(P > 0. 05). Conclusions:Metronidazole-containing triple therapy may reduce the CD infection secondary to eradication of Hp infection in pediatric patients,and has no negative impact on efficacy of Hp eradication.

Objective To analyze the dose‐effects of different doses of dexmedetomidine for sedation and sleep of the patients under epidural nerve block anesthesia .Methods A total of 82 patients undergoing elective lower limbs surgery(ASA grade Ⅰ - Ⅱ) were randomly divided into 4 different doses of dexmedetomidine groups(group 1 ,n=19 ;group 2 ,n=22 ;group 3 ,n=20;group 4 , n=21) ,under continuous epidural nerve block ,the loading dose of dexmedetomidine 0 .7 ,0 .8 ,0 .9 ,1 .0μg · kg -1 · h-1 was intrave‐nously pumped for 30 min ,then pumped at a rate of 0 .7 ,0 .8 ,0 .9 ,1 .0 μg · kg -1 · h-1 in the group 1 ,2 ,3 and 4 respectively .If any patient in 4 groups fell asleep at less than half an hour ,the loading dose was stopped and the continuous dose was changed to pump , the drug administration was discontinued at wound dressing after operation .Whether the patient falling asleep was recorded ,and the mean arterial blood pressure ,heart rate at 4 time points of 10 ,30 ,60 ,90 min after infusion of dexmedetomidine were also recorded . The 50% effective dose(ED50 ) ,ED95 and 95% confidence interval(CI) were calculated by using the Probit method .Results ED50 and ED95 of dexmedetomidine were 0 .65μg/kg(95% CI:0 .36-0 .73μg/kg)and 1 .00 μg /kg(95% CI:0 .90-1 .74μg/kg) ,which could decrease the heart rate and increase the arterial blood pressure .Conclusion Although dexmedetomidine can decrease the heart rate and increase the arterial blood pressure ,but the patients quietly fall asleep without discomfort and pain occurrence by the intra‐venous administration under continuous epidural nerve block .

Objective To explore the expression of tissue inhibitor of metalloproteinases-2(TIMP-2) in peripheral blood lymphocytes in patients with chronic obstructive pulmonary diseases(COPD) and the association of smoking and TIMP-2 mRNA. Methods The expression of TIMP-2 mRNA in peripheral blood lymphocytes was measured by reverse transcription-polymerase chain reaction(RT-PCR) in 44 patients with COPD and 42 healthy smokers.The correlation analysis was then conducted between TIMP-2 mRNA expression and smoking index. Results The expression of TIMP-2 mRNA was 0.753?0.154 and 1.170?0.196,respectively,in patients with COPD and healthy smokers(P

To explore the new method of discriminating Cistanche deserticola, Cynomorium songaricum and Orobanche pycnostachya by using PCR amplification of specific alleles. 30 samples of the different C. deserticola, 21 samples of C. songaricum and O. pycnostachya were collected. The total DNA of the samples were extracted, the ITS sequences from C. deserticola, C. songaricum and O. pycnostachya were amplified by PCR and sequenced unidirectionally. These sequences were aligned by using ClustulW. Specific primer was designed according to the ITS sequences of specific alleles, and PCR reaction system was optimized. Additionally, compare with the identification of specific PCR method and DNA sequence analysis method. The result showed that the 331 bp identification band for C. deserticola and the adulterants not amplified bands by a single PCR reaction, which showed good identification ability to the three species. PCR amplification of specific alleles can be used to identify C. deserticola, C. songaricum and O. pycnostachya successfully.
Alleles ; Cistanche ; classification ; genetics ; DNA Primers ; genetics ; DNA, Intergenic ; genetics ; DNA, Plant ; genetics ; Drug Contamination ; prevention & control ; Phylogeny ; Polymerase Chain Reaction ; methods

Objective To investigate the effects and relations of carvedilol on heart rate turbulence and secretion of sympathetic nerve in patients with myocardial infarction. Methods Sixty-six patients selected with acute myocardial infarction were randomized to enroll into experimental group ( n = 33 ) treated with earvedilol and control group( n = 33 ) treated with metoprolol for 12 months follow-up treatment. The concenrrarions of plasma norepinephrine(NE) and epinephrine (E) and 24 hour Holter monitoring were messured respectively before the treatment ,after 6 months and 12 months; and new cardiac events were supervised for all cases. Quantification of heart rate turbulenee(HRT) were carried out by computer analyzing two factors: turbulence onset(TO) and turbulence slope(TS) from the data of 24 hour Holter monitoring. NE,E,TO,TS and the occurrence rate of new cardiac events were compared between two groups and in different times of treatment. The correlation between TO,TS and NE,E was analysed. Results Before the treatment, there was no significant differences between two groups to the comparisons of NE,E,TO and TS(P＞0.05). After treating 6 and 12 months, NE, E and TO of experimental group were all lower than control group's significantly, accordingly TS were all higher(P＜0.05). By comparing 3 times( before,after 6 and 12 months of treatment), NE, E and TO of two groups dropped, meanwhile TS rose; experimental group showed significant changes( P＜0.05 ), but control group showed no significant differences(P＞0.05 ). The occurrence rate of new cardiac events of experimental group was lower than control group's significantly (P＜0.05 ).There was significant correlation between NE, E and TO, TS (P＜0.05 ). Conclusion Carvedilol treatment can block the secretion of sympathetic nerve after myocardial infarction and prevent the occurrences of new cardiac events significantly; the changes of the secretion of sympathetic nerve can play an important role for heart rate turbulence (HRT) ,the changes of HRT would be hopeful to predict new cardiac events alter myocardial infarction.

OBJECTIVETo investigate the mid-term outcome of operation for thoracolumbar tuberculosis. METHODS : Twenty-eight patiens with thoracolumbar tuberculosis underwent one stage anterior debridement,interbody fusion with bone graft and posterior pedicle screw internal fixation treatment from July 2006 to July 2011. There were 17 males and 11 females. Total 17 patients had nerve injuries ,including 6 cases of grade B, 5 cases of grade C, 6 cases of grade D according to Frankel classification. The poisoning symptoms of tuberculosis and recovery of spinal function were observed. The bone fusion and recovery of [umbar function were evaluated.

RESULTSAll the patients were followed up ,and the duration ranged from 39 to 85 months (mean 57 months). The clinical symptoms were controlled gradually, and the thoracolumbar back pain was alleviated after operation. Among the 17 patients with complications of nerve injuries, 3 patients were improved from preoperative grade B to postoperative grade D, 3 patients were improved from preoperative grade B to postopertive E, 5 patients with preoperative grade C and 6 patients with preoperative D were almostly recovered to normal after operation. According to JOA scoring system for curative effect evaluation, the excellent and good rate at the 3rd month, the 1st year, the 3rd year and the 5th year after operation were 67.86% ,82.14% ,85.71% ,89.29% and 91.30% respectively. The results at the 6th month and the 1st year had no statistical differences compared to the results at the 3rd month (P > 0.05); but the results at the 3rd year and the 5th year were better than that at 3 months after operation (P < 0.05); and the results between 3 yesrs and 5 years after operation had no statistical differences (P < O.05). The degeneration of adjacent segments were evaluated according to the California University (Universith of California at Los Angeles , UCLA) score. The degeneration rate was 53.57% (15/28) at the 3rd year after surgery, which was better than that before surgery. Twenty-three patients were followed up for 5 years ,and the degeneration rate was 86.96% (20/23) ,which was better than those of before surgery and 3 years after surgery.

CONCLUSIONThe surgical treatment for thoracolumbar spinal tuberculosis can achieve the thorough debridement, reconstruction of spinal stability, recovery of lumbar function and promote the functional recovery of the spinal cord, which is an effective method of treatment. However, the mid term follow-up showed that more severe degenerative changes were found in the postoperative adjacent segment.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; physiopathology ; surgery

Objective To study the effects of carvedilol on the stability of plasma catecholamine in patients with post-acute myocardial infarction during consecutive periods. Methods Thirty-slx patients selected with acute myocardial infarction were randomized to experimental group treated with the nonselective beta-blocker earvedilol( n=18) and control group treated with the selective beta-blocker metoprolol(=18) for 12-months follow-up. In the two groups,the concentrations of plasma norepinephrine and epinephrine were measured before the treatment and after 2 months,4 months,6 months,8 mouths,10 months and 12 months and new cardiac events were supervised. Results After the treatment, in each point of periods, experimental group showed lower concentrations of plasma norepinephrine and epinephrine statistically than control group(P<0.05) ,and a stable dynamic change during 12 months of treat-ment( P>0.05 ) ;the occurrence rate of new cardiac events was lower significantly in experimental group than in con-trol group(P<0.05). Conclusion Carvedilol can decrease the spillover of sympathetic nerve, control more stably cardiac sympathetic nerve activity and then decrease more sharply the occurrence rate of new cardiac events in pa-tients with acute myocardial infarction than metoprolol.

BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insufficiency (CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit (ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group (n=32) and a control group (n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone (150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers of inflammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically significant. RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4％. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI (23.8％ vs. 8.7％, P<0.01). Kaplan-Meier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group (P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group (18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers of infection and inflammation (P<0.01), such as C-reactive protein (13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α (26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin (3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group (P<0.01). CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers of infection and inflammation.

Functional magnetic resonance imaging (fMRI), a newly developing technique, contains function, anatomy and image, which makes the real-time, dynamic and non-invasive measurement of the functional brain imaging availability. This paper summarized the characteristics of fMRI in health and stroke populations, introduced the advances of fMRI in neuroplasticity, rehabilitation assessment and prognosis in hand movement dysfunction in patients with stroke, and discussed the difficulty fMRI faced in rehabilitation assessment and the further researches.

Objective To explore the correlation of serum γ-glutamyltransferase (γ-GT) level in normal range to metabolic syndrome (MS) in middle-aged and elderly Chinese women. Methods Female inhabitants aged 40 years in Nan'an community, Chongqing, were recruited to receive questionnaire interview and physical examination. Blood glucose, lipid, liver and kidney function profiles were also examined. A total of 1308 subjects were involved in our study, and they were divided into four groups according to the γ-GT quartiles. The correlation of MS prevalence, odds ratio and the relation of menopausal status with γ-GT level was analyzed. Results As the quartile of serum γ-GT level increased, the multiple metabolic risk profiles tended to deteriorate, and the number of postmenopausal women increased gradually. From the first quartile to the fourth quartile of γ-GT level, the prevalence of MS was 22.5%, 27.4%, 42.7% and 58.5%, respectively (P<0.01). Compared with those subjects in the first quartile of γ-GT, the MS risks in the fourth quartile increased by 2.92-fold, central obesity by 2.31-fold, high triglycerides by 3.76-fold, hypertension by 1.84-fold, and hyperglycemia by 1.63 fold. The γ-GT levels increased significantly in proportion to the number of elements of MS (P<0.01). Multiple stepwise regression analysis showed that triglycerides, waist circumference, menopausal status, 2h postprandial blood glucose and body mass index were independent influencing factors of γ-GT levels. Conclusions Serum γ-GT is an independent metabolic risk factor related to woman's menopausal status. An increased γ-GT level in normal range might imply an increased MS risk in middle-aged and elderly Chinese women.