Objective To evaluate the effect of dexmedetomidine alternative to propofol administered in general anesthesia on maintainance and recovery in patients undergoing gynecologic laparoscopy.Methods One hundred and twenty patients undergoing gynecologic laparoscopy,were divided into group C,D1 and D2 with 40 cases each by random digits table method.Group C received propofol 100 μ g / (kg min) and remifentanil 0.10-0.25 μ g / (kg min) intravenous infusion,group D1 received propofol 100 μ g/(kg min),remifentanil 0.10-0.25 μ g/(kg min) and dexmedetomidine 0.2 μ g/(kg h) intravenous infusion,while group D2 received dexmedetomidine 2.0-3.0 μ g / (kg h) and remifentanil 0.10-0.25 μ g/ (kg min).Cis-atracurium was given on time to maintainance of anesthesia.The heart rate (HR),mean arterial pressure (MAP) were recorded at the following time points:arriving at operating room (To),anesthesia induction (T1),intubation (T2),skin incision (T3),pneumoperitoneum (T4),10 min after pneumoperitoneum (T5),20 min after pneumoperitoneum (T6),the end of operation (T7),discharge from post anesthesia care unit(T8) and the first postoperative day (T9).The time of emergence,extubation and duration in post anesthesia care unit were recorded too.Ramsay scale and Riker Sedation-Agitation Scale on emergence,extubation and discharge from post anesthesia care unit and post anesthesia recovery score at T9 were also recorded.Results The MAP in group D2 was higher at T3 to T7 time-points than that in group C and group D1 [(93 ± 10),(99 ± 11),(94 ± 13),(95 ± 10),(91 ± 10) mm Hg (1 mm Hg =0.133 kPa) vs.(88± 11),(90± 10),(87±9),(86±9),(83±8)mmHgand (87±9),(90± 10),(86±8),(85 ±7),(83 ± 7) mm Hg],there were significant difference (P ＜ 0.05).There were no significant difference among groups on the HR at each time point and the time of emergence,extubation and duration in post anesthesia care unit (P ＞ 0.05).Ramsay scale was lower on emergence and Riker Sedation-Agitation Scale was higher on emergence and extubation in group C than that in group D1 and group D2 [(3.7 ± 1.3) scores vs.(4.0 ± 0.9),(4.2 ±0.9) scores,(3.1 ± 1.0) scores vs.(2.8 ±0.6),(2.7 ±0.9) scores,(3.3 ±0.7) scores vs.(3.2 ± 0.4),(3.0 ± 0.5) scores],there were significant differences (P ＜ 0.05).Riker Sedation-Agitation Scale was higher on extubation in group D1 than that in group D2(P ＜ 0.05).Post anesthesia recovery score at T9 in group D2 was apparently increased compared with that in group C and group D1 [(108 ± 10) scores vs.(93 ± 13),(93 ± 15) scores] (P ＜ 0.05).Conclusions Dexmedetomidine 2.0-3.0 μ g/ (kg h) administered in general anesthesia on maintainance in gynecologic laparoscopy can improve the quality of extubation and promote postoperative recovery without prolonging extubation time,but have a influence on hemodynamic changes at early stage of pneumoperitoneum.

CD4+ ..CDS+ -.CD4+ /CDS+ was decreased more significantly in those patients who were older, severe, demential and depressive. Conclusion:Severe natural kill cell and T lymphocyte immune functional decline and disbalance were observed in PD patients. The significant decline of the levels of CD3+ ,CD4+ .CD8+ ,CD4+ /CD8+ in PD patients might be closely related to it's pathogenesis. The levels of CD3+ ,CD4+ ,CD8+ CD4+/CD8+ was even significantly lower in older, severe,dementia and depressive patients, so the levels of natural kill cell and T lymphocyte subsets can provide basis for evaluating severity .progression and prognosis of disease in PD. It was a new connotation for the study of PD on prevention and therapy in the future.

Enhanced biological phosphorus removal (EBPR) is widely accepted as one of the most economical and sustainable processes to remove phosphorus from wastewater.Poor performance or complete failure of EBPR processes has been substantially reported because of the proliferation of glycogen-accumulating organisms (GAOs) in the system.This paper presented the GAOs' metabolic mechanism and the impact factors, such as influent substrate, P/C ratio, pH value, temperature and SRT, on competition between GAOs and PAOs to better understand GAOs' characteristics and improve the performance and reliability of EBPR systems.

Central Nervous System ; pathology ; Humans ; Lymphoproliferative Disorders ; pathology ; Transplantation ; adverse effects

Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; Spinal Cord Injuries ; therapy

To study the regulation of androgen receptor (AR) expression in human prostate cancer LNCaP cells by triptolide (TP) and the possible mechanism, by using qRT-PCR and Western blot, the AR mRNA and protein levels in TP treated LNCaP cells were detected, and the AR protein level in TP and NF-κB inhibitor treated LNCaP cells was also detected; a series of pGL3-AR promoter reporter gene vectors were built using restriction-free cloning method, and the vectors were employed to investigate the effects of TP on the transcriptional activity of AR promoter in LNCaP cells; the upstream proteins which may play regulatory roles were detected using western blot assay. After treated LNCaP cells with TP for 48 h, AR mRNA and protein expressions decreased with increasing TP concentration. The expression of AR target gene PART1 and prostate specific antigen (PSA) was also downregulated by TP treatment; a series of pGL3-AR promoter reporter vectors were constructed and validated by sequencing and luciferase activity; the results of dual luciferase reporter assay showed that TP downregulated AR at the transcriptional level; PI3K/AKT/NF-κB pathway which is associated with AR promoter activity was drowregulated by TP. In conclusion, our results demonstrated that the transcriptional activity of AR in LNCAP cells was downregulated by TP, and PI3K/AKT/NF-κB pathway may be involved in the regulation mechanism.

Objective To analyze the therapeutic outcomes and adverse effects of high-dose intravenous immunoglobulin (hd-IVIg) in the treatment of some severe skin diseases (toxic epidermal necrolysis, drug hypersensitivity syndrome, connective tissue disease, autoimmune bullous disease, acute graft-versus-host disease). Methods Twenty-five cases of severe skin diseases were treated with hd-IVIg (0.4 g/kg/day for a course of 5 days). Results The therapeutic outcomes were different from each other. Of all the cases, 21 improved, especially those of acute onset of toxic epidermal necrolysis and drug hypersensitivity syndrome; 1 adult dermatomyositis and 2 elder bullous pemphigoid were not relieved. A patient with acute graft-versus-host disease died. Three patients presented with minor adverse effects (headache and blood pressure rising). Conclusions hd-IVIg is effective and safe in the treatment of some severe skin diseases. More importantly, it has a substantial effect on shortening disease course and decreasing the dosage of glucocorticoids and immunosuppressants as well as on preventing infections.

Objective To study the relationship between chromosomal abnormalities of diffuse large B-cell lymphoma and its survival time.Methods Chromosome preparations were made by using modified method.Karyotypes were analyzed by stain of G-banding. And all patients were treated by chemotherapy. All patients' survival time was calculated.Results Mitotic cells that could be used for analysis were found in 28 cases.5 of 28 karyotypes were normal and 8 cases were polyploid.There were 4 cases with t(14,18)(q32;q21),5 cases with t(3; 14) (q27;q32),2 cases with t(2;3) (p11 ;q27),1 case with t(3 ;22) (q27 ;q11) respectively.There were 2 cases with ectopia between 7 chromosome and other chromosomes and 1 case with ectopia between 17 chromosome and other chromosomes.The survival time of patients with normal karyotype,t(14,18) (q32;q21)or 3q+ was longer than that of other groups.The survival time of group in Ⅰ, Ⅱ stages was longer than that in Ⅲ, Ⅳ stages. Conclusion The treatment, survival time and prognosis could be expected according to chromosomal abnormalities and its relevance to stages in diffuse large B-cell lymphoma.

Objective To establish a convenient, reliable and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of two kinds of endogenous hormones (testosterone, cortisol) in the saliva of healthy human. Methods A positive ion mode was performed on the Agilent 6410A mass spectrometer. Carbamazepine was used as the internal standard. The saliva samples were centrifuged at 21 912.8×g for 10 min with OMGEA NANOSEP 10K ultrafiltration tubes, and chromatographic separation was achieved on an Agilent ZORBAX SB-C18 column with isocratic elution. The mobile phase was acetonitrile∶0.1% formic acid awter solution (60∶40); flow rate was 0.3 mL/min; injection volume was 10 μL; column temperature was 25 ℃; and the analysis period of each sample was 3 min. Results Testosterone and cortisol had good linear relationship with correlation coefficient (r) being both 0.990. Inter-and intra-day precision was both less than 15%. Conclusion This method can be used to determine the contents of testosterone and cortisol in saliva, which provides a reference for rapid and simple detection of hormone levels in vivo.