As a non-pungency inhaled agent with less respiratory irritation,sevoflurane has been widely used in various surgeries for induction and maintenance of general anesthesia.However,the incidence of pediatric emergence delirium has been significantly increased with sevoflurane general anesthesia which severely disturbs the surgical effect and increases the requirement of medical staff in post anesthesia care unit.This article systematically reviews the research advance in emergence delirium in children with sevoflurane general anesthesia and introduces the reasonable intervention for the improvement of anesthesia quality.

The clinic diagnoses, autopsy and ultrastructure of anterior pitutary ot a case or progeria was reported.In electron microscopic study, some pathological changes of the somatotropes were observed. The rough-surfaced endoplasmic reticulum of these cells showed significan, difference in their form, which seemed to be characteristic for this disease.Based on the results obtained in this case of progeria, it is suggested that the functional disturbance of endoplasmic reticulum might be the cause of disease.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on brain injury in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-five patients with chronic valvular heart disease,aged 36-62 yr,weighing 42-92 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with New York Heart Association of Ⅱ or Ⅲ,undergoing cardiac valve replacement with CPB,were randomly divided into 3 groups (n =15 each) using a random number table:control group (group C),and different doses of rHuEPO groups (EPO1 group,EPO2 group).In EPO1 and EPO2 groups,rHuEPO 40 and 80 IU/kg were injected intravenously before anesthesia induction,respectively.Before anesthesia induction (T0,baseline value),immediately after endotracheal intubation (T1),immediately after aortic cannulation (T2),immediately after cannulation of superior and inferior vena cava (T3),immediately after the beginning of CPB (T4),when each index was decreased to the minimal value during CPB (T5),after rewarming to 36.5 ℃ (T6),immediately after termination of CPB (T7),and at 1 h after termination of CPB (T8),regional cerebral oxygen saturation (rSO2),tissue hemoglobin index (THI),and changes in concentrations of oxyhemoglobin (△ O2Hb),deoxyhemoglobin (△ HHb) and total hemoglobin (△ cHb) in bilateral frontal lobes were recorded.The patients whose minimal rSO2 ≤ 50％ and decrease in minimal rSO2 ≥ 20％ of the baseline value (△rSO2) were recorded.At T0,T8 and 2 h after termination of CPB (T9),venous blood samples were taken for determination of serum concentrations of S100 protein and neuron-specific enolase (NSE) by ELISA.At 1 day before surgery and 8 days after surgery,the patient's cognitive function was assessed using Mini-Mental State Examination,the Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R),the Digit Symbol subtest of the WAIS-R,the Trailing Making Test (Part A)and the Stroop Color Word Interference Test,while depression and anxiety were assessed by Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scale,respectively.The occurrence of postoperative cognitive dysfunction was recorded.Results There was no significant difference among the three groups in bilateral rSO2 and △ cHb,incidence of bilateral rSO2 ≤ 50％ and postoperative cognitive dysfunction,Zung Self-Rating Depression Scale score,and Zung Self-Rating anxiety Scale score at each time point (P＞0.05).Compared with group C,the incidence of left △ rSO2 ≥ 20％ was significantly decreased,the right △ O2 Hb was increased at T6,8,the serum NSE concentrations were decreased at T9,the serum S100 protein concentrations were decreased at T8,and the number of the Digit Symbol subtest of the WAIS-R completed was increased in group EPO1,and right THI was significantly decreased at T2,T3,T5,T7 and T8,right △ HHb was increased at T2 and T3,and the completion time of Stroop color word interference test B was shortened at 8 days after surgery in group EPO2 (P＜0.05 or 0.01).Compared with group EPO1,the incidence of left △rSO2 ≥ 20％ was significantly increased,the right THI was decreased at T2-4 and T6-8,and the left △ O2 Hb at T6-7 and right △ O2 Hb at T8 were decreased in group EPO2 (P＜0.05).Conclusion rHuEPO 40 IU/kg injected intravenously before induction of anesthesia can mitigate brain injury in the patients undergoing cardiac valve replacement with CPB.

Objective To analyze behavior of having multiple sexual partners among outside school adolescents and the impact factors in one county.Method Participatory method was adopted in the survey,trainees of an occupational training center were trained to investigate their peers with anonymous questionnaires.Results The subjects who had more than 3 sexual partners accounted for 38.3%,and the factors related to multiple sexual partners were complicated.The most im- portant protective factor was to raise level of HIV/AIDS related knowledge (OR=0.85);the key risk factors were: promiscuous behaviors (OR=4.91) and prostitution(OR=3.37) among their friends.Conclusion For reducing behav- ior of having multiple sexual partners among outside school adolescents,it is essential to promote HIV/AIDS related health education and to enhance their ability to respond to pressures from their bad peers.

The body mass index (BMI)is one of the important indexes to evaluate the nutrition / health status.BMI is weight in kilograms divided by height in per square meter (unit of kg/m2).BMI is changing with age.However,there are no BMI guidelines for the elderly.It is really necessary to set up a proper BMI range for the elderly.This research analyzed the relationship of BMI with all-cause mortality,cardiovascular mortality and body composition change in the elderly.The result showed that an appropriate higher BMI could help to decrease the all-cause mortality and cardiovascular mortality in the elderly and could also increase bone density and lean body mass,which could prevent the geriatric fracture and sarcopenia.Furthermore,underweight-related mortality was much higher than overweight-related mortality.

Objective To explore the effects of acupoint application of midnight-noon ebb-flow with hour-prescription of points on dysfunction for sufferers with senile osteoporosis(SOP).Methods In this study,76 patients with SOP in clinic in this hospital were recruited and randomly divided into the experimental group(n=38) and the control group(n=38) in accordance with random number table.Both were on the basic treatment of Caltrate D.The experimental group performed acupoint application of midnight-noon ebb flow with hour-prescription of points,while the control one performed common acupoint application.Oswestry Disability Index(ODI) was used to evaluate the dysfunction before,after 4 weeks and 8 weeks of intervention.SF-36 was adopted to evaluate the patients' quality of life before and after 8 week's intervention.Results The ODI scores of the experimental group after 4 weeks and 8 weeks were lower than those of the control group(P＜0.01).Repeated ANOVA indicated that the scores of ODI in group effect,time effect and interaction effect were of statistical significance(P＜0.01).Further comparison showed that the scores of ODI in three different time sections suggested that the latter time point were lower than those of the former time point(P＜0.01).The scores of eight dimensions of SF-36 after the intervention of the experimental group were higher than those of the control group(P＜0.05).Conclusion The acupoint application of midnight noon ebb flow-with hour-prescription of points can effectively improve the dysfunction whose curative effect enhanced with time increasing and improve the quality of life.

OBJECTIVEThe present study aimed to explore the role of P2Y(1) receptor in glial fibrillary acidic protein (GFAP) production and glial cell line-derived neurotrophic factor (GDNF) secretion of astrocytes under ischemic insult and the related signaling pathways.

METHODSUsing transient right middle cerebral artery occlusion (tMCAO) and oxygen-glucose-serum deprivation for 2 h as the model of ischemic injury in vivo and in vitro, immunofluorescence, quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blotting, enzyme linked immunosorbent assay (ELISA) were used to investigate location of P2Y(1) receptor and GDNF, the expression of GFAP and GDNF, and the changes of signaling molecules.

RESULTSBlockage of P2Y(1) receptor with the selective antagonist N(6)-methyl-2'-deoxyadenosine 3',5'-bisphosphate diammonium (MRS2179) reduced GFAP production and increased GDNF production in the antagonist group as compared with simple ischemic group both in vivo and in vitro. Oxygen-glucose-serum deprivation and blockage of P2Y(1) receptor caused elevation of phosphorylated Akt and cAMP response element binding protein (CREB), and reduction of phosphorylated Janus kinase2 (JAK2) and signal transducer and activator of transcription3 (STAT3, Ser727). After blockage of P2Y(1) receptor and deprivation of oxygen-glucose-serum, AG490 (inhibitor of JAK2) reduced phosphorylation of STAT3 (Ser727) as well as expression of GFAP; LY294002, an inhibitor of phosphatidylinositol 3-kinase (PI3-K), decreased phosphorylation of Akt and CREB; the inhibitor of mitogen-activated protein kinase kinase1/2 (MEK1/2) U0126, an important molecule of Ras/extracellular signal-regulated kinase (ERK) signaling pathway, decreased the phosphorylation of JAK2, STAT3 (Ser727), Akt and CREB.

CONCLUSIONThese results suggest that P2Y(1) receptor plays a role in the production of GFAP and GDNF in astrocytes under transient ischemic condition and the related signaling pathways may be JAK2/STAT3 and PI3-K/Akt/CREB, respectively, and that crosstalk probably exists between them.

Animals ; Astrocytes ; metabolism ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Glial Cell Line-Derived Neurotrophic Factor ; biosynthesis ; Glial Fibrillary Acidic Protein ; biosynthesis ; Infarction, Middle Cerebral Artery ; metabolism ; RNA, Messenger ; analysis ; Rats ; Receptors, Purinergic P2 ; metabolism ; Receptors, Purinergic P2Y1 ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; physiology

OBJECTIVETo explore whether BzATP could promote the growth of primary cultured astrocytes (AS) of rat and its possible mechanism, and whether TGF-β1 was involved in the event.

METHODSThe primary cultured ASs were derived from new born Sprague-Dawley rats. Glial fibrillary acidic protein (GFAP) immunofluorescent staining was used to check the purity of cultured AS. Morphometry was used to detect the changes of AS. The proliferation index of AS was detected by BrdU incorporation assay. Western blot was used to detect the changes of GFAP under different conditions. Changes of TGF-β1 gene transcription were detected by RT-PCR. ELISA was utilized to detect the variation of TGF-β1 protein in the supernate.

RESULTSThe purity of primary cultured AS reached 99%. BzATP promoted the hypertrophy of AS including the elongation of AS processes and the enlargement of cell bodies, BzATP also promoted the expression of GFAP in existence of Ca²⁺, but had no effect on cell proliferation. BzATP increased the transcription of TGF-β1 mRNA and the release of TGF-β1 protein in existence of Ca²⁺. TGF-β1 neutralizing antibody partially inhibited the expression of GFAP induced by BzATP, but had no effect on AS proliferation and cell morphology.

CONCLUSIONBzATP enhanced the hypertrophy of primary cultured AS, increased the expression of GFAP partially through TGF-β1. Mechanisms of the enhancement of AS growth induced by BzATP other than TGF-β1 pathway remain to be elucidated.

OBJECTIVETo seek the key platelet functional proteins (PFPs) for the occurrence of blood-stasis pattern (BP) in patients with coronary heart disease (CHD).

METHODSPeripheral blood platelet protein of 22 patients and 24 healthy person (for control) were extracted respectively in 4 batches for carrying 4 times of the test out. Differential PFPs in samples were screened out by two-dimensional fluorescence difference gel electrophoresis, and identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry; then the identified proteins were further authenticated by Western-blotting.

RESULTSThirteen differential PFPs were screened out, and among them the 7 identified by spectrometry were: isoform 1 of integrin alpha- II b, isoform 2 of integrin alpha- II b, actin-cytoplasmic 1, actin-cytoplasmic 2, cDNA FLJ52842, cDNA FLJ55253, and cDNA FLJ43573 fis. Among them isoform 2 of integrin alpha- II b (CD41) and actin-cytoplasmic 2 (Acting) were authenticated successfully.

CONCLUSIONCD41 and acting are the possible marker proteins, and the other PFPs might play crucial roles in the occurrence and development of BSS in CHD.

Adult ; Aged ; Blood Platelets ; Case-Control Studies ; Coronary Disease ; blood ; diagnosis ; physiopathology ; Electrophoresis, Gel, Two-Dimensional ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Platelet Membrane Glycoproteins ; isolation & purification ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVEIntravenous administration of basic fibroblast growth factor (bFGF) is effective to reduce the volume of cerebral infract due to ischemia. This study was designed to investigate the molecular mechanism, especially the signal transduction pathways, involved in this protective role of bFGF.

METHODSAnoxia-reoxygenation treated astrocytes were used to study the role of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MAPK/ERK kinase, MEK)-ERK signaling pathway after exogenous bFGF administration by Western blot. Electrophoretic mobile shift assay was used to detect the binding activity of early growth response factor-1 (Egr-1), an important transcription factor for endogenous bFGF.

RESULTSbFGF could protect some signal transduction proteins from the oxygen-derived free radicals induced degradation. ERK1/2 was activated and involved in Egr-1 binding activity enhancement induced by exogenous bFGF.

CONCLUSIONMEK-ERK MAPK cascade may be an important signal transduction pathway contributed to bFGF induced enhancement of Egr-1 binding activity in anoxia-reoxygenation injured astrocytes.

Animals ; Animals, Newborn ; Astrocytes ; drug effects ; metabolism ; Cells, Cultured ; Early Growth Response Protein 1 ; metabolism ; Electrophoretic Mobility Shift Assay ; methods ; Fibroblast Growth Factors ; pharmacology ; Mitogen-Activated Protein Kinase Kinases ; metabolism ; Oxygen ; metabolism ; Protein Binding ; drug effects ; Rats ; Signal Transduction ; physiology ; Time Factors