AIM: To investigate the feasibility and infection efficiency of MSCs with replication-deficient adenovirus containing delivered gene, and whether enhanced green fluorescence protein (EGFP) gene track the change during rMSCs differentiating neuron-like cells. METHODS: Rat marrow mesenchymal stem cells (rMSCs) were expanded in low density in vitro . Under the control of CMV promoter, pAd-EGFP-Vector was constructed by homologous recombination in E.coil BJ 5183, and the recombinant virus was produced in HEK 293 packaging cell line. rMSCs infected with Ad-EGFP were observed and analyzed with fluorescence microscope. Infection efficiency was assessed by microscopical scoring and flow cytometrics. After withdrawing serum and exposure to ?-mercaptoethanol medium, rMSCs infected with Ad-EGFP was induced to differentiate into neuron-like cells. As a control, the plasmid of pTrack-EGFP also was transfected into rMSCs to evaluate transfection efficiency.RESULTS: The results showed that Adenovirus vector (AdVec) delivered EGFP gene with high efficiency to marrow mesenchymal stem cells. Gene expression analysis showed that 36%?2 % of rMSCs infected with recombinant adenovirus expressed the transgene of EGFP at high levels. However, the transfection of plasmid pTrack-EGFP using routine method of lipofectamin mixed with plasmid DNA (pTrack-EGFP) was not easily successful and the transfection efficiency was much lower. rMSCs infected with Ad-EGFP in different passage could differentiate into typical morphology alike neural cells after withdrawing serum and exposure to ?-mercaptoethanol medium. Immuno-staining with neuron-specific enolase (NSE), a neuronal marker, was strong positive, which suggested that rMSCs infected with Ad-EGFP had the potential to differentiate into neurons or neuron-like cells. CONCLUSION: The AdVec system can deliver target gene into MSCs and EGFP gene carried by AdVec can track the change during rMSCs differentiating into neuron-like cells.

Objective To compare the analgesic effect and motor function of epidural analgesia and continuous adductor canal block in the elderly patients with internal malleolus fracture,in order to provide a reference for the choice of postoperative analgesia.Methods A total of 80 patients aged 65-74 years were enrolled in this study.They were randomly divided into adductor canal block group (T group,n =40) and epidural block group (C group,n =40) by computer random software.The T group underwent laryngeal mask intubation with general anesthesia + ultrasound guided transnasal saphenous nerve block.The C group underwent epidural anesthesia.The systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) were measured before anesthesia (T0),10 minutes after anesthesia (T1),30 minutes after operation (T2),before leaving OR (T3).Visual analogue (VAS) was recorded immediately before leaving OR,2h,6h,12h,24h and 48h after operation.The incidence of complications such as hypotension,ephedrine use,postoperative urinary retention and other anesthesia-related complications were also recorded.Results The SBP and DBP were significantly higher in the T group at T1,T2 and T3 than those in group C (t =5.069,3.087,3.019,5.659,2.744,2.254,all P ＜ O.05).The HR was lower in the T group at T1 and T2 than those in the C group (t =4.138,3.797,all P ＜ 0.05).There were no statistically significant differences in VAS between the two groups at 2h,6h,12h,24h and 48h postoperatively (all P ＞ 0.05).The incidence of intraoperative hypotension (7 cases),ephedrine use (6 cases) and postoperative urina-ry retention (12 cases) were significantly higher in the C group than those in the T group (0 cases,O cases,1 cases,x2 =11.11,P ＜0.05).Conclusion Compared with epidural anesthesia,ultrasound-guided adductor canal block anesthesia can maintain hemodynamics stability in elderly patients with internal malleolus fracture,it can provide the same analgesic effect as epidural analgesia,and has no effect on the motor function of the contra lateral limbs and can reduce the risk of postoperative complications.

Objective To compare the effects of general anesthesia and epidural block anesthesia on postoperative short-term cognitive function of elderly orthopedic patients.Methods From January 2015 to March 2013,80 elderly patients with orthopedic surgery in the Sixth Hospital of Ningbo were selected in the research ,According to the anes-thesia method,40 patients received general anesthesia were enrolled into general anesthesia group ,40 patients received epidural anesthesia were enrolled into epidural group.The cognitive function of different time were compared between the two groups.Results There were no statistically significant differences in blood pressure and heart rate between the two groups (all P＞0.05).The simple mental health scale (MMSE) scores at 6h,12h,24h after anesthesia in the general anesthesia group were (26.4 ±0.7)points,(25.9 ±0.5)points,(29.2 ±0.8)points,respectively,compared with that before anesthesia[(29.1 ±1.1)points],the difference was statistically significant (t＝6.235,P＜0.05). The MMSE scores at 6h,12h after anesthesia in the epidural group were (26.5 ±0.4) points,(25.8 ±0.7) points, compared with that before anesthesia[(29.2 ±0.8)points],the difference was statistically significant (t＝5.123, P＜0.05).The MMSE score at 24 h after anesthesia in the epidural group was (29.5 ±0.7)points,which was obvi-ously higher than (27.2 ±0.8)points in the general anesthesia group (t＝13.684,P＜0.05).The incidence rates of postoperative cognitive dysfunction (POCD) at 6h,12h after anesthesia in the general anesthesia group (17.50%, 20.00%) were significantly higher than those in the epidural group (7.50,5.00%) ( χ2＝4.571,10.285,all P＜0.05).Conclusion The effect of general anesthesia on postoperative cognitive function is significantly greater than that of epidural anesthesia.

Objective To explore the safety and efficacy of dezocine combined with flurbiprofen axetil in postoperative analgesia in elderly patients undergoing upper abdominal surgery.Methods 80 patients underwent abdominalsurgery were selected.They were divided into study group(T group) and control group(C group) according to the random number table,40 cases in each group.The visual analogue scale(VAS) and Ramsay sedation score were recorded at 2h,6h,12h,24h,48h after operation,respectively.The anesthesia-related complications such as sleepiness,chills,postoperative nausea and vomiting (PONV),and pulmonary infection in 48 hours were also recorded.Results There were no statistically significant differences in the VAS score between the two groups in the resting state and the active state(t =0.287,0.436,all P ＞ 0.05).The VAS scores of T group were significantly lower than those of C group at 2h,6h,12h,24h and 48h after operation (t =4.096,4.241,5.510,6.121,5.752,3.542,3.866,4.948,5.542,4.030,all P ＜ 0.05).There were no statistically significant differences in Ramsay sedation scores between the two groups at postoperative 2h,6h,12h,24h and 48h (t =0.323,0.226,0.541,0.297,0.771,0.795,all P ＞ 0.05).There were no statistically significant differences in the incidence of drowsiness,chills,PONV,skin itching and pulmonary infection in the two groups (4 cases vs.6 cases,6 cases vs.5 cases,5 cases vs.3 cases,1 case vs.3 cases,5 cases vs.1 case,P =0.499,0.712,0.745,0.615,0.201).Conclusion The postoperative analgesic compatibility of dezocine combined with flurbiprofen axetil can effectively relieve the postoperative pain in elderly patients with upper abdominal surgery and provide good postoperative analgesic effect and does not increase the incidence of drug related complications.It is worth to promote in clinical.