Objective To evaluate the gender differences in neuromuscular blockade induced with rocuronium in patients undergoing abdominal surgery. Methods Twenty-four ASA Ⅰ or Ⅱ patients aged 20-59 yrs undergoing abdominal surgery under general anesthesia were enrolled in this study. Their body mass index (BMI) ranged between 18.5-25 kg?m-2. Patients with neuromuscular disease were excluded and no patient was taking any drug that might influence the effect of muscle relaxant. The patients were divided into male group ( n = 12) and female group (n = 12). The neuromuscular function was monitored and recorded using accelerography (DK-5210, Biometer, Denmark). The response of adductor pollicis muscle to train-of-four (TOF) stimulation of ulnar nerve were recorded. Body temperature was maintained at 36.0-36.9℃ and room temperature at 24-26℃ during surgery. The premedication included intramuscular atropine 0.01 mg?kg-1 and oral diazepam 10 mg. Anesthesia was induced with fentanyl 2-4 ?g?kg-1, propofol 2-3 mg?kg-1 and rocuronium 0.6 mg?kg-1. The patients were intubated and mechanically ventilated (VT = 7-10 ml RR = 12-14 bpm). PET CO2 was maintained between 35-45 mm Hg. Anesthesia was maintained with propofol by TCI (effect-site concentration was set at 3-4 ?g?ml-1) and intermittent i.v. boluses of fentanyl. Rocuronium (1 mg?ml-1) was infused and T1 was maintained at 5%-10% of the control height. At the end of surgery rocuronium infusion was terminated and neostigmine 0.05 mg?kg-1 was given i.v. .Results There were significant differences in body weight and height between male and female groups ( P

Objective To investigate the influence of epigallocatechin gallate ( EGCG)on reactive oxygen species (ROS) in mouse podocytes exposed to high glucose. Methods Mouse podocytes cultured in high glucose were exposed to different concentrations of EGCG (0.2, 10, 100 μmol/L) or α-tocopherol (0.2 μmol/L) for 6, 12, 24 hours. The viability of podocytes was detected by MTT. The intracellular formation of ROS was detected by confocal microscopy with fluorescent probe CM-H2DCFDA and was measured by fluorescence microscopy. RT-PCR was used to examine the expression of p22phox, p47phox and p67phox mRNA in cultured podocytes exposed to different concentrations of EGCG. Results Intracellular ROS generation was significantly higher in high glucose than that in control conditions (P<0.01). EGCG could significantly inhibit ROS induced by high glucose significantly (P<0.01). EGCG (100 μmol/L) led to an inhibition of the increased production of NADPH oxidase components of p22phox and p67phox mRNA in high glucose (P<0.05). The expression of p47phox mRNA in high glucose was inhibited by EGCG(0.2 μmol/L) and ot-tocopherol(0.2 μmol/L) (P<0.05). Conclusion EGCG can protect cultured mouse podocytes from injury of high glucose by inhibiting ROS formation.

Objective:To discuss the structure of medical humanistic curriculum system based on the research of quality features of excellent doctors .Methods:The goal , content and form of humanistic curriculum were based the factor of famous doctors'competencies which was build on the basis of literature review and experts'interview. Results:Ability and attitude or values accounted for high proportion of overall quality features .Humanities con-tained in most factors of excellent doctors'quality features;guiding significance of the structure of medical humanis-tic curriculum system is provided with excellent doctors'quality features .Conclusion:We should focus on the inte-gration of humanistic knowledge and practice , push humanities course into every stage of the medical education , further enrich category and quantity of medical humanities course and teaching form of medical humanities course , perfect the examination mode of medical humanities course in order to cultivate more excellent doctors .

Host-Pathogen Interactions ; Humans ; Immunocompromised Host ; MicroRNAs ; genetics ; immunology ; RNA, Viral ; genetics ; immunology ; Viruses ; genetics ; immunology

AIM:To clarify if interferon-?(IFN-?), tumor necrosis factor-?(TNF-?)and interleukin-1?(IL-1?)can induce apoptosis of human airway smooth muscle cells (ASMCs) in vitro. METHODS: Human ASMCs were isolated and cultured in DMEM containing 10% fetal bovine serum. Passage 4-6 cell was used in the experiment. IFN-?,TNF-? and IL-1?, were used separately or together in the treatment of human ASMCs. The effects of IFN-?,TNF-? and IL-1? on the growth of the cells was detected by MTT method at the hour 0,24,48 and 72. Light microscopy and electron microscopy were used to examine the morphological change. DNA fragmentation was analyzed by agarose gel electrophoresis. SP immunohistological staing method was performed to detect the change of expressions of p53 , bcl-2 and bax gene. The apoptosis cell percentage were detected by in situ end labeling technique (TUNEL)of fragmental DNA. RESULTS: (1)IFN-? or IFN-? together with TNF-? and IL-1? decreased the number of viable cells in a time dependent manner. (2) Light and electron microscopic examination showed cell shrinkage, membrane blebbing, nuclear contraction, chromatin condensation and nuclear fragmentation in human ASMCs. (3) Agarose gel electrophoresis showed a characteristic"ladder"of DNA bands representing integer multiples of the internucleosomal fragments (about 180-200 bp) in cytokine cotreated human ASMCs. (4)The expression of p53 and bax gene in cytokine cotreated group was significantly higher than in control group, but the expression of bcl-2 gene was lower than in control group. (5)Stimultaneous treatment with IFN-?(4?10 5 U/L),TNF-?(4?10 5 U/L)and /or IL-1? (10?10 4 U/L) induced apoptosis of human ASMCs. Apoptotic index of human ASMCs in cytokine co-treated group was significantly higher than in control group ( P

Objective To investigate the serum levels of fatty cytokines in hepatitis B patients with liver fibrosis.Methods Fifty six hepatitis B patients with liver fibrosis admitted in Wenzhou Central Hospital from April 2014 to March 2016 were recruited as case group and 65 healthy subjects as control group.Serum cytokines including omentin,leptin,adiponectin and visfatin were detected in both two groups and glutamyl endopeptidase (ALT),aspartate aminotransferase (AST) and hepatitis B virus DNA were detected in the case group.Liver biopsy was performed in the case group and histologic activity (HA) and histologic fibrosis (HF) stage were evaluated.Results The level of omentin in the case group was significantly higher than that in the control group [(358-119) vs.(305 ± 108) μg/L,t =2.236,P =0.037].Serum omentin,visceral fat hormone,leptin and adiponectin were not associated with liver function and HBV-DNA (P ＞0.05).There was no significant difference in adipocytokines levels between the low and high HA group (P ＞ 0.05).The level of omentin in high HF stage group was significantly higher than that in low HF stage group [(398 ± 130) vs.(292 ± 120) μg/L,t =2.648,P =0.009],while the other fatty cytokines did not show significantly differences between high and low HF groups (P ＞ 0.05).Conclusion Serum omentin level is elevated in hepatitis B patients with liver fibrosis and is associated with liver fibrosis severity.

AIM To investigate weather and how aminophylline induces human trachea smooth muscle cells (TSMCs) to apoptosis. METHODS Human TSMCs were isolated and cultured in DMEM containing 10% fetal bovine serum. Passage 4～6 cell were used in experiment. The cells were cultured with aminophylline or 8 Br cAMP for 24 or 48 h. Light micros copy and electron microscopy were used to observe morphological change. DNA fragmentation was analyzed by agarose gels electrophoresis. SP Immunohistological staing method was performed to detect the changes of expressions of p53,bcl 2 and bax gene. The apoptosis cell percentage were detected by situ end labeling technique(TUNEL) of fragmental DNA. RESULTS ①Aminophylline or 8 Br cAMP decreased the number of viable cells in time and concentration dependent manner; ② Electron microscopic examination showed nuclear contraction, chromatin condensation and apoptotic bodies formation in aminophylline group or 8 Br cAMP group; ③ Agarose gel electrophoresis of fragmented DNA showed a ladder like pattern; ④ The expression of p53 or bax gene in apoptosis group was significantly higher than in control group, but the expression of bcl 2 gene was lower than in control group; ⑤ The positive rate of TUNEL in aminophylline or 8 Br cAMP group was significantly higher than in control group ( P

OBJECTIVETo investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.

METHODSFrom June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.

RESULTSAll patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.

CONCLUSIONAnterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Spondylosis ; surgery

Melatonin has been reported to inhibit hepatic fibrosis and the mechanism may be correlated to its anti-oxidant effect.Nevertheless,the mechanism is not completely identified.This study was conducted to investigate the effects of melatonin on TGF-β1/Smad signaling pathway in liver fibrosis in rats.The liver fibrosis model was made by the subcutaneous injection of CCl4.The liver pathology changes were detected using hematoxylin and eosin (H&E) staining and Van Gieson (VG) staining.Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were measured with an autoanalyzer.Glutathione peroxidase (GPx) activities and levels of malondialdehyde (MDA) and hydroxyproline (Hyp) in liver were evaluated by spectrophotometry.Expression levels of TGF-β1,Smad2/3,phosphorylated Smad2/3 (p-Smad2/3) and Smad7 in liver were detected by immunohistochemistry and Western blot analysis.Results showed that melatonin suppressed CC14-induced liver fibrosis,along with an improvement in histological changes,significant decreases in pathologic grading sores and obvious decreases in Hyp levels in liver.Melatonin improved liver function indicated by decreased serum ALT and AST activities.In addition,melatonin exerted its anti-oxidant effects,as supported by decreased MDA levels and increased GPx activities in liver.Furthermore,melatonin inhibited TGF-β1/Smad pathway,as evidenced by decreased TGF-β1,Smad2/3 and p-Smad2/3 expression and increased Smad7 expression in liver.In conclusion,melatonin may suppress CCl4-induced hepatic fibrosis in rats via inhibiting TGF-β1/Smad pathway.It is possible for melatonin to be a potential reagent to treat and cure liver fibrosis.

Objective To investigate the clinical efficiency of Huayu Xiaozhong Decoction (HXD) on preventing peri-operative deep venous thrombosis (DVT) in lower limbs following artificial total hip replacement. Methods Ninety cases following artificial total hip replacement were randomized into blank control group, Rivaroxaban group and HXD group, 30 cases in each group, and were treated with brown sugar water, Rivaroxaban, HXD respectively. Before operation, and one, 3 and 14 days after operation, we monitored the changes of bleeding volume, DVT incidence, hemoglobin, prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , international normalized ratio (INR), and D-dimer (DD) in the three groups. Results (1) Fifteen cases had DVT, with a total incidence rate of 16.67%. Of the 15 cases, 10 were from blank control group, 2 from Rivaroxaban group, and 3 from HXD group. ( 2) The amount of bleeding volume of Rivaroxaban group was larger than that of the blank control group and HXD group (P<0.05), but the bleeding was mild. (3) One, 3 and 14 days after operation, PT and APTT were shortened in blank control group (P<0.01 compared with those before operation). PT, APTT and INR were prolonged, and coagulation function was improved in Rivaroxaban group and HXD group, the differences being significant as compared with the blank control group ( P<0.05). HXD group had better effect on improving INR than Rivaroxaban group ( P<0.05). ( 4) In the three groups, hemoglobin level began to decrease on postoperative day one, arrived to the bottom on postoperative day 3 (P<0.05), and rose up near to the normal level on postoperative day 14; HXD group had higher hemoglobin level than blank control group and Rivaroxaban group on postoperative day 3 and 14 ( P<0.05). The 3 groups had higher plasma DD level than the normal level before the operation, arrived to the highest level on postoperative day one and 3 ( P<0.05) , and fell down near to the normal level on postoperative day 14. The inter-group comparison results showed that Rivaroxaban group and HXD group had lower DD level than the blank control group on postoperative day 3 and 14 ( P<0.05). Conclusion HXD is effective on preventing DVT in the peri-operation period through reducing bleeding, increasing hemoglobin level and improving postoperative anemia. The efficiency and safety of HXD are similar to Rivaroxaban.