Objective To investigate the effects of patient-controlled intravenous analgesia (PCIA) with lornoxicam and fentanyl on arrhythmia and the expression of platelet membrane glycoproteins in patients with coronary artery disease (CAD) after abdominal surgery.Methods Eighty ASA II or III patients with CAD aged 51-66 yrs weighing 59-68 kg presenting for bdominal surgery participated in this study. CAD was diagnosed by clinical symptoms and ischemic changes on ECG. The patients were premedicated with intramuscular henobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with fentanyl, droperidol, propofol and vecuronium and maintained with propofol, fentanyl and vecuronium. The patients received PCIA after operation. The PCIA solution contained fentanyl 0.9 mg and droperidol 5 mg in 100 ml of normal saline (N.S. ) in group A ( n - 40) or lomoxicam 56 mg, fentanyl 0.2 mg and dropendol 5 mg in 100 ml N.S. in group B ( n = 40). In group A the loading dose was fentanyl 0.05 mg and in group B lornoxicam 4 mg. PCIA included a background infusion at 2 ml ? h-1 and a bolus of 0.5 ml with a 15 min lock-out. VAS (0 = no pain, 10 = worst pain) was used to measure pain intensity In addition to BP, HR and SpO2 monitoring ECG was continuously monitored with a Holler monitor after operation Blood samples were taken from peripheral vein before and 6h after operation and on the 1st, 2nd, 7th and 8th postoperative days for determination of the expression of CD62p, CD63 and CD41/CD61 on the platelet membrane, platelet count, prothrombin time ( PT) thrombin time (TT) and partial thromboplastin time (PTT) Results The two groups were comparable with respect to sex, age, body weight, severity of CAD, duration of operation and intraoperative blood loss. The patients received no blood transfusion during operation. There was no significant difference in VAS score, platelet count, PT, TT and PIT between the two groups. The incidence of atrial and ventricular premature beat on ECG and the expression of CD41 /CD61 , CD62P and CD63 on the platelet membrane were significandy lower in group B than in group A on the 7th and 8th postoperative days (P

The carbamyl phosphate synthetase I (CPS,) cDNA probe labelled with alpha ~(35)S-dATP was obtained by using modified nick translation technigue. The specific radioactivity of the obtained probe reached 0.9-1.5?10~8cpm/ug DNA. This probe could be satisfactorily used in RNA-DNA in situ hybrioization for detecting the gene expression of CPS_1 in liver tissue sections. The advantages of using ~(35)S instead of ~(32)P and ~3H for labelling DNA probe were discussed.

Objective To compare the effect between i-gel mask and SHPA mask in the airway management of general anesthesia.Methods Sixty patients of general anesthesia with ASA I or Ⅱ were randomly divided into two groups:i-gel mask group (30 cases) and SLIPA group(30 cases).After intubation and general anesthesia,fiberoptic bronchoscopy was used to detect and evaluate.The peak airway pressure,mean airway pressure,condition of the laryngeal mask intubation,time of intubation,time of extubation,time of recovery and the side effect occurrence of extubation were recorded.Results The time of anesthesia,time of operation,time of extubation,time of recovery,achievement ratio of first time,achievement ratio of second time,time of intubation,peak airway pressure and mean airway pressure had no significant difference between two groups (P ＞ 0.05).The airway seal pressure in i-gel mask group was significantly higher than that in SL1PA group [(29 + 6) cm H2O (1 c m H2O =0.098 kPa) vs.(23 ± 4) cm H2O] (P ＜ 0.05).For the grade of fiberoptic bronchoscopy in i-gel mask group,there was 27 patients in I grade,3 patients in Ⅱ grade.But in SL1PA group,there was 3 patients in I grade,4 patients in Ⅱ grade,13 patients in Ⅲ grade,10 patients in ⅣVgrade.There was significant difference between two groups (P ＜ 0.05).There were none of regurgitation in two groups.Conclusions The i-gel mask and SLIPA mask can provide the same effective ventilation.The i-gel mask has higher airway seal pressure,less side effect during the intubation and extubation,and have better airway management of general anesthesia.

ObjectiveTo observe the apoptotic effect of cardamonin on K562 cells and its relationship with the expressions of PTEN, p-Akt, NF-κB and Bcl-2.Methods K562 cells were treated with cardamonin for 48 h, and the following tests were performed:(1) The cell morphology was observed by light microscopy.(2)IC50 of the K562 cells was dtermined by MTT test.(3) The apoptosis rate was detected by flow cytometry.(4) The expressions of Bcl-2 and Bax mRNA were detected a by RT-PCR.(5) The expressions of PTEN, p-Akt, NF-κB and Bcl-2 proteins were detected by Western blot.Results Obvious apoptosis was observed in the K562 cells after treated with cardamonin for 48 h.MTT assay indicated that the proliferation of K562 cells was obviously inhibited in a dose-and time-dependent manner. Comparing with the blank group, the early apoptosis rate and expression of Bax mRNA were significantly increased.At the same time, the expression of Bcl-2 mRNA was significantly decreased.All of them presented a dose-dependent manner. The expression of PTEN obviously increased with the increasing dose of cardamonin and the expressions of p-Akt, NF-κB and Bcl-2 were decreased.Conclusions Cardamonin promotes the apoptosis in K562 cells in a dose-dependent manner by increasing the expression of PTEN and decreasing the expressions of p-Akt, NF-κB, and Bcl-2.

Objective To understand current status of occupational protection awareness and behavior among dif-ferent professional medical interns,and provide basis for strengthening the education about occupational protection among medical interns .Methods Questionnaire survey was used to survey medical interns at the end of their clini-cal internship.Results A total of 385 cases of occupational exposure occurred during internship period,occupation-al exposure rate was 42.31 % (385/910),occupational exposure mainly occurred in nursing interns (n =190).358 (39.34%)medical interns understood self-protective antibody (hepatitis B surface antibody);difference in occupa-tional exposure rates and awareness of self-protective antibody among different professional medical interns was sta-tistically significant (all P <0.05);222 (57.66%)medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure,exposure mainly occurred in the wards (32.21 %).After occupational exposure,46.75% of medical interns felt nervous, 35.06% were worried,18.18% appeared serious psychological reaction,only 14.03% sought support and help from others.Conclusion Awareness of occupational protection among medical interns is insufficient,education and awareness of occupational protection should be intensified,psychological behavioral after occupational exposure should be paid attention among medical students.

[Summary] Microcephalic or Majewski's osteodysplastic primordial dwarfism type Ⅱ ( MOPD Ⅱ) is an extremely rare genetic disease mainly caused by pericentrin ( PCNT) gene mutations. This paper reported one 13-year-old boy, who was admitted because of the slow growth for more than 13 years and deepened skin color over six months. He was diagnosed as MOPD Ⅱ associated with a combination of growth hormone deficiency, type 2 diabetes, hypertension, acanthosis nigricans, multiple café-au-lait spots. On magnetic resonance imaging of brain, no vascular malformations such as aneurysms were shown. There were novel compound heterozygous mutations of PCNT gene in the patient, with the nonsense mutations of c. 502C > T ( p. Gln168 * heterozygous variation) and c. 3103C > T (p. Arg1035* heterozygous variation). His father carried a nonsense mutation c. 3103C > T ( p. Arg1035 *heterozygous variation ) and his mother had a nonsense mutation c. 502C > T ( p. Gln168 * heterozygous variation). After treatment with metformin for three months, his blood glucose returned to normal, and acanthosis nigricans was improved. It seems critical to evaluate the abnormal condition of blood vessels regularly for MOPD Ⅱpatients with PCNT gene mutations.

Objective To explore the occurrence and development of schistosomiasis japonica hepatic fibrosis, and the treatment countermeasure. Methods Three groups of patients,including advanced schistosomiasis (splenectomy involved), non-advanced schistosomiasis splenomegaly and advanced schistosomiasis with hepatitis, were followed up. Biochemical tests including hepatic fibrosis indexes, liver ultrasonography,lymphocyte subcluster, and membrane CD35 were examined. Immunohistochemical tests of liver cells were performed in some patients. Results A total of 94.06% of 1212 patients took various anti-schistosome treatments. The difference was significant for positive antigen and antibody to schistosome, LN and HA ,and the ultrasonic indexes of liver fibrosis among the three groups. The degree of liver substance pathohistological examinations showed inflammation had a positive correlation with hepatic fibrosis. The contents of C-Ⅰ, C-Ⅲ in portal regions, central vein and hepatic sinusoid were increased in advanced schistosomiasis hepatic fibrosis. In hepatic fibrosis, hepatic sinusoid showed two pathological changes of dilation and stricture. Conclusions In schistosomiasis japonica, hepatic sinusoid changes play a great role in hepatic fibrosis.Hepatic fibrosis would still develop even after the thorough anti-schistosome therapy. So, anti-fibrosis therapy is necessary.

Objective To explore the clinical manifestation and gene mutation of primary renal glucosuria (PRG). Methods The clinical data and gene detection results of a child with PRG were analyzed. Results A girl aged 2 years and 10 mouths had glucose ++++ by urine dipstick analysis and 22.4 g of the 24 h urine glucose. Her father was urine glucose positive. Genome DNA was extracted from peripheral blood of the girl and her parents, SLC5A2 gene were amplified by PCR for sequencing, including exons and splicing areas. The results showed a homozygous point mutation (c.127-16C>A) in girl, and both of her patents had the same heterozygous mutation. This mutation had been classified to pathogenic mutations by ClinVar data base. Conclusions The diagnosis of PRG is confirmed in this child and SLC5A2 gene mutation is the cause.

Objective To establish a flow cytometric measurement of detecting minimal residual disease(MRD) according to the leukemia-associated immunophenotypes in children with acute lymphoblastic leukemia(ALL) and to explore the significance of MRD detection in ALL children for a individualized treatment. Methods A variety of four-color fluorescent antibody combinations were used to investigate the children's normal bone marrow. The normal bone marrow pattern at two-parameter plots was established to identify the residual tumor cells, seventy-five bone marrow samples from newly diagnosed ALL children were analyzed with four-color cytometry to determined the optimal combinations which can clearly distinguish the tumor cells from normal cells. The bone marrow samples were monitored with the combination panel in 60 patients at the end of induction therapy and follow-up treatment. Cytomorphology test, PCR amplification of 29 fusion genes as well as IgG and TCR gene rearrangements were performed simultaneously. Results Sixty-nine cases (92.0%) could be identified for effective antibody combinations to monitor MRD by four-color cytometry. Fusion genes or IgG and T cell receptor (TCR) gene rearrangements can be detected in 21 cases (28.0%) to monitor MRD by PCR. No MRD can be detected in 25 bone marrow samples at the end of induction therapy and follow-up treatment. Four-color cytometry could detect as low as 0.021%-4.130% residual leukemia cells. Conclusion MRD can be monitored by flow cytometry which is faster than PCR, and the sensitivity is superior to morphology method.

Objective To analyze the clinical feature, diagnosis and treatment of Alstrom syndrome. Method The clinical data of a case of Alstrom syndrome and the result of her ALMS1 sequencing by the two generation sequencing were retrospectively reviewed. Results The 12 year and 10 month old female suffered from dilated cardiomyopathy, obesity, optic nerve diseases, sensorineural hearing loss, high blood glucose and irregular menstruation since one month of birth. Laboratory examination showed she had high testosterone level, hyperglycemia, hyperlipidemia and fatty liver. High-throughput sequencing confirmed there was ALMS1 gene mutation which includes hybrid frameshift mutations of c.5418delC and p.Y1807Tfs*23, and heterozygous nonsense mutation of c.10549C>T and p.Q3517*, and c.5418delC was a new variation reported for the first time. Conclusion Alstrom syndrome is an autosomal recessive genetic disease, which is characterized by multiple organ dysfunction and metabolic syndrome, and can be diagnosed by gene detection.