Objective To investigate the optimum concentration and dose of ropivacaine for caudal block in the neonates undergoing laparotomy under general anesthesia.Methods One hundred pediatric patients of both sexes,aged 9-30 days,weighing 2.5-4.5 kg,scheduled for elective pyloromyotomy,were randomly divided into 5 groups (n =20 each) using a random number table:control group (group C),0.10％ ropivacaine 1.0 ml/kg group (group 0.1％ L1),0.15 ％ ropivacaine 1.0 ml/kg group (group 0.15 ％ L1),0.10 ％ ropivacaine 1.2 ml/kg group (group 0.10 ％ L2),and 0.15 ％ ropivacaine 1.2 ml/kg group (group 0.15 ％ L2).Anesthesia was induced with sevoflurane and cisatracurium.The pediatric patients were tracheally intubated and mechanically ventilated.Remifentanil was infused intravenously at 0.2-0.3 μg· kg-1 · min-1 in group C.In 0.10 ％ L1,0.15 ％ L1,0.10 ％ L2 and 0.15％L2 groups,the corresponding concentrations and doses of ropivacaine were injected into the sacral canal under the guidance of ultrasound.The operation was started at 15 min after administration and sevoflurane was inhaled and the end-tidal concentration of sevoflurane was maintained at 0.8-1.0 MAC.Before induction (T1),at pyloric muscle retraction (T2),and at 4,8,12 and 24 h after operation (T3-6),blood samples were collected from the central vein for determination of plasma concentrations of cortisol and interleukin-6 (IL-6).Pain was assessed using CRIES score at T3-6.When CRIES scores ＞ 3,10％ chloral hydrate 0.5 ml/kg was given by retention enema for analgesia,and the requirement for chloral hydrate was recorded.The emergence time,extubation time,duration of stay in post-anesthesia care unit (PACU) and hospital discharge time were recorded.Bradycardia and hypotension during operation,and development of motor block of lower extremities,infection and dehiscence of incision,vomiting,and urinary retention after operation were also recorded.Results Compared with group C,no significant changes were found in the emergence time,extubation time,duration of stay in PACU,hospital discharge time,plasma concentrations of cortisol and IL-6,the requirement for chloral hydrate,and the incidence of bradycardia,hypotension,motor block of lower extremities,and infection and dehiscence of incision in 0.10％ L1 and 0.15 ％ L1 groups,the emergence time,extubation time,duration of stay in PACU,hospital discharge time were significantly shortened,and the plasma concentrations of cortisol and IL-6,requirement for chloral hydrate,and the incidence of hypotension and infection of incision were decreased in 0.10％ L2 and 0.15％ L2 groups,and the incidence of vomiting and urinary retention was increased in 0.15％ L1 and 0.15％ L2 groups.Compared with group 0.10％ L2,the incidence of vomiting and urinary retention was significantly decreased,and no significant changes were found in the other parameters mentioned above in 0.15％ L2 group.Conclusion The optimum concentration and dose of ropivacaine are 0.10％ and 1.2 ml/kg,respectively,for caudal block in the neonates undergoing laparotomy under general anesthesia.

It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

se—Met. In the experimental range of concentration, the activities of GSH—px were higher than that of control.

Objective To investigate the related factors of early angina after acute myocardial infarction,and to provide basis for the disease prevention and control.Methods 1 32 cases with acute myocardial infarction were selected.The clinical data were collected.The occurrence rate of early angina pectoris after acute myocardial infarc-tion,and clinical characteristics were analyzed.The related factors of acute myocardial infarction angina were explored.Results The incidence rate of early angina pectoris after acute myocardial infarction was 29.55%.Within 7 days after acute myocardial infarction occurred angina,the highest rate for 64.1 0%,followed by 7 -1 4 days in the occurrence of angina pectoris,28.21 %.34 cases were the original location of myocardial infarction ischemia and 5 cases were the far part of ischemia,21 cases showed ST segment elevation,1 8 cases showed ST lack blood group downward.Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension,heart function classification more than or equal to grade III in patients with acute myocardial infarction occurred after the proportion of early angina pectoris were signifi-cantly higher (all P <0.05).Conclusion Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension and cardiac functional grading more than or equal to grade III are related to early angina pectoris after acute myocardial infarction. We should actively take measures aimed at early prevention and treatment of early angina pectoris after acute myocar-dial infarction to avoid illness aggravating,improve the patients'prognosis.

Objective To investigate the construction of compound membrane with corneal stromal cells and collagen-chitosan by tissue engineering technique and its biocompatibility.Methods Rabbit and human corneal stromal cells were separated and seeded into collagen-chitosan membrane.The compound membrane was transplanted into rabbit corneal stroma.Then the growth condition of keratocytes,the effect on normal keratocytes and degradation of compound membrane were detected by corneal confocal microscope,anterior OCT and histological and immunohistochemical methods ex vivo 1,2,4 weeks after grafting.Results The rabbit and human corneal stromal cells grown well in collagen-chitosan scaffold.The compound membrane degradated gradually after grafting.There was no necrosis and dissolvation.Corneal epithelium,stroma and endothelial cells were all normal.Conclusion Collagen-chitosan can be used as a biological scaffold for construction of corneal stroma.Corneal confocal microscopy and anterior OCT are new methods to observe the biological activity of constructed corneal stroma.

In the aromatic amino acid biosynthetic pathway 3-dehydroshikimate (DHS) is a key intermediate. As a potent antioxidant and important feedstock for producing a variety of important industrial chemicals, such as adipate and vanillin, DHS is of great commercial value. Here, in this study, we investigated the effect of the co-expression of aroFFBR (3-deoxy-D-arabino-heptulosonate 7-phosphate synthase mutant with tyrosine feedback-inhibition resistance) and tktA (Transketolase A) at different copy number on the production of DHS. The increased copy number of aroFFBR and tktA would enhance the production of DHS by the fold of 2.93. In order to further improve the production of DHS, we disrupted the key genes in by-product pathways of the parent strain Escherichia coli AB2834. The triple knockout strain of ldhA, ackA-pta and adhE would further increase the production of DHS. The titer of DHS in shake flask reached 1.83 g/L, 5.7-fold higher than that of the parent strain E. coli AB2834. In 5-L fed-batch fermentation, the metabolically engineered strain produced 25.48 g/L DHS after 62 h. Metabolically engineered E. coli has the potential to further improve the production of DHS.
3-Deoxy-7-Phosphoheptulonate Synthase ; genetics ; Amino Acids, Aromatic ; biosynthesis ; Biosynthetic Pathways ; Escherichia coli ; genetics ; metabolism ; Fermentation ; Metabolic Engineering ; Shikimic Acid ; analogs & derivatives ; metabolism ; Transketolase ; genetics

Adult ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; Pregnancy ; Pregnancy Complications ; diagnosis ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis

BACKGROUND:Compared with the conventional composite resin, the 3M Z350 nano-resin has good wear
resistance, physical mechanical properties, and polishing, and exerts a lower irritation to the dental pulp. Besides fil ing materials, a reliable tooth-prosthesis bonding interface is necessary for resin bonded repairs.
OBJECTIVE:To compare the clinical effects of self-etch bonding Adper Easy One and total-etch bonding Single Bond 2 on nano-resin bonding restoration of the anterior teeth.
METHODS:120 anterior teeth with vital pulp, which had defects at the incisal ends and were to be restored with nano resins, were divided into two groups randomly. Two kinds of adhesives, self-etch adhesive and total-etch adhesive, combined with nano-resin were used to restore the teeth. The patients were re-examined immediately, 6 months, 1 year and 2 years after the treatment. The fil ings, teeth and pulps of patients were examined,
including whether the prosthesis and tooth color were coordinated, whether the gap between the prosthesis and the teeth were sealed, whether the surface of the prosthesis was intact with no loose, whether the prosthesis and teeth had no staining and secondary caries, whether the condition of the tooth pulp had hot or cold
stimulation-induced pain.
RESULTS AND CONCLUSION:No significant difference in the fil ing effects was found between the two groups when the patients were re-examined immediately, 6 months and 1 year after the treatment (P>0.05). The pulp
lesions of the self-etching group were fewer than those of the total-etch group 2 years after the treatment (P<0.05). Self-etching group had 1, 6, 0, 2 cases and total-etch group had 0, 2, 1, 2 cases in uncoordinated color, edge seal,
incomplete restoration and secondary caries, respectively. No statistical y significant differences were found in these four aspects between the two groups (P>0.05). The 2-year fol ow up showed a low incidence of pulp lesions and satisfactory clinical performance after 3M Z350 nano-resin working with self-etching bonding system in the nano-resin fil ing of
anterior teeth with vital pulp.

Objective To study the relationship between urinary albumin excretion rate(UAER)and cardiac structure and function in type 2 diabetes mellitus(T2DM).Methods Five hundred and twenty patients with T2DM were divided into three groups by 8 h UAER:normoalbuminuria group(424 cases),microalbuminuria group(75 cases)and macroalbuminuria group(21 cases).At the same time,50 healthy people were selected as control group.The cardiac structure and function in four groups were evaluated by echocardiographic measurements.Results Left atrial dimensio[(34.39±3.46)mm],left ventricular posterior wall thickness[(10.34±1.05)mm],relative wall thickness(0.46±0.05),interventricular septal thickness[(10.49±1.07)mm],left ventricular mass[(167.37±32.12)g],left ventricular mass index[(87.62±12.16)g/m2]in macroalbuminuria group were significantly higher than those in control group[(32.59±2.71)mm,(9.30±0.77)mm,0.42±0.04,(9.75±0.81)mm,(147.33±27.23)g,(80.14±13.81)g/m2](P＜0.05),mean while the ratio of E/A(0.82±0.19)in macroalbuminuria group was significantly lower than that in control group(1.21±0.16)(P＜0.05).Conclusions In T2DM patients with albuminuria,the cardiac structure and function have changed.With the increase of UAER,the impairments are more prominent.And it may predict diabetes cardiomyopathy.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.