The striatum is involved in diverse behaviors which depend on intact dopaminergic innervation. Recent electrophysiological studies have revealed that dopamine alters both voltage dependent conductances and synaptic transmission, resulting in state dependent modulation of target cells. This review makes clear predictions about how dopamine should alter the responsiveness of striatal neurons to extrinsic excitatory synaptic activity.

Prostate cancer is the most prevalent malignancies in elderly men. At present, gene therapy is the most po-tential treatment for late-stage prostate cancer. However, virus vector or nonvirus vector are less safety, weaker targeting function and higher immunogenic. Ultrasound microcapsular contrast agent as a drug transporter is a new type of disease tar-geted treatment strategies. It has provided a high-targeted, an effective and a safety gene therapy for prostate cancer, and brings a new hope for late-stage prostate cancer patients. This article aims to summarize the recent progress in using the mi-crobubble technology in prostate cancer.

Objective Adult isolated ACTH deficiency ( IAD) is an uncommon and underestimated disorder with high rate of misdiagnosis.This paper aimed to analyze and summarize the clinical features of 6 patients with IAD to have deeper understanding of the disease. Methods Retrospective analysis was made on the data of 6 IAD cases enrolled in Nanjing Hospital of Nanjing Medical University from 2007 to 2015.Statistical analysis was made on the clinical manifestations, therapeutic schemes, laboratory and imaging results, along with outpatient follow-up(ranging from 0.5-10 years), in order to analyze clinical efficacy and prognosis result. Results Of 6 IAD patients, 4 patients showed main symptoms of long-term fatigue, anorexia, weight loss;5 patients were with differ-ent degrees of hypoglycemia (fasting blood glucose2.70 [1.2-3.0]mmol/L), among which 3 had hypoglycemic coma (fasting blood glucose <1.8mmol/L), 1 had chronic hypoglycemia and 1 had asymptomatic hypoglycemia( asymptomatic hypoglycemia by continu-ous glucose monitor system).4 of them had refractory hyponatremia (Serum Na+117 [110-120]mmol/L).ACTH values of all the patients were less than 0.01ng/L.After glucocorticoid replacement therapy, all the patients were followed up for six months after treat-ment and cortisol rhythm, plasma cortisol, urine cortisol, fasting blood glucose, serum sodium of the patients were in normal range, but still at a low level of ACTH. Conclusion The clinical manifestation of IAD is characterized as hypoglycemia, hyponatremia, low ACTH with other normal pituitary hormones.Long-term glucocor-ticosteroid therapy has favorable prognosis for patients with adult isola-ted ACTH deficiency.

Objective To compare the effects of propofol intravenous balanced anesthesia with infusion of remifentanil combined with fentanyl to simple infusion of remifentanil or fentanyl during laparoscopic cholecystectomy(LC).Methods Sixty patients scheduled for LC were randomly divided into three groups(n=20): simple remifentanil group(R),remifentanil combined with fentanyl group(RF) and simple fentanyl group(F).Mean arterial pressure(MAP),heart rate(HR) and SpO2 during the anesthesia induction phage,maintenance phage and analepsia phage,the recovery time of spontaneously breathing and consciousness from withdrawal,extubation time,pain score(verbral report score,VRS) and conscious state score(observers assessment of alertness/sedation scale,OAAS) at instant,1 h,3 h,7 h,12 h after extubation and complications of analepsia phage were recorded.Results As compared with the RF Group,the F Group and pre-induction intro-group,the R Group showed lower MAP and quicker HR when induction intubation,higher MPA and quicker HR after operation,and no obvious difference in maintenance phage was found.MAP and HR showed no obvious difference between the RF and F Group as well as within groups in induction and maintenance phage.MAP increased and HR became quicker in the RF Group when extubating and leaving operating room.All observed index at every time showed no significant differences between the R and RF Group after operation,but it prolonged significantly in the F Group.Complications of the three groups showed no statistical difference.VRS of the R Group was significantly higher than that of RF and F groups after operation(P

This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.

Objective To investigate the effects of parecoxib and morphine on remifentanil-induced postoperative hyperalgesia in patients undergoing orthopedic operation. Methods Sixty ASA Ⅰ or Ⅱ patients,aged 20-62 yr, weighing 45-100 kg, undergoing orthopedic surgery, were randomly divided into 3 groups ( n = 20 each). Anesthesia was induced with midazolam, propofol, remifentanil and rocuronium. The patients were mechanically ventilated after tracheal intubation. Group Ⅰ received iv injection of morphine 0.15 mg/kg, group Ⅱ received iv injection of parecoxib 20 mg and morphine 0.075 mg/kg and group Ⅲ received iv injection of parecoxib 40 mg and morphine 0.075 mg/kg. Anesthesia was maintained with infusion of propofol and remifentanil and intermittent iv boluses of vecuronium. The emergence time, consciousness recovery time, extubation time,incidence of agitation and shivering, and VRS score at 5 min after recovery of consciousness were recorded. Pain at rest and at movement was evaluated using VAS score at 1,2, 4, 8, 12 and 24 h (T1-6) after surgery and MAP andHR were recorded simultaneously. The incidence of nausea and vomiting during 24 h after surgery was also recorded. Blood samples were taken before induction of anesthesia, at the end of operation and 24 h after operation for determination of plasma concentrations of PGE2 and TNF-α. Results There was no significant difference in emergence time, consciousness recovery time, extubation time, VRS scores, MAP, HR, incidence of agitation,shivering, nausea and vomiting among the 3 groups. Compared with group Ⅰ , VAS scores at rest at T1-2 and at movement at T1-6 were significantly increased in group Ⅱ , while VAS scores at rest and at movement decreased at T1-5 in group Ⅲ (P＜0.05). VAS scores at rest at T1-6 and at movement at T1-5 were significantly lower in group Ⅲ than in group Ⅱ (P＜ 0.05). There was no significant difference in the plasma concentrations of PGE2 and TNF-α at different time points between group Ⅰ and Ⅱ (P＞0.05). The plasma concentrations of PGE2 and TNF-α were significantly lower at the end of surgery in group Ⅲ than in group Ⅰ and Ⅱ (P＜0.05). Conclusion Preoperative iv parecoxib 40 mg and morphine 0.075 mg/kg can reduce remifentanil-induced postoperative hyperalgesia in patients undergoing orthopedic operation, and the efficacy is better than that of morphine alone.

Adolescent ; Alleles ; Asian Continental Ancestry Group ; genetics ; Erythropoietin ; genetics ; Ethnic Groups ; genetics ; Female ; Genotype ; Humans ; Male ; Polymorphism, Single Nucleotide ; Young Adult

AIM: To observe the effect of microRNA-16 (miR-16) on the megakaryocytic differentiation of K562 cells, and to explore the potential mechanism.METHODS:miR-16 was over-expressed or silenced by transfection with miR-16 mimics or inhibitor in K562 cells.The level of miR-16 was detected by real-time PCR.The expression of CD41, CD42b and CD61, as megakaryocytic differentiation markers, was detected by flow cytometry.The effect of miR-16 on the expression of myeloblastosis oncogene ( MYB) was measured by Western blotting, and flow cytometry was performed to confirm whether the effect of miR-16 on expression of CD41, CD42b and CD61 was mediated by MYB.RESULTS:Transfection with miR-16 mimics dramatically elevated the level of miR-16 and the expression of CD41, CD42b and CD61 in the K562 cells.Transfection with miR-16 inhibitor decreased the level of miR-16 and the expression of CD41, CD42b and CD61 in the K562 cells (P<0.05).The expression of MYB was regulated by miR-16, and MYB silencing reversed the regulation of CD41, CD42b and CD61 induced by miR-16.CONCLUSION:miR-16 regulates the megakaryocytic dif-ferentiation of K562 cells by targeting MYB.

Objective To investigate the pelvic floor in cystocele patients using translabial ultrasound,and discuss the ultrasound appearance.Methods Translabial 2D ultrasound was performed on 136 patients who were diagnosed or suspected as anterior vaginal wall prolapse or cystocele using pelvic organ prolapse quantitation system,the position of bladder,the retrovesical angle and urethral rotation were measured during maximum Valsalva maneuver.Cystocele subtypes were diagnosed according to the ultrasound findings.Results Translabial 2D ultrasound diagnosed 88 cases cystocele based on the position of bladder,retrovesical angle and urethral rotation,including ten cases cystocele type Ⅰ,32 cases type Ⅱ and the remaining 46 classified as type Ⅲ.Conclusions Translabial 2D ultrasound successfully acquired the ultrasonic characteristics of cystocele subtypes,which could provide imaging evidence for clinic diagnosis of this disease.

Teaching the foreign students clinical medicine in English in the earlier period of foreign students education has played a vital role but also has such problems as teachers,difficulties in the later teaching and so on.Through practice we find that it is necessary to transit the mode from teaching in English to bilingual education,and finally teaching in Chinese in the internship to conform with the present medical foreign students education situation.Therefore ability of teaching in English and proficiency in Chinese are needed to improved as soon as possible.