Objective To evaluate the effect of the high concentration of sevoflurane wash-in in induction of anesthesia on the cardiac function in young infants.Methods ASA Ⅰ young infants,aged 28-60 days,undergoing resection of hemangioma on body surface under general anesthesia,were studied.According to the principle of randomized block design,8 blocks were designed based on the body weight (3.0-3.4 kg,3.5-3.9 g,4.0-4.4 kg,4.5-4.9 kg,5.0-5.4 kg,5.5-5.9 kg,6.0-6.4 kg,6.5-6.9 kg),with 3 infants in each block.The infants were randomly divided into 3 groups (n =8 each):anesthesia induction with 6％,7％ and 8％ sevoflurane groups (groups S1-3).In groups S1-3,the infants inhaled 6 ％,7 ％ and 8 ％ sevoflurane respectively for induction of anesthesia.Transthoracic echocardiographic examinations were performed before sevoflurane inhalation (baseline,T1) and at 4 min of sevoflurane inhalation (T2) to record the stroke volume (SV),left ventricle end-diastolic volume (LVEDV),ejection fraction (EF),stroke volume index (SI),heart rate (HR),cardiac output (CO),cardiac index (CI),peak early diastolic velocity of mitral annulus (Ea),peak late diastolic velocity of mitral annulus (Aa),peak systolic velocity of mitral annulus (Sa),and Tei index.The mitral annulus poteroseptal Ea/Aa (Ea/Aa) was calculated.Results Compared with the baseline value,SV,EF,SI,Ea/Aa and Tei index were significandy increased,HR,Sa,Ea and Aa were significantly decreased (P ＜ 0.05),and no significant change was found in LVEDV,CO and CI at 4 min of sevoflurane inhalation in groups S1-3 (P ＞ 0.05).Tei index was significantly higher in groups S2.3 than in group S1 (P ＜ 0.05).There was no significant difference in the parameters of cardiac function between group S2 and group S3 (P ＞ 0.05).Conclusion 6 ％,7 ％ and 8 ％ sevoflurane wash-in in induction of anesthesia exert no effect on the cardiac function in young infants,and the 3 concentrations can be recommended for clinical use.

Objective To discuss the diagnostic value of two-dimensional speckle tracking imaging in the evaluation of left ventricular rotation and torsion in pre-apical hypertrophic cardiomyopathy(PAHCM)patients. Methods A total of 26 patients with PAHCM,26 patients with hyperten-sive left ventricular hypertrophy(HLVH)and 26 healthy volunteers were recruited for the study. Two-dimensional echocardiographs were performed carefully. Two-dimensional images were obtained from the left ventricular apical four-chamber section,two-chamber section and two short-axis sec-tions,including mitral valve and apical levels. The peak subendocardial rotation(endo-rot),epicardial rotation(epi-rot),transmural torsion(mural-tor)and bulk rotation(bulk-rot)of each short-axis section were measured and analyzed using QLAB 9.1 software. Results In the mitral level, there was no statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the PAHCM group and normal control group (P>0.05). There was statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the PAHCM group and HLVH group (all P<0.05). There was statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the HLVH group and normal control group(all P<0.05). In the apical level,there was no statistically significant difference in epi-rot among three groups(P>0.05). There was statisti-cally significant difference in endo-rot,mural-tor and bulk-rot between each two groups(P<0.05). There was statistically significant difference in G-tor between each two groups(P<0.05). The receiver operating characteristic curve analysis showed that the accuracy of differential diagnosis of G-tor PAHCM was high(the area under the receiver operating characteristic curve is 0.89),the sensitivity was 73.08%,and the specificity was 92.31%. Conclusion Two-dimensional speckle tracking imaging could accurately and quantitatively measure the left ventricular rotation and tor-sion in PAHCM patients. The G-tor could accurately screen and identify between PAHCM and HLVH.

Objective To evaluate the effects of sevoflurane anesthesia on the left ventricular function in young infants.Methods Sixteen ASA physical status Ⅰ pediatric patients,aged 28-75 days,weighing 4.0-6.1 kg,undergoing elective resection of hemangioma on the body surface under general anesthesia with sevoflurane were studied.After the pediatric patients inhaled 6 ％ sevoflurane for 4 min,tracheal intubation was performed,and the pediatric patients were mechanically ventilated.Anesthesia was maintained with sevoflurane with the endtidal concentration of 4.48％-5.12％.Transthoracic echocardiographic examinations were performed before induction of anesthesia (baseline,T0),immediately before intubation (T1),at 10 and 30 min after intubation (T2,3),and at 20 min and 1 h after extubation (T4,5) to calculate Tei index.Results Compared with the baseline value at T0,Tei index was significantly increased at T1-4 (P ＜ 0.05 or 0.01),and no significant change was found in Tei index at T5 (P ＞ 0.05).The blood pressure and heart rate were stable and no adverse cardiovascular events were found during surgery.Conclusion Although sevoflurane anesthesia does not induce cardiovascular events,it decreases the left ventricular function to some extent in young infants.

Objective:To investigate the current status of satisfaction with training program and loyalty to the university among professional postgraduate students majoring in clinical medicine, as well as the association between satisfaction with training program and loyalty to the university.Methods:The 2017 National Medical Student Satisfaction Survey Database was used. A total of 1 944 professional postgraduate students in the second or third year, as well as those with delayed graduation, from 59 postgraduate training colleges and universities who participated in clinical internship were selected. SPSS 20.0 software was used for analysis; descriptive analysis was used to describe satisfaction with training program and loyalty to the university; factor analysis was adopted to calculate comprehensive satisfaction score to reduce the number of variables; logistic regression analysis was applied to investigate the association of general information and satisfaction with training program with loyalty to the university.Results:The professional postgraduate students majoring in clinical medicine had a degree of 60.44% of loyalty to the university. Satisfaction with training program reflected low satisfaction at each link of the training program. For every 1-point increase in the comprehensive satisfaction scores of the four links of courses, research training, college support, and practice, the loyalty to the university was increased to 2.11, 1.83, 1.77, and 1.75 times as the original, respectively, of the baseline scores.Conclusion:There is still room for further improvement in the satisfaction with training program and the loyalty to the university among professional postgraduate students majoring in clinical medicine, and the satisfaction with training program is closely associated with the loyalty to the university. Colleges and universities need to take measures for courses, practice, research training, and college support, so as to improve satisfaction and thus enhance loyalty to the university.

OBJECTIVETo compare the method of detecting heat-sensitive (HS) condition of Neiguan (PC 6) with moxibustion sensation and with infrared in heart-qi deficiency patients (HQD), and to find an objective detection method for HS condition of acupoints.

METHODSThe study was performed on 74 HQD patients. Take infrared thermograph of the tested skin area in natural state. Then thermosensitive test was taken after infrared thermograph acquisition (suspended moxibustion for 10 min). After moxibustion infrared radiometry was implemented for the second time. The infrared radiation information of the forearms was collected and the major axis of the moxibustion reaction area was recorded. The effect of moxibustion sensation and infrared detection on HS Neiguan (PC 6) in HQD patients was compared.

RESULTSWhen the Neiguan (PC 6) in HQD patients was on HS condition, most of the infrared intensity was high temperature and compared with moxibustion sensation method, the sensitivity was 66.7%, the specificity 76.9%, and the accuracy 70.3%. After moxibustion on the HS Neiguan (PC 6) area, the infrared intensity diffused longitudinally along inner side of forearms. Compared with the result of the moxibustion sensation method, its sensitivity was 87.5%, the specificity 92.3%, and the accuracy 89.2%.

CONCLUSION(1) The state of HS condition of Neiguan (PC 6) in HQD patients could be detected objectively by infrared radiation. (2) After moxibustion, the HS condition of acupoints produced thermal phenomena as thermal expansion, heat transfer, which could be demonstated objectively by the infrared radiation image as well as the sensation of subjects.

Acupuncture Points ; Aged ; Female ; Heart ; physiopathology ; radiation effects ; Hot Temperature ; Humans ; Infrared Rays ; Male ; Middle Aged ; Moxibustion ; Qi ; Radiometry ; Sensation ; Thermography

Lactobacillus casei was selected as an antigen delivery vehicle for the development of oral vaccine to express recombinant LTB and porcine parvovirus (PPV) VP2 protein. The fusion protein gene encoding PPV VP2 protein and LTB, was cloned into the surface expression vector pPG, and then the recombinant expression vector pPG-VP2-LTB was electrotransformed into Lactobacillus casei 393, generating recombinant strain pPG-VP2-LTB/L. casei 393. After induced by 2% Lactose in MRS broth, an about 78 kD protein was detected in the recombinant Lactobacillus casei by SDS-PAGE. The result of Western blot indicated that the protein possessed the antigenic specificity same as the native virus protein. The result of the whole bacteria cell ELISA indicated that the LTB protein was expressed at the same time. The results of indirect immunofluorescence test and immuno-gold electron microscopy showed that the interest protein was expressed on the surface of L. casei 393. The results provide potential for the development of lactic acid bacteria oral vaccine of PPV, which used LTB as mucosal adjuvant.

Objective To explore effects of the nursing care combined with low molecular weight heparin on the lower extremity deep venous thrombosis after cesarean section incidence. Methods 192 patients who underwent cesarean section from October 2015 to October 2016 in Yongkang maternal and child health hospital, excluding the relevant taboos, according to the different nursing methods, were divided into the control group (n=96) and the study group (n=96). Two groups of patients after 24 h of cesarean section were treated with low molecular weight heparin calcium 5000 IU subcutaneous injection, once a day, continuous treatment for 5 days; the control group was given routine cesarean section nursing after the operation; the study group was given targeted nursing (psychological guidance, preoperative guidance, postoperative care, dietary guidance, exercise guidance, and environmental care). Results The incidence of deep venous thrombosis of patients (2.08%) in the study group was significantly lower than (9.38%) in the control group with statistical significance (P<0.05); the plasma D dimer in the study group was significantly lower than the control group with statistical significance (P<0.05); nursing satisfaction rate of patients in the study group was (95.83%) higher than (81.25%) of the control group with statistical significance (P<0.05). Conclusion The combination of targeted care plus low molecular weight heparin could improve the satisfaction of nursing and the quality of life, reduce the incidence of postoperative deep vein thrombosis. It is worthy of clinical application.

Lyme disease is a natural zoonotic infectious disease transmitted by ticks infected by different genotypes of Borre-lia burgdorferi sensu lato,which was discovered in the 1970s.This pathogen is prevalent primarily in temperate and subtropi-cal areas.Dogs,cats,horses,cattle,deer,and other animals are susceptible,and humans are also susceptible hosts.The main symptoms of Lyme disease in humans are erythema migrans,arthritis,and other neurological symptoms,and the common symptoms in infected animals include joint diseases,coat shedding,fever,laminitis,and lameness.Lyme disease is wide-spread,but diagnosis is difficult,and this disease is easily misdiagnosed and missed.Awareness of Lyme disease must be in-creased to avoid its toll on livestock and the pet industry.Therefore,this article reviews research progress in diagnosis and con-trol technology for animal Lyme disease and Borrelia burgdorferi,to provide a reference for accurate,rapid diagnosis and con-trol of Lyme disease.

Previous studies demonstrated that interleukin-12 (IL-12) enhances the non-MHC-restricted cytotoxic activity of NK cells and facilitate specific allogeneic human cytotoxic T lymphocyte responses against fresh leukemia cells and cell lines. The Wilms' tumor gene, WT1 mRNA, has been used as a marker of minimal residual disease (MRD) for evaluating therapeutic efficacy of patients with leukemia or myelodysplastic syndrome (MDS). This study was aimed to investigate whether in vitro IL-12 can lower WT1 gene expression in peripheral blood monuclear cells (PBMNC) from patients with leukemia or MDS. PBMNC from these 30 patients and 5 healthy volunteers were cultured at 5 x 10(5) cells/ml alone with or without 100 units/ml of IL-12 for 3 days. WT1 mRNA was measured by competitive reverse transcription polymerase chain reaction (RT-PCR) since WT1 mRNA is considered as a marker of minimal residual disease (MRD) in leukemia and MDS. The results demonstrated that WT1 mRNA in PBMNC of 5 healthy volunteers was less than 10(3) copies/microg of total RNA. Following the 3-day IL-12 treatment, mean WT1 mRNA of PBMNC was reduced from 10(4.8) to 10(4.2) copies/microg of total RNA in 6 CML patients, from 10(5.4) to 10(4.8) copies/microg in 12 MDS patients and from 10(5.0) to 10(4.2) copies/microg in 5 AML patients in CR, but not reduced in 5 of 7 AML in non-CR. It is concluded that IL-12 significantly decrease the quantity of leukemia cells in PBMNC of most patients with MDS, CML and AML in CR. IL-12 may be of considerable benefit in the elimination of MRD in patients with hematological malignancies.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Interleukin-12 ; pharmacology ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; metabolism ; Neoplasm, Residual ; genetics ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; WT1 Proteins ; biosynthesis ; genetics

This study was purposed to investigate the expression of c-fes gene in leukemia patients and its clinical significance. The expression of c-fes mRNA in bone marrow cells from 121 cases of acute and chronic leukemia patients, and the expression of c-fes mRNA in peripheral blood mononuclear cells of 20 normal persons were detected by real time-quantitative reverse transcription polymerase chain reaction (RQ-PCR). The results showed that the level of c-fes mRNA in AML patients was higher than that in normal controls [(48.017 +/- 57.170) x 10(-3) vs (0.152 +/- 0.398) x 10(-3)] (p < 0.0001); but there was no significant differences of level of c-fes mRNA between samples of ALL and normal controls(0.047 +/- 0.068) x 10(-3) vs(0.152 +/- 0.398) x 10(-3) (p>0.05); the level of c-fes mRNA in CML patients was higher than that in normal persons (21.605 +/- 24.818) x 10(-3) vs (0.152 +/- 0.398) x 10(-3) (p < 0.0001). The positive expression rate of c-fes gene in CML-CP patients (80%) was higher than that in CML-AP patients (66.7%) and CML-BP (28.6%) patients. In AML patients, c-fes gene was expressed higher in M(2) (80.77%) and M(3) (92.86%) patients. The remission rate of AML (except M(3))patients who had expression of c-fes gene was 81.08%, which was higher than that of patients with no expression of c-fes gene (40.00%). It is concluded that c-fes gene expression was found in myeloid leukemias, whereas low or no expression in lymphocytic leukemias. The differentiation of myelocytic cells may be related to c-fes gene. All AML (except M(3))patients with high level of c-fes mRNA may get good prognosis.
Adult ; Case-Control Studies ; Female ; Gene Expression ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Leukemia, Myeloid ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Male ; Prognosis ; Proto-Oncogene Proteins c-fes ; genetics ; RNA, Messenger ; genetics