Objective To investigate the effects of esmolol and remifentanil on minimum alveolar concentration (MAC) of isoflurane in patients undergoing upper abdominal surgery. Methods One hundred ASAⅠorⅡpatients aged 18-60 yr undergoing upper abdominal surgery under general anesthesia were randomly divided into 5 groups (n=20 each):group A isoflurane alone; group B isoflurane + large dose esmolol; group C isoflurane + remifentanil; group D isoflurane + remifentanil + small dose esmolol and group E isoflurane + remifentanil + large dose esmolol. In group B and E esmolol was infused at 250 μg·kg-1·min-1 after a loading dose of 1 mg/kg (large dose esmolol). In group D esmolol was infused at 50 μg'kg-1·min-1 after a loading dose of 0.5 mg/kg (small dose esmolol). In group C, D and E remifentanil was infused at 0.05 μg·kg-1·min-1 after a loading dose of 0.25 μg/kg. As soon as the patients lost consciousness, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg. The patients were mechanically ventilated (VT=8 ml/kg, RR 12 bpm, FiO2= 100% ). PET CO2 was maintained at 32-38 mm Hg and naso-pharyngeal temperature above 35.5℃. End-tidal isoflurane concentration was continuously monitored. If the patient moved his/her hand, foot, head or body within 60 seconds after skin incision was made the end-tidal isoflurane concentration was increased by 10% in the next patient; if the patient did not respond to skin incision the end-tidal concentration of isoflurane was decreased by 10% in the next patient. The initial end-tidal isoflurane concentration was 1.24% in group A and B, 0.78% in group C, D and E. Results The MAC of isoflurane was 1.24% ± O.14%, 1.22%±0.09%, 0.77%± 0.05%, 0.75% ±0.06%, 0.60%±0.05% in group A, B, C, D, E respectively. Remifentanil significantly reduced MAC of isoflurane in group C, D and E as compared with group A. The MAC of isoflurane was significantly lower in group E than in group C. Conclusion Remifentanil infusion at 0.05 μg·kg-1·min-1 combined with large dose esmolol can reduce MAC of isdlurane by 52% in patients undergoing upper abdominal surgery.

Objective To use bioinformatics methods to analyze large amounts of data generated by gene chips and to screen common key genes in hepatocellular carcinoma in human and rat.Methods For search of the medical literature,3 sets of gene chip with data which met our predetermined criteria were downloaded from the GEO database.The data were standardized by using the bioconductor and R version of the 2.10.1 version.The original data of the affymetrix platform were normalized with background correction,standardized and transformed into log2 by using the algorithm of the affy packages RMA.The TTEST function of the excel was then used to calculate the significance of each gene.The DAVID was used for gene ID conversion and a table was established for samples and the corresponding gene expression data.A meta analysis was performed to calculate the common genes of human and rat.An enrichment regulation pathway was gained with the KEGG in the DAVID library. Results There were 26 common expression genes in the development process of hepatocellular carcinoma in human and rat.Five of these genes were up-regulation genes,while twenty-one were down-regulation genes.An enrichment pathway,which is a focal adhesion pathway,was found and this pathway has been reported to be associated with development of hepatocellular carcinoma.Conclusion With bioinformatics,we were able to screen common key genes and a pathway which were closely related to development of hepatocellular carcinoma in human and rat.

Objective To evaluate the effect of esmolol on bispectral index (BIS) in patients undergoing orotracheal intubation during induction of anesthesia and to investigate the mechanism of inhibiting the cardiovascular responses to tracheal intubation.Methode Forty patients in physical status of ASA Ⅰ or Ⅱ and aged 20-60 years were randomly divided into 2 groups ( n = 20 each): esmolol group (group E) and control group (group C). Anesthesia was induced with midazolam 0.1 mg/kg, fentanyl 5 μg/kg and vecuronium 0.1 mg/kg. In group E, esmolol 1 mg/kg was given intravenously before anesthesia induction and followed by an infusion of esmolol 250 μg· kg- 1·min-1, while a comparable volume of saline was given for group C. Mean arterial pressure (MAP), heart rate (HR) and BIS were recorded before esmolol administration, before induction of anesthesia, before orotracheal intubation, and at 1, 2 and 5 min after intubation, respectively.Results There were no significant differences in HR, MAP and BIS between the two groups before tracheal intubation. HR and MAP significantly increased after tracheal intubation in both groups, but BIS only in group C significantly increased after intubation.HR, MAP and BIS were significantly lower after intubation in group E than in group C ( P＜ 0.05).Conclusion Esmolol can decrease BIS during tracheal intubation and its antinociceptive property is related to the mechanism of inhibiting cardiovascular responses to tracheal intubation.

Stroke is a hi-attack rate,hi-multilation rate and hi-death rate disease.More than 70 percent patients with stroke remain functional disturbance,which destroy their quality of life and bring them heavy burden.The early multidisciplinary rehabilitation treatment,rehabilitation care,family rehabilitation training and application of new technology are the major strategies in kinds of rehabilitation treatment on stroke patients.The clinical researches have showed that the effect of multidisciplinary rehabilitation treatment is obviously better than simple treatment.So these therapeutic regimens have wonderful prospect and valuable generalization.

ObjectiveTo study the protective effects of tumor necrosis factor α(TNF-α) antibody on liver ischemia reperfusion injury in rats. Methods120 SD rats were randomly divided into three groups, the normal control group(Group A,n=40), ischemia group(Group B,n=40) and TNF-α antibody group(Group C,n=40). After 60 minutes ischemia and followed reperfusion, the animals were killed at 0,1h,3h,6h,12h,serum concentration of alanine aminotransferase(ALT), malondialdehyde(MDA) was meassured and liver histopathology was observed. ResultsAfter ischemia reperfusion, the serum concentration of ALT and MDA in Group B significantly increased (P<0.01),and the hepatic congestion was obvious compared with Group A. Treatment of TNF-α antibody could significantly decrease serum concentration of ALT and MDA in Group C compared with Group B(P<0.01),and relieve hepatic congestion. ConclusionTNF-α antibody can suppress the inflammatory reaction, and protect injury induced by hepatic ischemia reperfusion in rats.

ObjectiveTo study the effect of aprotinin and tumor necrosis factor alpha(TNF-α) antibody on preventing postoperative abdominal adhesion in mice.Methods96 BALB/c mice were randomly divided into 4 groups:normal saline group(n=24),aprotinin group(n=24),TNF-α antibody group(n=24),and aprotinin combined with TNF-α antibody group(n=24).After an identical peritoneal injury operation,all mice were treated intraperitoneally with normal saline , aprotinin,TNF-α antibody and aprotinin combined with TNF-α respectively at the time of abdominal closure .The mice were killed 20 days after operation,the abdominal incisions and the development of intraabdominal adhesions were observed.Adhesion score was based on an overall assessment of the extent,location,and type of adhesions .ResultsAprotinin combined with TNF-α antibody group showed significantly lower adhesion score and 2-3 grade adhesion(advanced significant adhesion) rate was lower than that of other groups(P<0.01).Conclusions The intraperitoneal administration of aprotinin and TNF-α antibody can inhibit postoperative adhesion formation.

Objective To inspect the source of an outbreak with Mycoplasma pneumoniae (Mp).Methods We carried out real-time PCR to analyze specimens collected from pediatric patients in Beijing during January 2010 to May 2012,diagnosed as pneumonia or a respiratory infection according to clinical symptoms.These positive samples were analyzed by the M-P typing system(M:multiple-locus variable-number tandem-repeat analysis,MLVA; P:P1-restriction fragment length polymorphism analysis,P1-RFLP).Results Sixty-nine specimens were tested positive to Mp by the real-time PCR in 446 specimens from pediatric patients.The infection rate was 11.69％,15.56％ and 20.00％ respectively in 2010,2011 and the first half of 2012.According to the M-P system,11 distinct genotypes were identified from 69 positive specimens,M43562P1 and M53562P1 were the two main genotypes that showed an increasing trend from 2010 to 2011,and M33562P1 and M63562P1 showed an increasing trend from 2011 to 2012 in China.Conclusion During this international Mp epidemic,the infection rate of Mp was also increase in Beijing in 2011,and M43562P1 and M53562P1 were the two main genotypes.Among them,M43562 were consistent with pop genotypes in Europe,and M53562 were consistent with pop genotype in Israel.The M-P system would be valuable to monitor the epidemic of Mp in different countries in the world.

Objective To investigate cross-cultural differences in picture recognition memory of medical students. Methods Picture recognition memory were assessed by the classic new-old picture recognition,and behavioral results were recorded during the test. Results For new medical picture recognition, mean accuracy of Chinese medical students( 83.21 ± 8.95 )% was considerably higher than that of Indian medical students( 75.56 ±12.63)% (P＜0.05), while for old medical picture recognition, reaction time (RT) of Chinese medical students ( ( 887.57 ± 104.07 ) ms ) was longer than that of Indian medical students ( ( 840.93 ± 1 22.48 ) ms) (P＜0.05).Three way ANOVA suggested that cultural background and picture type significantly affected accuracy and RT,learning experience affected RT. In addition to picture type and learning experience, the interaction of each factors is not remarkable. Conclusion Cultural background, professional background and learning experiences have affected recognition memory. Medical students of different cultural background adopted difference strategies in picture recognition memory.

Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104) and the IDD monitoring program of the central transfer fund at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.

Objective The present study aimed to trace the behavior results and event-related potential (ERP) of conflict monitoring from 7 ～ 12 years old to explore the development features of the conflict monitoring.Methods In six groups of 144 children aged from 7 to 12,behavior and non-target N2 amplitude were analyzed in continuous performance test (CPT) task. Results 1. Behavior results:the reaction time of target stimulus decreased ( ( 533.33 ± 66.65 ) ms, (523.91 ± 92.96 ) ms, (468.37 ± 64. 13 ) ms, ( 46 1.48 ± 98.31 ) ms, (457.57 ±84.05 ) ms, (405.02 ± 67.90) ms) and the hitting number increased ( ( 34.87 ± 4.84 ), ( 37.64 ± 3.54 ), ( 37.95± 2.92 ), (38.67 ± 1.23 ), (39.31 ± 1.08 ), ( 39.45 ± 1.00 ) ) as age increased, and the difference was statistically significant ( P＜0.01 ). 2. ERP: ①The non-target N2 amplitude was significantly higher than the target,and the difference was statistically significant (F= 98.57, P＜ 0.01 ). ②The amplitude of non-target N2 amplitude decreased with age, and the difference was statistically significant (F= 5.54, P＜ 0. 01 ). Conclusion The non-target N2 was closely related to the monitoring conflict, and the behavior and ERP results in this study showed the development trend. 8 ～ l0 and 12 years old are the critical development period of information processing speed, attention and conflict monitoring function for children.