Objective To investigate the effect of subanesthetic dose of esketamine for postoperative analgesia on early recovery in elderly patients undergoing laparoscopic radical resection of rectal cancer.Methods Elderly patients undergoing laparoscopic radical resection of rectal cancer were included,and they were divided into the AS group(61 cases received esketamine for intravenous self-controlled analgesia)and the SF group(60 cases received sufentanil for intravenous self-controlled analgesia)by random number table method.The operation time,intraoperative infusion volume,urine output,intraoperative blood loss,postoperative rescue analgesia,tramadol dosage and the number of patient controlled intravenous analgesia(PCIA)compressions within 48 hours after surgery,postoperative visual analogue scale(VAS)score,Ramsay sedation score,first ambulation time after surgery,first gas passage time after surgery,and first feeding time after surgery were compared between the two groups.The occurrence of adverse reactions in the two groups was recorded.The levels of interleukin-6(IL-6)and C-reactive protein(CRP)immediately after surgery,24 hours and 72 hours after surgery in the two groups were detected by ELISA.The scores of anxiety and depression 3 days,1 week and 1 month after surgery were compared between the two groups.Results There was no significant difference in the operation time,intraoperative infusion volume,urine output,intraoperative blood loss,postoperative rescue analgesia,tramadol dosage or PCIA compressions within 48 hours after surgery between the two groups(P＞0.05).The levels of IL-6 and CRP gradually increased immediately after surgery and 24 hours and 72 hours after surgery in the two groups(P＜0.05),and the levels of IL-6 and CRP 24 hours and 72 hours after surgery in the AS group were significantly lower than those in the SF group(P＜0.05).The first ambulation time after surgery,first gas passage time after surgery,and first feeding time after surgery in the AS group were earlier than those in the SF group(P＜0.05).The incidences of nausea,vomiting and dizziness in the AS group were significantly lower than those in the SF group(P＜0.05).The levels of IL-6 and CRP 24 hours and 72 hours after surgery in the AS group were significantly lower than those in the SF group(P＜0.05).The scores of anxiety and depression 3 days and 1 week after surgery in the AS group were significantly lower than those in the SF group(P＜0.05).Conclusion Subanesthetic dose of esketamine for postoperative analgesia can alleviate short-term postoperative anxiety and depression in elderly patients undergoing laparoscopic radical resection of rectal cancer,relieve postoperative pain and inflammatory responses and have a low incidence of adverse reactions,which contribute to early recovery of patients.

Objective:To explore the clinical characteristics, therapeutic efficacy and prognosis of congenital coronary artery fistula (CAF) in children.Methods:Clinical data of 71 pediatric patients diagnosed with congenital CAF at Department of Cardiology and Department of Cardiac Surgery, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from January 2013 to June 2019 were retrospectively analyzed.The median age was 2.2 years (0.1-14.0 years), and the median body weight was 18.3 kg (3.2-55.8 kg), including 37 males (52.1%) and 34 females (47.9%). They were divided into the transcatheter closure group (30 cases) and surgical repair group (41 cases). The therapeutic effect and follow-up data of the 2 groups were compared by the Fisher′ s exact test. Results:Among the 71 congenital CAF children, 70 had heart murmurs, 2 had chest tightness after activity, and 5 were prone to recurrent respiratory tract infection.Transcatheter closure and surgical repair were successfully performed in 22/30 (73.3%) and 41/41 (100.0%) cases with a statistically significant difference ( P=0.001). However, in the surgical repair group, 1 (2.4%) case died after operation and 2(4.9%) needed further transcatheter closure due to large residual shunt during the follow-up period.At the last follow-up, there were 2 cases with minimal or small residual shunt in both groups ( P=0.567). There were 2/71(2.8%) cases suffering from postoperative thrombosis. Conclusions:Cardiac murmur is the main sign of congenital CAF in children, and some of them may have frequent respiratory tract infection due to increased lung blood caused by a large amount of shunt.A few children have chest tightness and chest pain due to myocardial ischemia caused by coronary steal.Both percutaneous closure and surgical repair are safe and effective with few complications.

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

Objective To study the metabolic transformation pathways of 4F-MDMB-BUTINACA in vivo by establishing zebrafish models. Methods Six adult zebrafish were randomly divided into blank control group and experimental group, with three fish in each group. After the zebrafish in the experimental group were exposed to 1 μg/mL 4F-MDMB-BUTINACA for 24 h, they were transferred to clean water and cleaned three times, then pretreated for instrumental analysis. The zebrafish in blank control group were not exposed to 4F-MDMB-BUTINACA. Mass spectrometry and structural analysis of 4F-MDMB-BUTINACA and its metabolites were conducted by liquid chromatography-high resolution mass spectrometry and Mass Frontier software. Results A total of twenty-six metabolites of 4F-MDMB-BUTINACA were identified in zebrafish, including eighteen phase Ⅰ metabolites and eight phase Ⅱ metabolites. The main metabolic pathways of phase Ⅰ metabolites of 4F-MDMB-BUTINACA in zebrafish were ester hydrolysis, N-dealkylation, oxidative defluorination and hydroxylation, while the main metabolic pathway of phase Ⅱ metabolites was glucuronidation. Conclusion Metabolite Md24 （ester hydrolysis） and Md25 （ester hydrolysis combined with dehydrogenation） would be recommended to be potentially good biomarkers for abuse of 4F-MDMB-BUTINACA.
Animals ; Cannabinoids ; Chromatography, Liquid ; Illicit Drugs ; Microsomes, Liver/chemistry* ; Zebrafish

Objective To determine the proportions and correlates of recent HIV infections among newly reported HIV/AIDS cases from 2005 through 2009 in Dehong prefecture, Yunnan province. Methods All available serum samples of newly reported HIV/AIDS cases during 2005-2009 period in Dehong prefecture, were tested using the BED HIV incidence capture enzyme immunoassay (BED-CEIA). Results A total of 9367 HIV/AIDS cases were newly reported in 2005through 2009, of whom 7252 (77.4%) were tested with BED-CEIA. Among the tested, 954 (13.2%)were positive for BED-CEIA and were regarded as recent HIV infections. The proportion of recent HIV infection among newly reported HIV/AIDS cases was 11.21% in 2005, 11.87% in 2006, 17.55%in 2007, 13.22% in 2008, and 12.22% in 2009. Multiple logistic regression analysis indicated that the proportion of recent HIV infections among newly reported HIV/AIDS cases in 2009 was significantly higher among females, those aged 11-19 years, and internal residents outside of Dehong prefecture,but significantly lower among immigrants who were mostly from Myanmar, than local residents.Conclusion From 2005 to 2009, the proportion of recent HIV infections among newly reported HIV/AIDS cases in Dehong prefecture in Yunnan province was fluctuating slightly. Future research is needed to examine its long-term and secular trend. Such proportion was significantly different by different sociodemographic characteristics.

OBJECTIVETo determine the pulmonary pathological changes in hematological malignancy patients with pulmonary complications.

METHODS17 hematological malignancy patients underwent surgical treatment were evaluated retrospectively. The pathological changes of all the surgical specimens were examined postoperatively by standard hematoxylin and eosin (HE) staining.

RESULTSPathological examination confirmed: aspergillus infection in 9 patients, sub-acute inflammation (fibrosis and hematoma formation) in 3, and each in 1 of pulmonary infarction with granulomatous tissue in the periphery; granulomatous inflammation with calcified tubercle; alveolar dilation and hemorrhage, interstitial fibrosis and focal vasculitis; intercostal neurilemmoma; and moderate-differentiated adenocarcinoma accompanied by intrapulmonary metastasis. And several operative complications (1 case of fungal implantation, 3 pleural effusion and adhesions and 2 pulmonary hematoma) were occurred. The coincidence rate of pre- and post-operative diagnosis was 9/14 (64.3%). After surgery, 8 patients were received hematopoietic stem cell transplantation (HSCT, allo-gene or autologous), with 7 succeeded. On effective secondary antifungal prophylaxis, 4 of 5 patients of aspergillosis succeeded in transplantation with free from mycotic relapse, one patient died from fungal relapse.

CONCLUSIONHematological malignancies with persistent and/or resistant pulmonary infection, hemoptysis, or unexplained lung diseases, should be treated in time by surgery operation to effectively eliminate residual disease and obtain a definitive diagnosis, so as to create a prerequisite condition for the following treatments. Moreover, the secondary antifungal prophylaxis can provide active roles for patients scheduled for chemotherapy and/or HSCT.

Aspergillosis ; diagnosis ; Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation ; Humans ; Lung Diseases ; Neoplasm Recurrence, Local

OBJECTIVETo investigate the effects of valsartan on expression of angiotensin II receptors in different regions of heart after myocardial infarction (MI).

METHODSCanines were divided into sham-operated control group (n=7), infarction group (n=7) and Valsartan group (10 mg x kg(-1) x day(-1) for 4 weeks after MI operation, n=7). Four weeks after operation, Doppler tissue imaging (DTI) was used to evaluate regional ventricular function in the noninfarcted myocardium (apical and basal near to the infarction region). The mRNA and protein expressions of angiotensin II type 1 receptor (AT1-R) and angiotensin II type 2 receptor (AT2-R) on the corresponding regions were detected by competitive reverse-transcriptase polymerase chain reaction technique and immunohistochemical technique respectively. Results The protein and mRNA expressions of AT1-R were significantly increased in both apical and basal regions near to the infarction in dogs with MI compared with those in control group (P < 0.05) which could be downregulated by valsartan (P < 0.05). AT2-R expressions were significantly upregulated in infarction group in both apical and basal regions compared with those in control group and valsartan further increased AT2-R expressions in both areas (P < 0.05). Myocardial peak systolic velocity (Sm), myocardial peak early diastolic velocity (Em) and myocardial peak late diastolic velocity (Am) at both apical and basal regions near to the infarction regions were significantly lower in MI group than those in the control group which could be significantly improved by valsartan.

CONCLUSIONBoth mRNA and protein expressions of AT1-R and AT2-R are upregulated in noninfarcted regions near MI, valsartan improved myocardial function via inhibiting AT1-R upregulation and enhancing AT2-R upregulation.

Angiotensin II Type 1 Receptor Blockers ; pharmacology ; therapeutic use ; Animals ; Dogs ; Female ; Male ; Myocardial Infarction ; drug therapy ; metabolism ; physiopathology ; Myocardium ; metabolism ; RNA, Messenger ; metabolism ; Receptor, Angiotensin, Type 1 ; metabolism ; Receptor, Angiotensin, Type 2 ; metabolism ; Tetrazoles ; pharmacology ; therapeutic use ; Valine ; analogs & derivatives ; pharmacology ; therapeutic use ; Valsartan

Objective To investigate the effects of valsartan on expression of angiotensin Ⅱ receptors in different regions of heart after myocardial infarction(MI).Metbods Canines were divided into sham-operated control group(n=7),infarction group(n=7)and Valsartan group(10 mg·kg-1·day-1 for 4 weeks after MI operation,n=7).Four weeks after operation,Dopplor tissue imaging(DTI)was used to evaluate reglonal ventricular function in the noninfarcted myocardium(apical and basal near to the infarction region).The mRNA and protein expressions of angiotensin Ⅱ type 1 receptor(AT1-R)and angiotensin Ⅱ type 2 receptor(AT2-R)on the corresponding regions were detected by competitive reverse-transcriptase polymerase chain reaction technique and immunohistochemical technique respectively.Results The protein and mRNA expressions of AT1-R were significantly increased in both apical and basal regions near to the infarction in dogs with MI compared with those in control group(P<0.05)which could be down-regulated by valsartan(P<0.05).AT2-R expressions were significantly upregulated in infarction group in both apical and basal regions compared with those in control group and valsartan further increased AT2-R expressions in both areas(P<0.05). Myocardial peak systolic velocity(Sm),myocardial peak early diastolic velocity(Em)and myocardial peak late diastolic velocity(Am)at both apical and basal regions near to the infarction regions were significantly lower in MI group than those in the control group which could be significantly improved by valsartan.Conclusion Both mRNA and protein expressions of AT1-R and AT2-R are upregulated in noninfarcted regions near MI,valsartan improved myocardial function via inhibiting AT1-R upregulation and enhancing AT2-R upregulation.

Objective To understand the evaluation on graduates' professional quality from the employment institutions,and to provide the references for the higher vocational schools in improving students' training model and strengthening students' professional quality. Methods The questionnaires designed independently were answered by the employment institutions hiring 2003-2005 four majors(namely nursing,laboratory science,dental technology,optometry) graduates from Shanghai Institute of Health Sciences. Results The overall evaluation of employment institutions on the graduates was quite good,but the evaluation on graduates' professional ability was low. Conclusion With strengthening the student' specialized knowledge and skill training,higher vocational schools must pay more attention to the students' professional ability education.

RecQ is a highly conserved helicase necessary for maintaining genome stability in all organisms. Genome comparison showed that a homologue of RecQ in Deinococcus radiodurans designated as DR1289 is a member of RecQ family with unusual domain arrangement: a helicase domain, an RecQ C-terminal domain, and surprisingly three HRDC domain repeats, whose function, however, remains obscure currently. Using an insertion deletion, we discovered that the DRRecQ mutation causes an increase in gamma radiation, hydroxyurea and mitomycine C and UV sensitivity. Using the shuttle plasmid pRADK, we complemented various domains of the D. radiodurans RecQ (DRRecQ) to the mutant in vivo. Results suggested that both the helicase and helicase-and-RNase-D-C-terminal (HRDC) domains are essential for complementing several phenotypes. The complementation and biochemical function of DRRecQ variants with different domains truncated in vitro suggested that both the helicase and three HRDC domains are necessary for RecQ functions in D. radiodurans, while three HRDC domains have a synergistic effect on the whole function. Our finding leads to the hypothesis that the RecF recombination pathway is likely a primary path of double strand break repair in this well-known radioresistant organism.
Amino Acid Sequence ; Deinococcus ; enzymology ; genetics ; Molecular Sequence Data ; Mutation ; genetics ; Phenotype ; Protein Structure, Tertiary ; RecQ Helicases ; chemistry ; genetics ; metabolism ; Sequence Alignment ; Sequence Homology, Amino Acid