Aim To investigate the effects of paclitaxel(PTX) on the expression of CD69, CD25 and proliferation of T cells by polyclonal stimulas in vitro, and explore the molecular mechanism of paclitaxel. Methods Fluorescence conjugated monoclonal antibodies and flow cytometry were used to detect the express of CD69 and CD25 by activated T cells in vitro in response to Concanavalin(Con A) and Phorbol 12,13-dibutyrate(PDB) or T cell proliferation index stained by CFDA-SE in response to PDB+Ion or Con A. Results Paclitaxel had no effect on the expression of CD69, but inhibited the expression of CD25 in activated T cells in response to Con A or PDB in a concentration-dependent manner. Paclitaxel caused a dose-dependent suppression of T cell proliferation to Con A as well as to PDB+Ion. Whether added at the beginning or after 24 h of stimulation by Con A or PDB+Ion, paclitaxel had identical effects. Conclusion The mid and later activation and proliferation of murine T cells stimulated by Con A or PDB+Ion were significantly inhibited by paclitaxel, suggesting that paclitaxel acts on the downstream signaling pathways of PKC?,and not act on the intitial activated associated proteins such as PTK and PKC?.

Animals ; Macrophages, Alveolar ; drug effects ; enzymology ; Male ; Muramidase ; biosynthesis ; Quartz ; toxicity ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the incidence and severity of pulmonary embolism (PE) in patients with different leg deep vein thrombosis (DVT) by computed tomography pulmonary angiography (CTPA).Methods A total of 145 cases who had been confirmed DVT and undergone CTPA were retrospectively analyzed.The DVTs were divided into left side DVT,right side DVT,and bilateral lower DVT groups.The incidence of PE was compared among different groups.CT obstruction index (CTI) was used to estimate the severity of pulmonary artery obstruction.DVT/PEs with CTI were compared among different groups.Results The incidence of PE of the bilateral lower DVT group was 71.4％,which was higher than that in left side DVT group (39.2％).However,no significant difference was found between bilateral lower DVT group and right side DVT group (52.9％) (P ＞ 0.05).The CTI of the bilateral lower DVT (30.20±14.20)％ was higher than that of the left side DVT (19.26 ± 14.02)％ and the right side DVT (18.56 ±11.79) ％ (P ＜ 0.05).Conclusions The bilateral lower DVT was more likely complicated with PE than the left side DVT,the severity of pulmonary artery obstruction of the bilateral lower DVT with PE patient was higher than that of single side DVT with PE patient.

With the development of basic disciplines such as molecular biology,immunology,cell biology and so on. the pathogen biology research do not stop at the organ and cellular level,but go deep into the protein and gene level. It is a great boost to the deep studies of pathogen biology in diagnosis,treatment,pathogenesis,prevention and epidemiology.

Objective To explore the effect of lysophosphatidic acid(LPA)on blood-brain barrier(BBB) permeability and its possible mechanism.Methods LPA or LPA+suramin(L+S)were stereotaxically injected into the right eaudate nucleus in SD rats in vivo.Evans blue(EB)was used to quantitatively measure the permeability of BBB at different time points.The expression of matrix metalloproteinase-9 was detected by immunohistochemistry technique.The pathological ultrastruetural changes of BBB were assessed by transmission electron microscopy.Results The BBB permeability began to increase after LPA administered into ipsilateral eaudate nucleus,and reached the peak at 24h.Then the permeability of BBB gradually lowered after 48h.In comparison with the same time points of control group,there were quite significant differences(P＜0.01).After L+S was injected,the change of BBB permeability had differences in comparison with those of LPA group in the same time points,(P＜0.05).MMP-9 positive cells were mainly vascular endothelial cells.The numbers of MMP-9 positive blood vessels grew at 6h in LPA group,and the expression of it reached maximum at 24h,then the number of it decreased at 48h,showing significant statistical differences in comparison with the L+S group(P＜0.01),It was observed microscopically that ultrastrueture of BBB of the LPA group was changed sharply,such as basement membrane roughed and fragmented,astroeyte end-feet swolled markedly and perivaseular space enlarged obviously.But there were no remarkable changes in BBB in L+S group.Conclusion LPA can induce increase of BBB permeability and its possible mechanism is the strong expression of MMP-9 protein produeted by endothelial cells through the mediation of LPA receptor,leading to degradation of basement membrane.

A 29-year-old woman was admitted to the Department of Rheumatology,Peking Union Medical College Hospital due to intermittent rashes,fever and headache.Palpable purpura were symmetrically distributed on the extremities and trunk.Other manifestations included headache with nausea and vomiting.Elevated white blood cell (WBC) count,platelet (PLT) count,erythrocyte sedimentation rate (ESR) and C-reactive protein were the main laboratory findings.Antinuclear antibodies and antineutrophil cytoplasmic antibodies were negative.Examination of the cerebrospinal fluid (CSF) revealed high intracranial pressure,while routine cytology and biochemical tests of CSF were normal.Head MRI scan and PET-CT did not detect remarkable findings.A diagnosis of systemic vasculitis was confirmed by the biopsy of skin lesion which showed inflammatory infiltration of the muscular vessel wall.Combination therapy of corticosteroids and cyclophosphamide lead to a rapid improvement in clinical symptoms and laboratory parameters.The patient was in stable remission till 6 month follow-up.

Objective To explore the applications and effect of experience-based health education in maternal nursing in community.Methods According to the random number table,150 women pregnant for the first time were divided into control group and observation group with 75 in each group. In the control group,the traditional method for health education was used and in the observation group the experience-based teaching based on traditional health education.The two groups were compared in terms of the awareness rate of knowledge about maternal and infant health care and the incidence of postpartum depression.Result The awareness of knowledge about maternal and infant health care in the observation group was significantly higher than that of the control group and the incidence of postpartum depression in the observation group was significantly lower than that of the control group(P<0.01).Conclusion Experience-based health education can improve the level of knowledge about maternal and infant health care and reduce the incidence of maternal postpartum depression.

Objective To compare the efficacy of continuous lumbar plexus block (LPB) with different concentrations of dexmedetomidine added to ropivacaine for postoperative analgesia in elderly patients undergoing hip replacement.Methods Sixty elderly patients of both sexes,aged 65-85 yr,weighing 50-71 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective total hip replacement,were divided into 2 groups (n =30 each) using a random number table:0.5 μg/ml dexmedetomidine+0.1％ ropivacaine group (group D1) and 1.0 μg/ml dexmedetomidine + 0.1％ ropivacaine group (group D2).Lumbar-sacral plexus block combined with general anesthesia was used.At the end of operation,LPB pump was started and set up to deliver a 4 ml bolus dose with a 30 min lockout interval and background infusion at a rate of 8 ml/h.The analgesia solution contained 0.5 μg/ml dexmedetomidine and 0.1％ ropivacaine in group D1 and 1.0 μg/ml dexmedetomidine and 0.1％ ropivacaine in group D2.Postoperative analgesia lasted for 48 h,and the visual analogue scale score was maintained ≤ 3.Patientcontrolled intravenous analgesia (PCIA) pump was connected when break-through pain happened.PCIA solution contained morphine 50 mg diluted to 50 ml in 0.9％ sodium chloride.PCIA pump was set up to deliver a 1 ml bolus dose with a 5 min lockout interval and no background infusion.When the visual analogue scale score ＞3,the patient-controlled LPB pump was used first,and 15 min later if analgesia was still ineffective,PCIA pump was applied.The number of patients in whom analgesia was effective and occurrence of adverse reactions were recorded.Results Compared with group D1,the rate of effective analgesia was significantly increased,and the incidence of nausea,vomiting and pruritus was decreased in group D2 (P＜ 0.05).No bradycardia,hypotension,over-sedation,respiratory depression,urinary retention or local skin infection was found in the two groups.Conclusion Continuous LPB with 1.0 μg/ml dexmedetomidine added to 0.1％ ropivacaine provides better efficacy for postoperative analgesia in elderly patients undergoing hip replacement.

Objective To explore the effect of dexmedetomidine combined with ropivacaine for continuous lumbar plexus block on the quality of early recovery in patients undergoing total hip ar-throplasty.Methods Sixty patients (35 males and 25 females)with ASA physical status Ⅱ or Ⅲ, aged 65-84 years,undergoing total hip replacement were randomly assigned to dexmedetomidine com-bined with ropivacaine group (group D)or ropivacaine group (group C).All patients received ropiva-caine which was administered via continuous lumbar plexus block as patient-controlled analgesia (PCA)after surgery.The PCA were programmed with a background infusion 8 ml/h of ropivacaine, bolus dose was 4 m1 and the block time was 30 min;the patients in group C received 0.2% ropiva-caine,and the patients in group D received 0.1% ropivaciane combined with 1 μg/ml of dexmedeto-midine by the way of intravenous infusion.In addition,all patients received another patient-controlled intravenous analgesia (PCIA)with 1 mg/ml of morphine for relieving the explosive pain.The PCIA was programmed with a lobus dose of morphine 1 mg without background dose,the block time was 5 min.Consumption of morphine and visual analog scale (VAS)score,muscle strength and maximum flexion and abduction of hip joint were recorded at the time points of 6,12,24 and 48 h after opera-tion.The side-effect reactions such as nausea,vomiting,drowsiness and itching were recorded.The sleep quality was assessed with Pittsburgh sleep quality index (PSQI)on day 1 before operation,day 1 and day 7 after operation.Results The consumption of morphine in group D was significantly fewer than group C (P <0.05).Compared with group C,muscle strength and maximum flexion and abduc-tion of hip joint in group D were increased at 6,12,24 and 48 h after operation (P <0.05 ).PSQI scores were decreased on the day 1 and day 7 after operation.The incidence of delirium,nausea and vomiting,drowsiness and itching in group D were decreased (P <0.05).Conclusion 0.1% ropiva-ciane continuous lumbar plexus block combined with 1 μg/ml of dexmedetomidine by the way of in-travenous infusion could provide satisfied analgesia for the operation of total hip arthroplasty;the sleep quality is improved,the functional exercise of hip joint is promoted.

Objective To investigate the feasibility of laparoscopic-assisted transanal pull-through resection and anastomosis in the treatment of ultra-low rectal cancer.Methods From November 2005 to December 2006,21 patients with ultra-low rectal cancer had undergone laparoscopic-assisted transanal pull-through resection and anastomosis in Southwest Hospital.The perioperative condition,postoperative complications and the result of follow-up were retrospectively analyzed.Results The operation was successfully performed on all the patients.The mean operation time and postoperative hospital stay were(216±25)minutes(170-260 minutes)and(9.4±1.0)days(7-11 days),respectively.The time needed for the recovery of gastrointestina]function was(65±14)hours(38-88 hours).The mean perioperative blood loss was(140±49)ml(80-250 ml).All the patients were followed up for(22±4)months(15-28 months),and no anastomotic bleeding or fistula was observed.Six patients developed mild to moderate anastomotic striclure,1 local recurrence and 1 liver metastasis.Conclusions Laparoscopic-assisted transanal pull-through resection and anastomosis for ultra-low rectal cancer is safe and feasible,and the short-term effect is satisfactory.