ObjectiveTo investigate the feasibility and clinical effect of bispectral index (BIS) monitoring target controlled infusion of midazolam and propofol for sedation of mechanically ventilated patients.MethodsEighty cases with severe respiratory failure,sane,the need for endotracheal intubation mechanical ventilation for at least 24 h were divided into 4 groups by random digits table with 20 cases each.Group A and group C patients routinely received propofol and midazolam,group B and group D patients used BIS monitoring target controlled infusion of propofol and midazolam.The correlation of BIS and Ramsay score was analyzed,and the changes of mean arterial pressure (MAP) and heart rate (HR) were compared among 4 groups.ResultsBIS was negatively correlated with Ramsay score in group B and group D (P ＜ 0.05).MAP after 24 h intubation was lower than that at intubation immediately among 4 groups [group A:(63.89 ±4.68) mm Hg (1 mm Hg =0.133 kPa) vs.(92.33 ±3.57) mm Hg,group B:(62.66 ±3.97) mm Hg vs.(93.76 ± 4.02) mm Hg,group C:(64.59 ± 3.29) mm Hg vs. (93.78 ± 4.61 ) mm Hg,group D:(63.18 ±2.51 )mm Hg vs. (93.61 ± 5.36) mm Hg],and there were significant differences (P＜ 0.05).Group A and group B reached the standard after 1 h intubation.HR after 24 h intubation decreased in 4 groups,but there was no significant difference (P ＞ 0.05).ConclusionsBIS monitoring target conmolled infusion of midazolam and propofol for sedation of mechanically ventilated patients can achieve similar sedative effects,in addition,the need for rapid sedation of mechanically ventilated patients with suitable choice of propofol.At the same time,BIS is negatively correlated with Ramsay score.

Objective To investigate the clinical significance in diagnosis and prognostic judgments of acute myelocytic leukemia with combined detection of morphology ,peripheral blood and immune typing of bone marrow cells .Methods Microscopic examina‐tion of bone marrow cell morphology ,automatic blood cell analyzer detection of peripheral blood parameter and flow cytometry anal‐ysis of immune markers of leukemia cells ,all these datas were analyzed statistically .Results Peripheral blood cell analysis showed that instruments may indicate the presence of abnormal or naive cells in about 85% patients ,different kinds of leukemia had signifi‐cant difference in total leukocyte count (majority higher in M1 - 2 ,M5 ;majority lower in M3) ;while anemia and thrombocytopenia were observed in most patients ,but the degree was different ;M1 - 2 and M5 can not be identified by classification of leukocyte by automatic blood cell analyzer ,CD7 ,CD10 and CD2 can cross express in myeloid leukemia ,which have a prompt effect with treatment and prognosis .Conclusion Detection of peripheral blood parameters has an important role in early screening ,differential diagnosis and prognosis judgment of leukemia ,immunological markers detection is the powerful supplement and support for leukemia diagno‐sis and typing ,sensitive markers have close contact with prognosis ,which significantly improves the effect of the diagnosis and treatment of leukemia .

Objective To construct the recombinant plasmid carrying shRNA to ATX and analyze the nucle- ic acid sequence for further searching new gene therapy method of tumor.Methods Two DNA sequences containing short hairpin structure were designed and synthesized.The complement form was obtained by annealing and inserted into vector Psilcncer2.1-U6 neo,and the recombinant plasmid was transformed into DH5a strain.Finally the plasmid identified by restriction enzyme was used for sequence analysis.Results The recombinant Psileneer2.1-U6 neo car- rying shRNA to ATX had been constructed and the aim sequence had been obtained.Conclusion The construction of the recombinant plasmid carrying shRNA to ATX lays the basis for the study of its inhibitive effect on tumor.

AIM: To explore the relationship between the expression of caspase-2 and caspase-3 and the apoptosis in retinal ischemia/reperfusion (I/R) injury of rats, as well as the therapeutic effects of brain derived neurotrophic factor (BDNF)on the ischemic and reperfused retina.METHODS: This experiment was conducted at the laboratory of Affiliated Hospital of Qingdao University Medical College from February 2007 to July 2007. The models of retinal ischemia/reperfusion injury were made by transiently elevating intraocular pressure. A total of 28 rats were divided into Normal and Operative Groups. Operative group was divided into six subgroups. In each subgroup there were four rats. The left eyes of rats were used for I/R and the right eyes were used for intravitreal injection of brain-derived neurotrophic factor (BDNF) as treatment group. After reperfusion we divided our subgroups according to the reperfusion time as 1, 6, 12, 24, 48, 72 hours. The retinal ganglion cell number was counted by using optic microscope(BX-51,Olympus). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and the expression of caspase-2,caspase-3 was studied by enzyme linked immunosorbent assay (ELISA) and strept avidin-biotin complex (SABC)immunohistochemistry.RESULTS: No positive apoptotic cells were observed in the normal rats' retinae, but there were a significant number of positive apoptosis cells in 6-24 hours after transient ischemia followed by a decrease at 48 hours. The number of apoptotic cells reached a maximum at 24 hours after ischemia .The expression of caspase-2 gradually increased as early as at 6 hours, reached a peak at 24 hours, then decreased between 48 and 72 hours. Similarly, caspase-3 has the same rule with caspsae-2 in the time courses of expression in retinal tissues.BDNF administered before reperfusion inhibited the expression of apoptosis and ameliorated the retinal tissue damage. It also decreased caspase-2 and caspase-3 expression in ischemic/reperfused retina.CONCLUSION: Retinal ischemia-reperfusion can induce apoptosis of cells in the retina. BDNF rescues retinal ganglion cells (RGCs) from retinal ischemia/reperfusion injury through down-regulation of cell apoptosis and caspase-2 and caspase-3 expression. BDNF have a neuroprotective effect on retina.

BACKGROUND: Bone-induced protein and its carrier are widely used at present; however, the source is limited, and the preparation is complex. Demineralized dental matrix (DDM) is a natural compound containing many osteoinductional proteins and carriers, thus DDM is an ideal material as the substitute of allogenic bone transplantation.OBJECTIVE: By co-culture of MC-3T3 osteoblast and DDM, to evaluate the biocompatibility of DDM via measuring proliferation and alkaline phosphatase (ALP) activity of osteoblast.DESIGN, TIME AND SETTING: A randomized controlled experiment was performed in Stomatology Hospital of Lanzhou University and Stomatology Hospital of Liwan from November 2007 to May 2009.MATERIALS: DDM was supported by Shenzhen Chuangbo Biological Products Development Co., Ltd.; hydroxyapatite (HAP) was supported by Nanjing Emperor Nano Material Co., Ltd.METHODS: 0.1 g HAP and DDM were added in to a 24-well plate, three wells per samples, and the MC-3T3 osteoblasts were seeded onto the surface of samples. After culturing for 2, 4, and 6 days, the cell proliferation percentage was calculated according to MTT assay. ALP activity was evaluated by the quantitative ALP assay.MAIN OUTCOME MEASURES: The effect of DDM on the proliferation and ALP activity of osteoblasts.RESULTS: The proliferation of osteoblasts in DDM group was obviously higher than that in HAP group. With culture time increasing, the ALP activity of osteoblasts in two groups was all augmented, and DDM group was higher than HAP group. There was significant difference between the two groups (P < 0.05).CONCLUSION: DDM can promote adhesion and proliferation of osteoblasts, and promote osteoblastic growth, displaying a great biocompatibility.

ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.

Objective To compare volumetric‐modulated arc therapy(VMAT) with intensity‐modulated radiation therapy (IMRT) for brain metastases with regard to the dosimetric character .Methods Sixty patients who were diagnosed with brain me‐tastases were included in this study .The target area received two dose levels using late addition amount technique ,WBRT (30 Gy/10 F) with following addition (20 Gy/10 F) to 59 Gy .For a fair comparison ,VMAT and IMRT treatment plans were respectively designed for every patient with the same dosimetric constraints .Dosimetric comparisons between VMAT and IMRT plans were ana‐lyzed to evaluate :target coverage and homogeneity ,conformity of PTV ;sparing of OARs ;monitor units (MUs) .Results Two treatment plans all reached the treatment need .When compared with IMRT ,there was no significant difference in Dmean of eyeball , len ,optic never ,visual chiasma ,parotid ,brain stem ,and external auditory canal of VMAT (P>0 .05) .The Dmax of eyeball ,len ,pa‐rotid ,and external auditory canal of VMAT were lower than that in IMRT group (P<0 .05) .The VMAT group has the less MUs (P=0 .017) and less treatment time .Conclusion VMAT can reach the big‐dose radiotherapy need on brain metastases clinically . There are no significant diffference between VMAT and IMRT on Dmax ,Dmean ,CI ,and HI .The Dmax of eyeball ,len ,parotid ,and external auditory canal of VMAT were lower than that in IMRT group .The VMAT can reduce the radiotherapy time .

Objective To investigate the effects of acupoint therapy on inflammatory factors and its clini-cal efficacy in relieving bronchial asthma. Methods Selected patients with bronchial asthma which was in remis-sion were randomly divided into a treatment group that was treated with acupoint therapy and a control group that was given Seretide. Each group had 30 cases. The treatment period was 4 weeks. Both groups were evaluated in terms of Asthma Control Test ( ACT) scores and the serum content of interleukin-5 ( IL-5) and interleukin-10 ( IL-10) before and at one month ( short-term) , as well as three months after the end of the treatment ( long-term) . The asthma control situation ( fully controlled, partially controlled or uncontrolled) was evaluated. Results Before treatment the average ACT scores of the two groups were not significantly different. After the treatment both the short-term and long-term average ACT scores of the treatment group were significantly higher than those of the con-trol group. The total effectiveness rate of asthma control in the treatment group in the short term ( 93%) was signifi-cantly higher than that in the control group ( 70%) . After the treatment the IL-5 and IL-10 levels in the treatment group were improved to a significantly greater extent than those in the control group. Conclusion Acupoint thera-py can reduce airway inflammation, control bronchial asthma symptoms and show good clinical efficacy, probably by regulating IL-5 and IL-10 levels.

OBJECTIVETo explore a new experimental method for screening of allergens in post-market traditional Chinese medicine injections by confirming allergens in Huachansu injection.

METHODFirst of all, the serum of patients allergic to Huachansu injection were collected, at the same time, the dubious allergen was conjugated to bovine serum albumin (BSA) by EDC coupling procedure to form complete antigen (BNP-BSA), which makes it possible to reproduce the allergic reaction of Huachansu injection in vitro. The histamine liberation ratio, the level of TNF-alpha and Histamine released from RBL-2H3 mast cell were detected; the above data were compared with those obtained in vivo.

RESULTThe difference of the histamine liberation ratio, the levels of TNF-alpha and histamine of the resibufogenin-BSA group, group of patients allergic to Huachansu injection were not significant compared with those of normal control group. However, there were significant difference in those data among the cinobufagin-BSA group, the blank control and normal control group (P<0.05).

CONCLUSIONThe allergen in the serum collected from patients allergic to Huachansu injection is resibufogenin.

Allergens ; adverse effects ; immunology ; Amphibian Venoms ; adverse effects ; immunology ; Animals ; Anura ; Bufanolides ; adverse effects ; immunology ; Drug Hypersensitivity ; immunology ; Histamine Release ; Humans ; Mast Cells ; immunology ; Medicine, Chinese Traditional

OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged