Effects of different depths of anesthesia on CD4 + T cell function in patients undergoing radical resection for malignant tumor / 中华麻醉学杂志

Objective:To evaluate the effects of different depths of anesthesia on CD4 + T cell function in the patients undergoing radical resection for malignant tumor. Methods:Forty-two American Society of Anesthesiologists physical status Ⅱ patients, aged 36-64 yr, weighing 49-95 kg, undergoing elective radical surgery for malignant tumor, were divided into 2 groups ( n=21 each) using a random number table method: light anesthesia group (L group) and deep anesthesia group (D group). The AAI values were maintained at 30-40 and 20-29 during operation in L group and D group, respectively.The time to eye opening, extubation time and consumption of propofol were recorded.The peripheral venous blood samples were collected immediately before induction of anesthesia (T 0), at 2 h of operation (T 1) and at 4, 24, and 72 h after operation (T 2-4) for determination of serum interferon (IFN)-γ and interleukin-4 (IL-4) concentrations (by enzyme-linked immunosorbent assay), and IFN-γ/IL-4 ratio was calculated. Results:Compared with the baseline value at T 0, the serum IFN-γ concentrations were significantly increased at T 3, 4, the serum IL-4 concentrations were decreased at T 1-4, and IFN-γ /IL-4 ratio was increased in group D ( P<0.05). Compared with group L, the serum IFN-γ concentrations were significantly increased at T 3, 4, the serum IL-4 concentrations were decreased at T 1-4, IFN-γ/IL-4 ratio was increased, the consumption of propofol was increased, and the extubation time was prolonged in group D ( P<0.05), and no significant change was found in the time to eye opening between the two groups ( P>0.05). Conclusion:Deep anesthesia can improve CD4 + T cell function in the patients undergoing radical resection for malignant tumor.

Effect and potential signaling pathway of hedgehog protein on the function of human retinal microvascular endothelial cell / 中华实验眼科杂志

Objective@#To explore the impact of Hedgehog protein on human retinal microvascular endothelial cell(HRMEC)and its signaling pathway.@*Methods@#The cultured HRMECs were divided into normal control group, 0.5 μmol/L agonist group and 1.0 μmol/L agonist group, and were cultured in medium with final concentration of 0, 0.5 and 1.0 μmol/L Hedgehog agonist, respectively; HRMECs cultured in high glucose medium were divided into high glucose control group, 1.5 μmol/L inhibitor group and 2.5 μmol/L inhibitor group.Erismodegib, the Smoothed inhibitor with final concentration of 0, 1.5 and 2.5 μmol/L was added into corresponding group, respectively.MTS method and Transwell cell migration method were used to detect the proliferation(A490 value)and relative mobility of HRMEC.The phosphorylation of PLCγ1, Akt and Erk proteins were detected by Western blot.@*Results@#The relative expression of Hedgehog protein in the high glucose control group was 6.24±0.11, which was significantly higher than 1.00±0.00 in the normal control group(t=667.573, P<0.001). The A490 value was 1.349±0.050 and 1.422±0.053, and the relative mobility rate was 2.34±0.14 and 3.59±0.32 in the0.5 μmol/L agonist group and the 1.0 μmol/L agonist group, respectively, which were significantly higher than 1.203±0.101 and 1.00±0.00 in the normal control group(all at P<0.01). The A490 value was 0.849±0.010 and 0.737±0.030, and the relative mobility rate was 0.43±0.02 and 0.27 ±0.01 in the 1.5 μmol/L inhibitor group and the 2.5 μmol/L inhibitor group, respectively, which were significantly lower than 1.000±0.040 and 1.00±0.00 in the high glucose control group(all at P<0.01). The phosphorylation ratios of PLCγ1, Akt and Erk in the 0.5 μmol/L agonist group and the 1.0 μmol/L agonist group were significantly higher than those in the normal control group(all at P<0.01). The phosphorylation ratios of PLCγ1, Akt and Erk in the 1.5 μmol/L inhibitor group and the 2.5 μmol/L inhibitor group were significantly lower than those in the high glucose control group(all at P<0.01).@*Conclusions@#High glucose induces the expression of Hedgehog protein in HRMEC.Hedgehog protein may regulate the function of HRMEC by regulating the phosphorylation of PLCγ1, Akt and Erk in G Protein-coupled receptors pathway.

Effect and potential signaling pathway of hedgehog protein on the function of human retinal microvascular endothelial cell / 中华实验眼科杂志

Objective To explore the impact of Hedgehog protein on human retinal microvascular endothelial cell(HRMEC) and its signaling pathway. Methods The cultured HRMECs were divided into normal control group,0. 5μmol/L agonist group and 1. 0μmol/L agonist group,and were cultured in medium with final concentration of 0,0. 5 and 1. 0μmol/L Hedgehog agonist,respectively;HRMECs cultured in high glucose medium were divided into high glucose control group,1. 5μmol/L inhibitor group and 2. 5μmol/L inhibitor group. Erismodegib,the Smoothed inhibitor with final concentration of 0,1. 5 and 2. 5 μmol/L was added into corresponding group,respectively. MTS method and Transwell cell migration method were used to detect the proliferation( A490 value) and relative mobility of HRMEC. The phosphorylation of PLCγ1, Akt and Erk proteins were detected by Western blot. Results The relative expression of Hedgehog protein in the high glucose control group was 6. 24±0. 11,which was significantly higher than 1. 00±0. 00 in the normal control group(t=667. 573,P<0. 001). The A490 value was 1. 349±0. 050 and 1. 422±0. 053,and the relative mobility rate was 2. 34±0. 14 and 3. 59±0. 32 in the 0. 5μmol/L agonist group and the 1. 0μmol/L agonist group, respectively, which were significantly higher than 1. 203 ± 0. 101 and 1. 00 ± 0. 00 in the normal control group(all at P<0. 01). The A490 value was 0. 849±0. 010 and 0. 737±0. 030,and the relative mobility rate was 0. 43 ± 0. 02 and 0. 27 ± 0. 01 in the 1. 5 μmol/L inhibitor group and the 2. 5 μmol/L inhibitor group, respectively,which were significantly lower than 1. 000±0. 040 and 1. 00±0. 00 in the high glucose control group(all at P<0. 01). The phosphorylation ratios of PLCγ1,Akt and Erk in the 0. 5μmol/L agonist group and the 1. 0μmol/L agonist group were significantly higher than those in the normal control group ( all at P<0. 01 ) . The phosphorylation ratios of PLCγ1,Akt and Erk in the 1. 5μmol/L inhibitor group and the 2. 5μmol/L inhibitor group were significantly lower than those in the high glucose control group ( all at P<0. 01 ) . Conclusions High glucose induces the expression of Hedgehog protein in HRMEC. Hedgehog protein may regulate the function of HRMEC by regulating the phosphorylation of PLCγ1,Akt and Erk in G Protein-coupled receptors pathway.

Investigation of diagnostic method and treatment on acute appendicitis with acute intestinal obstruction as presenting manifestation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>Prevention of the misdiagnosis of acute appendicitis when it first manifested as acute intestinal obstruction, and to search proper way of diagnosis and treatment for such event to provide the reference.</p><p><b>METHODS</b>Clinical data of 33 acute appendicitis cases presented with acute intestinal obstruction in Beijing Tong Ren Hospital during January 2000 and December 2015 were analyzed retrospectively.</p><p><b>RESULTS</b>All 33 patients were admitted to the Emergency Department with symptoms of various degrees abdominal pain and abdominal distension. There was no passage of gas and feces. The mean time of onset was (62.2±25.0) hours. The imaging examination showedthat all patients had complete bowel obstruction. Twenty one patients(63.6%) had peritonitis, three of whom developed with septic shock. Abdominal CT was performed in 17 patients preoperatively, which showed retention of gas and fluid in the small intestine in all the patients and 13 were suggestive of acute appendicitis. All of these patients received surgical treatment, 12 patients underwent laparoscopic exploration, and the remaining 21 patients received exploratory laparotomy during which acute appendicitis was confirmed to be the cause of intestinal obstruction, of whom 14(42.4%) was identified as mechanical intestinal obstruction. Nine patients underwent appendectomy and lysis of adhesion, five appendectomy and partial excision of the greateromentum. Nineteenpatients(57.6%) were identified as paralytic ileus and underwent appendectomy only. Twelve patients required respiratory and circulatory support and were admitted to ICU postoperatively. The mean duration time in ICU was(8.8±5.2) days. Postoperative pathology showedgangrene accompanied with perforation in the appendix. All patients were discharged without any complication. The length of hospital stay was (15.4±4.6) days. All patients were followed up for 3 ~ 12 months. One patient with chronic obstructive pulmonary disease developed repeated pulmonary infection and died of respiratory failure at 185 days postoperatively. The remaining patients were followed up and there were no patients developed intra-abdominalsepsis, intestinal obstruction, surgery-related complications, or death.</p><p><b>CONCLUSION</b>Patients with acute appendicitis presenting with acute intestinal obstruction are mostly in severe condition. Clinical diagnosis for this patients is difficult and surgery should be performed as soon as possible.</p>

Influences of Dictionary of Occupation on the Career Development of Medical Representatives in China / 中国药师

Objective:To analyze the profound influence of the Dictionary of Occupation on the career development of medical rep-resentatives in our country. Methods:The relationship of the Dictionary of Occupation and the career development of medical represent-atives was discussed, and then the influence of including the dictionary on medical representatives was analyzed. Results and Conclu-sion:The Dictionary of Occupation puts forward higher requests to the code of conduct, professional ability and professional ethics of medical representatives, which plays important roles in the career development of medical representatives. And as a professional stand-ard with clear definition and description, the Dictionary of Occupation also leads to the direction of sustainable and healthy development of medical representatives.

Role of the small intestinal decompression tube and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).</p><p><b>METHODS</b>Twelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012. Initially, nasogastric tube decompression and other conventional conservative treatment were administrated. After 14 days, obstruction symptom improvement was not obvious, then the SIDT was used. At the same time, Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy.</p><p><b>RESULTS</b>In 11 patients after this management, obstruction symptoms disappeared, bowel function recovered within 3 weeks, and oral feeding occurred gradually. Another patient did not pass flatus after 4 weeks and was reoperated. After postoperative follow-up of 6 months, no case relapsed with intestinal obstruction.</p><p><b>CONCLUSION</b>For severe and long course of early postoperative inflammatory intestinal obstruction, intestinal decompression tube plus Gastrografin is safe and effective, and can avoid unnecessary reoperation.</p>

Perioperative treatment effects of colorectal cancer in elderly patients / 中华老年医学杂志

Objective To explore the clinical features and perioperative treatment effects of colorectal cancer in elderly patients.Methods Retrospective analysis of clinical data especially focusing on perioperative treatment from 104 elderly patients with coloreetal cancer were performed.Results A total of 99 patients (95.2%) were cured or improved at discharge.Perioperative pulmonary infection occurred in 13 cases (12.5%), of whom 6 cases (5.8%) suffered from respiratory failure.Lower extremity deep venous thrombosis occurred in 3 cases (2.9%), incision infection in 6 cases (5.8%), wound dehiscence in 2 cases (1.9%), intestinal fistula in 1 case (1.0%) and gastroparesis in 1 case (1.0%).About 5 cases (4.8%) died from multiple organ failure.Conclusions Old age is not a contraindication in surgical treatment for colorectal cancer.Paying attention to accurate and timely treatment in perioperative peroid can reduce postoperative complications and improve patients' quality of life.

Discussion on Situation and Future of Traditional Chinese Medical Theory in the Debate of Brain or Heart Governing Mind / 广州中医药大学学报

This article aims at discussing the situation and future of traditional Chinese medical theory. By comparing the differences of the concept and knowledge about mind between traditional Chinese medicine (TCM) and western medicine, the debate about the source and destination of "brain governing mind" and "heart governing mind" were analyzed and the meaning of mind was thoroughly explained. It is concluded that in the theory of TCM mind is the essence of life. To develop the theory of TCM, the eoncept of TCM terminology should be understood thoroughly; it should be neither misused nor applied mechanically. Only having a good and correct beginning, can the development of TCM theory and its guidance in clinic be achieved.

The Effect of Modern Science and Technologies on Human Reproductive Behavior / 中国医学伦理学

With the development of modern medical science and technology,especially modern assisted reproductive technologies,the natural attribute of human reproductive behavior is being increasingly eliminated by its social attribute.The quantity and quality of reproduction have direct influence on the status of social existence and development,thus human have made more and more interfere in human reproductive behavior for social benefits by controlling the demand of childbearing,changing the manner of reproduction,and designing and choosing the result of childbearing.The interference is eliminating the connection of reproduction and sexes,and breaking the original stable social relation based on natural order.While the nature attribute of human reproductive behavior is being eliminated,the urgent problem facing modern people is how to rebuild the stability of social order.