Objective To evaluate the efficacy of different doses of dexmedetomidine combined with propofol for drug-induced sleep endoscopy (DISE) in the patients with snoring.Methods Sixty patients with snoring,aged 24-62 yr,with body mass index of 24-37 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective DISE,were randomly divided into either group Ⅰ or group Ⅱ,with 30 patients in each group.In Ⅰ and Ⅱ groups,dexmedetomidine was infused over 10 min in a loading dose of 0.4 and 0.8 μg/kg,respectively,followed by an infusion of 0.4 μg · kg-1 · h-1.At 15 min of dexmedetomidine infusion,propofol was given by target-controlled infusion with the initial target plasma concentration (Cp) of 1.0 μg/ml.At 2 min after the target effect-site and plasma concentrations were balanced,the Cp of propofol was increased/decreased by 0.2 μg/ml to maintain the Cp of propofol stable during DISE.Bispectral index (BIS) value was recorded before anesthesia (T1),at 10 and 15 min of dexmedetomidine infusion (T2,3),at 2 min after the target effect-site and plasma concentrations were balanced (T4),at the beginning of DISE (T5),when the fiberoptic laryngoscope was placed at the site of oropharynx (T6),at the end of DISE (T7),at emergence (T8),and while discharge from the examination room (T9).Richmond Agitation Sedation Scale (RASS) scores were recorded at T1-4.Sleep was recorded within 15 min of dexmedetomidine infusion.The emergence time,discharge time,and anesthetics-related adverse events were recorded.Results All the patients completed DISE successfully.BIS values were maintained at 75-90,and RASS scores ≤ 4 during dexmedetomidine infusion.BIS values were maintained at 65-75 during DISE.Compared with group Ⅰ,BIS values were significantly decreased at T4,and RASS scores were significantly increased at T2-4,the sleep rate was significantly increased within 15 min of dexmedetomidine infusion,the Cp of propofol was significantly decreased during DISE,the emergence time was significantly prolonged (P＜0.05),and no significant change was found in the discharge time and anesthetics-related adverse events in group Ⅱ (P＞ 0.05).Conclusion Dexmedetomidine infused at 0.4 μg · kg-1 · h-1 after infusion of a loading dose of 0.8 μg/kg combined with propofol provides better efficacy for DISE in the patients with snoring.

OBJECTIVE Topreparealipidderivativeofgemcitabine(Gem)anditspolymericmi-celles to overcome the disadvantages of Gem.METHODS N-benzyl-3′-acetyl-gemcitabine(BAG)was synthesized.A BAG-loaded poloxamer polymeric micelle (BAG∶poloxamer 188 =10∶1 ,mol/mol)was prepared using an injection method.The micelles were characterized with a laser particle size and elec-tric charge instru ment and negatively-stained trans mission electron microscopy.Hu man breast cancer cells MCF-7 were cultured with Gem or BAG polymeric micelles of 5,10,20,30,50,70,90 μmol·L-1 for 24,48 and 72 h,respectively.The inhibitory rate of cells was measured with an MTT method.The MCF-7 cytotoxicity of BAG polymeric micelles was investigated.A pharmacodynamic study was per-formed on the mice bearing mouse hepatocellular cancer cells H22.Intravenous (iv)and oral (ig)ad-ministration was used at the dose of Ge m 40 mg·kg -1 or BAG polymeric micelles 62 mg·kg -1 .The mice were administered on the 1 st,4th and 7th day and sacrificed on the 8th day.Tumor inhibitory rates were measured.RESULTS TheBAGstructurewasidentifiedbythinlayerchromatograph,1Hand13C NMR,infrared ray chromatograph and mass spectrum.The appearance of BAG micelles was a slightly blue suspension.The micelles were spheres according to the electron microscopic observation.Their size was 62.82 nm and the zeta potential was -18.8 mV.The half inhibition concentration (IC50)of Gem and BAG polymeric micelles was 40.6 and 90.0 μmol·L-1 ,5.0 and 14.9 μmol·L-1 ,5.0 and 1 3.6 μmol·L-1 at 24,48 and 72 h,respectively according to the MTT results.According to the in vivo results,compared with the tumor model group,Gem (ig),Gem (iv)and BAG polymeric micelles (iv and ig)had significant effect on the tumor weight of H22 cell xenograft mice (P<0.01 ).As for anti-tumor efficiency,BAG polymeric micelles (ig)were better than Gem (ig)(P<0.05);BAG polymeric micelles (iv)were better than BAG polymeric micelles (ig)(P<0.05),and BAG polymeric micelles (iv)were almostequaltoGem(iv).CONCLUSION ThelipidderivativeofGemcanbeloadedinthepoloxamer 1 88 polymeric micelles.BAG polymeric micelles show in vitro MCF-7 cell inhibition and in vivo inhibition of mouse H22 xerografts;iv or ig.BAG polymeric micelles (ig)show better anti-tumor effect than Gem (ig),indicating that BAG polymeric micelles are a promising novel anti-tumor oral preparation.

Objective To study the effects of Chinese herbs Yiyanheji on intestinal mucosa barrier in rats with SAP.Methods Animal models of SAP were induced by retrograde injection of 5% sodium taurocholate (0.1ml/100g) into the common biliopancreatic duct.90 healthy Wistar rats weighing (250?30)g were randomly divided into 3 groups:sham operation group (SO,n=30),SAP group (SAP,n=30) and Chinese herbs Yiyanheji treated group(SAP+YH,n=30).Treated group was treated with Yiyanheji after operation.The SAP group was treated with physiological saline.Three groups of rats were killed at 72 hours after operation or treatment.Bacterial cultures were performed in all animals.The changes of terminal ileum' tissue were observed by optical electron mi- croscopy.The data of test were analyzed by statistic software.Results The incidence of bacterial translocation was 22.5% in Yiyanheji treated group,and it was lower than that in SAP group which was 90.0 %.The difference was significant(P

This paper gives the statistical analysis on the examination of Computer-Based Case Simulation to test 350 undergraduate clinical medical students of 5th or 6th year students,and analyses the statistical items of examination,then gives some discussion and reasonable suggestions.Finally,the author makes a series of discussion and views in the application of the medical education evaluations in future.

OBJECTIVETo investigate the role of endogenous hydrogen sulfide (H2S) in erectile dysfunction (ED) induced by androgen deficiency.

METHODSWe randomly divided 30 eight-week-old healthy male SD rats into six groups: 2-week control (A), 4-week control (B), 2-week castration (C), 4-week castration (D), 2-week castration + androgen replacement (E), and 4-week castration + androgen replacement (F), those in groups E and F subcutaneously injected with testosterone propionate (TP) at the physiological dose of 3 mg/kg per day after castration, while those in the other groups with isodose oil instead. At 2 and 4 weeks after operation, we determined the level of serum testosterone (T) , intracavernous pressure (ICP) , mean carotid arterial pressure (MAP) of the rats, measured the concentration of H2S in the plasma and corpus cavernosum tissue, and detected the expressions of cystathionine-P3-synthase (CBS) and cystathionine-gamma-lyase (CSE) by immunohistochemistry and Western blot.

RESULTSThe serum T level was significantly lower in group C ([0.63 +/- 0.15] nmol/L) than in A ( [ 16.55 +/- 4.17] nmol/L) and E ( [ 18.99 +/- 4.62] nmol/L) (P <0.05), as well as in group D ([0.70 +/-0.22] nmol/L) than in B ([15.44 +/-5.18] nmol/L) and F ([20.99 +/-6.41] nmol/L) (P <0. 05) , and so were ICP/MAP after 5 and 7 V electrical stimulation of the pelvic ganglia (P <0. 05) , H2 S concentration (P <0.05), and the expressions of CBS and CSE (P <0.05). The expressions of CBS and CSE proteins were also significantly decreased in group C as compared with D (P <0.05).

CONCLUSIONThe reduced expressions of CBS and CSE may inhibit the H2 S signaling pathway, which might be one of the mechanisms underlying androgen deficiency-induced ED in rats.

Androgens ; deficiency ; Animals ; Cystathionine beta-Synthase ; metabolism ; Cystathionine gamma-Lyase ; metabolism ; Erectile Dysfunction ; metabolism ; Hydrogen Sulfide ; metabolism ; Male ; Orchiectomy ; Penis ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To analyze the safety of methimazole in the treat-ment of hyperthyroidism before menopause and its effect on regulatory T cells( Treg) , cytokines of CD4 +CD25 +.Methods A total of 164 pa-tients with hyperthyroidism were randomly divided into treatment group and control group , 82 cases in each group.Patients in treatment group were orally given methimazole 10 mg, tid, after 30 d reduced to bid, 10 mg each time, after another 15 d, reduced to qd, 15 mg each time.Pa-tients in control group were orally given propylthiouracil 100 mg, tid, af-ter 30 d reduced to bid, 100 mg each time, after another 15 d, reduced to tid, 50 mg each time.All patients were treated for 3 months.The thy-roid serological index , CD4 +CD25 + regulation T cells and cytokines levels between the two groups before and after treatment were compared.The incidences of adverse drug reactions in two groups were also observed.Results The thyroid stimulating hormone ( TSH ) , thyrotrophin receptor antibody ( TRAb ) significantly increased in two group ( P <0.05 ).The free triiodothyronine (FT3), free thyroxin(FT4) and thyroid peroxidase antibody(TPOAb) in two groups were significantly decreased.The TSH, FT3 ,and FT4 were improved more significantly in treatment group ( P<0.05 ).There was no significant change in the number of CD4 +T cells in the two groups before and after treatment (P>0.05).The number of CD4 +CD25 +Tregs cells, IL-6 and IL-10 levels significantly decreased , and treatment group were significantly lower than control group ( P<0.05 ).The incidence of adverse reactions was 2.4% in treatment group , 6.1% in control group ( P>0.05 ).The total effective rate of treatment group was 97.6%, significantly higher than 81.7% in control group ( P<0.05 ).Conclusion Compared with propylthiouracil , methimazole had better effect on thyroid hormone level and immune function in premenopausal hyperthyroidism patients.

Objective: To observe the changes of somatosensory evoked potential(SEP) and nitric oxide (NO) after subarachnoid hemorrhage(SAH), and the influence of Ginkgo biloba extract (EGb). Method: Rats in sham-operated group, SAH model group and EGb-treated group underwent measurement of dynamic changes of regional cerebral blood flow( rCBF),SEP and NO levels both in serum and in brain tissue within 24h after operation. Result: In SAH group, rCBF decreased immediately after operation, with no tendency to recover within 24h. The latency of SEP delayed progressively from 1h to 24h after SAH. NO levels in serum and in brain tissue decreased and increased respectively from 1h to 24h after SAH. EGb effectively antagonized the changes of above parameters. Conclusion: SEP is helpful in the judgement on brain ischemic damage after SAH. Decrease of NO in serum and increase of that in brain tissue may lead to cerebral vasospasm and ischemic brain damage respectively after SAH. EGb relieves SAH-induced brain ischemic damage by reversing the pathological alterations of NO.

A three-dimensional biomechanical tracting appliance is introduced in the article, which is used to treat the protrusion of intervertebral disc. The appliance is light, practical, adjustable 3D biomechanic, simple and with multiple functions and convenient operation.
Biomechanical Phenomena ; Equipment Design ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; pathology ; Traction ; instrumentation ; methods ; Treatment Outcome