Objective To study the role of N‐acetylcysteine (NAC) in protecting rats against con‐trast‐induced acute kidney injury .Methods Forty‐five adult Wistar rats were randomly divided into control group ,model group and NAC group (15 in each group) .Their serum levels of creati‐nine ,CRP ,TNF‐a were measured before ,and 48 and 72 h after contrast medium injection .The an‐imals were killed 72 h after contrast medum injection .Their serum levels of malondialdehyde , SOD ,NO were measured .Eexpressions of Bax and Bcl‐2 were detected .Results The serum levels of creatinine ,CRP ,TNF‐a ,malondialdehyde and the expression level of Bax were significantly higher in model group and NAC group than in control group ,and in model group than in NAC group after contrast injection (P< 0 .05) .The serum levels of SOD and NO and the expression level of Bcl‐2 were significantly lower in model group and NAC group than in control group ,and in model group than in NAC group after constrast injection (P< 0 .05) .Immunohistochemistry demonstrated that the TGFβ1 expression level was significantly higher in model group and NAC group than in control group and was significantly lower in NAC group than in model group .Con‐clusion NAC can protect rats against kidney injury and reduce contrast‐induced acute kidney in‐jury by inhibiting inflammation ,oxidation ,apoptosis and cytokines .

Objective To evaluate the effects of different doses of dexmedetomidine on the anterograde amnesia of propofol in the patients undergoing gynecological surgery.Methods Sixty patients,aged 20-50 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic total hysterectomy,were randomly divided into 3 groups (n =20 each) using a random number table:propofol group (group C),low-dose dexmedetomidine combined with propofol group (group D1) and high-dose dexmedetomidine combined with propofol group (group D2).Dexmedetomidine 0.2 and 0.4 mg/kg were infused intravenously over 15 min in D1 and D2 groups,respectively.Target-controlled infusion of propofol was then started at an initial target plasma concentration (Cp) of 0.5 μg/ml.The Cp increased to 0.9,1.3,1.7 and 2.1 μg/ml in turn and maintained at each level for 3 min.After entering the operating room (baseline),at the end of dexmedetomidine infusion,and when Cp was maintained at each level for 3 min after being increased to 0.9,1.3,1.7 and 2.μg/ml in turn,and amnestic test and OAA/S score were performed.The Cp of propofol and BIS value were calculated when the amnestic rate reached 95 ％.The development of hypotension,bradycardia,respiratory depression,and upper airway obstruction was also recorded.Results Compared with group C,the amnestic rate was increased,the Cp of propofol and incidence of respiratory depression were decreased when the amnestic rate reached 95％,BIS value was increased (P ＜ 0.05),and no significant change was found in the incidence of the other adverse events in D1 and D2 groups (P ＞ 0.05).Compared with group D1,the amnesia rate was increased,the Cp of propofol was decreased and the BIS value was increased when the amnestic rate reached 95 ％ in group D2 (P ＜ 0.05),and no significant change was found in the incidence of the other adverse events in D1 and D2 groups (P ＞ 0.05).Conclusion The optimum dose of dexmedetomidine enhancing the anterograde amnesia of propofol is 0.4 μg/kg in the patients undergoing gynecological surgery.

Object To develop a capillary GC-MS analytical method for identification and deter- mination of ginkgolide A, B, C and bilobalide (GA, GB, GC and BB) in Ginkgo biloba L. leaves. Methods The leave samples were extracted in ultrasonic bath with ethanol-water (20∶80). The extract was purified by liquid-liquid extraction with ethyl acetate followed by solid-phase extraction on a column mixed with acid Al 2O 3, active carbon and celite. The terpenes were trimethylsilylated by BSTFA (with 1% TMCS) for 60 min at 100 ℃ and determined by GC-MS with HP-5 MS capillary column in the selected-ion monitoring mode. The intense fragment ions were chosen as monitoring ions for quantitative analysis. Cholesterol was used as an internal standard. Column temperature gradient: initial temperature 180 ℃, maintained 1 min, and then increased at 20 ℃/min to 260 ℃, and finally at 2 ℃/min up to 300 ℃, maintained 2 min. Results The retention times of GA, GB, GC and BB were 13.7,14.3,15.3 and 6.8 min, the major fragmentation ions (monitoring) were at m/z 537, 625, 713 and 455 (299), the average recoveries of GA, GB, GC and BB were 102.0%, 99.4%, 96.0%, 96.3%, RSD were 0.54%, 2.40%, 1.98% and 2.43%, respectively. Conclusion This method is repeatable, specific, accurate and easy to operate. It is adoptable for quality and quantity analysis of terpene lactones from G. biloba leaves.

Objective To study CEAmRNA、CK19mRNA and CK20mRNA in peripheral blood of lung cancer patients by Real-time RT-PCR,consequently discussing those result′s clinical significance.Methods 48 lung cancer patients,8 benign lung disease patients and 30 healthy volunteers of CEAmRNA,CK19mRNA and CK20mRNA in peripheral blood were detectd by Real-time RT-PCR.Results The levels of 48 lung cancer patients CEAmRNA in peripheral blood reach (16 264?28 765) copies/ml,of which 26 patients,results are positive; The levels of 48 lung cancer patients CK19mRNA in peripheral blood reach (14 891?27 244) copies/ml,of which 27 patients,results are positive; The levels of 48 lung cancer patients CK20mRNA in peripheral blood reach (10 924?21 678) copies/ml,of which 20 patients,results are positive. Among of 8 benign lung disease patients,there is just CK20mRNA was detected in one patient,both CEAmRNA and CK19mRNA were not detected in their peripheral blood. As for those 30 healthy volunteers,there is none of the mRNA was detected. Moreover,there is a marked positive correlation between the levels of CEAmRNA,CK19mRNA and CK20mRNA,the levels of CEAmRNA,CK19mRNA and CK20mRNA were correlated to the physiological cause or degree of lung cancer.Conclusion CEAmRNA,CK19mRNA and CK20mRNA in peripheral blood can be as auxiliary index for diagnosing lung cancer micrometastasis,also can monitor the lung cancer micrometastasis by quantity it.

OBJECTIVETo investigate the distribution process of puerarin contained in Zige freeze-dried powder injection in rat liver and kidney and the safety of Zige freeze-dried powder injection.

METHODRats were divided into the Zige freeze-dried powder injection group and the puerarin freeze-dried powder injection control group randomly. The liver and kidney samples were collected at 5, 10, 20, 30, 45, 60 and 120 min after intravenous administration of puerarin (26.7 microg x g(-1)) through caudal vein and detected by HPLC.

RESULTThe concentration of puerarin in kidney reached the max value of 58.12 microg x g(-1) for the Zige freeze-dried powder injection group and 71.28 microg x g(-1) for the Puerarin freeze-dried powder injection group. The value of AUC(0-2h) was 26.24 microg x h x g(-1) for the Zige freeze-dried powder injection group and 35.24 microg x h x g(-1) for the puerarin freeze-dried powder injection group, MRT(0-2h) was 0. 39 h for the Zige freeze-dried powder injection group and 0. 42 h for the puerarin freeze-dried powder injection control group. Compared with the control group, the Zige freeze-dried powder injection group showed a significant decrease in Cmax and AUC(0-2h) (P < 0.05), with no notable difference in peak time tmax and MRT(0-2h). The two groups showed no obvious difference in tmax Cmax, AUC(0-2h) and MRT(0-2h) of puerarin in rat kidney.

CONCLUSIONCompared with Zige freeze-dried powder injection, Zige freeze-dried powder injection can reduce the distribution of puerarin in rat kidney, with no obvious change in the elimination of puerarin in rat kidney. It also showed no significant change in distribution and elimination in liver. This indicates that Zige freeze-dried powder injection is safer to kidney than puerarin freeze-dried powder injection.

Animals ; Freeze Drying ; Injections ; Isoflavones ; administration & dosage ; adverse effects ; pharmacokinetics ; Kidney ; metabolism ; Liver ; metabolism ; Male ; Powders ; Rats

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Objective: To evaluate the feasibility of expanded indication for endoscopic submucosal dissection (ESD) in undifferentiated early gastric cancer, to investigate the risk factors of lymph node metastasis (LNM), so as to provide the theoretical evidence for the choice of treatment. Methods: From June 2007 to December 2018, at the Affiliated Hospital of Qingdao University, the clinical and pathological data of 807 patients with undifferentiated early gastric cancer and undergoing gastrectomy plus lymphadenectomy were retrospectively analyzed. Chi-square test was performed to analyze the correlation between clinicopathologic characteristics of early gastric cancer and LNM. Multivariate logistic regression model was used to analyze the independent risk factor of LNM. Results: LNM was found in 17.2% (139/807) patients with undifferentiated early gastric cancer. And no LNM was detected in 110 patients who met the expanded indication of ESD. The results of univariate analysis indicated that LNM was significantly associated with increased carcinoembryonic antigen (CEA), tumour size, gross type, ulcer, invasion depth, lymphovascular invasion and perineural invasion (χ²=4.500, 13.332, 16.611, 6.083, 51.064, 0.564 and 17.006, all P<0.05). The results of multivariate analysis demonstrated that the maximum diameter of tumor over 20 mm (odds ratio (OR)=1.606, 95% confidence interval (CI) 1.021 to 2.526, P=0.040), lymphovascular invasion (OR=16.835, 95%CI 10.510 to 26.966, P<0.01), the depth of submucosal superficial invasion (≤500 μm ; OR=1.962, 95%CI 1.022 to 3.765, P=0.043) and the depth of submucosal deep invasion (>500 μm ; OR=3.014, 95%CI 1.753 to 5.181, P<0.01) were independent risk factors of LNM in early gastric cancer. Conclusions The expanded ESD indication of undifferentiated early gastric cancer is applicable for endoscopic treatment considering the low risk of LNM. In early undifferentiated gastric cancer, maximum diameter of tumor over 20 mm, lymphovascular invasion, submucosal superficial and deep invasion are the independent risk factors of LNM.

Objective To explore the possible role of thrombospondin-1(THBS1)in the excessive fibrosis of vaginal wall induced by estrogen deficiency in rats,the morphological structure of collagen fibers and the expression of THBS1 in the vaginal wall were detected in the estrogen deficiency model of rats.Methods Twenty-four SD rats aged 3 months without delivery were randomly divided into sham operation group and experimental group,with 12 rats in each group.After 12 weeks of modeling,the rats were killed and the vaginal walls were taken for analysis.Masson staining was used to observe the morphological and structural changes of collagen fibers in vaginal wall of rats.Immunohistochemical staining and Western blotting were used to detect the expression level of THBS1 protein.Results After 12 weeks of modeling,the uterine atrophy of experimental group was obvious,the increase of body mass was significantly higher than that of sham operation group,and the level of estradiol was significantly lower than that of sham operation group(P<0.01).Compared with the sham operation group,the upper cortex of vaginal wall of experimental group was significantly atrophy,the smooth muscle bundles were thinner,the muscle gap was wider,the collagen fiber deposition in lamina propria and muscle layer was increased,and the arrangement and distribution were disordered and fragmented.THBS1 expression in vaginal wall of experimental group was significantly higher than that of sham operation group(P<0.05).Conclusion Estrogen deficiency may mediate excessive fibrosis of vaginal wall by upregulating THBS1 expression,thereby damaging the biomechanical properties of vaginal wall and leading to an increased susceptibility to pelvic organ prolapse development.

Objective:To evaluate the optimization strategy of labor analgesia in obese parturients using dural puncture epidural (DPE) combined with programmed intermittent epidural bolus (PIEB).Methods:Eighty American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ obese primiparae, who were at full term with a singleton fetus in vertex presentation, aged 20-40 yr, with body mass index of 30-40 kg/m 2, at 37-42 week gestation, with cervical dilation of 2-5 cm, and with visual analogue scale score ≥50 mm, were divided into 2 groups ( n=40 each) using a random number table method: DPE plus PIEB group (DPEP group) and DPE plus continuous epidural infusion group (DPEC group). All parturients received DPE labor analgesia, and parturients received PIEB (DPEP group) and continuous epidural infusion (DPEC group) to maintain analgesia during labor. In DPEP group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 2 ml/12 min after an initial dose of 8 ml. In DPEC group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 10 ml/h after an initial dose of 8 ml. The analgesia solution contained 0.1% ropivacaine plus 0.3 μg/ml sufentanil. The time to achieve adequate analgesia, consumption of ropivacaine per unit time, height of sensory block at the thoracic vertebral level, modified Bromage score, effective pressing times of patient-controlled analgesia, the number of rescue analgesia, Apgar score, delivery mode, occurrence of adverse reactions and maternal satisfaction with labor analgesia were recorded. Results:Compared with DPEC group, the time to achieve adequate analgesia was significantly shortened, the consumption of ropivacaine per unit time was decreased, and the number of rescue analgesia and effective pressing times of patient-controlled analgesia were decreased in DPEP group ( P<0.05). There were no significant differences in the height of sensory block at the thoracic vertebral level, modified Bromage score, Apgar score, delivery mode, incidence of adverse reactions and maternal satisfaction with labor analgesia between the two groups ( P>0.05). Conclusions:DPE combined with PIEB offers faster onset and better effect and achieves a greater local anesthetics-sparing effect when used for labor analgesia in obese parturients.

Objective:To investigate and analyze the somatic symptom disorder, anxiety and depression in patients with myocardial bridge.Methods:A total of 276 patients with myocardial bridge diagnosed by coronary angiography (CAG) were enrolled in the department of cardiology of Renji hospital in Shanghai from June to December in 2016. There were 151 cases of simple myocardial bridge (no coronary stenosis or coronary artery stenosis <30%) and 125 cases of complex myocardial bridge (combined with coronary stenosis >30%). A total of 1067 patients with myocardial bridge without coronary angiography were collected at the same time. Self-rating somatic symptom scale (SSS), generalized anxiety disorder (GAD-7) and patient health questionnaire (PHQ -9) were given to these patients during hospitalization. At the same time, somatic symptoms disorder and anxiety and depression in the myocardial bridge group and non-myocardial bridge group were compared.Results:The prevalence of somatic symptom disorder in patients with myocardial bridge was higher than that in non-myocardial bridge patients (35.86% vs 28.30%, P<0.05). There was significant correlation between somatic symptom disorder and depression and anxiety, with correlation coefficients of 0.629 and 0.565, respectively. The prevalence of depression and anxiety in myocardial bridge patients was higher than that in non-myocardial bridge patients (depression: 23.91% vs 22.11%. P=0.467; anxiety: 17.02% vs 14.15%, P=0.22), but there was no statistical difference. For male patients or female patients, the prevalence of somatic symptom disorder, depression and anxiety in the simple myocardial bridge patients were higher than those in the complex myocardial bridge patients, but there was no statistical difference. The most common non-specific somatic symptoms disorder in patients with myocardial bridge were fatigue (64.5%), followed by sleep disorders (63.8%) and decreased attention (63.0%). Conclusion:The somatic symptom disorder in patients with myocardial bridge is significantly higher than that in non-myocardial bridge group. Especially for patients with myocardial bridge with non-specific somatic symptoms, early identification of somatic symptoms disorder of myocardial bridge patients will be beneficial to proper clinical invitation.