Objective To investigate the effect of dexmedetomidine ( Dex) combined with ropivacaine in brachial plexus block ( BPB) on serum basic fibroblast growth factor ( bFGF) levels of upper limb fracture patients in the perioperative period. Methods 80 patients ( ASA gradeⅠ~Ⅱ) scheduled for selective upper extremity surgery were randomly divided into the dexmedetomidine combined with ropiva-caine group ( RD group) and the ropivacaine group ( R group) with 40 patients in each group. BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine (200 mg) was diluted into 40 mL in group R and ropivacaine (200 mg) +1 μg/kg dexmedetomidine were diluted into 40 mL in group RD. Drew 5 mL blood at T0~T4 points respectively,and serum bFGF concentration were determined. Results Compared with group R,MAP and HR at T1~T3 points were significantly lower in group RD (P<0. 05). SpO2 in the two groups at each point had no statistical significance (P>0. 05). Compared with T0 points,bFGF concentration were increased in two groups at T1~T4 points (P<0. 05),and it was higher in group RD compared with group R (P<0. 05). Conclusion Dex combined bra-chial plexus block promote the secretion of bFGF more than simple brachial plexus block,which is conducive to fracture healing after opera-tion,but it should be cautious to apply for patients with bradyarrhythmia.

AIM: To investigate the relationship between human cholesteryl ester transfer protein CETP gene polymorphism and postoperative neurocognitive disorders (PND). METHODS: A total of 124 elderly patients over 65 years of age who underwent elective non-cardiac surgery were enrolled in the study while 25 healthy volunteers matching age and sex were recruited as the control group. Neuropsychological tests were performed 1 day before surgery, 7 days, and 3 months after surgery. PND was determined using the Z value method. The venous blood sample of the surgical patient was taken before the operation, followed by direct gene sequencing. Statistical methods were used to calculate the correlation between CETP gene polymorphism (rs5882) and PND. RESULTS: The incidence of PND was 29.3% and 18.2% at 7 days and 3 months after operation respectively. The A allele frequency of PND patients was significantly higher than that of non-PND patients 7 days and 3 months after surgery (65.52% vs. 41.43%, 34.48% vs. 58.57%, P=0.001), while the G allele frequency in PND group lower than that of non-PND (58.33% vs. 37.86%, 41.67% vs. 62.14%, P=0.004).AA genotype in PND patients was 34.48%, 38.89% at 7 days and 3 months after surgery respectively, significantly higher than 14.29%, 16.05% of non-PND (P=0.023, P=0.029). CONCLUSION: CETP rs5882 polymorphism is associated with PND and AA genotype may be a predisposing factor for postoperative PND in Chinese Han elderly patient.

Objective To investigate the regulating function of human gingival mesenchymal stem cell (GMSC) on the proliferation and differentiation of B cells and its underlying molecular mechanism. Methods GMSC were isolated and B cells were isolated from peripheral blood. GMSC or fibroblasts were co-cultured with B cells in vitro and assigned into the GMSC group and fibroblast group. The proliferation of B cells was detected in two groups. The expression of IgG1 and IgM in the cell supernatants was measured between two groups. The secretion of interleukin (IL)-6, Perforin, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was compared between two groups. The expression levels ofIL-10 and transforming growth factor (TGF)-β in B cells were detected between two groups. The expression of PC-1 in B cells was measured in two groups. The signaling pathway involved with the regulating effect of GMSC on B cell function was investigated. The regulating effect of GMSC on the role of B cells in activating T cell function was assessed. Results Compared with the fibroblast group, the proliferation of B cells was significantly weakened in the GMSC group (P < 0.05). Co-culture of GMSC and B cells significantly inhibited the secretion of IgG1 and IgM from B cells and the secretion ofIL-6, Perforin, IFN-γ and TNF-α (all P < 0.05). Compared with the fibroblast group, the secretion of IL-10 and TGF-βwas significantly higher in the GMSC group (both P < 0.05). The expression level of PC-1 in the GMSC group was significantly down-regulated (P < 0.05). After adding ALK5, an inhibitor of TGF-β receptor, the inhibitory effect of GMSC upon B cells was significantly weakened (P < 0.05). Compared with the fibroblast group, the ability of B cells to activate and proliferate T cells was significantly attenuated in the GMSC group (P < 0.05). Conclusions GMSC can inhibit B cells and their mediated immune responses. The activation of B cells and other related functions can be suppressed through the TGF-β signaling pathway.

OBJECTIVETo explore relationship between HBeAg seroconversion with HBV genotypes and HBV specific CTL in patients with chronic hepatitis B (CHB) treated with Adefovir dipivoxil.

METHODSSeventy CHB patients had positive HBV DNA (HBV DNA > or = 1 x 10(4) copy/ml), 45 cases had positive HBeAg, of whom 23 cases (51. 11%) had genotype B, 22 cases (48.89%) had genotype C. ALT > 2 x upper limit of normal value (ULN), human leukocyte antigen (HLA)-A(n) positive, patients were treated with Adefovir dipivoxil (commercial name is Mingzheng, Zhengda Tianjing Pharmaceutical Company), 10 mg, orally, once a day. After treatment for 12 months, observe relationship between HBeAg seroconversion with HBV genotypes and HBV specific CTL.

RESULTSAfter treatment with Adefovir dipivoxil for 12 months, HBV specific CTL (0.68% +/- 0.11%) was higher than that before treatment (0.33% +/- 0.11%), t = 8.36 P < 0.001, HBV DNA (3.01 +/- 0.2) log10 copy/ml was lower than that before treatment (6.27 +/- 0.70) log10 copy/ml, t = 12.63 P < 0.001, HBV DNA turned negative (< 500 copy/ml) 43 cases (61.43%), in 45 cases with positive HBeAg, HBeAg turned negative in 13 cases (28.89%), 8 cases had HBeAg seroconversion (17.78%), HBV specific CTL (0.86% +/- 0.05%) of patients with HBeAg seroconversion is higher than (0.61% +/- 0.07%) of patients without HBeAg seroconversion (37 cases, 82.22%) t = 7.88, P < 0.001. In 8 cases with HBeAg seroconversion, 7 cases had genotype B (30.43% of genotype B), 1 cases had genotype C (4.55% of genotype C), chi2 = 5.15, P < 0.05.

CONCLUSIONAdefovir dipivoxil can enhance HBV specific cellular immunity of CHB patients. After treatment, occurrence of HBeAg seroconversion is related to increase of HBV specific CTL level and may be related to genotypes.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; immunology ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Immunity, Cellular ; drug effects ; Male ; Organophosphonates ; therapeutic use ; T-Lymphocytes, Cytotoxic ; immunology

Electrode array misplacement is a rare complication of cochlear implant. This article reports an 11-year-old boy who was mistakenly implanted the cochlear electrode array into the superior semicircular canal during the initial cochlear implant. After the diagnosis was confirmed, he underwent a second cochlear implant and the electrode array were successfully implanted into the cochlea. This article conducted a systematic review of the literature on electrode array misplacement, and the causes of electrode array misplacement were analyzed from different implantation position.
Male ; Humans ; Child ; Electrodes, Implanted ; Reoperation ; Cochlea ; Cochlear Implantation ; Cochlear Implants/adverse effects* ; Semicircular Canals/surgery*