Combined acupuncture-medication anesthesia refers to an anesthesia method by combining acupuncture and small dose of anesthetics, i.e. acupuncture plus local anesthesia, acupuncture plus epidural anesthesia, acupuncture plus general anesthesia, and so on, used in cardiac, chest, skull, throat, abdominal, and urinary operations. Clinical studies show that the combined acupuncture-medication anesthesia has integrated the advantage of acupuncture in regulating the function of internal organs and the advantage of drugs insedation, thus producing a better protective effect on important organs than dry drug anesthesia during and after operation. This article summarized the latest research progress of the combined acupuncture-medication anesthesia in protecting organs duringthe perioperative period of pneumonectomy, pointed out the research frontiers of the application of this anesthesia method in pneumonectomy, and was of valuable reference for the clinical study in the future.

AIM:To analyse the risk factors of age, sex, course, best corrected visual acuity(BCVA),diopter and fundus features of high myopes with progressive high myopia. METHODS: A total of 167 patients with high myopes were categorized into four groups: group 1,age of 29 years or younger; group 2,between the age of 30 to 49 years; group 3,between the age of 50 to 69 years and group 4,age of 70 years or older. The refractive errors of all patients were measured without cycloplegia with an autorefractometer. Data of the spherical equivalent(SE) of the refractive errors in diopters (D)and fundus examed by direct ophthalmoscope were used in statistical analyses.RESULTS: The number of female was statistically larger than that of male(P＜0.01),also the disease course was correlated to the age. The visual acuity of high myopes significantly decreased as they grew older including the higher incidence of lacquer cracker, submacular hemorrhage, Fuchs spots, chorioretinal atrophy . CONCLUSION: Female maybe a risk factor of high myopia, advanced age is an important factor of visual acuity decrease. High myopes ought to be treated early to delay the progress of myopia and development of macular degeneration.

Objective To study whether L-cysteine and lysolecithin (16:0) could be as a serum markers in the detection of OVC for overcoming the OVC defects of early detection .Methods Totally 142 cases of healthy check -up patients ( control group ) 100 cases from First Affiliated Hospital of Wenzhou Medical University in January 2012 to January 2014 were extracted patient specimens .These pa-tient specimens were used to detect by MALDI -TOF-MS mass spectrometer and obtain the peak m/z by the method of principal compo-nent analysis for screening expression difference between the two groups in the metabolites and the correlation between metabolites and pathological grade.Results The most difference substance between two groups were 184.05 and 496.30m/z which identified as LPC (16:0) and HCA;On HCA average level and detection rate , OVC group was significantly higher than control (P<0.01); On 184.05 and 496.30m/z peak area, control group was significantly higher than OVC group (P<0.01);HCA positively was correlated with patho-logic grade (P<0.05);184.05 and 496.30 m/z peak area were negative correlation with pathologic grade (P<0.05).Conclusion L-cysteine and lysolecithin (16:0) mechanism in the pathogenesis of OVC is unclear , but it can be used for the detection of serum OVC markers.

ObjectiveTo determine whether aadA2 gene can be translated from the ATG triplet,which there was no plausible ribosome binding site preceding it,and synthetized a functional protein in class 1 integron.MethodsSite-specific mutagenesis was used to construct aadA2 gene cassette with different start codons,together with their upstreamed promoters of variable regions were cloned into plasmid pACYC184 respective.The constructed plasmids were then transfored into Escherichia coli JM109,Western blot was used to detect the translation products of aadA2 gene with different start codons.Broth microdilution method was used to detect the minimal inhibitory concentrations to streptomycin in Escherichia coli JM109 containing aadA2 gene with different start codons.ResultsaadA2 gene can initiate translation from both ATG and GTG triplets in aminoacyl -3-adenylyltransferase protein synthesis,though there was no plausible ribosome binding site preceding the ATG triplet.Besides GTG and ATG triplets,there was other start codon downstream of the GTG triplet in aadA2 gene.The translated products that initiated from the start codons that described above were all functional AAD(3) proteins that can be detected by anti- aminoacyl -3-adenylyltransferase polyclonal antisera in Western blot and conferred different resistance levels to streptomycin in E.coli.ConclusionWhen inserted as the first gene cassette in class 1 integron,aadA2 gene can initiate translation from ATG triplet and synthetized a functional protein,though there was no plausible ribosome binding site preceding it.This structural characterization of class 1 integron can initiate translation of the open reading frame harbored in gene cassette that integrated into class 1 integron,though there was no plausible RBS preceding the start codon.This make class 1 integron be more convenience to express the genes that capture from environment.

ObjectiveTo prepare antiserum specific to aminoacy1-3″-adenylyltransferase [ AAD (3″) ],and to explore the application value of the prepared antiserum in detecting the expression levels of aadA2 gene that downstream of 8 different promoters (PcS,PcH2,PcH1,PcW,PcS-P2,PcH2-P2,PcH1P2 and PcW-P2 ) of variable regions in class 1 integron.MethodsaadA2 gene was amplified by polymerase chain reaction(PCR) and cloned into the expression plasmid pET19b.After inducing,the recombined aminoacy1-3″-adenylyltransferase[ AAD(3″)] with His-tag was expressed,purified and immunized rabbits to get anti- AAD(3″) specific serum.The prepared antiserum was used to detect the translation levels of aadA2 gene that downstream of different promoters of variable regions in class 1 integron by Western blotting (WB).Broth microdilution method was used to detect the minimal inhibitory concentrations (MIC) to streptomycin in Escherichia coli JM109 with aadA2 gene downstream of different promoters of variable regions.ResultsRecombined AAD (3″) expression plasmid pET19b-aadA2 was constructed successfully and was verified by sequence analysis.After transformed into E.coli BL21 ( DE3 ),a resoluble recombined AAD(3″) high expression strain was obtained.After fermentation,recombined AAD(3″) was purified and immunized rabbits.The anti- AAD(3″) specific serum was obtained with titer ＞ 1∶100 000.WB was used to detect the expression levels of AAD (3″),the translation product of aadA2 gene,that downstream of 8 different promoters of variable regions.The relative expression level of AAD (3″) that downstream of PcW was assumed to be 1,then the relative expression levels of AAD(3″),which all were detected 3 times independently,that downstream of PcS,PcH2,PcH1,PcS-P2,PcH2-P2,PcH1-P2 and PcW-P2 were 12.9±2.3,9.1±1.0,2.0±0.4,16.0±1.3,14.1 ±1.3,10.5±0.7 and 8.9 ±1.7 respective.Very different expression levels of AAD (3″) that downstream of different promoters of variable regions were obtained( F =32.421,P ＜ 0.01 ).The mean values of MIC,which all were detected 3 times independently,to streptomycin in E.coli JM109 with aadA2 gene downstream of PcS,PcH2,PcH1,PcW,PcS-P2,PcH2P2,PcH1-P2 and PcW-P2 were 256,256,64,128,32,128,4 and 64 mg/L respective.These results indicated the different expression levels of aadA2 gene that downstream of different promoters of variable regions can confer their host bacteria different resistance levels to streptomycin.Conclusions Resoluble recombined AAD(3″) is purified successfully and high titer anti- AAD(3″) specific antiserum is obtained from the immunized rabbits.This laid foundation for further investigation on the correlationship between the expressions of intI1 gene and the gene cassettes within variable regions.The expression levels of antibiotic gene cassettes that downstream of different promoters of variable regions are very different,so are the very different antibiotic resistance levels of the host bacteria.Therefore more attentions should be paid to the researches on the classification of promoters of variable regions when molecular epidemiology studies on the class 1 integrons in clinical isolates were conducted.

A novel chitosan derivant, N-octyl-N-arginine chitosan (OACS) with a mimetic structure of cell-penetrating peptides was synthesized by introducing hydrophilic arginine groups and hydrophobic octyl groups to the amino-group on chitosan's side chain. Structure of the obtained polymer was characterized by FT-IR and 1H NMR. The substitution degree of octyl and arginine groups was calculated through element analysis and spectrophotometric method, separately. The critical micelle concentration of OACS was 0.12 - 0.27 mgmL(-1) tested by fluorescence spectrometry. The solubility test showed OACS could easily dissolve in pH 1 - 12 solutions and self-assemble to form a micelle solution with light blue opalescence. The OACS micelles have a mean size of 158.4 - 224.6 nm, polydisperse index of 0.038 - 0.309 and a zeta potential of +19.16 - +30.80 mV determined by malvern zetasizer. AFM images confirmed free OACS micelle has a regular sphere form with a uniform particle size. MTT test confirmed that OACS was safe in 50 - 1 000 micromol-L(-1). The result of HepG2 cell experiment showed that the cell internalization of OACS micelles enhanced with increased substitution degree of arginine by 40 folds compared to chitosan. Thus, OACS micelles were a promising nano vehicle with permeation enhancement and drug carrier capability.

AIM To elucidate the possible antiarrhythmic mechanism of matrine. METHODS Whole-cell patch-clamp technique was used to record ionic currents in ventricular myocytes. RESULTS In guinea pig ventricular myocytes, matrine 100 μmol·L-1 prolonged 90% action potential duration (APD90) by 40% at a stimulation of 0.1 Hz in a frequency-independent manner, inhibited IK1 by 47% at the test potential of -120 mV, reduced IKr,tail by 50% and had no effect on IKs,tail. CONCLUSION Matrine prolonged APD through blockade of multiple potassium currents, which may relate to its antiarrhythmic efficacy.

Objective To investigate CT features of similar Hexheimer's reaction during initial treatment of active pulmonary tuberculosis. Methods The similar Hexheimer's reaction in 44 patients diagnosed by clinic and follow-up CT scans were retrospectively reviewed by three radiologists. Results During initial treatment of active pulmonary tuberculosis, development of radiographic progression were observed in 57 foci, including 28 pulmonary lesions increased at the site of their original lesion or new opacities elsewhere, ipsilateral or contralateral to the original lesion or both, 10 lesions related to the pleura (pleural effusion, pleural tuberculoma), 15 lymphadeneetasis, 3 thymus reactions, and 1 cardiac pericardium thickening, respectively. These reactions appeared from the 20 days to 3. 5 months, then with continuation of the initial chemotherapy for 1.0-3.0 months, the radiographic response was excellent with the areas of progression and the original lesions demonstrating resolution or improvement. Conclusion The CT appearances of similar Hexheimer's reaction during initial treatment of active tuberculosis are specific to a certainty.

Objective To investigate the effects of different upper limb abduction angles on the occurrence of malposition of PICC into internal jugular vein. Methods Totally 210 cases of patients treated with PICCs for unilateral breast cancer of our hospital from August,2015 to January,2017 were randomly assigned to three groups with 70 cases in each group. The abduction angle of the upper limb for placement was set at 45° ,90° and 160° , respectively. We chose the basilic vein of the uninfected arm using modified Seldinger technique under the guidance of ultrasound for PICC,and malposition was confirmed by detecting the tip of PICC in internal jugular vein. Results The incidence rate of internal jugular venous dislocation in 45° group was 7.14%(5 cases) and 8.57% in 90° group (6 cases),and no internal jugular venous dislocation in 160° group. There was no statistically significant difference among 45°,90° and 160° groups(χ2=5.95,P>0.05). Significant differences of group comparisons for 45° v.s. 160° and 160° v.s. 90° were found (P<0.05). There was no statistically significant difference between 45° and 90° groups (P>0.05). Conclusion Abduction angles of 45° ,90° and 160° can all be used for PICC placement. The abduction angle can be selected according to specific situation of patients instead of being limited to the standard abduction angle of 90°.

Objective To investigate the correlation between femoral popliteal artery stent fracture and in-stent restenosis (ISR) in patients with arteriosclerosis obliterans of superficial femoral artery and proximal popliteal artery after receiving stent implantation.Methods The clinical data of a total of 97 consecutive patients with arteriosclerosis obliterans of superficial femoral artery and proximal popliteal artery (107 diseased limbs in total),who were treated with primary stent implantation during the period from March 2012 to March 2016,were retrospectively analyzed.The imaging materials,including Doppler ultrasonography,plain radiography,contrast-enhanced CT scan,DSA,etc.were collected,and Kaplan-Meier survival analysis and other statistical analysis methods were used to analyze the related data.Results During the follow-up period,71 patients (72 limbs in total) developed ISR and the incidence of ISR was 67.3％ (72/107).The incidences of ISR in the stent-fracture group and non-fracture group were 84.2％ (32/38) and 58.0％ (40/69) respectively,the difference between the two groups was statistically significant (P=0.01).Conclusion After stent implantation of femoral popliteal artery,fracture of stent is one of the important risk factors for the occurrence of ISR.