Clinical observation of the application of dezocine combined with fentanyl in high intensity focused ultrasound in the treatment of uterine fibroids / 重庆医学

Objective To observe the feasibility of combining dezocine with fentanyl in the application of single integral high in‐tensity focused ultrasound(HIFU)ablation of uterine fibroids .Methods One hundred and sixty patients with uterine fibroids trea‐ted by HIFU under conscious sedation were randomly divided into 2 groups(n=80):group A with treatment combined fentanyl and midazolam and group B treated with combined dezocine ,fentanyl and midazolam .Analgesic effect was evaluated with visual analog scale (VAS) .Variation of patients′vital signs (blood pressure ,heart rate ,electrocardiogram ,oxygen saturation) ,pain scores ,com‐fort scores ,sedation scores ,analgesic consumption and side effects were recorded before treatment (T0 ) ,during drug delivery (T1 ) , at the beginning of the treatment(T2 ) ,30 minutes after drug delivery (T3 ) ,at the end of the treatment(T4 ) ,2 hours after treatment (T5 ) ,4 hours after treatment (T6 ) ,8 hours after treatment (T7 )and 24 hours after treatment(T8 ) .Results Both groups showed reliable analgesic effects and vital signs of each time point were stable .VAS scores and Ramsay scores of group A were higher than those of group B ,but there was no statistical difference (P>0 .05) .Three patients in group A showed dysuria and relieved after symptomatic treatment .No respiratory depression occurred in both groups .But compared to group A ,the incidence of the analgesic side effects of group B was significantly lower and patients satisfaction was significantly higher(P<0 .05) .Conclusion The analge‐sic effects of dezocine combined with fentanyl are reliable in HIFU ablation of uterine fibroids with fewer side effects ,and could be worthy to be promoted in clinical use .

Analysis of a case with Brucellosis misdiagnosed as osteoarthrosis / 中南大学学报(医学版)

Brucellosis is far more frequent in a pasturing area in the northern part of our country and it has many clinical manifestations. It may cause multiple organ damage and its features lack specificity. It is rare in the south, so it is extremely easy to be misdiagnosed or overlooked. The retrospective analysis of a case with Brucellosis misdiagnosed as osteoarthrosis provides a guide for clinical doctors to understand Brucellosis, so that early diagnosis would be accessible, and prognosis could be improved.

Resistance by hypermutable Pseudomonas aeruginosa and beta-lactamases production / 中南大学学报(医学版)

OBJECTIVE@#To determine the relation between resistance of hypermutable Pseudomonas aeruginosa and beta-lactamases produced.@*METHODS@#The bacteria cultured were identified with API 20NE system. Susceptibilities of the bacteria were detected by disk diffusion method. The hypermutable strains were tested with broth dilution assays. The beta-lactamases produced by these strains were characterized by 3-dimensional test and 2-mercaptopropanoic acid inhibited assays.@*RESULTS@#Altogether 120 strains were analyzed and 45 (37.5%) trains were hypermutable.The resistant rates of hypermutable strains were close to or above 60.0% for imipenem, meropenem, cefoperazone/sulbactam, piperacillin/ tazobactam, ceftazidime, cephfime, aztreonam, amikacin and ciprofloxacin.The 3-dimensional test showed that 18 (40.0%) strains produced extended spectrum beta-lactamases (ESBLs), 25 (55.6%) strains produced AmpC enzymes, and 6 (13.3%) strains produced metallo-beta-lactamases.@*CONCLUSION@#The resistant rates of hypermutablce strains of Pseudomonas aeruginosa to routine antibiotics are high, which is one of the most important reasons for multi-drug resistance that the hypermutable strains produced ESBLs, AmpC enzymes, and metallo-beta-lactamases.

Resistance and ?-Lactamases of Acinetobacter baumannii / 中华医院感染学杂志

OBJECTIVE To investigate the relationship of resistance and ?-lactamases of Acinetobacter baumannii.METHODS The bacteria cultured were identified with API 20NE system.The susceptibilities of the bacteria were detected by disk diffusion method.The ?-lactamases produced by these strains were characterized by three-dimensional test and 2-mercaptopropionic acid inhibition assays.RESULTS In 150 strains,the resistant rates of strains were 4.0% to cefoperazone/sulbactam.The resistant rates to imipenem,meropenem,piperacillin/tazobactam,ampicillin/sulbactam and levofloxacin were between 20.0% and 55.0%.The resistant rates to ceftazidime,cefepime,aztreonam and amikacin were above 60.0%.Three-dimensional test showed that 37 strains(24.7%) produced extended spectrum ?-lactamases(ESBLs),66 strains(44.0%)produced AmpC enzymes and 16 strains(10.7%)produced carbapenemases,in which 12 strains(8.0%) produced metallo-?-lactamases.CONCLUSIONS The resistant rates of A.baumannii to routine antibiotics are high except cefoperazone/sulbactam and carbapenem.It is the most important reason for multi-drug resistance that the strains of A.baumannii produce ESBLs,AmpC enzymes and metallo-?-lactamases.

Expression of TLR2 in colon mucosa of ulcerative colitis / 中华消化内镜杂志

Objective To investigate the expression of TLR2 in colon mucosa of ulcerative colitis (UC) and to analyze the correlation with clinical activity and endoscopic grading. Methods The biopsies from 47 UC patients and 13 healthy controls were collected, and the expression of TLR2 protein and mRNA in colonic mucosa was determined by Western Blot and semi-quantitative RT-PCR, respectively. The patients were graded according to endoscopic and clinical findings. Results The expressions of TLR2 protein and TLR2 mRNA in UC patients were significantly increased than those in healthy controls, which was correlated with the progression of the disease. Conclusion The expressions of TLR2 protein and TLR2 mRNA in colon mucosa from UC patients might be used as a marker for disease activity.

Dynamic monitoring of leukocytes in patients undergoing renal transplantation / 中国组织工程研究

BACKGROUND: Changes of leukocytes are related with some postoperative complications after renal transplantation. OBJECTIVE: To observe dynamically the level of white blood cell (WBC) and its morphological changes using automatic blood cell analyzer to evaluate its relationship with infection, immunosuppressive intoxation and acute rejection. DESIGN, TIME AND SETTING: Observation and controlled trial was performed at Second Xiangya Hospital, Central South University from June 2004 to October 2005. PARTICIPANTS: Sixty-eight patients who received renal transplantation were selected. According to clinical symptoms and laboratory biochemical indexes, X-ray, B ultrasound, and renal puncture biopsy, the patients were divided into stable group (n=36), infection group (n=9), intoxation group (n=6) and acute rejection group (n=13). METHODS: The blood routine was tested with Sysmex XE-2100 automatic blood analyzer following renal transplantation and WBC manual differentiation was done to observe peripheral blood morphology, their liver function. In addition, renal and liver functions were detected by automatic biochemical system 7600A. MAIN OUTCOME MEASURES: WBC count and its morphological changes in peripheral blood and liver and renal function after renal transplantation. RESULTS: WBC count of the stable group and intoxation group was normal, and that of the acute rejection group and infection group were significantly higher than the stable group (P

Detection and antimicrobial resistance of hypermutable Pseudomonas aeruginosa strains / 临床检验杂志

Objective To investigate the isolation and antimicrobial resistance of hypermutable Pseudomonas aeruginosa strains.Methods The cultured bacteria were identified by API 20NE system.The susceptibilities of bacteria were detected by disk diffusion method and the results were confirmed with the rules of NCCLS/CLSI.The hypermutable strains were identified byhigh concentration of rifampin-resistant growth assay.Results Among analyzed 100 strains,37 strains(37.0%) were hypermutable.The resistant rates of hypermutable strains to imipenem,meropenem,cefoperazone/sulbactam,piperacillin/tazobactam,ceftazidime,cephfime,aztreonam,amikacin and ciprofloxacin were significantly higher than those of non-hypermutable strains.The multidrug resistance rates of hypermutable strains were also higher than those of non-hypermutable strains.Conclusion The hypermutable strains of Pseudomonas aeruginosa sourced from chronic respiratory tract infections dominantly.The hypermutable strains were hyper-resistant and multidrug resistant to many antibiotics,so strengthened monitoring should be encouraged to control the prevalence of hypermutable Pseudomonas aeruginosa strains.

Effects of norepinephrine on hepatic stellate cells apoptosis in vitro / 基础医学与临床

Objective To investigate the effects of NE on hepatic stellate cells(HSCs)apoptosis.Methods After NE and the antagonists of adrenoceptor subtypes were administered to HSCs,MTT method was used to evaluate cell proliferation.TUNEL assay and flow cytometry(FCM)were used to identify cell apoptosis.Results(1)Compared with control group,NE at concentrations of 1、10 and 100 ?mol/L induced HSCs proliferation in a time-dependent manner;The action of NE at concentrations of 10 ?mol/L reached the peak(0.262?0.085 vs 0.048?0.055,P

Regulation of the catecholamine beta-adrenergic system in ventricular remodeling of hypertension.

Differences in structural remodeling are believed to be influenced by hormonal systems in hypertension. The objective of the present study was to investigate the change in the circulating catecholamine beta-adrenergic system in the left ventricle remodeling process in hypertensives. One hundred and thirty-four men (mean age, 53 years) had essential hypertension and underwent echocardiography before treatment. Normal morphology (n = 26) and concentric remodeling (n = 41) were defined by a relative wall thickness at diastole (RWT) of < 0.44 and > or = 0.44, respectively, and concentric hypertrophy (n = 28) and eccentric hypertrophy (n = 39) by a left ventricular mass index (LVMI) of < 150 g/m(2) and > or = 150 g/m(2), respectively. Forty healthy males were studied as normal controls. Plasma levels of norepinephrine (NE) and epinephrine (E) were measured by high performance liquid chromatography. The density of lymphocyte beta-adrenoceptors (beta-AR) and the content of intralymphocyte cyclic AMP (cAMP) in peripheral blood were measured using (3)H-dihydroalpneol as a ligand and protein binding assay, respectively. The plasma levels of NE and E in the 4 groups of patients with essential hypertension were significantly increased compared with the control group. The density of lymphocyte beta-AR and the content of intralymphocyte cAMP of peripheral blood in the normal morphology, concentric remodeling, and concentric hypertrophy groups were significantly higher than those in the control group, while the values in the eccentric hypertrophy group were significantly lower than those in the control group. Among the 4 groups, the plasma levels of NE and E had increased the most in the normal morphology group, followed in decreasing order by the concentric remodeling, concentric hypertrophy, and eccentric hypertrophy groups; the density of lymphocyte beta-AR and the content of intralymphocyte cAMP of peripheral blood in the normal morphology, concentric remodeling, and concentric hypertrophy groups increased while they decreased in the eccentric hypertrophy group in patients with essential hypertension. The catecholamine beta-adrenergic system appears to be related to left ventricular remodeling of hypertension. In this process, catecholamines increased continually. The density of beta-AR and the content of cAMP in peripheral lymphocytes increased at first and then decreased.

Changes and significance of subtype function of beta-adrenoreceptors in left ventricular remodeling of hypertension.

Changes in the density of myocardium and blood lymphocyte beta-adrenoceptors (beta-AR) in left ventricular (LV) geometry have been found in patients with essential hypertension (EH). However, it is not known whether intrinsic beta-AR subtype function changes during left ventricular remodeling of hypertension. The purpose of this study was to further investigate the changes and clinical significance of beta-AR subtype function in LV remodeling in patients with EH. One hundred and thirty-four men (mean age, 53 years) with EH as defined in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure grades 1 to 2 and 40 normotensives were studied. Based on the echocardiographic LV mass index and relative wall thickness, four patterns of LV geometry, ie, normal left ventricle, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy were identilied. beta-Adrenoreceptor subtype responsiveness was measured by a treadmill exercise test (to measure cardiac beta1-adrenoreceptor responsiveness) and by Salbutamol injection test (to measure cardiac beta2-adrenoreceptor responsiveness) in 134 male patients with EH. Forty normotension subjects were also studied as controls. In patients with EH in the groups of concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, heart rate in response to the treadmill test (peak exercise-resting rate) was significantly higher (P < 0.05, P < 0.01. P < 0.01, respectively) than that in the control group. In the concentric remodeling and concentric hypertrophy group, the chronotropic doses of salbutamol required to increase the heart rate by 30 beats/min (CD30) were significantly lower (P < 0.05, P < 0.01, respectively) than that in the control group. However, in the eccentric hypertrophy group. CD30 was higher significantly (P < 0.01) than that in the control group. In the concentric remodeling, concentric hypertrophy, and eccentric hypertrophy groups, beta1-AR responsiveness significantly increased them in the normotensive group, whereas beta2-AR responsiveness significantly increased in the concentric remodeling and concentric hypertrophy groups them in the normotensive group, and significantly decreased in the eccentric hypertrophy them in the normotensive group. The results suggest that non-beta-selective blocker may be beneficial for normal morphology, concentric remodeling and concentric hypertrophy, while beta1-selective blockers may be beneficial for eccentric hypertrophy in patients with EH.

Effects of catecholamine-beta-adrenoceptor-cAMP system on severe patients with heart failure / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the association between catecholamine-beta-adrenoceptor (beta-AR)-adenosine 3', 5'-monophosphate (cAMP) system and long-term prognosis in patients with chronic heart failure (CHF).</p><p><b>METHODS</b>The study population comprised 73 patients with CHF (EF: 23% +/- 10%) with a mean follow-up of 3.8 +/- 1.9 years. Plasma levels of norepinephrine (NE) were measured using high performance lipid chromatography, beta-adrenergic receptor density (Bmax) and the content of cAMP in peripheral lymphocytes were calculated using 3H-dihydroalpneolo as ligand and competitive immunoassay, respectively. Deaths due to cardiovascular events within the follow-up period were registered.</p><p><b>RESULTS</b>The total mortality was 64.7%, 57.4% of which was for cardiogenic (worsening heart failure: 32.4%; sudden death: 25.0%). In the cardiogenic death group, plasma levels of NE and epinephrine (E) (3.74 nmol/L +/- 0.09 nmol/L and 3.17 nmol/L +/- 1.0 nmol/L) and the contents of peripheral lymphocyte cAMP (3.64 pmol/mg protein +/- 1.4 pmol/mg protein) were significantly increased as compared with the survival group (2.68 nmol/L +/- 0.07 nmol/L, 2.41 nmol/L +/- 0.24 nmol/L and 2.73 pmol/mg protein +/- 0.9 pmol/mg protein, respectively, all P < 0.01). In the sudden death group, plasma levels of NE and E (5.01 nmol/L +/- 0.06 nmol/L and 4.13 nmol/L +/- 0.08 nmol/L) were significantly increased as compared with the worsening heart failure group (2.49 nmol/L +/- 0.07 nmol/L and 2.33 nmol/L +/- 0.8 nmol/L, all P < 0.001) and to the survival group (2.68 nmol/L +/- 0.07 nmol/L and 2.41 nmol/L +/- 0.14 nmol/L, all P < 0.01). The incidences of sudden death were 0%, 75%, and 100% (chi(2) = 16.018, P < 0.01) in patients with plasma NE < 2.5 nmol/L, NE 2.5 nmol/L - 4.5 nmol/L, and NE > 4.5 nmol/L, respectively. In the worsening heart failure group, the content of peripheral lymphocyte cAMP (4.46 pmol/mg protein +/- 0.18 pmol/mg protein) was significantly increased compared with the sudden death group (2.39 pmol/mg protein +/- 0.9 pmol/mg protein, P < 0.001) and to the survival group (2.73 pmol/mg protein +/- 1.1 pmol/mg protein, P < 0.001). The worsening heart failure death occurences were 5.0%, 72.2%, and 100% (chi(2) = 14.26, P < 0.01) in patients with a content of peripheral lymphocyte cAMP < 2.5 nmol/L, cAMP 2.5 nmol/L - 4.5 nmol/L, and cAMP > 4.5 nmol/L, respectively. Bmax in peripheral lymphocyte was not significantly different (P > 0.05) among the sudden death, worsening heart failure, and survival groups in CHF patients.</p><p><b>CONCLUSIONS</b>Plasma levels of catecholamine increase significantly, and Bmax and the contents of cAMP in peripheral lymphocytes decrease significantly in patients with CHF. High plasma catecholamine levels may be associated with sudden death, and high intralymphocyte cAMP content may be associated with worsening heart failure in CHF patients.</p>

Relationship of PTEN expression with apoptosis of hepatic stellate cells in liver tissues of rats with hepatic fibrosis induced by bile stagnation / 解放军医学杂志

Objective To explore the relationship of phosphatase and tensin homology (PTEN) deleted on chromosome ten with the apoptosis of hepatic stellate cells (HSCs) in liver tissues of rats with hepatic fibrosis induced by bile stagnation.Methods Fifty adult male SD rats were randomly divided into model group (n=40) and sham operation group (n=10).The model of hepatic fibrosis was reproduced in model group by common bile duct ligation (BDL).Liver tissue of rats in model group (1,2,3 and 4 weeks after BDL) and sham operation group were obtained.PTEN expression in liver tissue was detected by immunohistochemistry.Apoptosis of HSC was determined by dual staining of terminal deoxynucleotidy transferase UTP-nick end labeling (TUNEL) and ?-SMA immunohistochemistry.Results Only a few apoptotic HSCs were found in normal livers.With the development of liver fibrosis,the expression of PTEN decreased gradually (P

Effects of endothelin-1 on proliferation and changes of Ca~(2+) in activat ed hepatic stellate cells / 中华消化杂志

Objective To elucidate the effects of endothelin-1(ET-1) on expression of extra-regulated kinase 1(ERK 1), cell cycle and changes of Ca 2+ in activated hepatic stellate cells (HSCs). Methods Effects of different concentra tions of ET-1 on ERK 1 expression were determined by Western blotting. Effects of ET- 1 on cell cycle were observed by flow cytometry(FCM) analysis. Effects of ET-1 on changes of calcium concentration and cell area were observed by laser scanning confocal microscopy (LSCM). Results ET-1 could inhibit the expression of ERK 1 i n a dose-dependent manner, compared with the control, the expression of ERK 1 in E T-1 highest concentration group decreased 10.91%?3.36% (P