Objective To investigate the relationship between bispectral index (BIS) and cerebrospinal fluid (CSF) concentrations of propofol or effect-site concentrations during target-controlled infusion (TCI) of propofol and evaluate the accuracy of the infusion system targeting at effect-site concentration.Methods Twelve healthy mongrel dogs weighing (17.04? 1.53) kg were anesthetized with intramuscular ketamine 5 mg?kg-1 followed by enflurane inhalation. A catheter was inserted into subarachnoid space and advanced to the base of skull for the collection of CSF. BIS, hemodynamics and PETCO2 were monitored continuously during the experiment. Target effect-site propofol concentration was set at 3 ?g?ml-1 and infusion was continued for 15 min. CSF was collected at 1, 3, 5, 10, 15, 20, 30, 45 and 60 min after infusion was started for determination of propofol concentration by high performance liquid chromatography with fluorescence detection. Results The equilibrium between predicted plasma and effect-site concentration was reached at 10.9 min and the target effect-site concentration was maintained at 3 ?g?ml-1 .The peak CSF concentration of propofol was (0.29? 0.14)?g?ml-1 .CSF concentrations were much lower than the effect-site concentrations at all sampling times (about 18.7% of the effect-site concentration on average) . BIS was consistent with the CSF concentrations of propofol. Both of them reached the lowest or peak values at 5 min after infusion was started, while the peak effect-site concentration was reached relatively later. BIS was found to be better correlated with CSF concentration (? = 0.9195) than with the effect-site concentration (? = 0.554) . The dogs developed hypotension as expected but no other severe adverse effect was observed. Conclusion The inconsistency of BIS with effect-site concentration during TCI of propofol may result from its pharmacokinetic parameters. Good correlation between BIS and CSF concentration indicates that CSF concentration can reflect the pharmacokinetic profileof propofol at effect-site more accurately than the plasma concentration during TCI of propofol targeting at effect-site concentration.

Objective To evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Published articles from the earliest date available to July, 2016 were recalled from PubMed, OVID, Embase, Co-chrane Library, CNKI, VIP and Wanfang Database. Two reviewers selected independently the randomized controlled trials (RCTs) about rT-MS for stroke patients with unilateral spatial neglect, and extracted data independently and analyzed with RevMan 5.3 and GRADE profiler 3.6. Results Twelve trials that represented 353 participants were evaluated. For improving Line Bisection Test, Star Cancellation Test, Albert Test, rTMS groups were significantly more effective than the controls. rTMS groups with different frequencies all showed significantly effec-tive:for low frequency rTMS, SMD=-1.21, 95%CI=-2.17 to-0.25;for high frequency rTMS, SMD=-2.56, 95%CI=-3.54 to-1.58;for continuous theta burst stimulation (cTBS), SMD=-2.51, 95%CI=-3.66 to-1.36. Conclusion rTMS is effective on unilateral spatial neglec-tin in stroke patients.

Objective To evaluate the value of using fluorescence in situ hybridization (FISH)technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor.MethodsFISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold.The morning's first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results.Results The sensitivity of single using were 73.3％ (55/75),76.0％ (57/75),62.7％ (47/75) and 62.7％ (47/75) for the 4 probes (3,7, 17 and 9p16)respectively.The sensitivity of combined detection was 85.3％ (64/75) and specificity was 96.0％ (24/25) The sensitivity and specificity of urine cytology examination was 9.3％ (7/75) and 100％ (25/25) .The sensitivity of FISH examination was significantly higher than that of urine cytology examination (85.3％ vs 9.3％ ,x2 = 57.00, P ＜ 0.001) .Sensitivity of FISH examination was not correlated with cancer pathologic grading(low vs high : 84.2％ vs 86.5％, x2 = 0.08, P ＞ 0.05)and clinical stage (ta-tl : 82.9％, t2-t4 :87.5％, x2 = 0.32 ,P ＞ 0.05) .ConclusionFISH technique is a non-invasive and effective method for the early diagnosis of bladder tumor and is more sensitive than urine cytology.Furthermore, FISH technique can be used to predict the tumor's biological behavivor and prognosis.

Objective In order to find out the properly corresponding solutions of stomatology doctors' profession exhaustion,we investigated and analyzed the current situations and the influential factors.The solutions would help stomatology doctors improve the working efficiency and the enthusiasm to job.Methods The survey was conducted using MBI-GS questionnaire.Results Among all the participants 52％ had a certain degree of emotional exhaustion,58％ had emotional exhaustion,61％ were cynic and had doubts about personal accomplishments.Females were even worse than the male in emotional exhaustion.Significant correlation was found between wage satisfaction and oral health care provider's emotions (P＜0.05) No significant relationship was seen between the marital status and different nature of the unit,and the score was not statistically significant (P＞0.05).No obvious difference wss observed in different professional titles.Concltsion In Hainan Area,the stomatology doctors have partly job burnout,according to these surveys,we now taking diversified and adjusted measures to make corrections and prevent the job burnout.

Objective: After establishing standard multi-modal therapy, prognosis of refractory and metastatic high-grade osteosarcoma remains dismal and unchanged over the last decades. Early clinical intervention to newly detected metastatic lesions is crucial and effective for better prognosis. Arsenic trioxide (ATO) is one of the oldest remedies used in traditional oriental medicine and is recently rediscovered as an immunomodulator due to its activity against other solid tumors. This study aims to evaluate the efficiency of ATO combined with first-line chemotherapy in treating pulmonary metastatic osteosarcoma patients with long-term follow-up in our institution.Methods: Osteosarcoma patients with pulmonary metastasis were intravenously administered with ATO (5-10 mg) daily combined with first-line chemotherapy for their treatment. A total of 119 patients were finally enrolled; 65 presented metastasis, and 54 relapsed with lung metastasis. Results: Two-year and five-year overall survival (OS) rates for these patients reached 52.6% and 30.9%, respectively. Only 20 cases underwent thoracotomies (16.8%). Our five-year OS was nearly similar to that of other institutions (37% in Rizzoli, Italy). We observed that combined with bone metastasis, bilateral metastasis, and >3 pulmonary nodules, incomplete resection of pulmonary lesions deteriorated the disease and significantly influenced survival as compared with all other parameters. Conclusion:Combined with conventional chemotherapy, ATO may be effective and well-tolerated as new therapeutic option for patients with nonresectable pulmonary metastatic osteosarcoma. Lung metastasectomy should be strictly selected only for populations who benefit from this treatment.

Objective To assess the clinical outcome of varicose veins with incompetent great saphenous vein(GSV) treated with ultrasound guided foam sclerotherapy. Methods Forty limbs with moderate to severe symptomatic varicose veins with incompetent GSV in 38 patients were injected with foam sclerosing agent (Fibro-Vein) under ultrasound guidance. There were 36 patients with unilateral varicose veins and 2 with bilateral varicose veins. No of them suffered from deep vein incompetence or perforating vein incompetence. Second injection was performed one month after the initial injection in 7 limbs. Thirty-eight of 40 limbs were followed up with clinical examination and duplex ultrasound scan 30-47 months (mean 40 months) after the treatment. Results Among 38 limbs with follow-up mild debilitation was found in two limbs(5. 3%). There were no other symptoms or complications. Duplex ultrasound demonstrated four type of results: type I, sclerosed GSV trunk with no detectable venous flow in 32 of 38 limbs (84. 2%) ;type II,patent GSV trunk in 3 limbs (7. 9%) ,two of them had mild reflux in the GSV trunk;type III,sclerosed GSV trunk and mild reflux in the GSV tributaries, 1/38(2. 6%) ; type IV,sclerosed proximal GSV trunk,patent distal GSV communicated with a superficial vein and mild reflux in the veins, 2/38 (5. 3% ). Conclusions Clinical examination and duplex ultrasound scan demonstrated excellent results of varicose veins with incompetent GSV treated with ultrasound guided foam sclerotherapy 40 months after the treatment. Sclerotherapy is less invasive treatment option for varicose veins with incompetent GSV with satisfactory clinical and cosmetic outcome.

Objective To investigate the expression of extraeellular signal-regulated protein kinase (ERK1/2)pathway in rat brains with fluorosis and the effects of fluoride on learning and memory of the rats,and to reveal the mechanisms of damaged nervous system resulted from the toxicity of the ion.Methods Seventy-two SD rats were divided into 3 groups and 24 rats were in each group.Three groups were fed respectively with different concentrations of fluoride(NaF)for 6 months to establish rat models with fluorosis.Controls were fed with tap water (NaF＜0.5 mg/L):lower and higher concentration group were fed with water containing NaF(5,50 ms/L).Animals are sacrificed after 6 months of treatment with fluoride and the dissected brains were kept for analysis.The protein levels of ERK1/2 in rat brains were detected by Western-blotting and the mRNA level by RT-PCR. The spatial learning and memorizing ability was measured by Morris water maze test. Results The ERK1/2 protein in control group,lower and higher concentration group was 0.944±0.10,1.253±0.02,1.953±0.07,the differece being statistieally sighificant between any two groups (P ＜ 0.05). The phospho-ERKl/2 protein in control group,lower and higher concentration group was 0.73±0.08,0.77±0.07,1.28±0.11,the differece being statistieally sighificant between any two groups(P ＜ 0.05);the activation rate of phospho-ERK1/2 in lower and higher concentration group [(68.4± 3.8)%,(64.1±3.2)%] was decreased compared to control group[ (82.3±10.7)%],the differece being significant(P ＜ 0.05). In the navigation trial,longer escape latencies of lower concentration group on the second, the third,the fifth and the sixth day were observed[ (46.0±8.0),(24.0±2.7),(8.9±5.3),(7.4±4.1 )s] compared to the control[ (39.3±6.9),(19.1±9.1 ),(8.3±3.4),(4.8±2.7)s],the differece being significant (P ＜ 0.05 or ＜ 0.01 );the similar results were also observed in the higher concentration group[ (36.9±16.8),(37.7±12.9), (19.7±7.6),(12.2±5.7 )s],and the escape latencies of the higher concentration group on the third,the fifth and the sixth day were longer than that in lower concentration group. In the probe test,the rats took more time to reach the first cross in lower and higher concentration group[(1.17±0.75),(4.18±1.10)s] than control group[ (5.89± 0.56 ) s ],the differece being significant (P ＜ 0.05 or ＜ 0.01 ) ;stayed shorter [ ( 17.05±4.25 ),(18.20±4.57 ) s ] than control [(25.37±5.65 )s ] in platform area (P ＜ 0.01 );the activation rates of ERK1/2 were directly correlated with the time taken to reach the first cross platform located in the probe test(r = 0.364,P ＜ 0.05) and the activation rates were also directly correlated with the escape latencies on the sixth day(r = 0.497,P ＜ 0.05). Conclusion Long-term exposure of excessive fluoride induces the change of expression and activating rate of the ERK1/2 in rat brains,leading to the decreased capacity of learning and memory.

Objective To detect and analyze thyroid tumor by two-dimensional sonogram and Doppler parameter, and evaluate the value of high-frequency ultrasound in diagnosing thyroid benign and malignant tumors. Methods The ultrasonic images of 104 thyroid tumor from 80 patients with typical features were collected. Thyroid tumor was classified into benign and malignant nodules, based on the shape, border, or the rear wall echo, echo attenuation loss, internal echo, and microcalcifications in two-dimensional sonogram and systolic blood peak velocity (Vmax) and resistant index (RI) in Doppler examination. The expected results of high frequency ultrasound were compared with pathological results on consistency and error rate. Results Prediction of benign tumor by high frequency ultrasound was 66, and pathology 61, consistency rate of the two was 92.4%. Prediction of malignant lesions was 38, and pathological examination 32, consistency rate of the two was 84.2%. The total coincidence rate was 89.4%(93/104) and the error rate was 11.6%( 11/104). Conclusions The typical features of thyroid tumor on high-frequency ultrasound are helpful in diagnosis of benign or malignant nodules, which is valuable in guiding clinical treatment.

Objective To master current operating situation of water-defluoridation-project and the level of fluoride in drinking water of Zhangjiakou city and provide a scientific basis for prevention and control of the disease.Methods Itemized survey of current operating situation of water defluoridation projects built in 2010 and before,and the source of fund situation in Zhangjiakou city was carried out.One source water and 2 terminal water samples of the projects in use were collected,respectively.Water fluoride were determined by Sanitary Standard for Drinking Water Testing Method (GB/T 5750.5-2006).Results A total of 386 water improvement projects to reduce fluoride were investigated,310 in good operation,accounting for 80.31％; 6 in intermittent use,accounting for 1.55％; 70 out of use,accounting for 18.14％.Water fluoride was surveyed in 316 water improvement projects to reduce fluoride,175 of the projects provided water with normal fluoride,accounting for 55.38％; 141 of the projects provided water with fluoride exceeded the standard,accounting for 44.62％.The total investment of 386 water defluoridation projects was 21.8682 million yuan,the investment of the state,the collective and the individual were 10.0780 million yuan,6.2104 million yuan and 5.5798 million yuan,accounted for 46.09％,28.40％,25.51％,respectively.Conclusions The current situation of the projects is very worrying in Zhangjiakou city.Further instensify the water improvement project in diseased areas,insist on sustainable water defluoridation strategy.

Objective To investigate the expression and distribution of the downstream substrate of extracellular regulated protein kinase(ERK1/2) pathway, ternary complex factor phospho-Elk-1, in rat brains with chronic fluorosis, and reveal the mechanism of the impaired learning and memory ability caused by chronic fluorosis. Methods Seventy-two SD rats, weighing 100 - 120 g, were randomly divided into 3 groups, 24 in each group (half male and half female). The rats in control group were fed with tap water (fluoride < 0.5 mg/L); low- and high-dose fluoride groups were fed with tap water with different concentrations of NaF(5.0,50.0 mg/L F-, respectively). After 6 months, body weight was weighed, dental fluorosis was determined by observation and urinary fluoride and bone fluoride were detected by fluorine ion-selective electrode; the learning ability of rats was measured by navigation test of Morris water maze, and memory ability by spatial probe test in Morris water maze; the expression and distribution of phospho-Elk-1 in different brain regions were detected by immunohistochemistry method. Results In low- and high-fluoride groups, the body weight of rat[(449.2 ± 77.1), (312.8 ± 89.7)g] was significantly decreased than that of control [(635.5 ± 76.2 )g, all P< 0.05], the varying degrees of dental fluorosis were observed(x2 = 7.83, P<0.05), urinary fluoride[(2.56 ±0.91),(5.73 ±3.14)mg/L] and bone fluoride[(709.2 ± 37.4) ,(1306.3 ± 102.4) mg/kg] were significantly higher than those in controls[(0.92 ± 0.30)mg/L,(348.5 ± 89.2)mg/kg, all P< 0.05]. The escape latency of low- and high-fluoride groups[ (7.4 ± 4.1), (12.2 ± 5.7)s] was longer than that of control [(4.8 ± 2.7 )s, all P < 0.05] and the escape latency in high-fluoride group was significantly longer than that in other groups (all P < 0.05); in spatial probe test, the time of first crossing platform was longer in rats with fluorosis [(4.18 ± 1.10),(5.89 ± 0.56)s] as compared to control[(1.17 ± 0.75)s, all P< 0.05]. Expressions of phospho-Elk-1 in the hippocampus CA1(167.4 ± 8.3,163.2 ± 9.4), CA2(175.7 ± 5.0,183.3 ± 4.2), CA3(165.2 ± 11.6,162.9 ± 4.4), CA4(168.7± 6.9,169.5 ±5.3), fascia dentate (185.2 ±4.0,193.1 ±6.1) and caudate putamen( 181.4 ± 3.8, 179.8 ± 5.5) in low- and high-fluoride groups were higher than those of controls(142.4 ± 8.1,144.9 ± 8.4,143.6 ± 5.8, 116.8 ± 9.1,140.2 ± 7.8,163.1 ± 13.1, all P< 0.05). Conclusion Chronic fluorosis can cause increased expression of phospho-Elk-1 in the hippocampus and caudate putamen region of rat brains, which might be related to the mechanisms of decreased learning and memory ability of rats overexposed to fluoride.