95mmHg) were randomly divided into 3 equal groups of 20 each : thiopental group, etomidate group and propofol group. All patients were prmedicated with intramuscular phenobarbital 0. 1g and atropine 0.5mg. Anesthesia was induced with thiopental 4mg?kg-1 or etomidate 0.3mg?kg-1 or propofol 2mg?kg-1, midazolam 0.1mg?kg-1, fentanyl 5?g?kg-1 and vecuronium 0.1mg?kg-1 and maintained with isoflurane inhalation and intermittent boluses of fentanyl and vecuronium. Blood samples were taken before anesthesia(To), 2min after induction(T1) and 2 and 10 min after tracheal intubation (T2, T3) for determination of plasma levels of endothelin(ET), calcitonin gene-related peptide(CGRP), neuropeptide Y (NPY) and neurotensin (NT). Results The three groups were compared with regard to age, sex and weight. BP significantly decreased after induction with thiopental or propofol but increased significantly after intubation in thiopental group and etomidate group. ET and NPY decreased but CGRP and NT increased significantly after induction in thiopental and propofol group. The plasma levels of all four neuropeptides increased significantly after tracheal intubation in thiopental and etomidata group but remained unchanged in propofol group. Conclusions Propofol is the intravenous anesthetic of choice for induction of anesthesia in patients with hypertension.

The open reading frame of Spinacia oleracea Betaine Aldehyde Dehydrogenase (SoBADH) was retrieved from Spinacia oleracea and inserted into the Agrobacterium tumefaciens binary vector pBin438, which was driven by CaMV35S promoter, and produced the new binary vector pBSB. A. tumefaciens LBA4404 carrying this plasmid was used in genetic transformation of plants. Forty-five primary transgenic plants were detected by PCR and verified by the Southern blotting from 65 regenerated plants, of which 27 transgenic plants had only one copy of T-DNA. The Northern blotting and Western blotting analysis indicated that the SoBADH gene had been transcribed mRNA and expression protein in the transgenic cotton lines. The testing of SoBADH activity of transgenic plant leaves showed that the enzyme activity was much higher than that of the non-transgenic cotton. The growth of transgenic plants was well under the salinity and freezing stress, whereas the non-transgenic plant grew poorly and even died. Challenging with salinity, the height and fresh weight of transgenic plants was higher compared with those of non-transgenic plants. Under the freezing stress, the relative conductivity of leaf electrolyte leakage of the transgenic cotton lines was lower than that of non-transgenic plants. These results demonstrated that the SoBADH gene could over express in the exogenous plants, and could be used in genetic engineering for cotton stress resistance.
Adaptation, Physiological ; Betaine-Aldehyde Dehydrogenase ; biosynthesis ; genetics ; Cold Temperature ; Gossypium ; enzymology ; genetics ; Plants, Genetically Modified ; enzymology ; genetics ; Salinity ; Spinacia oleracea ; enzymology ; genetics ; Stress, Physiological ; genetics

Objective To study the survival rate,cause of death and the incidence of complications of extremely low birth weight (ELBW) infants.Method Clinical data of the ELBW infants admitted in our hospital between December 2013 and November 2016 were retrospectively analyzed.The cases were assigned into five groups based on gestational age (GA) or birth weight (BW) to further analyze the survival rates among each group.According to the time of death,the cases were assigned into two groups (death within 7 days or after 7 days) to analyze their direct death causes.ELBW infants were categorized into three groups according to GA (＜ 26 weeks,26-27 weeks and ≥ 28 weeks) or into two groups according to birth weight (＜ 750 g and ≥ 750 g) to analyze the incidence of complications within 14 days or after 14 days.Result A total of 122 ELBW infants were enrolled in this study.The mean GA was 27.6 ± 2.1 (range of 22-33) weeks,mean birth weight was 849 ± 112 (range of 525-995) g.GA and BW were both positively correlated with the survival rate.Among all the studied cases,43 were dead cases.Within these 43 cases,13 of them died within 7 days.The top 3 causes of death of them were neonatal respiratory distress syndrome (RDS),severe asphyxia and pulmonary hemorrhage of neonatal.The other 30 cases died after 7 days,while the top 3 causes of death of them were sepsis,bronchopulmonary dysplasia (BPD) combined with pneumonia and neonatal necrotizing enterocolitis (NEC).The incidences of complications of all 122 ELBW infants within 14 days of hospitalization were as follow:ELBW infants with BW ＜ 750 g had higher morbidity of neonatal severe asphyxia and neonatal blood glucose disorder than ELBW infants with BW ≥ 750 g (37.0％ vs.8.4％,51.9％ vs.24.2％,P ＜0.05);ELBW infants with GA ＜ 26 weeks and 26-27 weeks had higher morbidity of neonatal RDS than ELBW infants with GA≥28 weeks (86.5％ and 94.3％ vs.59.4％,P ＜ 0.05).99 cases of ELBW infants whose duration of hospitalization were more than 14 days were analyzed.The incidences of retinopathy of prematurity (ROP) in GA ＜ 26 weeks group was higher than that in GA between 26-27 weeks group and GA ≥ 28 weeks group (40.7％ vs.18.2％ and 14.3％,P ＜ 0.05).The incidences of BPD and anemia in GA ＜ 26 weeks group and GA between 26-27 weeks group were higher than that in GA≥28 weeks group (BPD:70.4％ and 68.2％ vs.35.7％;anemia:88.9％ and 84.1％ vs.57.1％;P ＜ 0.05).The incidence of sepsis in GA ＜ 26 weeks was higher than that in GA ≥ 28 weeks group (74.1％ vs.39.3％,P ＜0.05).The differences of the incidences of all the complications between BW ＜ 750 g group and BW ≥750 g showed no significance statistically (all P ＞ 0.05).Conclusion As the increasing of GA and BW,the survival rates of ELBW infants increase significantly,and the incidence of complications decline significantly.The complications related to ELBW infants during hospitalization should be prevented to improve the early survival quality of them.

The cross regional loose medical alliance is an important carrier in the current integrated development process of medical services in the Yangtze River Delta region. Smith policy implementation process model was used to analyze the development difficulties of cross regional loose medical alliances from idealized policies, policy implementation institutions, policy target groups, and policy implementation environment. Such medical alliances were formed under the background of integrated development in the Yangtze River Delta, with Shanghai′s tertiary public hospitals as leading units and medical institutions in Jiangsu, Zhejiang, and Anhui provinces as member units. Analysis showed that the policies for such medical alliances development had not yet clearly defined the organizational management mode, operational mechanism, and implementation path, and the corporate governance structure of medical alliance was immature; The policy implementation agencies were relatively lagging behind in the support of special funds and the formulation of related supporting policies; Participation of policy target groups was insufficient and their incentive mechanisms was imperfect; There were problems in the policy implementation environment, namely inconsistent medical and health service regulations and systems in different regions, different health financing capabilities of local governments, insufficient coordination of medical institution management concepts, and a lack of unified standards in information systems. Based on the above difficulties, this study proposed to strengthen the development planning and layout of cross regional loose medical alliances, and improve the corporate governance structure; To strengthen the government′s main responsibility and improving policy implementation capabilities; To improve the internal cooperation and operation mechanism of cross regional loose medical alliances, and enhance the sense of identity of the target group; To optimize the policy implementation environment and implement various support measures, so as to provide references for further promoting the coordinated development of high-quality medical resources in the Yangtze River Delta region.

Irreversible destruction of bronchi and alveoli can lead to multiple incurable lung diseases. Identifying lung stem/progenitor cells with regenerative capacity and utilizing them to reconstruct functional tissue is one of the biggest hopes to reverse the damage and cure such diseases. Here we showed that a rare population of SOX9 basal cells (BCs) located at airway epithelium rugae can regenerate adult human lung. Human SOX9 BCs can be readily isolated by bronchoscopic brushing and indefinitely expanded in feeder-free condition. Expanded human SOX9 BCs can give rise to alveolar and bronchiolar epithelium after being transplanted into injured mouse lung, with air-blood exchange system reconstructed and recipient's lung function improved. Manipulation of lung microenvironment with Pirfenidone to suppress TGF-β signaling could further boost the transplantation efficiency. Moreover, we conducted the first autologous SOX9 BCs transplantation clinical trial in two bronchiectasis patients. Lung tissue repair and pulmonary function enhancement was observed in patients 3-12 months after cell transplantation. Altogether our current work indicated that functional adult human lung structure can be reconstituted by orthotopic transplantation of tissue-specific stem/progenitor cells, which could be translated into a mature regenerative therapeutic strategy in near future.
Bronchiectasis ; genetics ; metabolism ; Humans ; Pulmonary Alveoli ; cytology ; metabolism ; SOX9 Transcription Factor ; genetics ; metabolism ; Stem Cell Transplantation ; methods ; Stem Cells ; cytology ; metabolism