Objective To summarize the anesthesia management in laparoscopic surgery for early pregnant women with tubal pregnancy. Methods Forty-eight women diagnosed as early intrauterine pregnancy combined with tubal pregnancy from January 2010 to July 2014 were enrolled in this retrospective study.All the patients received laparoscopic surgery under endotracheal intubation and total intravenous anesthesia.Their general conditions, perioperative conditions, pregnant complications, pregnant outcomes and newborns status were recorded. Results All the patients were operated successfully and recovered uneventfully.Among the 48 patients, spontaneous abortion occurred in 7 patients (14.6%).Among the remaining 41 patients who continued on their gestation, 39 cases (95.1%) had full term deliveries, 2 cases (4.9%) terminated pregnancy with premature birth, 8 cases (19.5%) got different complications related to pregnancy, and 34 cases (82.9%) received cesarean sections.All the newborns survived, with an average weight of 3429.2 ±499.4 g.There were 2 cases (4.9%) of low birth weight.No asphyxia or congenital malformation was seen in all the newborns. Conclusions Total intravenous anesthesia can be applied to laparoscopic surgery smoothly for early pregnant women with tubal pregnancy.When surgery is indicated during pregnancy, maintenance of marternal oxygenation, perfusion and homeostasis with the minimum effective anesthetic dose will assure the best outcomes for the fetus.

Objective This paper summarizes the safety management of 13 ARDS patients resulting from influenza A (H7N9) virus infection with daily awakening during analgesia and sedation treatment.Methods Safety management was given to 13 ARDS patients with influenza A (H7N9) virus infection during analgesia and sedation treatment.Results No serious complications or adverse events occurred during interruption period of analgesia and sedation.Conclusions To give safety management of daily awakening to patients with influenza A (H7N9) virus infection during analgesia and sedation treatment can increase treatment effect and facilitate early recovery of patients.

AIM:To investigate the inhibitory effect of P12,a kind of lipopolysaccharide(LPS)-binding protein(LBP) inhibitory peptide,on the binding of LPS to macrophage in vitro.METHODS:Human monocyte-like cell line(U937 cells) was grown in RPMI-1640 and stimulated with PMA in order to induce their differentiation to macrophage stage.The relative affinity of P12 to LPS was determined by enzyme-linked immunosorbent assay(ELISA).The effects of P12 on the binding of LPS to U937 cells were determined by flow cytometry analysis.The production of tumor necrosis factor-alpha(TNF-?) was measured by ELISA.RESULTS:The relative binding activity of P12 to LPS was higher than that of LBP in the same mass concentration.P12 inhibited the binding of FITC-conjugated LPS(FITC-LPS) to U937 cells.The productions of TNF-? was also significantly suppressed by P12.CONCLUSION:The results suggest that blockage of LBP at the inflammatory sites might attenuate LPS-induced circulatory shock.

Objective To investigate the predictive value of serum glycated hemoglobin A1c (HbA1c)level and early neurological deterioration (END)in patients with acute cerebral infarction. Methods From June 2014 to January 2016,the consecutive patients with acute ischemic stroke (interval time from onset to admission < 3 days)admitted to the Department of Neurology,Suqian People′s Hospital were enrolled retrospectively. The neurological deficits of all patients were evaluated on the day of admission with the National Institutes of Health Stroke Scale (NIHSS). The symptoms of neurological deficits in patients were evaluated repeatedly for all patients within 7 days after admission. Any score increased ≥2 compared with before admission was defined as END. The 226 patients met the inclusion and exclusion criteria were enrolled,and they were divided into either an END group (n = 50,22. 1%)or a non-END group (n = 176,77. 9%)according to whether END occurred after acute cerebral infarction. Univariate analysis was used to analyze the differences between the 2 groups. Multivariable Logistic regression analysis was used to analyze the correlation between the HbA1c level and END. Results Compared with the non-END group,there were significant differences in the age,prevalence of diabetes,NIHSS score,hypersensitive C-reactive protein level,rate of ASPECT score 0-7,and serum HbAlc level in the patients of the END group (all P < 0. 05). The results of logistic regression analysis showed that the elevated hypersensitive C-reaction protein and serum HbA1c levels were the independent risk factors for END of acute cerebral infarction (OR,1. 048 and 1. 809 respectively,95% CI 1. 008 -1. 089 and 1. 429 -2. 292 respectively;P = 0. 018 and 0. 002 respectively). Conclusion The increased serum HbA1c level is an independent risk factor for END of acute cerebral infarction. It has certain predictive value for END.

BACKGROUND:Wnt5a is able to inhibit canonical Wnt signaling and activate non-canonical Wnt signaling pathway. In recent years, it has been found that non-classical Wnt5a/PCP signaling pathway mediated by Wnt5a plays an important role in the process of bone marrow mesenchymal stem cel proliferation and differentiation, but the underlying mechanism is unclear.
OBJECTIVE:To summarize the progress in downstream effector molecules related to Wnt5a/PCP signaling pathway, and its roles in the chondrogenic and osteogenic differentiation of bone marrow mesenchymal stem cel s.
METHODS:A computer-based online search of CqVip, CNKI and PubMed databases between January 2000 and February 2016 was performed using the Chinese keywords of“BMSCs, Wnt signaling pathways, chondrogenic differentiation, osteogenic differentiation”and English keywords of“BMSCs, chondrogenic differentiation, osteogenic differentiation, Wnt, Fzd, Ror2, RhoA, ROCK, JNK”, respectively. Literatures related to bone marrow mesenchymal stem cel chondrogenic and osteogenic differentiation were selected. Final y, 43 eligible articles were included for analysis through excluding the old and repeated research.
RESULTS AND CONCLUSION:Wnt5a, a representative protein in non-canonical Wnt signaling pathway, paticipates in the cytoskeleton, cel migration and cel polarization and other activities by mediating its downstream signaling molecules such as Fzd, Ror, RhoA, ROCK, JNK, thereby regulating its proliferation and differentiation. But it is unclear how Wnt5a/PCP participates in the bone marrow mesenchymal stem cel chondrogenic and osteogenic differentiation and how the downstream effector molecules interact or function independently, which requires further studies.

The TLC UV scanning assay for tanshinone IIA and cryptotanshinone in Yangxuezhitong pills was built up.Their wave lengths were 260 nm and 255 nm respectively.The regressive equation and coefficient of corelation were Y=40.48+5526.90X,r=0.9995 and Y=-12.91+5640.48X,r=0.9999 respectively.The recovery ratio of cryptotanshinone was(?)=102.62%.This me- thod is simple and convenient,and elicits accurate and reproduceable results.

Objective To compare the bone microstructure and osteoblast and osteoclast activity in different regions of osteonecrosis of the femoral head.Methods The osteonecrosis femoral heads were collected from 10 patients (Ficat Ⅳ) who had undergone total hip arthroplasty from March 2011 to May 2013.There were 6 males and 4 females.Their average age was 47.7 years old (range,40-57 years).The samples were divided into subchondral bone region,necrotic region,sclerosis region and healthy region according to radiographic results,then the bone microstructure,micro mechanism and osteoblasts/osteoclasts activity were analyzed byMicro-CT,RT-PCR,Nanoindentation,immunohistochemistry and Trap staining.Results According to the micro-CT results,the continuity of trabecular bone in necrotic region was damaged.The number of trabecular was increased and the gap was narrowed in sclerosis region.The shape and number of trabecular bone were normal in the healthy region.The elasticity moduli in different regions were:subchondral bone region 13.808±4.22 GPa,necrotic region 13.999±3.816 GPa,sclerosis region 17.266±3.533 GPa and healthy region 11.927±1.743 GPa.The hardness were subchondral bone region 0.425±0.173 GPa,necrotic region 0.331±0.173 GPa,sclerosis region 0.661±0.208 GPa,and healthy region 0.423±0.088 GPa.The trap staining of subchondral bone in healthy region and necrotic region were positive while other regions were negative.Immunohistochemistry staining showed that compared with necrotic region,the RANK and RANKL staining level increased significantly in subchondral bone and necrotic region,while Runx2 and BMP2 staining level increased significantly in sclerosis region.Conclusion The mechanical properties of trabecular have no significant difference between necrotic region and healthy region in the progress of the osteonecrosis,while the bone structure has obvious changes.An active bone resorption is observed in subchondral bone and necrotic region,while a higher bone formation activity is found in sclerosis region.

Objective:To investigate the clinicopathological features and prognosis of IgA nephropathy (IgAN) patients with gross hematuria.Methods:The clinical and pathological data of 490 primary IgAN patients admitted in the Affiliated Hospital of Qingdao University from January 2010 to June 2019 were analyzed. Patients were divided into gross hematuria group and non-gross hematuria group. The clinical and pathological features and prognosis were compared between the two groups. All patients were diagnosed by kidney biopsy, and followed up until June 30, 2020. Kaplan-Meier survival curve was used to examine the renal survival,and Cox regression model was used to analyze the risk factors affecting renal survival in two groups.Results:Among 490 patients there were 111 patients (22.7%) in the gross hematuria group and 379 patients (77.3%) in the non-gross hematuria group. Age, hypertension, 24-h urine protein, serum creatinine, blood uric acid, blood triglycerides, total blood cholesterol level, mesangial cell hyperplasia (M1), the proportion of renal tubular atrophy or renal interstitial fibrosis (T1/2) in gross hematuria group were lower than those in non-gross hematuria group ( P<0.05), while the estimated glomerular filtration rate (eGFR) in gross hematuria group was higher than those in non-gross hematuria group ( P<0.05). Four hundred and twenty six patients (86.9%) were followed up for at least 6 months, including 93 patients in gross hematuria group and 333 patients in non-gross hematuria group. There was no statistically significant difference in treatment method between the two groups ( P>0.05). The incidence of end-point events in non-gross hematuria group was higher than that in gross hematuria group [18.6%(62/333) vs. 6.5%(6/93), χ2=8.023, P<0.05]. Kaplan-Meier survival analysis showed that the cumulative renal survival rate of the gross hematuria group was higher than that of the non gross hematuria group (χ2=11.44, P<0.001). Multivariate Cox regression analysis showed that urine protein>1 g/24 h, eGFR<60 ml·min -1·(1.73 m 2) -1, hypertension, hyperuricemia and the elevated serum IgA/C3 were risk factors for renal survival [ HR(95% CI)=3.457(1.137-10.514),2.736(1.073-6.977),2.720(1.144-6.465),2.789(1.102-7.060),1.070(1.009-1.135), all P<0.05]. Conclusions:IgAN patients with gross hematuria has less severe kidney damage and higher cumulative renal survival rate than non-gross hematuria patients. Urinary protein>1.0 g/d, hypertension, hyperuricemia and the elevated serum IgA/C3 are risk factors for adverse end-point events, to which timely attention and corresponding treatment should be given.

Objective To investigate the effect of incomplete cryoablation on the biological behavior of prostatic cancer RM-1 cells and its mechanism.Methods RM-1 cells of prostatic cancer were placed in -20℃ icebox to be frozen for 5 min.After the recovery of the cell state,the RM-1 cells were frozen again for 10 min and 15 min successively.After culture for one day,the cellular morphology was microscopically examined.A total of 20 C57/BL mice were used to establish the tumor-bearing models,which were randomly and equally divided into the control group and the incomplete cryoablation group with 10 mice in each group.At scheduled time points the tumor lesion size was measured for all mice.The mice were sacrificed at 14 days,the lung tissues were collected and were stained with lE;the numbers of metastatic lesions in the lung were calculated.Transwell assay was used to test the cell migration and invasion,immuno-blotting method was adopted to determine the epithelial-mesenchymal transition-related (EMT-related) protein expression level,and the enzyme-linked immunosorbent assay (ELISA) was employed to check the secretion volume of transforming growth factor-beta (TGF-β).Results After incomplete cryoablation,RM-1 cells became disorderly arranged,their morphology was changed,and antenna structure might be formed.At 3 and 7 days after cryoablation,the tumor size in the incomplete cryoablation group was slightly smaller than that in the control group,but only the difference at 7 days after cryoablation was statistically significant between the two groups (P=0.019).At 10 and 14 days after cryoablation,the tumor volume of the two groups was almost equal.The pulmonary metastatic lesions in the incomplete cryoablation group were obviously much more than those in the control group (P＜0.001).Transwell assay indicated that the cell migration and invasion ability in the incomplete cryoablation group was stronger than that in the control group (P＜0.05).Immuno-blotting test revealed that,when compared with the control group,in the incomplete cryoablation group the expressions of N-cadherin,MMP-9 and Vimentin were up-regulated,while the expression of E-cadherin was downregulated.ELISA test showed that increased secretion of TGF-β was observed in the incomplete cryoablation group.Conclusion Incomplete cryoablation can enhance the migration and invasion ability of RM-1 cells,increase the number of pulmonary metastatic lesions in tumor-bearing mice,and affect the EMT-related protein expression level.

Objective To explore the relation between the Integrin alpha 2 (ITGA2)-807 C/T gene and diabetic nephropathy (DN) in Han nationality in northern part of Guangxi. Methods 206 patients with type-2 diabetes were selected from the hospital. According to the diagnosis of diabetic nephropathy (DN) standards, 206 patients with type-2 diabetes were divided into diabetes without diabetic nephropathy (T2DM) and DN group, and 90 healthy people were selected as normal control (NC) group. The plasma lipid and lipoprotein levels were measured by routine method.And the genotypes and allele frequencies distribution were assessed by Polymerase chain reaction-restriction fragment length Polymorphism (PCR-RFLP). Results compared with the control group,plasma total cholesterol(TC),triglyceride(TG) and low density lipoprotein-cholesterol (LDL-C) levels in DN group blood were significantly higher (P < 0.05). ITGA2 gene - 807 - c/T genotype distribution and allele frequency in DN group were statistically significant (P<0.05). CT+TT genotypes and T allele frequency in DN group were significantly higher than control group (P<0.05).The relative risk for DN in subjects carrying T allele was 1.72 times of that in the C allele carriers(OR = 1.72, 95% CI = 1.72 ~ 2.517). And compared with control group and the DN group, ITGA2 gene-807-c/T genotype distribution and allele frequency differences in T2DM group had no statistical significance (P > 0.05). Conclusions The polymorphism of ITGA2-807C/T gene is associated with the development of DN in Han nationality in northern part of Guangxi. The T allele may be a genetic susceptibility genes for DN, which may promote the level of TC high expression and increase the risk of DN.