dose of remifentanil by 3-patient cohorts.Six Cps were selected from 1.0-3.5 μg/L before beginning and they were 1.0,1.5,2.0,2.5,3.0,3.5 μg/L.The Cp of remifentanil was 3.0 μg/L in the first cohort.After completion of the trial in each cohort,the posterior probability of each concentration was calculated according to the condition of sedation/analgesia and anterior probability of each concentration.The concentration with the posterior probability closest to 95 ％ was chosen as Cp in the next cohort.The concentration-probability curve was made according to the posterior probability of each concentration,and then EC95 and 95 ％ confidence interval of remifentanil were calculated.Results The EC95 and 95 ％ confidence interval of remifentanil were 2.77μg/L (2.65-2.83 μg/L) for tracheal tube tolerance during the recovery period from anesthesia following cervical spine surgery.Conclusion The EC95 of remifentanil for tracheal tube tolerance during the recovery period from anesthesia is 2.77 μg/L in patients undergoing cervical spine surgery.

OBJECTIVE:To provide reference for the implementation of Quality Management Guidance of TCM Trust-agent Decocting in Medical Institutions in Shanghai. METHODS:Stratified random sampling method was adopted for the questionnaire of TCM trust-agent decocting in 13 medical and health institutions in the suburb of Shanghai. RESULTS:A total of 13 question-naires were sent out and 13 valid questionnaires were received with the effective rate of 100%. In the 13 medical and health institu-tions,12 medical and health institutions partially or fully adopted trust-agent decocting,and the trust-agent decocting in the 12 med-ical and health institutions accounted for 92.3% in all trust-agent decocting;the 12 medical and health institutions with TCM trust-agent decocting service for patients included 9 pharmaceutical factories and 3 pharmacies;label related problems (including name error,oral and topical label error and stickers unclear) and leakage were the main quality problems,accounting for 33.0%and 31.0%,respectively;83.3% of the medical and health institutions didn’t establish the file of the quality control for TCM trust-agent decocting;decocting process was the most important factor that affects the quality. CONCLUSIONS:Implementing a re-gional Quality Management Guidance of TCM Trust-agent Decocting in Medical Institutions in Shanghai and establishing a system that drug administration,industry associations and medical and health institutions are participated in have great significance to pro-mote the healthy development of TCM trust-agent decocting service and ensure patients’medication safety.

Objective To investigate the serum levels of β-amyloid precursor protein (β-APP) and hypersensitive-cross-reactive protein(hs-CRP) after acute spinal cord injury(SCI) in rats at different time points and study their roles in secondary spinal cord injury. Methods Ninety healthy adult female SD rats were randomly assigned into 3 even groups.Improved Allen method was used to create models of complete SCI (group A) and models of incomplete SCI (group B).In group C only laminectomy was performed without SCI.The serum was collected at 12 hours,24 hours,3 days,7 days,and 14 days after operation through femoral vein to detect levels of β-APP and hs-CRP by ELISA. ResultsThe serum level of β-APP reached the peak value 24 hours after acute SCI,and the serum level of hs-CRP reached the peak 3 days after acute SCI.There were significant differences between groups A and C in β-APP and hs-CRP levels at all time points( P ＜ 0.05).There were also significant differences between groups B and C in β-APP and hs-CRP levels at all time points (P ＜0.05) except at 14 days (P＞ 0.05). Conclusions The serum levels of β-APP and hs-CRP are positively associated with the severity of traumatic SCI.β-APP may be a more sensitive indicator than hs-CRP in a certain time.The dynamic changes of serum β-APP and hs-CRP suggest involvement of the 2 proteins in the secondary spinal cord injury.

ObjectiveTo find specific biomarkers related to HAART treatment in plasma samples of AIDS patients for clinical therapeautic efficacy evaluation and guidance for the prognosis of HIV treatment.MethodPlasma samples of AIDS patients were collected from Infectious Disease Department 1 of Shanghai Public Health Clinical Center in June of 2008 to February of 2009,including 11 successfully HAART treated cases (HIV load ＞ 50 copies/ml) and 11 unsuccessfully HAART treated cases (HIV load ＜50 copies/ml).Patients' age ranged from 22 to 63.Plasma samples were treated by Bio-rad AurumTM Serum Protein Mini Kit to remove high abundant proteins:albumin and immunoglobulin were removed.The treatedplasmaproteinswereseparatedbytwo-dimensionalelectrophoresisandanalyzedby electrophoretogram using Imagemaster software to find differentially-expressed proteins related to therapeutic efficacy.After digestion by trypsin,the differentially-expressed proteins were identified by online reversed-phasenano-flow liquid chromatography coupled with electrospray ionization ion trap mass spectrometry.ResultsLow abundant proteins were efficiently enriched after the AurumTM Serum Protein Mini Kit treatment.Six differentially-expressed proteins were detected while comparing successfully and unsuccessfully HAART treated group.These proteins were accurately identified by tandem Mass spectrometry (MS), including serum transferrin, serum β-fibrinogen, etc.ConclusionsOur proteomic research revealed that the differentially-expressed proteins such as transferrin,which is related to plasma virus loading in AIDS patients in the process of treatment,might be potential biomarkers evaluating HAART therapeutic efficacy.

OBJECTIVE:To systematically evaluate the therapeutic efficacy and safety of TCM external treatment for alopecia areata,and to investigate the regularity of prescription selection and medicine use. METHODS:Retrieved from PubMed,EMBase, Cochrane Library,CBM and CNKI,RCTs about TCM external treatment(trial group)vs. routine regimen(control group)in the treatment of alopecia areata were included. The qualities of included studies were evaluated with modified Jadad scale after literature screening and data extraction. Meta-analysis was conducted by using Rev Man 5.3 statistical software. Frequency statistics and ingredient analysis were conduced among included prescriptions. RESULTS:A total of 21 RCTs were included,involving 2 510 patients. Meta-analysis showed that total response rate of trial group was significantly higher than that of control group,with statistical significance [OR=4.14,95%CI(3.04,5.65),P<0.001]. There was no statistical difference in the incidence of ADR between 2 groups [OR=1.66,95%CI(3.04,5.65),P=0.48]. A total of 20 prescriptions among included 21 RCTs were included after the repeated prescriptions were deleted. Above prescriptions were analyzed statistically;there were 53 ingredients in 20 prescriptions,and the sum of use frequency for those ingredients was 138.The ingredients with high use frequency were Carthamus tinctorius,Platycladus orientalis,Salvia miltiorrhiza;main types of medicines were restoring vital energy,relieving exterior disorder,invigorating blood circulation and eliminating stasis,etc. CONCLUSIONS:TCM external treatment shows good therapeutic efficacy and safety. Medicines are mainly used for restoring vital energy,invigorating blood circulation and eliminating stasis.

Objective To explore the clinical features and radiological findings of patients with Sturge-Weber syndrome (SWS).Methods A retrospective study was performed on the course of illness,clinical data and neuroimages of 8 patients with SWS,admitted to our hospital from June 2012 to November 2015.Results The main symptoms included facial hemangioma in 7 patients,epilepsy in 5 patients,headache in 4 patients,limb hemiplegia in 3 patients,glaucoma in 3 patients,and thyroid dysfunction in one patient.Neurological imaging showed subcortical calcification,brain atrophy,gyriform enhancement and increased pial vascular tortuosity.Fundus examination revealed optic atrophy and vascular malformations of choroid.All symptoms in the patients were alleviated after treatment.Conclusions SWS should be highly suspected in young patients who present with typical glaucoma,epilepsy or hemiplegia with/without facial hemangioma.CT angiography or MR imaging (especially susceptibility-weighted imaging) is required to confirm the diagnosis.If medications fail to control seizures,surgery could be considered in some patients.

In order to develop clinical diagnostic tools for rapid detection of the SARS-CoV (severe acute respiratory syndrome-associated coronavirus) and to identify candidate proteins for vaccine development, the C-terminal portion of the nucleocapsid (NC) gene was amplified using RT-PCR from the SARS-CoV genome, cloned into a yeast expression vector (pEGH), and expressed as a glutathione S-transferase (GST) and Hisx6 double-tagged fusion protein under the control of an inducible promoter. Western analysis on the purified protein confirmed the expression and purification of the NC fusion proteins from yeast. To determine its antigenicity, the fusion protein was challenged with serum samples from SARS patients and normal controls. The NC fusion protein demonstrated high antigenicity with high specificity, and therefore, it should have great potential in designing clinical diagnostic tools and provide useful information for vaccine development.
Antigens, Viral ; immunology ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Genome, Viral ; Humans ; Nucleocapsid Proteins ; genetics ; immunology ; Recombinant Fusion Proteins ; genetics ; isolation & purification ; metabolism ; SARS Virus ; genetics ; immunology ; Yeasts ; genetics

OBJECTIVETo evaluate the clinical performance of glass fiber reinforced resin-bonded fixed partial denture(GFR-RBFPD) as a periodontal splint on abutment teeth with reduced periodontal support.

METHODSThirty fixed-fixed GFR-RBFPD were delivered to restore anterior partial edentulous dentitions. The adjacent abutment teeth had severely reduced periodontal support and were not indicated for full crown retained FPD. The success rate and functional survival rate had been recorded and the periodontal condition had been evaluated for 4 years. The results were statistically analyzed with single factor variance analysis and chi square test(α=0.05).

RESULTSIn the first, second, and third year following restoration, one connector fractured in each year and they were repaired with adhesive resin and the pontics were kept in place for function. In the third and fourth years after restoration, there was one pontic displacement with fracture of connectors. The total survive rate was 83%(25/30) and the functional survival rate was 93% (28/30) at the end of the fourth year. The main reason of failure was fracture of connector. About 22%(13/60) of the adjacent teeth showed marginal bone height decrease, while the other 78% (47/60) increased with statistic significant difference from one year after the restoration to the end of the observation term(P<0.05). The periodontal condition of the adjacent teeth was improved after the restoration.

CONCLUSIONSThe four years clinical evaluation indicates that the GFR-RBFPD may be used as fixed prostheses to replace lost one to three anterior teeth with reduced periodontal support of abutment teeth.

Composite Resins ; Dental Abutments ; Dental Restoration Failure ; statistics & numerical data ; Denture Design ; Denture Retention ; Denture, Partial, Fixed ; Denture, Partial, Fixed, Resin-Bonded ; Glass ; Humans ; Incisor ; Periodontal Splints ; Time Factors