Objective To study the efficacy and safety of sedation in gastroscopy with a combined use of rimifentani and propofol compared to a control,non-sedative group.Methods 120 cases in sedative group were given intravenous rimifentani and propofol.Patients'feeling and discomfort,operator's satisfaction and operative duration were compared with the controI group(n=120,without sedation).The changes of blood pressure,heat rate and blood oxygen saturation were recorded and analysed.Results 118 patients(98.3%)in sedative group and 0 patient(0)in control group did not complain any discomfort and pain duing gastroscopy(P＜0.01).The incidence of cough,restlessness,nausea and vomiting,and guttural discomfort in sedative group(1.7%,3.3%,1.7%,and 0,respectively)was lower as compared with the control group(9.2%,26.7%,48.3%and 100%,respectively,P＜0.01).The blood pressure in sedative group was decreased duing the procedure and recovered after the procedure.Conclusion With intravenous use of rimifentani and propofol,gastroscopy can be performed effectively and safely.

Objective To investigate the association between the inflammatory factors and carotid atherosclerosis in patients with cerebral infarction. Methods The carotid intima-media thickness(IMT), plaque and inflammatory indexes were correlative analysed in 244 patients with acute cerebral infarction. Results Inflammatory factors ( monocyte proportion, levels of fibrinogen and CRP,erythrosedimentation) were associated with carotid atherosclerosis. Monocyte proportion (ORIMT =1.231,P

AIM:To investigate the role of p38 MAPK/ATF-2 pathway in C-relative protein ( CRP)-induced endothelial cell activation.METHODS:Human coronary artery endothelial cells ( HCAEC) were cultured and were used between passages 3 and 7.CRP served as a stimulus for endothelial cell activation.Western blotting was performed to de-termine the expression and phosphorylation of eNOS, p38 and ATF2.ELISA was carried out to detect the levels of ICAM-1, VCAM-1 and MCP-1 released from HCAEC.Pharmacological p38 inhibitors SB203580 and SB202190 were used to de-termine the effect of p38/ATF-2 pathway.RESULTS:CRP reduced the p-eNOS level in a concentration-dependent man-ner and induced the release of ICAM-1, VCAM-1 and MCP-1.The p38/ATF-2 pathway was activated by CRP treatment. SB203580 and SB202190 partially rescued p-eNOS level and suppressed the secretion of ICAM-1, VCAM-1 and MCP-1. CONCLUSION:p38MAPK/ATF-2 pathway participates in CRP-induced endothelial activation.

Objective To evaluate the effect of oxycodone pretreatment on autophagy during renal ischemia-reperfusion (I/R) in rats.Methods Thirty-six SPF healthy adult male Wistar rats,aged 6-9 weeks,weighing 180-220 g,were divided into 3 groups (n=12 each) using a random number table:sham operation group (Sham group),I/R group and oxycodone pretreatment group (Oxy group).The left renal pedicles were clamped with atraumatic microclips for 45 min followed by reperfusion to establish the model of renal I/R injury in I/R and Oxy groups.Oxycodone 0.5 mg/kg was injected via the caudal vein at 15 min before ischemia in group Oxy,and the equal volume of normal saline was given instead in I/R and Sham groups.At 24 h of reperfusion,blood samples were collected from hearts for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations.The animals were then sacrificed and left renal tissues were obtained for examination of pathological changes (with a light microscope) and for determination of Bcl-2 and Beclin-1 expression (by immunohistochemistry).Results Compared with Sham group,the concentrations of serum Cr and BUN were significantly increased,and the expression of Bcl-2 and Beclin-1 in renal tissues was up-regulated at 24 h of reperfusion in I/R and Oxy groups (P<0.05).Compared with I/R group,the concentrations of serum Cr and BUN were significantly decreased,the expression of Bcl-2 in renal tissues was up-regulated,and the expression of Beclin-1 in renal tissues was down-regulated at 24 h of reperfusion (P<0.05),and the pathological changes were significantly attenuated in Oxy group.Conclusion Oxycodone pretreatment inhibits autophagy through up-regulating the expression of Bcl-2 and down-regulating the expression of Beclin-1,thus attenuating renal I/R injury in rats.

Objective To investigate clinical significance and function of microRNA-106b (miR-106b) in retinoblastoma tissues and cells.Methods We detected miR-106b expression in 51 samples of thyroid cancer and the adjacent non-tumor tissues using qRT-PCR.The expression of miR-106b was altered by corresponding vectors in thyroid cancer cells,and then BrdU cell proliferation and flow cytometry assay were performed to examine the proliferation and apoptosis of thyroid cancer cells.Results The expression of miR-106b in thyroid cancer tissues was significantly lower than that in normal tumor-adjacent tissues (0.36±0.029 vs 0.98±0.034,P＝ 0.004).MiR-106b expression in tumor tissues was significantly associated with tumor size and tumor number.MiR-106b was obviously inhibited by miR-106b inhibitor in PTC-I cells (0.96±0.025 vs 0.29±0.032,P＝0.001),and inhibition of miR-106b resulted in significantly increased proliferation (89.33±5.67 vs 136.67±10.33,P＝0.03) and decreased apoptosis (16.33±3.20 vs 7.67±2.45,P＝0.04).On the contrast,over-expression of miR-106b using miR-106b mimics led to significantly decreased proliferation (98.00±4.65 vs 76.33±2.87,P＝0.03) and increased apoptosis (22.54±2.13 vs 32.45±4.34,P＝0.04).Conclusions Decreased expression of miR-106b is correlated with the adverse clinicopathological features of thyroid cancer.MiR-106b can inhibit cell proliferation and apoptosis of thyroid cancer cells,suggesting miR-106b plays a suppressive role in development and progression of thyroid cancer.

Objective To explore the effects of lead acetate on free radicals and lipid peroxidation in the cerebral cor?tex, cerebellum, and hippocampus in rat brains. Methods SD rats (n=48), who were just weaned, were randomly divided in?to 4 groups base on their weight. Then the rats were fed with lead acetate in drinking water at the final concentrations of 0 mg/L (deionized water), 200 mg/L, 400 mg/L, 800 mg/L respectively. Blood lead level as well as the hydroxyl free radical inhibiting activity, the levels of hydrogen peroxide (H2O2) and malondialdehyde (MDA) in cerebral cortex, cerebellum, and hippocam?pus were measured 60 days after lead contamination in water. Results Upon lead exposure, blood lead levels increased sig?nificantly as compared with the control. The hydroxyl free radical inhibiting activity in cerebral cortex, cerebellum, and hip?pocampus decreased significantly in a dose dependent manner of lead(P < 0.05). And they all correlated negatively with blood lead level (r=-0.505,-0.414,-0.448, P<0.05). By contrast, blood lead level was positively correlated with H2O2 and MDA in these brain tissues (r=0.301, 0.411, 0.378, and 0.404, 0.324, 0.510,P < 0.05). Conclusion Lead exposure can lead to lipid peroxidation of rat brain tissues through inducing free radicals.

Objective To explore the efficacy of process management on bladder function among traumatic brain injury (TBI) patients admitted to intensive rehabilitation and care unit (IRCU). Methods 33 cases were collected to control group who were cared with routing nursing during February, 2011 to December, 2012. Other 39 cases were recruited to trial group cared with process management of bladder function during January, 2013 to December, 2014. Process management of bladder function contained the establishment of process manage-ment guide, evaluation of removing catheter, nursing of bladder based on residue of urine volume and keeping a diary of urination, etc. Re-sults There were more cases with residue of urine volume less than 100 ml and less with catheter associated urinary tract infection in the tri-al group than in the control group (P<0.05). Conclusion Process management of bladder function can improve the recovery of bladder func-tion of TBI patients, shorten rehabilitation time and decrease the risk of catheter associated urinary tract infection.

Objective:To investigate the clinical features of Epstein-Barr virus associated lymphoproliferative disease in children and to improve the understanding of this disease.Methods:This study included the children with Epstein-Barr virus associated lymphoproliferative disease admitted to the First Affiliated Hospital of College of Medicine of Zhejiang University from January 2014 to December 2018.Data of these children were collected, including age, clinical manifestations, laboratory results, treatment and outcome.The clinical features and therapeutic effects were analyzed.Results:A total of 114 cases(mean age 6 years, 0~17 years)were enrolled in this study, including 53 males and 61 females.There were 107 cases(93.86%) in the mild group (38 cases of EBV infection and 69 cases of infectious mononucleosis) and 7 cases in the severe group (6.14%). Six cases of the severe group were T cell or NK cell proliferation.Compared with the mild group, the load of EBV-DNA was higher in the severe group, but there was no significant difference( χ2=0.957, P>0.05). The IgM in severe group was significantly lower( Z=-2.041, P<0.05). But the differences in the level of immune function including IgA, IgG, CD4 + cell and CD8 + cell between the severe group and the mild group were not significant.The cases in the mild group had improved after antiviral treatments.Among the severe group, 3 cases survived after treatment, another 1 case was diagnosed as hydroa vacciniforme-like EBV-related proliferative disease (HV-like LPD). After antiviral treatment, the effect was not good, then after high-dose IVIG treatment and Bortezomib combined with methylprednisolone treatment, the EBV-DNA load decreased and the condition improved.While 1 case lost to follow-up, there were 2 cases with EBV-associated hemophagocytic syndrome and 1 case with EBV-associated lymphoma died after chemotherapy or transplantation. Conclusion:EBV-associated lymphoproliferative disease may manifest as a condition similar to infectious mononucleosis.High IgE, low IgM or high DNA load may indicate poor prognosis.Immune function after EBV infection may have different effects on prognosis.When the infected lymphocyte types are NK or T cells, it may indicate poor prognosis.The efficacy of transplantation and chemotherapy in severe cases is still uncertain.

OBJECTIVETo investigate the change pattern of primary and secondary school teachers' work ability with the changes in their mental workload.

METHODSA total of 901 primary and secondary school teachers were selected by random cluster sampling, and then their mental workload and work ability were assessed by National Aeronautics and Space Administration-Task Load Index (NASA-TLX) and Work Ability Index (WAI) questionnaires, whose reliability and validity had been tested. The effects of their mental workload on the work ability were analyzed.

RESULTSPrimary and secondary school teachers' work ability reached the highest level at a certain level of mental workload (55.73< mental workload ≤ 64.10). When their mental workload was lower than the level, their work ability had a positive correlation with the mental workload. Their work ability increased or maintained stable with the increasing mental workload. Moreover, the percentage of teachers with good work ability increased, while that of teachers with moderate work ability decreased. But when their mental workload was higher than the level, their work ability had a negative correlation with the mental workload. Their work ability significantly decreased with the increasing mental workload (P < 0.01). Furthermore, the percentage of teachers with good work ability decreased, while that of teachers with moderate work ability increased (P < 0.001).

CONCLUSIONToo high or low mental workload will result in the decline of primary and secondary school teachers' work ability. Moderate mental workload (55.73∼64.10) will benefit the maintaining and stabilization of their work ability.

Faculty ; statistics & numerical data ; Humans ; Occupational Health ; Reproducibility of Results ; Sampling Studies ; Schools ; Stress, Psychological ; psychology ; Surveys and Questionnaires ; Work ; psychology ; Workload ; psychology

Objective To investigate the risk factors of fetal death in patients with severe preeclampsia Methods Clinical data of 70 cases with severe preeclampsia were analyzed retrospectively,including 53 cases of fetal survival and 17 cases of death.Results There was shorter pregnancy duration in fetal death group (P ＜ 0.05) but there were no significant differences in the age,serum albumin level,systolic blood pressure,diastolic blood pressure and mean arterial pressure in 2 groups (P ＞ 0.05).Pulmonary edema was correlated to gestational week (P ＜ 0.05);the higher the gestational age was,the higher the occurrence of pulmonary edema.Conclusion Earlier onset of severe preeclampsia predicts higher rate of fetal death.