Comparative study of different dosages of dexmedetomidine combined with fentanyl for monitored anesthesia care during endoscopic variceal ligation / 中华消化内镜杂志

Objective To investigate the ideal dosage of dexmedetomidine( DEX) with 1?0 μg/kg fentanyl for monitored anesthesia care ( MAC) during endoscopic variceal ligation ( EVL) . Methods A total of 60 patients scheduled for elective EVL were randomly divided into 3 groups ( n=20) . After fentanyl was infused intravenously at the dosage of 1?0 μg/kg, the loading dosage of DEX at 1?0 μg/kg ( group D1 ) , 1?5 μg/kg ( group D2 ) , or 2?0μg/kg ( group D3 ) was continuously infused in 10 min, respectively. When the modified OAA/S score reaching≥3 point, EVL was carried out. The change in modified OAA/S score, the operation duration time, recovery time, satisfaction rates of patient and doctor, and complications were recorded. Results There were no significant differences in regarding of general status, operation duration time and satisfaction score of patients between the 3 groups ( P>0?05 ) . Before endoscope insertion, the OAA/S score in group D3(4?4±0?2)was higher than that in D1(3?4±0?5)or D2 groups(3?8±0?3)(P0?05).At the time?point of 5 mins after endoscope insertion, the OAA/S score in group D3(4?5±0?3)was significantly higher than that in D1(3?5±0?6)or D2 groups(3?7±0?4)(P0?05) . At the end of the procedure,there was no significant difference in OAA/S score between the 3 groups(P>0?05).Compared with group D1(3?1±0?9)min and D2(3?8±0?8)min, the recovery time in group D3(6?6±1?2)min was significantly longer (P0?05). The satisfaction score of endoscopist in group D1(8?0±0?8) was significantly lower than that in group D2(9?4±0?6)or D3(9?5±0?5)(P0?05 ) . No tachycardia, hypertension or hypoxemia occurred during the procedure. There was no significant difference in rate of hypotension among the three groups ( P>0?05) . The incidences of nausea(30%) and body movement(15%) in group D1 were significantly higher than those in group D2 and D3(P0?05). The incidence of bradycardia in group D3(40%) was significantly higher than those in group D1(0) and D2(10%)(P0?05). Conclusion Combined with 1?0 μg/kg fentanyl, 1?5 μg/kg DEX is more efficient and safer for EVL in the status of MAC.

Limited endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation for common bile duct stones in elderly patients / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of minor endoscopic sphincterotomy (EST)with endoscopic papillary large balloon dilation(EPLBD)for common bile duct stones(CBDS)in elderly patients and to study the influence of the periampullary diverticula on efficacy. Methods Data of 209 patients with CBD stones(more than 1. 0 cm)over the age of 70 were retrospectively analyzed. The pa-tients were divided into EST group(103 cases)and the EST with EPLBD group(106 cases),which was further divided into two subgroups with and without periampullary diverticula.Operation time,complete stone removal rate in the first session,mechanical lithotripsy usage rate and complications were compared between the two groups. Results Compared with EST group,the EST with EPLBD group had shorter operation time [(25. 65±8. 76)min VS(35±6. 67)min,P= 0. 000],a higher success rate of the complete stone removal in the first session( 90. 57% VS 83. 50%,P = 0. 030),lower rate of mechanical lithotripsy( 8. 50% VS 55. 34%,P= 0. 000),but with a higher incidence of hyperamylemia(18/ 106 VS 7/ 103,P = 0. 044).The o-verall stone removal rates showed no difference(96. 23% VS 95. 14%,P= 0. 700).In the EPLBD group,di-verticulum had no effects on the results and complications of ERCP( P> 0. 05). Conclusion EST with EPLBD is a safe and effective method for CBDS in elderly patients. Periampullary diverticula does not affect the therapeutic effects of this method.

miR-610 suppresses lung cancer cell proliferation and invasion by targeting GJA3 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the function and mechanism of miR-610 in lung cancer cell proliferation and invasion.</p><p><b>METHODS</b>The expression of miR-610 was detected by real-time PCR in lung cancer cell lines 95D and 95C with different metastatic ability. miR-610 mimics and inhibitor were transfected into 95D and 95C cells, respectively, and CCK-8 kit and BrdU incorporation assay were used to detect the effect of miR-610 on lung cancer cell proliferation. Cell scratch test and Transwell test were used to detect the effect of miR-610 on lung cancer cell invasion. Bioinformatics software was used to predict the potential target genes of miR-610. Dual-luciferase reporter gene system and Western blot were applied to test whether miR-610 regulates GJA3 expression directly.</p><p><b>RESULTS</b>The expression of miR-610 in the weakly metastatic lung cancer 95C cells was (8.75 ± 0.21) times higher than that in the highly metastatic lung cancer 95D cells (P < 0.01). BrdU incorporation assay showed that the number of proliferating 95C cells was (37.41 ± 2.39)% in the control group and (59.63 ± 4.57)% in the miR-610 mimics transfection group (P < 0.01). The number of proliferating 95D cells was (68.75 ± 4.28)% in the control group and (46.13 ± 3.27)% in the miR-610 mimics transfection group (P < 0.01). Cell scratch test showed that at 24 and 48 hours after scratching, the scratch width of 95C cells in the miR-610 inhibitor group was reduced to (58.74 ± 4.62)% and (34.63 ± 2.73)%, respectively, of the initial scratch width, both were significantly lower than that of blank control group and miR-610 inhibitor control group (P < 0.01 for both). The scratch width of 95D cells in the miR-610 inhibitor group was (88.59 ± 6.92)% and (72.24 ± 5.46)%, respectively, of the initial scratch width, and both were significantly higher than that of the blank control group and miR-610 inhibitor control group (P < 0.01 for both). Transwell assay showed that the numbers of invading 95C cells after transfection with miR-610 inhibitor was (112.4 ± 10.6) cells/square in the miR-610 inhibitor control group and (161.8 ± 12.5) cells/square in the miR-610 inhibitor group, indicating a significantly increased invasion ability of 95C cells in the miR-610 inhibitor transfection group (P < 0.01). The numbers of invading 95D cells after transfection with miR-610 mimics was (178.4 ± 12.3) cells/square in the miR-610 mimics control group and (76.7 ± 5.8) cells/square in the miR-610 mimics group, indicating a significantly decreased invasion ability of 95D cells in the miR-610 mimics transfection group (P < 0.01). These data indicated that miR-610 can suppress the invasion of lung cancer cells.</p><p><b>CONCLUSION</b>miR-610 suppresses lung cancer cell proliferation and invasion by targeting GJA3 expression.</p>

Mechanical property and eluted character of vancomycin-impregnated polymethylmethacrylate / 吉林大学学报(医学版)

Objective To study the effects of vancomycin-impregnated polymethylmethacrylate (VCM-PMMA) on mechanics alteration and delayed release in order to guide clinical application.Methods The specimens of bone cement (each of 40 g) were divided into 7 groups depending on mixed different contents with vancomycin,containing 0,0.5,1.0,1.5,2.0,2.5 and 3.0 g vancomycin.The compressive strength,bending strength and bending elastic moduls were measured respectively.The elution examination of vancomycin from bone cement was performed by chromatography.Results There were no differences of compressive strength before elution of bone cement that were included from 0 to 3.0 g vancomycin.When the vancomycin in the content of the bone cement attained 3.0 g,the compressive strength after elution and bending elastic were lower than those in control group(P