ObjectiveTo explore the effects of propofol combined with remifentanil in different ratios for intravenous anesthesia. Methods63 patients were randomly divided into three groups,each group 21 cases,different target plasma concentration of propofol and remifentanil were dosed for every group.Hemodynamic parameters such as MAP,HR were recorded at different time.so as to stop time for the zero time of local anesthetic.The extubation time,the quality and time of awakening were compared as well. ResultsThe MAP and HR value of all patients after induction of general anesthesia were lower than that before intubation,which showed significant difference(all P＜0.05),and the MAP and HR value of all patients after intubation reseal and decannulation showed significant difference compared with that before intubation reseal.The resurgence time and decannulation time of group A were the shortest,and the postoperative detubation revive quality score was also the best when compared with that of group B and C. ConclusionThe target plasma concentration of propofol(2.5mg/L)and remifentanil(μg/L)was the best.With the increasing of target plasma concentration of remifentanil and the decreasing of target plasma concentration of propofol,the resurgence time,decannulation time and the postoperative detubation revive quality score were improved gradually.

Objective To investigate the role of recombinant Vibrio vulnificus cytolysin (rVvhA) in inducing THP-1 cells damage and study the pathway of associated calcium influx .Methods Inverted mi-croscope, CCK-8 cell proliferation kit, Fluo3/AM staining and caspase activity detection were performed to analyze the damage of THP-1 cells induced by rVvhA and the pathway of calcium influx .Results rVvhA had cytotoxic effects on THP-1 cells in a dose-dependent manner .The concentrations of extracellular K +and LDH were respectively up-regulated after 1 h and 6 h of 12 μg/ml rVvhA intervention .Verapamil , Mibe-fradil and SKF-96365 could not prevent the influx of free Ca 2+induced by rVvhA .The activities of caspase-3 and caspase-9 were singanificantly enhanced by rVvhA in a time-dependant manner .Conclusion rVvhA can induce THP-1 cells damage through triggering extracellular calcium influx via porous channel on cell membrane.Moreover, rVvhA might induce THP-1 cell apoptosis through activating caspase-9/3-dependent pathway .

OBJECTIVE To investigate the change in antibiotic resistance of Burkholderia cepacia in hospital for reference of clinical antimicrobial strategy.METHODS Data were collected of the 859 bacteria strains isolated from clinical specimens from Jan 2004 to Dec 2006.Drug sensitivity tests were made for 22 antimicrobial agents.RESULTS All of the drug-resistance rates were higher than 90.00% including ampicillin,ampicillin/sulbactam,amoxicillin/clavulanic acid,cefazolin,gentamicin,tobramycin,amikacin,imipenem and nitrofurantoin.but that of the others such as ceftazidime(23.57%),cefepime(26.95%),ciprofloxacin(31.73%),cefoperazone/sulbactam(33.33%),and piperacillin/tazobactam(21.45%) were lower.The resistance rate to sulfamethoxazole/trimethoprim was 5.73% which was the lowest.CONCLUSIONS The isolation rate as well as the resistance to most of the antibiotics are increasing in clinical specimens.Antimicrobial treatment should be guided by drug sensitivity test.

Objective To investigate the factors associated with vision and hole closure for idiopathic macular hole (IMH) after vitrectomy surgery.Methods Eighty-nine eyes of 89 patients with IMH were enrolled in this retrospective study.There were 15 males and 74 females.The patients aged from 42 to 82 years,with the mean age of (64.13 ± 7.20) years.All subjects underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations.The BCVA ranged from 0.01 to 0.4,with the mean BCVA of 0.12 ± 0.09.The MH stages was ranged from 2 to 4,with the mean stages of 3.56 ± 0.77.The basal diameter ranged from 182 μm to 1569 μm,with the mean basal diameter of (782.52± 339.17) μm.The treatment was conventional 25G pars plana vitrectomy combined with phacoemulsification and intraocular implantation.Fortyone eyes received internal limiting membrane peeling and 48 eyes received internal limiting membrane grafting.The follow-up ranged from 28 to 720 days,with the mean follow-up of (153.73 ± 160.95) days.The visual acuity and hole closure were evaluated on the last visit and the possible related factors were analyzed.Results On the last visit,the BCVA ranged from 0.02 to 0.8,with the mean BCVA of 0.26±0.18.Among 89 eyes,vision improved in 45 eyes (50.56％) and stabled in 44 eyes (49.44％).Eighty-six eyes (96.63％) gained MH closure but 3 eyes (3.37％) failed.By analysis,patients of early stages of MH and smaller basal diameter of MH will gain better vision outcome (t=2.092,2.569;P＜ 0.05) and patients of early stage MH will gain high hole closure rate after surgery for IMH (t=-5.413,P＜0.05).However,gender,age,duration,preoperative BCVA,surgery technique,gas types and follow-up time had no relationship with the effect after surgery for IMH (P＞0.05).Conclusions Stages of MH and basal diameter of MH may be the factors associated with the visual outcome for idiopathic macular hole after surgery.However,age,gender,duration,surgery patterns,gas types and followup time showed no effects on operational outcomes.

Aim To investigate the apoptosis mechanism of human gastric cancer cell SGC-7901 induced by Omphalia lapidescens protein pPeOp.Methods CCK-8 and flow cytometry were used to detect the inhibitory effect of different concentrations of pPeOp(30, 60, 90 mg·L-1) on SGC-7901.The mRNA and protein expression of TNF-R1, Fas/FasL, Bcl-2, caspase-3 and caspase-8 were detected by qRT-PCR and Western blot.Results SGC-7901 cells were treated with different concentrations of pPeOp(30, 60, 90 mg·L-1) for 24 h.CCK-8 test showed that there was no significant difference between PVP group and the control group.The survival rate of the 5-Fu group was(53.71±7.34)% (P<0.05).The survival rates of pPeOp group(30, 60, 90 mg·L-1) were(80.95±6.25)%, (53.48±5.70)% and(44.61±6.50)%(r=0.984,P=0.016),respectively.Flow cytometry showed that the apoptosis rate of PVP group had no significant difference with control group, and the apoptosis rate of 5-Fu group was about(39.30±3.34)%(P<0.05).The apoptotic rates of pPeOp group(30, 60, 90 mg·L-1) were(10.90±1.25)%, (28.80±2.70)% and (32.00±3.50)%,respectively(P<0.05).The mRNA and protein expression levels of Bcl-2 were down-regulated,whereas the expression of TNF-R1, Fas/FasL, caspase-3 and caspase-8 were significantly up-regulated(P<0.05).Conclusions pPeOp can significantly inhibit the proliferation of gastric cancer cell line SGC-7901 and induce apoptosis in a dose-dependent manner.Death receptor pathway and mitochondrial pathway may be related to pPeOp-induced apoptosis of gastric cancer SGC-7901.

Objective To compare the efficacy of intravitreal dexamethasone implant (OZURDEX（R）) in the treatment of macular edema (ME) caused by central retinal vein occlusion (CRVO) in different ages.Methods A retrospective case observation study was performed.Forty eyes of 40 patients diagnosed with ME secondary to CRVO were enrolled in the study.According to patient's age,all of the 40 eyes were divided into ＜40 years old group (20 eyes) and ≥40 years old group (20 eyes).All eyes went through best corrected visual acuity (BCVA),intraocular pressure (IOP) and optic coherence tomography (OCT) examinations.Early Treatment Diabetic Retinopathy Study chart was used to test visual acuity,and central macular thickness (CMT) was measured by OCT.Fundus fluorescein angiography (FFA) was proceeded selectively.All eyes went through intravitreal injections off intravitreal dexamethasone implant and BCVA,IOP,OCT were tested 1 month,2,3,6,9 and 12 months after injection.After 3 months follow-up,intravitreal dexamethasone implant or ranibizumab would be injected again for patients with ME recurrence or poor treatment effects.Changes of BCVA,IOP and CMT before and after injection were observed.Results BCVA and CMT in the ＜40 years old group and ≥40 years old group were compared at different time points,and the differences were significantly different (BCVA:Fgroup =2.071,P =0.044;Ftimc.=9.551,P ＜ 0.001.CMT:Fgroup =2.402,P=0.034;Ftime =13.175,P＜0.001),compared with before injection,the BCVA at each time point of post-injection was improved,and CMT was thinner than that before injection;at 2 months after injection,the BCVA was improved and CMT was thinner than those 1 month after injection,the differences were statistically significant (all at P＜0.05);at 12 months after injection,the BCVA in the ＜40 years old group was obviously better than that in the ≥40 years old group,the CMT was much thinner than that in the ≥40 years old group,the differences were statistically significant (both at P＜0.05).Compared with before injection,the IOP at 1 month,2 and 3 months after injection was increased,the IOP at 2 months after injection was higher than that at 1 month after injection,the differences were statistically significant (both at P＜0.05).The mean number of injections was (1.8±0.9) times in the ＜40 years old group and (2.7±1.4)times in the ≥40 years old group,with a statistical difference between them (t =2.569,P =0.014).Conclusions In different age groups,patients with ME caused by CRVO can be effectively treated by intravitreal dexamethasone implant,the therapeutic effect is significant at 1 month post-injection and most improvement is shown at 2 months post-injection.Compared with patients over 40 years of age,patients under 40 years of age have better long-term results,better visual improvement,thinner CMT and less intravitreal injections.

Objective To better understand the clinical features and the diagnosis of TAFRO syndrome.Methods The clinical data of a patient were analyzed and the related literatures were reviewed.Results A 51-year-old male characterized by fever,edema of the legs,serous cavity effusion,throm-bocyto-penia,and renal dysfunction;Kidney biopsy suggested a diagnosis of endocapillary proliferative glomerulon-ephritis and thrombotic microangiopathy.The pathology of lymph node biopsy supported the diagnosis of Castleman disease.After administering with glucocorticoids and supportive platelet transfusion,the clinical symptoms relieved.Conclusion Symptoms of patients with TAFRO syndrome are variable.The diagnosis relies on history and pathological examination.Currently,glucocorticoids can be used as first line therapy.TAFRO syndrome should be thoroughly investigated for differentiating with other diseases.

Objective To investigate the factors associated with short-term elevation ofintraocular pressure after ranibizumab intravitreal injection.Methods 292 eyes of 292 patients who were diagnosed retinopathy and suitable to receive ranibizumab intravitreal injection were enrolled in this prospective clinical study.There were 157 males and 135 females.193 patients diagnosed with age-related macular degeneration and 99 other retinopathy patients.Mean age of patients was 62.75 ± 13.74 years.All subjects underwent systemic and comprehensive ophthalmology examinations.The mean BCVA was 0.68± 0.47 logMAR.Mean basal intraocular pressure was 18.1 mmHg (1 mmHg=0.133 kPa).All patients received intravitreal injection with 0.05 ml of ranibizumab (0.5 mg).The intraocular pressure were measured by non-contact tonometer at 10,30,120 minutes and 1 day after injection in a sitting position.The patients were grouped by the changes ofintraocular pressure 10 minutes after injection.The elevation was more than 10 mmHg as elevation group and less than 10 mmHg as stable group.Analyze the possible related factors with elevation of intraocular pressure after ranibizumab intravitreal injection by comparing the different datum of two groups.Results The mean intraocular pressure were 23.8,20.5,19.9 and 17.4 mmHg at 10,30,120 minutes and 1 day after injection.The significant elevation level were 5.8,2.4,1.8,-0.7 mmHg compared with basal intraocular pressure.Among 292 eyes,intraocular pressure elevation in 68 eyes and stabled in 224 eyes.The age (Z=-0.732),gender (x2=1.929),right or left eye (x2=2.910),BCVA (Z=-0.039),diseases ((2=2.088) were no significant difference between two groups (P＞0.05).The injection number (Z=-2.413,P=0.001),basal intraocular pressure (Z=-3.405,P=0.016) and elevations after injection (Z=-11.501,-8.366,-5.135,-3.568;P＜0.01) were significantly different comparing two groups (P＜0.05).By logistic regression analysis,basal intraocular pressure was positively correlated with the elevation of intraocular pressure 10 minutes after injection (B=-0.844,OR=0.43,95％CI 0.24-0.76,P=0.004).Patients with higher basal intraocular pressure may occur intraocular pressure elevation after ranibizumab intravitreal injection much probably.Conclusions The factors associated with short-term elevation of intraocular pressure after ranibizumab intravitreal injection were basal intraocular pressure.The higher basal intraocular pressure,the higher risk to gain elevation of intraocular pressure after injection.

Objective: To analyze serum HBV-RNA levels in patients with chronic hepatitis B whose serum HBV-DNA has dropped to undetected levels after treatment with entecavir, and to explore the correlation between HBV-RNA level and liver biochemical parameters, which lay the research foundation for the clinical significance of new serological marker HBV-RNA. Methods: HBeAg negatively detected 107 cases with chronic hepatitis B whose serum HBV-DNA test results were lower than detection level for six consecutive months after receiving standard nucleoside therapy for more than 12 months were included. HBV-RNA level was detected by Perkin-Elmer reagent. HBV-DNA level was detected by Roche Cobas. Hitachi automatic biochemical analyzer was used to detect ALT and AST. Architect chemiluminescence analyzer was used to detect HBsAg, HBeAg, anti-HBe and anti-HBc. RStudio software was performed to analyze the correlation between HBV-RNA level and liver biochemical parameters. Logistic regression was used to analyze the independent factors influencing HBV-RNA level. Results: The positive detection rate of serum HBV-RNA in patients with chronic hepatitis B whose serum HBV-DNA had dropped to undetected levels after ETV treatment was 22.43%. HBsAg, ALT and AST levels in HBV-RNA positive group were slightly higher than HBV-RNA negative group, while anti-HBc levels were slightly higher in HBV-RNA negative group. There was no difference in the level of anti-HBe between the HBV-RNA negative and the positive group. Logistic regression analysis showed that anti-HBc was an independent factor influencing the level of HBV-RNA detection (P = 0.021). Conclusion HBV-RNA can be detected in some patients with chronic hepatitis B whose serum HBV-DNA level has dropped to undetected levels after ETV treatment. Serum HBV-RNA only comes from the direct transcription of cccDNA, so it is better than HBV-DNA and HBsAg to reflect cccDNA level or activity. Anti-HBc, as an independent factor influencing the level of HBV-RNA, may be used in combination as a new marker to predict the efficacy of antiviral therapy.