Objective To investigate the analgesic efficacy and safety of decozine combined with sufentanil on patients after laparoscopic radical gastrectomy.Methods Sixty patients undergoing laparoscopic radical gastrectomy,American Society of Anesthesiologists (ASA) Ⅰ ～ Ⅱ,were selected,and were randomly divided into two groups.All of the patients were treated with intravenous-inhalation combined anesthesia,and was given patient controlled intraveous analgesia (PCIA) when the patient was awoken.PCIA was administered with subsequent bolus of 0.5 ml with lockout time 15 minutes and background infusion of 2 ml/h.A ratio (3 μg/kg) of sufentanil and 0.5 mg palonosetron were mixed in PCIA pump in sufentanil group (S group);and 1.5 μg/kg sufentanil,0.3 mg/kg dezocine,and 0.5 mg palonosetron in PCIA were mixed in dezocine combined with sufentainl group (DS group),they were diluted to 100 ml with saline.The visual analogue scale (VAS),Bruggrmann comfort scale (BCS),Ramsay and incidence of adverse reactions of two groups were observed in 2 h (T1),6 h (T2),12 h (T3),24 h (T4),48 h(T5) after operation.Results There was no significant difference of VAS and BCS between two groups at each time point after operation (P ＞ 0.05);The Ramsay score of S group was significantly higher than that of DS group at T1,T2,and T3 (P ＜ 0.05).The Ramsay scores of two groups at T4,T5 were lower than those of T1,T2,and T3.The incidence of nausea,vomiting of DS group was significantly lower than that of S group (P ＜0.05).Conclusions Dezocine combined with sufentainl used in PCIA on postoperative gastric cancer patients can obtain satisfactory analgesic effects,but has fewer side effects than single sufentainl.

Objective To explore the application value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) and 99Tcm-methylene diphosphonate (99 Tcm-MDP) bone scintigraphy for detecting bone destruction in multiple myeloma (MM).Methods 18 F-FDG PET/CT and 99Tcm-MDP bone scintigraphy results of 27 MM patients were analyzed retrospectively.Inspection areas checked by magnetic resonance imaging (MRI) and X-ray were the limited scopes.The location and number of bone destruction were recorded,and the maximal standardized uptake value (SUVmax) was measured simultaneously.The results were comparatively analyzed.Diagnostic certainty regarding the presence or absence of bone destruction was evaluated according to the reference standard consisting of MRI and X-ray.Results A total of 235 lesions were found according to the reference standard.Of these,227 lesions (97％) were identified by 18F-FDG PET/CT,whereas 187 lesions (80％) were identified by bone scintigraphy,with a significant statistical difference (x2 =32.43,P ＜ 0.05).SUVmax was 8.3 ± 1.7 (4.3 to 18.9).The discovery rates of bone fracture of 18F-FDG PET/CT and bone scintigraphy were 100％ (97/97) and 90％ (87/97),and there was a significant statistical difference between them (x2 =78.09,P ＜ 0.05).Conclusion 18 F-FDG PET/CT is a possible method to detect bone lesions in patients with MM,and is better than 99Tcm-MDP bone scintigraphy.

AIM: To construct the prokaryotic expression system containing protein transduction domain (PTD) with heat shock protein 27 (HSP27) in order to prepare and purify the recombinant protein , and to verify whether the recombinant protein PTD-HSP27 has the ability to penetrate the human lens epithelial cell ( HLEC) membrane and the rabbit cornea.METHODS:The plasmid pKYB-PTD-HSPB1-6His was constructed by the technique of overlap extension PCR.The plasmid was transformed and PTD-HSP27 was purified through nickel affinity chromatography column and identi-fied by Western blotting.PTD-HSP27-6His was labeled with the fluorescein isothiocyanate (FITC).The penetrating ability of PTD-HSP27 into HLECs and rabbit cornea was tested .RESULTS:The recombinant PTD-HSP27 plasmid was success-fully cloned and effectively expressed .The correctness of the recombinant protein PTD-HSP27 was demonstrated .Fluores-cence microscopic examination showed that PTD-HSP27-FITC was internalized by HLECs .Fluorescent labeled PTD-HSP27 was then observed in the rabbit aqueous humor .CONCLUSION:The recombined gene PTD-HSPB1 was constructed by o-verlap extension PCR technique and the PTD-HSP27 fusion protein was prepared and purified by nickel affinity chromatog-raphy column.Using the technique of PTD-fusion protein, HSP27 was transduced into HLECs and passed through the cor-nea .

Objective To explore the diagnostic value of color doppler flow imaging (CDFI) on subclinical varicocele(SVC) and the weakening effect of SVC on male fertility.Methods Thirty patients with SVC were exam-ined by CDFI, the diameter and regurgitation duration of spermatic vein were recorded.All semen specimens were rou-tinely analyzed according to the WHO criteria for sperm morphology.Thirty healthy sperm donors were served as con-trols.Results CDFI displayed a widened diameter( 1.94±0.28 mm vs 1.36 ±0.15 mm, P < 0.05 ) and prolonged regurgitation duration[(1.33 ±0.22)s vs(0.43 ±0.16)]s,P<0.05)of spermatic vein in patients with SVC.Sperm density[(20.2±0.1)106/ml vs(86.3±0.6)]106/ml,motihty[(50.7±0.9)% vs(78.5±3.6)]% and vitality [(41.5 ±0.3)% vs (58.7 ±0.6)]% were significantly decreased in patients with SVC compared with those in con-trols (all P< 0.05) ,while the rate of teratospermia remarkably increased in SVC group[(10.5±0.2)vs(4.8±1.7 )]%(P< 0.05 ).Conclusion CDFI was clinically valuable for diagnosis of SVC for its revealing morphological and hemodynamic changes of varicocele.When combined with semen quality analysis,which evaluates the weakening effect of SVC on male fertility, CDFI was suitable to provide the appropriate clinical approaches for SVC therapy.

Objective To summarize the clinical outcomes of pectoralis major myocutaneous flap for repairing large defects in oral and maxillofacial area after resection of malignant tumor. Methods The clinical data of 27 patients underwent resection of malignant tumor in oral and maxillofacial area and reconstructed with pectoralis major myocutaneous flap were collected in our hospital from August 1998 to January 2015. The pectoralis major myocutaneous flaps were harvested with sizes ranging from 6 cm × 4 cm to 11 cm × 9 cm. The major myocutaneous flaps were used to reconstruct the defects of oral mucosa in 26 cases, and flap was used to reconstruct the defect of facial skin in 1 case. Seventeen major myocutaneous flaps reached the neck via the subclavicular tunnel, the other 10 were transferred over the clavicle. Results After surgery, 20 flaps (74.1%) were survived completely, 6 were partial necrosis (22.2%) and one was total necrosis (3.7%). Thirteen cases showed postoperative complications (48.1%), in which 10 cases were wound infection (37.0%), including 8 patients with infection at the recipient site and 2 patients with infection at the donor site. The wound infection was found in all of 7 patients with flap necrosis. The other complications included wound dehiscence in 1 patient (3.7%), neck hematoma in 1 patient (3.7%), and lung infection in 1 patient (3.7%). Conclusion In order to avoid the flap necrosis and reduce wound infection at the recipient site, the major myocutaneous flap should be designed based on the characteristics of blood supply, and the vascular pedicle should be protected carefully in the operation.

Background and purpose:Δ133p53 can promote tumor cell growth, but the exact mechanism is not clear. This study was aimed to observe the expression and signiifcant of the p53 isoformsΔ133p53 and p53 gene downstream molecules MDM2 and cyclin G1 genes by 5-FU-MKN45 gastric cancer cell line model. Methods:Af-ter using different concentrations of 5-FU (50μg/mL, 100μg/mL) to human gastric cancer cell line MKN45, inhibition rate should be detected by MTT assay, the changes ofΔ133p53 mRNA, MDM2 mRNA and cyclin G1 mRNA express-ing were detected by reverse transcription-polymerase chain reaction (RT-PCR). Differences between these groups were analyzed by ANOVA, comparisons within groups were analyzed by t-test, bivariate correlation was analyzed by Pearson linear correlation. Results:MTT results showed that with the increased concentration of 5-FU and the extension of time, the cell inhibition rates increased gradually. The inhibition rates of 50μg/mL 5-FU were 41.10%, 54.79%and 68.48%, for culturing 24, 48 and 72 hours. There were statistically signiifcant differences between the groups(F=45.52, P=0.00). The inhibition rates of 100μg/mL 5-FU were 69.53%, 78.21%and 86.92%, for culturing 24, 48 and 72 hours. There were statistically signiifcant differences between the groups(F=85.58,P=0.00). The inhibition rates of 50 and 100μg/mL were 41.10%and 69.53%, for culturing 24 hours. There were statistically signiifcant differences between the groups(F=51.29, P=0.00). The inhibition rates of 50 and 100μg/mL were 54.79%and 78.21%, for culturing 48 hours. There were statistically signiifcant differences between the groups(F=51.29, P=0.00). The inhibition rates of 50 and 100μg/mL were 68.48%and 86.82%, for culturing 72 hours. There were statistically signiifcant differences between the groups(104.91, P=0.00). RT-PCR results showed that with the increase of the concentration of 5-FU, theΔ133p53 mRNA, MDM2 mRNA and cyclin G1 mRNA expression gradually declined in gastric cancer cell line MKN45 cells, and there were statistically signiifcant differences between the groups(F=738.532, 1 396.607, 2 785.56,P=0.00). Cor-relation analysis showed that the expressions ofΔ133p53 mRNA and MDM2 mRNA in gastric cancer were positively correlated (r=0.871, P=0.01), while the expression of cyclin G1 mRNA and p53 mRNA had no obvious relevance (P=0.13). Conclusion:In the 5-FU-MKN45 gastric cancer cell line model, anti-tumor pathway ofΔ133p53 isomers is related with MDM2 but was not related with cyclin G1.

Background and purpose: Little about the function of p53 isoforms in gastric cancer was reported. This study was designed to explore the role ofΔ133p53 in the effect of recombinant mutant human tumor necrosis factor (rmhTNF) on gastric cancer cells, and provide a new basis for the diagnostics and therapeutics of gastric carcinoma. Methods: MKN45 (withΔ133p53 expression) or SGC7901 (withoutΔ133p53 expression) cells were treated with rmhTNF of different concentrations only or combined with 5-FU (a traditional gastric cancer cellular killer), and the growth inhibition rate and apoptosis was detected by CCK-8 and lfow cytometry. mRNA expressions ofΔ133p53, Gadd45αand CyclinB1 were measured by nested reverse transcription-polymerase chain reaction (nRT-PCR) or real-time polymerase chain reaction(RT-PCR). Results:On MKN-45 cells with positiveΔ133p53 expression, the inhibitory effect of rmhTNF was signiifcant, the inhibition rates of 50 and 500 IU/mL rmhTNF were 24.82%, 72.33%after culturing for 24 h (t=-9.558, P<0.01);also, the inhibitory effect of 5-FU was improved by rmhTNF remarkably in time-and dose-dependence, the inhibition rates of 5-FU (25 μg/mL), rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL), rmhTNF (500 IU/mL) combined with 5-FU (25 μg/mL) were 18.20%, 48.66%, 59.83%, separately, after culturing for 24 h (F=82.742, P<0.01);the inhibition rates of rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL) were 48.66%, 68.20%, 85.23%, separately, after culturing for 24 h, 48 h and 72 h (F=128.583, P<0.01). However, on SGC-7901 cells with negativeΔ133p53 expression, no growth inhibition was showed by rmhTNF only, the inhibition rates of 50 and 500 IU/mL were 2.74%, 3.25%after culturing for 24 h (t=-0.121, P>0.05). In apoptosis test, the apopto-sis-enhancing effect of rmhTNF was signiifcant on MKN45 cells, and the apoptosis-enhancing effect of 5-FU was fur-ther promoted signiifcantly by rmhTNF, the apoptosis of rmhTNF (50 IU/mL), rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL), rmhTNF (500 IU/mL) combined with 5-FU (25 μg/mL) were 18.20%, 48.66%, 59.83%, separately, after culturing for 24 h (F=123.931, P<0.05). In mRNA measurement, down-regulation ofΔ133p53 and CyclinB1, up-regula-tion of Gadd45αwere signiifcant in MKN45 cells treated by rmhTNF alone or combined with 5-FU. In nRT-PCR anal-ysis, the mRNA levels ofΔ133p53 were relatively 0.886, 0.499, 0.330, 0.161 (F=240.927, P<0.01);In real-time PCR analysis, the mRNA levels of Gadd45αwere 1.227, 1.694, 3.394, and the mRNA levels of CyclinB1 were 1.221, 0.722, 0.316, relatively. The expression ofΔ133p53 was positively related to CyclinB1 (r=0.977, P<0.01), but negatively re-lated to Gadd45α(r=-0.950, P<0.01). Conclusion:InΔ133p53 positively expressed MKN45 cells, rmhTNF showed as an effective tumor inhibitor and an enhancer of 5-FU as well, and this effect might be helped by two p53 down-stream molecules CyclinB1 and Gadd45α. The results suggest thatΔ133p53 might be a key target for the biological effect of rmhTNF against gastric cancer.

Objective:To evaluate the cytotoxicity of different dental bonding agents to human dental pulp cells. Methods:Four dental bonding agents(Prime & Bond NT,Single Bond,Xeno Ⅲ and iBond) were diluted with the culture medium by a ratio of 1∶1 000,1∶2 000 and 1∶4 000(v/v), and the fourth passage of dental pulp cells were then exposed to agent dilutions for 12, 24 and 48 h respectively, then the morphological changes of pulp cells were observed with microscopy and cytotoxicity was analyzed with modified 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay.Results:There was significant influence of the type of dental bonding agents,exposure time and concentration on the cell morphology. Total-etch system was more toxic than self-etch system.Conclusion:Dental bonding agents are toxic to pulp cells,Single Bond is the strongest cytotoxic agent among the 4 adhesive agents.

OBJECTIVE To investigate the clinical characteristics and drug resistance of meticillin-resistant Staphylococcus aureus(MRSA) among inpatients in Huaxi Hospital in five years.METHODS We analyzed clinical distribution and resistant data on inpatients infected with MRSA between Jan 2003 and Dec 2007 in Huaxi Hospital,and collected the annual consumption of common used antibiotics,amount of MRSA isolates and MRSA isolated rate from Staphylococcus aureus(SA) strains.The data were analyzed by the method of Spearman analysis in SPSS.RESULTS We analyzed totally 1478 MRSA strains.The most common specimens of MRSA were sputum(70.8%),other secretions(14.2%) and blood(4.6%).The MRSA strains were frequently detected in ICU(29.8%),Department of surgery(17.3%) and Department of respiratory Medicine(6.4%).The drug resistance rate to ampicillin,tetracycline,rifampin,imipenem,ciprofloxacin,gentamicin,cefalothin,cefotaxime and cefazolin were beyond 90% in five years.The drug resistance rate against Erythromycin,Clindamycin and Clarithromycin decreased gradually from 93.1%,92.2% and 95.5% in 2003 to 82.3%,76.7% and 81% in 2007.It had not been found the vancomycin-resistant MRSA.Except Cotrimoxazole,the drug resistance rates of MRSA in ICU were almost higher than those in non-ICU departments.Based on the SPSS analysis,we concludea that annual consumption of etimicin had a positive correlation with MRSA,and

Liver transplantation is an effective treatment of end-stage liver diseases. However, liver ischemia-reperfusion injury (IRI) and rejection significantly cause the decrease of survival rate of liver graft. Therefore, it is urgent to explore a novel method, which can not only alleviate liver IRI, but also promote immune tolerance of allograft, thereby improving the survival rate of liver graft. Extracellular vesicle (EV) is nanoparticle released from cells into the extracellular microenvironment, which may alleviate graft injury by repairing autophagy, immunosuppression and accelerating tissue regeneration. Hence, EV becomes a research hot spot in the field of liver transplantation. Nevertheless, the clinical application of EV encounters multiple challenges, such as separation, purification, identification, storage of EV and how to deliver EV to the target cells. In this article, the mechanism of EV in liver IRI, the challenges in clinical application of EV and the potential application of EV were reviewed, aiming to provide reference for the clinical application of EV in liver transplantation.