Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Primary biliary cirrhosis (PBC) is considered to be an autoimmune liver disease. Its etiology is unknown. Pathogenesis of PBC is associated with many aspects such as genetic factors, environmental factors, independent activity of target antigen, T-cell autoreactive immune responses and so on. Recently, new materials that involved in the morbidity of PBC have been identified constantly. Antimitochondrial antibodies (AMA) are characteristic of PBC. In particular, AMA-M2 is highly positive for the serological diagnosis mark of PBC. At present, treatment still cannot be for the etiology of PBC. Symptomatic treatment and support treatment are main measures. Ursodeoxycholic acid (UDCA)is the only one recognized medication with specific effect on the PBC. At present, the liver transplant can increase the survival rate and extend their survival time for end-stage of patients with PBC. This article emphasis on the progress of pathogenesis and treatment of the PBC are reviewed to explore research.

Objective To observe the effects of dexmedetomidine combined with propofol on the hemodynamics level in elderly patients undergoing gastroscopy.Methods 68 patients undergoing endoscopy from January 2014 to January 2015 in our hospital were selected and randomly divided into observation group and control group, 34 cases in each group.Propofol anesthesia combined with dexmedetomidine was used in the observation group and propofol anesthesia was used in the control group.The RR ( respiratory rate) and HR ( heart rate) of the two groups were observed before the administration (T0), after the administration (T1), when the gastroscope was inserted (T2), after the examination (T3), 5 min after the examination (T4), MAP (mean arterial pressure) and SpO2(pulse oxygen saturation) were measured.The postoperative consciousness, orientation recovery time and surgical tolerance were compared between the two groups.The anesthetic adverse reactions were recorded during the operation.Results The observation group in T1, T2, T3, T4 time point HR were lower than the control group, and the data remained relatively stable level, the difference was statistically significant (P<0.05).There was no significant difference in consciousness recovery time and recovery time of orientation force between observation group and control group.The tolerance of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).The total adverse reaction rate of the observation group was 32.35% lower than that of the control group 88.24%, the difference was statistically significant ( P <0.05 ) .Conclusion Dexmedetomidine combined with propofol for the elderly patients with painless gastroscopy , analgesic effect is good, and can better maintain hemodynamic fluctuations, reduce propofol anesthesia adverse reactions, does not Affect the patient's awareness and ability to restore the direction.

Objective To investigate the effect of partial liquid ventilation(PLV) with perfluorocarbon(PFC) on pulmonary surfactant during beatment of acute lung injury(ALI) induced by oleic acid. MethodsTwenty-four male Japanese white rabbits weighing 2. 1-2.6 kg were randomly divided into three groups(n = 8 ineach group): groupl: normal animal + mechanical ventilation (MV); group 2: ALI + MV; group 3: ALI +PLV.The animals were anesthetized with intraperitoneal ketamine 100 mg/kg, trachectomized and mechanicallyventilated (FiO_2 = 1, RR = 35 bpm, I: E = 1: 2, PEEP = 5 cm H_2O, PaCO_2 was maintained at 35-45 mm Hg byadjustment of tidal volume) .In group 2 and 3 ALI was induced by infusion of oleic acid 150?g/kg via centralvenous catheter over 30 min period. ALI was considered established when PaO_2 /FiO_2 was

Objective To determine if propofol-remifentanil and isoflurane have any different effects on intrapulmonary shunt during one-lung ventilation (OLV). Methods Twenty-four ASA Ⅰ or Ⅱ patients (18 male, 6 female) aged 42-69 yr undergoing radical esophagus cancer resection via left thoracotomy were randomly divided into 2 equal groups ( n = 8 each) : propofol group (Pro) and isoflurane group (Iso) . The preoperative lung function was normal in both groups. The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Radial artery was cannulated and S-G catheter was placed via right internal jugular vein in pulmonary artery. Anesthesia was induced with propofol 1.5-2.0 mg?kg-1, fentanyl 4 ?g?kg-1 and succinylcholine 1.5 mg?kg-1 and maintained with TCI of propofol and remifentanil (target plasma concentration was set at 3.2 ?g?ml-1 and 4.5 ng?ml-1 ) or isoflurane inhalation ( end- tidal isoflurane concentration = 1.5% -2.5 % ) and intermittent i. v. boluses of fentanyl. The patients were mechanically ventilated after endobronchial intubation with double-lumen tube (VT = 8-10 ml, RR= 10-12 bpm, I:E = 1:2) . During OLV VT was reduced to 6-8 ml and RR increased to 14-16 bpm.PaCO2 was maintained at 35-45 mm Hg. ECG, HR, MAP, SpO2, auditory-evoked potential index (AAI), cardiac index (CI), airway pressure and end-tidal isoflurane concentration were continuously monitored during operation. Blood samples were taken from radial artery and pulmonary artery at 10 min after S-G catheter placement (T0, baseline) at 10 min bilateral ventilation (in right lateral position) (T1) at 15, 30, 60, 90 min of OLV (T2-5) for measurement of blood gases and calculation of Qs/Qt.Results The two groups were comparable with respect to age, M/F ratio, body weight and preoperative lung function. AAI was below 30 during operation and PaCO2 and pH were within normal range in both groups. Qs/Qt was significantly increased while PaO2 was significantly decreased during operation (from T1 to T5 ) as compared to baseline values (T0) but Qs/Qt was gradually decreasing while PaO2 was gradually increasing from T2-5 in both groups. Qs/Qt was significantly lower in Pro group than in Iso group at each interval (T2-5) but there was no significant difference in PaO2 at T2-5 between the two groups. Conclusion There is less intrapulmonary shunt during OLV under general anesthesia with propofol-remifentanil than with isoflurane but the difference is not significant enough to affect PaO2.

Objective It has been shown that partial liquid ventilation (PLV) with perfluorocarbon (PFC) can reduce intrapulmonary aggregation of neutrophils (PMNs) and macrophages and their cytokine release during acute lung injury (ALI) . The purpose of this study was to investigate the effect of PFC on activation of nuclear factor-kappa B (NF-?B) in neutrophils induced by lipopolysacchride (LPS) .Methods PMNs were isolated from peripheral blood obtained from 36 healthy volunteers and incubated in RPM 1640 cell culture medium yielding a concentration of 1?108/ hole. The PMNs were randomly divided into two groups : (Ⅰ) LPS group in which PMNs were incubated with LPS 10?g?ml-1(n = 18) and (Ⅱ) PFC group in which 5 min after stimulation of PMNs with the same concentration of LPS (10?g?ml-1 ) , PFC was added to the cell suspension with the final concentration of PFC / cell culture medium (vol / vol) of 0.3 (n=18 ). After incubation with LPS for 3 h (T1), 8h (T2) and 24 h (T3), the cell suspensions were centrifuged. The supernatants were analyzed for TNF-? concentration and gray value of activated NF-?B was measured in the nuclear of neutrophils. Results The concentration of TNF-a and gray value of NF-?B in PFC group were significantly lower than those in LPS group at all time points ( P

Objective To observe of different facemask pressure controlled ventilation yongon gastric insufflation evaluated by ultrasound in infants during anesthesia induction.Methods Sixty ASA Ⅰ infants aged 1-3 yr,undergoing elective surgery,were randomly assigned to three groups ac-cording to facemask ventilation pressure:10 cm H 2 O (P10),1 5 cm H 2 O (P1 5 )and 20 cm H 2 O (P20)with twenty in each group.Infants were injected with propofol 2 mg/kg,fentanyl 0.002 mg/kg,cis-atracurium 0.1 5 mg/kg for general anesthesia induction until consciousness lost,then face-mask pressure controlled ventilation was applied for 120 s.Some respiratory parameters (SpO 2 , PET CO 2 )were recorded at the time of loss of consciousness (T0 )and after facemask pressure con-trolled ventilation for 30 s(T1 ),60 s(T2 ),90 s(T3 ),120 s(T4 )and after tracheal intubation(T5 ). The cross-sectional transverse and longitudinal diameter and area were measured respectively using ul-trasound at T0 and T4 .Results In all groups,SpO 2 was greater than or equal to 99% at all time points.PET CO 2 at T1-T5 was significantly higher than that at T0 and PET CO 2 at T5 was higher than that at T4 in all three groups.There were statistically significant increases in the values of the antral cross sectional area before and after facemask pressure controlled ventilation in group P20 (P <0.05). Conclusion During anesthesia induction in infants,1 5 cm H 2 O facemask ventilation pressure can guarantee adequate ventilation,and avoid gastric insufflation.

Respiratory depression is a common adverse effect of opioids .Currently, the mechanisms and manage-ment of opioid-induced respiratory depression ( OIRD) are one of the research foci .OIRD arises from stimulation ofμ-opioid receptors in the pre-Botzinger complex and the Kolliker-Fuse neurons .Adenylyl cyclase , calcium chan-nels, and G-protein-gated inwardly rectifying potassium (GIRK) channels may be the key cellular signaling mecha-nisms of OIRD .

OBJECTIVE To explore the scientific and standardized experience of blood purification center of infectious diseases hospital in the hospital infection management.METHODS The development of its experience was summed up.RESULTS Sound system,wide range of focused training,as well as hospital infection in day-to-day management basis,and establishment and improvement of the incident management were carried out to control the nosocomial infection.CONCLUSIONS Correct system and norms,stringent measures and continuously updating the concept of nosocomial infection can effectively improve the management of hospital infection.