Objective To investigate the effect of magnesium sulfate on epidural labor analgesia with ropivacaine in the patients with preeclampsia. Methods Seventy nulliparous parturients with pre?eclampsia, aged 23-34 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, weighing 63-81 kg, with a singleton fetus in vertex presentation, without contradications to neuraxial anesthesia, waiting for vaginal delivery, received epidural analgesia for labor. The patients were divided into magnesi?um sulfate group and control group using a random number table, with 35 patients in each group. In magne?sium sulfate group, magnesium sulfate 50 mg∕kg ( 30 ml) was infused intravenously over 15 min when their cervical dilation was 3 cm, while the equal volume of normal saline was given in control group. Epi?dural labor analgesia was performed with ropivacaine. The up?and?down sequential allocation was used to determine the median effective concentration of epidural ropivacaine ( EC50 ) . The severity of pain was as?sessed with visual analogue scale score. Effective analgesia was defined as visual analogue scale score of≤1. The initial concentration of ropivacaine was 0.15%. Each time the concentration was increased∕decreased according to whether or not analgesia was effective, and the ratio between the two successive concentrations was 0.9. The EC50 and 95% confidence interval ( CI) of ropivacaine for epidural labor analgesia was calcu?lated. Results The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.066% (0.062%-0.071%) in magnesium sulfate group. The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.078% (0.072%-0.085%) in control group. The EC50 of ropivacaine was significantly lower in magnesi?um sulfate group than in control group ( P<0.05) . Conclusion Magnesium sulfate can enhance the effica?cy of ropivacaine for epidural labor analgesia in the patients with preeclampsia.

Objective To evaluate the forecasting value of renal scintigraphy (ECT) on the diagnosis of renovascular hypertension (RVH). Methods Twenty-four cases of coronary heart disease and hypertension were selected. All of them were suspected of RVH. They underwent ECT and renal arterial angiography (RAA). Results The 24 cases were diagnosed as RVH. The diagnostic sensitivity of renal scintigraphy in RVH was 83.3% (P

Objective To explore the influence of alimentary tract reconstruction on blood glucose level in gastric cancer patients complicated with type 2 diabetes mellitus. Methods Clinical data of 67 gastric cancer patients complicated with type 2 diabetes mellitus and the level of blood glucose before operation, one month, three month, six month after operation were retrospectively analyzed. BMI of 53 patients was lower than 25kg/m2,9 patients between 25～29.9 kg/m2 and 5 patients was higher than 30kg/m2 .Total gastrectomy with P-type jejunal pouch Roux-en-Y esophagojejunostomy was performed in 26 cases, and total gastrectomy with Roux-en-Y esophagojejunostomy was performed in 11 cases, distal subtotal gastrectomy with Roux-en-Y gastrojejunostomy in 30 cases. Results Operations on sixty-seven patients were all uneventfully. The mean fasting blood glucose level in the morning was 9.6±3.3 mmol/L before operation, 7.4±2.6 mmol/L one month after operation, 7.5±2.3 mmol/L three month after operation, and 7.7±2.9 mmol/L six month after operation. There were significant differences between the blood glucose level of before operation and one month after operation (P<0.05), and there were no significant differences between three month,six month and one month after operation (P>0.05). Conclusions Alimentary tract reconstruction has obviousinfluence on blood glucose level in type 2 diabetes mellitus patients. It takes about one month for reveal the effect of operation. This phenomenon is of value for clinical application. Its mechanism needs further research.

Objective To study the plasma antioxidant vitamin status in patients receiving enteral nutrition(EN) or parenteral nutrition(PN) after upper gastrointestinal surgery.Methods One hundred and twenty patients who underwent upper gastrointestinal cancer surgery were randomized into EN and PN group.The plasma vitamin A,vitamin E and ?-carotene levels pre-and post-operation and one week after clinical nutrition supplement were studied.Results Vitamin A and ?-carotene levels decreased significantly after surgery(P=0.03 and P=0.01,respectively).Vitamin E decreased 10 weeks after the nutrition,and it was significantly lower in the EN group than in the PN group(P0.05).Conclusions A decrease of antioxidant vitamins is induced by surgery and vitamin E is recommended to be given in nutrition supplement patients,especially in the patients receiving EN.

BACKGROUND: MyoD gene is one of family members of muscle transcription factors. Transfection MyoD gene can switch on the procedure of differentiation of muscles, and transit non-muscle cells into muscle cells.The MyoD gene only expresses in skeletal muscles. Based on the same contractive structure in myocardial cells and skeletal muscle cells, it is imagined that the conversion from exogenous MyoD gene-induced fibroblast in local myocardium into skeletal muscle cells that had contractive function may become another method in the treatment of congestive heart failure on clinic.OBJECTIVE: To construct and identify a recombinant adenoviral vector carrying MyoD gene for further studies on the recovery function of MyoD gene in myocardial injury.DESIGN: Single sample experiment.SETTING: Department of Cardiology, First Affiliated Hospital, Nanjing Medical University.MATERIALS: The experiment was conducted at the Laboratory of Microbiology and Immunology, Nanjing Medical University between September 2004 and September 2005. MyoD gene and non-replicating form expressive vector of adenovirus were taken as research materials.METHODS: MyoD cDNA fragments were extracted from plasmids pEMSV-MyoD with polymerase chain reaction (PCR), and PCR was used to clone the whole-length gene of MyoD. After adding CACC sequence at 5' end, MyoD gene was cloned by orient topology into transfer ventor, pENTR/D-TOPO. Objective gene was transferred into adenoviral expression vector DNA via pENTR/D-TOPO vector. The recombinant adenoviral vectors transfected into HEK293A cells by using lipofectamine were packaged and amplified.MAIN OUTCOME MEASURES: Evaluation of PCR and DNA sequencing were used for confirming the size of segment and correctness of rank of MyoD cDNA and detecting the titre of virus.RESULTS: MyoD recombinant adenovirus contained target segment with precise length confirmed by PCR and DNA sequence that was correct. The titre of virus was 1.3×1011 pfu/mL.CONCLUSION: The recombinant adenoviral vector carrying MyoD gene is constructed successfully.

Objective To explore relevant factors of hyperthyroidism with periodic paralysis of hypokalemic (TPP).Methods The clinical data of 112 cased with hyperthyroidism complicated periodic paralysis of hypokalemic were retrospectively analyzed and to analyze the relevant factors. Results Compared to control group, the hyperthyroidism with periodic paralysis group had no obvious differences in general factors ( P ＞ 0. 05 ), but had obvious difference in Gender( P ＜0. 05 ) ;Compared to control group, the hyperthyroidism with periodic paralysis group had obvious differences in induction factors(P ＜ 0. 05);Compared to recurrent group, the incipient group had no obvious differences in several factors( P ＞0. 05) ,but had obvious difference in hyperthyroidism medical history over one year( P ＜0. 05) ; Hyperthyroidism with periodic paralysis was strongly associated with hypokalemia, age, gender, tiredness, getting a cold, satiation and hyperthyroidism genetic history ( P ＜ 0. 01 ). Conclusion The relevant factors of hyperthyroidism with periodic paralysis were hypokalemia, gender, tiredness, getting a cold, intemperance, satiation and hyperthyroidism medical history.

[Objective] To investigate the pathological features, secretion of interleukin-8 (IL - 8), tumor necrosis factor alpha (TNF-?) and secretory immunoglobulin A (sIgA) and helicobacter pylori (HP) infection in gastric mucosa (GM) of chronic superficial gastritis with spleen-stomach and damp-heat syndrome (SSDHS) and to explore their correlations. [Methods] Fifty-five cases of chronic superficial gastritis included 35 cases of SSDHS (Group A) and 20 cases of spleen-deficiency syndrome (Group B). Fifteen asymptomatic volunteers served as normal control group (Group C). Pathological changes, HP infection rate, levels of IL - 8, TNF -? and sIgA in GM were observed. [Results] HP infection rate was higher and inflammatory change was more obvious in Group A than those in Group B and Group C (P 0.05). [Conclusion] Gastric mucosa of chronic superficial gastritis with SSDHS presents inflammatory changes, which is related with the increase of IL - 8 and TNF -? secretion and the decrease of sIgA, and HP infection may be one of the factors inducing and enhancing the pathological changes.

Objective To explore the role of OAZ gene in the pathogenesis of systemic lupus erythe-matosus (SLE) by using RNA interfering technique. Methods Peripheral blood mononuclear cells (PBMC) from SLE patients were collected. Each sample was equally divided into four groups for cell culture in 96 well plates. Specific siRNA for OAZ and GAPDH were concordantly added to the experimental group and the positive control group, while nonspecific siRNA was added to the negative control group and only culture medium was added to the Mock control group. Cells and supernatants were harvested after culturing for 72 hours, then RNA was extracted and reverse transcripted to cDNA. OAZ, Id1, Id2, Id3, Id4 mRNA expression levels were analyzed by using real-time PCR. Levels of IFN-γ, IL-4, IL-10, IL-12, IL-21, CCL2, ANA in the supernatant were tested by ELISA. Relationships between the expression levels of OAZ mRNA with levels of cytokines and ANA were analyzed. Results OAZ, Id1, Id2, Id3 gene mRNA expression levels (△Ct: 12.5±1.4, 8.9±1.5, 4.3±0.8, 8.04±1.1) in the experimental group were significantly decreased comparing to those in the negative control group (△Ct: 10.2±1.1, 6.5±1.2, 2.4±1.3, 6.2±1.2 respectively, P<0.05). Levels of IFN-γ, IL-10, IL-12, IL-21 and ANA in the experimental group were significantly lower than those in the negative control group (P< 0.05), but level of CCL2 was higher than the negative control group (P<0.05). Difference of OAZ mRNA expression levels (△△Ct) between the experimental group and the negative control group was negatively correlated with changes of ANA, IL-21 levels, but positively correlated with changes of Th1/Th2, CCL2. Conclusion OAZ siRNA can effectively reduce the expression of genes involved in the OAZ signaling pathway in SLE. OAZ may lead to abnormal production of ANA via regulating Id genes and cytokines.

Objective To investigate the expression and significance of myeloid cell leukemia-1 (Mcl-1 )gene and protein in Hepatocellular Carcinoma(HCC).Methods The expression of Mcl-1 was detected respectively by Reverse Transcription-Polymerase Chain Reaction (RT-PCR),Western blot and ENVISION immunohistochemistry in 20 HCC specimens,19 liver cirrhosis(LC)specimens,and 12 control ones.Their relationship with clinical and pathological characteristics of HCC was investigated.Results The expression of Mcl-1 mRNA in the control group,LC group and HCC group was 0.52±0.17, 3.46±1.7,3.65±2.93,respectively.The level in HCC and LC group was statistically different compared with the control group,respectively (t=7.925,5.334,P<0.05).The relative expression of Mcl-1 protein in LC group (0.51±0.35)and HCC group (0.75±0.36)were significantly higher than that in the control group (0.21±0.19)(t=5.526,6.355,P<0.05).The positive expression rate of Mcl-1 in HCC group was 55.00% (11/20),significantly higher than that in the con-trol group 33.33% (4/12)(t=7.835,P<0.05).The positive expression of Mcl-1 was related to tumor necrosis and TNM staging (χ2=4.201,P<0.05).Conclusion Mcl-1 gene and protein are differentially expressed in HCC,LC and the control, which may be involved in the occurrence,development and malignant transformation of HCC.

Objective To choose one protocol that can quickly ,safely and effectively provide amount enough of bone marrow derived mesenchymal stem cells(MSCs) for use of clinical or experimental test through comparison of their growth characteristics and growth factors levels in culture solution .Methods Cells extracted from bone marrow of C57BL/C mice respectively underwent two different isolation protocols :whole bone marrow adherent culture(WBMAC) or gradient density separation(GDS);characteris‐tic surface antigens of MSCs were identified by flow cytometry on cells isolated in different ways ;the distinct growth curve of pri‐mary stem cells cultured in vitro described their different proliferation rate;levels of vascular endothelial growth factor(VEGF) and stromal cell‐derived factor‐1α(SDF‐1α) in culture medium were detected by ELISA .Results Primary MSCs obtained by WBMAC proliferated at higher speed and exhibited shorter growth cycle than those separated by GDS ;on MSCs from both groups ,surface antigens CD29 were detected positively ,and antigens including CD31 ,CD34 and CD45 were assayed negatively ;concentration of VEGF and SDF‐1αin both two nutrient solution primarily keep at low levels ,comparatively ,level of VEGF and SDF‐1αin the di‐shes which contain MSCs by WBMAC was higher than the one in the dishes which contain MSCs by GDS .Conclusion MSCs ex‐tracted by WBMAC shows unimpaired cell function ,can build automatically more suitable microenviroment for their growth;this classic method was qualified for clinical and experimental use in a safe ,rapid ,effective way .