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Objective@#To compare the effects of two anesthetic schemes on pediatric laparoscopic surgery, and the influence on stress response and hemodynamics.@*Methods@#From November 2016 to November 2017, 100 children underwent laparoscopic surgery in the Affiliated Hospital of Medical College of Ningbo University were selected and divided into two groups by odd even number of beds, with 50 cases in each group.The control group was treated with general anesthesia.The observation group received total intravenous anesthesia with remifentanil and propofol.The anesthesia effect, stress response and hemodynamic indexes were compared between the two groups.@*Results@#The postoperative waking time[(31.48 ±4.19)min], the time of disappearance of mascara reflex[(2.32±1.62)min], the recovery time of spontaneous respiration [(1.96±1.45)min], the incidence of adverse reactions[4.00%(2/50)], Ramsay score[(3.69±0.43)points], VAS score[(1.96±1.42)points], immediate Ramsay score[(2.11±0.82)points] and immediate VAS score[(2.31±0.43)points] in the observation group were better than those in the control group (t=15.623, 1.436, 5.436, χ2=5.432, t=1.187, 1.528, 2.136, 2.431, all P<0.05). At different time points, the MAP, HR and stress response(cortisol, blood glucose, PaO2, MAP) in the observation group were better than those in the control group(all P<0.05).@*Conclusion@#General anesthesia has higher risk in children undergoing laparoscopic surgery and can prolong the time of conscious consciousness.Remifentanil combined with propofol, total intravenous anesthesia can stabilize hemodynamics, improve the safety of anesthesia and alleviate stress reaction in children undergoing laparoscopic surgery.
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Objective:To compare the effects of two anesthetic schemes on pediatric laparoscopic surgery, and the influence on stress response and hemodynamics.Methods:From November 2016 to November 2017, 100 children underwent laparoscopic surgery in the Affiliated Hospital of Medical College of Ningbo University were selected and divided into two groups by odd even number of beds, with 50 cases in each group.The control group was treated with general anesthesia.The observation group received total intravenous anesthesia with remifentanil and propofol.The anesthesia effect, stress response and hemodynamic indexes were compared between the two groups.Results:The postoperative waking time[(31.48 ±4.19)min], the time of disappearance of mascara reflex[(2.32±1.62)min], the recovery time of spontaneous respiration [(1.96±1.45)min], the incidence of adverse reactions[4.00%(2/50)], Ramsay score[(3.69±0.43)points], VAS score[(1.96±1.42)points], immediate Ramsay score[(2.11±0.82)points] and immediate VAS score[(2.31±0.43)points] in the observation group were better than those in the control group ( t=15.623, 1.436, 5.436, χ 2=5.432, t=1.187, 1.528, 2.136, 2.431, all P<0.05). At different time points, the MAP, HR and stress response(cortisol, blood glucose, PaO 2, MAP) in the observation group were better than those in the control group(all P<0.05). Conclusion:General anesthesia has higher risk in children undergoing laparoscopic surgery and can prolong the time of conscious consciousness.Remifentanil combined with propofol, total intravenous anesthesia can stabilize hemodynamics, improve the safety of anesthesia and alleviate stress reaction in children undergoing laparoscopic surgery.
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ObjectiveTo investigate the dynamic changes of T helper (Th) responses and hepatic granuloma development during Schistosoma japonicum infection and to evaluate the possible correlation between the Th1/Th2 cytokines and pathological liver damage. MethodsSera from both Schistosoma japonicum infected C57BL/6 mice and uninfected controls were measured for interferongamma (IFN-γ), interleukin (IL)-4 and IL-13 at week 4, 6, 8 and 12 post-infection. At the same time, the splenic Th1/Th2 ratio was examined. The development of liver granulomas in infected mice was also observed and the correlation between the cytokines and granulomas were assessed. Wilcoxon test and Spearman rank correlation test were performed for data analysis. ResultsSerum IFN-γ level in infected mice was (2. 835±0. 049) lgpg/mL at week 4 post infection, which was significantly higher than that in controls [(1. 787 ± 0. 174) lgpg/mL, Z= - 2. 646, P = 0. 008]. Thereafter, the level declined after week 6, but remained higher than controls at the end of 12-week experiment (Z= -2.457, P=0. 014). IL-4 and IL-13 levels did not increase until week 6 (Z=-2. 646,P=0. 008;Z=-2. 646,P=0. 008), and peaked at week 8. After soluble egg antigen (SEA) stimulation, splenic Th1/Th2 ratio in infected mice was 0.5 (95％ CI 0. 2-1.2) at week 8 and 0.3 (95％ CI 0. 3-0.6)at week 12 post infection, both of which were significantly lower than those in uninfected controls (week 8: Z=2. 173, P=0.030; week 12:Z=2.551, P=0.011). Compared with unstimulated splenic cells, splenic Th1/Th2 ratio after SEA stimulation significantly decreased at week 8 (Z=2. 236, P=0. 025) and week 12 (Z=3. 130, P=0.002). Granulomas were first observed in livers at week 6 and the size kept on increasing. A negative correlation between serum IL-13 and the diameter of liver granulomas was discovered at week 12 post infection (r=0. 636, P= 0. 048). Conclusions Th1 response is dominant during the early stage of Schistosoma japonicum infection.However,followed by oviposition, Thl response declines and meanwhile a strong Th2 response gradually develops. Therefore, Th2 response probably plays a role in the development of hepatic granulomas.
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OBJECTIVE:To establish the quality standard for Compound huaihua granules.METHODS:Sophora japonica,salvia miltiorrhiza,and Lonicera joponica in the formulation were identified qualitatively by TLC,and the content of rutin in Sophora japonica was determined by UV spectrophotometry.RESULTS: The TLC spots were clear and well-separated.The linear range of rutin was 2.904～14.52 ?g?mL-1(r=0.997 7) and its average recovery was 98.43%(RSD=0.55%,n=6).CONCLUSION: The established standard is suitable for the quality control of Compound huaihua granules.
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<p><b>OBJECTIVE</b>To observe trinucleotide repeat number, (CTG)n in the 3'-untranslated region of the myotonic protein kinase (MTPK) gene in a clinically suspected woman with myotonic dystrophy (DM) family history and her abortus, in order to confirm the necessity of exerting antenatal examination in patients or suspected individuals with DM family history.</p><p><b>METHODS</b>Long Expand Template polymerase chain reaction (PCR) system was used to analyze CTG trinucleotide repeat numbers located in the 3' untranslated region of MTPK on chromosome 19q13.2-3 in both peripheral white cells and muscles of the suspected mother and the other two DM patients in the family. The tissues of her abortus and blood of a health woman were detected, too.</p><p><b>RESULTS</b>CTG repeats in both peripheral white cells and muscles of the suspected mother and the tissue of abortus were higher than normal range of CTG repeat number. There is no significant difference between blood and muscle samples. High CTG repeats were detected in blood and muscles of the typical DM members in the family, but in the blood sample of control, CTG repeats is normal.</p><p><b>CONCLUSION</b>CTG trinucleotide analyses and antenatal examination should be done in pregnant with a DM family history, in order to reduce the birth rate of DM offspring.</p>
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Adult , Female , Humans , DNA , Fetus , Metabolism , Myotonic Dystrophy , Diagnosis , Genetics , Prenatal Diagnosis , Trinucleotide RepeatsABSTRACT
AIM: To compare the effects between topiramate and slow-release sodium valproate in treating refractory epilepsy. METHODS: Topiramate group of 39 patients (M 21, F 18; age 28 a± s 20 a) was compared with sodium valproate group of 41 patients (M 22, F 19; age 27 a±17 a) in antiepileptic effect of refractory epilepsy. Adult's and children's dosages of topiramate were increased gradually about 200 mg*d-1 and 4 mg*kg*d-1 respectively during about 2 mo, po, bid, for 6 mo as a course. Adult's dosage of slow-release sodium valproate was 0.5-1 g*d-1, and children's was increased gradually to total dosage: 15-30 mg*kg*d-1, po, qd or bid (morning or morning and noon), for 6 mo as a course. Effects were analysed between these two drugs after treatment 4 and 6 mo. RESULTS： Simple and complex partial seizures with or without secondary generalized seizure, in topiramate group were much more improved than these in sodium valproate group 6 mo after treatment. Four patients of topiramate group appeared temporary adverse reactions of central nervous system, such as tiredness, sleepiness and distraction, but one patient of sodium valproate group had severer decreased function of bone marrow. CONCLUSION: Topiramate is one of effective antiepileptic drugs and superior to slow-release sodium valproate. There are the apparent absence of any effects of topiramate on the bone marrow and on indexes of liver and kidney.
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0.05). Conclusion In our samples, this two polymorphisms in A2M might play similar roles in the susceptibilities to PD and AD.
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Objective:To screen for simulation peptide binding specifically to the first and the second extra-cellular domain of CC chemokine receptor 5(CCR5),and to observe their therapeutic effect on mice with experimental autoimmune encephalomyelitis(EAE).Methods:Phage display peptide library was used to screen for peptide sequence binding specifically to CCR5;ELISA was used to identify its binding activity and analyze its DNA sequence.The simulation peptide was synthesized and was injected into abdominal cavity of the EAE mice.Spinal cord tissues were obtained and the pathologic changes were studied by H-E staining in EAE control group and simulation peptide group.Results:Twenty phage clones were randomly chosen for identification and ELISA showed that there were eighteen clones had a strong binding activity with CCR5.The positive clones were sequenced and four peptides of high frequency were obtained:STFTTTL,TPIPQLL,SLPLPKP,and QTSSAAL.Mean clinical score of mice in the EAE model group was 3 and that of the simulation peptide group was 1.H-E staining found that the spinal cord tissues in EAE model group had great number of inflammatory cells and evident demyelination changes;the simulation peptide group had less inflammatory cells and no demyelination changes.The four short peptides had an effect of suppressing and delaying the development of EAE,with the average inhibition rate being 43%(P
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Objective:To screen for peptides that specifically bind to PreS1 antigen from a phage-displayed peptide library.Methods: The PreS1 antigen was used as the target molecule to screen the binding peptide from the Ph.D.-7 peptide library with phage display technique,and the positive clones were identified by ELISA.Results: After three rounds of biopanning,the binding peptides were screened from the peptide library by ELISA and competitive inhibiting ELISA.Sequencing result showed that the binding peptides had high affinity and specificity.Conclusion: A peptide binding PreS1 antigen has been successfully obtained by screening the phage display library,which paves a way for the diagnosis and treatment of hepatitis B infection.
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Objective:To study the effect of Mg 2+ on glutamate and energy metabolites during focal cerebral ischemia and reperfusion in rats. Methods: Twelve male Wistar rats were divided into 2 groups(n=6):magnesium sulfate(100 mg/kg, i.p.) group and saline group.Cerebral ischemia was produced by occlusion of middle cerebral artery with a nylon thread for 60 min and followed by 60 min reperfusion.Microdialysis probes were stereotaxically implanted into the cortex; dialysates were collected every 15 min to determine the concentrations of glucose, lactic acid and glutamate. Results: There was a dynamic decrease of glucose and an increase of lactic acid and glutamate during ischemia and reperfusion in saline group.Glucose decreased slightly in magnesium sulfate group during ischemia and recovered to normal rapidly during reperfusion. The lactic acid levels in magnesium sulfate group were lower than that in saline group during early stage of ischemia(0-15 min) and reperfusion.There were significant attenuation in the elevation of glutamate during ischemia and reperfusion when magnesium sulfate was administered and recovered to normal after 30 min of reperfusion. Conclusion: The preservation of cellular energy metabolism,the decrease of lactacidosis and attenuation of glutamate level during ischemia and reperfusion may contribute to the neuroprotective effects of Mg 2+ .
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Objective: To observe the content of AVP changes in brain regions and pituitary of intracerebral hemorrhagic rats before and after treatment by ? sodium aescinate. Methods: Animal model was established by injecting collagenase into left caudoputamen of adult rats. Radioimmunoassay(RIA) was performed to measure the content changes of AVP, dye wet Weight methods was used to measure the changes of water contents in brain. Results: Compared with control group, the water content was increased significantly ( P
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Objective To explore the clinical and molecular biological characteristics of spinocerebellar ataxia type 3(SCA3).Methods Clinical manifestation and brain MRI data of 12 patients with SCA in two families were analyged.The polymorphic CAG repeated time in the encode region of SCA3,SCA1 and SCA7 genes were compared in 15 family numbers without abnormal presentations,and 12 healthy persons of controls.Results Among 27 numbers of 4 generations in the two families had 12 patients,male and female were affected,average onset was 32 years old.The main clinic features included gait ataxia,ambiguity in speech and action clumsiness.Brain MRI showed remarkable atrophy on cerebellum and brain stem.In the two families,the CAG lengths of SCA1 and SCA7 were normal in all numbers.The repeated times of CAG of SCA3 were 11~39 in two control groups,65 ~87 in 10 cases,diagnosed as SCA3 patients.The child Ⅳ2 of family 1 was 8 years old,the repeated times of CAG of SCA3 were repeats 21 and 64 times,repectively.He might be a asymptomatic patient,because he was too young to onset the disease.Conclusions SCA3 is an autosomal dominant genetic disease.The clinical manifestations are ataxia and dysarthria.The detection of repeated times CAG can provide an effective way for the genetic and asymptomatic diagnosis.
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Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.
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AIM: To study the difference in glucose and lactate levels between brain extracellular fluid (ECF) and plasma in rabbits in the different blood glucose levels. METHODS: Using intracerebral microdialysis technology, brain ECF levels of glucose and lactate were measured in every 10 min under basal conditions and during a hyperglycemia-hypoglycemia clamp study. RESULTS: Under basal condition, brain ECF glucose levels were markedly lower than ambient plasma levels (30% of plasma), whereas ECF lactate levels were substantially higher (165% of plasma). During the hyperglycemia-hypoglycemia clamps, the relationship between plasma and ECF levels of glucose remained similar, but changes in ECF glucose lagged about 30 min. There were no substantially changes in ECF levels of lactate during dynamical study. CONCLUSION: There are striking differences in glucose and lactate levels between brain ECF and plasma. Lactate may involve in the metabolic process of central nervous system.
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Objective: To study the clinical characteristics of antiepileptic drug discontinuation after seizure remission in patients with tuberous sclerosis (TS)-induced epilepsy. Methods: Of 98 epilepsy patients with TS,15 with seizure remission and subsequent antiepileptic drug discontinuation were followed up. The relapse rates of seizures and the retreatments were observed. The causes of seizure relapse were analyzed. Results :Ten(66. 7%) patients had sustained seizure remissions and 5 (33. 3%) had relapses in 15 patients after a mean follow-up of 5 years. Antiepileptic drugs was restarted in the 5 relapsed cases and were successful in a girl, leaving a total sustained remission rate of 73. 3% (11/15) and an absolute relapse rate of 26. 7% (4/15). The relapse was associated with abnormal electroencephalogram, multiple cerebral lesions and biological changes of puberty. Conclusion:The relapse rate of TS epilepsy is similar to the relapse rate of other epilepsies. Reasonable discontinuation of antiepileptic drugs should be considered in the patients who attained seizure remission.
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Objective: To study the clinical characteristics of dopa responsive dystonia (DRD),providing data for earlier diagnosis and treatment. Methods: Three cases of DRD patients from the same family were studied through their clinical data, laboratory investigations and therapeutic effects. Results: Two males and one female were the same generation. The age of onset remembered was about 10 years. The symptoms were insidiously progressive. Clinical features were extrapyramidal presentations such as fast words speed, limbs stiffness and involuntary movements. All 3 patients had leadtube muscle rigidity, exaggerated tendon reflexes; Two patients had feet deformity. Babinski signs were absent.CT, MRI, serum muscular enzymes and EMG, etc . were normal. Madopa,0.125 0.375 g, daily was effective with the longest treatment period for nearly 30 years and no obvious side effects found. Conclusion: The incidence of DRD is rare with specific presentations, early diagnosis and treatment may achieve better results.
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Objective: To investigate the clinical and pathological features of patients with cerebral amyloid angiopathy (CAA) related cerebral hemorrhage (C A AH). Methods : The clinical data of 5 patients with C A AH, including clinical manifestations, neuroimaging and topographical anatomy features were studied. Results: It was found that the onset and clinical manifestations of CAAH resembled hypertensive cerebral hemorrhage. CAAH could coexist with hypertension and hypertension might aggravate the pathological changes of CAA. Typical CAAH located in cortical and subcortical areas, but cerebral hemorrhage located in the basal ganglia and thalamus could not ruled out CAAH without the pathological confirmation of CAA. The neuroimages of some specific types of cerebral hemorrhage, such as insular cistern hematoma and subarachnoid hemorrhage, could manifest as hypertonial putaminal hemorrhage, but their outcomes were distinctly different. Conclusion: The causes of cerebral hemorrhage include hypertension and cerebral amyloid angiopathy, and CAA may have an important clinical value.