Evaluation of efficacy of intravenous nalbuphine before epidural labor analgesia in inhibiting uterine contraction pain in primiparae / 中华麻醉学杂志

Objective:To assess the value of nalbuphine intravenously injected before epidural labor analgesia in inhibiting uterine contraction pain in primiparae.Methods:A total of 140 expectant primiparae who were suitable and willing to receive epidural labor analgesia with a singleton fetus in vertex presentation, aged 20-40 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅱ, with their cervical dilation of 2-3 cm, were divided into nalbuphine group (N group) and routine control group (C group), with 70 cases in each group.Group N received intravenous injection of nalbuphine 0.1 mg/kg (in normal saline 5 ml) at 10 min before epidural puncture, while group C received intravenous injection of the equal volume of normal saline at 10 min before epidural puncture.The epidural puncture-related items including the intensity of pain (Numeric Rating Scale [NRS] scores) and degree of sedation-agitation (Riker sedation agitation scores) during uterine contraction, duration of epidural procedure, parturients′ satisfaction with epidural puncture, successful epidural catheterization at first attempt and complications (nerve paraesthesia and inadvertent intravascular punctures) were recorded.Results:Compared with group C, the NRS scores and Riker scores for uterine contraction pain were significantly decreased during epidural procedure ( P<0.05), with NRS score <6 and Riker sedation agitation scores of 4, the duration of epidural puncture was shortened, the success rate of epidural puncture at first attempt was increased(51%/70%), and the incidence of nerve paraesthesia and inadvertent intravascular puncture was decreased(17%/6%, 14%/4%), and the parturients′ satisfaction with epidural puncture was increased in group N ( P<0.05). Conclusions:Nalbuphine 0.1 mg/kg intravenously injected before epidural labor analgesia can safely and effectively reduce uterine contraction pain without limb agitation, which is helpful in implementating epidural puncture in primiparae.

Whole Genome Analyses of Chinese Population and De Novo Assembly of A Northern Han Genome / 基因组蛋白质组与生物信息学报·英文版

To unravel the genetic mechanisms of disease and physiological traits, it requires comprehensive sequencing analysis of large sample size in Chinese populations. Here, we report the primary results of the Chinese Academy of Sciences Precision Medicine Initiative (CASPMI) project launched by the Chinese Academy of Sciences, including the de novo assembly of a northern Han reference genome (NH1.0) and whole genome analyses of 597 healthy people coming from most areas in China. Given the two existing reference genomes for Han Chinese (YH and HX1) were both from the south, we constructed NH1.0, a new reference genome from a northern individual, by combining the sequencing strategies of PacBio, 10× Genomics, and Bionano mapping. Using this integrated approach, we obtained an N50 scaffold size of 46.63 Mb for the NH1.0 genome and performed a comparative genome analysis of NH1.0 with YH and HX1. In order to generate a genomic variation map of Chinese populations, we performed the whole-genome sequencing of 597 participants and identified 24.85 million (M) single nucleotide variants (SNVs), 3.85 M small indels, and 106,382 structural variations. In the association analysis with collected phenotypes, we found that the T allele of rs1549293 in KAT8 significantly correlated with the waist circumference in northern Han males. Moreover, significant genetic diversity in MTHFR, TCN2, FADS1, and FADS2, which associate with circulating folate, vitamin B12, or lipid metabolism, was observed between northerners and southerners. Especially, for the homocysteine-increasing allele of rs1801133 (MTHFR 677T), we hypothesize that there exists a "comfort" zone for a high frequency of 677T between latitudes of 35-45 degree North. Taken together, our results provide a high-quality northern Han reference genome and novel population-specific data sets of genetic variants for use in the personalized and precision medicine.

Clinical efficacy of programmed intermittent epidural bolus and continuous epidural infusion for labor analgesia / 临床麻醉学杂志

Objective To compare the clinical efficacy of programmed intermittent epidural bollus (PIEB)+patient controlled epidural analgesia (PCEA)and continuous epidural infusion (CEI)+PCEA for labor analgesia.Methods One hundred nulliparous parturients with cervical dilation of 2-3 cm were randomly assigned to PIEB group or CEI group for labor,with 100 parturients in each group.The background infusion in PIEB group delivered 8 ml bolus at a rate of 6 ml/min per 1 hour, in group CEI at 8 ml/h.Blood pressure,VAS score and modified Bromage score before labor anesthe-sia (T0 ),10 min after labor anesthesia (T1 ),30 min after labor anesthesia (T2 ),1 h after labor an-esthesia (T3 ),2 h after labor anesthesia (T4 ),the uterus opening to the full extent (T5 ),childbirth (T6 ),1 h after childbirth (T7 ),proportion of PCEA request,hourly ropivacaine and sufentanil con-sumption,uterine contraction,fetal heart,total delivery time,analgesic time,delivery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score,maternal satisfaction score were ob-served.Results The VAS score of PIEB group was significantly lower than that of CEI group at T4-T6 (P <0.01).Compared with the CEI group,protortion of PCEA request,the dosage of drug was de-creased obviously in group PIEB (P <0.05),the maternal satisfaction of PIEB group was significantly higher than that of CEI group (P <0.05).There was no significant difference in the blood pressure, duration and interval time of uterine contraction,fetal heart,total delivery time,analgesic time,deliv-ery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score and weight among two groups.Conclusion Compared with the CEI+PCEA,the need of PCEA and the dosage of drug was decreased obviously,the VAS score was significantly lower,the maternal satisfaction was signifi-cantly higher and adverse reactions did not increase in the PIEB+PCEA.

Assessment of the diffusion-weighted imaging for the pathology and renal function in IgA nephropathy / 天津医药

Objective To study the correlation between the diffusion-weighted imaging (DWI) measurements and glomerular filtration rate (GFR), Katafuchi scores in IgA nephropathy. Methods Thirty-five patients with IgA nephropathy (IgAN group) and twenty healthy volunteers (control group) were enrolled in this study. All of the subjects underwent bilateral renal DWI measurements with 3.0T MRI scanner. The values of apparent diffusion coefficient (ADC) of renal cortex and medulla were measured. GFR of IgAN group was detected with 99Tcm-DTPA scintigraphy. Based on the Lee classification and the Katafuchi score system, the pathological grading was carried out in patients of IgAN group. The ADC values were compared between control group and different grades of IgAN group. The correlations between ADC and GFR values were analysed in defferent groups. The correlations between ADC values and Katafuchi scores were analysed in IgAN group. Results The renal cortical ADC values were significantly higher than medulla ADC values in both control group and IgAN group (P 0.05). There was a positive correlation between the renal cortical and medulla ADC values and the GFR values in IgAN group (P medulla ADC values and the Katafuchi scores in IgAN group (P<0.05). Conclusion The diffusion-weighted imaging can reflect the physiological functions of kidney. It was feasible for application DWI in IgA nephropathy, which can be used for assessing the renal filtration function and the pathological damage. However, DWI measurement is not sensitive to early renal disease.

Effects of erythropoietin in high glucose induced proliferation and apoptosis of human kidney proximal tubular epithelial cells and the possible mechanism / 天津医药

Objective To study the effects of erythropoietin (rhEPO) in high glucose induced proliferation and apopto?sis of human kidney proximal tubular epithelial (HK-2) cells, and the possible mechanism thereof. Methods HK-2 cells cultured in vitro were divided into several groups randomly:blank control group, high glucose group, mannitol group, rhEPO control group, different concentrations of rhEPO treatment groups (5, 10, 20 U/mL) and Rho kinase group. The reverse tran?scription polymerase chain reaction (RT-PCR) was used to evaluate the mRNA levels of RhoA and ROCK after 24 hours. Tetrazolium salt method (MTT) was used to determine the cell proliferation. Cell apoptosis was detected by flow cytometry. Results Compared with blank control group the expression levels of RhoA and ROCK1 mRNA were significantly in?creased in high glucose group (P < 0.05). RhoA, ROCK1 mRNA expressions significantly decreased in rhEPO group than those of high glucose group (P<0.05). There was a positive correlation between the expression levels of RhoA mRNA and ROCK1 mRNA in high glucose group and rhEPO group. MTT method showed that rhEPO significantly promoted the prolifer?ation of HK-2 cells (P<0.05). Flow cytometry analysis showed that high glucose induced apoptosis in HK-2 cells, which was significantly inhibited in rhEPO group and Rho kinase group as compared to that of high glucose group in a concentra?tion dependent manner (P<0.05). Conclusion rhEPO can promote HK-2 cell proliferation and inhibit apoptosis, which may be related to RhoA/ROCK signaling pathway.

The influence of rHuEPO on inflammatory factors in the process of renal interstitial fibrosis and its possible mechanism / 医学研究生学报

Objective Clinical treatment can delay the development of renal interstitial fibrosis , but it can not reverse renal dysfuntion.The article was to discuss the influence of recombinant human erythropoietin ( rHuEPO ) on inflammatory factors in the process of renal interstitial fibrosis and its possible mechanism . Methods The vitro cultured HK-2 cells were randomized into 7 groups:the blank control group , rHuEPO control group ( addition of 20U/mL rHuEPO), albumin stimulation group (addition of 5mg/mL albumin), 5mg/mL rHuEPO intervention group (5mg/mL albumin +5U/mL rHuEPO), 10 U/mL rHuEPO intervention group (5mg/mL albumin +10 U/mL rHuEPO), 20U/mL rHuEPO intervention group (5mg/mL albumin +20U/mL rHuEPO), and Rho inhibi-taion group (addition of 5mg/mL albumin 30min after 10μmol/L Y27632), 24 h acting time for each group.We observed the changes of cell morphology in each group .Reverse transcription polymerase chain reaction ( RT-PCR) was used to evaluate the mRNA levels of RhoA, ROCK1 and IL-6 , and ELISA was applied to measure the levels of supernatant TNF-αand IL-6 protein. Results The form of pebbles or paving stone was observed in blank control group and rHuEPO intervention groups , a long and thin spindle change with the appearance of fibre cells in albumin stimulation group , the transformation to pebbles in 5, 10, 20 mg/mL rHuEPO intervention groups , the form of oval and slightly increased intercellular space in Rho inhibitaion group .Compared with the blank control group , the expressions of RhoA mRNA, ROCK1 mRNA and IL-6 mRNA significantly increased in the albumin stimulation group (P<0.05), while significantly reduced in 5, 10, 20 mg/mL rHuEPO intervention groups (P<0.05), which was in negative relation with the rHuEPO concentrations .Compared with the albumin stimulation group , the expressions of ROCK 1 mRNA and IL-6 mRNA reduced in Rho inhibtation group (P<0.05), while there was no significant difference as to the expression of RhoA mRNA .ELISA results showed:compared with blank control group , the expressions of supernatant TNF-α([452.32 ±33.23] ng/L vs [1347.54 ±41.52] ng/L), IL-6 protein([884.62 ±0.73] pg/L vs [95.12 ±0.32]pg/LP<0.05) increased significantly.Compared with albumin stim-ulation group, the expressions of TNF-αin 5, 10, 20 mg/mL rHuEPO intervention groups and Rho inhibitation group reduced signifi-cantly([1003.32 ±3.42] ng/L, [821.32 ±21.32] ng/L, [590.15 ±7.68] ng/L, [488.13 ±65.03] ng/L vs [1 347.54 ± 41.52]ng/L,P<0.05), while the expressions of IL-6 mRNA reduced accordingly in 5, 10, 20 mg/mL rHuEPO intervention groups and Rho inhibitation group reduced significantly ([656.68 ±0.55] pg/L, [422.35 ±0.22] pg/L, [217.32 ±0.35] pg/L, [309.49 ±0.21] pg/L vs [884.62 ±0.73]pg/L,P<0.05).Moreover, there was significant statistical difference among 5, 10, 20 mg/mL rHuEPO intervention groups(P<0.05). Conclusion RHuEPO can inhibit the transdifferentiation process of HK-2 cells in-duced by albumin by suppressing inflammation factors , and the mechanism may be involved in RhoA/ROCK signaling pathway .

Mechanism of active vitamin D and its analogues on the protection of podocytes / 医学研究生学报

In recent years , active vitamin D is a hot research drugs because of its renal protective effect of independent regu -lation of anti-inflammatory effects outside calcium and phosphorus metabolism , regulation of apoptosis , mediated immunity and reduc-tion of proteinuria .Podocyte is the main target of active vitamin D based on the result of clinical and animal studies .In this article, we review the current literature on mechanism of active vitamin D and its analogues on the protection of podocytes about and give the clini -cal perspectives of activity vitamin D .

Primary study of chronic kidney disease with MR diffusion tensor imaging / 中华放射学杂志

Objective To study the value of MR diffusion tensor imaging(DTI) in the staging of chronic kidney disease(CKD).Method MR diffusion tensor imaging was used on 26 CKD patients.All patients were diagnosed as CKD according to the criteria of clinical diagnostic.All MR images achieved diagnostic requirements.Diethylenetriamine pentaacetic acid(99mTc-DTPA) renal dynamic imaging was used to determine the unilateral renal function.CKD patients were determined as mildly renal impairment group and moderately to severely renal impairment group based on the glomerular filtration rate(GFR).Twenty healthy volunteers underwent DTI at the same time.The cortical and medullary ADC value and FA value were measured in all subjects who underwent conventional MRI and DTI.The paired Student's t test was used to compare the cortico-medullary difference of the mean ADC and FA values in all subjects.The oneway analysis of variance(ANOVA) was carried out to assess the difference among the medullary and cortical diffusion parameters(ADC,FA) of all the three groups,and LSD was used to assess multiple comparisons.The correlation of GFR and ADC value of the patients,and FA value of the patients were tested by Pearson correlation analysis.Results The cortical and medullary ADC values of 46 subjects were(2.25±0.25) × 10-3 and(2.10±0.20) × 10-3 mm2/s respectively,FA of them were(3.48±0.61) and(4.27±0.75) respectively(t =6.754,10.043 respectively; P＜0.01).The cortical ADC values of volunteers,mild renal impairment group,severely renal impairment group were(2.25±0.22) ×10-3,(2.31±0.19) ×103,(2.18±0.32) ×10-3mm2/s respectively.The medullary ADC value of the three groups were(2.09±0.19) × 10-3,(2.17±0.17) × 10-3,(2.06±0.24) × 10-3mm2/s respectively(F=0.968,0.882 respectively; P＞0.05).The cortical FA values of the three groups were 3.85± 0.47,3.18±0.62,3.20±0.52 respectively.The medullary FA of the three groups were 4.92±0.38,3.93±0.57,3.62 ± 0.53(F=8.725,33.705 respectively; P＜0.01).There was no correlation between cortical ADC,medullary ADC,cortical FA of the patients and GFR [(30.14±15.79) ml· min-1 · 1.73 m-2](r =0.243,0.197,0.196 respectively; P＞0.05).There was a positive correlation between medullary FA of the patients and GFR (r=0.556,P=0.003).Conclusion FA value has certain value in evaluating CKD early diagnosis and renal function.

Inhibitory effect of erythropoietin on high glucose-induced transition of human kidney proximal tubular epithelial cells and its possible mechanism / 医学研究生学报

Objective The core mechanism of renal insterstitial fibrosis (RIF) is epithelial-mesenchymal transition.This study aimed to investigate the effect of erythropoietin on high glucose-induced epithelial-mesenchymal transition ( EMT) of normal hu-man kidney proximal tubular epithelial cells (HK-2) and its possible mechanism. Mothods HK-2 cells cultured in vitro were ran-domly divided into a blank control group , a high glucose induction group , a mannitol induction group , an EPO induction group , an EPO (5, 10, and 20U/mL) inhibition group, and an Rho kinase inhibitor group.After 24 hours of intervention, the mRNA levels of RhoA and ROCK were determined by RT-PCR, those of E-cadherin and α-smooth muscle actin (α-SMA) proteins detected by immu-nofluorescence staining , and the expression of FN proteins in the supernatant measured by ELISA . Results Compared with the blank control group , the expressions of RhoA and ROCK 1 mRNA were significantly increased in the high glucose induction group (0.945 ±0.132 vs 1.400 ±0.022, 1.007 ±0.002 vs 1.913 ±0.011, P<0.05), but markedly decreased in the 5, 10, and 20U/mL EPO inhibition groups (1.400 ±0.022 vs 1.278 ±0.006, 1.400 ±0.022 vs 0.770 ±0.005, 1.400 ±0.022 vs 0.334 ±0.009, P<0.006) in comparison with the high glucose induction group , and the effects were related to the concentration of EPO .Compared with the blank control, the expression of E-cadherin protein was increased in the high glucose induction group (0.644 ±0.006 vs 0.107 ± 0.004, P<0.05), but remarkably decreased in the 5, 10, and 20 U/mL EPO inhibition groups (0.236 ±0.006, 0.433 ±0.010, 0.521 ±0.010) in comparison with the high glucose induction group (P<0.05), and the effects were also related to the concentration of EPO.Pearson correlation analysis showed a positive correlation between the mRNA expressions of RhoA and ROCK 1 in the high glu-cose induction and EPO inhibition groups . Conclusion EPO can inhibit high glucose-induced epithelial-mesenchymal transition of normal human kidney HK-2 cells and thus delay renal fibrosis , which mignt be related to the RhoA/ROCK signaling pathway .

Effect of propofol preconditioning on activities of ATPase on myocardial cell membrane in rats with myocardial ischemia-reperfusion injury / 临床麻醉学杂志

Objective To investigate the effect of propofol preconditioning on activities of ATPase on myocardial cell membrane in rats with myocardial ischemia-reperfusion injury. Methods Forty Sprague-Dawiey rats were subject to 30 min ischemia and 60 min reperfusion and randomly assigned to five groups, six rats per group: control(C) group; ischernia-reperfusion (IR) group; propofol preconditioning group(P, according to the dosage of propofol, P was assigned to three KM+-ATPase and Ca2+-Mg2+-ATPase of left ventricle myocardial tissue were measured by chemical colorirnetric method. The rnyocardium pathomorphism was observed with light microscopes. Results The activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in ischemia-reperfusion group were lower than control group and propofol preconditioning group(P<0. 05 or P<0.01). Conclusion Propofol preconditioning can produced cardioprotective effect against ischemia-reperfusion injury by recovering the ATPase activities of myocardial tissue.

Observation on Treatment of Depression with Acupuncture and Chinese Medicine: A Report of 52 Cases / 针灸推拿医学（英文版）

To study the effectiveness of combined Acupuncture and Chinese medicine on depression. Methods: Ninety-eight patients were randomly divided into two groups. The treatment group of 52 cases were treated by scalp acupuncture and electroacupuncture, Baihui (GV 20), Shenting (GV 24), Taichong (LR 3), Neiguan (PC 6),Guanyuan (CV 4), Zusanli (ST 36), Sanyinjiao(SP 6), plus Chinese medicine, modified Xiaoyao Powder (a decoction for soothing liver and relieving depression) and the control group of 46 cases, only with Chinese medicine, modified Xiaoyao Powder. Results: The total effective rate was 94.2% in the treatment group and 78.26% in the control group; with a significantdifference between two groups(P＜0.05) Conclusion: Acupuncture plus Chinese medicine has a marked effect on depression.