Objective Intranasal drops of dexmedetomidine can induce conscious sedation in children .This study was to com-pare the sedative effects of different doses of intranasal dexmedetomidine in different age groups of children patients . Methods We e-qually randomized 90 hernia children waiting for elective unilateral inguinal surgery ( ASAⅠ-Ⅱ) to groupsⅠ,ⅡandⅢ.At 35 minutes be-fore surgery, we obtained the heart rate (HR), mean artery pressure (MAP) of all the patients.The children in groupsⅠandⅡreceived nasal instillation of dexmedetomidine at 1 and 2μg/kg respectively, while those in groupⅢ0.4 mL of normal saline, followed by sevoflu-rane induction, intravenous injection of sufentanil (0.2μg/kg), and laryngeal mask airway anesthesia with sevoflurane .We recorded HR, MAP before medication, at 10 min, 20 min and 30 min before mediation, right after surgery, and at the recovery to consciousness . We also recorded the sedation onset time and post-surgery recovery time and assessed sedation satisfaction using the Ramsay score . Results The rates of satisfactory preoperative sedation were 50 and 63% in groupsⅠandⅡ, significantly higher than 10%in groupⅢ(P<0.05). In the 1-4-year group, the sedation satisfaction rate , sedation onset
time and post-surgery recovery time showed no significant differences between groupsⅠandⅡ(P>0.05).In the 5-8-year group, seda-tion satisfaction rate was markedly higher in groupⅡthan in groupsⅢ(77%vs 22%, P<0.05) andⅠ(77%vs 45%) . Conclusion At 1 and 2μg/kg, intranasal drops of dexmedetomidine produces similar rates of satisfactory sedation in children aged 1-4 years, and at 2μg/kg can achieve an even higher rate of satisfactory sedation without adverse hemodynamic effects in those aged 5-8 years.

Objective To compare the effects of transcranial and trans-spinal low frequency magnetic stimulation (MS) on the expression of growth-associated protein-43 (GAP-43) in the spinal neurons of rats after spinal cord injury (SCI). Methods Forty-five Sprague-Dawley female rats were divided randomly into a transcranial magnetic stimulation (TMS) group,a trans-spinal cord magnetic stimulation group and a model control group with 15 in each group.Another 6 rats served as a normal control group.Spinal cord injury at the T9-10 level was modeled according to the modified Allen's method.The rats in the two MS groups received magnetic stimulation at 0.5 Hz and 75％ of the maximum output intensity ( 1.9 T) of the magnetic stimulator beginning 24 h post injury.They received 30 pulses daily for 28 days while the rats in the model control group were not exposed to MS.Basso-Beattie-Bresnahan (BBB) scale scores and motion evoked potentials (MEPs) were measured at the 1st,7th,14th,21 st and 28th day post injury.The expression of GAP-43 protein was studied using immunohistochemical methods and semi-quantified by Western blotting. Results At the 4th week post injury the average BBB scores in the model control group,the TMS group and the trans-spinal cord magnetic stimulation group were all significantly different. MEP amplitudes decreased significantly in all groups after the injury,and the latency was prolonged,but there were no significant differences among groups at any time point.GAP-43 expression also increased after SCI,and it was significantly higher in the MS groups than in the model control group at 4 weeks. Moreover,the expression of GAP-43 in the trans-spinal cord MS group was significantly greater than in the TMS group.Conclusion Magnetic stimulation can promote nerve regeneration and improve locomotor recovery after spinal cord injury,at least in rats.The effect of trans-spinal cord magnetic stimulation is superior to that of TMS.The mechanism may be related to the activation of central pattern generators.

Objective To study the expression of activated leukocyte cell adhesion molecule (ALCAM/CD166) in serous ovarian tumors and its significance.Methods The expression level of CD166 protein,estrogen receptor,progestogen receptor were detected by immunohistochemical staining in 56 cases of malignant tumors,30 cases of borderline tumors and 10 cases of benign tumors,the relationship was investigated between the expression of CD166 and clinicopathologic information and its correlation with the expression of estrogen receptor (ER) and progestogen receptor (PR).Results The positive rates of CD166 protein in malignant,borderline and benign epithelial ovarian tumors were 87.5 ％ (49/56),56.7 ％ (17/30) and 10.0 ％ (1/10) respectively,there were significant differences (x2 =7.463,31.054,10.563,all P ＜ 0.01).There were also significant differences in positive rates of CD166 protein among different clinical stages,pathologic grades and lymph node metastasis of epithelial ovarian tumors (x2 =41.205,Z =-4.663,Z =-2.981,all P ＜ 0.01).There was a negative correlation between the expression of CD166 protein and the leves of ER and PR (x2 =23.36,21.441,both P ＜ 0.05).Conclusion CD166 takes part in development and progression of serous ovarian carcinoma.The expression of CD166 increase significantly in ovarian serous carcinoma.

In spite of the fact that rectal stromal tumor accounts for only 4.2％ of the gastrointestinal stromal tumor,its surgical treatment is still very difficult and challenging due to the special anatomical position of rectum,its complicated anatomical relationship with adjacent organs,and whether the anus be preserved.Local resection of rectal stromal tumor is feasible and reasonable owing to its biological characteristics.However,there are many approaches and methods for local resection and no consensus has been reached.The clinical data of 18 patients with rectal stromal tumor who were treated by local resection via transposterior approach at the Peking Union Hospital from March 2003 to September 2012 were retrospectively analyzed.The surgery not only applies with the oncology treatment principle,but also preserves anus and limits the surgical injury to a large extent.Therefore,it is one of the most ideal surgical methods for the treatment of rectal stromal tumor.

Objective To investigate the effect of forced-air warming system on the cellular immune function during radical esophagus cancer resection. Methods Thirty-six ASA Ⅰ or Ⅱ patients of both sexes, aged ≤ 64 yr, with body mass index ＜ 30 kg/m2 , scheduled for elective radical esophagus cancer resection, were randomized to 2 groups ( n = 18 each): normal temperature care group (group C) and forced-air wanning group (group T) . Anesthesia was induced with midazolam, sufentanil, propofol and vecuronium. The patients were tracheal intubated and mechanically ventilated. The patients were not warmed intraoperatively in group C. In group T, the patients were prewarmed for 20 min at 43℃, using forced-air warming system before induction and then kept warm until the end of operation. The nasopharyngeal temperature was measured at 0, 30, 60, 120 and 180 min after anesthesia induction and at the end of operation (T1-6 ) to reflect the body temperature. Venous blood samples were taken at T1,6 for analysis of T-lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+ /CD8+ ) and NK cells (by flow cytometry) and determination of the plasma concentrations of noradrenaline and adrenaline (by ELISA) . Results Compared with T1 , the body temperature was significantly decreased at T2-6 in group C, and the percentage of CD4+ cells and CD4+ /CD8+ ratio were significantly decreased and the percentage of CD8+ and plasma concentrations of noradrenaline and adrenaline increased at T6 in both groups ( P ＜ 0.05). Compared with group C, the body temperature was significantly increased at T2-6, plasma concentrations of noradrenaline and adrenaline were significantly increased at T, , while the change rate of concentrations was significantly decreased in group T ( P ＜ 0.05) . ConclusionThe efficiency of forced-air warming system in maintaining perioperative normothermia is good and it reduces the stress response, but it exerts no influence on the cellular immune function in patients undergoing radical esophagus cancer resection.

Objective To investigate the therapeutic method and effects of malignant tracheal stenosis with nitinol memory alloy stents.Methods Seventeen patients with malignant tracheal stenosis were treated by nitinol memory alloy stents.Of them,13 patients underwent chemotherapy or chemotherapy and radiotherapy after stents set.Results Eighteen tracheal stents were placed in 17 patients through interventional method,with 100% successful rate.All patients had made immediate disappearance in dyspnea.Followed-up time was taken for 1 to 11 months with no restenosis and stent migration.Conclusion Under fluoroscopic guidance,tracheal stent placement is a safe,rapid and reliable proceduce for treating malignant tracheal stenosis.

Based on the research project of the French language teaching reform in Kunming Medical College——the Application and Analogy of Modern Foreign Languages Pedagogy,the successes and disadvantages of the visual-audio-oral course were studied.The teaching reform's purpose and focal points were primarily introduced.Then,the successful experiences of academic period arrangement,teaching materials selection,in-class instruction and students' academic achievements were elaborated.Finally,by making a comparison of students' French language proficiency between the present experimental classes and the former ordinary classes,a few disadvantages of the reform were interpreted.

Objective To establish a convenient method for the selection of hair follicle stem cells and study the effects of ?-catenin on the regulation of proliferation and differentiation of hair follicle stem cells.Methods Based on the strong specific adherent ability of stem cells,hair follicle cells were incubated in the plates coated with human collagen before use.Hair follicle stem cell's marker K19 and clone forming efficency were used to identify the stem cells.The expression of ?-catenin was tested by immunocytochemistry and in situ hybridization.Results After adherence to collagen for 20min,the number of Kl9 positive cells among quickly-adhered cells increased 1.6 times more than unselected cells and clone forming efficiency increased 3.5 times.The expression of ?-catenin protein increased in the nuclear of quickly-adhered cells.Conclution The selection method of human hair follicle stem cells by quick-adherence to collagen was established for the first time.?-catenin was involved in the regulation of hair follicle stem cells'proliferation and differentiation.

Through thorough understanding of the pathophysiology of graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect, especial the effects of immune cells and cytokines, the article is designed to find out multiple ways to reduce GVHD and reserve or enhance GVL effect. Many kinds of cytokines are involved in the pathophysiologic mechanisms of GVHD and GVL effect. Different cytokines have different effects on GVHD and GVL effect. Immune cells play important roles in regulating GVHD and GVL effect. Studies shows that some cytokines and specific immune cells are able to reduce GVHD, as well as reserve or enhance GVL effect at the same time, which make the separation of GVL from GVHD can be achieved. On the whole, through thorough understanding of the mechanism of immune cells and cytokines in GVHD and GVL effect, we can find out multiple ways to reduce GVHD, as well as reserve or enhance GVL effect.

Objective To explore clinical characteristics in boys and girls with systemic lupus erythematosus(SLE) and provide refe-rences for clinician′s correct diagnosis and cognition.Methods The clinical characteristics and laboratory examination of 88 children with SLE were comparatively analyzed from Dec.1993 to Sep.2007 by a retrospective cohort study.There was a ratio of 1.04.9 between boys and girls with SLE,and the peak incidence was among adolescent girls(10-15 years old),accounting for 60.2% of all children with SLE.There was no difference in onset age between the 2 groups.Disease activity was evaluated using SLE disease activity index(SLEDAI).Clinical characteristics and laboratory examination were studied by Spearman rank correlation analysis.Results There were significant differences in the constituent ratio of onset symptom and clinical symptom between boys and girls with SLE.Initial manifestation in boys with SLE was mainly skin lesion while in girls with SLE was fever.There were no significant difference for the incidence of each organ lesion between boys and girls with SLE,but higher rate of anemia and hepatic disfunction in girls with SLE was found.There were up trends of splenomegaly,abnormal electroence phalogram,butterfly erythema occurred in girls with SLE,while gastrointestinal symptoms,serositis,eyes damage occured in boys with SLE.Nephrotic syndrome was the main type of renal damage in both groups(boys:40.0%,girls:45.7%).There were significant differences in the constituent ratio of detection rate in laboratory examination,but no significant difference of positive rate was found in any kind of item between boys and girls with SLE.There was some relationship between C3 and muti-organ lesion,double stranded DNA(dsDNA) and renal lesion through correlation analysis for girls with SLE.Conclusions There are some differences of initial manifestation between boys and girls with SLE,the clinical features and laboratory examination show no gender difference.C3 may be a indicator of the disease severity for girls with SLE.