Objective To evaluate the effects of dexmedetomidine plus sufentanil during postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy.Methods Sixty patients (aged 30-55 years,ASA Ⅰ or Ⅱ) scheduled for hysterectomy were randomly divided into the following 2 groups: group C (n=30,sufentanil) and group D (n=30,sufentanil plus dexmedetomidine).Polysomnography measures were performed,the night before surgery (PSG1),the first night after surgery (PSG2),and the second night after surgery (PSG3).In addition,pain levels (visual analogue scale,VAS),sedation levels,sufentanil consumptions,and possible adverse effects on MAP,HR and SpO2 were investigated.Results Compared with PSG1,N1 stage sleep in group C and N2 stage sleep in group D were significantly increased (P<0.05),N1 stage sleep at PSG2 and PSG3 in group D was decreased (P<0.05);N3 and REM stage sleep,sleep efficiency index and subjective sleep quality were decreased,arousal index was increased in two groups (P<0.05).Compared with group C,N1 stage sleep was decreased,and N2 stage sleep was increased at PSG2 and PSG3 in group D (P<0.05);sleep efficiency index,subjective sleep quality were increased,arousal index in group D was decreased (P<0.05).Patients in group D had a lower VAS score and cumulative sufentanil consumption,MAP,HR at 6,24,48 h after surgery (P<0.05) and a higher sedation score at 6,24 h after surgery than those in group C (P<0.05).Conclusion Besides offering effective analgesia,postoperative dexmedetomidine infusion has positive effects on sleep disturbance in patients undergoing hysterectomy.

Objective To evaluate the role of c?Jun N?terminal kinase ( JNK) and p38 mitogen?ac?tivated protein kinase ( p38MAPK) signaling pathways in attenuation of myocardial ischemia?reperfusion ( I∕R) injury by morphine postconditioning. Methods Healthy adult male Sprague?Dawley rats, weighing 180-240 g, were used in the study. Their hearts were excised and retrogradely perfused in a Langendorff apparatus with Krebs?Ringer ( K?R) buffer saturated with 95% O2?5% O2 at 37℃. After 15 min of equili?bration, 52 isolated hearts were divided into 4 groups ( n=13 each) using a random number table: control group (group C), I∕R group, morphine postconditioning group (group MP), and morphine postcondition?ing plus anisomycin group ( group MP+A) . The hearts were continuously perfused with K?R buffer for 105 min in group C. In group I∕R, the hearts were subjected to 45 min of global ischemia by stopping perfusion with K?R buffer, followed by 60 min of reperfusion by restoration of perfusion with K?R buffer. In group MP, the hearts were subjected to 45 min of global ischemia, followed by 10 min of reperfusion with K?R buffer containing 3?0 μmol∕L morphine and then by 50 min of reperfusion with K?R buffer. In group MP+A, the hearts were subjected to 45 min of global ischemia, followed by 10 min of reperfusion with K?R buffer containing 3?0 μmol∕L morphine and 1?0 μmol∕L anisomycin ( an activator of JNK and p38MAPK) and then by 50 min of reperfusion with K?R buffer. At 60 min of reperfusion, 8 hearts in each group were selected for measurement of the myocardial infarction and amount of creatine kinase?MB ( CK?MB) released from the myocardium, and the myocardial infarct size was calculated. At 20 min of reperfusion, 5 hearts in each group were selected to detect the expression of phosphorylated JNK ( p?JNK ) , phosphorylated p38MAPK ( p?p38MAPK) and cytochrome c ( Cyt c) in myocardial tissues ( by Western blot) and content of nicotinamide adenine dinucleotide ( NAD+) in myocardial tissues ( by spectrophotometry ) . Results Compared to group C, the myocardial infarct size and amount of CK?MB released from the myocardium were significantly increased, the expression of p?JNK, p?p38MAPK and Cyt c was significantly up?regulated, and the content of NAD+ was significantly decreased in I∕R, MP and MP+A groups ( P<0?05) . Compared to group I∕R, the myocardial infarct size and amount of CK?MB released from the myocardium were signifi?cantly decreased in MP and MP+A groups, and the expression of p?JNK, p?p38MAPK and Cyt c was sig?nificantly down?regulated, and the content of NAD+ was significantly increased in group MP (P<0?05). Compared to group MP , the myocardial infarct size and amount of CK?MB released from the myocardium were significantly increased, the expression of p?JNK, p?p38MAPK and Cyt c was significantly up?regula?ted, and the content of NAD+ was significantly decreased in group MP+A (P<0?05). Conclusion The mechanism by which morphine postconditioning attenuates myocardial I∕R injury is related to inhibition of activation of JNK and p38MAPK signaling pathways in rats.

AIM To observe the effects of Oxymatrine on induction of apoptosis in human ovarian cancer SKOV3 cells. METHODS Apoptosis induced by Oxymatrine in human ovarian cancer SKOV3 cells was tested by MTT assay, fluorescent microscope, and DNA gel eletrophoresis. RESULTS SKOV3 cell viability dropped down depending on the Oxymatrine concentration and treatment time. When incubated with Oxymatrine (0 189 mmol?L -1 and 0 378 mmol?L -1 ) for 48 h, SKOV3 cells showed morphological changes associated with the characters of apoptosis under fluorescent microscope. Typical DNA ladder was found during gel eletrophoresis. CONCLUSION Oxymatrine can induce apoptosis in SKOV3 cell lines.

Objective To evaluate the value of ultrasonographic measurement of the antral crosssectional area (CSA) in assessing the preoperative gastric content volume in preschool pediatric patients.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged ＜7 yr,undergoing elective non-gastrointestinal surgery,were fasted according to the preoperative fasting guidelines recommended by American Society of Anesthesiologists.Sedation was performed with intravenously injected midazolam or with intravenously injected midazolam and propofol after admission to the operating room.The antral CSA in the supine and right lateral decubitus positions was measured using bedside ultrasonography and free tracing method.A gastric tube was inserted after gastric sonography to collect the gastric fluid,and the total volume of the gastric fluid was considered to be the gastric content volume.Results Six pediatric patients were excluded due to the unsatisfactory ultrasound image,and 44 pediatric patients were included.Gastric content volume and gastric content volume per kilogram of body weight were positively correlated with the antral CSA in the right lateral decubitus position,and the Spearman correlation coefficients were 0.48 (P＜0.01) and 0.37 (P＜0.05),respectively.There was no correlation between gastric content volume and gastric content volume per kilogram of body weight and the antral CSA in the supine position (P＞0.05).Conclusion Ultrasonographic measurement of the antral CSA in the right lateral decubitus position can be used to assess the preoperative gastric content volume in preschool pediatric patients.

Objective To evaluate the accuracy of ultrasonographic measurement of the subglottic airway diameter in selecting the cuffed endotracheal tube (ETT) size for the pediatric patients with congenital heart disease.Methods Sixty pediatric patients of both sexes with congenital heart disease,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,aged 1 month-7 yr,undergoing elective open heart surgery,were included in this study.The subglottic airway diameter was measured by bedside ultrasonography after induction of anesthesia.The outer diameter of the cuffed ETT was determined according to the subglottic airway diameter.The air leak test was performed after intubation to determine whether or not the ETT size selected based on ultrasonography was appropriate.When the difference between the inner diameter of the finally selected ETT and the result calculated by the Motoyama formula was less than 0.2 mm,the ETT size selected based on the Motoyama formula was considered appropriate.The agreement and correlation between the subglottic airway diameter measured by age-based formula and ultrasonography and the outer diameter of the actually selected ETT were analyzed using Bland-Altman plot and Passing-Bablok regression analysis.Results The accurate rate of the ETT selected based on the ultrasonic measurement and Motoyama formula were 80％ and 55％,respectively,and there was significant difference (P＜0.05).Conclusion Ultrasonographic measurement of the subglottic airway diameter produces higher accuracy than the classical Motoyama formula in selecting the cuffed ETT size for the pediatric patients with congenital heart disease.

Objective To explore the clinical diagnostic value of polyclonal all immunoglobulin.Methods The specimens of pa-tients were simultaneously tested and identified by quantitative immunoglobulins,Immunofixation electrophoresis of serum and u-rine,urine protein electrophoresis,and other ways.Results From 1 patients with rheumatoid arthritis were detected the serum IgG, M,A,KAP and LAM,and urine KAP and LAM,at the same time show the increment of the polyclonal polyclonal all immune glob-ulin hematic disease.Conclusion Polyclonal all immune globulin hematic disease often appear in the complications of chronic in-flammation,which should be paid attention during its in clinical doctors.

Objective To investigate the anti-tumor activities of cell-penetrating peptide ( CPP) - mediated trichosanthin ( TCS) , which is a recombinant protein obtained from Radix Trichosanthis. Methods Cysteine residue was introduced to the C-terminus of TCS by protein recombinant technique, and then with the newly-formed terminal as the modification site, TCS was coupled with CPP. As a target protein, CPP-mediated TCS was isolated and purified by affinity chromatography. The expression of the target protein and its responsiveness to reducing substances were detected by using the sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The cellular uptake rate of CPP-mediated TCS was determined by using cell uptake test, and its anti-tumor activity was measured by using methyl thiazolyl tetrazolium (MTT) assay. Results The TCS-CPP compound had been successfully developed in this study, and showed certain reducing responsiveness. After modified with CPP, TCS had higher cellular uptake rate and stronger anti-tumor effect on HeLa and MCF-7 cells. Conclusion TCS modified by CPP can enhance the anti-tumor activities of TCS.

Objective To evaluate initial results of Ivor Lewis minimally invasive esophagectomy (MIE) for esophageal carcinoma using a diamond-shaped anastomosis with 45 mm linear-stapler.Methods Clinical data of 12 patients diagnosed middle to distal esophageal carcinoma and undergoing Ivor Lewis minimally invasive esophagetomy using a diamond-shaped anastomosis technique during Dec.2015 and Nov.2016 in Peking Union Medical College Hospital were collected and analyzed retrospectively.Results The mean operation time was (378 ± 56) min,the mean blood loss was (280 ± 120) ml,and the mean postoperative hospital stay was (12.2 ± 2.0) days.No positive margin,no peri-operative death occurred.Postoperative complication included atelectasis and pulmonary infection in 1 patient,paresis of left recurrent laryngeal nerve in 1 patient.No anastomotic leak or constriction occurred.Median follow up was 7 months,11 patients had no evidence of disease progress,1 patient had subcutanecous metastasis and was reoperated.Conclusion The diamond anastomosis technique utilizing in Ivor Lewis MIE for esophageal carcinoma is feasible,easy to manipulate,safe and reliable.

Background Research determined that TLR4 is positively expressed on the macrophages in iris and ciliary in acute endotoxin-induced uveitis(EIU),indicating that TLR4 participated in the pathogenesis of the anterior uveitis.Objective The aim of this study is to observe the expressions of toll-like receptor-4(TLR4),Myeloid differentiation factor 88(MyD88),NF-κB p65 in iris tissue in the eyes with endotoxin-induced acute anterior uveitis.Methods Animal models of acute anterior uveitis were established by a hind footpad injection of 200μg Cholera vibrio LPS in 40 SPF Wistar rats with the age of 6-8 weeks.Other 10 age-matched rats were as normal controls.Ocular inflammation was examined under the slit lamp microscope at the 2-hour interval after the injection and intensity of inflammation was scored according to the standard of Lajavardi[4].Histopathology examination was performed for the evaluation of inflammatory reaction of iris and ciliary tissues by HE staining at 24 hours after LPS injection.Expressions of TLR4,MyD88 and NF-κB p65 in iris and ciliary body tissue were detected through immunohistochemistry.TLR4~+,MyD88~+ and NF-κB p65~+ cells were counted.Results The inflammatory reaction was gradually enhanced after injection of LPS and peaked at 24 hours and allivated 48 hours later.The infiltration of lots of inflammatory cells and fibrinous exudate were exhibited in the anterior chamber,posterior chamber,iris and ciliary tissue under the optical microscope at 24 hours after injection of LPS.No positive expressions of TLR4,MyD88 and NF-κB p65 in iris-ciliary body complex were found in normal control rats.The positive cells for TLR4,MyD88 and NF-κB p65 in iris-ciliary body complex were significantly different among 12 hours group,48 hours group and 72 hours groups(F=46.79,P＜0.05;F=54.37,P＜0.05;F=85.32,P＜0.05),and the positive cells for TLR4,MyD88 and NF-κB p65 peaked at 24 hours after injection of LPS.Conclusion The expression of TLR4 and its downstream signal transduction molecules MyD88,NF-κB p65 vary in uvea during EIU,indicating the potential role of LR4-MyD88 dependent pathway in the pathogenesis of acute anterior uveitis.

Objective To detect the mutation of epidermal growth factor receptor(EGFR) gene,fusion of echinoderms microtubule associated protein sample-4 and gradual change of lymphoma kinase(EML4-ALK) gene,as well as describe their relationship with the clinicopathological features in patients with non-small cell lung cancer(NSCLC) from Zhongshan city of Guangdong province.Methods Mutations of EGFR gene and EML4-ALK fusion gene in 753 NSCLC patients from Zhongshan People's hospital were detected by ARMS real-time PCR.To study the relationship between the mutation and clinical features and explore the significance of EGFR gene mutation and EML4-ALK fusion in NSCLC.Results The EGFR mutation rate of 753 NSCLC patients is 43.16％(325/753),with highest mutation rate in 19 and 21 exons,43.08％(140/325) and 47.38％ (154/325) respectively,and the main mutation in 21 exon is L858R mutation.EGFR mutation is more common in female/non-smoking patients,or patients with adenocarcinoma/adenosquqmous carcinoma/adenocarcinoma metastasis(P＜0.05),but not relates with the age of patients(P＞0.05).The EML4-ALK fusion gene of 110 patients whose EGFR mutation were checked were simultaneously detected,showing a 9.09 ％ (10/110) mutation rate,and the mutation rate in type 1(80％) is significantly higher than type 2(10％) and 3(10％).Patients with EML4-ALK gene mutation tend to be younger(P＜0.05),but the EML4-ALK gene mutation rates show no significant differences in groups classified by gender,smoking history or pathological classification(P＞0.05).EGFR gene mutation and EML4-ALK fusion were detected in one patient simultaneously.Conclusion The EGFR mutation rate of patients with NSCLC in Zhongshan city is consistent with results reported in domestic and foreign literatures.Detections of EGFR gene mutation and EML4-ALK fusion are necessary test items,providing important evidence in molecular targeting therapy in NSCLS.