Objective To observe the effect of application of dexmedetomidine on cerebral injury in infants after cardiopulmonary bypass.Methods 60 cases of congenital heart disease were divided into 3 groups,each group 20 infants,namely D1,D2 and N group.Group D1 dexmedetomidine 1.0μg/kg,in 0.2μg · kg-1 · h-1 intravenous infusion,until the end of operation; group D2 with dexmedetomidine 0.5 μg/kg,in 0.1 μg · kg-1 · h-1,drug concentration and injection speed was the same as the group D1.Group N intravenous normal saline in the whole operation process,infusion speed was the same as the experimental group,anesthesia and experimental group agreement.Take blood samples sent to laboratory before the operation (T1),at the end of CPB (T2),after CPB 2 h (T3),6 h (T4),24 h (T5) respectively,colleced records of perioperative data.Results There were no significant in 3 groups,for infant's age,weight,operation time,CPB time difference (P ＞0.05).In T1,there was no statistical difference between the 3 groups in S-100β protein and NSE (P ＞ 0.05).In group N,S-100β protein and NSE in T2,T3,T4,T5 were increased significantly than the level in T1 (P ＜ 0.05).In T2,compared with group D2,S-100β and NSE increased significantly in group N and D1 (P ＜ 0.01),and there were more in D2 than D1 group.Differences in heart rate,blood pressure and hemodynamics were observed in infant during perioperative period was not significant (P ＞ 0.05).Conclusion Dexmedetomidine can reduce the ascensional range of S-100β and NSE in infant after cardiopulmonary bypass,and relieve the cerebral injury.

Objective To compare the effect and safety of propofol with intranasal dexmedetomidine in analgesic enteroscopy for children.Methods Ninety children undergoing analgesic enteroscopy were ran-domly assigned to 3 groups.Intranasal dexmedetomidine followed by propofol was administered in the observ-ing group;sufentanil and followed by propofol was intravenously given to the control group A;propofol was given to the control group B.The scale of anesthetic effect,HR,RR,MAP and SpO2 30 min after intranasal administration were monitored.The intranasal sedation satisfaction rate,the dose of propofol,wake-up time, hospitalization,hemodynamics,adverse reaction and complication after anesthesia were recorded.Results Intranasal sedation satisfaction rate of the observing group was 83.3%(25 /30).The anesthetic effect in ob-serving group(excellent/good /bad:24 /6 /0)showed no significant difference from that in the control group A (excellent/good /bad:25 /5 /0),but better than that in the control group B(excellent/good /bad:12 /14 /4) (P <0.05).The amount of propofol in the observing group(96.2 ±5.3)mg showed no significant difference from that of group A(93.7 ±4.6)mg,but less than group B[(121.1 ±4.9)mg,P <0.05].The time of re-covery of infants in the control group A[(14.2 ±5.5)min]and the control group B[(13.7 ±3.9)min] were longer than that in observing group[(7.9 ±4.1)min,P <0.05].The hospitalization time of observing group[(14.3 ±5.4)min]was shorter than those of group A[(27.5 ±3.7)min,P <0.05]and group B [(26.3 ±6.6)min,P <0.05].The incidences of breath suppression,glossoptosis,nausea and dizziness were the lowest in the observing group,compared with the two others (all P <0.05).Conclusion In-tranasal dexmedetomidine combined with propofol,increasing children compliance,decreasing the adverse reaction,is satisfactory and safe for children anesthesia.

Familial non-medullary thyroid carcinoma (FNMTC) is de fi ned as the presence of two or more affected fi rst-degree relatives with non-medullary thyroid cancers without other known familial syndromes. FNMTC is one of the most inheritable forms of all cancers, with a high risk of a first-degree relative developing the disease. Compared with sporadic non-medullary thyroid carcinoma (NMTC), FNMTC presents at a younger age and is associated with a higher incidence of multifocal disease and metastasis. This in-creased aggressiveness has been hypothesized to translate into higher recurrence rates and decreased survival of patients with FNMTC. The genes involved in the pathogenesis of FNMTC are yet to be elucidated, although some recent studies identified several predisposi-tion loci with a high degree of genetic heterogeneity. Since 2005, next-generation sequencing (NGS) technologies have been developing as rapid, high-throughput, and cost-effective approaches to fulfill medical sciences and research demands. With the use of NGS, the un-derlying causative genes can be directly distinguished via systematic filtering, through which the identified gene variants are verified for novelty and functionality.

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.

Objective:To determine the effect of Hes1 on bone marrow CD34+cells in acute myeloid leukemia (AML). Meth-ods:Bone marrow mononuclear cells were isolated by using Ficoll. Then, the proportion and cell cycle of CD34+cells were analyzed by using fluorescence-activated cell sorting (FACS). CD34+cells were cultured in vitro for colony-forming cells (CFC). The expression of Hes1 in CD34+cells was evaluated by using real-time polymerase chain reaction. After upregulating the expression of Hes1 in CD34+cells, the cell cycle was analyzed through FACS, and the colony formation of CD34+Hes1+cells was analyzed by CFC. Results:The ra-tio of CD34+cells in the bone marrow was lower in the AML group than in the control group. In addition, more CD34+cells underwent quiescence in the AML group than in the control group. In vitro assay showed that the colony formation of CD34+cells was lower in the AML group than in the control group. The expression of Hes1 was higher in the CD34+cells from the AML patients than that in the CD34+ cells from normal donors. After Hes1 transduction, more CD34+ cells underwent quiescence and showed weak proliferation. Conclusion:The proportion of CD34+cells in the bone marrow was lower in AML patients than in normal donors. A large proportion of CD34+cells underwent quiescence, which was related to Hes1, in AML patients.

One hundred and fifty ASA Ⅰ-Ⅱ infants scheduled to undergo surgery on unilateral inguinal region,were randomly assigned to 3 groups with 50 in each group.In groups Ⅰ and Ⅱ puncture was performed at traversus abdominis plane under ultrasound-guidance,0.4 or 0.5/kg of 0.25％ ropivacaine was injected respectively.In group Ⅲ the triangle of Petit was positioned through palpating and then 0.5 ml/kg of 0.25％ ropivacaine was injected.HR,RR,SpO2,PETCO2,expired sevoflurane concentration and BIS value at the time of entering the operation room (T1),incision of skin (T2),pulling hernia sac (T3),ending the surgery (T4),waking (T5),the number of pressing the analgesia pump after operation were recorded.The results showed that HR at T2 and T3 of groups Ⅰ and Ⅱ was lower than group Ⅲ (P ＜ 0.05).The were significant differences in case numbers of insufficient intraoperative analgesia among 3 groups(x2 =10.500,P =0.005).The CHEOPS scores and the number of pressing analgesia pump after operation in groups Ⅰ and Ⅱ were lower than those in group Ⅲ (x2 =7.230,P =0.027).Results indicate that ultrasound-guided transversus abdominis plane block is safer and more effective than conventional method for operations of inguinal region in infants; it may reduce dose of local anesthetics and postoperative use of analgesics.

Objective To approach the operative effect of dural bilaminar saturation in frontal -temporal skull defect repairs after standard decompressive craniectomy.Methods Fifty-two patients with titanium cranioplas-ty in frontal-temporal skull defect were retrospectively analyzed;27 of them adopted dural bilaminar saturation in the first standard decompressive craniectomy(test group);25 of them adopted dural monostratal saturation in the first operation (control group).The operation time,blood loss,postoperative complications in the two groups were compared. The mean operation time:the test group was (65.00 ±8.15)min and the control group was (83.00 ± 10.25)min,there was statistically significant differences between the two groups(t =7.059,P<0.05);average amount of bleeding:the test group was (55 ±8)mL and the control group was (79 ±12)mL,there was statistically significant differences between the two groups (t=8.541,P<0.05);postoperative complications:adverse reactions were noted in 4 patients of test group (14.8%),5 cases of control group (20%),there was no significant differences between the two groups (χ2 =0.016,P>0.05).Conclusion Skull repairs in second standard decompressive crani-ectomy by dural bilaminar saturation,can be shortened the operation time and lessened amount of bleeding.

Objective To construct the recombinant RIP3 over-expressed plasmids and transfect them in breast cancer MCF7 cells, and identify the expression and localization of fusion protein, as well as its effect on the death way of MCF7 cells. Methods The expression levels of RIP3 mRNA in four breast cancer cell lines and normal mammary epithelial cells were detected by reverse transcription polymerase chain reaction (RT-PCR). The RIP 3 coding sequence was amplified by polymerase chain reaction and subcloned into mCherry vector to construct recombinant plasmids. The plasmids were transfected into MCF7 cells by lentivirus after DNA sequencing, then screened by basticidin (4 mg/L) for 1 week. The efficiencies of RIP3 expression were validated by Western blotting assay. The death way of mCherry-RIP3-MCF7 cells was observed under the treatment of TNF-αand Z-VAD-FMK. Results The lowest expression of RIP3 mRNA was found in MCF7 cells. The sequencing results validated the well recombinant plasmids. The expression of mCherry-RIP3 fusion pro-tein with a molecular weight of 85 ku was detected by Western blot assay. The mCherry-RIP3 expression enhanced the sensi-tivity of MCF7 cells to TNF-αand Z-VAD-FMK induced cell death. Conclusion The recombinant RIP3 over-expressed plasmids were successfully constructed, and the stable MCF7 cells with ectopic RIP3 transfection were obtained. The mCher-ry-RIP3 fusion protein was expressed in the cytoplasm and was conformed to mediate TNF-αinduced necroptosis.

Objective To investigate clinical biologic characteristics and factors that impact prognosis of patients with follicular thyroid carcinoma(FTC).Method Clinical data of 105 FTC patients treated surgically in the Department of Head& Neck,Tianjin Cancer Hospital from 1970 to 1990 was analyzed retrospectively.Results The overall 5-year,10-year and 15-year survival rates of these patients were 85.3％,76.7％ and 72.9％ respectively.The overall 15-year survival rates of patients ≥45 years and those ＜ 45 years were 45.9％,89.8％ respectively.The overall 15-year survival rates of patients with unilateral and bilateral carcinoma was 50.0％,76.2％ respectively.The overall 15-year survival rates of patients with neck lymph node metastasis and without were 54.2％,79.2％ respectively.The overall 15-year survival rates of patients at stage Ⅰ,stage Ⅱ,stageⅢ and stageⅣ were 89.3％,70.0％,45.5％ and 35.3％respectively.During the follow-up period,11 patients were diagnosed with distant metastasis from 1 year to 33 years after surgical treatment and 9 died of cancer within 5 years after diagnosis.Seventeen patients had local recurrence from 3 months to 34 years after surgery and 10 of these patients died of local recurrence.Conclusions The factors influencing prognosis of patients with FTC were age,clinical stage,bilateral carcinoma and neck lymph node metastasis,therefore early treatment and close following-up are essential to improve the prognosis of patients with FTC.

Objective:To investigate the chemical constituents in the roots of Angelica dahurica var.formosana.Methods: The dried rhizomes of Angelica dahurica var.formosana were chopped and extracted with 80% EtOH for 3 times under reflux.The EtOH extract was isolated by chromatography on silica gel using a gradient solvent system(PE:EtOAc & CHCl_3MeOH) and Sephadex LH-20.The structures of the contents were elucidated by nuclear magnetic resonance and MS spectral analysis.Results: Seventeen compounds were identified,namely,isoimperatorin(1),imperatorin(2),bergapten(3),alloimperatorin(4),xanthotoxol(5),cnidilin(6),byakangelicin(7),bergaptol(8),byakangelicol(9),pabulenol(10),oxypeucedanin hydrate(11),desmodimine(12),palmitic acid(13),stiamasterol(14),?-sitosterol(15),?-daucosterin(16),and sucrose(17).Conclusion: Compounds 8 and 12 have been isolated from Angelica dahurica var.formosana for the first time.Compound 12 has been firstly isolated from Umbelifera plants.All the courmarin compounds belong to linear 6,7-furanocourmarins.