Clinical and mutation analysis of a case of Noonan-like syndrome with loose anagen hair / 中华皮肤科杂志

To report a case of Noonan-like syndrome with loose anagen hair, and to detect gene mutations in the family. A 3-year-old female patient presented with a special facial appearance, short stature, deep palmar and plantar creases, and dark skin. The scalp hair was sparse and thin, dermoscopy showed black spot sign, single-hair follicular units, hair shafts varying in the diameter, upright hair and new vellus hair, and constriction of hair shafts and nodular hair were occasionally observed. Peripheral blood samples were collected from the proband and her parents, and the genomic DNA was extracted for whole-exome sequencing. A heterozygous missense mutation c.4A>G was identified in exon 2 of the SHOC2 gene in the proband, resulting in the substitution of serine by glycine at amino acid position 2 (p.S2G) . The mutation was not identified in either of her parents. Combined with the clinical phenotype and gene mutation, the diagnosis of Noonan-like syndrome with loose anagen hair was confirmed.

Comparison between ultrasound-assisted and landmark-guided paramedian spinal anesthesia for hip fracture surgery in the elderly / 中华老年医学杂志

Objective:To investigate the efficiency of the ultrasonic-assisted positioning technique for lumbar anesthesia in elderly patients with hip fractures through the paramedian approach compared with body surface labeling.Methods:Patients(aged ≥65 years)with hip fractures were randomized(1∶1)to receive either ultrasound-assisted or landmark-guided paramedian spinal anesthesia in a lateral position.The primary outcome was the number of needle passes needed for a successful dural puncture.The secondary outcomes included one-pass success rate, number of needle attempts, one-attempt success rate, total time of spinal anesthesia and adverse effects.Results:A total of 88 subjects were randomized.The ultrasound-assisted approach significantly reduced the number of needle passes, compared with the landmark-guided approach[2.0(1.0-3.0) vs.5.0(3.0-8.8); Z=-4.708, P<0.001]. The one-pass success rate was higher in the ultrasound-assisted approach than in the landmark-guided approach[40.9%(18/44) vs.4.5%(2/44); χ2=16.565, P<0.001]. There was no statistical difference in the number of needle attempts and one-attempt success rate between the two groups( P>0.05 for both). The total time of spinal anesthesia was longer in the ultrasound-assisted group than in the landmark-guided group[252(218-317) s vs.168(143-195) s; Z=-5.592, P<0.001]. In the ultrasound-assisted group, fewer patients developed bloody cerebral spinal fluid taps than in the landmark-guided group[0%(0/44) vs.18.2%(8/44); χ2=6.738, P=0.009]. Conclusions:In elderly hip fracture patients, ultrasound-assisted paramedian spinal anesthesia is superior to the landmark-guided approach in reducing the number of needle passes and should be recommended for these patients.

Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE) / 대한뇌졸중학회지

Background@#and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. @*Methods@#Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). @*Results@#Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P<0.0001). @*Conclusions@#The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk.

Analysis of pulmonary complications and related factors in elderly patients following major abdominal surgery / 中华老年医学杂志

Objective:To analyze the incidence of postoperative pulmonary complications and related factors in elderly patients after major abdominal surgery.Methods:Clinical data of elderly patients undergone major abdominal surgeries at Beijing Hospital were retrospectively analyzed.The incidence of postoperative pulmonary complications was studied, and related factors were analyzed using Logistic regression analysis.Results:A total of 96 cases were included.The incidence of postoperative pulmonary complications was 53.1%(51/96)in elderly patients after major abdominal surgery.Logistic regression analysis showed laparoscopy was a protective factor for postoperative pulmonary complications( OR=0.293, 95% CI: 0.100-0.865, P=0.026), while driving pressure > 18 cmH 2O(1 cmH 2O=0.098 kPa)( OR=3.300, 95% CI: 1.148-9.434, P=0.027)and intraoperative bleeding volume > 500 ml( OR=4.444, 95% CI: 1.091-18.180, P=0.037)were risk factors for postoperative pulmonary complications. Conclusions:Attention should be paid to the incidence of postoperative pulmonary complications in elderly patients after major abdominal surgery.Laparoscopy is a protective factor for postoperative pulmonary complications, while driving pressure more than 18 cmH 2O and intraoperative bleeding volume more than 500 ml can increase the risk of postoperative pulmonary complications.

Clinical effect of laparoscope combined with choledochoscope in one-stage treatment of patients with cholecystolithiasis and choledocholithiasis / 中国基层医药

Objective:To explore the effect of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods:Totally 40 patients with cholecystolithiasis complicated with choledocholithiasis in the Second People's Hospital of Anqing from January 2016 to December 2019 were divided into double mirror combined group (20 cases) and open surgery group (20 cases) according to the operation mode.The patients in the double mirror combined group were treated by laparoscope combined with choledochoscope, and patients in the control group were treated by cholecystectomy and common bile duct exploration.The operation time, amount of bleeding, time to first flatus, postoperative complications and blood indicators were compared between the two groups.Results:The amount of bleeding[(32.50±14.82)mL], the length of hospital stay[(17.30±3.34)d], and the incidence of complication[ 5%(1/20)] in the double mirror combined group were lower than those in the open surgery group[(68.50±30.82)mL, (21.15±5.18)d, 40%(8/20)], the operation time[(162.50±56.39)min] in the double mirror combined group was longer than that in open surgery group[(102.25±21.18)min], there were statistically significant differences ( t=4.707, 2.792, 4.473, χ 2=2.692, all P<0.05). The levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and albumin (ALB) in the two groups after operation were lower than those pre-operation, which in the double mirror combined group were better than those in the open surgery group[double mirror combined group (preoperation and postoperation): ALT(215.35±272.00)U/L, (44.60±44.63)U/L, TBIL(38.80±43.23)μmol/L, (16.68±11.93)μmol/L, ALB(42.65±3.25)g/L, (39.58±3.78)g/L; open surgery group(preoperation and postoperation): ALT(201.78±61.14)U/L, (61.14±48.35)U/L, TBIL(80.89±91.16)μmol/L, (40.24±53.61)μmol/L, ALB(39.37±6.81)g/L, (34.11±4.78)g/L], there were statistically significant differences ( t1=2.86, 2.72, 4.02; t2=3.54, 3.89, 4.34, t3=3.56, 4, 12, 4.01, all P<0.05). There was no statistically significant difference in white blood cell count ( P>0.05). Conclusion:The clinical efficacy of laparoscope combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis is better than open surgery.

Application of Dexmedetomidine versus Propofol in elderly patient undergoing transurethral resection of the prostate / 中华老年医学杂志

Objective To investigate the efficiency and safety of Dexmedetomidine as adjuvant to local anesthetics in elderly patient undergoing transurethral resection of the prostate.Methods Sixty elderly patients undergoing selective transurethral resection of the prostate were randomly divided into the Dexmedetomidine group and the Propofol group(n =30,each).After block level of spinal anesthesia was determined,Dexmedetomidine(a bolus dose of 0.5 μg/kg for 10 minutes,then continuous injection of 0.2-0.4 μg· kg-1 · h-1)or Propofol(initial plasma concentration of 0.5 mg/L,after getting equal to an effect compartment drug concentration,plasma concentration was gradually increased by 0.1 mg/L)was injected with an infusion pump.Observation items were recorded,including the onset time [observer's assessment of alertness/sedation (OAA/S) ≤ 3 points],blood pressure,heart rate,respiratory rate,pulse oxygen saturation,end-tidal carbon dioxide partial pressure,bispectral index value(BIS),and OAA/S score as well as adverse events and patients' satisfaction to sedation.Results The OAA/S score after 20 minutes of drug injection was lower in the Propofol group than in the Dexmedetomidine group(3.0 ± 0.5 scores vs.3.5 ± 0.6 scores,t =2.300,P =0.030).The systolic pressure levels were lower in the Propofol group than in the Dexmedetomidine group after 30 minutes and 40 minutes of drug injection(107.6 ± 11.2 mmHg vs.119.2 ± 16.4 mmHg,106.7±9.6 mmHg vs.121.2±18.3 mmHg,1 mmHg=0.133 kPa,t =2.151 and 2.555,P=0.041 and 0.017).The diastolic pressure was lower in the Propofol group than in the Dexmedetomidine group after 10 minutes of drug injection(69.8±6.7 mmHg vs.78.0±10.1 mmHg,t =2.462,P =0.021).The incidence of bradycardia was higher in the Dexmedetomidine group than in the Propofol group(20.0％ or 6/30 vs.0.0％ or 0/30,x2 =6.667,P=0.010).The incidences of respiratory depression and involuntary movement were lower in the Dexmedetomidine group than in the Propofol group(0.0％ or 0/30 vs.13.3％ or 4/30,0.0％ or 0/30 vs.30.0％ or 9/30,x2 =4.286 and 10.588,P =0.038 and 0.001).Conclusions Compared with the conventional Propofol,Dexmedetomidine has a definite sedative effect in elderly patients undergoing transurethral resection of the prostate under spinal anesthesia,with peace and cooperation,greater stability of blood pressure,without breath depression,but with higher incidence of bradycardia.

Application of a reinforced laryngeal mask airway with drain tube in elderly patient undergoing endoscopic sinus surgery / 中华老年医学杂志

Objective To investigate the safety and efficiency of a reinforced laryngeal mask airway(LMA) with drain tube in elderly patient undergoing endoscopic sinus surgery.Methods Sixty elderly patients were selected and randomly divided into two groups:a reinforced LMA group (group R,n=30)and a reinforced endotracheal tube group(group T,n=30).Observation items include the difficulty degree of device insertion,the time for successful insertion,the number of attempts required for successful insertion,fiberoptic view of glottis,the difficulty degree of gastric tube insertion,oropharyngeal leak pressure(OLP),ventilatory indicators at a certain time,haemodynamics during insertion,the blood stain on the mask were compared between the two group.The postoperative complications 1,6,24 hours after operation were recorded.Results There were no significant differences in general conditions,the successful insertion rate at first attempt,the total success insertion rate,airway quality and the anesthetic drug dosage between the two groups.The insertion time was shorter in group R than in group T [(34.1± 13.0 s)vs (45.4± 15.6 s),t =5.274,P=0.001].The incidence of cough during extubation was less in group R than in group T [0％ (0/30) vs.53.3％(16/30),x2 =21.222,P=0.000].Conclusions The reinforced LMA with drain tube is safe and effective for elderly patients during endoscopic sinus surgery.

Effect of natrin from Naja naja atra on calcium overload and expression of related genes in neonatal rat primary cardio myocytes exposed to hydrogen peroxide / 中国药理学与毒理学杂志

OBJECTIVE To observe the effect of natrin from Naja naja atra(Chinese cobra)on intracellular free calcium overload,and to discuss the protective effect and the possible mechanism of natrin on myocardium calcium(Ca2+)and potassium(K+)ion channels in the primary cardiomyocytes of SD neonatal rats. METHODS The primary cardiomyocytes of SD neonatal rats were used,which were respectively pretreated with natrin 5,25 and 125 mg · L-1 for 24 h before injury was induced by H2O2 0.3 mmol · L- 1. The dynamic variation of intracellular calcium was monitored by laser confocal microscopy using Fluo-3 as Ca2+fluorescence probe. Additionally,the cardio myocytes of neonatal rats were pretreated for 24 h using different concentrations of natrin 5,25,125 mg · L-1 and verapamil 5 nmol · L-1,followed by exposure to H2O2 0.3 mmol · L-1 for 15 min. Then,the mRNA expressions of calcium channels subunits Cav1.2,Calm,RyR2 and potassium channel Kir6.2 were analyzed by FQ-PCR method. RESULTS Laser confocal microscopy revealed that H2O2 obviously caused calcium overload in cardiomyocytes, giving rise to 49.37% fluorescence increase in intracellular calcium compared with the control group(P<0.01). However,natrin 5,25 and 125 mg·L-1 resulted in 27.52%, 12.71% and 5.15% fluorescence increase in intracellular calcium,respectively,compared with the control group(P<0.01). Moreover, the PCR results showed that the mRNA expressions of Cav1.2, Calm and RyR2 in the myocardial cells treated with H2O2 were increased 2.78,2.26,and 5.34 times as compared with the control group,while Kir6.2 displayed a 1.79-fold expression level(P<0.01). By contrast, the combination of natrin and verapamil significantly decreased the mRNA expression of Cav1.2,Calm and RyR2,compared to the H2O2-treated group(P<0.01). Meanwhile,the expression of Kir6.2 was considerably higher than that of the H2O2-treated group(P<0.05). CONCLUSION Natrin can reduce the intracellular calcium overload of cardiomyocytes induced by H2O2 and shows a protective effect against oxidative damage for cardiomyocytes. The possible mechanism is that natrin can decrease the mRNA expression of Cav1.2,Calm,RyR2 and increase the expression of Kir6.2 of the H2O2-induced cardiomyocytes.

Influence of age on neuromuscular block effect of cisatracurium in myasthenia gravis patients / 中华老年医学杂志

Objective To investigate the neuromuscular block effect of intravenous injection of cisatracurium in myasthenia gravis patients with different ages.Methods Fifteen geriatric patients defined as geriatric group(≥ 65 years old)with ASA Ⅰ-Ⅱ scheduled for video-assisted thoracoscopic (VATS)thymectomy with Ⅱ b MG and fifteen young-middle aged Ⅱ b MG patients defined as youngmiddle aged group (20-50 years) with paired sex,clinical symptoms,duration of symptoms,preoperative treatment regimen,anesthesia management and surgical time were included.Neuromuscular block was monitored with TOF Watch acceleration instrument.After induction of intravenous anesthesia,0.05mg/kg Cisatracurium was administrated intravenously,followed by increments of 0.015 mg/kg until T1/T0 was less than 5％ for each patient.A double-lumen bronchial tube was intubated when T1/T0 was less than5％.0.015 mg/kg cisatracurium was injected during the operation when T4/T1 was achieved to 25％.The dose of cisatracurium,the duration of blockade maintenance,duration of clinical action and neuromuscular block recovery index were obtained.Results There were no significant differences in tracheal doses of cisatracurium [(0.058 ± 0.013)mg/kg vs.(0.053±0.009)mg/kg]and the duration of blockade [(31.5±9.6)min vs.(40.0±19.8)min] between geriatric group and young-middle age group (P＞0.05).The duration of clinical action of cisatracurium [(21.6±6.7)min vs.(33.7±13.4)min]and the time to achieve a TOFr of 25％ were significantly shorter in geriatric MG group than those in young-middle aged MG group (P=0.045,0.037).The geriatric MG group were administrated more increments of ciastracurium than the young middle aged MG group during surgery (P=0.025).There was no significant difference in the time to achieve a TOFr of 70％ [(49.3±16.4)min vs.(57.4±34.7)min] and 90％ [(61.6± 19.2)min vs.(64.3±35.9)min] between geriatric MG group and young-middle aged MG group (P＞ 0.05).Conclusions The duration of clinical action of cisatracurium in geriatric MG patients was shorted than that in young-middle aged MG patients which was different with neuromuscular block effect in normal patients.It is suggested to do more studies to estimate the influence of age on cisatracurium and other muscle relaxants in MG patients.

Preparation of tissue-engineered skin grafts with hTERT cells carrying human papillomavirus type 6 genome in vitro：a preliminary study / 中华皮肤科杂志

Objective To establish a model for preparation of tissue-engineered skin grafts with hTERT cells carrying human papillomavirus type 6 (HPV 6) genome in vitro, so as to lay a foundation for studying HPV life cycle. Methods The full-length linear HPV6 genome and plasmid pEGFP-▲EGFP were electrophoretically cotransferred into hTERT cells. After selection using G418 resistance, Southern blotting was performed to determine the viral load of HPV6 in transfected cells. 3T3 J2 trophoblastic cells, type I rat-tail collagen and hTERT cells containing the full-length HPV6 genes (HPV6.hTERT cells)were mixed and cocultured on metal meshes to form skin graft-like structures. Hematoxylin and eosin (HE)staining was performed to observe the structure of formed skin grafts, an immunohistochemical assay to measure the expression of HPV6 L1 protein, and electron microscopy to observe virus particles in the skin grafts. Results The linear HPV6 gene was successfully transferred into hTERT cells, and Southern blotting showed the presence of HPV6 DNA in the transferred hTERT cells. The HPV6.hTERT cells, which were cocultured with 3T3 J2 trophoblastic cells and type I rat-tail collagen, proliferated and differentiated over time, and gradually formed skin grafts giving the appearance of verrucous hyperplasia. HE staining showed that the cocultured HPV6.hTERT cells could form typical stratified structure of skin after 7 days of cultivation, and histopathologic features of HPV infection, including obvious papillomatous hyperplasia, presence of vesicular cells, hyperkeratosis and parakeratosis, could be observed after 21 days. The immunohistochemical assay showed the expression of HPV6 L1 protein in the upper portion of skin grafts, and electron microscopy revealed the presence of HPV6 virus particles in skin grafts. Conclusions The established model for preparation of tissue-engineered skin grafts using HPV 6 genome-carrying cells provides a basis for biological studies of HPV, but its application is limited to some degree.

Research on advantage chooses of CT and MRI in diagnosing spine tuberculosis / 中国医学装备

Objective:To analyze manifestation of spine tuberculosis in CT and MRI, compare two kinds of techniques respectively of diagnosis advantage. Methods: Retrospective analysis of 18 cases confirmed by the surgical operation and pathology imaging of CT and MRI Material of spine tuberculosis. Results: The CT can nicely show that the bone destruction, the bone increase osteoslerosis, sequester and new-born formation and narrow of intervertebral disc, swelling paraspinal soft tissue and psoas major muscle abscess, spinal canal of bone is narrow, calcification. Although CT can show intervertebral disc involvement and terminal plate of vertebral body destruction in sagittal reconstruction, not equal to MRI sensitive, Evaluating intervertebral disc involvement and area of paraspinal soft tissue swells, changed in early days spine tuberculosis of valuation, MRI had obvious advantage. Conclusion: Combining CT and MRI can reflect the image of spine tuberculosis to learn a characteristic completely and be advantageous to diagnosing and discriminate diagnosis of spinal tuberculosis.

Association analysis between human papillomavirus genotypes and viral load and clinical features of verruca vulgaris / 中华皮肤科杂志

Objective To study the association between human papillomavirus (HPV) genotypes and viral load and clinical features of verruca vulgaris.Methods Tissue samples were collected from 48 outpatients with verruca vulgaris,and DNA was extracted from these tissue samples.To determine the genotype of HPV,PCR was performed to amplify the L1 fragment of HPV with universal primers followed by bidirectional sequencing and BLAST.The genotyping results were validated by PCR with type-specific primers.Real-time fluorescence-based quantitative PCR was conducted to measure the viral load of HPV,and hematoxylin and eosin (HE) staining to observe histological changes in these tissue specimens.Results The L1 fragment of HPV was amplified from 35 out of the 48 tissue specimens.Of the 35 L1-positive specimens,32 harbored HPV 7,1 harbored HPV 57,and 2 harbored both HPV 2 and HPV 7.Multiple lesions were observed on extremities in the patient infected with HPV 57,but on the head,face and trunk in the patients coinfected with HPV 2 and HPV 7.There were no significant differences in HPV viral load or vacuolated cell number between patients with single lesions and those with multiple lesions,or between patients with a clinical course of ＜ 6 months and those with a clinical course of 6-12 months.However,HPV viral load tended to decrease one year after the onset,and there was pronounced hyperkeratosis and less vacuolated cells in lesions of long duration (more than 2 years) compared with those of short duration (less than 2 years).Conclusions HPV 7 appears to be the most common HPV genotype associated with verruca vulgaris,and HPV 7 infection usually occurs on the head and face.For verruca vulgaris of less than 1 year,neither HPV viral load nor vacuolated cell number is associated with the count or clinical course of warts.

Observation of postoperative analgesic effects of intravenous parecoxib in gerontal patients undergoing laparoscopic cholecystectomy / 中华老年医学杂志

Objective To observe the postoperative analgesic effects of perioperative intravenous parecoxib in gerontal patients undergoing laparoscopic cholecystectomy. Methods A prospective,randomized, double-blind, placebo-controlled, parallel group study was performed. The 40 American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ patients (aged 60-80 years) undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly allocated to 2 groups (n = 20,each): the parecoxib group received intravenous parecoxib 40 mg at 10 minutes before incision and 12 hours and 24 hours after incision; however, the placebo group received 5 ml normal saline instead of parecoxib at the same time. The intensity of algesia was measured using visual analogue scale (VAS)scores (1-10, 0 = no pain, 10 = worst pain), and was recorded at 2, 4, 6, 12, 24 hours after operation. The patients' global evaluation of postoperative analgesia was recorded and compared between the two groups. Results The VAS scores at the different time points were significantly less in parecoxib group than in placebo group (all P＜ 0.05). The patients' global evaluation of postoperative analgesia was higher in parecoxib group than in placebo group [(8. 1 ± 1.2) scores vs.(5.2± 0. 9 ) scores, t = 7. 402, P ＜ 0. 05]. Conclusions Intravenous parecoxib can effectively relieve postoperative algesia and improve postoperative analgesia after laparoscopic cholecystectomy.

Effect of different time administration of parecoxib sodium on postoperative analgesic efficacy in patients undergoing thoracic surgery / 中华麻醉学杂志

Objective To investigate the effect of different time administration of parecoxib sodium on the postoperative analgesic efficacy in patients undergoing thoracic surgery. Methods This was a prospective,randomized, double-blind, placebo-controlled study. Sixty ASA Ⅰ orⅡ patients aged 17-83 yr undergoing pulmonary lobectomy were randomly allocated to one of 3 groups (n=20 each):A, B and C groups. Group A received normal saline 2 ml at 30 min before skin incision and the end of operation. Group B received iv parecoxib sodium 40 mg at 30 min before skin incision and normal saline 2 ml at 30 min before the end of operation. Group C received normal saline 2 ml at 30 min before skin incision and iv parecoxib sodium 40 mg at 30 min before the end of operation. All the patients received patient-controlled intravenous analgesia with morphine and VAS score was maintained≤3. The patients were followed up after operation.The morphine consumption, patients' global evaluation of the postoperative analgesia (0-100, 0=worst pain, 100=no pain), nausea and vomiting, body temperature , volume o chest drainage, hepatic, renal and blood coagulation function were recorded. Results Compared with group A, the morphine consumption was significantly reduced, the patient' s satisfaction score increased and body temperature decreased in B and C groups(P＜0.05 or 0.01). There was no significant difference in the morphine consumption, patient's satisfaction score and body temperature between B and C groups(P＞0.05). No significant difference was found in the parameters of hepatic, renal and blood coagulation function, volume of chest drainage and incidence of nausea and vomiting among the three groups(P＞0.05).Conclusion When postoperative analgesia is assisted with iv parecoxib sodium 40 mg given at 30 min before skin incision or at 30 min beforethe end of operation,the efficacy is similar,and both can improve the postoperative analgesic efficacy of morphine and reduce fever after operation in patients undergoing thoracic surgery.

Efficacy of laryngeal mask airway Guardian and laryngeal mask airway Supreme in patients undergoing gynecological surgery / 中华麻醉学杂志

Objective To compare the efficacy of laryngeal mask airway Guardian (GLMA) and laryngeal mask airway Supreme (SLMA) in patients undergoing gynecological surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients aged 19-80 yr weighing 50-70 kg undergoing gynecological surgery were randomly divided into 2 groups: SLMA group (group S, n = 59) and GLMA group (group G, n =61). LMA was inserted after induction of anesthesia with propofol 2.0-2.5 mg/kg, sufentanil 0.2 μg/kg and rocuronium 0.6 mg/kg. All the patients were mechanically ventilated. BP, HR, SpO2, PETCO2 and Ppeak were monitored during operation. The rate of successful placement, placement time, fiberoptic bronchoscope grade, airway sealing pressure, airway pressure during normal ventilation with tidal volume of 8 ml/kg, airway pressure and air leakage during ventilation with large tidal volume of 20 ml/kg, air leakage during opertion, complications, anesthesia time, duration of surgery, extubation time and emergence time were recorded. Results There was no significant difference in the rate of successful placement, placement time, airway pressure during normal ventilation and during ventilation with large tidal volume, blood stain at LMA removal, incidence of sore throat, choking hoarseness and dysphagia, anesthesia time, duration of surgery, extubation time, and emergence time between the two groups (P ＜ 0.05). The BP,HR, SpO2, Ppeak and PETCO2 were within the normal range during operation in both groups. The fiberoptic bronchoscope grade and airway sealing pressure were significantly higher, and the incidence of air leakage during ventilation with large tidal volume and during operation was significantly lower in group G than in group S (P ＜ 0.01).Conclusion GLMA and SLMA can provide adequate ventilation during operation with fewer complications and can be used effectively for gynecological surgery. The efficacy of GLMA is better.

Studies on triterpenoid saponins in Hemsleya chensnsis / 中国中药杂志

<p><b>OBJECTIVE</b>To study the triterpenoid saponins in Hemsleya chensnsis.</p><p><b>METHOD</b>The chemical constituents were isolated and purified by various chromatographic methods and their structures were elucidated on the basis of spectral analysis.</p><p><b>RESULT</b>Seven known triterpenoid saponins were isolated from the root of H. chensnsis and were identified as 3-O-beta-D-glucuropyranosyl-oleanol-icacid (1), 3-O-beta-D-glucopyra-noside-oleanolicacid-28-O-beta-D-glucopyranoside (2), 3-O-(6'-methylester)-beta-D-glucuropyranosyl olea- nolic acid-28-O-alpha-L-arabinopyranoside (3), 3-O-(6'-methylester)-beta-D- glucuropyranosyl- oleanolic acid-28-O-beta-D-mannupyranoside (4), 3-O-(6'-ethyl ester)-beta-D-glucuropyranosyl oleanolic acid-28-O-beta-D- glucopyranoside (5), 3-O-alpha-L-arabinopyranoside-(1-->3) -beta-D-glucuropyranosyl- oleanolic acid-28-O-beta-D-glucopyranoside (6), 3-O-beta-D-glucu-ropyranosyl-oleanolic acid-28-O-beta-D-glucopyra-noside-(1-->6)-beta-D-glucopyranoside (7).</p><p><b>CONCLUSION</b>Compounds 1-7 were isolated from this plant for the first time.</p>

Effect of Qi-strengthening and Blood-activating Therapy on Inflammatory Mediators in Acute Ischemic Stroke Patients Complicated with Systemic Inflammatory Response Syndrome / 广州中医药大学学报

0.05).After treatment for 7 days,TNF-a and IL-6 levels decreased in the medication groups(P

Genetic structure analysis of cultivated Scrophularia ningpoensis in Zhejiang Province / 中草药

Objective To observe the genetic structure of cultivated Scrophularia ningpoensis in Zhejiang Province.Methods The genetic structures of six typical S.ningpoensis populations were analyzed by fluorescence AFLP marker.Results Bands(12 552) were generated by seven pairs of AFLP primer combinations,of which 8 808 were polymorphic,and the polymorphic rate was 70.17%.The variety ranges of PPB among different populations were 41.67%—55.56%,and 47.30% in average.I was between 0.190 8—0.238 3,and 0.221 8 in average.Ne was between 1.201 4—1.280 6,and 1.236 9 in average.Gst was 0.127 1,Nm was 3.432 4.UPGMA Cluster analysis showed that the six populations can be divided into two clusters,as that of Tiantai,Jinyun,and Jingning were one sub-cluster,and Dongyang,Pan′an,and Xianju were another one sub-cluster.Conclusion There is a relative high genetic diversity level in cultured S.ningpoensis of Zhejiang Province.Genetic differentiation exists among populations,but it exists in population mostly.There is a relative high genetic intercommunion among populations.The genetic distance is not related to the geographic environment.

AFLP Analysis on genetic diversity for germplasm resources of Fritillaria thunbergii cultivated in Zhejiang Province / 中草药

Objective To study the genetic diversity of Fritillaria thunbergii,a traditional Chinese herb in Zhejiang Province in China.Methods The genetic diversity of six representational populations of F.thunbergii including 32 individuals was investigated by amplified fragment length polymorphism(AFLP) maker technique.Results The genetic diversity was revealed as follow: the Nei′s genetic diversity index(He) 0.169 0?0.175 7,Shannon′s information index(I) 0.269 8?0.245 3,percentage of polymorphic loci(PPB) was 76.85% at the species level;Ht 0.169 0?0.030 9,and Hs 0.150 8?0.024 0,I 0.233 3?0.261 9, PPB was 50.38% at population level.The genetic differentiation index(Gst) was 0.107 6,Nm 4.147 0.The result of dendrogram of six populations indicated that Dongyang and Yongkang populations shared the minimum genetic distance(0.015 0),they were classified into a group,and Xiangshan and Jinyun populations shared the maximum genetic distance(0.032 4).Conclusion The genetic diversity of F.thunbergii cultivated in Zhejiang Province is very rich,which could ensure the long-term survival of F.thunbergii.But the genetic diversity of F.thunbergii is relatively higher in population levels while lower at the species levels and the degree of genetic differentiation occured among the populations is not significant.The germplasm resources are relatively stable among these six populations.These populations could be used to breed the fine strains of F.thunbergii as the bases.