Objective To investigate the effects of different doses of dexmedetomidine on the minimum alveolar concentration (MAC) of sevoflurane for sedation in patients.Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,undergoing elective lower abdominal surgery performed under general anesthesia,were randomly divided into 4 groups:control group (group C) and different doses of dexmedetomidine groups (D1,D2 and D3 groups).In D1,D2 and D3 groups,the loading dose of dexmedetomidine 0.4,0.6 and 0.8 μg/ kg was intravenously infused over 15 min,respectively,adverse cardiovascular events were then recorded,followed by infusion at 0.4,0.6 and 0.8 μg· kg-1 · h-1 via a pump,respectively,while in group C,the equal volume of 0.9 ％ normal saline was given instead of dexmedetomidine.Sevoflurane administration was begun after completion of infusion of the loading dose.Up-and-down sequential allocation was used to determine the MAC.The initial end-tidal concentration of sevoflurane was set at 0.8％,0.7％,0.6％ and 0.5％ in C,D1,D2 and D3 groups,respectively,and maintained at this level for 15 min.Each time the concentration of sevoflurane increased/decreased in the next patient depending on whether or not the patients correctly followed the verbal command to open his eyes.The ratio between the two consecutive concentrations was 0.9.The middle point between the positive response and negative response served as a crossover pair.After at least 7 independent crossover pairs were observed in each group,the experiment was stopped.The MAC and 95 ％ confidence interval of sevoflurane were calculated.Results The incidence of adverse cardiovascular events was significantly higher in D3 group than in D1 and D2 groups (P ＜ 0.05).In C,D1,D2 and D3 groups,the MAC (95％ confidence interval) of sevoflurane was 0.68％ (0.64％-0.74％),0.50％ (0.47％-0.52％),0.36％ (0.32％-0.41％) and 0.28％(0.26％-0.31％),respectively.The MAC-awake of sevoflurane was significantly lower in D1-3 groups than in group C,in D2 and D3 groups than in group D1,and in D3 group than in group D2 (P ＜ 0.05).Conclusion Dexmedetomidine 0.6μg/kg can significantly decrease the MAC of sevoflurane for sedation,induces no side effects and is the optimum dose in patients.

Objective To evaluate the effects of different doses of dexmedetomidine on the median effective concentration (EC50) of propofol given by target-controlled infusion (TCI) at loss of consciousness (LOC).Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index ≤25 kg/m2,scheduled for operations under general anesthesia,were randomly allocated to one of four groups(n=20 each): control group (group C) and dexmedetomidine 0.4 μg/kg group (group D1),dexmedetomidine 0.5 μg/kg group (group D2) and dexmedetomidine 0.6 μg/kg group (group D3).Dexmedetomidine 0.4,0.5 and 0.6 μg/kg were infused intravenously over 10 min in groups D1-3,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol was then given by TCI and the EC50 was determined by up-and-down sequential trial.The target plasma concentration was set at 2.0μg/ml in the first patient in each group.The ratio of the target plasma concentration between the two consecutive patients was 1.1.Loss of response to eyelash stimulation and verbal command (2 times) was considered to be signs of LOC.The EC50 and 95％ confidence interval (CI) of propofol causing LOC were calculated.Complications such as bradycardia,hypotension and respiratory depression were recorded.Results The EC50 (95％ CI) of propofol causing LOC was 2.59 (2.51-2.67),2.09 (2.02-2.16),1.82 (1.70-1.95) and 1.60 (1.49-1.72) μg/ml in groups C and D1.3 respectively.The EC50 of propofol causing LOC was significantly lower in groups D1-3 than in group C.Dexmedetomidine significantly decreased the EC50 of propofol required for causing LOC in a dose-dependent manner in groups D1-3 (P ＜ 0.05).The incidences of bradycardia and hypotension were significantly lower in groups D1.3 than in group C (P ＜ 0.05).Compared with group D1,the incidence of bradycardia was increased in groups D2,3 and the incidence of hypotension was increased in group D3 (P ＜ 0.05),There was no significant difference in the incidences of bradycardia and hypotension between groups D2 and D3 (P ＞ 0.05).No patients developed respiratory depression.Conclusion The optimum dose for dexmedetomidine infused intravenously when combined with propofol given by TCI is 0.4 μg/kg and it can decrease the EC50 of propofol administered by TCI at LOC with no adverse reactions.

Objective To explore the clinical significance of Ezrin and β?catenin in breast cancer. Methods Immunohistochemical staining method was adopted to detect Ezrin and β?catenin protein expression level in 145 cases of breast cancer tissues,and their correlation with clinical data and prognosis of breast cancer was analyzed. Results Ezrin was expressed in 70 cases(48.3%),β?catenin was expressed in 82 cases (56.6%),and there was significantly negative correlation(r=0.267,P=0.001). The higher histologic grade of breast cancer,the higher expres?sion level of Ezrin(P=0.007),and the lower expression level of β?catenin(P<0.001). Ezrin expression level was increased significantly(P=0.027),but β?catenin expression level was reduced significantly(P=0.011)in lymph node positive breast cancer tissue. Ezrin expression was sig?nificantly correlated with shorter overall survival(P=0.004)and disease free survival(P=0.017)of breast cancer patients,but β?catenin expres?sion was significantly correlated with longer overall survival(P<0.001)and disease free survival(P=0.001)of breast cancer patients. However , Ezrin and β?catenin were not the independent risk factors of breast cancer patients as determined by multivariate Cox regression. Conclusion Ez?rin was significantly negative correlated with β?catenin in breast cancer. They play a role in the progression and poor prognosis of breast cancer , which can be used as breast cancer treatment targets.

Objective To investigate the relationship between interleukin-17 (IL-17) and vitiligo.Methods Totally,32 vitiligo patients and 30 healthy human controls were enrolled in this study.Blood samples were collected from all the subjects,and enzyme-linked immunosorbent assay (ELISA) was performed to determine the plasma levels of IL-17.The relationship of plasma IL-17 levels with disease stage,clinical course and lesion area was assessed.Results The plasma levels of IL-17 were significantly higher in the patients with progressive and stable vitiligo than in the healthy controls (both P ＜ 0.05),and higher in the patients with progressive vitiligo than in those with stable vitiligo (P ＜ 0.05).Moreover,the plasma levels of IL-17 were positively correlated with the area of vitiligo lesions (r =0.456,P ＜ 0.05),but unrelated to the clinical course of vitiligo (r =0.239,P ＞ 0.05).Conclusion IL-17 may play a certain role in the occurrence and development of vitiligo.

Objective To investigate the effect of Mepilex on pressure sores in patients at lateral position after craniocerebral surgery.Methods Toally 60 patients lying at lateral position after craniocerebral surgery were randomized into two groups in equal number with random digit table:the control group and experiment group.In the control group,Gel pad was used to prevent and treat the pressure sores and in the experiment group Mepilex was used between the compressed skin and operation table before setting the position.The skin conditions of the two groups were observed after operation.Result The prophylactic effect of pressure sore in the experiment group was significantly better than that in the control group (P＜0.05).Conclusion Mepilex can prevent the skin pressure sores in the patients at lateral position after cerebral surgery.

The clinical thought is the core and the foundation of clinical ability.The logical teaching strengthens the students'clinical thought most directly and effectively.Through the thought training,the inference thought training and the basic thought rule training the medical students' clinical thought ability can be effectively strengthened.

Objective·To explore the biologic effect and mechanism of adenanthin (Aden) on multiple myeloma (MM) cells. Methods·MM cells, H929 and U266 were treated with various dose of Aden for different time, and the density and viability of MM cells were detected by trypan blue exclusion assay. After H929 and U266 cells were treated with various dose of Aden for 24 hours, cell growth inhibition was examined by CCK8 assay, and cell apoptosis was examined by AnnexinV-APC/PI staining assay. Apoptosis related proteins, NF-κB signaling pathway associated proteins and the NF-κB regulated proteins were detected by Western blotting. The effect of Aden on the thermal stability of IKKβ protein was determined by CETSA assay. Results·Trypan blue exclusion results showed that Aden inhibited cell growth and reduced cell viability in concentration and time dependent manners. U266 was more sensitive than H929 when exposed to the same concentration of Aden. The CCK8 results showed that Aden inhibited the growth of H929 and U266 cells in a concentration dependent manner. Flow cytometry results suggested that Aden induced a low apoptosis rate of MM cells. Moreover, cleavage of caspase3 and PARP were detected in U266 cells but not in H929 cells. CETSA assay indicated that Aden decreased the thermal stability of IKKβ. Expression of p-p65 and p-IκBα proteins decreased in MM cells treated with Aden. Conclusion·Aden significantly inhibits MM cell proliferation by inhibiting NF-κB activation through interacting with IKKβ. Aden has little effect on apoptosis of MM cells.

Ashi point (tonsil) in combination of the pricking and bleeding technique on Shaoshang (LU 11 )and Shangyang (LI 1) were used to treat 58 outpatients of acute tonsillitis. The results showed cure in 38 cases,remarkable effect in 17 cases and failure in 3 cases by one treatment, and the total effective rate in 95%.

The known members of inhibitor of growth (ING) gene family are considered as candidate tumor suppressor genes. ING4, a novel member of ING family, is recently reported to regulate brain tumour angiogenesis through transcriptional repression of NF-?B-responsive genes, induce G2/M arrest by the increased p21 expression in a p53-dependent manner, suppress the loss of contact inhibition and represses activation of the hypoxia inducible factor, which plays an important role in the progression of tumorigenesis. However, seldom studies about ING4 inducing tumor cells apoptosis were reported.The C6 cells (mouse glioma cells) were infected respectively with the blank adenovirus carrying GFP (Ad) and the recombinated Ad-hING4-His, then RT-PCR assay was used to detect the transcriptions of hING4, as well Western-blotting assay was ued to detect the expressions of hING4. The effects of hING4 expression upon C6 cells were observed, and the growth curve was drawed and tumor control rates were calculated. The C6 cells, which were affected by blank Ad and Ad-hING4-His, were respectively observed by LSCM (laser scan confocal microscope) and transmission electron microscope (TEM), detected by flow cytometry; and the genomic DNA of both groups were extracted and electrophoresised in agarose gel to examinate the DNA fragments. The results showed hING4 can significantly inhibit the growth of C6 cells by promoting the cell’s apoptosis, which probably is the first one to prove this property of ING4.The experimental and theoretical foundation for gene therapy for gliomas with ING4 in the future was established.

Objective To study the antitumor effect and mechanism of co-cultured cytokine-induced killer(CIK) cells and autologous DC modified with IL-24 gene on A549 cells in vitro. Methods DC and CIK cells were prepared routinely from human peripheral blood mononuclear cells(PBMC). Recombinant adenovirus vector pAdEasy-1-pTrack-CMV-IL-24 was extracted from DH5α, it was lineared with Pac I and transfected into A293 cells, and then the IL-24 recombined adenovirus(Ad-IL-24) was obtained. Ad-IL-24 was used to infect DC. The cells obtained were named DC-IL-24. RT-PCR and ELISA were used to evaluate the expression of IL-24 gene in transfected DC. The phenotypes change of DC were identified by flow cytometry analysis, the concen-tration of IL-12 and TNF-α in supernatant of DC were determined by EIJSA. The ability of CIK producing per-forin was measured by homolysis method. FCM was used to determine the cytotoxicity of cocultured CIK cells and autologous DC modified with IL-24 gene to A549 cells. Results We obtained the high titre of Ad-IL-24.IL-24 gene was transfered into DC successfully via Ad-IL-24. The green fluorescence was observed on DC by fluorescence microscope. The expression rate of CD80, CD83, HI.A-DR, CD40, CXCR4 on DC-IL-24 was sig-nificantly increased compared with that of the control group. DC-IL-24 produced markedly higher levels of IL-12 and TNF-α as compared with DC. DC-IL-24 can enhance the ability of CIK cells producing perforin. On com-parison with non-transfected DC co-cultured with CIK cells, transfected DC co-cultured with CIK cells had a sig-nificantly higher lytic activity against A549 cells. Conclusion IL-24 gene modification can enhance the anti-tu-moral immunity of DC. The mechanism of which might be related to the increased secretion of IL-12 and TNF-α, up-regulation expression of co-stimulatory molecules and MHC Ⅱ class molecules on DC, promoting the acti-vation and maturation of DC, and then enhancing CIK cells to generate specific anti-tumoral immunity.