Objective To observe the analgesic effects of dexmedetomidine combined with dif-ferent-doses of sufentanil in patients undergoing spine surgery.Methods Sixty patients(ASA grade Ⅰor Ⅱ degree,age 18-70 years)undergoing spine surgery were randomly assigned into three groups ac-cording to PCA formulation(n =20):3 μg/kg sufentanil group (group S1),1.5 μg/kg dexmedetomi-dine+ 2 μg/kg sufentanil group (group S2 )and 1.5 μg/kg dexmedetomidine + 1 μg/kg sufentanil group (group S3).The same anesthesia method was applied among three groups.Patient-controlled intravenous analgesia pump was applied before 30 minutes prior to the end of surgery.The drugs in each group were diluted to 1 50 ml and infused by a pump at a rate of 3 ml/h with a patient-controlled analgesia (PCA)bolus of 0.5 ml and lock time of 30 minutes.VAS and Ramsay scores at 2 h(T0 ),4 h (T1 ),8 h(T2 ),12 h(T3 ),24 h(T4 )and 48 h(T5 )after surgery were estimated.Postoperative nausea and vomiting,bradyrhythmia and hypersomnia were also recorded.Results Compared with group S1, VAS of groups S2 and S3 was significantly decreased at T1-T5 (P <0.05).There were also no signifi-cant difference in the incidence of postoperative nausea and vomiting,bradyrhythmia and hypersomnia among three groups.Conclusion Dexmedetomidine of 1.5 μg/kg can significantly reduce the dosage of sufentanil on postoperative analgesia in patients undergoing spine surgery,and decrease the rate of postoperative nausea and vomiting without any bradyrhythmia and hypersomnia.

Objective To investigate the clinical features of capillary leakage syndrome ( CLS ) occurring in critically ill newborns in Guangzhou. Methods Three tertiary hospitals in Guangzhou were chosen as research field;critically ill newborns with diagnosis as CLS in NICU of three hospitals were retro-spectively studied from January 2011 to December 2015; and the morbidity,mortality,causes,treatment and outcome of CLS neonates were analyzed. Results There were 49 cases diagnosed as CLS, accounting for 1. 62%(49/3 029)of the total number of critically ill newborns admitted to NICUs in the same period. The common primary factors were preterm low birth weight(34 cases,69. 4%),respiratory distress syndrome(38 cases,77. 5%),congenital anomaly(19 cases,38. 8%),asphyxia(17 cases,34. 7%),and intrauterine infec-tion(12 cases,24. 5%). The 83. 7%(41/49) of CLS occurred within 72 hours after admission. The overall mortality of CLS was 30. 6%( 15/49 ) . The main lethal cause was multiple organ dysfunction syndrome (60. 0%,9/15). Treatment included antibiotics,vasoactive drugs,fluid resuscitation,corticosteroids,and me-chanical ventilation. Conclusion CLS is a common critical illness in NICU with high mortality and poor prognosis. Early prediction and early intervention could improve survival and prognosis in critically ill neonates with CLS.

OBJECTIVETo study the major risk factors and characteristics of Schistosoma japonicum in the newly identified areas around the Dong Ting Lake.

METHODSData was collected regarding the distribution of snails, prevalence of infection as well as the source of transmission in the newly identified areas in Hunan province from 1979 to 2003.

RESULTSIn all the newly identified sites, Schistosomiasis japonica patients appeared to be the first-seen evidence, some even under acute phase. The highest infection rate among residents had reached 87.1% in the newly identified villages. Most of the new endemic areas concentrated in the ditch and beach areas that close to cities and towns.

CONCLUSIONSEvidence showed that snails had been transferred through boats and fishing nets to be disseminated. Data also revealed that the sources of transmission would include those local infected residents who had been infected in the old endemic areas and the newly imported domestic animals with infection.

Adolescent ; Adult ; Animals ; Cattle ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Disease Reservoirs ; Female ; Health Education ; Humans ; Male ; Middle Aged ; Prevalence ; Schistosomiasis japonica ; epidemiology ; prevention & control ; Snails ; parasitology

Adult ; Aged ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Male ; Neoplasms, Multiple Primary ; diagnosis ; therapy ; Thyroid Neoplasms ; diagnosis ; therapy

ABSTRACT:Objective To explore the changes of serum cytokine interleukin-17 (IL-17)in patients with chronic hepatitis B of different clinical types and its clinical significance.Methods We selected 30 cases of mild chronic hepatitis B,34 cases of moderate one,29 cases of severe one,38 cases of liver cirrhosis,and 21 cases of acute on chronic liver failure.Another 30 cases over the same period served as the healthy control group.Cytokine IL-1 7 level in peripheral blood was detected in each group,and all the groups except the control group were detected for liver function and HBV-DNA.These related serum markers were detected and the results were statistically analyzed.Results ① IL-17 in the peripheral blood was (8.103±2.061)ng/mL in healthy control group;(25.551 ±7.078)ng/mL,(45.442±18.358)ng/mL and (75.378±19.05)ng/mL in the groups with mild,moderate and severe chronic hepatitis B;and (97.16±17.066)ng/mL in acute on chronic liver failure group.Its levels gradually increased with the severity;and there were significantly different among the five groups and between every two groups (P<0.01).The peripheral blood level of IL-17 was (8.103±2.061)ng/mL in the healthy control group, (34.517±8.905)ng/mL in compensatory cirrhosis group,and (45.615±15.623)ng/mL in the decompensated cirrhosis group.These three groups had pairwise comparison,and the difference between every two groups was significant (P<0 .0 1 ).The peripheral blood level of IL-1 7 in the decompensated cirrhosis group increased compared with that in the compensatory group.③ In the 1 5 2 cases detected,serum IL-1 7 level and serum ALT,AST,TBIL,HBV-DNA levels were positively correlated,and serum PTA had negative correlation with the level of IL-1 7 .④ In the 2 1 cases of acute on chronic liver failure,the peripheral blood level of IL-1 7 did not significantly differ between antigen-e positive and negative groups (P=0.654).⑤ In 21 patients with chronic on acute liver failure,the level of IL-1 7 in peripheral serum and MELD scores showed a positive correlation by Pearson correlation analysis (r=0.533,P=0.013).Conclusion In patients with chronic hepatitis B,the level of IL-17 in peripheral serum increased with disease severity.Moreover,the level of IL-1 7 in peripheral blood may play a role in promoting the progression of cirrhosis and the development of acute on chronic liver failure.

Objective To detect the change of cerebral perfusion in pediatric patients with Leigh's syndrome (LS)by using MR perfusion technique.Methods Twelve patients with Leigh's syndrome and thirteen normal children were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T_1 measurement (FAIREST).Their relative cerebral blood flow(rCBF)values were obtained in regions of bilateral basilar nuclei and bilateral thalami.Student t-test was used to compare them between the two groups and receiver operating characteristic(ROC)curve analysis was carried out.Results Statistical analysis revealed significant difference between two groups in the regions of bilateral basilar nuclei and right thalamus(t =3.26,P =0.002;t =2.25 ,P =0.018 ;t =2.88 ,P =0.004,respectively).The rCBF values for LS group and control group were 0.432?0.158 and 0.619?0.125 for right basilar nuclear, 0.478?0.186 and 0.621?0.123 for left basilar nuclear,0.630?0.189 and 0.833?0.160 for right thalamus,respectively.The areas under the ROC curves were 0.833 and 0.756 for the rCBF of right and left basilar nuclear,respectively.Conclusion Relative CBF maps may reveal changes of cerebral blood flow in some specific brain regions in patients with Leigh's syndrome.It can provide additional information to the clinicians in the evaluation of the disease.

OBJECTIVETo analyze the structure of bacteria in drinking water by molecular biological techniques.

METHODSDNA of bacteria in drinking water was directly extracted without culture. 16S ribosomal DNA fragments, including V-6, -7, and -8 regions, were amplified with universal primers (EUBf933GC and EUBr1387) and analyzed by DGGE.

RESULTSDGGE indicated that amplification products could be separated. The results showed that DGGE could be used in the separation of different microbial 16SrRNA genes extracted from drinking water. Though there were special bacteria in different water samples, the predominant bacteria were essentially the same. Three sequences of the reclaimed specific bands were obtained, and phylogenetic tree of these bands was made.

CONCLUSIONBacterial diversity in drinking water is identified by molecular biological techniques.

Bacteria ; enzymology ; Biodiversity ; Electrophoresis, Agar Gel ; methods ; Polymerase Chain Reaction ; methods ; RNA, Ribosomal, 16S ; analysis ; Water Microbiology

ObjectiveTo evaluate the safety, and the brief-and prolongedterm therapeutic efficacy for im- plantation of biodegradable stent Excel combined with Tirofiban made in China into patients with acute coronary syndrome(ACS). MethodA total of 301 patients were divided into Excel group (n = 100), Cypher group (n =102) and bare metal stem(BMS) (n = 99). The Tirofiban used in three groups was administered intravenously during and after operation.The loading dose of Tirofiban was 10 μg/kg given within 3 min followed by a Tirofiban intravenous maintenance infusion in 0.15 μg/(kg·min) with micro pump for 48 hours. Safety and efficacy were compared among three groups after stents implantation by the observation of TIMI flow, complication of bleeding, changes of platelet count, haematoglobin and hematocrit, incidence of angina, acute and subacute thrombosis inner stent and major adverse cardiac events (MACE) (cardiac death, nonfatal myocardial infarction and target ves-sel revascularization). Follow-up information got from out-patient clinic and telephone call including incidence of angina, MACE and rehospitalization were comapared sucessively 1 month, 6 monthes and 12 monthes after dis- charge. ResultsAmong there groups,there were no significant differences in demographics,and physical and lab-oratory findings before treatment. Successful rate of implantation was 100 percent and the TIMI flow of class Ⅲ was found in all patients. There was no complication of stroke and massive hemorrhage of gastrointestinal tract, and no significant differences in complication of bleeding, platelet count, hemoglobin and hematocrit after implantation. Incidence rates of acute thrombosis were 0, 0.98 and 1.01 percent in three groups, and there was no significant difference in acute thrombosis inner stent among three groups (P >0.05). The rates of angina, sub.acute stent thrombosis, MACE and rehospitalization among three groups had no differences at 1 month and 6 monthes follow-up (P > 0.05), but significant differences were not found until 12 monthes follow-up (P < 0.05). Conclusions Drug-eluting stent Excel with biodegradable polymer combined with Tirofiban made in China implanted in patients with ACS were capable of preventing acute and later thrombosis inner stent. This procedure had favourable safety, and brief-term and proionge-term therapeutic efficacy.

OBJECTIVETo simulate the chemical microenvironment of injured brain tissue, and to explore the effect of this chemical microenvironment on temperature sensitive umbilical cord mesenchymal stem cells (tsUC).

METHODSRat models of traumatic brain injury (TBI) were made by fluid percussion injury, and then the brain tissue extracts of the injured regions were acquired. Human umbilical cord mesenchymal stem cells (UC) were isolated and cultured, and the tsUC were obtained through the infection of temperature-sensitive Simian 40 Large T- antigen (ts-SV40LT) retrovirus. After that, both the two kinds of cells were cultured on the polyacrylamide gels which mimicking the elastic modulus of brain. Four groups were included: UC cultured under normal temperature (UC group), UC cultured added brain tissue extract under normal temperature (UC plus extract group), tsUC cultured under mild hypothermia (tsUC group), and tsUC added brain tissue extract under mild hypothermia for 3 days, then normal temperature for 4 days (tsUC plus extract group). After 24 hours, the apoptosis level was checked. Cell growth and morphological changes in each group were given dynamic observation. Seven days later, cell immunofluorescences were implemented for examining neural differentiation level.

RESULTSCompared with UC plus extract group, the apoptosis and proliferation in UC plus extract group were significantly reduced (P < 0.01) and increased (P < 0.01) respectively. Cell immunofluorescence showed that the both GFAP and Neuron positive cells were significantly enhanced in UC plus extract group than those in tsUC plus extract group.

CONCLUSIONtsUC combining with mild hypothermia could significantly reverse injury induced cell apoptosis, improve cell proliferation and neural differentiation under chemical microenvironment after brain injury, which confirmed the adaptation and resistance of tsUC under mild hypothermia after TBI.

Animals ; Apoptosis ; Brain ; cytology ; pathology ; Brain Injuries ; pathology ; Cell Proliferation ; Humans ; Mesenchymal Stromal Cells ; chemistry ; Neurons ; cytology ; Rats ; Temperature ; Umbilical Cord ; cytology

OBJECTIVETo investigate the effects and prognosis of surgical treatment in primary gastrointestinal stromal tumors (GIST).

METHODSThe clinicopathological data of 73 patients with primary GIST underwent operation from April 1997 to December 2007 was retrospectively analyzed, and the prognosis was evaluated too.

RESULTSAmong the 73 cases, 68 cases received complete tumor resection, among which 12 cases underwent laparoscopic operation; while palliative resection and biopsy only were carried out in the other 5 cases. There was significant difference in survival rate between the two groups (P = 0.000). The 1-, 3-, 5-year survival rates of the 66 cases had been followed up was 91.0%, 78.2% and 74.1%, respectively. The malignancy risk grades of GIST was related to the survival rates on statistical analysis (P = 0.002). Significant differences were found in the survival rates between the patients with very low grade, low grade and high grade malignancy tumors (P = 0.012, 0.002).

CONCLUSIONSComplete tumor resection should be emphasized in primary GIST, and more attention should be paid to the initial surgical treatment. Extended surgical resection is required for tumors of higher malignancy risk. The indications of laparoscopic surgery in GIST should be selected with caution for tumor complete resection.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis