Objective To investigate the changes of stress responses and fibrinolysis under three anesthesia techniques undergoing elective hysterectomy during perioperative period. Methods Thirty ASA Ⅰ or Ⅱ patients aged 31-57yr weighing 45-70 kg undergoing elective hysterectomy were divided randomly into 3 groups ( n = 10 each): group Ⅰ continuous epidural anesthesia (E); group Ⅱ general anesthesia combined with continuous epidural anesthesia (G + E) and group Ⅲ general anesthesia (G) . The patients in the 3 groups were all premedicated with midazolam 0.05 mg?kg-1 i.v. . In group G and G + E the patients received an additional scopolamine 0.3 mg i.v. . In group E and G + E an epidural catheter was placed through L1-2 interspace and 2% lidocaine 5 ml was given as test dose. The spinal segments blocked was extended from L3 to T6 using 0.75 % bupivacaine. In group G and G + E general anesthesia was induced with fentanyl 2-3 ?g ? kg-1, propofol 1.5-2.0 mg?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation and intermittent i.v. boluses of vecuronium. The patients were mechanically ventilated after tracheal intubation. BIS, ECG, BP, HR, SpO2 , PETCO2 and end-tidal isoflurane concentration were continuously monitored during operation. BIS value was maintained below 60. PCEA or PCIA was started as soon as the patients were awake. VAS scores were maintained below 3-4. Venous blood samples were taken before anesthesia (T0 baseline) at the end of operation (T1) and 24 and 72 h after operation (T2 , T3) for determination of plasma adrenaline (A) and noradrenaline (NA), D-dimer level (DD), tissue type plasminogen activator (t-PA ) and plasminogen activator inhibitor ( PAI-1) concentrations. Results The plasma NA and A concentrations in group G were significantly increased at T1-3 as compared to the baseline value at T0 and were significantly higher than those in group E and G + E. There was no significant difference in plasma NA concentration between group E and G + E. The DD level was significantly increased at T2 as compared to the baseline value at T0 in all 3 groups and remained high at T3 in group E and G + E. The t-PA and PAI-1 activities were significantly increased at T1 as compared to the baseline values at T0 in all three groups and then gradually decreasing at T2 and T3 . In group E the PAI-1 activity returned to baseline level at T3 . Conclusion Epidural anesthesia helps in maintaining fibrinolytic activity by attenuating the responses to surgical stress and inhibiting the increase in PAI-1 activity.

Objective:To observe the hemorheological change of vitiligo patients both before and after treatment by Vitiligo Granules or Vitiligo Liniment combined with UVA phototherapy, researching the relationship and clinical significance between vitiligo and hemorheology. Methods: Hemorheological detection was made before and after treatment for 30 normal cases and 58 cases of vitiligo. Results: The total effective rate was 74.15%. The indexes levels of hemorheology of treatment group was higher than those of normal group before treatment (P

Trichinella spiralis infection in rodents is a well-known model of intestinal inflammation associated with hypermotility. The aim of the study was to use this experimental model to elucidate if Th17 cells are involved in the development of gastrointestinal hypermotility. Colonic smooth muscle contractility was investigated in response to acetylcholine. The levels of IL-17, IL-23 and TGF-beta1 in colon were measured by Western blotting. Flow cytometric detection of intracellular IFN-gamma/IL-4/IL-17 cytokine production was used to analyze the proportions of CD4+ T cells subsets in colon. Our results showed that colonic muscle contractility was increased 2 weeks post infection (PI) and stayed high 12 weeks PI when no discernible inflammation was present in the gut. The proportion of Th17 cells and the expression of IL-17 were up-regulated in colon 2 weeks PI and returned to normal 8 weeks PI. The content of IL-17 was correlated with the colonic smooth muscle hypercontracility 2 weeks PI. Meanwhile, TGF-beta1 was increased 2 weeks PI, while IL-23 was normal. Our results suggest that Th17 cells affect the colonic muscle contractility in mice infected with Trichinella spiralis at intestine stage but not at muscle stage and the effect of Th17 cells on muscle contractility might be induced by TGF-beta1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

Objective To explore the behavioral and emotional status of the migrated children one year after they were victimized from earthquake in Wenchuan. Methods 513 victimized children migrated out of disaster area were investigated, with Achenback Child Behavior Checklist ( CBCL), the Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depression Self-rating Scale for Children (DSRSC). The controls were local children ( n = 475 ) coming from the same schools. Results 487 answered files were validated. There were significant differences between the victimized and migrated children and the local children in many scores of CBCL, such as total sores( (26.73 ±6.28)Vs (20.26 ±5.76), t= 16.64, P＜0. 01 ) and withdrawal( (3.23 ±1. 68 ) Vs ( 2.02 ± 1.43 ), t = 12.91, P ＜ 0.01 ), somatization complaining( ( 2.79 ± 1. 34 ) Vs ( 1.67 ± 1.22 ), t =13.55, P ＜ 0. 01 ) and anxiety-depression scores ( ( 3.38 ± 1.79 ) Vs ( 1.95 ± 1. 21 ), t = 14.48, P ＜ 0.01 ), as well as its factors such as social problem, attentional problem, attack behavior, internalizing behavior, social communication and school scores. On the SCARED and DSRSC, the two groups were significantly different in total scores of anxiety and depression as well as in such factors as somatization, generalized anxiety, separated anxiety. Conclusion Though migrated out of the earthquake area, the victimised children still suffer obviously from behavioral problems, and anxious and depressive emotion one year after the earthquake.

Objective To discuss the expression of mitochondrial phosphate carrier (PiC) in myocardial injury caused by doxorubicin, and the protective mechanism of curcumin in myocardial injury caused by doxorubicin .Methods 60 adult SD rats were randomly divided into three groups:control group, doxorubicin group, curcumin+doxorubicin group.Control group was injected 0.9% sodium chloride injection (2.5 mL/kg) by rat tail vein injection, one times per week, 6 times in total.Doxorubicin group was injected with 0.5 mg/mL doxorubicin which diluted with 0.9% sodium chloride injection by rat tail vein injection, and the dosage was 1.25 mg/kg(about 0.5 mL).Curcumin+doxorubicin group was injected the same dose doxorubicin as doxorubicin group.After that, 12 mg/mL curcumin injection was added with 30mg/kg by rat tail vein injection.one times per week, 6 times in total.The glutathione peroxidase (Gpx) assay kit, superoxide dismutase (SOD) assay kit and malondialdehyde (MDA) detection kits were used to test the oxidative stress levels in myocardial cells of SD rats.Flow cytometry is used to test the SD rat cardiomyocytes transferred level. Application of Western blot and Real-time PCR technology were used to detect expression of PiC.ResuIts The Gpx activity and SOD vitality in myocardial cells of SD rats in curcumin with doxorubicin group all significantly increased compare with those of doxorubicin group, and all decreased compare with those of control group.But the rate of myocardial apoptosis, content of malondialdehyde and expression of Slc25a3 gene and PiC protein from myocardial cells of SD rats from curcumin with doxorubicin group all significantly increased compare with those of control group , and all decreased compare with those of doxorubicin group.ConcIusion Doxorubicin could increase the expression of PiC in myocardial mitochondria, the levels of oxidative stress, and the apoptosis of myocardial cells, and the effect of curcumin could be effective against the injury induced by doxorubicin .

ility might be induced by TGF-β1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

Objective:To study the genotype distribution of drug-related gene polymorphism of methotrexate (MTX) and leflunomide (LEF) in patients with rheumatoid arthritis (RA).Methods:The genotyping results of RA patients' MTX and LEF related genes(MTHFR677C/T, MTHFR1298A/C, ABCB13435T/C, DHODH19C/A and CYP1A2734C/A) detected in Shanghai Guanghua Hospital from December 2018 to May2019 and drug-related adverse effect were statisticallyanalyzed. The independence of allele distribution was tested by Hardy-Weinberg test. Counting data of genotypes and allele frequencies among the groups were analyzed by the chi-square test. Measurement data were showed as Mean±SD deviation. The network between incidence of adverse events and genotypes of patients was analyzed by cytoscape software. Results:Genotype distribution in 151 patients was consistent with Hardy-Weinberg genetic balance ( P>0.05), and genotype and allele distribution of each gene showed no statistical difference in gender ( P>0.05). The results showed that the most common genotype in RA were that genotypes of the good response with moderate resistance to MTX (MTHFR677CC/MTHFR1298AA/ABCB13435CT) (16 cases, 13.5%) and the good response with moderate side effect risk to LEF(DHODH19CC/CYP1A2734AC) (25 cases, 28.4%). According to the distribution frequency of alleles, the incidence of high side effects caused by MTX combined with LEF was predicted to be 2.9%, which was close to 1.8% of the actual genotypes of patients. The types and proportion of clinical adverse reactions in patients were retrospectively analyzed and the correlation network analysis was conducted with the genotype analysis results. It was found that the incidence rates of adverse reactions were liver injury (35.4%, 35/99), leukopenia (14.1%, 14/99), thrombocytopenia (2.0%, 2/99), and skin rash (1.0%, 1/99) from the top to the bottom. The top two genotypes that were related to the occurence of adverse events were MTHFR677CT/MTHFR1298AA/ABCB13435CT and DHODH19CA/CYP1A2734AC, respectively, which verified the consistency between drug-related genotype and clinical manifestations in RA patients. Conclusion:Our results suggested that genotype in RA patients is closely related to drug efficacy and adverse events. 2.9% of RA patients need to stop taking MTX and LEF due to high MTX resistance and poor MTX response and increased toxicity when combined with LEF, in which the proportion of liver injury is the highest.

Objective To investigate the nutritional status and dietary structure of tuberculosis patients among dif-ferent populations, analyze the factors influencing the nutritional status of tuberculosis patients, and provide theo-retical basis for improving clinical nutrition and related issues in tuberculosis patients.Methods Tuberculosis pa-tients, non-tuberculosis patients, and healthy individuals were randomly selected for a questionnaire survey.De-scriptive analysis was conducted using SPSS 20.0 software.Statistical description was performed using rates and composition ratios, and qualitative data were described using relative numbers.Chi-square test was used to compare overall rates and composition ratios among different health conditions groups, with a significance level of α=0.05.Independent factors analysis of nutritional status body mass index (BMI) was conducted using multiple Logistic re-gression analysis for variables with statistically significant differences in the univariate analysis.Results There were differences in the nutritional status (x2 =62.184, P<0.05) and dietary diversity score (x2 =64.049, P<0.05) among tuberculosis patients, non-tuberculosis patients, and healthy individuals.Univariate analysis of nutri-tional status BMI showed statistically significant differences in gender, smoking, meat-based diet, vegetable-based diet, moderate diet diversity score, and 6 other variables for tuberculosis patients (P <0.05) , and in gender, age, ethnicity, marital status, occupation, education level, smoking, drinking white wine, drinking beer, meat-based diet, moderate diet, and 11 other variables for healthy individuals (P<0.05) .The variables with statisti-cally significant differences in the univariate analysis were included in the multiple ordinal logistic regression analy-sis model for both tuberculosis patients and healthy individuals.The results showed that the level of education, veg-etable intake, moderate food diversity score (DDS) of 4-6 were independent influencing factors of nutritional sta-tus BMI among tuberculosis patients (P<0.05);marital status was an independent influencing factor of nutritional status BMI among non-tuberculosis patients (P<0.05);while gender and occupation were independent influencing factors of nutritional status BMI among healthy individuals (P<0.05).Conclusion The dietary nutritional status of the three population groups varied.Targeted health education should be conducted, especially for tuberculosis patients, to address the issue of uneven dietary intake and promote good dietary habits among local tuberculosis pa-tients.