The prognostic value of DTA gene mutations in myelodysplastic syndrome / 中华内科杂志

To investigate the clinical features and prognostic significance in myelodysplastic syndrome (MDS) patients with DTA (DNMT3A,TET2,ASXL1) mutations. Clinical characteristics of 140 patients diagnosed as de novo MDS at People′s Hospital of Xinjiang Uygur Autonomous Region from September 2015 to December 2019 were retrospectively analyzed. Next-generation sequencing was used to detect 34 related genes in MDS patients. DTA mutations and the correlation with progression-free survival (PFS) and overall survival (OS) in MDS patients were evaluated. Among 140 MDS patients, DTA mutations was detected in 62 (44.3%) patients. And the positive rate of DTA mutations in IPSS-R lower-risk group was 65.4%, significantly higher than that of higher-risk group (31.8%)( P=0.000). Compared with the non-mutated group, patients with DTA mutations had a lower rate of conversion to leukemia (9.7% vs . 29.5%, P=0.004).Survival analysis showed that PFS in patients with DTA mutations was comparable as that in MDS patients without DTA mutations ( P=0.787), but the median OS was significantly shorter (16 months vs . 20 months, P=0.022).According to IPSS-R classification, the median OS in patients with and without DTA mutation was only statistically significant in the higher-risk group (15 months vs. 18 months, P=0.034).Among 62 patients with DTA mutations, 60 (96.8%) had additional gene mutations. DTA mutations were not independent prognostic factors when mutation frequency is greater than 10% were considered in Cox regression model ( P>0.05). DTA mutations often developed in the early stage of MDS, therefore they were more common in IPSS-R lower-risk subgroup which was correlated to the low rate of conversion to leukemia. In conclusion, DTA mutations are not associated with disease progression, but predict unfavorable survival when other add-on genes are mutated.

Clinical and laboratory characteristics of 11 cases of chronic B lymphocyte proliferation disease without lymphoid proliferation / 肿瘤研究与临床

Objective To explore the clinical and laboratory characteristics of chronic B lymphocyte proliferation disease (B-CLPD) without typical lymphoid proliferation. Methods The clinical records of patients with B-CLPD only characterized by pancytopenia form January 2007 to March 2016 in hematology department of Xinjiang Uygur Autonomous Region People ' s Hospital were collected, and the cell morphology, bone marrow pathology, cytogenetics and molecular characteristics were retrospectively analyzed. Results The median age of 11 patients was 68 years old. The lymphocyte ratio of peripheral blood smears in all patients increased in different level (0.36-0.68), but absolute lymphocyte count was normal or decreased (0.59×109-1.99×109). Lymphocyte-like plasma cell or small numbers of plasma cell can be seen in the bone marrow smears of 4 cases and lymphocytes with irregular burr-like protrusions were observed in 2 cases while there were no characteristic morphological changes in remained 5 cases. Immunophenotypical analysis showed that all patients expressed CD19, CD20, CD22, SmIg, not expressed CD5, CD10 which with scores of 0-2 according to chronic lymphocytic leukemia (CLL) points system;CD103, CD11C, CD25 and FMC7 were highly expressed in 2 cases while there were no characteristic expression in remaining cases. There were no abnormal karyotypes observed from the conventional cytogenetic and fluorescence in situ hybridization (FISH) analysis (both of IgH/CCND1, bcl-2/IgH were negative) in all patients. 8 patients were found IgH gene rearrangement, MYD88L256P and BRAF V600E was positive in 5 cases and 2 cases respectively. 5 cases were diagnosed as Waldenstrom macroglobulinemia, 3 cases were B-CLPD, 2 cases were hairy cell leukemia, 1 case was nodal marginal zone B-cell lymphoma after comprehensive analysis of their clinical and laboratory data. Conclusion Even if there are no increased peripheral blood lymphocytes in pancytopenia patients, it is necessary to perform bone marrow smears, immunophenotyping, IgH gene rearrangement, cytogenetics and other molecular laboratory tests to exclude B-CLPD, and reduce misdiagnosis.

The expression and prognostic significance of microRNA-34a in Uygur and Han patients with chronic lymphocytic leukemia in Xinjiang Uygur Autonomous Region in China / 中华内科杂志

To investigate the expression of microRNA-34a (miR-34a) in patients with chronic lymphocytic leukemia (CLL) in Xinjiang Uygur and Han nationalities and its prognostic significance. Our data showed that miR-34a expression in Uygur and Han CLL patients was significantly higher than that in their respective healthy controls, while miR-34a levels were similar between Uygur and Han patients. By comparing with known prognostic factors, receiver operating characteristic (ROC) curves showed that miR-34a was a good predictive factor for the prognosis of CLL (demarcation value was 3.567 6). Survival analysis was further performed according to miR-34a expression level, that low expression of miR-34a translated into poor prognosis.

Examination of the expressions of miR-221 in the human pulmonary fibrosis tissues and in A549 cells treated with TGFβ1 / 中国医师杂志

Objective To investigate the expressions of microRNA-221 (miR-221) in the human pulmonary fibrosis tissues and in adenocarcinoma(A549) cells treated with transforming growth factor beta 1 (TGFβ1).Methods Real time-PCR was used to detect the expressions of miR-221 in pathologically diag nosed as pulmonary fibrosis tissue and in A549 cells treated with TGFβ1.Results miR-221 in pulmonary fibrosis tissue was downregulated compared to normal tissues (P ＜ 0.05).The morphology of cells was changed from long spindle type to short, the number of cells was increased, and the adjacent cells were not connected closely.TGFβ1, N-cadherin, vimentin, α-smooth muscle actin (α-SMA), collagen Ⅰ, and collagen Ⅲ levels were higher, whereas E-cadherin level was lower in TGFβ1-treated group compared to the control group.miR-221 expression was downregulated in cells after TGFβ1 treatment (P ＜ 0.05).Conclusions miR-221 was downregulated in pulmonary fibrosis tissues and in A549 cells, which indicates that miR-221 may play an important role in the formation of pulmonary fibrosis.

Imaging atherosclerosis model rabbits with 99Tcm-single chain antibody fragment against vascular cell adhesion molecule-1 / 中华核医学与分子影像杂志

Objective To investigate the imaging performance and feasibility of 99Tcm labeled scFv against VCAM-1(99Tcm-scFv-VCAM-1) on atherosclerosis model rabbits.Methods HYNIC was used as a chelator for 99Tcm labeling.The labeling efficiency and radiochemical purity of 99Tcm-scFv-VCAM-1 were measured by instant thin layer chromatography after PD-10 purification.New Zealand white rabbits were employed for establishing atherosclerotic animal models by endothelia immunity injury and high fat diet, and plaques at aorta lesions were examined by HE staining.Model rabbits were sacrificed after administration of 99Tcm-scFv-VCAM-1 at 1 or 2 h respectively, and tissue samples were measured with gamma counter and weighted to obtain in vivo biodistribution data.Planar imaging was performed 1 and 2 h after the injection of 99Tcm-scFv-VCAM-1 to investigate radioactivity of abdominal aorta.After imaging study, atherosclerosis plaque and VCAM-1 expression at aortas were confirmed by the immunohistochemistry (IHC) study.Two-sample t test was used to analyze data.Results 99Tcm-scFv-VCAM-1 was successfully synthesized.Its labeling efficiency was 75%-83%, radiochemistry purity was (98.54±1.03)% and specific activity was 216 MBq/nmol.Atherosclerosis plaque was confirmed at the aortas of experimental rabbits by HE staining, while no plaque was observed in controls.Biodistribution data indicated that the tracer was cleared mainly through the kidneys.Planar imaging showed that the tracer uptake in abdominal aorta of model rabbits was higher than that of control rabbits, the T/B ratios at 2 h of the model group and control group were statistically different (3.68±0.73 vs 2.42±0.39;t=2.950, P<0.05;n=5).Atherosclerosis plaque and high level of VCAM-1 expression were observed at aortas of model rabbits by IHC study.Conclusions It is feasible and effective to detect vulnerable plaques using 99Tcm-scFv-VCAM-1.It may provide a promising way for early diagnosis and accurate evaluation of atherosclerosis.

Therapeutic effects of traditional Chinese medicine aqueous extract on acne vulgaris models of rabbit's ear / 中华医学美学美容杂志

Objective To observe the effects of traditional Chinese medicine aqueous extract on acne vulgaris models of rabbit's ear.We observed the medical effects of traditional Chinese medicine aqueous on rabbit's ear acne vulgaris models.Methods 7 twelve-week's old male rabbits were selected to establish acne vulgaris models by Kligman method.Coal tar was daubed at the opening of rabbits' ears tubes about 2 cm × 2 cm areas by the frequency of once a day for two weeks.Then 50 μl bacterial suspension of the propionibacterium acnes was subcutaneously injected into each ear of rabbit at the seventh day which concentration of propionibacterium acnes was 1.0)× 108 CFU/ml.14 ears of rabbits were divided into 7 groups randomly after the molds were finished,two ears per group.6 group ears of rabbits were daubed with TCM aqueous extract respectively,while the last group was daubed with physiological saline on one ear and fusidic acid cream on the other one,once a day.At last,the treatment effects and adverse reactions were observed respectively on the 7th day,15th day and 21st day.Results The sWollen rabbits' ears were reclined and even disappeared in groups with six kinds of TCM aqueous extract after 7 days;the local hair follicles corneous plugs became flattened,pimples and comedos reduced in groups with aqueous extract of Cortex phellodendri,Scutellaria baicalensis and Rhubarb.Conclusions Aqueous extracts of Cortex phellodendri,Scutellaria baicalensis,Rhubarb,Sophora flavescens,Honeysuckle and Forsythia have therapeutical effects on rabbifs ear acne vulgaris models.

The analysis and countermeasures of important problems in medical association projects / 中国医学装备

Objective:In recent years, the medical systems has continuously explored the construction of Regional Medical Association, and promoted the classification diagnosis and treatment mode, as the reform of the medical system in our country. Through the regional information sharing, the Medical Association can realize the interconnection and information resource sharing among various medical institutions at all levels, which is for optimizing the allocation of medical resources, improving the level of medical services and alleviating the difficult and expensive medical treatment has an important significance.Methods: This paper adopted the method of literature research. Through the arrangement of the Chinese Medical Association of exploration and the progress of abroad regional medical care grade development, the paper focused on the analysis of problems in preparation and the continued operational of the Medical Association projects, such as guiding patient stratification clinics, the utilization of data in medical research, protection of the quality of medical care, integration of data and other critical medical problems. Results: The paper also presented the following recommendations to build and operate high-quality of the Medical Association, rational allocation of functions at all levels of medical institutions to guide patient stratification clinics, establish disease specialist data centers, and establish quality evaluation system to protect the quality of medical care, develop information standards and integrate medical data.Conclusion:Establishing Regional Medical Association is significantly important to optimize the distribution of medical resources, improve the levels of basic medical services and relieve the problems in the treatment.

Antimicrobial activities of traditional Chinese medicine aqueous extract on propionibacterium acnes in vitro / 中华医学美学美容杂志

Objective To observe the effects of 19 kinds of traditional Chinese medicine (TCM) aqueous extracts in vitro on the standard and clinical strains of propionibacterium acnes.Methods We collected lesion contents of acne vulgaris patients and conducted anaerobic cultivation of propionibacterium acnes at 35 ℃ for forty-eight hours.After tested by oxygen resistance experiment,Gram staining microscopy,catalytic test,nitrate test and sugar fermentation experiment,ANI anaerobic identification card,and VITEK fully-automatic microbe instrument,the strains were identified as propionibacterium acnes.We used AGAR dilution method to test the MIC values of various TCM aqueous extracts.Results The MIC values of Cortex phellodendri,Scutellaria baicalensis,and Rhiubarb were 25 mg/ml,respectively;the MIC values of Sophora flavescens and Honeysuckle were 50 mg/ml;the MIC values of Forsythia was 100 mg/ml.13 kinds of TCM aqueous extract did not produce bacteriostasis at the highest concentration of 200 mg/ml including Belvedere fruit,Chinese bulbul,Hedyotis diffusa,Houttuynia cordata,Purslane,Yerbadetajo herb,Radix isatidis,Lithospermum erythrorhizon,Folium isatidis,Taraxacum,Semen plantaginis,Angelica dahurica,and Fructus cnidii.Conclusions Aqueous extracts of Cortex phellodendri,Scutellaria baicalensis,Rhubarb,Sophora flavescens,Honeysuckle and Forsythia have good inhibitory effects in vitro on Propionibacterium acnes.

Biological characteristics of bone marrowversus adipose-derived mesenchymal stem cells from C57 mice / 中国组织工程研究

BACKGROUND:Adipose-derived stem cels have similar characteristics of bone marrow mesenchymal stem cels, including adhesion and fibroblast-like clone formation. In addition, adipose-derived stem cels can differentiate into bone, adipose, cartilage. OBJECTIVE:To compare the biological characteristics of C57 mouse adipose-derived and bone marrow mesenchymal stem cels. METHODS:Mesenchymal stem cels were obtained respectively from the adipose and bone marrow of C57 mice under sterile condition. Adipose-derived and bone marrow mesenchymal stem cels were isolated and purified in vitro to determine cellmorphology, suface marker, growth kinetics, differentiation potential and Notch signal related gene. RESULTS AND CONCLUSION:Morphology was similar between adipose-derived and bone marrow mesenchymal stem cels under an optical microscope. Adipose-derived and bone marrow mesenchymal stem cels at passage 3 expressed CD29, CD105, Sca-1, but not expressed CD34, CD133. In addition, bone marrow mesenchymal stem cels also expressed CD45. The growth kinetics and cellclone analysis indicated that the proliferation rate of adipose-derived mesenchymal stem cels was significantly faster than that of bone marrow mesenchymal stem cels. Both of adipose-derived and bone marrow mesenchymal stem cels were induced to osteoblasts, adipocytes and chondrocytes, but the adipose-derived mesenchymal stem cels were easier to the osteogenetic differentiation than bone marrow mesenchymal stem cels. Notch signal related gene detection shown that adipose-derived mesenchymal stem cels expressed lower levels of Jagged-1 mRNA, but higher levels of Hes-1 mRNA compared with bone marrow mesenchymal stem cels. These findings suggest that the proliferation rate of adipose-derived mesenchymal stem cels is significantly faster than that of bone marrow mesenchymal stem cels, and the former is apt to the osteogenetic differentiation and may be related with the expressed levels of Hes-1 mRNA.

Clinical features and risk factors analysis of acute graft-versus-host disease in patients with related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the clinical features of acute graft-versus-host disease (aGVHD) and its risk factors for the related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation (RHNT-PBSCT).</p><p><b>METHODS</b>From July 2002 to December 2012, 104 patients who underwent the RHNT-PBSCT were enrolled to analyze the incidences, location and its risk factors of aGVHD, compared with those of the 103 patients who received the HLA-matched sibling non T cell-depleted in vitro PBSCT (MSNT-PBSCT) in the same period.</p><p><b>RESULTS</b>(1)The cumulative incidence of aGVHD in the RHNT-PBSCT group was significantly higher than the MSNT-PBSCT group [(56.2±4.7)% vs (34±3.6)%, P<0.05], but the cumulative incidences of II-IV and III-IVgrade aGVHD had no significant difference between the two groups[(39.5±2.9)% vs (21.2±5.4)%, P>0.05; (12.6±4.1)% vs (10.8±2.4)%, P>0.05]. (2)The cumulative incidence of cutaneous aGVHD was significantly higher in RHNT-PBSCT group than that in MSNT-PBSCT group [(42.3±3.2)% vs (17.5±2.3)%, P<0.05]. The cumulative incidences of liver and gastrointestinal aGVHD between the two groups had no significant difference [(7.7±2.1)% vs (12.6±3.4)%, P>0.05; (16.3±4.5)% vs (10.3±2.5)%, P>0.05]. (3)The 3-year disease free survival (DFS) and overall survival(OS) of RHNT-PBSCT group and MSNT-PBSCT group were (63±5.5)%, (65.2±4.7)% and (74.2±5.4)%, (77.4±5)% respectively, without significance (P=0.078, P=0.052). (4)aGVHD occurrence with HLA haplotype (P=0.003) and matched loci (P=0.002) were significantly correlated by univariate analysis. Multivariate analysis showed that only the HLA typing is a risk factor for aGVHD (HR=1.891, P=0.03).</p><p><b>CONCLUSION</b>Although the incidence of total aGVHD in RHNT-PBSCT protocol is higher than that in MSNT-PBSCT, but there was no significance in severe aGVHD and cutaneous aGVHD was the common type, which indicates that RHNT-PBSCT protocol is feasible.</p>

Changes in expression of cyclooxygenase-2 in the spinal dorsal horn after intrathecal p38MAPK inhibitor SB203580 on neuropathic pain in rats / 中南大学学报(医学版)

Objective:To investigate the changes of cyclooxygenase-2 (COX-2) expression in the spinal cord dorsal horn atfer intrathecal a speciifc p38MAPK inhibitor-SB203580 on neuropathic pain in rats induced by chronic constrictive injury (CCI) to the sciatic nerve. Methods:Twenty-four male SD rats atfer intrathecal catheter placement were randomly divided into 4 groups:a sham group with sham surgery, the neuropathic pain model of a NS group, a DMSO group and an SB group were established by CCI to sciatic nerve. NS or DMSO or SB203580 was injected IT NS or 2%DMSO or SB203580 twice a day for 5 consecutive days starting at 6th day when the model of chronic constrictive injury was established. Mechanical stimuli were measured before the surgery and on 1st, 3rd, 5th, 7th, 9th, and 11th day atfer the surgery. hTen all rats were sacriifced and the lumbar segment of spinal cord was removed to determine the COX-2 expression in the dorsal horn by immunocytochemistry. Results:Day 1 to 11 after the surgery, the threshold to mechanical on the surgery side was signiifcantly lower in the NS group and the DMSO group than in the sham group. Day 7 to 11 atfer the sugery, the threshold to mechanical on the surgery side was signiifcantly lower in the SB group than in the NS group and the DMSO group. hTe expression of spinal COX-2 was higher in the NS group and the DMSO group than in the sham group, but lower in the SB group than in NS group and the DMSO group. Conclusion:Intrathecal administration of SB203580 has signiifcant analgesic effect in the CCI rat model. Expression of COX-2 is signiifcantly reduced when p38MAPK is inhibited by intrathecal SB203580, and p38MAPK stimulation is essential for COX-2 expression.

Effect of musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation / 中国医师杂志

Objective To evaluate musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation.Methods Sixty lung cancer surgery patients (ASA Ⅰ-Ⅱ grade) were selected and divided randomly into musical therapy (group M; n =30) and control (group C; n =30).In group M,patients accepted music relaxation training for fifteen minutes before surgery,and music intervention for one hour at 3,7,15,19 hour after surgery.Whereas,in Group C,patients did not listen to any music during the same period.In the intensive care unit,patients were connected to a patient controlled analgesia (PCA) device.The PCA device (sufentanil 2 μg/kg,100 ml saline) was set to deliver a bolus of 2 ml,with a lockout interval of 10 min and background infusion volume of 0.5 ml/h.Hemodynamic changes,the visual analog scale (VAS) and consumption of sufentanil were recorded at the 4th,8th,12th,16th,20th and 24th hour after operation.Results SBP,DBP,HR and VAS of group M were significantly decreased compared to the group C,respectively (P ＜0.05),and significant difference was found in the PCA delivery frequency [group C (30.96 ± 4.00),group M (19.06 ± 3.49),t =12.39,P ＜ 0.01] and postoperative sufentanil consumption[group C (82.65±6.19)μg,group M (52.68 ±7.07)μg,t =20.00,P ＜0.01].Conclusions Musical therapy combined with sufentanil postoperative intravenous analgesia was able to produce better analgesic effect in the treatment of patient accepted lung cancer operation,which decreased postoperative sufentanil consumption and effectively reduced SBP,DBP and HR,and relieved the patient's anxiety.

Effect of intrathecal sufentanil and protein kinase C inhibitor on pain threshold and the expression of NMDA receptor/ CGRP in spinal dorsal horn in rats with neuropathic pain / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of intrathecal sufentanil and protein kinase C inhibitor on pain threshold and the expression of N-methyl-D-aspartate receaptors (NMDAR)/calcitonin generelated peptide (CGRP) in spinal dorsal horn in rats with neuropathic pain.@*METHODS@#Fifty-four healthy male Sprague-Dawley rats were randomly divided into 6 groups (9 in each group). The rats in the sham group(Group S) + spared nerve injury (SNI), SP+SNI, and P+SNI were intrathecally injected sufentanil (1 μg), sufentanil (1 μg) and chelerythrine chloride (11 μg), chelerythrine chloride (11 μg) followed by 10 μL normal saline once every day for 14 days postoperatively, respectively. Similarly, rats in the control group (Group C), the sham group (Group S), and SNI model group (Group SNI) were intrathecally injected 20 μL normal saline in the uniform interval. Pain behaviours were measured on Day 1 pre-surgery and on Day 1, 2, 7, and 14 after the intrathecal injection. The expressions of NMDAR and CGRP in the spinal dorsal horn of L5 segment were determined by immunohistochemistry on Day 2, 7, and 14 after the intrathecal injection.@*RESULTS@#Compared with Group C and Group S, mechanical allodynia threshold in group SNI was decreased after the surgery (P<0.01), and expressions of NMDAR and CGRP immunoreactive soma in the spinal dorsal horn was significantly increased (P<0.01). Mechanical stimulation pain threshold was elevated in Group S+SNI, Group P+SNI, and Group SP+SNI compared with Group SNI (P<0.01), while expressions of NMDAR and CGRP immunoreactive soma in Group S+SNI, Group P +SNI, and Group SP+SNI were significantly decreased (P<0.05 or 0.01).@*CONCLUSION@#Intrathecal administration of sulfentanil and protein kinase C inhibitor can provide significant antinociception in rats with neuropathic pain and obviously inhibit the upregulation of NMDAR and CGRP expressions in the spinal dorsal horn of SNI rat models.

Changes in cerebral glucose metabolism induced by postoperative delirium in elderly patients and the effects of dexmedetomidine on it / 中华麻醉学杂志

Objective To investigate the changes in cerebral glucose metabolism induced by postoperative delirium in the elderly patients and the effects of dexmedetomidine on it.Methods Forty-two patients of both sexes aged 65-85 yr with a body mass index of 19-25 kg/m2 undergoing abdominal surgery under general anesthesia were enrolled in this study.Delirium occurred during the first 2 days after operation in 39 out of the 42 patients (29/42).The 29 patients were randomly divided into 2 groups:group delirium without any treatment (group D,n =13) and group delirium + dexmedetomidine (group Dex,n =16).The remaining 13 patients did not develop delirium after operation and served as control group (group C).In group Dex a loading dose of dexmedetomidine 1 μg/kg was administered iv over 10 min after occurrence of delirium followed by continuous infusion at 0.2-0.7μg· kg-1 · h-1.PET scan was performed within the time period in which delirium occurred.18 Fluorine-deoxyglucose was injected for observation of imaging of glucose metabolism.The standard uptake value of glucose of bilateral parietal,temporal and frontal lobes was calculated.Results Delirium was controlled within 30 min after adminnistration of dexmedetomidine.Delirium significantly reduced cerebral glucose metabolism in the bilateral parietal,temporal and frontal lobes in group D as compared with group C (P ＜ 0.05).Dexmedetomidine significantly attenuated the delirium-induced decrease in cerebral glucose metabolic rate of the 3 lobes in group Dex as compared with group D (P ＜ 0.05).Conclusion Postoperative delirium reduces cerebral glucose metabolism and dexmedetomidine can significantly control pastoperative delirium in the elderly patients.

Application of intravenous flurbiprofen axeyil injection combined with sufentanil for postoperative analgesia of ovarian cancer radical operation / 中国医师杂志

ObjectiveTo evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.ResultsAll the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).ConclusionsIntravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.

The changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope and macintosh direct laryngoscope / 中国医师杂志

Objective To observe the changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope (GSVL) and macintosh direct laryngoscope (MDLS). Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 35 ～ 67 yrs were enrolled in this study, who were scheduled for elective pulmonary cancer or cancer of esophagus radical correction tients were random divided into 2 groups( n =24 each), GSVL group and MDLS group. After anesthesia was induced, all patients were given a score of Cormack grading under MDLS and GSVL, and then endobronchial intubation was performed. Noninvasive BP and HR were recorded before and after induction of anesthesia, during endobronchial intubation and after endobronchial intubation was completed for 1,2, 3, 4,5 min. The CSI was continuously monitored and recorded before and after induction of anesthesia, and after endobronchial intubation for 1 ～ 2 min and 3 ～ 5 min. Results Compared with MDLS group, the rate of Cormack grade 1 was significant higher in GSVL group (91% vs 58% ) ( P ＜0. 01 ). BP of two groups at T1 and T5 ～ T7 were significantly decreased compared to T0 values ( P ＜0. 01 ). Endobronchial intubation (T2 ～T4) caused significant increase in BP and HR compared to post-induction values(T1 ) ( P ＜0. 01).The highest values of HR after intubation exceeded even their baseline values before induction of anesthesia.The haemodynamic responses to endobronchial intubation in GSVL group at T2 ～ T4 were significantly different from those in MDLS group( P ＜0. 05). CSI of two groups at T1 was significantly decreased compared to To values( P ＜0. 01 ), CSI of two groups at T2 induced significant increase compared to T1 values, and the increase of CSI in MDLS group was stronger than that in GSVL group( P ＜0.01). Condusion The haemodynamic responses produced by orotracheal intubation using GSVL had more obvious advantages than MDLS, but GSVL seemed to provide a clear view of glottis and a little change CSI effect.

Pit pattern classification for diagnosis of early colorectal cancers and precancerous lesions / 中华消化内镜杂志

Objective To evaluate pit pattern analysis for detection of early colorectal carcinoma and precancerous lesions. Methods A total of 162 lesions in 144 patients were examined with magnifying colonoscopy after staining, and their pit patter was analyzed with morphology and pathologic diagnosis. Results With confirmation of pathology, there were 34 non-neoplastic lesions and 128 neoplastic ones, in which 12 were carcinomas. The pit patterns in most non-neoplastic lesions (76. 5%, 26/34) were type Ⅰ or Ⅱ , and those in most neoplastic lesions (96. 1% , 123/128) was type Ⅲ, Ⅳ or Ⅴ. Pit patterns of cancerous lesions were mainly type Ⅴ (75.0%, 9/12), and those of 3 cases of advanced cancers were all type Ⅴ N. Conclusion Pit pattern classification is a very important tool to differentiate between neoplastic, nonneoplastic lesions and early cancer, which helps to decide later therapeutic intervention.

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients / 中华老年医学杂志

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.