0.05).Conclusion:MBL B allele is not a risk component in the developing process of SLE Chinese patients.

Objective To investigate the effect of dexmedetomidine on cognitive dysfunction after offpump coronary artery bypass grafting in patients.Methods Fifty-eight ASA physical status Ⅱt or Ⅲ patients,aged 51-63 yr,weighing 52-83 kg,undergoing off-pump coronary artery bypass grafting,were randomly divided into 2 groups (n =29 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,sufentanil and pipecuronium.The patients were thracheal intubated and mechanically ventilated.Anesthesia was maintained with propofol,sufentanil,isoflurane and pipecuronium.A loading dose of dexmedetomidine 1 μg/kg was infused over 15 min after tracheal intubation,followed by dexmedetomidine infusion at 0.5 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume of normal saline was infused in group C.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 24 h before operation and 24,48 and 72 h after operation.The development of postoperative cognitive dysfunction was recorded within 72 h after operation.The consumption of sufentanil and extubation time after extubation was recorded.Results Compared with group C,MMSE scores at 24 and 48 h after operation were significantly increased and the incidence of postoperative cognitive dysfunction within 72 h after operation was decreased (P ＜ 0.05),and no significant change was found in the consumption of sufentanil and extubation time in group C (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development of postoperative cognitive dysfunction after off-pump coronary artery bypass grafting in patients.

Objective: To study the effect of oxymatrine on oxidative stress and inflammatory reaction after cerebral ischemia reperfusion in rat. Methods: A total of 140 SD rats were randomly divided into the sham group, model group and oxymatrine low, medium, high-dose groups (28 in each group). Beyond the sham group, the other groups were established the rat model of focal cerebral ischemic reperfusion with Zea-Longa occluded suture. The the low-, medium- and high-dose matrine groups were given 25, 50, and 100 mg/kg oxymatrine solutions injected intraperitoneally from the second day after operation for 7d. , The model group and the sham group were injected with an equal volume of saline. The neurological deficits, ratio of infarct volume, water content of the brain were evaluated; the morphological changes of brain tissue were observed by HE Staining, and the cell apoptosis were observed after TUNEL staining; the activity of antioxidant enzymes and malondialdehyde (MDA) in brain tissue were measured by biochemical analysis; the content of NO and the activity of iNOS were measured; the expression of NF-ĸB were determined by Western blotting. The inflammatory cytokines in brain tissue were determinated. Results: Compared with the model group, the neurological function score, brain tissue water content, infarct volume and apoptotic index decreased in the rats of oxymatrine medium-, high-dose groups (P<0.05 or P<0.01). The activity of SOD (148.68 ± 9.12 U/mg, 161.34 ± 10.09 U/mg vs. 140.63 ± 8.47 U/mg), CAT (3.90 ± 1.32 U/mg, 4.15 ± 1.47 U/mg vs. 2.73 ± 0.89 U/mg), GSH-Px (11.46 ± 2.65 U/mg, 13.59 ± 3.27 U/mg vs. 9.35 ± 2.03 U/mg) were significantly increased (P<0.05 or P<0.01). The content of MDA (20.18 ± 3.59 μmol/g, 17.46 ± 3.21 μmol/g vs. 29.86 ± 5.40 μmol/g), iNOS (12.64 ± 1.83 U/mg, 11.75 ± 1.62 U/mg vs. 14.17 ± 2.06 U/mg), NO (23.64 ± 2.18 μmol/g, 21.27 ± 2.03 μmol/g vs. 27.82 ± 2.42 μmol/g), TNF-α (43.9 ± 6.3 nmol/L, 37.2 ± 5.8 nmol/L vs. 56.3 ± 6.9 nmol/L), IL-1β (715.0 ± 68.5 nmol/L, 683.9 ± 70.8 nmol/L vs. 930.8 ± 91.4 nmol/L), IL-6 (168.4 ± 22.5 nmol/L, 133.7 ± 18.1 nmol/L vs. 212.5 ± 24.7 nmol/L) were significantly decreased (P<0.05 or P<0.01). The expression of NF-ĸB in brain (0.35 ± 0.13, 0.24 ± 0.08 vs. 0.62 ± 0.15) were significantly down-regulated (P<0.05 or P<0.01). Conclusions The Oxymatrine inhibits oxidative stress injury and inflammatory response after cerebral ischemia-reperfusion in rats.

Objective To evaluate the effect of dexmedetomidine on the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.Methods Forty-two patients of either sex with intracranial aneurysm,aged 57-78 yr,weighing 53-86 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective balloon occlusion test of the internal carotid artery under general anesthesia,were assigned into 2 groups (n =21 each) using a random number table:propofol conbined with remifentanil group (group PR) and dexmedetomidine combined with propofol and remifentanil group (group DPR).In group DPR,dexmedetomidine was intravenously infused over 15 min in a loading dose of 0.5 μg · kg-1 before induction of anesthesia,followed by an infusion of 0.3 μg · kg-1 · h-1 throughout surgery.Propofol and remifentanil were given by target-controlled infusion (TCI) after infusion of the loading dose.The patients were mechanically ventilated after placement of the laryngeal mask airway.Maintenance of anesthesia was as follows:propofol and remifentanil were given by TCI with the target plasma concentrations of 0.5-1.0 μg/ml and 1-3 ng/ml,respectively,in group DPR;propofol and remifentanil were given by TCI with the target plasma concentrations of 3-5 μg/ml and 3-6 ng/ml,respectively,in group PR.Bispectral index (BIS) value was maintained at 40-60.Before wakeup test,propofol infusion was stopped and the target plasma concentration of remifentanil was decreased to 0.5 ng/ml in two groups,and the infusion rate of dexmedetomidine was decreased to 0.1 pg · kg-1 · h-1 in group DPR.The wake-up time was recorded and the wake-up quality was assessed.After admission to the operating room (T0,baseline),at 10 min before wake-up test (T1),immediately after patients were wakened (T2),at 10 min after patients were wakened (T3) and at the end of wake-up test (T4),the mean blood pressure (MAP),heart rate,respiratory rate (RR),SpO2 and BIS values were recorded.The development of intraoperative awareness,emergence time,postoperative agitation,nausea and vomiting,regurgitation and aspiration and severe pain was recorded.Results MAP,heart rate,SpO2 and RR were all within the normal range during wake-up period in two groups.Compared with the baseline at To,MAP was significantly decreased at Ti,3,4 in group PR,and BIS value was decreased at T1-4 in DPR and PR groups (P＜0.05).Compared with group PR,MAP was significantly increased at T1.3,BIS value was decreased at T24,the wake-up time was shortened,Ramsay sedation score and wake-up quality were increased,the emergence time was shortened,and the incidence of agitation was deceased (P＜0.05),and no significant change was found in verbal rating scale scores assessed after extubation in group DPR (P ＞ 0.05).No cardiovascular events,respiratory depression,intraoperative awareness,postoperative nausea and voniting,regurgitation and aspiration or severe pain was found in two groups.Conclusion Dexmedetomidine can raise the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.

Objective To explore the effect of topical application of sodium hyaluronate on preventing perivascular adhesion of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months, were randomly and equally divided into 2 groups: groups A and B. Arterial defect model was established by cutting about 1cm artery from the middle part of the dissected left common carotid artery. A section about 3cm was cut from the right external jugular vein, and the harvested vein was inverted and anastomosed end-to-end to the artery defect. After the anastomosis, the adventitia and two anastomoses of the grafted veins in group A were coated locally with 0.2ml sodium hyaluronate. The grafted veins were obtained 1, 2 and 4 weeks after the operation, with the perivascular adhesion of the vein grafts being examined macroscopically before the resection. HE staining and Masson staining were preformed for histological changes of grafted vein wall and the perivascular adhesion of the vein grafts. At 2, 4 weeks postoperation, the perivascular adhesions of the vein grafts were graded by the grading criteria of adhesion in macroscopic evaluation and histological evaluation. Result At 1, 2 and 4 weeks postoperatively, the macroscopic and histological observation found that the perivascular adhesions in group A were looser than those in group B. The macroscopic grade and histological grade were lower in group A than in group B, there was a significant difference between the two groups at 2 and 4 weeks postoperation (P<0.05). Conclusion Topical application of sodium hyaluronate can reduce the perivascular adhesion and is an ideal treatment strategy for preventing perivascular adhesion of vein grafts.

ObjectiveTo evaluate the adverse events occurred during tumour necrosis factor (TNF)-αblocker treatment in Chinese Han population patients with ankylosing spondylitis (AS).MethodsThis study had enrolled 369 Chinese Han population patients with ankylosing spondylitis.They all received TNF-αblocker treatment in the hospital.All 1011 administration were recorded in total.All of them were evaluated for adverse events 2 hours after injection,126 of them had received long-term TNF-α blocker injection,and they were followed-up at week 8,12,52,104.Mild immediate adverse events and long-term adverse events were all counted.SPSS 10.0 software package was used for Fisher's exact test.ResultsThree hundred and sixty-nine patients had 1011 administrations in total,652 had received rhTNFR:Fc,316 had infliximab,21had etanercept,22 had adalimumab injections.Adverse events 2 hours after injection were:17 (2.6％) for rhTNFR:Fc,12 (3.8％) for infliximab,0 for etanercept,1 (4.5％) for adalimumab.Twenty adverse events were mild(12 for rhTNFR:Fc,9 for infliximab),5 events were moderate(3 for rhTNFR:Fc,1 for infliximab,1 for adalimumab),4 events were severe(2 for rhTNFR:Fc,2 for infliximab).The frequency of adverse events were comparable between rhTNFR:Fc and Infliximab injection in immediate adverse reactions (P=0.31).One hundred and twenty-six (69 rhTNFR:Fc,57 infliximab) patients had long-term usage,and were followed-up at week 8,12,52,104,39 patients had adverse reactions:20 (51.3％) for rhTNFR:Fc,19(48.7％) for infliximab.Thirty-seven patients had infectious events(94.9％ ),1 neurological event(2.6％),and 1 patient had tuberculosis relapse (2.6％).Outcomes were comparable with rhTNFR:Fc and infliximab in long-term usage(P=0.69).ConclusionAttention should be paid to the above events in Chinese Han patients with ankylosing spondylitis who were treated with TNF-α blocker treatment.Special attention should be paid to those patients who are in their third or fourth injection.The occurrence of immediate reaction or long-term adverse events between rhTNFR:Fc and infliximab are comparable.

Objective To evaluate the median effective anesthetic dose of ropivacaine in ultrasound-guided transversus abdominis plane ( TAP ) block for analgesia in patients undergoing appendectomy. Methods Twenty-eight cases of appendectomy under general anesthesia were analyzed.After standardized general anaesthesia,a bilateral ultrasound-guided TAP block was performed on patients undergoing appendectomy using ropivacaine. Sequential method was applied. The initial dose of ropivacaine in first patient was 1.6 mg·kg-1,the dose adjustment interval was 0.2 mg·kg-1.Numerical Rating Scale was used to estimate the level of pain postoperatively. If NRS≤3, dosage of ropivacaine was decreased by 0. 2 mg·kg-1. The transversus abdominis plane block analgesia duration and incidences of postoperative adverse reactions were analyzed. Results Median effective dose (ED50) of ropivacaine in ultrasound-guided transversus abdominis plane block was 2.73 mg·kg-1.95%CI (1.94, 3.84) mg·kg-1. Conclusion The determination of ED50of ropivacaine in ultrasound-guided transversus abdominis plane block improved the anesthesia efficacy and safety.

Objective To explore the role of serum inflammatory factors in prediction of infection following internal fixation of closed fractures and its significance for surgical timing and infection prophylaxis.Methods A retrospective study was conducted of the 100 patients who had been treated by internal fixation for closed fracture from January 2014 through July 2016.They were 52 men and 48 women,aged from 24 to 76 years (average,45 years).There were 14 femoral fractures,19 tibial plateau fractures,25 patella fractures,8 pilon fractures,22 tibiofibular shaft fractures,and 12 calcaneal fractures.Of them,21 were inflicted by wound infection.The preoperative and postoperative infection indexes,CRP,ESR,PCT and leukocyte count,were recorded.Logistic regression analysis was conducted to test the correlation between the infection indexes and postoperative infection.The optimal cut-off value was determined by the receiver operating characteristic curve.Results CRP showed a significant correlation with postoperative infection while other indexes did not.The optimal cut-off value was 25 mg/L at one day before operation.Conclusions Preoperative determination of CRP may predict the risk of postoperative infection.CRP ＞ 25 mg/L at one day before operation may indicate the following day is not suitable for surgery and active infection prophylaxis should be conducted after surgery.

Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.

This paper was aimed to study the effect of Qing-Chang Wen-Zhong (QCWZ) decoction on interferon gamma induced protein 10 (IP10) in colon tissues of rats with ulcerative colitis (UC).The UC model was induced using 4.5％ DSS added to distilled water for 7 days.At the same time,low-,medium-and high-dose of QCWZ decoction and mesalazine was given by gavage route daily.Then,the rats were killed and the colon tissues were taken.Expression level of interleukin-1 alpha (IL-1α),IL-1β,IL-6,tumor necrosis factor alpha (TNF-α) and interferon gamma (INF-γ) in colon were detected by Elisa assay.The expression and distribution of IP10 protein were detected by immunohistochemistry (IHC).The results showed that compared with the normal group,inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ) and IP10 expression level in DSS-induced UC rats were significantly increased.After 7 days of intervention,inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ) and IP10 decreased significantly (p＜0.01,p＜0.05).It was concluded that QCWZ decoction may down-regulate the expression of IP 10 and inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ),and then inhibit intestinal inflammation and repair intestinal mucosal damage,so as to achieve the purpose of UC treatment.