Objective To evaluate the effect of hyperbaric oxygen (HBO) treatment on postoperative cognitive dysfunction (POCD) in rats.Methods Eighteen healthy male Sprague-Dawley rats,weighing 260-290 g,were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.POCD was induced by injecting Aβ-40 2μl into the bilateral hippocampi by using a brain stereotaxic apparatus.The rats were randomly divided into 3 groups (n =6 each) using a random number table:normal sahne group (group NS),POCD group,and HBO treatment group(groupHBO).0.9％ normal saline 2 μl was injected into hippocampus in group NS.In group POCD,Aβ0 2 μl was injected into hippocampus.In group HBO,Aβ 2μl was injected into hippocampus,and then the rats received hyperbaric oxygen treatment lasting for 60 min once a day within 1-5 days after operation.Morris water maze test was performed on 7,14 and 21 days after operation in each group and the swimming distance and speed and escape latency were recorded.The animals were sacrificed after the end of test,the hippocampi were then removed to detect the activation of astrocytes (by immuno-histochemistry) and content of tumor necrosis factor-α (TNF-α) (by ELISA).Resets There were no significant differences in the parameters of behavior in Morris water maze test on 7 and 14 days after operation between the three groups.Compared with group NS,the swimming distance and escape latency were significantly prolonged,and the activation of astrocytes and TNF-α content were increased on 21 days after operation in group POCD,and the swimming distance and escape latency were significantly prolonged,the activation of astrocytes was increased,and no significant change was found in TNF-α content on 21 days after operation in group HBO.Compared with group POCD,the swimming distance and escape latency were significantly shortened,and the activation of astrocytes and TNF-α content were decreased in group HBO.There was no significant difference in the swimming speed at each time point among the three groups.Conclusion HBO treatment can alleviate POCD in rats,and the mechanism is related to inhibition of activation of astrocytes and inflammatory responses in hippocampi by HBO.

Objective To evaluate the effect of hyperbaric oxygen (HBO) treatment on the expression of nerve growth factor (NGF) in the spinal cord of rats with neuropathic pain (NP).Methods Thirty healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 270-300 g,were randomly divided into 5 groups (n =6 each) using a random number table:sham operation group (group S),group NP,pure oxygen group (group O),treatment with HBO at 2.5 atmosphere absolute group (group H2.5) and treatment with HBO at 3.0 atmosphere absolute group (group H3.0).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.NP was induced by chronic constrictive injury.The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1-mm intervals with 4-0 silk thread.HBO treatment was performed with the corresponding atmosphere absolute once a day for 7 consecutive days starting from 1 day after operation in H2.5 and H3.0 groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on 3,5,7 and 14 days after operation.The animals were sacrificed after the last measurement of pain threshold,and the lumbar segments of the spinal cord were removed to detect the expression of NGF by immuno-histochemistry and Western blot analysis.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of NGF was up-regulated at each time point after operation in NP and O groups.Compared with group NP,MWT was significantly increased,TWL was prolonged,and the expression of NGF was up-regulated at each time point after operation in H2.5 and H3.0 groups,and no significant change was found in MWT,TWL and expression of NGF in group O.Compared with group H2.5,the expression of NGF was significantly down-regulated,and no significant change was found in MWT and TWL in group H3.0.Conclusion The mechanism by which HBO treatment mitigates NP is related to up-regulation of the expression of NGF in the spinal cord of rats.

ObjectiveTo observe the effect of Gankang Ⅱ in reducing bilirubin level of patients with chronic hepatitis B,and discuss the mechanism.Methods124 cases hyperbilirubinemia patients with chronic hepatitis B were randomly divided into Gankang Ⅱ treatment group (the treatment group for short),and Yinzhihuang particles treatment group (the control group for short),with 62 eases in each group.The cure rate,recover rate of the treatment group and control group were observed,together with the changes of ALT,AST,GGT,and TBiL.Results①The cure rate was 80.6％,the recover rate was 19.4％ in the treatment group; the cure rate of was 62.9％ and the recover rate was 37.1％ in the control group; the cure rate of the treatment group was obviously higher than the control group.② There was no significant difference between the treatment group and the control group on TBiL,ALT,AST,and GGT before the treatment (P＞0.05).while after treated,TBiL (20.75±3.77) μmol/L,ALT (52.53± 12.23) U/L,AST (51.75 ±9.93) μmol/L,GGT (48.75 ±16.68) U/L of the treatment group were obviously lower than the TBiL(26.68 ±4.99)μmol/L,ALT(79.68± 1 1.92)U/L,AST (60.12 ± 8.12) μmol/L,GGT (58.97±15.47)U/L of control group.There was significant difference(P＜0.05～0.01).ConclusionThe effect of Gankang Ⅱ in reducing the bilirubin level of patients with chronic hepatitis B was sound.

Objective:To determine the dose-effect relationship of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol in pediatric patients undergoing gastroenteroscopy.Methods:Pediatric patients, aged 3-8 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective gastroenteroscopy, were enrolled in the study.The doses of nalbuphine were determined by up-down sequential allocation, nalbuphine 0.2 mg/kg was injected intravenously in the first child, and 5 min later medium plus long chain triglyceride propofol 2.5 mg/kg was given intravenously.Ambesh 4-point method was used to evaluate the injection pain of propofol.When the prevention of injection pain was ineffective, the dose of nalbuphine was increased in the next patient, otherwise the dose was reduced, and the difference between the two successive doses was 0.01 mg/kg.This process was repeated until the 7th turning point occurred.The ED 50 and ED 95 of nalbuphine and 95% confidence interval (CI) preventing injection pain of propofol were calculated by Probit regression. Results:The ED 50 and ED 95 (95% CI) of nalbuphine preventing medium plus long chain triglyceride propofol injection pain were 1.57 (1.50-1.62) and 1.71 (1.64-2.05) mg/kg, respectively. Conclusion:The ED 50 and ED 95 of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol are 1.57 and 1.71 mg/kg, respectively, in pediatric patients undergoing gastroenteroscopy.

Objective To establish a multiple PCR method that can be used to spontaneously detect five kinds ofpathogens such as NG,MH,MG,CT and UU.Method With the fluorescence-quantitative PCR technique in conjunction with another detection technique as the golden standard,evaluation was conducted on the sensitivity,specificity,accuracy and repeatability on the detection of 5 kinds of STD pathogens using single-tube multiplex PCR.Result The sensitivity,specificity and match rate of the method ale 10-9fg/μl,100%,97.8%respectively,and the repeatability of 5 continuous days of 20 clinical specimens is good.Conclusion Single-tube multiplex PCR technique provides a new method to detect 5 kinds of STD pathogens.

Objective To investigate the role of nuclear factor-kappa B (NF-κB)signaling pathway in propofol-induced suppression of up-regulation of inducible nitric oxide synthase (iNOS) gene expression in LPSstimulated RAW264.7 cells.Methods RAW264.7 cells were purchased from cell bank of Chinese Academy of Sciences and cultured in DMEM culture medium containing 10％ fetal bovine serum.The cells were seeded in 6 cm diameter dishes (3 ml/dish) or in 6-well plates (2 ml/well) with a density of 5 × 105/ml and randomly divided into 3 groups ( n =18): normal control group (group C),group LPS (group L)and group LPS + propofol (group LP).The cells were incubated with LPS 1 μg/ml in groups L and LP.Propofol 50μmol/L was added to the culture medium at 2 h before LPS in group LP.Cells were harvested at 30 min after being stimulated with LPS.Phosphorylation of IκB kinase(p-IKK) and NF-κB activity were detected by Western blot.The expression of iNOS mRNA was determined after 6 h exposure of the cells to LPS.Results LPS significantly up-regulated the expression of p-IKK and iNOS mRNA and increased NF-κB activity in group L as compared with group C.Propofol pretreatment significantly attenuated the effects of LPS on p-IKK,iNOS mRNA expression and NF-κB activity.Conclusion NF-κB signaling pathway is involved in the propofol-induced suppression of up-regulation of iNOS mRNA expression in LPS-stimulated RAW264.7 cells.

Objective To investigate the effects of exendin-4 (exenatide) on insulin sensitivity and adipocytokine in high-fat-fed rats. Methods Rats were divided randomly into normal-chow group (NC), high-fat group (HF) and high-fat+exendin treated group (HE). HE rats were given exenatide (2 μg/kg) twice daily for 6 wk. The insulin sensitivity was evaluated by intravenous insulin tolerance test (IVITT). Insulin-stimulated changes in insulin signal transduction, visfatin and adiponectin mRNA expressions as well as their plasma levels were also observed in these rats. Results Plasma free fatty acids (FFA), triglyceride (TG), total cholesterol (TC) levels were significantly reduced after exenatide treatment (in HE rats all P<0.01). And IVITT parameters were also improved in these rats. Insulin-stimulated IRS-1 tyrosine phosphorylation was slightly increased in exenatide-treated rats as compared with HF rats (P<0.05). In addition,plasma visfatin level was significantly reduced in HF and HE groups as compared with controls (P<0.05 and P<0.01). The adiponectin mRNA expression in adipose tissues and circulating adiponectin level were significantly elevated in exenatide-treated rats as compared with untreated rats and controls (P<0.01). Conclusions Chronic exenatide treatment improves insulin resistance in high-fat-fed rats, and the changes of IRS-1 tyrosine phosphorylation and adiponectin may be related to the role of exenatide in elevating insulin sensitivity

Objective To investgate the effects of exenatide on islet β-cell function, insulin sensitivity and glucose-lipid metabolism in insulin resistant rats induced by high-fat-chow. Methods High fat-fed rats were treated with exenatide for 6 weeks. The insulin sensitivity, islet β-cell function and glucose lipid metabolism in awake rats were evaluated by intravenous glucose tolerance test (IVGTT), insulin tolerance test (ITT) and hyperinsulinemic-euglycemic clamp technique combined with 3-[3H] glucose as a tracer. In addition, plasma adiponectin level was measured by ELISA. Results Lee′s index and levels of plasma free fatty acids (FFA), triglyceride and total cholesterol were significantly reduced in high fat-fed rats after exenatide treatment for 6 weeks (all P＜0.01). In these rats exenatide also improved IVGTT and ITT, and increased the level of insulin secretion, especially when a high dose was given. In addition, plasma adiponectin level was also significantly increased in the group with high dose exenatide (HFH, P＜0.01). During the clamp steady-state, there were significant increases in plasma FFA and insulin and significant decreases in glucose infusion rate (GIR), glucose disposal rate (GRd) in high-fat group (HF) compared to control group (NC, all P＜0.01). The suppressive effect of insulin on hepatic glucose production (HGP) was significantly blunted (only 26%) in HF group. In HFH group, plasma insulin and FFA levels were significantly decreased (both P＜0.01), GIR and GRd were significantly increased (both all P＜0.01), and HGP was suppressed by 72%. Conclusion It is possible that exenatide pretreatment ameliorates high-fat induced insulin resistance by promoting β-cell insulin secretion, elevating adiponectin level, and improving glucose-lipid metabolism.

Objective:To evaluate the efficacy of auricular acupoint pressure therapy combined with intranasal dexmedetomidine for transthoracic echocardiography in pediatric patients.Methods:A total of 117 pediatric patients with congenital heart disease, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, aged 3-36 months, weighing 5-20 kg, scheduled for elective transthoracic echocardiography under outpatient sedation, were selected.Transthoracic echocardiography was performed under sedation using intranasally administered dexmedetomidine or using auricular acupoint pressure therapy combined with intranasal dexmedetomidine.The interval between the two sedation methods was at least 1 week.Intranasal dexmedetomidine: Dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.Intranasal dexmedetomidine combined with auricular acupoint pressure: auricular acupressure with Wang Bu Liu Xing (semen vaccariae) seeds was used at the auricular acupoints.After each acupoint was rubbed for about 1 min, dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.After the examination, auricular acupoint pressure therapy was continued at home, and pressing-rubbing at the acupoints was manipulated for 3 times daily, one of which was performed at 30 min before going to bed, for 3 consecutive days.When the University of Michigan Sedation Scale score≥2 and body movement score ≥2 within 30 min after giving dexmedetomidine, sedation was considered to be successful.The onset time of sedation, examination time, waiting time, recovery time and the success of sedation were recorded.The incidence of adverse reactions such as bradycardia, hypotension, hypertension, hypoxemia, nausea and vomiting, respiratory depression, restlessness, hyperactivity, action imbalances and allergic reaction were recorded within 24 h after administration of dexmedetomidine.Time to recovery and improvement of sleep quality at night were recorded.Results:Compared with intranasal dexmedetomidine, the successful rate of sedation and incidence of improvement of sleep quality at night were significantly increased ( P<0.05), and no significant change was found in adverse reactions using intranasal dexmedetomidine combined with auricular acupoint pressure ( P>0.05). Conclusion:Intranasal dexmedetomidine combined with auricular acupoint pressure therapy can increase the successful rate of sedation and improve the sleep quality at night in pediatric patients undergoing transthoracic echocardiography when compared to intranasal dexmedetomidine.

Objective:To identify the risk factors for weaning failure after mandibular distraction osteogenesis in the infants with Pierre Robin sequence.Methods:A retrospective cohort study was conducted to collect clinical records of infants with Pierre Robin sequence underwent mandibular distraction osteogenesis at Guangzhou Women and Children′s Medical Center from November 2016 to May 2019.The inclusion criteria consisted of the following: age <1 yr and no serious cardiopulmonary disease or serious airway malformation.The medical charts were reviewed for sex, age, weight, premature delivery, low birth weight, preoperative intubation, preoperative pulmonary infection, ventilator-associated pneumonia, as well as mechanical ventilation time and distraction length at first weaning.The infants were divided into 2 groups according to the outcome of ventilator weaning at first attempt: successful group and failure group.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify weaning failure-related risk factors. Results:A total of 140 infants were included in this study, of which 9 cases developed failure of weaning at first attempt after operation, with the incidence of 6.4%.The results of logistic regression analysis showed that the distraction length and incidence of ventilator-associated pneumonia were independent risk factors for weaning failure after operation ( P<0.05). Conclusion:The length of distraction and ventilator-associated pneumonia are independent risk factors for weaning failure after mandibular distraction osteogenesis in the infants with Pierre Robin sequence.