OBJECTIVETo explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6).

METHODSForty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided into I to II degree by the American Society of Anesthesiologists (ASA) and were randomized into an observation group and a control group, 20 cases in each one. Before general anesthesia induction, in the observation group, the transcutaneous electric stimulation was applied to bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min, with dense-disperse wave, 2 Hz/100 Hz in frequency; in the control group, the sham-stimulation was applied to the acupoints, with the lamp on, but without electric current output. Afterwards, the general anesthesia induction started. When the target concentration of propofol and remifentanil was stabilized at the preset value, the endotracheal intubation was conducted. Dixon sequential method was applied for the determination of ECs in remifentanil inhibition of tracheal intubation response.

RESULTSThe level of EC50 in remifentanil inhibition of tracheal intubation response was 3. 46 ng/mL, 95% confidence interval was 2. 80 ng/ml to 4. 27ng/mL in the observation group; those were 4. 18 ng/mL and 3. 30 ng/mL to 5. 29 ng/mL in the control group separately. The differences were significant in comparison of the two groups (P<0. 01).

CONCLUSIONTEAS apparently reduces EChe in the remifentanil inhibition of tracheal intubation response by around 17%as.

Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Middle Aged ; Pain ; etiology ; Pain Management ; Piperidines ; administration & dosage ; Transcutaneous Electric Nerve Stimulation

Objeetive To investigate the expression of claudin-4 in the eutopic and ectopic endometfium of women with endometriosis and evaluate the role of clandin-4 in the pathogenesis of endometriosis.Methods Thiny-five women with endometriosis and 35 controls were studied.Expression of elaudin-4 was investigated using immunohistochemistry,western blot and RT.PCR,respectively.Morphologic change of tight junction was also observed in different kinds of endometria.Results (1)G1andular epithelial cells of control endometrium and eutopic endometrium showed intact tight iunctions in electron micrographs,whereas the morphology of tight junctions in ovarian endometriotic tissue was disrupted and collagen bundles could be easily detected.(2)The immunohistochemical staining of claudin-4 was localized to the glandular epithelial cell membrane.Deftcient or weak staining Wag found in ovarian endometriotic tissues. In control endometrium.eutopic and ectopic endometrium of women with endometriosis,the expression of clandin-4 protein Was 89±24.84±22 and 27±14.respectively.Relative expression of claudin-4 mRNA Was 14.5±6.8,13.8±9.5 and 2.6±2.5.respectively.Expression of claudin-4 Was significantly lower in the ectopic endometriotic tissue than in the eutopic cndometrium and the control at both mRNA and protein levels(P<0.05). N0 significant difference Was foand between eutopic endometrium from women with endometriosis and control endometrium from women without endometriosis (P>0.05).Conclusion Down-regulated expression of claudin-4 might play a pathogenic role in the formation of endometriosis.

Objective To study the effect of postoperative adjuvant transarterial chemoembolization (TACE) on prognosis of patients after radical resection of primary hepatocellular carcinoma.Methods A retrospective analysis was conducted on 311 patients with primary hepatocellular carcinoma treated from 2002 to 2008 in Quanzhou First Hospital affiliated to the Fujian Medical University.Utilizing the COX regression model and the Kaplan-Meier analysis,the effects of adjuvant TACE on prognosis of both the high risk group (n =76) and the low risk group (n =91) with tumor ≤5 cm,as well as both the high risk group (n =65) and the low risk group (n =78) with tumor ＞ 5 cm were determined.The low risk group was defined as patients with a single tumor and without vascular invasion,while the high risk group was defined as patients with multiple tumors or with vascular invasion.Results The postoperative overall survival rate of the high risk group who underwent postoperative adjuvant TACE with tumor ＞ 5 cm was higher than that of the high risk group who did not undergo postoperative adjuvant TACE (P ＜ 0.05).However,whether or not postoperative adjuvant TACE was given had no effect on prognosis in the other subgroups of patients (P ＞ 0.05).Conclusion Postoperative adjuvant TACE was beneficial to the high risk group of patients with tumor ＞ 5 cm after radical resection of primary hepatocellular carcinoma.

Transformation and quality improvement of clinical pharmacy is key to assuring quality of care for public hospital reform.The clinical pharmacist working model has been established after years of exploration in China,which plays a positive role in promoting such quality and optimizing the allocation of medical resources.However,with the advance of the health care reform,the original working model and methods of clinical pharmacists need to be further improved to meet emerging demands.This paper puts forward a new model of clinical pharmacist development based on the concept of hospital total quality management,which involves the clinical pharmacists′ duty,the work model from the “Pay a visit to bedside”to “Stay by bedside”in clinic,professional development training and performance evaluation.The reform provides a feasible way for the transformation and development of clinical pharmacists in public hospitals.

Objective To induce skin cancer in BALB/c mice using DMBA as initiator and TPA as tumor promot-er. Through optimizing the doses and frequencies of DMBA administration to establish a stable skin cancer model with less time and causing less skin damage. Methods Shaving the back of mice to expose a piece of skin around 2 cm × 2 cm. The mice were divided into a blank control group and four treatment groups randomly. These four groups were given 1, 2, 4, 7 times 100μg/100μL DMBA/acetone, respectively, in the first week, and twice 4μg/100μL TPA/acetone per week in the next 11 weeks. The body weight changes, time of tumor formation and number of tumors formed were recorded during the experiment. The mice were sacrificed at 12th week and samples of tumor tissue and adjacent normal skin tissue were taken for pathological examination using HE staining. Results Tumors were observed at the 7th week in the group with once DMBA administration in the first week and at the 4th week in the group with twice DMBA administration in the first week. Skin cancers were formed also in the group with 4?time DMBA administration in the first week, however, with signif?icantly more severe skin damages. The mice receiving DMBA everyday in the first week died at the 3th week. Conclusions The best induction protocol for skin cancer in BALB/c mice should be twice DMBA in the first week followed by twice TPA

Objective To observe how ox-LDL impacts the mRNA expressions of MMP-9 and LOX-1 of human umbilical endothelial cells (HUEVC) and how LOX-1 acts as in inflamation course.Methods HUVEC were incubated in vitro.mRNA Expressions of MMP-9 and LOX-1 were determined by reverse transcription polymerase chain reaction (RT-PCR).Results Compared to the control group(0.252±0.032;0.279 ±0.041 ),ox-LDL significantly increased the mRNA expressions of MMP-9 and LOX-1 (25 ng/group 0.486 ± 0.012,0.586 ± 0.02;50 ng/L group 0.668 ± 0.011,0.739 ± 0.014; 100 ng/group 0.817 ±0.030,0.872 ±0.003,P ＜0.01 ).Those expressions were increased by ox-LDL( 1.020 ±0.039)in a concentration-and time-dependent manner.MMP-9 mRNA(0.872 ±0.046) was reduced when LOX-1 was inhibited by polyinosinic acid ( P ＜ 0.01 ).Conclusions The mRNA expressions of MMP-9 and LOX-1 were induced by ox-LDL in HUVEC.Inhibition of LOX-1 may decrease the expression of MMP-9.Those data demonstrate that LOX-1 is involved in the process of ox-LDL-induced MMP-9 expression.

Objective To investigate the clinical significance of CD55,CD59 and Aeromonas hydrophila toxin variant (FLAER) in the diagnosis of anemia and paroxysmal nocturnal hemoglobinuria (PNH).Methods Collected 30 healthy controls,22 cases of PNH,33 cases of aplastic anemia (AA),37 cases of iron deficiency anemia (IDA),45 cases of megaloblastic anemia (MA),30 cases of hemolytic anemia (HA) and 31 cases of myelodysplastic syndrome (MDS) from January 2009 to March 2017,CD55,CD59 and FLAER negative cell ratio of peripheral blood neutrophil of them were detected by multipa rameter flow cytometry.Results The detection rates of FLAER in PNH,AA and MDS groups were higher than those of CD55 and CD59,but there was significant difference in AA (x2 =7.759,5.518,P=0.005,0.019＜0.05).The average CD55,CD59 and FLAER deletion rate in PNH and AA group were significantly higher than those in normal control group and other groups (t=2.163～17.890,P=0.000～0.038＜0.05).The number of FLAER in PNH group was higher than CD59 and CD59 was higher than CD55 with the statistically significant difference (t=2.503 ～ 6.308,P=0.000 ～0.016＜ 0.05).Conclusion CD55,CD59 and FLAER have important value in the diagnosis of PNH and differential diagnosis with other anemia diseases,and can also be used to detect the presence of MDS and AA in patients with PNH.FLAER outperforms CD59,CD59 outperforms CD55.

AIM:To investigate the expressions of methylthioadenosine phosphorylase(MTAP)and ornithine decarboxylase(ODC)in human ovarian cancer.METHODS:60 fresh samples of ovarian cancer were collected.The expressions of MTAP mRNA and protein were analyzed by using RT-PCR and Western blotting,respectively.ODC activity was measured by high performance liquid chromatography.RESULTS:The expression levels of MTAP mRNA and protein in ovarian cancer were lower than those of control.In 9 of the 60 samples(15%)there were absence of detectable MTAP mRNA and protein.No significant relevance was found between the expression of MTAP and clinical pathologic features.ODC activity in ovarian cancer was(3.82?1.03)U,which was higher than that of normal ovarian tissues(1.38?0.59)U.ODC activity was related with tumor grade.In MTAP-deficiency ovarian cancer tissues ODC activity was significantly increased when compared with that of MTAP-expressing ovarian cancer samples.CONCLUSION:Down-regulated MTAP expression and up-regulated ODC activity really exist in ovarian cancer.Activation of ODC resulting from MTAP deletion may be one of the pathogenetic factors of ovarian cancer.

Objective:To study the short-term effects,toxic side effects and immune function of Aidi injection adjuvant GP methods chemotherapy for advanced non-small cell lung cancer(NSCLC).Methods:130 patients with advanced NSCLC were divided into study group and the control group according to treatment methods.The study group were given Aidi injection +GP,and the control group only treated with GP.The short-term effects,toxic side effects gradeⅢ-Ⅳand immune function changes were compared between the two groups.Results:The overall response rate was 40.28%in study group,higher than 37.93% in control group(P>0.05).The two groups showed differences in the rates of leucocyte decrease,gastrointestinal reaction and platelets decrease(P<0.05).The levels of CD4,CD8 and CD4/CD8 didn′t changed obviously in study group(P>0.05),while in the control group the levels of CD4,CD8 and CD4/CD8 changed more significantly than before(P<0.05).The two groups also produced differences in CD4,CD8 and CD4/CD8 after treatment( P<0.05 ) .Conclusion: The short-term effects of Aidi injection adjuvant GP chemotherapy regimen for advanced NSCLC is similar to only GP chemotherapy,but it can obviously reduce the incidence of toxic side effects and prevent the immune func-tion.

Objective To clarify the role of claudin-4 in endometrial tumorigenesis and explore claudin-4 be as potentially useful agent in the treatment of endometrial carcinoma.Methods The expression of claudin-4 in 62 endonetrioid endometrial carcinoma (EEC),30 atypical hyperplasia endometrial tissue and 60 human normal endometrium was determined using immunohistochemistry and realtime PCR.Ninety female BALB/c mice were transplanted with Ishikawa endometrial cancer cells,which were divided into three groups with different intraperitoneal treatments with cisplatin,paclitaxel and saline solution.After the observation period,the tumors were extracted and stained with monoclonal antibody against claudin-4.The messenger RNA expression of claudin-4 was also detected using real-time PCR.Results Among the EEC samples,34％ (21/62) showed medium staining for claudin-4 and 66％ (41/62) showed intense staining.In atypical hyperplasia group,27％ (8/30) showed weak staining,53％ (16/30) showed medium staining and 20％ (6/30) showed intense staining for claudin-4.Of the normal endometrial tissue,47％ (28/60) showed weak staining and 53％ (32/60) showed no staining for claudin-4.According to real-time PCR,the relative quantity of claudin-4 was 170 ± 12 in EEC group,89 ± 15 in atypical hyperplasia group and 18 ± 3 in normal endometrium.Compared with those in atypical hyperplasia group and normal endometrium group,the protein and mRNA expression of claudin-4 were significantly increased in the group of EEC (all P ＜ 0.05).In the study of Ishikawa xenografts,no significant changes in tumor volume and claudin-4 expression were shown in paclitaxel group compared with that in the control group.Nevertheless,a significant reduction of the tumor growth and a significant decrease in claudin-4 expression were observed in cisplatin group.After cisplatin treatment,the tumor volume was significantly decreased [(0.51 ±0.21) versus (0.73 ±0.12) cm3],and the mRNA expression of claudin-4 was also significantly decreased (153 ± 35 versus 273 ± 27).Conclusion These results demonstrate that claudin-4 is strongly expressed in EEC,which may be a useful biomarker to monitor the effects of chemotherapy in patients with endometrial carcinoma.