AIM: To explore the influence of clonidine on inflammatory response in lung injury mice and its possible mechanism.METHODS: Clonidine solution was intravenously injected into the mice with lung injury induced by LPS.The left upper lobe of the lung was collected to detect lung wet/dry weight ratio (W/D) and total lung water content (TLW).The concentrations of IL-6, IL-1β and TNF-α were measured by ELISA.The expression of α7 nicotinic acetylcholine receptor (α7nAChR) and high-mobility group box protein 1 (HMGB1) at mRNA and protein levels was determined by RT-PCR and Western blot.After importing α7nAChR siRNA lentiviral vector or injecting exogenous HMGB1 protein, the inflammatory cytokines were detected.RESULTS: Clonidine attenuated lung injury and inhibited inflammatory reaction.Clonidine promoted the activation of cholinergic anti-inflammatory pathway by promoting α7nAChR expression.Clonidine inhibited HMGB1 expression, which promoted the secretion of IL-6, IL-1β and TNF-α.HMGB1 was negatively regulated by α7nAChR.CONCLUSION: Clonidine functions as an anti-inflammatory reagent to the lung injury mice.The mechanism may be related to activating the cholinergic anti-inflammatory pathway and inhibiting the expression of HMGB1.

Objective To investigate the effect of resveratrol (RES)on sevoflurane-induced nerve cell injury and its mechanism.Methods Fetal hippocampal tissues were taken from SD pregnant rats and primary nerve cells were isolated and cultured,then the cells were randomly divided into four groups:group control (group C),normal primary nerve cells;group 3% sevoflurane (group S),cells treated with 3% sevoflurane gas;group 3% sevoflurane+RES (group SR),cells treated with RES for 6 h,and then treated with 3% sevoflurane gas;group RES (group R),cells treated with RES.Flow cytometry assay was used to detect the apoptosis of nerve cell;CCK-8 Kit was used to detect cell proliferation;Western blot was used to detect the expression level of Caspase-3,Bax,Bcl-2 and Bace-1;ELISA method was used to detect the protein level of amyloid precursor protein (APP)andβ-amyloid peptide (Aβ).Results Compared with the group C,cell apoptosis was increased (P <0.05),cell proliferation was decreased (P <0.05),the expression levels of Caspase-3 and Bax were up-regulated (P <0.05),the expression level of Bcl-2 was down-regulated (P <0.05), and the protein levels of Bace-1,APP and Aβwere significantly decreased by 3% sevoflurane treat-ment (P <0.05),which were all significantly reversed by RES treatment.Compared with group S, cell apoptosis was decreased (P <0.05),cell proliferation was increased (P <0.05),the expression levels of Caspase-3 and Bax were down-regulated (P <0.05),the expression level of Bcl-2 was up-regulated (P <0.05),and the protein levels of Bace-1,APP and Aβwere increased in group SR (P <0.05).Conclusion Resveratrol alleviated sevoflurane-induced nerve cell injury in vitro by reducing cell apoptosis and promoting cell proliferation,which may be related with the reduction of Aβexpression and the reduced Aβ-induced neurotoxicity.

At the moment of its WTO accession, China also enters the stage of mass higher education. Mass higher education is an objective inevitability of the economic and social development. China's mass higher education lays a firm foundation for China to join the WTO and the WTO entry in turn brings considerable opportunities to it. It is expected that the WTO entry will promote the process of mass higher education of China.

Objective To investigate the clinical effect of three dimensional conformal radiation therapy combined with EP regimen for limited-stage of small cell lung cancer in elderly.Methods A total of 83 elder patients with limited-stage of small cell lung cancer were divided into treatment group and control group by random digits table method.In treatment group,42 patients received three dimensional conformal radiation therapy with synchronized EP regimen chemotherapy.In control group,41 patients received 2 cycles of EP regimen chemotherapy in advance,then received three dimensional conformal radiation therapy.Results The complete remission rate and objective response rate of treatment group and control group had significant differences [45.2％ (19/42) vs.17.1％ (7/41),81.0％ (34/42) vs.51.2％ (21/41)] (P =0.006,0.004).Follow-up for 2 years,there were 2 patients lost in treatment group,there was 1 patient lost in control group.The 1,2 years survival rate of treatment group and control group had significant difference [87.5％(35/40) vs.60.0％(24/40),65.0％(26/40) vs.32.5％(13/40)](P =0.005,0.004).The incidence of leukopenia,anemia,radiation pneumonitis and radiation esophagitis in treatment group were higher than those in control group,but there were no significant differences (P＞ 0.05).The 2-year local recurrence rate and distant metastasis rate of treatment group and control group had significant differences [17.5％(7/40) vs.42.5％ (17/40),32.5％ (13/40) vs.62.5％ (25/40)] (P =0.015,0.007).Conclusions Three dimensional conformal radiation therapy combined with EP regimen for limited-stage of small cell lung cancer in elderly can improve the short-term efficacy,long-term survival and reduce the rate of local recurrence and distant metastasis.It is safe and effective in the treatment of limited-stage of small cell lung cancer in elderly.

Objective Through the effect comprison of analgesic calm and side-effect on postoperative analgesia under different concentration dexmedetomidine with butorphanol,to research the best concentration of dexmedetomidine on postoperative analgesia.Methods Ninety patients with lower abdominal surgery with general anesthesia,ASA Ⅰ-Ⅱ grade,were divided into 3 groups by random digits table:group A,group B and group C,each group with 30 cases.The group A received 0.2 μg/ (kg·h) dexmedetomidine.The group B received 0.3 μg/ (kg ·h) dexmedetomidine,both added 0.15 mg/kg butorphanol and 8 mg ondansetron.The group C only received 0.15 mg/kg butorphanol and 8 mg ondansetron.Applied patient controlled intravenous analgesia (PCIA) pump continuous infusion gave total 100 ml,background infusion 2 ml/h,patient controlled analgesia (PCA) 2 ml,lock time 30 min,analgesia was continued 48 h.Below were recorded at 2,6,12,24 and 48 h after the beginning of PCIA:analgesia VAS score,ramsay sedation scale (RSS),adverse reaction.The total number of button pressing of PCA and the consumption of patient controlled liqnid analgesia (PCLA) solution were also recorded.Results There was no statistically significant difference in VAS score after each time point between group A and group B (P＞ 0.05).The VAS scores after each time point in group A and group B were significantly lower than those in group C [(2.7 ±0.8),(2.6 ± 0.8) scores vs.(3.2 ± 0.9) scores; (1.8 ± 0.6),(1.7 ± 0.6) scores vs.(2.5 ± 0.6) scores; (1.0 ±0.6),(0.9 ±0.7) scores vs.(1.8 ±0.6) scores; (1.0 ±0.5),(0.8 ±0.5) scores vs.(1.4 ±0.5) scores; (0.7 ±0.5),(0.7 ±0.4) scores vs.(1.0 ±0.5) scores,P ＜0.05].There was no statistically significant difference in RSS score among 3 groups (P ＞ 0.05).The RSS scores after 6,12,24 and 48 h in group A and group B were significantly higher than those in group C [(2.6 ±0.5),(3.5 ±0.6) scores vs.(2.0 ±0.3) scores; (2.9 ± 0.6),(3.8 ± 1.2) scores vs.(2.4 ± 0.3) scores; (2.8 ± 0.7),(3.9 ± 0.7) scores vs.(2.5 ± 0.4)scores; (2.8 ± 0.6),(3.9 ± 0.6) scores vs.(2.5 ± 0.5) scores,P ＜ 0.05],group A was significantly higher than those in group B (P＜ 0.05).There was no statistically significant difference in rate of hypoxemia among 3 groups (P ＞ 0.05).The rates of nausea and vomit,deliration in group A and group B were significantly lower than those in group C [3.3％(1/30),0 vs.10.0％(3/30) ;0,0 vs.10.0％(3/30),P＜ 0.05].The rates of hypotension and bradycardia in group B were significantly lower than those in group A and group C[16.7％ (5/30) vs.3.3％(1/30),0;20.0％(6/30) vs.3.3％(1/30),0,P＜ 0.05].The total number of button pressing of PCA 24 h and the consumption of PCLA solution in group C were significantly higher than those in group A and group B [(13.9 ±2.4) times vs.(9.7 ±2.2),(7.4 ± 1.5) times; (60.9 ± 1.8) ml vs.(54.5 ± 1.2),(50.7 ± 0.7) ml,P ＜ 0.05].Conclusion Concentration 0.2 μ g/(kg· h) dexmedetomidine with butorphanol has better effects on postoperative analgesia and calm,less side-effect.

Objective To compare the efficacy of video-assisted thoracoscopy plus minithoracotomy(VAMT) and limited axillary thoracotomy(LAT) for the treatment of lung cancer.Methods 85 consecutive lung cancer patients were treated by either VAMT or LAT.The operative time,blood loss during operation,postoperative chest drainage time,and hospital stay time and postoperative complication were compared between the two groups.Results There was no death in two groups.The operative time and blood loss during operation were significant less in VAMT than inLAT(t =6.514,2.413,all P ＜0.05).But postoperative chest drainage time,and hospital stay time and postoperative complication were no significant difference between the two groups (t =0.490,0.338,all P ＞ 0.05).Conclusion VAMT is a safe and less traumatic procedure in the treatment of lung cancer,which is worthy of promotion and application.

Objective To investigate the risk factors of hemorrhagic transformation (HT) after cerebral infarction. Methods The clinical and neuroimaging data of 100 patients (gender,age-matched)with cerebral infarction and hemorrhagic transformation from January 2005 to January 2010 were analyzed retrospectively. The following factors were listed for single factor analysis: the history of hypertension, diabetes mellitus,admission blood pressure,blood sugar,infarction size,alcohol,smoking,atrial fibrillation,hypercholesterolemia, combined anticoagulant and antiplatelet aggregation therapy. All the above factors were analyzed by chi-square test or t test, and Logistic regression analysis was used to screen out the related risk factors of HT from the potentially related factors. Results Atrial fibrillation (OR =5.483,95%CI:fibrillation,extensive cerebral infarction,blood sugar,high blood pressure at the beginning of the disease,combined anticoagulant and antiplatelet aggregation therapy are the major risk factors of HT. At the same time, the occurrence of HT is the result of the joint effect of multiple factors and multiple mechanisms.

Purpose To investigate the correlation of the expression of Cyclin D1 and BRAF ( V600E) mutation in papillary thyroid carcinoma ( PTC) and their clinical significance, and to analyze their role in the pathogenesis of PTC. Methods The expression of CK34βE12 and MC protein was detected by immunohistochemical EnVision method in 52 cases of PTC and 52 cases of thyroid benign lesions (25 cases of nodular goiters, 15 cases of Hashimoto’s thyroiditis, 12 cases of follicular adenoma), and the mutation status of BRAF gene protein in above specimens were detected by polymerase chain reaction and DNA sequencing. Expression of Cyclin D1 and BRAF (V600E) mutation in papillary thyroid carcinoma and their correlation clinicopathologic features were also analyzed. Results The positive rate of Cyclin D1 in 88 cases of PTC was 84. 6%,and the immunoreactivity score (4. 6 ± 2. 4), compared with thyroid be-nign lesions (1. 3 ± 1. 6), was statistically significant difference (t=8. 525, P<0. 01). Expression of Cyclin D1 was closely related with lymph node metastasis, capsular invasion, tumor stage Ⅲ+Ⅳ and BRAF (V600E) mutation (P<0. 05), but not related with age, gender, number and diameter of tumor nodules. In 52 cases of PTC BRAF gene mutation rate was 63. 5%, but in thyroid benign lesions mutation rate was 0, with significant difference (P<0. 01). The BRAF mutation is closely related with lymph node metastasis, capsular invasion and tumor stage Ⅲ+Ⅳ(P<0. 05), but not related with age, gender, number and diameter of tumor nodules. The expression of Cyclin D1 in BRAF (V600E) mutation group was stronger, the positive expression rate was significantly higher than that of wild group (100% vs 57. 9%), and expression of the mean score was higher than that of the wild group (5. 7 ± 1. 6 vs 4. 0 ± 2. 5);the comparison between the two groups showed statistical difference (t=2. 652, P<0. 05). Conclusions The expression of Cyclin D1 and BRAF (V600E) mutation are positively related, which are also closely related with the occurrence and development of PTC, and can be used as an index to predict the invasion and metastasis in PTC.

Ambulatory blood pressure monitor (ABPM) was done on 103 hypertensive patients according to clinical stages and left ventricular measure (LVM) was randomly done on a portion of the patients. The results showed that the variability of stage-Ⅱ-group's 24 hour systolic pressure and stage-Ⅲ-group's systolic and diastolic pressures was significantly higher than that of stage-Ⅰ-group (P

Objective To comparative analysis the effect of radiotherapy,thermoradiotherapy and chemora-diotherapy on esophageal cancer.Methods 120 patients with esophageal carcinoma were selected and randomly divided into the radiotherapy group,thermoradiotherapy groupand chemoradiotherapy group by digital table method, with 40 cases in each group,which were treated with radiotherapy alone,thermoradiotherapy alone and radiotherapy combine with chemotherapy respectively.The effects of treatment of the three groups were compared.Results The main toxic reaction in the three groups during the treatment for adverse reaction were digestive system reaction,hema-tologic toxicities and radioactive esophagitis.The incidence of toxic reaction of the three groups were not statistically significant(P >0.05).Total response rate of simple radiotherapy group,the thermal radiation group,chemoradiothera-py group were 52.5%,75.0% and 85.0%.,The total remission rate of chemotherapy group was higher than those of the radiotherapy group and the thermal radiation group(χ2 =5.218,3.857,all P <0.05).Conclusion The different treatment methods of esophageal cancer can obtain certain curative effect,but there are some adverse reactions.Among different treatment methods,radiotherapy and chemotherapy in the treatment of esophageal carcinoma can get better effect than the radiotherapy and chemoradiotherapy.