Objective To observe the security and efficacy of sevoflurane inhalation in combination with remifentanil controlled hypotension in patients undergoing functional endoscopic sinus surgery.Methods Forty pa tients undergoing elective functional endoscopic sinus surgery were randomly divided into propofol group (group P)and sevoflurane group(group S).In group P,patients received remifentanil 0.2μg · kg-1 · min-1 and propofol 4 ～6mg · kg-1 · min-1 intravenously,those in group S received remifentanil 0.2pg · kg-1 · min-1 and continuous inhalation of sevoflurane 2 ～ 3％,the end-tidal concentration was 1.1 ～ 1.7MAC.MAP was retained at 65 ～ 75 mmHg in the two groups.MAP and HR were recorded before controlled hypotension (T1),5min after controlled hypotension (T2),30min after controlled hypotension(T3),the termination of surgery(T4) and 5min after the termination of surgery(T5).Record the patient opening eyes time,wake extubation time,duration of surgery,blood loss.Also observed with or without respiratory depression,drowsiness,restlessness,nausea,vomiting and other adverse reactions.The same surgery fell surgical field quality rating according to Fromme operative field score table.Results Compared with T1,MAP(F =73.68) and HR(F =24.60) decreased significantly(P ＜ 0.05) at the other time points.There was no statistically significant difference in MAP(t =0.90) and HR(t =1.00) at the same time points between the two groups (P ＞ 0.05).Extubation time (t =0.44),duration of operation (t =1.23),operative field score (t =0:43) and blood loss (t =0.58) has no significant differences (P ＞ 0.05).Conclusion Inhalation hypotension by sevoflurane is feasible and safe in the functional endoscopic sinus surgery.It shows good quality of surgical field and less adverse reactions.

Background and purpose:Chemotherapy is the important way of breast cancer treatment, but the drug-resistance has attracted special attention. The emergence of drug resistance is closely related to the abnormal enhancement of DNA-damage repair. Both Kif4A and PARP-1 are important molecules of DNA repair. The research investigated the function of Kif4A in epirubicin up-regulating the activity of PARP-1 in breast cancer cells and possible significance. Methods:Western blot was used to detect the expression of Kif4A and PARP-1 after treatment with epirubicin in MDA-MB-231 and MCF-7 cells; the expression of PARP-1 and its activity were detected after high expression of Kif4A and treatment with epirubicin;FCM was used to detect cell apoptosis after treatment with epirubicin combined with PARP-1 inhibitor 3-ABA. Results:Epirubicin up-regulated PARP-1 activity and induced low expression of Kif4A in breast cancer cells, both of them showed dose-dependent and time-dependent. After high expression of Kif4A, the activity of PARP-1 was inhibited and the apoptosis of cells increased, epirubicin partially reversed the activity of PARP-1 inhibited by high Kif4A expression. Both of epirubicin and 3-ABA induced cell apoptosis, combination of them further increased cell apoptosis compared with alone used (P<0.05). The results also showed the apoptosis rate of MDA-MB-231 cells induced by epirubicin, PARP-1 inhibitor 3-ABA and high expression Kif4A was higher than that of MCF-7 cells (P<0.05). Conclusion:Epirubicin increases the activity of PARP-1 dependent on the low expression of Kif4A in breast cancer cells. Kif4A might become a novel target for overcoming resistance of epirubicin.

Objective To determine whether the cross-sectional area (CSA)of the calf measured with MRI could stage lower ex-tremity lymphedema (LEL)secondary to gynecological cancer treatments.Methods 148 patients were enrolled in this research.116 females with unilateral LEL and 32 without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T),muscle CSA (M)and subcutaneous tissue CSA (S)of affected calf,and difference of T (DT),M (DM) and S (DS)between calves were obtained on MRI at mid-calf level.Volume of affected calf and difference of volume (DV)between calves were obtained by water displacement.Statistical analysis was performed to determine feasibility of MRI measurements for ac-cessing LEL.Results There were close correlations between volume and T or S of affected calf,and between DV and DT or DS of calves.The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than the volume of affect-ed calf and DV (P< 0.01).Multivariate analysis showed more significant differences in T and S than in volume of affected calf,and in DS than in DV between LEL stages (P< 0.05).No difference was found in volume of affected calf and in DV between stage 0 andⅠ. For staging LEL,DS showed the most profound discrimination ability among all measurable parameters.Conclusion DS of calves could be the most reliable parameter recommended for staging and early diagnosis of LEL.

Objective To study the long-term neurodevelopment in term neonates with hyperbilirubinemia and explore the predictive value of cerebrospinal fluid neuron specific enolase (CSF-NSE) on long-term neurodevelopment outcome.Methods A mental and psychomotor scale for 0-4 years old was performed to evaluate the intelligence development of 39 neonates with hyperbilirubinemia and 39 randomly selected healthy controls when they were at 3 to 24 months old. The former were tested for the level of CSF-NSE in jaundice climax.Results There was significant difference between 2 groups in total development quotient (DQ) tested at 3 month and 24 month old (P=0, 0.047). It was shown that the DQ scores for fine activity and social behavior were significantly lower in the study group than those in the control group (Pa=0). Furthermore, within the hyperbilirubinemia group, CSF-NSE was significantly associated with DQ of 3 month and 24 month old, while there was not association with TSB. The correlation coefficients were -0.46(P=0.04) and -0.32(P=0.047),respectively.Conclusions Hyperbilirubinemia may influence long-term neurodevelopment of term infants and CSF-NSE can predict this outcome.

Objective To study the neuropsychological behavior development of preterm infants and low birth weight infants,and to provide a reference to the early prevention and intervention on developmental retardations.Methods A total of 101 preterm infants and/or low birth weight infants received the infant development test of 0 ～ 6 year-old children intelligence developmental scale for neurological development and autism behavior checklist(ABC).Results 25 boys and 5 girls suffered from different psychological mental disorders.The occurrences were as follows:10 cases with mental retardation,9 cases with the language development delay,9 cases with motor retardation,1 case with cerebral palsy and 1 case with autism spectrum disorder.The incidence of intelligence problems were that language retardation (18.9％),the fine motor (16.8％),the adapative ability (12.6％),social action (9.5 ％) and the motor delay (3.2％).There were significant differences in the scores of social communication(x2=8.88,P=0.003),adaptive ability(x2=7.41,P=0.007),the fine motor(x2 =6.22,P=0.01) and total developmental quotient(x2 =5.58,P=0.02) between city children'and rural area.The behavioral problems more consisted in self-care ability and language retardation.Conclusion Preterm infants and low birth weight infants are exposed to language,fine motor,adaptive and communication ability problems,especially the children living in country.It is necessary to improve the early education and intervention for the rural preterm infants and low birth weight infants.

Objective To investigate the diagnostic value of ultrasound in primary hepatic lymphoma (PHL).Methods The ultrasonic and clinical features in 40 cases of PHL were analyzed retrospectively.All cases were pathologically confirmed by surgical operation or ultrasound-guided biopsy.Results The most common presentation of PHL was a solitary lesion which occurred in 57.5％ (23/40) of patients,followed by multiple lesions in 30.0％ (12/40),and diffuse infiltration patterns in 12.5 ％ (5/40).The first two types were usually shown on ultrasound as hypoechoic lesions with surrounding normal liver parenchyma in 88.6％ (31/35) of cases.The diffuse pattern presented as diffuse hepatomegaly without nodules in the liver parenchyma.There were 52.5％ (21/40) of the lesions which could not be diagnosed either as benign or malignant by ultrasound.Conclusions The clinical presentations and imaging features of PHL are non-specific.PHL should be considered as a differential diagnosis in cases of liver metastases when no primary tumour is apparent,or when sonographic findings show atypical features of primary liver carcinoma or hemangioma.When patients with unexplained fever and diffuse hepatomegaly,PHL should be considered and precaution should be taken to prevent to misdiagnose these patients as having fatty liver or chronic liver disease.

OBJECTIVE: To test the technical parameters of GlobalFiler® PCR Amplification Kit for its application to forensic application value and to investigate the genetic polymorphisms. METHODS: The validation was conducted in sensitivity, mixed samples, species specificity, adaptability, survivability, consistency, peak height balance and stability. The amplification and detection of the genomic DNA from 373 unrelated individuals from Beijing Han nationality were extracted by automation workstation. RESULTS: Global-Filer® PCR Amplification Kit was adaptive to some mixed, degraded and inhibited samples. The power of sensitivity and adaptability and peak height balance showed well. The distributions of genotype frequencies for 21 STR loci in the population were all in accordance with Hardy-Weinberg equilibrium (P > 0.05). The PIC value of the 21 STR loci was among 0.536 to 0.940; the H value was among 0.558 to 0.933; the DP value was among 0.783 to 0.992; the PE value was among 0.243 to 0.874. CONCLUSION GlobalFiler® PCR Amplification Kit is suitable for criminal cases and DNA database in forensic practice. And 21 STR loci in Beijing Han nationality have high polymorphism, which have application value in forensic practice and population genetics.
Asian People/genetics* ; Beijing ; Databases, Nucleic Acid ; Ethnicity ; Gene Frequency ; Genetic Loci/genetics* ; Genetics, Population ; Genotype ; Humans ; Polymerase Chain Reaction/standards* ; Polymorphism, Genetic ; Reproducibility of Results ; Species Specificity

Objective To determine if the cardiac index (CI) measured with arterial pressure-based cardiac output (APCO) agrees with that measured with pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension.Methods Thirty parturients with congenital heart disease and severe pulmonary hypertension,scheduled for elective cesarean section,were enrolled in the study.APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2-3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5-6).The correlation was tested by Pearsone correlation analysis.CI derived from APCO and PAC was compared by Bland-Altman analysis for agreement.Results CI measured with PAC was significantly higher than that measured with APCO (P ＜ 0.05).Compared with the baseline value at T1,no significant difference in CI measured with PAC and APCO was found at T11-T4 and T6 (P ＞ 0.05),and CI measured with PAC and APCO was significantly increased at T5 (P ＜ 0.05).Bland-Ahman analysis showed poor agreement between CI measured with the two methods.The correlation analysis showed that there was positive correlation between CI derived from the two methods at T1-6 (the correlation coefficient was 0.93,0.95,0.94,0.89,0.96 and 0.91 at T1-6,respectively,P ＜ 0.05).Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.

Acupuncture has remarkable effects of pain relieving and functional restoration on injuries of soft tissue and joint due to military training. As more and more attention has been attached to the impact of psychological states and biorhythm disorder on the fighting ability of military staff, acupuncture has found its place in treating chronic fatigue, combat stress reaction, traumatic brain injury and post-traumatic stress disorder as well as regulating circadian rhythms. The therapeutic effect of acupuncture in military training-related physical damage and psychological trauma has already been proved by numerous clinical practices and researches. It is held that using acupuncture as an alternative could not only save medical resources, but also enhance the fighting ability of the army. However, the current clinical studies is facing the problem of limited sample size. Therefore, randomized controlled trials in large scale and multiple centers should be further carried out toward military staff, so as to provide more speaking evidences to the prevention and treatment of physical and psychological diseases.
Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Military Personnel ; psychology ; Pain Management ; Stress Disorders, Post-Traumatic ; therapy ; Wounds and Injuries ; therapy ; Young Adult

An HPLC method for the determination of geniposide concentration in mouse plasma was developed and the pharmacokinetics after intranasal administration of Xingnaojing microemulsion (XNJ-M) and mPEG2000-PLA modified Xingnaojing microemulsion (XNJ-MM) were investigated. Eighty mice were treated by XNJ-M and XNJ-MM nasally. The plasma samples were collected at different times and the drug in samples was detected by HPLC. The pharmacokinetic parameters were calculated by the software of Kinetica. The pharmacokinetic parameters of geniposide of XNJ-M were C(max) (4.36 +/- 2.69) mg x L(-1), t(max) 1 min, MRT (29.73 +/- 4.54) min, AUC (53.63 +/- 14.03) mg x L(-1) x min. The pharmacokinetic parameters of geniposide of XNJ-MM were C(max) (9.75 +/- 4.14) mg x L(-1), t(max) 1 min, MRT(22.34 +/- 2.90) min, AUC (131.87 +/- 40.13) mg x L(-1) x min. Geniposide can be absorbed into blood in a higher degree after intranasal administration with XNJ-MM compared to XNJ-M, which maybe caused by its less irritating and more absorption.
Animals ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Emulsions ; Iridoids ; blood ; pharmacokinetics ; Lactic Acid ; chemistry ; Male ; Mice ; Polyesters ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry