Objective To investigate the effect of dexmedetomidine sedation on perioperative hemodynamics and heart rate variability (HRV) in the aged patients with cataract operation.Methods Fifty aged patients with cataract who accepted phacoemulsification operation in local anesthesia,were divided into experiment group(dexmedetomidine group) and control group (0.9％ sodium chloride group) by random digits table method with 25 cases each.The experiment group was given local anesthesia,after dexmedetomidine load at 0.5 μg/kg intravenous infusion,dexmedetomidine continuous pumping [0.2-0.3 μg/ (kg ·h)] to maintain the depth of anesthesia.The control group was given the same dose 0.9％ sodium chloride intravenous infusion.Local anesthesia method:2％ lidocaine and 0.75％ bupivacaine 3 ml mixing for retrobulbar anesthesia.The changes of HRV and hemodynamics in the 2 groups before operation (T0),beginning operation (T1),perioperative10min (T2),perioperative30min (T3),postoperative (T4) were recorded,and hemodynamies was analyzed.Results The normalized units of low frequency (LFnu) and low frequency (LF)/high frequency (HF) at T1,T2,T3 in control group were significantly higher than those at T0 [(73.9 ± 9.2)％,(74.5 ± 9.0)％,(75.8 ± 8.5)％ vs.(61.3 ± 7.5)％ and 2.4 ± 1.1,2.6 ± 1.3,2.7 ± 0.9 vs.1.6 ± 0.5],total frequency power (TP) was significantly lower than that at T0 [(1372 ± 419),(915 ± 243),(1389 ± 142) Hz vs.(2351 ± 608) Hz],there were statistical differences (P ＜ 0.05).The LFnu and LF/HF at T1,T2,T3 in experiment group were higher than those at T0,but there were no statistical differences (P ＞0.05).The TP at T1,T2,T3 in experiment group was significantly lower than that at T0 [(1458 ± 325),(983 ±272),(1497 ± 210) Hz vs.(2235 ± 513) Hz],there was statistical difference (P ＜ 0.05).There was no statistical difference in normalized units of HF at all time points between the 2 groups (P ＞ 0.05).The LFnu,LF/HF and TP at T1,T2,T3 in experiment group were better than those in control group,there were statistical differences (P ＜ 0.05).The fluctuation of hemodynamics in experiment group was significantly lower than that in control group,there was statistical difference (P ＜ 0.05).Conclusion Dexmedetomidine sedation little effects on HRV during perioperative period in aged patients with cataract operation,can significantly reduce the influence of operation stimulation on autonomic nervous system and hemodynamics.

Objective To increase curative rate of nonoperation treatment for adult blunt splenic trauma.Methods Data of 141 patients with blunt splenic trauma treated in our hospital from March 2010 to October 2014 were retrospectively analyzed in accordance with the spleen injury degree classification issued by the Spleen Surgery Group of Chinese Society of Surgery in 2000.According to the treatment within 6 hours of injury,these patients were divided into operative and nonoperative management groups.Results The proportion of non operation was 69.5％ (98/141) and the success rate was 89.8％ (88/98).43 cases were in operation group:34 cases in grade Ⅲ,9 cases with grade Ⅳ,3 cases died; 98 cases were in non operation group:including 32 cases of grade Ⅰ,50 cases of grade Ⅱ,15 cases of grade llⅢ,1 case with grade Ⅳ.10 cases failed non operation treatment including 1 case with grade Ⅰ complicated by pancreatic and intestinal injury causing peritonitis during the period of observation,1 case of grade Ⅱ complicated by contusion of the liver and secondary bleeding on day 3 after the trauma,7 cases of grade Ⅲ,were converted to surgery because of multiple organ injury and rebleeding secondary to pulmonary complications,and 1 case of grade Ⅳ with multiple organ injury and shock being immediately converted to surgery.In overall there were 2 deaths in nonsurgery group,1 case with grade Ⅲ and 1 case with grade Ⅳ.Condusions Nonoperative treatment of blunt splenic trauma is safe and feasible in grade up to]Ⅱ blund splenic trauma patients.

Objective:To investigate the marginal microleakage after cavity preparation by Er:YAG la-ser and conventional bur applying different adhesive systems , conditioning surface with acid etching or not.Methods:In the study, 50 primary teeth were divided into 5 groups.(1) Bur+etch-and-rinse sys-tem, (2) Bur+self-etching system, (3) Er:YAG laser+etch-and-rinse system, (4) Er:YAG laser+self-etching system, (5) Er:YAG laser+none-etched.The class V cavities were all filled with composite resin.The microleakage tests were performed , observed and scored under stereomicroscope .Results:Bur+etch-and-rinse group had higher microleakage than Er:YAG laser +etch-and-rinse group , and Bur+self-etching group had higher microleakage than Er:YAG laser +self-etching group ( P<0 .05 ) . There was no difference between Er:YAG laser+etch-and-rinse group and Er:YAG laser+self-etching group, while they had significantly lower microleakage than that of Er:YAG+none-etched group.Con-clusion:Composite resin restoration showed less marginal microleakage when all-in-one self-etch system was used after irradiation by Er:YAG laser on primary teeth .

Objective To study the expression of brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) in the guinea pig cochlea of cisplatin-induced ototoxicity, and to understand its protective role for the inner ear.Methods The animals were divided into normal group and experimental group with cisplatin. Sodium chloride was used for the control. All animals were sacrificed on the day 3, 5 and 7, and the cochlea were used for BDNF and NGF staining.Results The weak expression of BDNF and the moderate expression of NGF were observed in the cochlea in the normal group. The strongest expression of BDNF and NGF was observed in the animals with cisplatin.Conclusion The existence of NGF in the normal cochlea indicates that NGF plays an important role to maintain auditory physiology.BDNF and NGF may be involved in self-protection mechanism for the cochlea and auditory nerves from cisplatin-induced ototoxicity.

Objective To establish human brain-derived neurotrophic factor (BDNF) genetical modified marrow stromal cells and to evaluate the influence on the viability of the cultured spiral ganglion cells from Kunming mice.Methods Eukaryotic expression plasmid——pcDNA3.1(-)-BDNF was constructed according to the molecular clone approach. Marrow stromal cells(MSC) were separated and cultured. BDNF genetical modified marrow stromal cells were established and verified by biochemical analysis.The bio-effect to spiral ganglion cells, especially with the oxidative damage under the different concentration of H_2O_2 was observed.Results PcDNA3.1(-)-BDNF and BDNF genetical engineering cells were successfully established. The supernatant from BDNF-MSCs remarkably improved the survival rate of the spiral ganglion cells.Conclusion BDNF genetical modified marrow stromal cells are successfully established, and the genetical engineering cell plays an important role in the protection the spiral ganglion cells from the oxidative damage. This study provide a strong basis for genetical engineering cells transplantation into the inner ear.

Objective To investigate the clinicopathologic features and the expression of p53,PCNA and Bcl-2in tricholemmal carcinoma.Methods Skin lesions were studied with HE staining and immunohis-tochemical markers for p53,PCNA and Bcl-2(S-P method)in22cases of skin tricholemmal carcinoma.Both morphological manifestations and immunohistochemical expression were observed.Results There were15fe-male and7male cases of tricholemmal carcinoma with the ages of40-79y,including16cases whose scalp were involved.Positive staining of p53,PCNA and Bcl-2was found in72%,100%and63%of patients,re-spectively.The positive cells of p53were diffusely distributed.PCNA-positive cells were increased along with the degree of differentiation.Significant differences of Bcl-2expression were found among the various degrees of differentiation(P

Objective To inspect the therapeutic effect and prognosis of treating Unstabled Angina Pectoris (UAP) with drugs and interventional methods.Methods 40 patients were treated randomly with PTCA and stenting or traditional drugs: Beta blockers, Calcium resistants, Ester nitrates, Asprin, Heparin and so on.Compared degrees of angin pectoris, cases of AMI, mortality arising from heart disease or no heart disease before and 8 months after the treatment. Results Happening of AMI and mortality in interventional group were less than those of drugs group. Distinctly improving rate of clinical effect of the former was much more than that of the later.Conclusion In short term interventional treatment (PTCA and stenting) were piror to drugs in therapeutic effects and improving prognosis.

TMPRSS3 (transmembrane protease, serine 3) is a member of Ⅱ transmembrane serine proteases (TTSPs), and like the other members of this family, it contains typical domains including a serine protease domain, a transmembrane domain, a LDL receptor-like domain (LDLRA), and a scavenger receptor cysteine-rich domain (SRCR). Four alternative protein isoforms have been described, and isoform A is thought to be primary isoform which is expressed in many tissues, especially in the cochlea. TMPRSS3 protein is primarily localized in the endoplasmic reticulum membranes where it may be anchored by its transmembrane domain. TMPRSS3 is mutated in non-syndromic autosomal recessive deafness (DFNB8/10). Therefore TMPRSS3 is thought to be involved in the development and maintenance of the inner ear, and isoform D may be proposed as a novel diagnostic marker in ovarian carcinoma. TMPRSS3 protein is the first protease which mutation could lead to deafness. These data indicate that important signaling pathways in the inner ear are controlled by proteolytic cleavage. However, it is not clear about TMPRSS3 substrates and its function. The epithelial amiloride-sensitive sodium channel (ENaC) which is regulated by membrane-bound channel activating serine proteases (CAPs), a member of TTSPs, may be a potential substrate of TMPRSS3, but this hypothesis is still to be verified in vivo. With the development of protease research and the application of protease proteomics, substrate degradomes of a protease may therefore represent an important tool for the research of TMPRSS3 function and its molecular mechanism.

Objective:To investigate the expression of human epidermal growth factor receptor 4 (HER4) and metastasis-related protein (MMP-9) in human esophageal carcinoma tissues, and their relationship with clinicopathological features of the disease. Methods:Immunohistochemical Envision technique was applied to detect the expressions of HER4 and MMP-9 in 45 specimens of esophageal carcinoma tissues, paracancerous tissues and normal tissues. Statistical method was used to analyze the association of the positivity of HER4 with clinical pathological index and MMP-9 expression.Results:The positive rates of HER4 expression were 73.3%, 33.3%, and 2.2% in 45 specimens of esophageal carcinoma tissues, paracancerous tissues, and normal tissues, respectively. The expression of HER4 was correlated with TNM stage and lymph node metastasis (P<0.01), but not correlated with histological grade (P>0.05). The expression of MMP-9 correlated with T stage, invasion depth, TNM stage, and lymph node metastasis (P<0.05). Conclusion:The expression of HER4 is apparently different in esophageal carcinoma tissues, paracancerous tissues, and normal tissues. Its positive expression in esophageal carcinoma tissues is correlated with TNM stage and lymph node metastasis. The expression of MMP-9 in esophageal carcinoma tissues is correlated with the T stage, TNM staging, and lymph node metastasis. The positive expression of HER4 in esophageal carcinoma tissues is associated with the expressions of MMP-9.

Objective To investigate the X-ray,CT and MRI features of peripheral primitive neuroectodermal tumors (pPNETs).Methods 14 patients were pathologically diagnosed with pPNETs.The imaging of X-ray (twelve image),Computed Tomography(eleven image) and Magnetic Resonance Imaging(five image) were retrospectively analyzed.Results Of 14 patients,there were two sites of tumour:soft tissue( eight patients) and bones( six patients).For tumoura of the soft tissue region,the appearance of X-ray and CT imaging showed equal or lower density soft mass without dear boundary.In some cases,tumours invaded adjacent bones.The appearance of MRI imaging showed large heterogeneous masses inside soft tissue without clear boundary.Tumours displaced adjacent cortical bone and cavitas medullaris.All masses were heterogeneous enhancement on contrast images.For tumours of bone region,X-ray and CT scan showed large scale osteolysis osteoclasia in bone surrounding with soft tissue masses of various size.The lesions were equal or lower signal on T1 WI.All masses were intermediate or hyperintense signal with heterogeneous midrange or obvious enhancement on T2WI.Conclusion Imaging characteristics of pPNETs were described.X-ray,CT and MRI were useful in understanding the property,extent and staging of tumor and very useful in the diagnosis.