Objective To investigate the effects of caudal block with lidocaine plus drugs on postoperative analgesia in children. Methods Eighty children aged 1 to 4 years old received caudal block with 1% lidocaine 1 ml/kg and were randomly allocated to 4 groups with 20 cases each. The local anesthetic solution was added fentanyl 2 μg/kg in group Ⅱ , neostigmine 2 μg/kg in group Ⅲ, tramadol 2 mg/kg in group Ⅳ or nothing in group Ⅰ. Postoperative analgesia with fentanyl (nurse controlled analgesia, NCA) was given in all patients. Pain and sedation scores were evaluated at 1, 2, 4, 6 and 24 h after surgery. The duration of caudal analgesia, fentanyl requirements, sicle effects,and discharge time were recorded. Results Duration of caudal analgesia in group Ⅳ was (510. 7±64. 9)rain, which was longer than (174.5±39. 3) rain in roup Ⅰ , (291.7 ± 50. 8) min in group Ⅱ , or (242.0±62. 8) min in group Ⅲ. The incidence of postoperative nausea and vomiting was more [requent in group Ⅳ than that in the other groups(P<0. 05). Conclusion Combined 1 % lidocaine 1 ml/kg with tramadol 2 mg/kg for caudal block can provide better and longer postoperative analgesia, but with a higher incidence of postoperative nausea and vomiting.

Inflammatory bowel disease(IBD)is a chronic nonspecific intestinal inflammatory disease and its etiology is not yet clarified. MicroRNAs( miRNAs)is a class of endogenous noncoding RNA that exerts post-transcriptional regulation on gene expression. Studies found that miRNAs is involved in the regulation of intestinal mucosal barrier and mucosal immune system;abnormal expression of miRNAs is associated with the occurrence of IBD. This article reviewed the regulatory mechanism and clinical application of miRNAs in IBD.

Inflammatory bowel disease( IBD)is a chronic and nonspecific intestinal inflammatory disease caused by multiple factors such as environment,genetic susceptibility and immune disturbance. Autophagy plays an important role in cellular homeostasis and immune. Autophagy abnormalities may be involved in the pathogenesis of IBD. Genome-wide association studies(GWAS)have provided compelling evidence that autophagy related genes,including ATG16L1,IRGM and NOD2,are significantly associated with IBD. This article reviewed the abnormal autophagy in pathogenesis of IBD.

Objective To investigate the effect of Smad7 gene on the activation of rat hepatic stellate cells (HSCs) in primary culture and on the regulation on gene expression of HSCs. Methods HSCs were isolated from male SD rats by collagenase perfusion of liver from portal vein and by 8.2% Nycodenz gradient centrifugation, and thereby transfected with AdSmad7 and AdGFP (control) respectively. The mRNA expression of transforming growth factor (TGF) ?1, Smad3 and Smad7 were measured by RT-PCR. Meanwhile, Smad7 and ?-smooth muscle actin (?-SMA) expressions were detected by immuno- cytochemistry. Results The expression of Smad7 mRNA in AdSmad7 group increased remarkably compared with TGF?1 control group, while the expression of Smad3 and TGF?1 mRNA remains unchanged. The expression of Smad7 protein was significantly higher in AdSmad7 group than that in other three groups. Accordingly, the expression of ?-SMA protein in the group of HSCs transfected with AdSmad7 was the lowest(P

Objective To study the anti-hepatofibrotic effects of rhubarb and tetrandrine in experimental rat model, and to explore its possible mechanism. Methods The experimental hepatic fibrosis was induced by subcutaneous injection of CCl 4. The rhubarb and tetrandrine were administered through gastric tube respectively. The liver function test was performed by enzyme kinetics and the extracellular matrix (ECM) contents were determined by radioimmunoassay. The pathological changes of liver tissues were detected by HE and VG staining; meanwhile, ultra microstructural changes were observed by electron microscope in randomly selected samples. Results Both rhubarb and tetrandrine could improve the liver function in liver fibrosis, decrease the contents of ECM and reduce the degree of liver fibrosis, with the best results in rats receiving high dosage of rhubarb and low dosage of tetrandrine. Conclusions Rhubarb and tetrandrine could protect hepatocytes, inhibit the ECM synthesis, and thereby could prevent the development of liver fibrosis and cirrhosis in the experimental animal models.

Objective To verify the effect of activin A neutralizing antibody (AANA) on inhibition of hepatic fibrosis and mRNA expression of various cytokines. Methods Mouse hepatic fibrosis model was induced by CCl_4. Male Kun-ming mice were divided into 5 groups: normal control group,olive oil control group, CCl_4 model group, AANA group and antibody control group. The mRNA expressions of activin A, transfer growth factor (TGF)-?_1, platelet derived growth factor (PDGF) and tissue inhibitors of metalloproteinas (TIMP)-1 in liver tissue were determined by semiquantitative reverse transcription-polymerase chain reaction(RT-PCR) analysis. Results Compared with CCl_4 model group and antibody control group, the pathologic changes of hepatic fibrosis were ameliorated in AANA group, the mRNA expressions of activin A,TGF-?_1, PDGF and TIMP-1 were down-regulated in AANA group ( P

(0.05)).Conclusions Losartan can only effectively hypertension following renal transplantation,but also obviously lessen slight hyperuricemia.

Objective The aims of this study were to investigate the prognostic value of CEA and CA19-9 expression in advanced gastric cancer and the prognostic factors of advanced gastric cancer.Methods A total of 255 patients with advanced gastric cancer who underwent radical R0 radical surgery were enrolled in the Department of Gastrointestinal Surgery,Harbin Medical University Cancer Hospital from January 2010 to December 2010,and were divided into group A(CEA<2.19ng/mL and CA19-9<10.78U/mL),group B(CEA≥2.19ng/mL or CA19-9≥10.78U/mL)and group C(CEA≥2.19ng/mL and CA19-9≥10.78U/mL).These groups were analyzed the differences in gastric cancer patients with clinical pathology and survival,and prognostic factors of patients with advanced gastric cancer factors.Results There were statistically significant differences in clinical N staging,clinical TNM staging and pathological TNM staging in three groups of patients with advanced gastric cancer(P<0.05).There was no significant difference in the median survival time in three groups of patients with advanced gastric cancer(P>0.05).The 1-year,3-year and 5-year survival rates of group A were higher than those of group B and group C(P>0.05).The factors affecting the prognosis of gastric cancer included the degree of tumor differentiation,pathological T staging,pathological TNM staging,the total number of lymph nodes,the number of positive lymph nodes and lymph node metastasis.Conclusion Combined detection of CEA and CA19-9 expression indicates a certain reference value for prognosis of gastric cancer.

Objective To evaluate the outcome of AF ablation in patients with paroxysmal atrial fibrillation (AF) related tachycardia-bradycardia syndrome. Methods Fifty consecutive patients with paroxysmal AF and prolonged symptomatic sinus pauses on termination of AF referred to our hospital for ablation were evaluated (ABL group). In another 61 patients, paroxysmal AF was treated with anti-arrhythmic drug and a pacemaker was implanted due to AF related tachycardia-bradycardia syndrome. These patients were used as control (PM group). Results A total of 50 patients in the ABL group fulfilled Class I indication for pacemaker implantation at baseline but they actually underwent AF ablation. Re-evaluation at the end of follow-up showed that 47 (94%) patients no longer needed a pacemaker (Class III indication) because of free from AF with no recurrences of pre-syncopal or syncopal events or documented sinus pauses after the last procedure. More patients in the PM group were on AADs (PM 42.6%, ABL 6.0%, P < 0.001) while sinus rhythm maintenance at the end of follow-up was remarkably higher in the ABL group (82.0%vs. 21.3%in PM group, P < 0.001). The total rates of cardiac related re-hospitalization was not significantly different between the two groups, but hospitalizations caused by tachyarrhythmia was significantly higher in the PM group (PM group 14.8%, ABL group 2.0%, P=0.020).The embolic events, heart failure and death rate were not significantly different between the two groups. Conclusions In patients with paroxysmal AF related tachycardia-bradycardia syndrome, AF ablation seems to be superior to a strategy of pacing plus AAD. Pacemaker implantation can be waived in the majority of patients after a successful ablation.

Objective To explore the impact and mechanism of miR-200 b on intestinal epithelial tight junction. Methods The negative-lentivirus and human-miR-200 b-lentivirus were employed to infect the Caco-2 cell thus establishing two stable cell lines which were then stimulated by 10 ng/mL human tumor necrosis factor-α(TNF-α) to establish the model of the intestinal epithelial injury. Those Caco-2 cells were divided into NC, NC+TNF-α, 200b, and 200b+TNF-αgroups.The tight junction permeability was detected by transepithelial electrical resistance (TEER) and Fluorescein isothiocyanate-labeled dextran (FITC-dextran). The protein alterations myosin light chain kinase (MLCK)/phosphorylated myosin light chain (P-MLC) pathways were measured by Western blot analysis. Results Compared to NC group, NC+TNF-αgroup had lower TEER, higher FITC-dextran, and up-regulated expressions of MLCK and P-MLC proteins (P