Acupuncture Therapy ; methods ; Adult ; Craniocerebral Trauma ; complications ; therapy ; Electroacupuncture ; Female ; Hearing Loss, Sensorineural ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Scalp ; Young Adult

Objective To observe the effects of dexmedetomidine on the perioperative stress response and immunologic function in hepatectomy patients with hepatitis cirrhosis.Methods Forty patients(Child-Pugh A or B),ASA Ⅱ or Ⅲ with hepatitis cirrhosis undergoing hepatectomy were randomly divided into dexmedetomidine group(group D)and control group(group C)with 20 cases in each.Patients in group D were administered 0.5 μg/kg bolus dose of dexmedetomidine over 10 min, followed by 0.4 μg·kg-1 ·h-1 infusion until closing abdomen.And patients in group C were given normal saline by the same way as in group D.Flow cytometry was used to detect peripheral blood T lymphocytes (CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + ),NK cells at 30 min before anesthesia(T0 ),imme-diately(T1 ),24 h(T2 )and 48 h(T3 )after surgery.Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2,IL-10)at T0-T3 and stress hormones (Cor,ACTH,ALD)at T0 ,T2 and T3 .The levels of SBP,DBP and CVP at T0 ,immediately with intu-bation(Ta ),T1 and extubation(Tb ).Results Compared to those at T0 ,the levels of CD3 + ,CD4 + , CD8 + ,CD4 +/CD8 + at T1 and T2 were significantly lower in both groups(P <0.05),and the levels in group D were obviously higher than those in group C(P <0.05).The levels in group D were back to preoperative levels at T3 ,but the levels in group C were still lower than those at T0 (P <0.05).The levels of NK cells were higher at T1 in both groups,and the levels in group D was significantly higher than those in group C(P <0.05).Compared to those at group D,the concentration of IL-2 was lower at T1 and T2 ,the concentration of IL-10 was higher at T2 and T3 in group C (P <0.05).The levels of Cor,ALD,ACTH at T2 and T3 were significantly higher than those at T0 in both groups,but those in group D were markedly lower than those in group C (P < 0.05 ).The SBP,DBP and CVP of two groups was no statistically significant difference at T0 ,and SBP,DBP and CVP of the group D at Ta , T1 ,Tb was lower than that of T0 and group C (P <0.05).Conclusion Patients with hepatitis cirrho-sis underwent general anesthesia has certain immune suppression after liver cancer surgery,and con-tinuous intravenous infusion of dexmedetomidine during anesthesia may suppress the perioperative stress reaction effectively and alleviate the inhibition of immunologic function.

AIM: To compare pharmacokinetics and relative bioavailability of telmisartan capsule (T) and telmisartan tablet(R). METHODS: 20 male healthy Chinese volunteers were enrolled in a randomized two-way crossover designs with a single-oral dose study(80 mg once per day for each preparation). The plasma telmisatan concentration was determined by HPLC- fluorescence detector. Plasma levels of telmisatan were followed up to 96 h. Area under the telmisartan concentration time curve was calculated by variance analysis and the bioequivalent was determined by two one-side t-test. RESULTS: A two-compartment model was adopted in telmisartan plasma concentration-time data analysis. The pharmacokinetic parameters of T and R in single-dose study including Cmax (μg·L-1), Tmax (h), T1/2β (h), MRT(h), AUC0-92(μg·h·L-1) were as following: 456±253 and 760±314, 1.61±0.71 and 1.08±0.36, 22.39±6.29 and 21.08±5.24, 27.02±6.23 and 24.27±5.79, 3454±1050 and 3635±1300, respectively. Statistically significant differences were observed between the parameter values of the two products in Cmax and Tmax; whereas there was no statistically significant difference between AUC0-∞μg·h·L-1 (3601±1095 and 3767±1399). The relative bioavailability for T was 97.28%±12.74%. CONCLUSION: The test telmisartan capsule is bioequivalent to the reference tablet.

Objective To compare the short-term efficacies of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity and type 2 diabetes mellitus,and to investigate the relationship between the body weight loss and the decrease of glucose of the 2 treatment methods.Methods The clinical data of 40 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Changhai Hospital of the Second Military Medical University from January 2010 to December 2011 were retrospectively analyzed.There were 14 patients treated by LAGB (LAGB group) and 26 by LSG (LSG group).The body weight loss and the decrease of glucose at postoperative year 1 of the 2 groups were compared.The differences in the body weight and glucose before and after operation within groups were compared using the paired t test,and the differences in the body weight and glucose between the 2 groups were compared using the multiple analysis of variance.The correlation between the body weight loss and the decrease of glucose was analyzed using the linear regression analysis.Results Laparoscopic surgery was successfully done without conversion to open surgery or intraoperative complications.The operation time and volume of blood loss were (69 ± 16)minutes and (31 ± 14)mL in the LAGB group,(120 ± 15) minutes and (148 ± 48) mL in the LSG group.Complications including postoperative malnutrition,electrolyte disturbance,delayed gastric emptying,bleeding,anastomotic leakage did not occurr in the 2 groups.Two patients were complicated with abdominal incision fat liquefaction,and were cured by symptomatic treatment.(1) The body weight,body mass index (BMI) and waistline had a decrease trend.The body weight,BMI and waistline in the LAGB group were decreased from (117 ± 28)kg,(40 ± 8)kg/m2 and (118 ± 15) cm before operation to (94 ± 28) kg,(33 ± 8) kg/m2 and (92 ± 15) cm at postoperative week 48.The body weight,BMI and waistline in the LSG group were decreased from (119 ± 25)kg,(42 ± 6)kg/m2 and (123 ± 14)cm before operation to (74± 16)kg,(26± 4)kg/m2 and (86 ± 13)cm at postoperative week 48.The EWL had an increase trend in the 2 groups.The EWL in the LAGB group was increased from 7％ ± 2％ at postoperative week 1 to 53％± 24％ at postoperative week 48,and the EWL in the LSG group was increased from 11％ ± 4％ at postoperative week 1 to 90％ ± 20％ at postoperative week 48.There were significant differences in the changes of body weight,BMI,waistline and EWL between the 2 groups (F =60.660,74.490,57.650,90.020,P ＜ 0.05).(2) The levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LAGB group were decreased from 8.1％± 0.8％,(8.4±0.6)mmol/L,(21±8)μmol/L,7.9 ±2.9,(1.68±0.50)mmol/L,(6.0±1.1)mmol/L (4.1 ± 0.8) mmol/L,(1.09 ±0.15)mmol/L to 6.4％ ±0.8％,(6.3 ±0.3) mmol/L,(10 ± 3) μmol/L,2.7 ±0.9,(1.04 ± 0.09) mmol/L,(4.3 ± 0.8) mmol/L,(2.3 ± 0.4) mmol/L,(1.22 ± 0.09) mmol/L at postoperative week 48 ; the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LSG group were changed from 7.9％ ± 1.0％,(9.0±1.0)mmol/L,(21 ±9) μ mol/L,8.5 ±3.5,(2.09 ± 0.70) mmol/L,(6.0 ± 1.2)mmol/L,(3.9 ± 1.1) mmol/L,(1.06 ± 0.21) mmol/L before operation to 5.1％ ± 0.8％,(5.2 ± 0.4) mmol/L,(4 ± 1)μmol/L,0.9±0.2,(1.22±0.17)mmol/L,(4.2±0.8)mmol/L,(2.3 ±0.6)mmol/L,(1.30±0.13)mmol/L at postoperative week 48.There was a decrease trend of the glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,trigluceride,total cholesterol and low density lipoprotein and a increase trend of the high density lipoprotein in the 2 groups.There were significant differences in the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein between the 2 groups (F =57.650,74.270,36.750,42.960,10.870,30.650,32.560,11.490,P ＜0.05).The levels of glucose of the LAGB group at postoperative month 1 and 3 were influenced by BMI (b =0.543,0.753,P ＜ 0.05),while the levels of glucose of the LAGB group did not be influenced by BMI at postoperative month 6 and year 1 (b =0.130,0.222,P ＞0.05).The levels of glucose of the LSG group did not be influenced by BMI at postoperative month 1,3,6 and year 1 (b =0.185,0.035,0.212,0.126,P ＞0.05).Conclusions The efficacy of LSG is superior to LAGB for the treatment of obesity combined with type 2 diabetes mellitus.The efficacy of LAGB is correlated with the change of body weight,while the efficacy of LSG does not correlated with the change of body weight.

Objective To improve scientific research capacity and disciplines development,we performed grading system to specialize and quantize the management in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods With assistance of forum survey related to 20 clinical and technical departments in hospital,we assessed the status of disciplines development,designed assessment criteria,and revised relevant regulations in grading system.Results The implementation of grading system promoted scientific achievements,academic communications and human resource development in hospital as relative to their pre-implemental controls.Conclusions The implementation of grading system facilitates scientific research and improves disciplines development.

Objective To investigate the clinical significance of detection of hepatitis E virus (HEV) RNA in sera from patients with acute hepatitis E using real-time reverse transcription (RT)-PCR to detect hepatitis E virus RNA in sera from patients with acute hepatitis E.Methods A real-time RT-PCR assay, which can amplifies and detect the conserved region on ORF3, was used in this study. 434 outpatients and hospitalized patients with acute HEV infection was enrolled into this study.Simultaneously,the serum samples from 40 patients with HAV infection, 100 patients with HBV infection and 110 healthy blood donors were collected as the control The real-time RT-PCR was performed to detect HEV RNA in all these sera.Results 232 sera (53.5%) were positive for HEV RNA by real-time RT-PCR and all of the control were negative.The results of real-time RT-PCR and anti-HEV IgM (ELISA) were concordant in 67.1% samples.There was significant difference between the two methods ( Kappa = 0.308, P = 0.000 ).The first serum sample from five serum samples of the patients was positive for HEV RNA and negative for anti-HEV IgM.Follow-up studies showed all the five sera samples were positive for anti-HEV IgM.HEV RNA in serum could be detected between 2 and 10 days.Conclusions The real-time fluorescent RT-PCR method has high specificity, and can be applied to the qualitative detection of the serum with genotypes Ⅰ and Ⅳ of hepatitis E virus.Its clinical use can improve the early diagnosis of HEV.

Objective To investigate the changes of serum miR-21 expression level in patients with HCC before and after transcatheter arterial chemoembolization (TACE) and to discuss its clinical significance. Methods Before and after TACE the levels of serum miR-21 in 42 patients with HCC and 42 healthy subjects were determined by reverse transcriptase quantitative PCR (RT-PCR), and the levels of serum AFP were also estimated by enzyme-linked immunosorbent assay (ELISA). The results were analyzed. Results The serum miR-21 level in patients with HCC was (12.9 ± 3.5) times of that in normal subjects(t=19.430 7, P < 0.01). One month after TACE, the serum miR-21 level became (7.2 ± 1.7) times of that of normal reference value, which was remarkably lower than that obtained before the treatment (t=9.493 7, P<0.01). The serum miR-21 level was closely correlated with the tumor size, the presence of tumor thrombus and HBV infection. One month after TACE the serum miR-21 levels in patient groups showing partial response, stable disease and progressive disease were (4.0 ± 0.3), (6.0 ± 1.5) and (8.6 ± 1.5) times, respectively, of that of normal reference value, and statistically significant difference existed between each other among the three groups (F=38.168, P=0.000). ROC-AUC value of MiR-21 in diagnosing HCC was 0.910 ± 0.041, which was significantly higher than that of AFP (0.860 ± 0.037, t=6.3042, P<0.01). The specificity of miR-21 in detecting HCC was 88.1%, which was remarkably higher than that of AFP (69%, χ2= 4.5253, P = 0.033).Conclusion After TACE the serum MiR-21 level in HCC patients is significantly decreased, which is very helpful in predicting the therapeutic efficacy of TACE. Therefore, MiR- 21 can be regarded as a potential molecular marker of HCC.

Objective To detect anti-HCV in serum of hepatic disease patients by performing the confirmatory test, and further to confirm HCV infection. Methods Two recombinant immunoblot assays (CWT and CHIRON RIBA HCV 3.0 Strip Immunoblot Assay) were used respectively to detect anti-HCV in 477 human serum samples, which comprised 350 HCV-infected patients' specimens, 7 none-A none-E hepatitis specimens, 30 HBV-infected patients' specimens, 30 hepatitis E virus infected patients'specimens, and 60 specimens drawn from blood donors. The latter three groups served as controls. Results A total of 120 control non-HCV-infected patients' specimens were negative when tested by both assays. Among 350 HCV-infected patients, 341 were positive and 9 were indeterminated by CWT assay; 343 were positive and 7 were indeterminated by CHIRON RIBA HCV 3. 0 SIA. Seven none-A none-E hepatitis specimens tested by both assays turned out to be 2 positive, 4 negative and 1 indeterminate. The consistency rate of these two assays was 99. 16% (Kappa=0.98). Conclusion CWT assay is highly coherent with CHIRON RIBA HCV 3.0 SIA assay in the methodology of anti-HCV antibody detection, which can be applied in the determination of HCV infection among none-A none-E hepatitis patients.

Objective To explore the normal range of the volume of frontal lobe in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain. Methods This is a clinical multi-center study. Two hundred Chinese healthy volunteers (age range= 18 to 70) recruited from 16 hospitals were divided into 5 groups, i. e. , age range from 18 to 30, age range from 31 to 40, age range from 41 to 50, age range from 51 to 60, and age range from 61 to 70. Each group contained 20 males and 20 females. All of the volunteers were scanned by MR using T1 weighted threedimensional magnetization prepared rapid acquisition gradient echo sequence. We used the manual method to trace the region of interest and measured the left and right frontal lobe volumes separately. All the data were analyzed with SPSS (version 13.0). The sex differences in the frontal lobe volumes were analyzed by independent-samples t test, and the side differences were analyzed by paired-samples t test. Correlation and regression analysis was used between the age and the frontal lobe volumes. Results In 200 healthy Chinese Han volunteers, the total frontal lobe volumes was (563 ± 73) cm3. For male, the volumes of the left and the right frontal lobe were (288±42) cm3 and (292 ±41 ) cm3 ,respectively. The volumes of the left and right frontal lobe in 100 women were (273 ±30) cm3 and (274 ± 30) cm3 respectively. The differences of sex (t = 3. 334, P < 0. 05 ) and side ( t = - 3.09, P < 0. 05 ) in the total frontal lobe volumes reach significant. There was no significant differences in women ( t = - 1. 304, P > 0. 05 ). There were negative correlations between the frontal lobe volumes and age in men and women ( r = - 0. 586, - 0. 498, P <0. 01 ). Conclusions The total frontal lobe volume of men was larger than that of women. The volume of the right frontal lobe was larger than the left frontal lobe in men, and the asymmetries didn't exist in women.The total frontal lobe volumes were both shrinking with age in men and women, which was more rapid in men than in women.

OBJECTIVETo investigate the effect of Xinnao Shutong Capsule, whose main ingredients gross saponins from Tribulus Terrestris L (GSTT) on cardiac muscle cell (CMC) apoptosis and expressions of Bcl-2 Compound rat model of and Bax in murine model of hyperlipemia after myocardial infarction (MI).

METHODSMI and hyperlipemia was adopted. TUNEL assay was applied to detect CMC apoptosis after 4 weeks' administration of GSTT or simvastatin, and immunohistochemical SP technique was used to detect the expressions of Bcl-2 and Bax protein.

RESULTSGSTT can relieve the damage of CMC and attenuate the ventricular remodeling after MI; high dose of GSTT and simvastatin could decrease CMC apoptosis (P<0.05), and lower Bax protein expression (P < 0.05); and there was no significant difference among the effects in all the treated group (P> 0.05).

CONCLUSIONGSTT can reduce CMC apoptosis through regulating protein expressions of Bcl-2 and Bax, which may be one of the mechanisms of its anti-ventricular-remodeling effects after MI.

Animals ; Apoptosis ; drug effects ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Hyperlipidemias ; complications ; drug therapy ; Male ; Myocardial Infarction ; complications ; drug therapy ; Myocytes, Cardiac ; metabolism ; pathology ; Phytotherapy ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; biosynthesis ; genetics