Objective: To research the effect of dexmedetomidine on regional cerebral oxygen saturation(rSO2)and postoperative cognitive function in elder patients received prostatectomy by using laparoscope. Methods: 60 elderly patients received prostatectomy by using laparoscope were divided into observation group (30cases) and control group (30cases) as random number table. In observation group, the dexmedetomidine was injected by venous pump after endotracheal intubation of general anesthesia was implemented, while the equivalent normal saline (NS) was injected by venous pump in control group. The rSO2, PaCO2 and PaO2 of different time point between the two groups were observed and compared. The usages of propofol and remifentanil, the situation of postoperative restlessness, and situation of nausea and vomiting between the two groups were compared. Besides, the scores of MoCA of different time point between the two groups also were compared. Results: The usages of propofol and remifentanil of observation group were significantly lower than that of control group (t=3.449, t=9.466, P<0.05), respectively. The occurrence rate of postoperative restlessness and occurrence rate of nausea and vomiting were 10.0% and 6.7%, respectively, while they were 13.3% and 3.3%in control group, and the differences of them between the two groups were no significant (x2=0.162, x2=0.351, P>0.05). The score of MoCA of observation group was significant higher than that of control group (t=8.938, P<0.05) at postoperative 1d. Conclusion: In the elder patients received prostatectomy by using laparoscope, the dexmedetomidine doesn't affect the rSO2 level of patients, while it contributes to fast recover the postoperative cognitive function of patients.

Objective:To investigate the effect of early postoperative cognitive dysfunction and postoperative analgesia situation after intercostal nerve block was applied on elderly patient received thoracic surgery.Methods: 105 elderly patients underwent thoracic surgeries were divided into observation group (35 patients received intercostal nerve block combined with general anesthesia), control A group (35 patients received epidural anesthesia combined with general anesthesia) and control B group (35 patients received routine general anesthesia). The cognitive function, postoperative pain, intraoperative mean artery pressure (MAP) and heart rate of the patients among different groups were respectively compared.Results: The cognitive function scores in postoperative 12h, 24h, 72h of observation group were significantly higher than that of control A group (t=20.917,t=27.780, t=74.081,P<0.05), respectively. And all of these data also were significantly higher than that of control B group (t=37.922,t=48.969,t=62.653,P<0.05), respectively. The differences of MAP, HR value between observation group and control A group were statistically significant (t=18.927,t=22.380,P<0.05), respectively. And the differences of them between observation group and control B group also were statistically significant (t=31.051, t=19.932, P<0.05), respectively. Besides, the differences of pain scores in postoperative 6h, 12h, 24h, 48h between observation group and control A group were not statistically significant, while all of pain scores of observation group were significantly lower than that of control B group (t=18.731,t=19.035, t=21.093,t=17.036;P<0.05).Conclusion:Intercostal nerve block combined with general anesthesia can ensure more stable intraoperative vital signs for elderly patients underwent thoracic surgeries, and it contributes to improve early cognitive function and possesses better postoperative analgesic effect for elderly patients.

Objectives To evaluate the inhibitory effect of low dose glucocorticoid on progression of radiological damage in rheumatoid arthritis by systematic review.MethodsA search of MEDLINE (from 1966 to April 2010),Embase(from 1966 to April 2010),Cochrane Library(2 Issue,2010),CBM disc,CNKI,WANFANG and VIP Database was undertaken to collect randomized controlled trials published before April 2010 based on the Cochrane Collaboration recommendations.Additional reports were identified from the reference lists.Statistical analysis was performed with RevMan 5.0 software.ResultsEleven studies that met the inclusion criteria,in which 1395 patients,were included.Meta-analysis showed that the standardised mean difference in progression was 0.40 (95％CI 0.27～0.54 ) in favour of glucocorticoids over the first year.In studies that lasted for 2 years,the standardised mean difference in progression in favour of glucocorticoids at 1 year was -0.39[95％CI(-0.50～-0.27)] and was -0.73[95％CI(-1.29～-0.16)] at 2 years.All studies except one showed benefit of glucocorticoids treatment.ConclusionsThe results of this study has shown that low dose glucocorticoids can substantially reduce the progression rate of erosion in rheumatoid arthritis.

Objective To study how ANGPTL4 modulates phenylephrine(PE)-induced cardiac fibrosis. Methods PE was applied to induce cardiac fibrosis. The knockdown effect of ANGPTL4 under PE stimuli was confirmed by Western blot;the proliferation of cardiac fibroblast was detected by CCK-8;mRNA levels of Collagen 1(Col1)and connective tissue growth factor(CTGF)were detected by QPCR to investigate the regula-tion of cardiac fibrosis by ANGPTL4. Results PE induced the proliferation of cardiac fibroblast and the up-regula-tion of mRNA levels of Col1 and CTGF;ANGPTL4 knockdown deteriorated cardiac fibrosis,manifested by the up-regulation of Col1 and CTGF. Conclusion ANGPTL4 inhibits PE-induced cardiac fibrosis.

Objective To analyse effect of nalmefene hydrochloride adjuvant therapy on serum nitric oxide(NO), endothelin (ET) and cardiac troponin I ( cTnI) in patients with traumatic shock.Methods 48 patients who were diagnosed with traumatic shock were collected.All patients were randomly divided into experimental group and control group, 24 cases in each group.On the basis of conventional anti shock treatment, the control group were treated with naloxone, the patients in experimental group received nalmefene hydrochloride treatment, after treatment, the serum levels of NO, endothelin and cardiac troponin I were detected in all patients.Results After treatment, compared with control group, the serum level of NO was lower in experimental group(P<0.05);the serum level of ET was lower in experimental group(P<0.05);the serum level of cTnI was lower in experimental group(P<0.05).Conclusions Nalmefene hydrochloride adjuvant therapy could significantly reduce the serum levels of NO, ET and cTnI in patients with traumatic shock,control the development of the disease, prevent myocardial injury.

Objective To explore the effects of urokinase type plasminogen activator (uPA) gene-modified bone marrow-derived liver stem cells ( BDLSC) transplantation on hepatocyte regeneration in CCl4-induced liver fibrosis rats. Methods Ten male Fisher 344 rats were donor rats of BDLSC. The BDLSC of male rat was transfected with AduPA. Thirty-six female Fisher 344 rats were equally divided into normal group (injected subcutaneously with olive oil) , model group (CCl4 induced the model, injected through tail vein with 0. 9% sodium chloride), BDLSC group (CCl4 induced the model, injected through tail vein with BDLSC) and gene transfected group (CCl4 induced the model,injected through tail vein with gene transfected BDLSC). Liver function and area of collagen were observed. The expression of hepatic growth factor ( HGF) and its receptor c-met mRNA in rats' liver tissues were tested by semiquantitative RT-PCR. The expressions of proliferating cell nuclear antigen (PCNA) in rats' liver tissues were determined by immunohistochemistry staining. Results The areas of collagen in normal group, model group, BDLSC group and gene transfected group was 0. 12% ± 0.03%, 14. 49%±1.40%, 8. 25%±0. 82% and 5. 12%±0. 40% accordingly, there were significant differences between groups (P<0. 05). Compared with model group and BDLSC group, the liver function of gene transfected group significantly improved, the serum levels of hyaluronic acid (HA),procollagen Ⅲ (PCⅢ) and the content of hydroxyproline in liver tissues decreased dramatically. The expression of HGF and c-met at mRNA levels were up-regulated significantly, and the expression of PCNA protein in liver tissues increased obviously. Conclusion uPA gene-modified BDLSC transplantation may induce proliferation of hepatocytes, and then improve the liver functions of fibrotic rats induced by CCl4.

Objective To observe the clinical effect of peroutaneous ethanol injection therapy (PEIT) of parathyroid gland guided by color ultrasound on dialysis patients with secondary hyperparathy-roidism. Methods Percutaneons ethanol injection therapy (PELT) was used for seven patients who suf-fered from secondary hyperparathyroidism, and systemic perioperative nursing care and relative health edu-cation were applied. Results All patients had obtained successful operation without any operative sud-denness or associated complications,Patients" serious scratching and bone ache was obviously relieved.Conclusions Treatment with PEIT and effective nursing to patients suffered from secondary hyper-parathyroidism can reduce the complications, and than improve the quality of live for patients.

Objective To observe the impacts of different storage temperatures on the activities of adipose tissues and the extraction and proliferation of adipose-derived stem cells (ADSCs) situated in harvested fat.Methods Adipose tissues obtained by liposuctions in healthy females were kept in different temperature;all groups of adipose tissues were studied in context of the histomorphology and activity of GAPD as well as the extraction efficiency and proliferation of ADSCs.Results Adipose tissues cryopreserved at 4 ℃ within 24 hours could retain their activities effectively,but their activities would decrease rapidly if they preserved at room temperature.The efficiency of adipose tissues extracting stem cells and their proliferations were affected by storage temperatures and times.If adipose tissues were preserved at room temperature for over 1 hour,the extraction efficiency and proliferation of their ADSCs would be lower significantly.Conclusions Adipose tissues cryopreserved at 4 ℃ can effectively ensure their activities and their extraction efficiency and proliferation of ADSCs.It is important to preserve adipose tissues at low temperature after harvesting fat graft.

Objective To investigate the efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi (PRT) and erythrocyte-rich thrombi (ERT) in different ages.Methods PRT and ERT in different ages were prepared both in vitro and in vivo of common carotid artery in rats.All the participants were divided into 8 groups with 4 in vitro and another 4 in vivo experiment,including PRT 3 h,PRT 24 h,ERT 3 h,ERT 24h in vitro groups and PRT 3 h,PRT 24 h,ERT 3 h,ERT 24 h in vivo groups.Microbubble-enhanced sonothrombolysis was carried out in both in vitro and in vivo experiments,and the ultrasonic images were collected.The components of PRT and ERT were identified by histopathological examination.The percentage increase of luminal cross sectional area and lytic ratio in vitro,and the recanalization rate and mean blood flow velocity of common carotid artery in vivo were mainly analyzed.Results After sonothrombolysis,both in vitro and in vivo experiment showed there was no statistically significant difference of the percentage increase of luminal cross sectional area ([121.12 ± 13.21]％ vs [130.09 ± 15.34]％),lytic ratio ([39.83± 7.09]％ vs [42.14±5.17]％),recanalization rate (83.33％ vs 91.67％) and blood flow velocity of common carotid artery ([0.21±0.02]m/s vs [0.22±0.01]m/s) between PRT 3 h group and ERT 3 h group (both P＞0.05).PRT 24 h group compared with EPR 24 h group,PRT 24 h group compared with PRT 3 h group,as well as ERT 24 h group compared with ERT 3 h group,the percent increase of luminal cross sectional area,lytic ratio,recanalization rate and blood flow velocity of common carotid artery reduced (all P＜0.05).Conclusion The efficacy of microbubble-enhanced sonothrombolysis on PRT and ERT in vitro and in vivo of of rat common carotid artery model decrease with the increase of thrombus age,especially for the PRT.

Objective To explore the association of CD40 gene single nucleotide polymorphisms (SNPs) and haplotypes with the susceptibility to systemic lupus erythematosus (SLE),as well as the association of serum levels and genotypes of CD40 with the occurrence of SLE.Methods A multiplex PCR single-base extension assay (PCR-SBE) and DNA sequencing were performed to analyze 4 SNPs of the CD40 gene,including rs1883832 C/T,rs13040307 C/T,rs752118 C/T and rs3765459 G/A,in 205 patients with SLE (SLE group) and 220 healthy human controls (control group).Enzyme-linked immunosorbent assay (ELISA) was conducted to measure serum levels of CD40 in these subjects.Results Compared with the control group,the SLE group showed significantly increased serum levels of CD40 (P ＜ 0.05).There were significant differences in genotype and allele frequencies of the SNP rs1883832 C/T in the CD40 gene between the SLE group and control group (all P＜ 0.01).Relative risk analysis showed that the risk of developing SLE in rs1883832 T allele carriers was 1.517 times that in rs1883832 C allele carriers (OR =1.517,95％ CI:1.157-1.990,P=0.003).Moreover,serum levels of CD40 were significantly higher in rs1883832 T allele carriers than in rs1883832 C allele carriers (P ＜ 0.01).The risk of developing SLE was significantly increased in TCCA haplotype carriers compared with the healthy controls (OR =2.322,95％ CI:1.181-4.564,P=0.012).Conclusion The CD40 gene rs1883832 C/T polymorphism and its TCCA haplotype were both associated with the occurrence of SLE,and the rs1883832 T allele may be a gene predisposing to SLE.