The use of genetic approaches to probe relative genes that control sensitivity to volatile anesthetics in intact model has recently emerged as the powerful tools and strategies in dissecting mechanisms of anesthesia. Multiple model organisms such as yeast, nematodes, fruitflies and mammals are currently being exploited, and a number of sensitive genes have been screened, with some of them being cloned, located, and function identified. The emerging technologies are likely to provide further great advances for elucidating the specific anesthetic molecular sites.

G1.(3)Among 5 groups,the highest incidences of nausea,vomiting and pruritis were observed in group G1 for about 24% 32%,but with no statistical difference compared with other groups.Conclusion: With equal doses of bupivacaine and fentanyl mixed,the concentration/volume ratios may affect the analgesic effects of postoperative epidural analgesia in patients with hepatectomy.

Understanding and learning the up-date clinical information of evidence-based medicine are the important part of knowledge for clinical postgraduates and are the basic ability required in their future clinical work.The necessity and role of literature retrieval course were studied with meta analysis of literature retrieval course teaching as the core content,and with meta analysis of literature retrieval course teaching as the writing objective.The literature retrieval course teaching process was displayed by demonstrating the case design and analysis,retrieval methods and their implementation in different stages of literature retrieval course teaching.

Objective To assess the left ventricular(LV) regional myocardial systolic function after bone marrow mesenchymal stem cells (BMSCs) injection in rabbits with acute myocardial infarction(AMI) by 2-dimensional ultrasound speckle-tracking imaging.Methods Twenty-four healthy rabbits were randomly divided into three groups:group of sham-operated,group of masculine control (AMI was induced by ligation of left anterior descending coronary artery),and group of cell infusion(after two weeks of AMI,bone marrow mesenchymal stem cells were injected to the region of AMI).Four weeks after cell deliver two-dimensional strain images were acquired from LV short-axis view(at the levels of mitral annulus,muscle papillary and apex),radial strain rate (SrR),circumference strain rate (SrC),rotation rate (RotR) and rotation (Rot) of three levels in short-axis views were measured by speckle-tracking imaging.The conventional echocardiography indices included LV diameter of end diastole(LVEDd),LV ejection fraction(LVEF),LV fractional shortening(LVFS).The catheter indices included LV systolic pressure(LVSP),LV end diastolic pressure (LVEDP)and maximum rate of rise and descend of LV pressure(LVdp/dtmax).ResultsCompared with sham-operated group,rabbits had significantly larger LVEDd,lower LVEF and LVFS,lower LVSP and LVdp/dtmax,higher LVEDP in control group,SrR,SrC,RotR and Rot of LV anterior regional myocardial function and global myocardial function of three levels in short-axis views were lower.Compared with control group,the rabbits had significantly smaller LVEDd,larger LVEF and LVFS,larger LVSP and LVdp/dtmax,lower LVEDP,SrR,SrC,RotR and Rot of LV anterior regional myocardial function and global myocardial function of three levels in short-axis views were larger in group of cell infusion.There was no significant between group of cell infusion and group of sham-operated.Conclusions Speckle tracking imaging can evaluate the regional myocardial systolic function of the area of BMSCs transplantation accurately.

Objective To study the changes of left ventricular structure and function after transcatheter closure of atrial septal defect(ASD)by strain rate(SR)imaging.Methods Twenty-eight patients with secundum type ASD were undergone transcatheter closure.Left and right ventricular end-diastolic diameter(LVED and RVED),left ventricular ejection fraction(LVEF),the Doppler transmitral filling velocities(E values and A values)and tricuspid regurgitation pressure were measured respectively at pre-operation,3 days,1 month and 3 months of post-operation.According to tricuspid regurgitation pressure,systolic pulmonary artery pressure(SPAP)was estimated.SR curves in all segments of left ventricular walls were acquired for all patients.The SR values including the peak of systolic SR,early-diastolic SR,late-diastolic SR were measured respectively.ResultsAfter operation,LVED,LVEF,E values and A values increased significantly while RVED and SPAP decreased.Almost all left ventricular walls' SR increased at post-operation except that SR of interventricular septeum(IVS)and left ventricular post wall(LVPW)decreased at 3 days,1 month of post-operation.Conclusions LV systolic and diastolic function are improved after operation,but SR characteristic changes of IVS and LVPW is the one of the most unique characters.

Objective To investigate the relationship between matrix metalloproteinase-9 (MMP-9) gene-1562 C/T polymorphism and hemorrhagic transformation (HT) from (IS) in Chinese Han population in Henan province.Methods The promoter-1562 C/T gene polymorphism in 84 IS patients with HT and 138 age-and sex-matched IS patients without HT were tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The genotypes and alleles frequencies of-1562 C/T polymorphism were analyzed.Results The frequency of CT and TT genotype and T allele was lower in IS patients with HT than in IS patients without HT (17.86％ (15cases) vs.30.43％ (42 cases),8.93％ (15 cases) vs.15.94％ (44 cases),x2=4.326 and 4.458,P=0.037 and 0.035).The relative risk for HT from IS was decreased in patients with T allele than those withCTandTTgenotype[0.517 (95％CI:0.278-0.961) vs.0.497 (95％CI:0.255-0.967)].Conclusions The MMP-9 gene-1562C/T polymorphism may be related to hemorrhagic transformation of in Chinese Han population in Henan province.The T allele is a protective factor for hemorrhagic transformation of in the population.

Objective·To investigate factors affecting the prognosis of aged esophageal cancer patients after esophagectomy.Methods·Clinical data of 103 aged patients (≥ 80 years old) undergoing esophageetomy were collected.Effects of age,sex,clinical manifestations,pre-operative diseases,post-operative complications,T stage,lymph node metastasis,maximum diameter and location of the tumor,and surgical methods on the post-operative survival were analyzed.Results·1,3,and 5 years survival rates of 103 patients were 63.2％,15.9％,and 2.7％,respectively.Kaplan-Meier survival curve analysis indicated that the post-operative survival was significantly higher in patients with T1 and T2 stages than in patients with T3 stage.The 3 and 5 y survival rates of patients with T 1 stage were 50％ and 25％,respectively.Results of Cox regression multivariate analysis showed that T stage,maximum diameter of tumor,postoperative complications,and lymph node metastasis were independent factors affecting the post-operative survival.Conclusion·Esophageal cancer patients aged over 80 years with smaller tumor diameters,less postoperative complications,and negative lymph node metastasis have a longer post-operative survival period.Esophagectomy for patients with earlier stages (T1 and T2) can achieve an ideal post-operative survival period.

Objective To investigate the awareness,willingness,motivation,and influencing factors of outpatients for participating drug clinical trials,and provide references for decision-making of drug clinical trials.Methods An amnonymous survey was conducted in the departments of internal medicine,surgery,gynecology,and obstetrics of a randomly selected tertiary referral center,and the results were statistically analyzed.Results A total of 1 067 available questionnaires were received.The total awareness rate of clinical trials was 31.02％,which was closely correlated with age and the degree of education.40.86％ of respondents were willing to participate in drug clinical trials.And 55.28％ of them chose yes because of the willingness to contribute to the development of medical science.People having cognition on clinical trials had more willingness to participate in drug(OR:1.361,95 ％ CI:1.042-1.777).59.14％ of the respondents refused to participate in drug clinical trials,68.62％ of whom refusing to participate mainly worried about the safety of drugs.57.37％ of the respondents comfirmed that they might change their idea if experts were involved.41.33％ were willing to accept training about clinical trials.Conclusion Investigators'overall cognition on clinical trials is closely correlated with the willingness to participate in drug clinical trials.There should propagandize drug clinical trials to make sure the improvement of drug clinical trial progress.

Objective To investigate the application of parametric quantification (PQ) with targeted microbubbles on angiogenesis after stem cell transplantation in rabbits with myocardial infarction.Methods A CD34-targeted microbubble was prepared.Acute myocardial infarction (AMI) model were established by ligating coronary artery in 80 New Zealand white rabbits.Rabbits in common microbubble group (T + C group) and CD34-targeted microbubble group (T + T group) were subjected to myocardial contrast echocardiography(MCE),then compare myocardial perfusion parameters (A,β and A × β values) pre- and 3d post- ligation and 4 weeks after stem cell transplantation.Microvessel density (MVD) were determine by CD34 antibody immunohistochemistry.Results Compared to before stem cell transplantation,the perfusion scores ( P ＜0.05) and A,β and A× β values( P ＜0.01) of T+ C group and T+ T group were increased than before transplantation and control group.MVDs after stem cell transplantation in experimental groups were higher than those of control group ( P ＜0.01),especially the T + T group.A × β value in the T + C group was correlated with MVD ( r =0.658,P ＜ 0.05) ; β and A × β value in the T + T group were correlated with MVD ( r =0.620,0.859,P ＜0.05).A × β value ( X ) and MVD ( Y ) were included to establish the following regression equation:Y =- 130.986 + 34.505 X ( R 2 =0.556,P ＜ 0.05).Conclusions PQ and CD34-targeted microbubble probably provides some value in invasive evaluation of angiogenesis after stem cell transplantation.

Objective To estimate the safety and efficacy of submucosal tunneling endoscopic resection (STER) on treatment of large esophageal submucosal tumors (SMTs) originating from muscularis propria layer.Methods The data of patients with large esophageal SMTs (diameter ≥ 3.5 cm) undergone STER (n=17) or endoscopic submucosal dissection (ESD,n =15) at the Endoscopy Center of Tianjin Medical University General Hospital from December 2009 to March 2016 were retrospective analyzed.The therapeutic effects,hospitalization times,post-operation expenses,and occurrence of complications were evaluated and compared between the two groups.Results All the endoscopic treatments of the 32 patients were successfully completed.The operating time of the STER group was significantly longer than that of the ESD group (t =2.595,P =0.015).There was no statistical difference on the en bloc resection rate,complete resection rate and complication rate between STER group and ESD group (P＞0.05).The mean post-operative hospital stay of the STER group was significantly less than that of the ESD group (3.8± 1.0days VS 6.7±1.8 days,t=5.644,P=0.000).The mean hospital cost of the STER group was significantly less than that of the ESD group (22 456.1±5 232.0 yuan VS 27 392.5±5 747.9 yuan,t =2.543,P =0.016).The wound healing rates at 1 month after operation in the STER group was significantly higher than that of the ESD group [94.1％ (16/17) VS 20.0％ (3/15),P=0.000].No recurrence and metastasis occurred in the STER group and ESD group during the 41.2±20.6 months follow-up.Conclusion STER is a safe and effective technique for treating large esophageal SMTs originating from the muscularis propria layer,with earlier wound healing,shorter hospital stay and lower cost compared with those of the traditional method of ESD.