Objective To explore the safety and feasibility of intravenous dexmedetomidine(Dex)combined with targeted infusion of remifentanil in endoscopic retrograde cholangiopancreatography(ERCP)anesthesia in older adult patients.Methods From January to August 2021,98 older adult patients(≥65 years old)undergoing ERCP were randomly divided into TRP and TRD groups.The TRP group was anesthetized with target-controlled infusion of propofol and remifentanil and the TRD group was treated with Dex combined with target-controlled infusion of remifentanil.mean arterial pressure(MAP),heart rate(HR),electrocardiogram(ECG),respiratory rate(RR),pulse oxygen saturation(SpO2),bispectral index(BIS)before anesthesia induction(T0),immediately after induction of anesthesia(T1),endoscopic introduction(T2),duodenal papilla intubation(T3),endoscopy withdrawal(T4)and postoperative awakening(T5)were observed.Arterial blood gas analysis at different time points(T0,every 15 min after anesthesia induction and T5),PaO2,and PaCO2,were recorded at the above mentioned time points;and the remifentanil concentration in target-controlled infusion,operation time,recovery time(from infusion of remifentanil to consciousness recovery),anesthesia recovery time(from consciousness recovery to leaving the operating room),intraoperative body movement,Aldrete scores out of the room,Visual Analogue Scale(VAS)at 60 min after surgery,occurrence of post-operative adverse reactions,as well as the satisfaction of anesthesiologists,endoscopists,and patients were recorded.Results Compared with the TRP group,MAP at T1 and T3,SpO2 and RR at T1,T2,T3,and T4,and BIS at T2,T3,T4,and T5 increased,whereas HR at T1,T2,T3,and T4 decreased;the number of mandibular rests,incidence of hypoxemia,Aldrete score,and satisfaction increased,whereas the VAS score at 60 min after surgery decreased in the TRD group(P<0.05).There were no statistically significant differences in postoperative adverse reactions,PaO2 and PaCO2,target-controlled infusion remifentanil concentration,operation time,recovery time,and anesthesia recovery time between the two groups.Conclusion Compared with the target-controlled infusion of propofol-remifentanil,intravenous infusion of Dex combined with target-controlled infusion of remifentanil can reduce the incidence of hypoxemia in older adult patients during ERCP surgery,and the anesthesia regimen can meet the anesthesia needs of ERCP surgery,which is safe and feasible.

Objective: An isochronous substitution model was established to explore the association and substitution effect between college students 24 hour activity behavior and physical health, so as to provide specific activity behavior suggestions for college students to improve their physical health. Methods: A stratified random cluster sampling method was used to conduct physical fitness tests and 24 hour activity behavior surveys among 2 794 college students in 12 colleges and universities in Tianjin.Time spent on sedentary behavior(SB), light intensity physical activity(LPA), moderate to vigorous physical activity(MVPA) and sleep(SLP) time. The isochronous method of components was used to explore the relationship between 24 h activity behavior and physical health. Results: Except for 50 m running, MVPA was negatively correlated with BMI Z ( β =-0.62, P <0.05), but positively correlated with other physical fitness indexes ( β =0.34~274.23, P <0.05). LPA was not associated with lung capacity, sitting forward flexion and 50 m running, and negatively correlated with other physical fitness indexes ( β =-14.30- -0.19, P <0.05). SB was negatively correlated with most physical fitness indexes ( β =-11.57- -0.33, P <0.05), but positively correlated with BMI Z ( β =0.45, P < 0.05 ). In addition to lung capacity, SLP was positively correlated with BMI Z , total physical fitness score,1 minute sit-ups, pull ups, 800/1 000 m running, sitting forward flexion, and 50 m running ( β =0.27-11.21, P <0.05), but negatively correlated with long jump ( β =-0.10, P <0.05）. Isochronous substitution showed that the adverse effects of 30 min/d SB and LPA substitution of MVPA were much greater than the beneficial effects of MVPA substitution for corresponding behaviors (total physical score: SB, -0.58 vs 0.47 points; LPA, -0.50 vs 0.38 points). Conclusion MVPA and SLP have been found to have a positive effect on physical fitness among college students. Therefore, in the process of improving the physical health of college students, ensuring adequate sleep, improving MVPA and reducing SB as much as possible may be one of the effective methods.

Objective To evaluate the effect of sevoflurane on the expression of aquaporin 8 (AQP8) in the intestinal mucosa in a pig model of hemorrhagic shock.Methods Twenty-four Bama miniature pigs of both sexes, weighing 22-25 kg, were randomly divided into 3 equal groups using a random number table: sham operation group (group S), hemorrhagic shock group (group HS) and sevoflurane group (group PS).The femoral artery and jugular vein were cannulated for blood pressure monitoring, blood-letting, and blood sampling in anesthetized pigs.Hemorrhagic shock was induced by withdrawing blood from the right femoral artery.Hemorrhagic shock was induced after cannulation in group HS.In group PS, 2％ sevoflurane was inhaled for 30 min after the model of hemorrhagic shock was successfully established.Before anesthesia, and at 0.5, 1, 1.5, 2, 3 and 4 h after hemorrhagic shock, blood samples were collected from the jugular vein for determination of serum D-lactic acid and intestinal fatty acid-binding protein (I-FABP) concentrations.The animals were sacrificed at 4 h after hemorrhagic shock, and the intestinal specimens were obtained for microscopic examination and for determination of AQP8 expression in the intestinal mucosa (by enzyme-linked immunosorbent assay).The intestinal water content was calculated.Results Compared with group S, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly increased in HS and PS groups (P＜0.05).Compared with group HS, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly decreased in group PS (P＜0.05).The pathological changes of intestinal tissues were significantly reduced in group PS as compared with group HS.Conclusion Sevoflurane can decrease the intestinal mucosal edema through inhibiting AQP8 expression, thus reducing hemorrhagic shockinduced damage to the intestinal mucosa in pigs.

ObjectiveTo detect the changes of gastroesophageal reflux disease (GERD) with high resolution endoscopy,and to explore its diagnostic value for nonerosive reflux disease (NERD). Methods From April 2007 to January 2008, consecutive out-patients visiting the Department of Gastroenterology due to continuous or recurrent symptoms of acid reflux, heartburn, cardiac-like chest pain for at least three months and volunteer healthy controls were recruited to the study. The subjects were classified into the normal group ( n =48 ), the NERD group ( n =70), the erosive esophagitis (EE) group ( n =70), and the Barrett esophagus (BE) group ( n =48). All subjects underwent endoscopy, and the shape of Z-lines, the shape of mucosal pits, mucosa roughness above Z-line and the shape of mucosal blood vessels were observed. The NERD changes were analyzed with optimal scale. ResultsZ-line shape of NERD group showed a significant difference from that of EE and BE groups ( P ＜ 0. 01 ), which was not different from that of normal controls ( P ＞0. 01 ). The shape of mucosal pits of NERD group was different from that of EE and BE (P ＜0. 01 ), which also was not different from that of control (P＞0. 01 ). Roughness of the mucosa above Z-line of NERD group was different from other 3 groups (P ＜0. 05). And the shape of mucosal blood vessels of NERD was different from the control (P＜0. 05), but was not from two others. Features of NERD relative images were thin,straight and spiral blood vessels, bar-like pits, plat mucosa, round, smooth and wide tooth-like Z-line and mucosa of white particle hypertrophy. ConclusionHigh resolution endoscopic features of most NERD patients are cloudy, white and rough mucosal surface, with white particular hypertrophy, spiral vascular dilation, extending to Z-line. These features can be indicators of NERD.

Objective To study the effect of TFF_2 gene theragy on the healing of experimental gastric ulcer in rats and its mechanism.Methods From Jun.10,2005 to Mar.15,2006.48 Wistar rats were randomly divided into two groups:24 in therapy group,24 in control group.pcDNA3.1-TFF_2 100?g was used in each rat in therapy group,and the same volume of pcDNA 3.1 was used in control group.Each rat was injected under serous membrane of the gastric wall after making model.The rats were executed separately after 3、7、14 days.Results Ulcer index was 9.7?2.9 mm2 in therapy group and was 17.7?3.1 mm2 in control group on the 14th day.There was significant difference between the two groups.The average amount of mucous glycoprotein was 83.35?4.54 mg/g in the therapy group and 70.36?4.22 mg/g in the control group.There was no significant change in the secretion of acid between the two groups.Conclusion TFF_2 gene therapy can promote the healing of experimental gastric ulcer in rats.Its mechanisms may include increasing mucous glycoprotein of the gastric wall without suppressing gastric acid secretion.

Objective To investigate the expression changes of histidine decarboxylase(HDC)and H+,K+-ATPase in gastric mucosa during the healing of experimental gastric ulcer in rats.Methods The ulcers were caused by applying acetic acid to the serosal surface of the anterior face of the rat gastric body.At different time points during ulcer healing,HDC and H+,K+-ATPase mRNA and protein expressions were studied by using reverse transcription-polymerase chain reaction and Western blot respectively.Results An ulcer crater developed on the anterior face of the gastric body on day 1 after the induction of ulcers,and the ulcer area was biggest on day 3.On day 12,most of the gastric ulcers had healed.Compared with the control group,the HDC and H+,K+-ATPase mRNA expression in the gastric mucosa of ulcer rats showed a decrease on day 1,and increased back to initial level on day 9.The protein expression of HDC and H+,K+-ATPase in gastric mucosa of ulcer rats decreased immediately on day 1,more on day 6,and returned to the initial levels on day 12.Conclusion The mRNA and protein expressions of HDC and H+,K+-ATPase decrease in the healing process of gastric ulcers,resulting in accelerated ulcer healing through inhibiting gastric acid secretion.

Objective To study the relationship between gastric emptying dysfunction and neurotensin(NT) in functional dyspepsia(FD) patients. Methods Gastric emptying function in 54 FD patients was measured with solid radioopaque markers. Patients were divided into two groups according to the results, one of which with delayed gastric emptying and the other with normal gastric emptying. Seventeen healthy volunteers served as normal control group. The NT levels in plasma (fasting and postprandial) and the mucosa of gastric antrum and descending portion of duodenum were measured by radioimmunoassay(RIA). Results The NT levels in fasting and postprandial plasma and the mucosa of gastric antrum and descending portion of duodenum in FD group with delayed gastric emptying were significantly higher than those in FD group with normal gastric emptying and in normal control group. The three groups did not differ significantly in incremental extent of plasma NT after test meal. The NT levels in fasting and postprandial plasma and the mucosa of gastric antrum and descending portion of duodenum in FD group with normal gastric emptying did not differ statistically from those in normal control group. Conclusion Gastric emptying dysfunction is closely related to NT, which can inhibit gastrointestinal motility and delay gastric emptying. Thus, NT is important in the pathogenesis of FD.

0 05). However, the gray of G cells were significantly enhanced( ?

Revised immunoelectron microscopic technique was used to examine G cells and D cells in rat antral mucosa. The number of colloidal gold granules in G and D cells was analysed through quantitative analysis. The results showed that immunological granules of colloidal gold distributed in both G and D cells. Gastrin- or somatostatin-labeled granules were present mainly as lobation-like or island-like congeries. Most of the golden congeries dissociated in the cytoplasm of G or D cells, being in the basement membrane side. A few of the golden congeries located in nucleus. The number of golden granules was 107. 04 ?19. 68 and 83. 36?17. 58 per one G and D cell, respectively.

Isolation of rat gastric mucosal cells was performed with scraping method followed by protease and collagenase digestion. Parietal cells were observed and identified with phase-contrast microscopy, light microscopy with hematoxylin and eosin staining, electron microscopy, fluorescence microscopy, and also immunocytochemistry technique. The diameters of parietal cells were measured. The results showed that the mucosal cells were successfully isolated, and it was confirmed that the parietal cells were the biggest cells among all the mucosal cells.