OBJECTIVE:To investigate the cardiac-protective effects and safety of dexmedetomidine on cardiac muscle of elder-ly patients with non-coronary artery bypass grafting (OPCABG). METHODS:50 elderly patients underwent OPCABG were se-lected and randomly divided into observation group and control group,with 25 cases in each group. Both groups received mor-phine 0.2 mg/kg+scopolamine 0.3 mg/kg intramuscularly 30 min before operation,and were given sulfentanyl 1 μg/kg+etomidate 0.1-0.2 mg/kg+pipecurium bromide 0.1 mg/kg for anesthesia induction. Observation group was given Dexmedetomine hydrochloride injection 1 μg/kg,ivgtt,within 15 min,and then by pump injection at 0.5 μg/(kg·h) till the end of operation;control group was given constant volume of 0.9% Sodium chloride injection,ivgtt. cTnⅠ,IMA,SOD and MDA levels and the occurrence of ADR were observed in 2 groups after entering the operation room(T1),at the end of vascular anastomosis(T2),6(T3),12(T4),24 h (T5) after operation. RESULTS:IMA of observation group at T2,T3 and T4 were significantly lower than those of control group, and cTnI at T2,T3,T4 and T5 were significantly lower than those of control group,with statistical significance (P<0.05). There was no statistical significance in SOD level at T1,T2,T3,T4 and T5 between 2 groups(P>0.05). Serum level of MDA in 2 groups at T4 and T5 were decreased significantly,and the observation group was lower than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Dexmedetomidine can protect cardiac muscle of elderly pa-tients with OPCABG to certain extent,and relieve myocardial injury with good safety.

OBJECTIVE:To evaluate effects of dexmedetomidine hydrochloride on cardiovascular response of middle aged and elderly patients during tracheal extubation period. METHODS:110 general anesthesia patients with colorectal cancer were collected and randomly divided into observation group and control group,with 55 cases in each group. All patients received general anesthe-sia with same dose. Observation group was given intravenous pump of dexmedetomidine hydrochloride 0.5 μg/kg after surgery,and control group was given intravenous pump of propofol 0.5 μg/kg. HR and MAP of 2 groups were compared 10 min before tracheal extubation,at the moment of tracheal extubation,5 and 10 min after tracheal extubation. The oxygen saturation of blood,the time of respiration recovery,opening eyes and extubation were recorded in 2 groups. RESULTS:There was no statistical significance in HR and MAP between 2 groups 10 min before extubation and 10 min after extubation (P>0.05). HR and MAP of observation group were significantly lower than those of control group at the moment of extubation and 5 min after extubation,the levels of HR and MAP were significantly increased in the 2 groups with statistical significance (P<0.05). There was no statistical signifi-cance in oxygen saturation of blood,the time of respiration recovery and extubation between 2 groups(P>0.05). The time of open-ing eyes in observation group was significantly shorter than in control group,with statistical significance (P<0.05). CONCLU-SIONS:Dexmedetomidine hydrochloride could significantly decrease cardiovascular stress response and shorten recovery time of middle age and elderly patients with colorectal cancer during tracheal extubation period.

OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in CD4+,CD8+ and CD4+/CD8+between 2 groups(P>0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in the levels of NE,E and Cor between 2 groups(P>0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONS:The target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.

Objective To analyze the relationship between anti Mullerian hormone (AMH) levels and abnormal endocrine metab-olism in patients with polycystic ovary syndrome (PCOS) .Methods From January 2014 to December 2015 ,a total of 200 PCOS pa-tients were recruited into experimental group ,180 infertility patients causing by tubal disorder were selected into the control group . According to the level of AMH ,PCOS patients were divided into high AHM group(AMH=10 ng/mL ,98 cases) and low AMH group (AMH<10 ng/mL ,102 cases) .According to the index of insulin resistance(HOMA) ,PCOS patients were divided into high HOMA group(HOMA index=2 .97 ,108 cases) ,and low HOMA group (HOMA index <2 .97 ,92 cases) .Follicle stimulating hor-mone(FSH) ,serum AMH ,estradiol ,luteinizing hormone(LH) ,fasting blood glucose and fasting insulin ,testosterone(T) ,high den-sity lipoprotein(HDL) ,low density lipoprotein(LDL) were detected ,the level of insulin resistance(factor HOMA-IR were calculat-ed ,then internal secretion metabolic differences and the effect of AMH were analyzed .Results The AMH ,HOMA-IR ,LH ,T in the control group were significantly lower than those in the experimental group(P<0 .05) ,body mass index(BMI) in the control group was significantly higher than that in the experimental group(P<0 .05) .BMI ,HOMA-IR in the high AMH group were sig-nificantly lower than those in the low AMH group(P<0 .05) .There were no significant differences on LH and T between the high AMH group and low AMH group (P>0 .05) .AMH ,INS ,BMI in the high AMH group were higher than those in the low AMH group(P<0 .05) .Conclusion AMH in patients with PCOS increased significantly ,and AMH was negatively correlated with BMI and HOMA-IR ,and positively correlated with testosterone .

Objective To investigate the affecting factors on auditory and speech performances in preschool children with unilateral cochlear implantation (CI) .Methods The clinical data of the preschool children (n=165) with unilateral cochlear implantation in the Second Xiangya hospital from January 2006 to April 2013 were collected . These children received rehabilitation according to the method recommended by the China Rehabilitation Research Center for Deaf Children ,and the data were analyzed retrospectively .The categories of auditory performance (CAP) and speech intelligibility rating (SIR) were used to assess their auditory and speech performances .The relationships between the performance and gender ,implanted age ,genotype ,inner ear malformation ,history of hearing aid were evaluated .Results Implanted ages and genotypes were associated with the auditory and speech performance of par‐ticipants (P<0 .05) ,while genders ,hearing aid experience ,and inner ear malformations(enlarged vestibular aque‐duct syndrome ,EVAS)were not significant related (P<0 .05) .Children were found to have achieved better CAP and SIR growths when CI was implanted during 1~3 years old and 2~4 years old ,respectively (P<0 .05) .The outcomes of CI recipients with GJB2 mutation were significantly better than those of the GJB2-nonrelated CI recipi‐ents (P<0 .05) .Conclusion This study provides evidence that CIs during first 1~3 years old having better auditory rehabilitation results than those of during 4~6 years old ,and CIs during 2~4 years old obtaining a better speech development in the first 12 months after operation .Deaf children with GJB2 mutation show better auditory and speech performances after CIs than those of the peers without GJB2 mutation .CIs can be effectively performed in deaf children associated with EVAs as in those without EVAS .

The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Objective To establish the blood Septin9 methylation detection system for early screening of colorectal cancer based on fluorescence PCR technology .Methods The PCR primer of Septin9 was designed by searching the CpG island site of Septin9 methylation in the NCBI database .The high methylation site of Septin9 gene promoter region was confirmed by PCR amplification and sequencing after extracting DNA from colorectal cancer and para-carcinoma tissues .The fluorescence PCR and TaqMan probe detection technique was designed by aiming at high methylation site for constructing the plasma sample methylation detection sys-tem .Then its accuracy ,specificity ,repeatability and minimum detectable amount were performed the assess-ment and analysis .The SETP9 methylation detection was performed in plasma samples from 57 cases of color-ectal cancer and 30 healthy persons .Results The high methylation site of Septin9 gene in tissue samples was confirmed by sequencing .This site served as the target for designing fluorescence PCR detection system .After assessment ,the accuracy ,specificity and repeatability of this detection system were 100％ ,the lowest detection amount reached 0 .1 ng/μL .Among the plasma samples in 57 cases of colorectal cancer ,the positive rate of Septin9 methylation site detection was 71 .92％ (41/57) and the positive rate of in the patients with pathologi-cal stage Ⅰ and Ⅱ of colorectal cancer reached 64 .2％ .But Septin9 gene had no methylation in plasma of healthy population .Conclusion The plasma fluorescence PCR detection system with Septin9 gene methylation as the target has the characteristics of high sensitivity ,high specificity and high accuracy ,which is the reliable detection technique for the early screening of colorectal cancer and has good clinical application prospect .

Objective:To investigate whether tetrandrine could be used as an agonist of cGAMP to enhance the activation of cGAS-STING signaling pathway and analyze the antiviral function of tetrandrine.Methods:THP1-Lucia-ISRE and RAW-Lucia-ISRE cells were incubated with different doses of tetrandrine in combination with cGAMP, respectively. IRF3 reporter activity was analyzed by luciferase reporter assay. Western blot was used to detect the activation of cGAS-STING signaling pathway. The expression of IFN-β, CXCL10 and CCL5 at mRNA level was quantified by real-time quantitative PCR. The expression of IFN-β at protein level was assessed by ELISA. HeLa cells stably expressing STING-GFP gene (HeLa-STNG-GFP cells) were constructed and stimulated with tetrandrine and cGAMP, then puncta-like structures were imaged by ZEISS LSM780. THP1-Lucia-ISRE cells were infected with herpes simplex virus type 1 (HSV-1) in the presence or absence of tetrandrine or cGAMP. The antiviral function of tetrandrine was analyzed by Western blot and fluorescence intensity assay.Results:Tetrandrine enhanced cGAMP-mediated IRF3 responses and activated cGAS-STING signaling pathway in combination with cGAMP. Tetrandrine combined with cGAMP triggered STING translocation and the formation of puncta-like structures in HeLa-STNG-GFP cells. The titer of HSV-1, the expression of HSV-glycoprotein D/UL30 and the fluorescence intensity of HSV-GFP were all decline after treating HSV-1-infected THP1-Lucia-ISRE cells with tetrandrine and cGAMP.Conclusions:Tetrandrine combined with cGAMP activates cGAS-STING signaling pathway, thus enhancing the host antiviral response.

Objective To analyze the risk factors of cerebral microbleeds (CMBs) in acute cerebral infarction patients. Methods We consecutively included 255 acute cerebral infarction patients who were admitted in Neurology Department of the First Affiliated Hospital of Fujian Medical University from January 2014 to December 2016. According to the number and location of CMBs, the patients were divided into infratentorial, cortical and deep cerebral groups, each of which included non-mild and moderate-severe subgroups. The differences of the level of glomerular filtration rate (eGFR) and some common arteriosclerotic risk factors were analyzed between subgroups, and the multiple logistic regression analysis was performed. Results A total of 140 subjects (54.9%) had CMBs. In the infratentorial group, the proportion of patients who were with low eGFR level in the moderate-severe CMBs subgroup was higher than in the non-mild CMBs subgroup (P=0.024). The low eGFR level (OR=3.874, 95% CI:1.261～11.901, P=0.018) and the long duration of hypertension (OR=2.128, 95%CI: 1.004～4.510, P=0.018) were the independent risk factors of the moderate-severe infratentorial CMBs. Conclusion The low eGFR level and long duration of hypertension are risk factors for the moderate and severe infratentorial CMBs after acute ischemic stroke.

Traditional Chinese Medicine (TCM) shows unique advantages in the field of adjuvant treatment of gastric cancer. The main mechanism of TCM in improving gastric cancer includes regulating cell proliferation and apoptosis, reversing cell resistance, reducing the ability of invasion and metastasis and epithelial-mesenchymal transformation, regulating immune function, inhibiting neovascularization, regulating autophagy exosome, and ferroptosis.