Objective To investigate the effects of fentanyl and remifentanil on the viability of human adenocarcinoma cell line A549.Methods Human adenocarcinoma A549 cells cultured in logarithmic growth phase were seeded in 75 ml culture bottles or 96-well plates.After being cultured for 24 h,the cells were randomly divided into 9 groups (n =30 each):4 fentanyl groups (groups F1-4 ),4 remifentanil groups (groups RF1-4 ) and control group (group C).Groups F1-4 were exposed to fentanyl with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.Groups RF1-4 were exposed to remifentanil with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.The viability of the cells was determined by methyl thiazolyl tetrazolium assay after being incubated for 24,48 and 72 h.The cell cycle progression and apoptosis were determined by flow cytometry after being incubated for 24 h.Results Compared with group C,the viability of A549 cells were gradually decreased at 72 h of incubation,the proportion of the cells in S phase was gradually decreased at 24 h of incubation,and the proportion of the cells in G2/M phase and apoptotic rate were gradually increased in groups F2-4 and in groups RF2-4 ( P ＜ 0.05).Conclusion Fentanyl and remifentanil with the final concentration ≥5 ng/ml can inhibit the viability of human adenocarcinoma cell line A549 in a dose-independent manner by inducing cell apoptosis and cell cycle arrest in G2/M phase.

Objective To evaluate the effect of chemotherapy on sedation with propofol in breast cancer patients.Methods One hundred female patients,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,scheduled for elective modified radical mastectomy,were divided into 2 groups (n =50 each) according to whether receiving neoadjuvant chemotherapy before operation:non-chemotherapy group (group Ⅰ) and neoadjuvant chemotherapy group (group Ⅱ).The breast cancer patients received operation directly in group Ⅰ.The breast cancer patients received neoadjuvant chemotherapy in group Ⅱ.Epirubicin 75-100 mg/m2 was injected intravenously on 1st and 2nd days,docetaxel 75 mg/m2 was injected intravenously on 3rd day,and 3 weeks were considered as 1 course of treatment.The patients received operation at 3 weeks after the end of 4 courses of treatment in group 1.Anesthesia was induced with propofol given by target-controlled infusion and the target plasma concentration of propofol was 3.5 μg/ml.The time for loss of consciousness and consumption of propofol at loss of consciousness were recorded.Results Compared with group Ⅰ,the time for loss of consciousness was significantly shortened,and the consumption of propofol at loss of consciousness and BIS value were decreased in group Ⅱ.Conclusion Chemotherapy can enhance propofol-induced sedation and promote the onset of propofol in breast cancer patients.

Objective To evaluate the effect of sleep dysfunction on sedation induced by propofol in the patients undergoing radical mastectomy.Methods One hundred breast cancer patients,aged 25-60 yr,with body mass index of 19-23 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective modified radical mastectomy,were randomly divided into 2 groups according to sleep quality.The patients with global Pittsburgh Sleep Quality Index (PSQI) score ≤7 served as regular sleep quality group (Ⅰ group,n =59).The patients with global PSQI score ＞ 7 served as sleep dysfunction group (group Ⅱ,n =41).Anesthesia was induced with propofol given by target-controlled infusion (target plasma concentration of 3.5 μg/ml),and then with remifentanil 4 μg/kg and rocuronium 0.6 mg/kg after loss of consciousness.The consumption of propofol at loss of consciousness was recorded.Results Compared with group Ⅰ,the consumption of propofol at loss of consciousness was significantly decreased in group Ⅱ.Conclusion Sleep dysfunction can enhance propofol-induced sedation in the patients undergoing radical mastectomy.

0.05). Conclusion The lesions of left and right hemisphere can both cause cognitive impairment, which is significantly correlated with the severity of motor dysfunction in acute stroke patients with subcortical lesion.Great attention should be paid to the evaluation and treatment of cognitive dysfunction in patients with serious hemiplegia.

Objective To investigate the effect of Nourishing Yin and Nonifying Yang sequential therapy (NYNYST )com-bined with western medicine on expression levels of Smad2 ,Smad3 ,Smad7 mRNA in rats with diminished ovarian reserve (DOR).Methods Totally 40 female rats were randomly divided into 5 groups ,the normal control group ,the model group ,the western medicine group ,the NYNYST group and the combination group(western medicine combined with NYNYST ) ,8 in each group. The DOR model was established through orally administering tripterygium pill for continuous 2 weeks. The normal con-trol group and the model group were administered with saline for 10 days. The western medicine group was treated with hor-mone replacement therapy(HRT ) and ovarian stimulation. The NYNYST group was administered with Nourishing Yin herbs in proestrus and Nonifying Yang herbs in late estrus and the combination group was administered with combination of Chinese herb and western drugs for 10 days ,with the same dose in the former two groups.Serum levels of FSH ,LH ,E2 ,anti-Müllerian hormone(AMH) ,Transforming growth factor beta 1(TGF-β1)and Inhibin B(INHB)were measured by ELISA.Changes of Smad2 ,Smad3 ,Smad7 mRNA in ovaries were detected by real-time PCR.Results Compared with the model group ,the serum levels of FSH ,LH were decreased significantly in western medicine group ,NYNYST group and combination group(P＜0.01) , the serum levels of E2 ,AMH ,TGF-β1 and INHB increased in the rats of the treatment group(P＜0.05 ,P＜0.01) ,and efficacy of the combination group was significantly superior to that of the western medicine group (P＜0.01 ,P＜0.05);compared with the model group ,Smad2 mRNA increased significantly in NYNYST group and combination group ,Smad3 mRNA increased sig- nificantly in combination group(P＜0.01) ,the efficacy of combination group was superior to that of the western medicine group (P＜0.05);compared with the model group ,Smad7 mRNA of treatment groups was decreased significantly (P＜0.01).Conclu-sion NYTYST combined with western medicine can improve the function of ovaries by up-regulating the expression of Smad2 , Smad3 mRNA and down-regulating the expression of Smad7 mRNA in DOR rats.

Purpose To evaluate the left ventricular systolic and diastolic function in patients with pulmonary hypertension (PH) using three-dimensional speckle tracking imaging (3D-STI) combined with two-dimensional ultrasound (2D ultrasound),and to investigate the effects of different-degree PH on left ventricular function.Materials and Methods Fifty-two patients who were diagnosed as PHin the First Hospital of Jilin University from September 2011 to November 2015 were retrospectively analyzed,and based on pulmonary artery systolic pressure (PASP),they were assigned into mild group (PASP 36-49 mmHg,n=20),moderate group (PASP 50-70 mmHg,n=18) and severe group (PASP＞70 mmHg,n=14).Besides,healthy volunteers were selected as control group (n=30).All the subjects accepted 2D and 3D imaging,their left ventricular diastolic diameter (LVDd),left ventricular ejection fraction (LVEF),left atrial maximum volume index (LAVI),PASP,e',E/e',etc.,were obtained by 2D ultrasound,and their left ventricular global longitudinal strain (GLS),left ventricular global radial strain (GRS),left ventricular global circumferential strain (GCS),left ventricular global area strain (GAS),etc.,were obtained by 3D-STI.The data of different groups were compared,and the correlation between PASP with left ventricular systolic and diastolic function was analyzed.Results E/e'and LAVI in moderate group and severe group were significantly higher than those in control group,and the differences were statistically significant (P＜0.05);the absolute values of GLS and GAS in moderate group were lower than those in control group (P＜0.05);the absolute values of GLS,GRS,GCS and GAS in severe group were all lower than those in control group,and the differences were statistically significant (P＜0.05).The correlation analysis showed that among 2D parameters,the correlation between LAVI and PASP was better (r=0.56,P＜0.01);among 3D strain values,the correlation between GLS absolute value and PASP was better (r=0.60,P＜0.01).Conclusion 3D-STI combined with 2D ultrasound can effectively assess the left ventricular systolic and diastolic dysfunction in patients with PH,which provides theoretical support for early clinical intervention.

Objective To explore the effect of biological resonance technique in the detection and treatment of milk protein induced allergic diarrhea in infants .Methods A total of 60 infants with protein allergic diarrhea were detected by bio-resonance technique of German -made Bikang Biotherapeutic Instrument .The statistical bio-reso-nance technique was used to detect the distribution of allergy in infantile milk allergic diarrhea and treatment effect . Results Bio-resonance technique for detection of infantile milk protein allergic diarrhea ,the first six allergies were milk,milk protein,fish mixture,normal intestinal flora,mite and breast milk.The total effective rate was 95.00％,the effective rate was 95.83％ in the female group and 94.44％ in the male group,the difference was not statistically significant(χ2 =0.142,P>0.05).There was no significant difference between the 9th and 6th month group(χ2 =0.671,P >0.05).After treatment for 1 month,the follow -up showed no recurrence.Conclusion Resonance technology is one of the best technique to detect and treat allergic diarrhea in infants and young children , which is suitable for clinical use .

OBJECTIVE: To explore the genetic etiology of a neonate with suggestive features of Cornelia de Lange Syndrome (CdLS). METHODS: Chromosome karyotyping, copy number variation sequencing (CNV-seq) and whole exome sequencing (WES) were carried out for the child. Meanwhile, peripheral venous blood samples were taken from his parents for verifying the suspected pathogenic variants detected in the child. RESULTS: The child has exhibited developmental delay, microcephaly, ptosis, micrognathia, and low ear setting, and was suspected as CdLS. No abnormality was found by karyotyping and CNV-seq analysis. WES has detected 5 heterogeneous variants and 1 hemizygous variant on the X chromosome. Combining the genetic pattern and result of family verification, a hemizygous C.3500T>C (p.ile1167thr) of the SMC1A gene was predicted to underlay the clinical manifestations of the patient. This variant was not recorded in the dbSNP and gnomAD database. PolyPhen2, Provean, SIFT all predicted the variant to be harmful, and PhastCons conservative prediction is was a conservative mutation. ACMG variant classification standard evidence supports are PM2, PP2, and PP3. CONCLUSION The novel c.3500T>C (p.Ile1167Thr) missense mutation of the SMC1A gene probably underlay the genetic etiology of CdLS in this child. Above results has enriched the mutation spectrum of CdLS type II, and facilitated clinical counseling for this family.
Cell Cycle Proteins/genetics* ; Child ; DNA Copy Number Variations ; De Lange Syndrome/genetics* ; Humans ; Infant, Newborn ; Mutation ; Phenotype ; Whole Exome Sequencing

Objective To explore the efficacy and prognostic factors of chemotherapy regimens including decitabine in treatment of elderly patients newly diagnosed with acute myeloid leukemia (AML). Methods The clinical data of 47 elderly patients newly diagnosed with AML (except M3) who received chemotherapy regimens including decitabine in the First Hospital of Jilin University from February 2013 to November 2017 were retrospectively analyzed, including 11 patients treated with single decitabine and 36 patients treated with decitabine combined with low_dose chemotherapy group. The treatment outcome and the impact of different factors on the prognosis were also analyzed. Results Of 47 patients, there were 15 males and 32 females, and the median age was 65 years old (60-83 years old). The overall response rate of decitabine plus low_dose chemotherapy group for 1 course was higher than that of single decitabine group [80.6% (26/36) vs. 27.3% (3/11), χ 2 ＝ 8.693, P＝ 0.003], and the former showed less courses to acquire remission than the latter (u＝ 3.133, P＝ 0.002); however, there was no significant difference in the median overall survival (OS) time between the two groups (14 months vs. 12 months, P＝ 0.950). Univariate analysis indicated that the median OS time in the complete remission (CR) group was longer than that in the non_CR group (17 months vs. 5 months, P <0.01). The median OS time of the elderly patients with primary AML was longer than that of the patients with secondary AML (16 months vs. 6 months, P＝ 0.01). Cox multifactor analysis showed that failing to achieve CR was identified as an independent adverse influencing factor ( HR＝0.180, 95% CI 0.085-0.382, P< 0.01). The incidence of neutropenia with fever in the patients treated with decitabine plus low_dose chemotherapy group was higher than that in single decitabine group [69.4% (25/36) vs. 36.4% (4/11), χ2＝3.902, P＝0.048]. Conclusion For newly elderly AML patients, chemotherapy regimens including decitabine are safe and effective.

Objective:To investigate the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with positive TLS-ERG fusion gene.Methods:The clinical data of 9 AML patients with positive TLS-ERG fusion gene in the First Hospital of Jilin University from June 2013 to August 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:Among 9 patients with positive TLS-ERG fusion gene, there were 5 males and 4 females, with a median age of 16 years old (6-40 years old). Five patients received chemotherapy alone, 3 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 1 patient did not receive systematic treatment. Among 8 patients with systematic treatment, 1 patient had complete remission after the first induction chemotherapy and 5 patients had complete remission after induction therapy. The median overall survival time of 5 patients with chemotherapy alone was 1.5 months (1-11 months), of which 3 patients did not respond to the first course of treatment and died of infection, and 2 patients died after relapse. The median overall survival time of 3 patients with allo-HSCT was 16 months (13-17 months), of which 2 patients died after relapse and 1 patient had sustained molecular complete remission by the end of follow-up.Conclusions:AML with positive TLS-ERG fusion gene has low incidence rate and poor induction efficacy. Hematopoietic stem cell transplantation may partially improve the survival prognosis of patients, but it cannot overcome the adverse effect of positive TLS-ERG fusion gene on prognosis.