Objective To evaluate the effectiveness of Inditherm warming system on prevention of intraoperative hypothermia in aged patients with transurethral resection of the prostate(TURP).Methods Fifty two aged patients with benign prostate hyperplasia(BPH) undergoing selective TURP were randomly divided into two groups:observation group(n =27) and control group(n =25).Patients in observation group received temperature prevention from hypothermia by using the patient warming system which temperature was set to 38-40 ℃.The control group were not provided with warming mattress and the ambient temperature of operation room was maintained at 21-23 ℃.The changes of the rectal temperature were continuously monitored during the operation and changes of vital signs,part of postoperative indicators were observed.Results The temperature of patients in both groups decreased after anesthesia.The decreasing degree of rectal temperature at 30,45,60,and 90 min after anesthesia and at the end of operation in observation group was less than those in control group[20min:(36.6±0.4)℃ vs(36.3±0.6)℃,t =2.1362;30 min:(36.4±0.5) ℃ vs(35.8±0.4) ℃,t =4.7536;45 min:(36.2±0.3)℃ vs(35.5±0.5)℃ ;t =6.1751;60 min:(36.1±0.4)℃ vs(35.3±0.4)℃,t =7.2057;90 min:(36.0±0.3)℃ vs(35.3±0.6)℃,t =5.3818;at the end of operation:(36.0±0.4)℃ vs(35.3±0.5) ℃,t =5.5948 ; P ＜ 0.05 or P ＜ 0.01].The occurrence rate of hypothermia(rectal temperature ＜36 ℃) after operation in observation group was lower than that in coutrol group[25.93％(7/27) vs 92.00％(23/25),x2=23.218,P ＜ 0.01];The occurrence rate of shiver was significantly lower in observation group than that in control group[14.81％(4/27) vs 64.00％(16/25),x2 =13.267,P ＜ 0.01].The VAS scores assessment of pain in the observation group was significantly less than that in the control group[(2.45±1.88)points vs(3.79±1.63) points,t =2.7362,P ＜ 0.01].The length of stay was shorten[(5.37±±2.31) d vs (7.13±3.06) d,t =2.3518,P ＜ 0.05]and the prognosis was better in observation group.Conclusion The patient warming mattress can effectively prevent the occurrence of hypothermia of aged patients undergoing TURP and reduce the occurrence of associated complication.

Aim To determine what effects propofol exerts on apoptosis in hippocampal neurons caused by anoxia-reoxygenation.Methods Newborn SD rats(0.05).When pretreated with propofol,neurons proliferation increased and apoptosis decreased(P

Objective To investigate effects of different concentrations of dexmedetomidine on onset time and clinical time-effect of rocuronium in the processes of the total intravenous anesthesia.Methods Sixty patients with elective anesthesia breast modified radical mastectomy,aged 26 to 55 years,were randomly divided into four groups of 15 patients.Group A (control group):uniform within 10 min before induction of anesthesia saline infusion (NS ; 0.25 ml/kg) ; group B:dexmedetomidine given initial dose 0.3 μg/kg uniform within 10 min before induction of anesthesia infusion finished,anesthesia period 0.3 μg/(g · h) continuous infusion until the end of surgery; group C:dexmedetomidine given initial dose 0.6 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia with continuous infusion 0.6 μg/'(kg · h) until the end of surgery ; and group D:dexmedetomidine given initial dose 1 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia to 1 μg/(kg · h) continuous infusion to the end of surgery.Patients after the burglary were under multi-monitor vital signs monitoring blood pressure (BP),heart rate (HR),oxygen saturation (SPO2),electrocardiogram (ECG),and after intubation monitoring end-tidal carbon dioxide (EtCO2),recording time T0 and T25.Results No significant difference was found at the T0 time in each group.However,the T25 time (48 ± 6) min in group C and (51 ±6) min in group D was significant longer than that (40 ±6)min in group A (P ＜0.05).The mean artery pressure(MAP) of group C and D [(88.76 ± 7.06)mmHg,(87.89 ± 6.95)mmHg] were significantly lower than group A after dexmedetomidine infusion 5 min later(P ＜ 0.05); The HR of groups B and C [(60.80 ± 7.11)bpm,(63.31 ± 5.78)bpm] were significantly lower than group A before induction (P ＜ 0.05).The HR of group D was significantly lower than group A before induction and after infusion 5 and 30 min later[(66.40 ± 9.49) bpm,(60.52 ± 7.45) bpm,(61.32 ± 7.11) bpm,P ＜ 0.05].Conclusions Under the status of total intravenous anesthesia,different concentrations of dexmedetomidine did not affect the onset time of rocuronium,but dexmedetomidine given up to a certain concentration could enhance the clinical time-effect of rocuronium.

BACKGROUND: The important pathological changes of acute respiratory distress syndrome (ARDS) is disruption of the lung alveolar-capillary membrane barrier and resultant pulmonary edema associated with a proteinaceous alveolar exudate. Bone marrow mesenchymal stem cells (BMSCs) are able to carry on dividing and renewing themselves, and can eventually develop into many other types of cells. This provides a new treatment for treating injury of lungs.OBJECTIVE: To investigate the prevention of endotoxin-induced acute lung injury in rabbit by BMSCs.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Central Laboratory of Tangdu Hospital from October 2007 to January 2008.MATERIALS: A total of 20 rabbits were used in this study. Two rabbits were utilized to culture BMSCs. Eighteen rabbits were randomly assigned to three groups, saline control group, acute lung injury group and cell transplantation group (n = 6). Endotoxin was purchased from Sigma, USA.METHODS: Rabbit BMSCs were isolated and cultured by the Ficoll method. At the third passage, BMSCs were harvested for use.In the acute lung injury and call transplantation groups, endotoxin was infused into the trachea to establish models of acute lung injury/ARDS. Thirty minutes following model establishment, 2 mL BMSC suspension (1 x 105) was infused into the right jugular vein in the cell transplantation group. An equal volume of saline was injected into the saline control and acute lung injury groups.MAIN OUTCOME MEASURES: Number of neutrophilic granulocyte, wet to dry weight ratio of lung tissue, protein content and pathological changes in lung tissue in bronchoalveolar lavage fluid were measured.RESULTS: The increase in wet to dry weight ratio indicated the existence of pulmonary edema. The increase in neutrophilic granulocyte number suggested severe inflammatory reaction. The increased protein content showed the damage to lung alveolar-capillary membrane barrier. Following 48 hours of transplantation, neutrophilic granulocyte number and protein content in bronchoalveolar lavage fluid was significantly decreased (P < 0.01), and wet to dry weight ratio was significantly increased (P < 0.01) in the acute lung injury group compared with the saline control group. Compared with the acute lung injury group,neutrophilic granulocyte number and protein content was significantly increased (P < 0.01), and wet to dry weight ratio was significantly diminished (P < 0.01) in bronchoalveolar lavage fluid in the call transplantation group. Hematoxylin-eosin staining suggested that pulmonary alveoli was normal in the saline control group, presented typical acute lung injury in the acute lung injury group, and the pathological changes were mild in the cell transplantation group.CONCLUSION: BMSC transplantation can significantly reduce endotoxin-induced acute lung injury.

Objective:To investigate whether hepatitis B virus X protein (HBx) mediates the podocyte injury through reactive oxygen species (ROS) /nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) signaling pathway.Methods:HBx-overexpressing lentivirus was transfected into renal podocytes of mouse to mimic the pathogenesis of hepatitis B virus-associated glomerulonephritis. Podocytes were divided into the following five groups: blank control group (no special treatment), negative control group (transfected with control lentivirus), HBx overexpression group (transfected with HBx overexpression lentivirus), HBx overexpression+NLRP3 siRNA group (transfected with HBx overexpression lentivirus and NLRP3 siRNA), and HBx overexpression+ROS inhibitor group (transfected with HBx overexpression lentivirus and adding ROS inhibitor). The morphological changes of podocytes were observed with electron microscope. The generation of ROS was detected by dichlorodihydrofluorescein diacetate assay (DCFH-DA). Hoechst 33342 staining was used to observe the morphological and quantitative changes of podocyte nuclei. Enzyme-linked immunosorbent assay was used to detect caspase-1 activity, and the levels of lactate dehydrogenase, interleukin (IL)-1β and IL-18. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression levels of mRNA and protein of pyroptosis-related protein, such as NLRP3, apoptosis-associated speck-like protein containing card (ASC), caspase-1, IL-1β and IL-18. TUNEL staining and flow cytometer were used to detect the number of pyroptosis cells. Immunofluorescence staining was used to detect the expression levels of desmin and nephrin.Results:After successful infection of podocytes with HBx-overexpressing lentivirus, pyroptosis-related morphological changes in the cells were observed under electron microscope. The level of ROS in the HBx overexpression group was significantly higher compared to the negative control group ( P<0.05). Hoechst 33342 staining revealed condensed nuclei in the HBx overexpression group. TUNEL staining and flow cytometer demonstrated that podocytes underwent increased pyroptosis in the HBx overexpression group. The mRNA and protein expression levels of pyroptosis-related proteins such as NLRP3, ASC, caspase-1, IL-1β and IL-18 were up-regulated upon HBx overexpression (all P<0.05). Caspase-1 enzyme activity, lactate dehydrogenase and desmin expression levels were enhanced after HBx overexpression (all P<0.05). However, NLRP3 knockdown or addition of ROS inhibitors attenuated the pyroptosis and increased expression levels of pyroptosis-related proteins caused by HBx overexpression (all P<0.05). Conclusion:ROS/NLRP3 pathway plays an important role in HBx-induced podocyte pyroptosis.

OBJECTIVE: To delineate laboratory and clinical characteristics of a case with chronic myelogenous leukemia (CML) and co-occurrence of t(9;22)(q34;q11) and t(8;21)(q22;q22). METHODS: The patient was subjected to cytogenetic, molecular, morphological and immunophenotypic analyses. RESULTS: Cytogenetic analysis revealed presence of t(8;21)(q22;q22) in addition to t(9;22)(q34;q11) in the patient. Chimeric BCR/ABL and AML1/ETO genes were detected by fluorescence in situ hybridization (FISH). Transcripts of BCR/ABL210 and AML1/ETO fusion genes were detected by relative quantity PCR. Morphological study suggested that the patient was at the chronic phase of CML. No significant immunophenotypic abnormality was detected by flow cytometry. CONCLUSION Co-occurrence of t(8;21)(q22;q22) and t(9;22)(q34;q11) is rare in CML. Only 5 similar cases have been described previously. This case suggested that chromosomal alterations may precede morphological, flow cytometric and clinical changes and accelerate progression of the disease.
Chromosome Aberrations ; Chromosomes, Human ; Fusion Proteins, bcr-abl ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Translocation, Genetic

Objective:To analyze the correlation between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD).Methods:The clinical Data, polysomnography (PSG) and cognitive function examination results of 112 OSA children admitted to Department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Xi′an Jiaotong University from January 2019 to June 2020 were retrospectively analyzed. According to the severity of OSA, the children were divided into mild, moderate and severe OSA groups, and the basic demographic characteristics, sleep parameters and ADHD occurrence were analyzed. According to the results of ADHD examination, the children were divided into ADHD group and non-ADHD group, and the basic demographic characteristics and sleep parameters were analyzed. Taking these parameters as independent variables, binary Logistic regression analysis was conducted to establish the model equation for predicting the risk of OSA associated ADHD among children.Results:Grouped by OSA severity, among the three groups, apnea-hypopnea index (AHI) [3.70 (2.84, 5.47) vs 8.59 (7.50, 9.54) vs 19.48 (15.83, 25.23)], obstructive apnea index (OAI) [1.31 (0.93, 1.82) vs 3.03 (1.54, 4.41) vs 11.69 (8.53, 15.42)], obstructive apnea-hypopnea index (OAHI) [2.82 (1.81, 3.64) vs 6.17 (5.58, 7.26) vs 15.68 (13.12, 21.25)], and respiratory event-related arousal index [0.50 (0.25, 1.05) vs 1.25 (0.70, 2.23) vs 2.40 (1.60, 4.70)] increased, minimum pulse oxygen saturation (SpO 2) [90.00 (88.00, 92.00) vs 87.00 (83.00, 90.25) vs 81.00 (76.00, 85.00)] decreased, the differences were statistically significant (all P<0.05). The non-rapid eye movement (NREM)1 period time ratio of the severe OSA group was significantly longer than that of the mild OSA group, while the average SpO 2 was significantly lower than that of the mild OSA group; the NREM3 period time ratio of the moderate and severe OSA group was significantly less than that of the mild OSA group; the arousal index of the severe OSA group was significantly greater than the mild or moderate OSA group. There were no statistically significant differences among the three groups in gender, age, body mass index, sleep efficiency, rapid eye movement (REM) period time ratio, and NREM2 period time ratio (all P>0.05). Mild OSA group had 10 cases of ADHD (17.54%), moderate OSA group had 7 cases (23.33%) of ADHD, severe OSA group had 9 cases of ADHD (36.00%), and the difference was not statistically significant. Grouped by ADHD examination, the AHI, OAI, OAHI, and NREM1 period time ratios of the ADHD group were significantly higher than those of the non-ADHD group, while the sleep efficiency, minimum SpO 2 and NREM3 period time ratio were significantly lower than those of the non-ADHD group. The Logistic regression analysis suggested that ADHD was correlated with sleep efficiency, minimum SpO 2, and NREM3 period time.The established Logistic regression equation was: X=15.670+0.061×(sleep efficiency)-0.212×(minimum SpO 2)-0.144×(NREM3 period time ratio), the sensitivity and specificity of the model prediction were 84.6% and 79.1% respectively when the area under the receiveroperating characteristic curves was 0.867. Conclusions:OSA and ADHD in children have a certain correlation. Sleep structure disturbance and intermittent hypoxia may be important reasons. The predictive model equations obtained by PSG in this study can be used to assess the risk of ADHD in children with OSA.

OBJECTIVETo observe the difference of clinical effects of acupoints selected based on meridian differen-tiation and conventional method for cervical spondylosis radiculopathy(CSR) treated with acupuncture and moxibustion.

METHODSSixty patients with CSR were randomly divided into an observation group and a control group,30 cases in each one.points of the injured meridians in the neck,namely six-points,were selected in the observation group,matched with-connecting points of the injured meridians on the same side and the interiorly-exteriorly correlated meridians on the opposite side. Conventional acupuncture was used on Fengchi(GB 20),Jiaji(EX-B 2) of the neck,Tianzhu(BL 10),Jianjing(GB 21),Houxi(SI 3),Hegu(LI 4) and Waiguan(TE 5) on the affected side in the control group. Treatment was given once every other day,three times a week and total 12 times in the two groups. Twenty subscales for CSR and visual analogue scale(VAS) were observed before and after treatment,and total effects were evaluated after treatment.

RESULTSThe effective rate of the observation group was 93.3%(28/30),which was better than 66.7%(20/30) of the control group(<0.05). The scores of 20 subscales and VAS after treatment were all improved compared with those before treatment in the two groups(all<0.01),with more apparent change in the observation group(both<0.05).

CONCLUSIONSThe effect of acupuncture and moxibustion based on meridian differentiation is obvious,and superior to that of conventional acupoints selection.

A retrospective analysis of audiologic outcome and graft take rate on post-tympanoplasty with different middle ear mucosal conditions in wet ear. According to the characteristics of middle ear mucosal condition and residual eardrum, 80 cases with wet ear of chronic suppurative otitis media were divided into the hydrocele group, the swelling group and the granulation group. The factors in different groups, including gender, age, disease course, sides, size and location of perforations, destruction of ossicular chain and reconstruction methods were analyzed. Moreover, postoperative hearing improvement and graft take rate were compared among the three groups. There was no significant difference in gender, age, disease course, sides, size and location of perforations among the hydrocele group, the swelling group and the granulation group （>0.05）. Overall, the postoperative average Air-Bone Gaps（ABG） were reduced in all wet ear patients after surgery （<0.01）. The ABG was decreased from （25.5 ± 10.8） dB to（15.4 ± 9.4） dB in the hydrocele group, and decreased from （27.6 ± 8.7） dB to （15.2 ± 9.6） dB in the swelling group, and from （29.5 ± 7.7） dB to （17.2 ± 17.2） dB in the granulation group. The graft take rates were 90.0% in totally. There were no significant difference in graft take rates among the three groups, and 84.6% in the hydrocele group, 93.3% in the swelling group and 100.0% in the swelling group（>0.05）. Wet ear is not an absolute contraindication of tympanoplasty for chronic suppurative otitis media. Whether there was effusion, swelling or granulomatous hyperplasia in the tympanoplasty, the patients'hearing improved significantly after tympanoplasty, and the healing rate of the tympanoplasty did not decrease. Further basic and clinical studies are needed to standardize the timing of wet ear surgery, clarify the operative contraindication and elucidate the pathophysiological mechanism of eardrum healing.

Objective: A retrospective analysis of audiologic outcome and graft take rate on post-tympanoplasty with different middle ear mucosal conditions in wet ear. Method: According to the characteristics of middle ear mucosal condition and residual eardrum, 80 cases with wet ear of chronic suppurative otitis media were divided into the hydrocele group, the swelling group and the granulation group. The factors in different groups, including gender, age, disease course, sides, size and location of perforations, destruction of ossicular chain and reconstruction methods were analyzed. Moreover, postoperative hearing improvement and graft take rate were compared among the three groups. Result: There was no significant difference in gender, age, disease course, sides, size and location of perforations among the hydrocele group, the swelling group and the granulation group （P>0.05）. Overall, the postoperative average Air-Bone Gaps（ABG） were reduced in all wet ear patients after surgery （P<0.01）. The ABG was decreased from （25.5 ± 10.8） dB to（15.4 ± 9.4） dB in the hydrocele group, and decreased from （27.6 ± 8.7） dB to （15.2 ± 9.6） dB in the swelling group, and from （29.5 ± 7.7） dB to （17.2 ± 17.2） dB in the granulation group. The graft take rates were 90.0% in totally. There were no significant difference in graft take rates among the three groups, and 84.6% in the hydrocele group, 93.3% in the swelling group and 100.0% in the swelling group（P>0.05）. Conclusion Wet ear is not an absolute contraindication of tympanoplasty for chronic suppurative otitis media. Whether there was effusion, swelling or granulomatous hyperplasia in the tympanoplasty, the patients'hearing improved significantly after tympanoplasty, and the healing rate of the tympanoplasty did not decrease. Further basic and clinical studies are needed to standardize the timing of wet ear surgery, clarify the operative contraindication and elucidate the pathophysiological mechanism of eardrum healing.