Objective To compare the effects of propofol,nidazolarm versus etomidate combined with sufentanil for anesthesia induction on intraocular pressure.Methods Forty-five ASA Ⅰ or Ⅱ patients,aged 20-40 yr,scheduled for surgery under general surgery,were randomly divided into 3 groups(n =15 each):propofol group(group P); midazolam group(group M)and etomidate group(group E).Anesthesia was induced with iv injection of propofol 2 mg/kg,midazolam 0.2 mg/kg,and etomidate 0.3 mg/kg in P,M and E groups respectively,and then with iv injection of sufentanil 0.2 μg/kg and cisatracurium 0.2 mg/kg in all the groups.The patients were then tracheal intubated.Intraocular pressure(IOP)and MAP were recorded at 1 m in before induction of anesthesia (T0),before intubation(T1),and at 0,1 and 2 min after intubation(T2-4).Results Compared with group P,the incidence of intraocujar hypotension was significantly decreased in group M(P ＜ 0.01).Compared with group E,the incidence of intraocular hypertension was significantly decreased in P and M groups(P ＜ 0.05),The correlation coefficient between MAP and IOP was 0.831,0.889 or 0.806 in group P,M or E respectively(P ＜0.05),and there was no significant difference in the correlation coefficient among the three groups(P ＞ 0.05).Conclusion Midazolam combined with sufentanil for anesthesia induction exerts less influence on lOP and the degree of MAP fluctuations is a major factor contributing to the change in IOP.

Amphetamine-type stimulants ( ATS ) , a group of new-type synthetic drugs mainly in psychological dependence, are abused more and more severely in recent years. MicroRNAs ( MiRNAs ) are an important class of endogenous non-coding small RNAs that mediate posttranscriptional negatively regulation of gene expression by targeting specific mRNA sequences to in-hibit the translation of mRNAs or degrade the expression of mR-NAs. ATS can induce the changes in the expression of miRNAs in addiction-related brain regions which directly involve in the regulation of ATS-induced addictive behaviors. Therefore, to study the regulatory role of miRNAs in ATS-induced addiction has important implications for dependent mechanisms of new-type drugs and the discovery of the new targets of drug actions.

Objective To evaluate the feasibility of methylene blue as a method in lymphatic mapping and the effect factors of SLNB identification rate. Methods The results of SLNB in 276 patients with clinical stage T-T2N0M0 breast eaneer were analyzed to evaluate the effect factors of identification rate and false-neg-ative rate of SLNB. Results The identification of SLN was carried out using methylene blne . When the mapping time of SLN and lymphatic were controlled in 20～30 minutes, the SLN could be visualized easily. SLN was successfully identified in 246 of 276 patients (89.1%) ,423 SLNs were retrieved(1～4). The SLN accurately predicted the status of the axilla in 226 of 246 patients (77.3%) yielding a FNR(false negative rate)of 8.1% (20/246) ,false positive rate of0, and an accuracy of 91.9% (226/241). For the identified rate of SLN, the clinical stage of T2N0M0 disease was higher than the clinical stage of T1N0M0 disease (P=0.046,P<0.05), Upper outer quadrant and lower outer quadrant were higher than other evidently (P<0.0010). SLNs were easily retrieved in those cases aged above 50 years than below 50 years (P<0.001).In the view of false-negative rate of SLNB, the FNR rate in patients of 50 years old was less than older ones (P=0.037, P<0.05). No significant correlation was found between the stage of TMN, the expression of ER and PR, histologic status and FNR. Conclusion When SLNB was performed using methylene blue, we found age, clinical stage of TMN, the location of tumor had relationship with the identified rate of SLN. Ag-ing and location of tumor may adversely affect FNR of SLNB.

Alemtuzumab (Campath) was successfully injected in 21 kidney transplant patients,7 islet transplant patients and 1 simultaneous kidney and islet transplant patient for either prevention or treatment of graft rejection.Prophylactic administration was successfully completed in all patients without discontinuation.Adverse events were not observed in 11 patients (38%),but hypertension in 18 patients (62%),shivering in 3 patients (10.3%),high fever in 3 patients (10.3%),and bronchospasm in 1 patient (3%),respectively.All complications alleviated after proper therapy.During the prophylactic administration of alemtuzumab,strict,timely and proper ward-management was needed.Care for lung,perineum,skin,diet and psychological nursing were necessary.Neither graft acute rejection nor graft chronic rejection episode occurred in all patients during 6 months to 2 years follow-up.Therefore,long term effects of Alamtuzumab and consequences of lymphocytopenia need further observation.

BACKGROUND:hIL-24, a tumor suppressor gene, can stimulate immune responses, inhibit the growth of tumor cel s, and the formation of tumor vessels, and induce cel apoptosis. OBJECTIVE:To explore the effects of hIL-24 gene on the proliferation and apoptosis of fibroblasts in the keloid and the underlying mechanisms. METHODS:Al the keloid specimens col ected from 13 patients were used for fibroblast culture and indentification. Fibroblast of the keloid was transfected with or without hlL-24 lentivirus. Subsequently, mRNA expressions of transforming growth factor-β, Smad3, proliferating cel nuclear antigen, matrix metal oproteinase-2,-9, and metal opeptidase inhibitor 1 were determined. RESULTS AND CONCLUSION:Immunofluorescent staining and flow cytometry showed that vimentin antibody was expressed positively in cytoplasma of fibroblast cultures, and the purity was more than 97.8%. Western blot assay showed that hIL-24 expression was significantly increased in the transfected fibroblasts. Quantitative PCR showed that the overexpression rate of hIL-24 in fibroblasts was 81.7%and mRNA expressions of transforming growth factor-β, Smad3, proliferating cel nuclear antigen, matrix metal oproteinase-2, and-9 were significantly decreased, while metal opeptidase inhibitor 1 mRNA expression was significantly increased in hIL-24 transfection group compared with control group (P<0.05). These findings suggest that hIL-24 gene inhibits the expressions of proliferating cel nuclear antigen, matrix metal oproteinase-2, and-9 in fibroblasts, and the underlying mechanism may involves TGF-β/Smad3 pathway.

Objective To screen and identify B cell epitopes in SAG1, SAG2, SAG3, GRA1, GRA6 and P35 antigens of Toxoplasma gondii. Methods The indexes such as hydrophilicity, accessibility, flexibility, secondary structure and polarity of the 6 antigen moleculars above mentioned were analyzed by BioSun system. Two B cell epitopes with high antigenicity from each antigen molecular were selected, and the total twelve pairs of oligonucleotide chains were designed according to the 12 B cell epitopes’ sequence and synthesized, then cloned into plasmid pET-32c. The 12 fragment B cell epitopes were expressed and the expressed fusion proteins were identified with Western blot. Results Twelve B cell epitopes from 6 Toxoplasma antigens (two from each antigen) were predicted and selected. The epitope genes were successfully cloned into pET-32c and expressed. Western blot results showed that 3 of 12 expressed fusion proteins could be recognized by the immunized rabbit sera with soluble antigen of Toxoplasma gondii, but not by the unimmunized rabbit sera Conclusion Three B cell epitopes of Toxoplasma[with potential diagnostic value are obtained.

Objective To analyze the clinical characteristics and pyridox (am)ine-5'-phosphate oxidase(PNPO) gene mutations in 2 patients with PNPO deficiency.Methods The identical twin brothers were diagnosed at the Department of Pediatrics of Peking University First Hospital in February 2016.The clinical presentations,course of treatment,blood biochemistry,metabolic screening,EEG,brain magnetic resonance imaging (MRI) and epilepsy-related genes detection (including PNPO gene) of them were analyzed.Results These 2 patients were born at 35 +5weeks gestation and had asphyxia after birth.The seizures started within the first day,which was uncontrolled by various antiepileptic drugs.EEG showed atypical hypsarrhythmia or multifocal epileptiform discharges.MRI showed nonspecific abnormality.Pyridoxine was used as monotherapy or combination with various antiepileptic drugs during the treatment.Seizures had ever been controlled by pyridoxine alone for up to 1 month.Antiepileptic drugs were withdrawn gradually under the circumstances of seizures persisting when they became 5 years old.During the past year,pyridoxine was used alone.They still had seizures at their age of 6 years and 4 months.Blood metabolic screening showed that the level of arginine,asparaginic acid and methionine decreased.Urinary metabolic screening showed vanillic acid elevating prominently in both patients,49.78 and 36.60 times beyond normal,respectively.Genetic analysis showed compound heterozygous variants ofPNPO gene in both patients:c.445_448del (p.P150RfsX27) and c.481C ＞T (p.R161C).These 2variants were not reported previously.After definite diagnosis was made,pyridoxine was replaced by pyridoxal-5'-phosphate (PLP) immediately.Seizures increased slightly at the initial treating with PLP,then reduced gradually and were controlled eventually.Psychomotor development was severely delayed in 2 patients.Conclusions Infantile onset intractable seizures in these 2 patients responded to pyridoxine.The results of blood and urinary metabolic screening suggest the possibility of PNPO deficiency.This is the first time to report patients with PNPO deficiency diagnosed by PNPO gene mutations in China.Seizures could be controlled by PLP monotherapy eventually.

Objective HBV DNA with two pairs of semi-hepatitis B treatment in the role.Methods ECLIA assay of serum hepatitis B two pairs of semi content was detected by PCR serum HBV DNA concentrations.Results Three positive-HBsAg,HBeAb,HBcAb (Ⅰ group) in patients with HBV DNA positive rate is 61.3％,Three positive-HBsAg,HBeAg HBcAb (Ⅱ group)in patients with HBV DNA positive rate is 84.3％,The positive rate of HBV DNA is 33.3％ in Ⅲ patients,Ⅳ groups of patients without HBV DNA positive.Conclusion HBV DNA with two pairs of semi-diagnosis and treatment for hepatitis B have complementary roles that can guide hepatitis B treatment.

Objective:To analyze the clinical phenotype and genetic characteristics of children with germline PIGA gene mutations. Methods:The clinical presentations, blood biochemistry, electroencephalogram (EEG), brain magnetic resonance imaging (MRI) and genetic test results of 10 children diagnosed at the Department of Pediatrics of Peking University First Hospital between January 2014 and June 2020 were analyzed.Results:All these 10 children were male, with seizures and severe developmental delay.Five out of eight cases showed hypotonia.Four out of nine cases had facial deformity or multiple organ abnormalities.The onset age of seizures ranged from one month and 28 days to 10 months, with an average age of 4.8 months.There were various types of seizures, and all patients showed focal seizures.The seizures of 6 patients in these 10 cases could be induced by fever disease.Diffuse slow waves mixed focal or multifocal discharges of interictal EEG in 9 cases with PIGA-deficient.Brain MRI showed enlarged subarachnoid space in 44.4% (4/9 cases) of patients.Slight elevated serum alkaline phosphatase could be seen in 2 cases.Genetic analysis confirmed that a total of 8 different mutation sites were found, 7 of which were unreported.In this group, 4 cases were diagnosed with multiple congenital anomalies -hypotonia -seizures syndrome 2 (MCAHS2), 5 cases were diagnosed with developmental delay and epilepsy without deformity, and one case was not classified, respectively. Conclusions:Focal seizure was common in these patients with PIGA mutations, and often induced by fever disease.Interictal EEG was characterized by diffuse slow waves mixed focal or multifocal discharges.Enlarged subarachnoid space was the most common brain MRI abnormality in these patients.The phenotype of patients only partially conformed to typical MCAHS2 manifestations, and most of them had no deformity.

Objective:To summarize the clinical phenotype and gene mutation characteristics of male patients with epilepsy caused by mosaic PCDH19 mutation. Methods:The clinical data of 3 male patients with epilepsy caused by mosaic PCDH19 mutation were analyzed.Microdroplet digital polymerase chain reaction (mDDPCR) was used for the detection of mosaicism in the three probands and their family members.Relevant literatures were reviewed. Results:The seizure onset age were 5 months, 9 months and 6 months of life respectively.Focal seizures occurred in 2 cases and multiple seizure types occurred in 1 case.Three patients presented with clusters of seizures.Fever sensitivity was observed in 2 cases out of the 3 cases.Two patients had intellectual disability and 1 patient had autistic manifestation.The clinical phenotype in 2 patient fulfilled the diagnosis of Dravet syndrome. PCDH19 mosaic mutations c. 317T>A(p.M106K), c.158dupT(p.D54Gfs*35) and c. 1639G>C(p.A547P) were detected respectively, and were identified as de novo after parental validation.Mutant allele fractions (MAF) in the blood samples were identified as 81.18%, 37.08%, 77.64%, respectively.The MAF of multiple tissues in 1 patient varied from 78.67% to 98.46%.Review of literature revealed that a total of 11 cases with mosaic PCDH19 mutation were reported.Among them, seizure onset occurred between 5 and 31 months of age.Focal seizures occurred in 9 cases, 3 cases of the 9 cases had only focal seizures.Generalized tonic clonic seizures occurred in 4 cases.Two or more seizures were observed in 6 cases.Clustering of seizures was found in all patient and sensitivity to fever was observed in 9 patients.Seven patients had mild to severe intellectual disability and 5 patients had autistic features. Conclusions:The clinical phenotypes of male patients with epilepsy caused by PCDH19 mosaic mutation are characterized by clustering of seizures, sensitivity to fever, focal seizures in most cases, varied degree of intellectual disability and autistic features in partial.