Objective To investigate the role of inducible nitric oxide synthase (iNOS) in reduction of myocardial ischemia-reperfusion (I/R) injury by sufentanil preconditioning in rats. Methods Thirty adult male SD rats, weighing 250-330 g, were randomly divided into 5 groups ( n =6 each): sham operation group (group S),I/R group, sufentanil preconditioning group (group SF), sufentanil preconditioning + a specific inhibitor of iNOS S-methyl thiourea (SMT) group (group SF+ SMT) and S-methyl thiourea group (group SMT). In I/R,SF,SF+SMT and SMT groups, myocardial I/R was produced by occlusion of left anterior descending coronary artery for 30 min followed by 120 min reperfusion. Group SF received 30 min infusion of sufentanil 120 μg/kg via caudal vein 24 h before ischemia. Group SF + SMT received infusion of sufentanil 120 μg/kg via caudal vein 24 h before ischemia and then SMT 10 mg/kg was injected 10 min before ischemia. In group SMT, SMT 10 mg/kg was injected 10min before ischemia. MAP and HR were recorded at 30 min before ischemia, at 30 min of ischemia and at the end of reperfusion. The rate-pressure product (RPP) was calculated. Arterial blood samples were obtained immediately at the end of reperfusion to determine the plasma concentration of NO. Then the animals were sacrificed and myo cardial tissues were obtained to determine the area at risk (AAR), infarct size (IS) and iNOS expression. IS/AAR was calculated. Results Compared with group S, MAP and RPP were significantly decreased, while IS/AAR was significantly increased at 120 min of reperfusion in the other four groups, and MAP and RPP were significantly decreased at 30 min of ischemia in I/R and SMT groups ( P ＜ 0.05). Compared with group I/R, no significant change was found in HR, MAP and RPP in SF, SF + SMT and SMT groups, and in IS/AAR and plasma NO concentrations in SF + SMT and SMT groups ( P ＞ 0.05), but IS/AAR was significantly decreased, and the plasma NO concentration and iNOS expression were significantly increased in group SF ( P ＜ 0. 05). Conclusion iNOS is involved in reduction of myocardial I/R injury by sufentanil preconditioning in rats.

Objective To evaluate the effect of remffentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing open heart surgery under CPB.Methods Thirty patients (ASA grade Ⅱ or Ⅲ, NYHA class Ⅰ or Ⅱ ) of both sexes aged 18-45 yr undergoing repair: of ventricular septal defect and/or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each): control group (group C)and remifentanil postconditioning group (group R). Anesthesia was induced with midazolam, sufcntanil, propofol and rocuronium. The patients received 5 min infusion of remifentanil at 4 μg · kg- 1 · min - 1 8 min before aortic unclamping in group R, while the patients received equal volume of normal saline in group C. Blood samples were obtained from the right internal jugular vein for determination of plasma concentrations of cardiac troponin-I (cTnI)and MDA and activities of CK-MB and SOD before induction of anesthesia (baseline) and at4, 8, 24 and48 h after aortic unclamping. Results The plasma concentrations of cTnI and MDA and activity of CK-MB were significantly lower, while the plasma SOD activity was significantly higher at 4 and 8 h after aortic unclmping, and the plasma concentration of MDA was significantly lower at 24 h after aortic unclamping in group R than in group C ( P ＜ 0.05 ). Conclusion Remifentanil postconditioning can attenuate myocardial I/R injury in patients undergoing open heart surgery under CPB through inhibiting lipid peroxidation.

Objective The functional relation between the correction angle and orthopedic force of scoliosis can be derived based on the force principle of scoliosis correction. The position and size of the orthopedic force with the best effect of spinal correction can be calculated to provide a theoretical calculation method for the application of orthopedic forces on scoliosis. Methods The coordinates of the scoliosis central axis were collected based on the computed tomography (CT) data of scoliosis. The spline curve of scoliosis was fitted using the MATLAB software. The scoliosis constitutive polynomial was obtained, and then, the scoliosis Cobb angle was calculated by programming. Based on the clinical medicine and experimental data of spinal biomechanics, a curved beam model was used for the correction calculation and analysis of scoliosis. Results The function relation between the orthopedic force and angle at any positions was derived at different orthopedic forces. The comprehensive elastic modulus of the spine was 0.29 MPa, as calculated by the function relation. Conclusions The calculation and analysis provided a reliable theoretical basis for the relationship between the loading position, size, and restoration angle of the orthopedic forces during scoliosis correction. For patients with different types of scoliosis, the function relation between the orthopedic angle and orthopedic force could be optimized to obtain the optimal orthopedic force and loading position.

Objective To investigate the endemic fluorosis of drinking water type in 3 counties in the northwest of Shandong Province,and to provide scientific basis for prevention and control of endemic fluorosis.Methods Seven villages in 3 counties of Ningjin,Xiajin and Wucheng were investigated to achieve the results including fluoride of drinking water,8-12 year-old children's dental fluorosis incidence rate,the fluoride of urine,prevalence of skeletal fluorosis by clinical and X-ray diagnosis in adults over 30-year old,and the bone mineral density.At the same time,set up a control point to detect the adult bone density in non-ward village of each investigated county,The water and urine fluoride were checked by selective electrode method,dental fluorosis was diagnosed by Dean method (WS/T 208-2011) and the diagnosis of adult fluorosis was performed in accordance with the diagnostic criteria of endemic fluorosis (WS 192-2008),and bone mineral density was measured by EXA-3000.Results The villages in Ningjin and Wucheng had finished defluoridation,where the water fluoride was at normal level.In the 7 villages,the total detection rate of 8-12 year-old children's dental fluorosis was 85.09％ (411/483),dental fluorosis index was 1.88;the dental fluorosis detection rate in Wucheng,Xiajin and Ningjin was 92.48％ (295/319),88.76％ (79/89) and 49.33％ (35/75),respectively,the difference was statistically significant (x2 =90.26,P ＜ 0.01).The average urine fluoride geometric mean of children (206) and adults (298) was 3.29 and 3.41 mg/L,respectively.The urine fluoride of Xiajin was the highest in the 3 counties,and the average urine fluoride geometric mean of the two groups was as high as 5.11 and 6.30 mg/L,respectively.The total detection rate of clinical and radiographic skeletal fluorosis in adults was 30.07％ (92/306) and 14.38％ (44/306),respectively.The osteoporosis detection rate of adults in endemic fluorosis area and non-endemic fluorosis area was 33.11％ (100/302) and 8.99％ (17/189),respectively.The difference was statistically significant (x2 =37.25,P ＜ 0.01);the average bone mineral density in endemic area and non-endemic area was 0.416 and 0.475 g/cm2,respectively,the difference was statistically significant (t =8.508,P ＜ 0.01).Conclusions The endemic fluorosis in the 3 counties in the northwest of Shandong Province is still existed.The defluoridation has not been completed in Xiajin County.Therefore,it is necessary to implement defluoridation measures of the drinking water as soon as possible and strengthen the water fluoride monitoring so as to prevent and control endemic fluorosis.

Objective To explore the clinical teaching effectiveness of LBL combination of PBL teaching mode in the intensive care unit. Methods The 2009-2010 cycle students 70 in the intensive care unit were randomly divided into control group and experiment group. Control group, the traditional LBL teaching;experimental group, LBL combined PBL teaching mode. Finally, different teaching effectiveness was evaluated by closed examinations and questionnaires. Results Examination total score, using the relevant sections of PBL teaching performance, comprehensive analysis of performance problems were significantly higher (P ＜ 0. 01 ),and training clinical thinking, theoretical understanding and promotion of memory, analytical ability,communication skills, team spirit of the experimental group students were significantly increased ( P ＜ 0. 05 or P ＜0. 01 ). Conclusions LBL combination of PBL teaching in the intensive care unit is feasible, effective and could help students improve overall quality.

Objective To investigate the prevalence of metabolic syndrome(MS)and its components among people aged over 15 years in Guangxi Zhuang Autonomous Region and to compare the difference between Zhuang and Han populations.Methods Adopting cluster sampling,a survey of diabetes mellitus was conducted in Guangxi from 2003 to 2005.A total of 27 240 subjects aged over 15 years with complete data,including background information of each individual,blood pressure,lipid profile,plasma glucose,blood uric acid and fasting insulin were analyzed in this study.The prevalence of MS and its components were analysed in Han and Zhuang Chinese in Guangxi.The criteria of International Diabetes Federation(IDF)in 2005 and the China Diabetes Society(CDS)in 2004 were applied for diagnosis.Results(1)The crude prevalence rates of MS according to IDF definition were 13.15%in total,12.41%in male and 14.11%in female respectively.The age- standardized prevalence rates of MS(according to the population composition in China in 2000)were 7.66%in total,7.26%in male and 8.81%in female.The crude prevalence rates of MS according to CDS definition were 10.75%in total,13.45%in male and 7.28%in female respectively and the age-standar-dized prevalence rates of MS were 5.9%in total,7.21%in male and 4.31%in female.The prevalence of MS in total,male and female was increasing with age(P

OBJECTIVETo explore the anatomical characteristics and surgical selections of upper lumbar disc herniation, and evaluate its clinical effects.

METHODSFrom January 2009 to January 2013, 26 patients with upper lumbar disc herniation were treated in our department. There were 16 males and 10 females, aged from 28 to 51 years old with an average of 45.7 years, 4 cases were in L₁,₂, 9 cases in L₂,₃, and 13 cases in L₃,₄. The data was collected including distance between outer edge of lower facet and the spinous process, the outer edge of the isthmus and spinous process, the lower edge of lamina and the upper edge of the intervertebral space, nerve root arising points and lower edge of the corresponding pedicle. Transforaminal discectomy and interbody fusion combined with pedicle screw fixation was performed in patients with L₁,₂, L₂,₃ herniated disk and 5 patients with L₃,₄ herniated disk complicated with lumbar instability. However another 8 patients with L₃,₄ herniated disk were treated with posterior fenestration decompression. Clinical effects were evaluated by Japanese Orthopaedic Association(JOA). The relative height rate(R) of the intervertebral space was measured preoperatively and 1 year postoperatively. The fusion of the bone graft was also observed.

RESULTSIntraoperative anatomical measurement was taken in all patients. All patients were followed up for more than 1 year with an average of 16 months, and all incisions got healing, JOA was improved from preoperative(10.13±1.49) points to last follow up (25.21±2.13) points with the improvement rate of 79.9%. Among the patients underwent fusion operation, 17 cases obtained bone fusion and 1 case maybe non fusion and no internal fixation failure was found;the R value was (0.231±0.056) mm preoperatively, however (0.345±0.076) mm at 1 year after operation with statistical difference(<0.05). In the patient underwent posterior fenestration decompression, the R value was(0.243±0.036) mm preoperatively, and (0.212±0.046) mm at 1 year after operation without statistical difference (>0.05). No spinal instability and lumbar disc herniation recurrence were found in these patients.

CONCLUSIONSAccording to the anatomical characteristics of L₁,₂ and L₃,₄ herniated disk, these patients could be treated with transforaminal discectomy and interbody fusion. The anatomical characteristics and clinical manifestations of L₃,₄ herniated disk is similar with the lower lumbar disc herniation, for the patients, an appropriate surgical method should be chosen according to the lumbar stability.

Background: With the development of assisted reproductive technology (ART) and its increasing success rate in the mainland of China, more attention has been paid to the safety of ART. In this study, we explored the associations between conception by ART and pregnancy/perinatal complications, and neonatal outcomes compared with similar outcomes following spontaneous conception. Methods: This retrospective cohort study of pregnancies over a 3-year period (2013-2015) was performed at Beijing Obstetrics and Gynecology Hospital, Beijing, China. Subjects were divided into two groups: conception by ART (n = 2256) or spontaneous conception (n = 6768). According to different fertilization modes, the ART group was divided into in vitro fertilization (IVF, n = 1873) and intracytoplasmic sperm injection (ICSI, n = 383) subgroups. The ART group was also divided into two different embryo transfer methods; fresh embryo transfer (ET, n = 1583) and frozen embryo transfer (FET, n = 673) subgroups. Pregnancy complications, perinatal complications, and neonatal outcomes of the enrolled subjects were investigated and analyzed by univariate analysis and multivariate logistic regression. Results: After adjustment for maternal age, gravidity, parity, maternal education, smoking, alcohol consumption, and body mass index (BMI), pregnancies conceived by ART were associated with a significantly increased incidence of gestational diabetes mellitus (GDM; OR 1.88, 95% CI 1.56-2.27), gestational hypertension (OR 2.18, 95% CI 1.83-2.60), and intrahepatic cholestasis of pregnancy (ICP) (OR 2.79, 95% CI 2.15-3.64), compared with spontaneous conception. These associations were similar for the singleton group. In the twin group, only the incidence of ICP was significantly higher than in controls. We found that pregnancies conceived by ART were associated with perinatal complications, including placental abruption (OR 2.14, 95% CI 1.33-3.45), premature rupture of membranes (PROM; OR 1.24, 95% CI 1.06-1.45), postpartum hemorrhage (OR 2.89, 95% CI 2.33-3.59) and polyhydramnios (OR 2.01, 95% CI 1.29-3.16). The singleton group had a similar result with placental abruption, but not with fetal membranes ruptures before labor and polyhydramnios. There were no significant differences in the incidence of these perinatal complications in the twin group. Some neonatal outcomes, including preterm labor (OR 4.29, 95% CI 3.84-4.80) and low birth weight (OR 1.72, 95% CI 1.42-2.08), were more likely to occur with singleton births after ART. However, there were no significant differences for these outcomes from twin pregnancies. Perinatal complications and neonatal outcomes were consistent between the IVF and ICSI subgroups. The FET and ET subgroups showed a similar increase in complications, except for the incidence of placental abruption. After taking into account the effects of parity, birth plurality and maternal age, the ART group still exhibited increased maternal and neonatal complications, although some differences narrowed or disappeared. Conclusions This retrospective cohort study demonstrated that patients who underwent ART were at increased risk of several adverse pregnancy outcomes compared with women who conceived spontaneously. These complications may be attributed in part to the relatively high multiple pregnancy rate after ART. Elective single embryo transfer should be promoted in China to reduce the obstetrical risks of ART pregnancy. Singletons of ART pregnancy exhibited increased maternal and neonatal complications as well, suggesting that underlying infertility or other maternal or parental factors may contribute to the adverse outcomes.

OBJECTIVE: To evaluate the influence of different transcutaneous electrical acupoint stimulation (TEAS) modes on ovarian responses and pregnancy outcomes in patients with infertility undergoing in vitro fertilization and embryo transfer (IVF-ET). METHODS: Two hundred infertility patients undergoing IVF-ET were divided randomly into experimental groups (TEAS groups: E-I, E-II, E-III, and E-IV, 40 cases each group) and a control group (mock TEAS group, 40 patients) using the random number method. The patients in the experimental groups received TEAS treatment of 20, 30, 40 and 50 mA for the E-I, E-II, E-III and E-IV groups, respectively. The control group received a treatment of 5 mA. TEAS was applied at acupoints of Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Zigong (EX-CA 1), and Taixi (KI 13), once a day for 30 min each time for a treatment period of 10-13 d. Treatment effect was assessed using the following indicators: endometrial thickness on the 6th day of gonadotropin treatment (GN6 day), endometrial thickness on the day on chorionic gonadotropin administration (HCG day), number of ovarian follicles on HCG day, number of ova captured, amount of estrogen required for each harvested ova, number of mature ova divided by the total number of ova, percentage of high-quality embryos, and clinical pregnancy. RESULTS: Endometrial thickness in the experimental groups on the HCG day was significantly better than that of the control group after TEAS stimulation (P=0.01). TEAS exhibited a greater impact on the number of ova captured (P=0.003). However, the effect of TEAS stimulation on the high-quality embryo rate and clinical pregnancy in patients was not statistically significant (P>0.05). CONCLUSIONS TEAS is an effective method in improving the ovarian state. When the stimulus intensity was at 40 mA and above, it could be helpful to improve the patient's endometrial condition and endometrial receptivity and to retrieve more oocytes. (Trial registration No. ChiCTR-TRC-11001780).
Acupuncture Points ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Pregnancy ; Pregnancy Outcome

An electrochemical chemical oxygen demand(COD)sensor was proposed based on a FTO/TiO2/PbO2 electrode and a thin-layer electrochemical cell.The FTO/TiO2/PbO2 electrode was characterized by X-ray photoelectronic spectroscopy(XPS),X-ray diffraction(XRD)spectroscopy and electrochemical technique,and the results indicated that the rapid decrease in the output signals of the electrochemical COD sensor could be attributed to oxidation of PbSO4 occurring on the surface of FTO/TiO2/PbO2 electrode.The PbO2 deposition time and concentration of Na2SO4 were further optimized and then the electrochemical COD sensor was challenged by real samples including laker water sample,river water sample and wastewater sample.The evolution trend of signals of the electrochemical COD sensor in response to lake and river water samples was identical with that obtained with the standard method(HJ/T399-2007,Water quality-determination of the chemical oxygen demand-fast digestion-spectrophotometric method).The electrochemical COD sensor exhibited significant increase in the signal intensity after the samples were switched from lake water to wastewater sample,and a mean value of 32.5 mg/L with relative standard deviation(RSD)of 6.8%were obtained after measuring 45 times the wastewater with COD value of 30 mg/L under a sampling interval of 400 s.The as-prepared electrochemical COD sensor possessed good promise in regular monitoring of COD,discharge of wastewater and industrial process control,with advantages such as a small sampling interval,mild reaction conditions and no requirement of toxic and harmful chemical reagents.