ObjectiveTo investigate the efficacy of different methods of anesthesia for laparoscopic hysterectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 45-60 yr,weighing 55-65 kg,scheduled for laparoscopic hysterectomy,were equally and randomly divided into 2 groups:combined intravenous-inhalational anesthesia group (group Ⅰ ) and combined spinal-epidoral anesthesia (CSEA) + general anesthesia group (group Ⅱ ).In group Ⅰ,anesthesia was maintained with inhalation of sevoflurane and infusion of remifentanil after induction of anesthesia.In group Ⅱ,CSEA was performed,after the upper level of sensory block was stable,general anesthesia was induced and maintained with inhalation of sevoflurane,and state entropy (SE) was naintained at 45-60.Arterial blood samples were taken to determine the plasma concentrations of adrenaline ( AE ),norepinephrine (NE) and dopamine (DA) after admission to the operation room,after completion of pneumoperitoneum,at 10 min after pneumopentoneum,during uterus traction,during removal of the laryngeal mask airway,and at 10 min after removal of the laryngeal mask airway (T0-5).The time for recovery of spontaneous breathing,extubation time,and time of regaining consciousness were recorded at the end of operation.The side-effects and number of patients requiring increments of analgesics were also recorded within 48 h after operation.Patient' s satisfaction was recorded at 48 h after operation.ResultsCompared with group Ⅰ,the plasma concentrations of AE and NE at T3-5 and the plasma concentrations of DA at T3,5 were significantly decreased,the time for recovery of spontaneous breathing,extubation time,and time of regaining corsciousess were significantly shortened,and the incidence of agitation and the number of patients requiring increments of analgesics were significantly decreased in group Ⅱ ( P ＜0.05).There was no significant difference in the incidence of intraoperative awareness,and nausea and vomiting after operation,and the level of patient' s satisfaction at 48 h after operation between the two groups ( P ＞ 0.05).ConctusionCSEA + general anesthesia has better efficacy than combined intravenous-inhalational anesthesia when used for laparoscopic hysterectomy.

Objective In this article we evaluated the sensitivities and specificities of real-time PCR assay for diagnosis of human brucellosis.Methods The species selectivity and specificity of real-time PCR were evaluated by direct amplification of a 169 bp portion of bcsp31 gene from 15 Brucella strains and 41 non-Brucella strains.According to the monitoring results of 2012 Harbin brucellosis,17 brucellosis patients and 30 health people were selected to collect their serum samples for assessing the sensitivity of real-time PCR,and additional 30 nonbrucellosis patients serum samples were as controls.Results The species selectivity and specificity of our realtime PCR method were evaluated by using genomic DNA from 15 Brucella strains and 41 non-Brucella strains.There were 11 sera with positive amplification signals among the 17 culture-proven brucellosis patients,the sensitivity was 64.7％(11/17).Whereas,the results of sera from the 60 control patients were all negative,corresponding to a specificity of 100.0％.Conclusion The results indicate that real-time PCR is well suitable for confirmation of brucellosis cases.

Objective Shunaoxin Dropping Pills (SDPs), a Chinese patent medicine, has been used widely in China for the treatment of headache, amnesia, and insomnia. The aim of the present study is to observe the effect of SDPs on inducing angiogenesis and neurogenesis in vitro. Methods The present testing system using the serum obtained from animals ig treated with SDPs and a co-culture system in vitro was used to investigate if SDPs promotes brain microvascular endothelial cells (BMECs) tube formation and neural differentiation of neural stem/progenitor cells (NSPCs), which plays important roles in angiogenesis and neurogenesis. Results The SDPs serum sampled from rats ig treated with SDPs for 3 d dose-dependently promoted the tube like structure formation of cultured BMECs, and enhanced the fraction of MAP-2 positive cells of NSPCs, which co-cultured with the BMECs and astrocyte. In addition, there was no significant change in the percentage of glial fibrillary acidic protein positive cells. Conclusion Our results show that SDPs serum can induce neural differentiation and BMECs tube formation in vitro.

Aim To investigate the vasorelaxation effects of saponins from flower of Panax notoginsen on the isolated thoracica aorta ,and to explore its possible mechanism.Methods Total saponins were extracted and high phase liquid chromatography was utilized to describe saponins ingredients;SD rat thoracic aortas were isolated.In vitro vascular ring experiment was used to observe,basal state of saponins on vascular ring,and high concentrations of K+solution pre-con-traction and phenylephrine (PE ) pre-contraction caused by systolic and diastolic function of the re-sponse.And different inhibitors were combined to ex-amine the possible mechanism of notoginsenoside in vascular ring.Results Cumulative concentration of saponins had no significant effect on the basis of state vessels,but had significant effect on endothelium-in-tact aortic (MAX Relaxation 23.6%) rings pre-con-tracted by high concentrations of K+;endothelium and endothelial aortia had significant effect on PE pre-con-traction, and endothelium MAX relaxation was 55.5 1%.Calcium-free solution and saponin cultivated aortic rings significantly inhibited pre-contraction.Af-ter nitric oxide synthase inhibitor L-NAME and indom-ethacin incubating vascular ring ,it could significantly inhibited vasodilatory effect of saponin.Conclusion Saponins have concentration dependent diastolic func-tion on rat thoracic aorta,and its main ways cause vas-odilation.Endothelial dependent diastolic function is related to activation of nitric oxide synthase and cy-clooxygenase pathway.

Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.

ABSTRACT:Objective To construct a recombinant adenovirus vector harboring fusion gene NT4p53(C22)Ant and study its killing effect on HepG2 tumor cells.Methods Using molecular cloning technology,the rAVV-NT4p53(C22)Ant was produced by homologous recombination.Then we collected virus supernatant and measured its titer after it was amplified by PCR.The effect of this fusion gene on HepG2 tumor cells was evaluated by IHC, MTT assay,PI staining and flow cytometry.Results The recombinant adenovirus was successfully constructed. The p53 expression rate in rAAV-NT4p53(C22)Ant group was (44.88±2.45)%.MTT assay showed that rAAV-NT4p53(C22)Ant could strongly suppress the growth of HepG2 tumor cells.Flow cytometry showed that rAAV-NT4p53(C22)Ant could induce obvious apoptosis of HepG2 tumor cells.Conclusion The recombinant adenovirus vector encoding gene NT4p53(C22)Ant has been successfully constructed and expressed in this experiment,and it can inhibit proliferation and induce apoptosis of HepG2 tumor cells.

Objective To evaluate the value of spiral CT and panoramic radiographs in preoperative assessment the jaw condition of patients for dental implantation.Methods 80 patients required dental implant restoration,these patients were Manned by CT and panoramic radiographs in preoperative,then selected suitable patients for dental implant restoration,reconstructed the jaw based on spiral CT data and guided the dental implant design and implanration.Results The spiral CT examination could be more accurate selection criteria for the patients needed dental implant restoration and more accurately showed the situation of edentulous ridge bone.Conclusion The reconstructed of three-dimensional imaging of spiral CT could precisely show the bone situation in the jaw needed dental implant and the important anatomic structures,could effectively assist denture design and the direction and depth of dental implants.was more superiority than panoramic radiographs.

OBJECTIVETo study the effect of piezosurgery in the extraction of mandibular impacted third molars.

METHODS228 mandibular impacted third molars with relative difficulty for extraction according to the scheme of degree of difficulty for extraction were included in the study, and were divided into two groups (114 teeth each group): Test group (treated by piezosurgery), control group (treated by traditional chisel osteotomy). The surgery time and pain, restriction of mouth opening and facial swelling after surgery, were evaluated in both groups.

RESULTSThe average surgery time was (16 +/- 5.2) min in test group and (30 +/- 8.7) min in control group. The surgery time, pain, facial swelling rate, and restriction of mouth opening were lower than control group (P<0.05).

CONCLUSIONCompared with traditional chisel osteotomy, the average surgery time with piezosurgery was significantly shorter and the complications are obviously reduced.

Adult ; Female ; Humans ; Male ; Mandible ; Molar, Third ; Osteotomy ; Piezosurgery ; Tooth Extraction ; Tooth, Impacted

Objective To observe the effect of Shenmai injection combined with enteral nutrition (EN) on immune function in patients with severe cardiac insufficiency. Methods Fifty-seven patients with severe cardiac insufficiency admitted to the Department of Critical Care Medicine of Taizhou Hospital of Zhejiang Province from June 2015 to June 2018 were divided into an EN group (31 cases) and an EN group combined with Shenmai injection group (26 cases). The EN group was given EN on the basis of routine western medicine treatment, while in the EN combined with Shenmai injection group was treated additionally by intravenous drip of Shenmai injection 100 mL/d on the basis of above EN group treatment. The efficacies of the two groups were evaluated after consecutive 7-day treatment in the two groups. The changes in levels of subsets of T-lymphocytes (CD3+, CD4+, CD8+, CD4+/CD8+) and immunosuppressive cells CD14+ monocyte human leukocyte antigen DR (HLA-DR) were observed before and after treatment. Results After treatment, the levels of T-cell subsets CD3+, CD4+, CD4+/CD8+ and CD14+ monocytes HLA-DR in the peripheral blood of the two groups were significantly higher than those before treatment [CD3+: EN group was 0.539±0.126 vs. 0.379±0.093,Shenmai injection group was 0.652±0.185 vs. 0.393±0.091; CD4+: EN group was 0.402±0.121 vs. 0.275±0.066,Shenmai injection group was 0.524±0.168 vs. 0.281±0.077; CD4+/CD8+:EN group was 1.83±0.70 vs. 1.11±0.70,Shenmai injection group was 2.81±0.91 vs. 1.19±0.58; CD14+HLA-DR:EN group was (43.3±7.1)% vs. (35.4±5.7)%,Shenmai injection group was (54.9±6.2)% vs. (36.1±8.3)%]; After treatment, CD8+ in EN group decreased (0.223±0.052 vs. 0.253±0.081), while CD8+ in shenmai injection group increased (0.288±0.051 vs. 0.259±0.078), and the increase degrees of the above-mentioned indexes in EN combined with Shenmai injection group were more obvious than those in the EN group after treatment [CD3+: 0.652±0.185 vs. 0.539±0.126, CD4+: 0.524±0.168 vs. 0.402±0.121, CD8+: 0.288±0.051 vs. 0.223±0.052, CD4+/CD8+: 2.81±0.91 vs. 1.83±0.70, CD14+HLA-DR: (54.9±6.2)%, (43.3±7.1)%, all P < 0.05]. Conclusion The combined use of Shenmai injection and early EN can improve the immune function of T-lymphocytes in patients with severe cardiac insufficiency. The mechanism may be related to the enhancement of the activation of T lymphocytes and promotion of the CD14+ monocytes increase and immune function.

Background: Porcine circovirus type 2 (PCV2) is an important infectious pathogen implicated in porcine circovirus-associated diseases (PCVAD), which has caused significant economic losses in the pig industry worldwide. Objectives: A suitable viral vector-mediated gene transfer platform for the expression of the capsid protein (Cap) is an attractive strategy. Methods: In the present study, a recombinant adeno-associated virus 8 (rAAV8) vector was constructed to encode Cap (Cap-rAAV) in vitro and in vitro after gene transfer. Results: The obtained results showed that Cap could be expressed in HEK293T cells and BABL/c mice. The results of lymphocytes proliferative, as well as immunoglobulin G (IgG) 2a and interferon-γ showed strong cellular immune responses induced by Cap-rAAV. The enzyme-linked immunosorbent assay titers obtained and the IgG1 and interleukin-4 levels showed that humoral immune responses were also induced by Cap-rAAV. Altogether, these results demonstrated that the rAAV8 vaccine Cap-rAAV can induce strong cellular and humoral immune responses, indicating a potential rAAV8 vaccine against PCV2. Conclusions The injection of rAAV8 encoding PCV2 Cap genes into muscle tissue can ensure long-term, continuous, and systemic expression.