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In this study, CM-5 spectrophotometer and Heracles NEO ultra-fast gas-phase electronic nose were used to analyze the changes in color and odor of vinegar-processed Cyperi Rhizoma(VPCR) pieces. Various analysis methods such as DFA and partial least squares discriminant analysis(PLS-DA) were combined to identify different processing degrees and quantify the end point of processing. The results showed that with the increase in vinegar processing, the brightness parameter L~* of VPCR pieces decreased gradua-lly, while the red-green value a~* and yellow-blue value b~* initially increased and reached their maximum at 8 min of processing, followed by a gradual decrease. A discriminant model based on the color parameters L~*, a~*, and b~* was established(with a discrimination accuracy of 98.5%), which effectively differentiated different degrees of VPCR pieces. Using the electronic nose, 26 odor components were identified from VPCR samples at different degrees of vinegar processing. DFA and PLS-DA models were established for different degrees of VPCR pieces. The results showed that the 8-min processed samples were significantly distinct from other samples. Based on variable importance in projection(VIP) value greater than 1, 10 odor components, including 3-methylfuran, 2-methylbuty-raldehyde, 2-methylpropionic acid, furfural, and α-pinene, were selected as odor markers for differentiating the degrees of vinegar processing in VPCR. By combining the changes in color and the characteristic odor components, the optimal processing time for VPCR was determined to be 8 min. This study provided a scientific basis for the standardization of vinegar processing techniques for VPCR and the improvement of its quality standards and also offered new methods and ideas for the rapid identification and quality control of the end point of processing for other traditional Chinese medicine.

Objectives: Obstructive sleep apnea syndrome (OSAS) is associated with increased risk of postoperative complications, which is possibly related to increased sensitivity to opioid. However, the effect of increased sensitivity to opioids in patients with OSAS remains controversial. This study aims to investigate whether male patients with moderate to severe OSAS have increased sensitivity to opioid remifentanil and its related predictive factors, so as to provide a reference for the rational use of opioids in patients with OSAS., Methods: This study was a prospective study. From December 28, 2021 to October 15, 2022, a total of 61 male patients aged 22 to 60 years old, American Society of Anesthesiologists (ASA) status I and II, who underwent nasopharyngeal surgery under general anesthesia, were selected. According to STOP-BANG questionnaire score and apnea-hypopnea index (AHI), the patients were divided into an OSAS group ( n =39) and a control group ( n =22). The pupil diameter (PD) of the patients was measured by hand-held monocular pupillometer, and the perception threshold (PT) and pain tolerance threshold (PTT) of the patients were measured by somatosensory evoked potential stimulator. The initial PD, PT, and PTT were measured in a quiet environment and recorded as PD0, PT0, and PTT0. Changes in PD, PT, PTT, respiration, and consciousness were recorded after remifentanil infusion. Age, body mass index (BMI), smoking, AHI, minimal oxygen saturation, and percentage of sleep time spent with oxygen saturation <90% (T90) were included as independent variables in multiple linear regression equations to analyze the possible predictors of increased opioid sensitivity in patients with moderate to severe OSAS., Results: There were no significant differences in PD0, PT0 and PTT0 between the OSAS group and the control group (all P >0.05). After remifentanil infusion, there was no significant difference in the rate of PT change between the 2 groups ( P >0.05). The change rate of PTT and PD in the OSAS group was significantly higher than that in the control group ( P <0.05 and P <0.001, respectively), PD in the OSAS group was significantly lower than that in the control group ( P <0.001). During remifentanil infusion, there were no significant differences in the incidence of respiratory depression and the distribution of observer's assessment of alertness/sedation (OAA/S) scores between the 2 groups (both P >0.05), and there were no changes in mental status and airway support in the patients of the 2 groups. Multiple linear regression showed that T90 was positively correlated with miosis rate ( β =0.597, 95% CI 0.269 to 0.924, P <0.05) and the rate of PTT change ( β =0.458, 95% CI 0.116 to 0.800, P <0.05). However, minimal oxygen saturation, age, BMI, smoking, and AHI were not correlated with PD change rate and PTT change rate in the OSAS patients (all P >0.05)., Conclusions: Male patients with moderate to severe OSAS have increased sensitivity to remifentanil, the duration of nocturnal desaturation may be its predictive factor. Male patients with moderate to severe OSAS with a longer duration of nocturnal hypoxia are more sensitive to remifentanil, and the use of opioids in these patients should be more cautious in clinical.

The chemical components of Huanglian Decoction were identified by ultra-performance liquid chromatography-quadrupole-time-of-flight-tandem mass spectrometry(UPLC-Q-TOF-MS/MS) technology. The gradient elution was conducted in Agilent ZORBAX Extend-C&#95;(18) column(2.1 mm×100 mm, 1.8 μm) with the mobile phase of 0.1% formic acid aqueous solution(A)-acetonitrile(B) at a flow rate of 0.3 mL·min~(-1) and the column temperature of 35 ℃. The MS adopted the positive and negative ion mode of electrospray ionization(ESI), and the MS data were collected under the scanning range of m/z 100-1 500. Through high-resolution MS data analysis, combined with literature comparison and confirmation of reference substances, this paper identified 134 chemical components in Huanglian Decoction, including 12 alkaloids, 23 flavonoids, 22 terpenes and saponins, 12 phenols, 7 coumarins, 12 amino acids, 23 organic acids, and 23 other compounds, and the medicinal sources of the compounds were ascribed. Based on the previous studies, 7 components were selected as the index components. Combined with the network pharmacology research and analysis me-thods, the protein and protein interaction(PPI) network information of the intersection targets was obtained through the STRING 11.0 database, and 20 core targets of efficacy were screened out. In this study, UPLC-Q-TOF-MS/MS technology was successfully used to comprehensively analyze and identify the chemical components of Huanglian Decoction, and the core targets of its efficacy were discussed in combination with network pharmacology, which laid the foundation for clarifying the material basis and quality control of Huanglian Decoction.

This study analyzed the main chemical components of Zhuru Decoction via ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS), and then predicted the mechanism of Zhuru Decoction in clearing heat, resolving phlegm, detoxifying, and treating vomiting and alcohol-related vomiting caused by heat in stomach based on network pharmacology. The gradient elution was conducted in Agilent ZORBAX extend-C&#95;(18) column(2.1 mm×100 mm, 1.8 μm) with the mobile phase of 0.1% formic acid aqueous solution(A)-acetonitrile(B) at a flow rate of 0.3 mL·min~(-1) and the column temperature of 35 ℃. The MS adopted the positive and negative ion mode of electrospray ionization(ESI), and the data were collected in the scanning range of m/z 100-1 500. A total of 98 compounds in Zhuru Decoction were identified via BATMAN, SYMMAP, TCMSP, and relevant literature, including 36 flavonoids, 7 triterpenoids, 8 gingerols, 20 organic acids, 5 amino acids, and 22 other compounds. On the basis of the available studies, 9 components were selected as index components, and the protein-protein interaction(PPI) network of the common targets was established with STRING 11.0. Finally, 10 core targets associated with the pharmacodynamic effect were screened out. This study established the UPLC-Q-TOF-MS/MS method for identifying the chemical components in the classic prescription Zhuru Decoction, and employed network pharmacology to explore the core targets of its efficacy, which provided a refe-rence for the quality control and the research of the pharmacodynamic substances of Zhuru Decoction.

Objectives: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a chronic disease characterized by repeated episodes of apnea or hypopnea, accompanied by intermittent awakening and sleep disturbances. The incidence of OSAHS is increasing and has become a serious disease. In recent years, more and more evidence shows that OSAHS is closely related to postoperative neurocognitive disorders, and the preparation of models of postoperative cognitive impairment in intermittent hypoxia animals is an important way to study its pathogenesis and intervention targets. This study aims to explore the establishment and evaluation of the animal model of postoperative cognitive impairment in intermittent hypoxia rats., Methods: A total of 108 male SD rats were randomly divided into 8 groups: a control group (C group, n =27), a surgery group (S group, n =27), an intermittent hypoxia 7 d group (H1 group, n =9), an intermittent hypoxia 14 d group (H2 group, n =9), an intermittent hypoxia 21 d group (H3 group, n =9), an intermittent hypoxia 7 d operation group (O1 group, n =9), an intermittent hypoxia 14 d operation group (O2 group, n =9), and an intermittent hypoxia 21 d operation group (O3 group, n =9). The rats in the H1, H2 and H3 group treated with intermittent hypoxia for 7, 14, and 21 d, respectively. The rats in the O1, O2 and O3 groups received left lateral hepatic lobectomy after 7, 14, and 21 d intermittent hypoxia, respectively. The rats in each group were subjected to open field test, new object recognition test, and Barnes Maze test. The expression of IL-1β mRNA in hippocampus of rats was detected at the 1st day after the surgery., Results: Compared with the C, S, and H2 groups, the discrimination index in novel object recognition test 6 h and 1 d after the surgery of the O2 group was significantly lower ( P <0.05), the latency and errors in Barnes maze at the 1st day and 2nd day after the surgery were increased significantly ( P <0.05) and the expression of IL-1β mRNA in hippocampus was significantly increased at the 1st day after the operation ( P <0.05). However, there was no difference in the preference index in NORT 6 h and 1 d after the surgery, the latency and errors in Barnes maze and the expression of IL-1β mRNA in hippocampus between the O1 group and the H1 group, the H3 group and the O3 group (all P >0.05)., Conclusions: The rate with intermittent hypoxia 14 d pretreatment with anesthesia and laparotomy could be established the animal model of postoperative cognitive impairment.

Purpose: The aim of this study was to investigate the molecular mechanism of autophagy and apoptosis induced by cyclic mechanical stretch and the potential role of autophagy in stretch-induced apoptosis of myoblasts., Methods: Loading model of L6 myoblasts was established in vitro. The cells were then subjected to cyclic mechanical stretch involving 3 s of 15% stretch alternating with 3 s of relaxation. The cells were collected after mechanical stretch for 6 h, 12 h and 24 h, respectively. Control cells were cultured on the same plates without mechanical strain. Apoptosis of myoblasts was assessed by Hoechst 33258 staining and Annexin V binding and propidium iodide staining. Autophagy was determined by MDC staining and transmission electron microscopy(TEM). The level of proteins associated with apoptosis and autophagy was detected by Western blot. The data were analyzed with SPSS 17.0 software package., Results: The results of Hoechst 33258 staining and Annexin V binding and propidium iodide staining indicated that mechanical stretch notably induced apoptosis of myoblasts. Caspase inhibitor z-VAD-fmk effectively abrogated apoptosis of myoblasts, indicating mechanical stretch induced caspase-dependent apoptosis. In addition, the results of TEM, MDC staining and Western blot proved that mechanical stretch elicited autophagy of myoblasts. Inhibition of autophagy using 3-MA enhanced caspase-dependent apoptosis induced by mechanical stretch., Conclusions: Cyclic mechanical stretch induced apoptosis and autophagy of myoblasts time-dependently. Protective autophagy, acting as the compensatory mechanism, inhibited caspase-dependent apoptosis induced by mechanical stretch.

Purpose: This study was aimed to figure out the way that cyclic-stretch influenced the apoptosis of myoblasts and evaluate the importance of PERK and its possible mechanism involved., Methods: L6 rat myoblasts were cultured in vitro and mechanical stimulation model was constructed successfully. The myoblasts were imposed tension for 0, 2, 6, 12 and 24 hours respectively by multi-channel cell stress loading system. The force value was 15% cell deformation and the frequency was 10 cycles/min. Each cycle was consisted of stretch for 3 seconds and relaxation for 3 seconds, and the group without tension was used as the control group. The apoptotic myoblasts were dyed by DAPI and observed through fluorescence microscopy to detect the apoptosis rate; the mRNA levels of PERK and CHOP in different groups were detected by real-time PCR and protein levels of PERK and p-PERK in different groups were detected by Western blot. PERK inhibitor was used to clear the role of PERK in apoptosis induced by cyclic-stretch and clarify the relationship between the endoplasmic reticulum stress and apoptosis induced by cyclic-stretch. SPSS 17.0 software package was used to analyze the data statistically., Results: DAPI nuclear stain showed that cyclical tensile stress can induce apoptosis in vitro cultured myoblast. Apoptosis rate showed a trend of rising gradually over time, peaked at 24 h. After dealt with the inhibitor of PERK, the apoptosis rate of the 24 h group under the cyclic stretch showed no difference compared with the control. The results of real- time PCR showed that the mRNA of CHOP was increased with the extension loading time, while the mRNA of PERK showed no difference compared with the control. Western blot results showed that the protein level of p-PERK was increased with the extension of loading time, while the expression of PERK showed no difference compared with the control group. When PERK inhibitor added, the mRNA level of CHOP along with the protein expression level of p-PERK showed no significant difference compared to the control., Conclusions: PERK signaling pathway is involved in the apoptosis of myoblasts induced by cyclic stretch, and the possible mechanism may be closely related to the phosphorylation of PERK.

This paper aimed to study the six chemical components of Polygoni Multiflori Radix (gallic acid, quercetin, luteolin, kaempferol, resveratrol, apigenin). By the established pregnane X receptor (human pregnant X receptor, PXR) CYP3A4 mediated drug induced rapid screening technique, the effect of chemical components on the cell activity was detected by MTS cell method, and the value of IC₅₀ was calculated. The dual luciferase reporter system was used to co-transfect PXR reporter gene expression vector containing transcriptional regulation and CYP3A4 with HepG2 cells, with 10 μmol·L⁻¹ rifampicin (RIF) as a positive control, and 10 μmol·L⁻¹ of ketoconazole (TKZ) as negative control. Gallic acid, quercetin, luteolin, kaempferol, apigenin, resveratrol(5, 10, 20 μmol·L⁻¹) were used to incubate for 24 h, and the luciferase activity was detected. The results showed that when plasmid pcDNA3.1 was co-transfected with pGL4.17-CYP3A4, gallic acid and resveratrol had an inhibitory effect on the regulation of CYP3A4, and quercetin, luteolin, kaempferol had an inductive effect on CYP3A4; when pcDNA3.14-PXR was co-transfected with pGL4.17-CYP3A4, quercetin, luteolin, kaempferol, apigenin, resveratrol had an inductive effect. To sum up, the 6 reported liver injury components had inhibitory or activating effects on CYP3A4. After PXR plasmid was involved, 5 components had an inductive effect on CYP3A4, and the inductive effects of 2 components were significantly different. In this experiment, we found that 2 kinds of potential liver injury components in Polygoni Multiflori Radix had been induced by CYP3A4, which was achieved through PXR regulation. It suggested that attention shall be paid to potential drug interactions when combined with Polygoni Multiflori Radix, so as to improve the safety and efficacy., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

The rapid screening technology was used to investigate the transcriptional regulation effect of main chemical constituents in tubers of Polygonum multiflorum, including 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucopyranoside(THSG) and anthraquinones (such as rhein, chrysophanol, aloe-emodin, emodin) on CYP3A4 drug inducers induced by human pregnancy X receptor (PXR).The effect of chemical composition on the cell activity was detected by MTS cell viability assay. IC₅₀ was calculated. The expression vector and the reporter vector were co-transfected into HepG2 cells, with 10 μmol•L⁻¹ rifampicin (RIF) as a positive control, and 10 μmol•L⁻¹ ketoconazole (TKZ) as a negative control. After treated with different concentrations of anthraquinones (2.5, 5, 10 μmol•L⁻¹) for 24 h, the cells were tested for dual luciferase activity. The results show that the inhibitory effect of THSG, chrysophanol, emodin, rhein and aloe-emodin on CYP3A4 was inhibited by co-transfection of pcDNA3.1 and pGL4.17-CYP3A4. The expressions of pcDNA3.14-PXR and pGL4.17-CYP3A4 were induced by the four compounds. Besides, emodin had a direct inducing effect. In conclusion, the four anthraquinone compounds have an inducing effect on CYP3A4 by PXR, but emodin can directly induce CYP3A4. THSG can inhibit CYP3A4, but plasmid can induce CYP3A4 after intervened with PXR.These results suggest that we should pay attention to the liver function and avoid liver damage in the combined administration of drugs., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To investigate the effect of clinical dose of Realgar-Indigo Naturais formula (RIF) and large-dose of Realgar on main drug-metabolizing enzymes CYP450s of rat liver, as well as its regulatory effect on mRNA expression. Wistar rats were administrated orally with tested drugs for 14 days. A Cocktail method combined with HPLC-MS/MS was used in the determination of 4 cytochrome P450 isozymes (CYP1A2, CYP2B, CYP3A and CYP2C) in liver of the rats, and the mRNA expression levels of the above subtypes were detected by real-time fluorescent quantitative PCR. The results showed that RIF can significantly induce CYP1A2 and CYP2B enzyme activity, and inhibit CYP3A enzyme activity. This result was consistent with the mRNA expression. However, its single compound showed weaker or even contrary phenomenon. Different doses of Realgar also showed significant inconsistencies on CYP450 enzymes activity and mRNA expression. These phenomena may be relevant with RIF compatibility synergies or toxicity reduction. The results can also prompt drug interactions when RIF is combined with other medicines in application., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To study the effect and mechanism of the light quality acting on Ganoderma lucidum, and provide a theoretical basis for G. lucidum mycelium cultivation, we focused on growth and endogenous IAA metabolism of G. lucidum mycelium under different light-emitting diode (LED) condition. The growth index, endogenous levels of IAA and Enzymes related to IAA metabolism and Polysaccharides content were investigated in different growth periods. Results showed that blue light irradiation was the best from the viewpoint of steady growth and polysaccharides accumulation, red light irradiation improved endogenous IAA level and promoted growth of mycelium in early stage of cultivation, green light irradiation decreased growth rate and fresh weight of mycelium, but increased drying rate. Enzymes related to IAA metabolism also significantly influenced by light quality. The activity of indole acetic acid oxidase (IAAO), peroxidase (POD) and tryptophan synthetase with blue light irradiation were showed high level in early time, but decreased later, and the IAA content was consistently at lower level than that in other treatments, while mycelium irradiated with yellow light showed the highest activity of both IAAO and tryptophan synthetase, and medium level of IAA content. In conclusion, the light quality affects growth and regulation of the level of endogenous IAA of G. lucidum mycelium.

Objective: To investigate the relationship between phenomenon of aggregation on multiple metabolic abnormalities and their family history., Methods: A random cluster sampling was carried out to study the phenomenon of multiple metabolic abnormalities among the adult inhabitants in a county of Henan province. Questionnaire, physical examination and biochemical tests were admitted. Multiple correspondence analyses were used to explore the aggregation of multiple metabolic abnormalities among objects including hyperlipidemia, diabetes, coronary heart disease etc. Corresponding relationships between objects and their parents on multiple metabolic abnormalities were also analyzed., Results: In total, 3901 people were investigated including 1428 (36.6%) males and 2473 (63.4%) females. The mean age of them was 32.8±6.3. Data showed that the Cronbach's α were 0.547 and 0.387 while Eigen values were 1.971 and 1.535 in two dimensions, regarding the correspondence analysis on their parents' multiple metabolic abnormalities. Cronbach's α levels were 0.598 and 0.457 together with Eigen values as 2.263 and 1.743 in two dimensions on the correspondence analysis of the objects' and their parents' multiple metabolic abnormalities. Results from Multiple correspondence analysis diagrams showed that there was an aggregation of variety metabolic abnormalities in both objects and their parents but not between objects and their parents or between fathers and mothers, though χ2 test showed a weak correlation between some of the categories. The ranges of contingency coefficients between metabolic abnormalities were 0.04 to 0.11, 0.04 to 0.08 and 0.04 to 0.11 between parents, objects and fathers, objects and mothers, respectively. When compared with simple obesity, the central obesity aggregated appeared more obviously with other metabolic abnormalities., Conclusion: Both objects and their parents showed an aggregation of variety metabolic abnormalities. Aggregation of central obesity showed more obvious on other metabolic abnormalities than the simple obesity. Family histories of metabolic abnormalities played a moderate role in the generations suffering from multiple metabolic abnormalities.

Objective: To study the relationship of the incidence of bronchial dysplasia (bronchial anomalous origin and bronchial stenosis) with congenital heart disease., Methods: A total of 185 children with congenital heart disease or bronchial dysplasia were enrolled. Bronchial dysplasia was identified by the 64-MSCT conventional scanning or thin slice scanning with three-dimensional reconstruction., Results: Forty-five children (25.3%) had coexisting bronchial dysplasia and congenital heart disease. The incidence rate of bronchial dysplasia in children with congenital heart disease associated with ventricular septal defect was higher than in those without ventricular septal defect (33.7% vs 15.0%; P<0.05). There were no significant differences in the incidence rate of bronchial dysplasia between the children with congenital heart disease who had a large vascular malformation and who did not., Conclusions: Bronchial dysplasia often occurs in children with congenital heart disease. It is necessary to perform a tracheobronchial CT scanning with three-dimensional reconstruction to identify tracheobronchial dysplasia in children with congenital heart disease, especially associated with ventricular septal defect.

Objective: To investigate the frequencies of leukotriene gene single nucleotide polymorphisms (SNPs) in the asthmatic subjects of Han population in Wenzhou district, and the association between SNPs and response to montelukast treatment., Methods: Sequenom matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) was used to genotype six polymorphisms in 60 asthmatic patients and 61 controls. According to the SNPs results, 11 cases with the LTC(4)S (rs730012) CC + AC genotype and 11subjects with the AA genotype were given montelukast treatment, and evaluated by the response of pulmonary function and urinary leukotriene E(4)., Results: The frequencies of mutant SNPs in ALOX(5) (rs2115819, rs4986832, rs4987105), LTA(4)H (rs2660845), ALOX(5)AP (rs10507391) and LTC(4)S (rs730012) were less than 50%. There were no statistical differences of the haplotype distribution (P values were 0.914, 0.609, 0.609, 0.315, 0.752 and 0.636 respectively). No statistical differences of the mutant allele frequencies were observed in the genes ALOX(5) (rs2115819, rs4986832, rs4987105) and LTA(4)H (rs2660845) (OR values were 1.112, 0.964, 0.964 and 0.673 respectively, all P > 0.05). The invalid value (OR = 1.0) was included in the 95%CI of odds ratios. There were no differences of genotype distribution in the above loci (χ(2) values were 0.792, 2.684, 2.683 and 2.524 respectively, all P > 0.05). There was a statistical difference in the ALOX(5)AP (rs10507391) mutant allele between the 2 groups, and the frequency of mutant allele A in the asthma group was 23.3% (OR = 2.016, 95%CI = 1.027 - 3.959, P < 0.05). There was a statistical difference in the LTC(4)S (rs730012) mutant allele between the 2 groups, and the frequency of the mutant allele C in the asthma group was 25.0% (OR = 1.926, 95%CI = 1.007 - 3.685, P < 0.05). Compared with the AA genotype, the LTC(4)S (rs730012) CC + AC genotype showed a significant improvement of FEV(1) (t = 6.185, P < 0.01) and urinary LTE(4) level (t = 2.925, P < 0.05) after receiving montelukast treatment., Conclusions: These results suggest that the SNPs of ALOX(5)AP (rs10507391) and LTC(4)S (rs730012) are associated with asthma in our patients. The LTC(4)S (rs730012) locus genetic polymorphism contributes to improvement in montelukast response.

Objective: To explore the effect of triptolide on airway remodeling and the expression of nuclear factor-kappaB, Bcl-2 in asthmatic rats., Methods: 40 rats were randomly divided into 5 groups (n = 8): (1) Control group; (2) Asthmatic 4 week group; (3) Asthmatic 6 week group; (4) Therapeutic 4 week group; (5) Therapeutic 6 week group. The airway resistance and eosinophilic inflammation of airway wall were observed. The airway wall thickness (WA/Pi), the bronchial smooth muscle thickness (smooth muscle area/Pi) and the number of bronchial smooth muscle nucleus (N/Pi) were measured by image analysis system. The expression of PCNA, nuclear factor-kappaB and Bcl-2 protein were determined by immunohistochemical staining and Western blot. The expression of Bcl-2 mRNA was determined by reverse transcription-polymerase chain reaction(RT-PCR)., Results: (1) The expression of NF-kappaB protein in asthmatic 4 week group and asthmatic 6 week group was significantly higher than that in control group, respectively (P < 0.01). The above-mentioned parameters of therapeutic 6 week group were significantly lower than those of asthmatic 4 week group, asthmatic 6 week group and therapeutic 4 week group, respectively (P < 0.01, P < 0.01 P < 0.05). (2) The expression of Bcl-2 protein and mRNA of asthmatic 4 week group and asthmatic 6 week group were significantly higher than those in control group respectively (P < 0.01). The expression of Bcl-2 protein of therapeutic 6 week group was significantly lower than those of asthmatic 4 week group, asthmatic 6 week group and therapeutic 4 week group respectively (P < 0.05, P < 0.01, P < 0.01), but the expression of Bcl-2 mRNA was significantly higher than the above-mentioned groups respectively (P < 0.01), the expression of Bcl-2 protein and mRNA of therapeutic 6 week group were higher than control group respectively (P < 0.05, P < 0.01). (3) The expression of PCNA protein of asthmatic 4 week group and asthmatic 6 week group were significantly higher than those of control group respectively (P < 0.01). (4) The WA/ Pi, the smooth muscle area/Pi and the N/Pi of asthmatic 4 week group and asthmatic 6 week group were significantly higher than those of control group, respectively (P < 0.01). The above-mentioned parameters of therapeutic 6 week group were significantly lower than those of asthmatic 4 week group, asthmatic 6 week group and therapeutic 4 week group, respectively (P < 0.01). (5) The airway resistance of asthmatic 4 week group and asthmatic 6 week group were significantly higher than those of the control group, respectively (P < 0.01). The above-mentioned parameters of therapeutic 6 week group were significantly lower than those of asthmatic 4 week group, asthmatic 6 week group and therapeutic 4 week group, respectively (P < 0.01, P < 0.01, P < 0.05)., Conclusion: The proliferation of airway smooth muscle(ASM) is related with apoptosis of airway smooth muscle cells in asthma. NF-kappaB may be involved in the process. Triptolide may prevent apoptosis of ASMCs and decrease the proliferation of ASM by inhibiting the expression of NF-kappaB, Bcl-2.

Background and Objective: CT-guided microwave coagulation is a minimally invasive surgery for patients with liver cancer. Total intravenous anesthesia with propofol and fentanyl is commonly used. The depth of anesthesia during microwave coagulation for liver cancer is still monitored by clinical signs. There are few subjective and effective indicators. This study explored the application of Narcotrend-assisted "depth of anesthesia" monitoring on microwave coagulation for patients with liver cancer during total intravenous anesthesia with propofol and fentanyl., Methods: Forty liver cancer patients underwent CT-guided microwave coagulation were randomly assigned to receive Narcotrend index monitoring or standard clinical monitoring for depth of anesthesia with 20 patients in each group. All patients received total intravenous anesthesia with propofol and fentanyl. The depth of anesthesia for patients in the Narcotrend group was measured according to a Narcotrend index, which was maintained between D2 and E0. The depth of anesthesia for those in the standard clinical practice group was measured according to heart rate, mean arterial pressure, and patient movement. Changes of hemodynamics, the duration of the emergence from anesthesia, and the recovery of orientation were recorded. The doses of propofol and fentanyl, postoperative visual analogue scores (VAS), and the incidence of postoperative nausea and vomiting were also recorded., Results: There was no significant alteration in heart rate or mean arterial pressure between the two groups. Compared with other anesthetic stages, both heart rate and mean arterial pressure decreased during the induction of the anesthesia in the two groups(P<0.05). The doses of propofol were higher in the standard clinical practice group than in the Narcotrend group [(460+/-30) mg vs. (380+/-35) mg, P<0.01]. The duration of emergence and orientation were longer in the standard clinical practice group than in the Narcotrend group [(9.5+/-2.9) min vs. (4.9+/-2.2) min, P<0.01; (12.2+/-3.5) min vs. (6.6+/-3.2) min, P<0.01, respectively]. There was no difference in the dosage of fentanyl, VAS, or the incidence of postoperative nausea or vomiting between the two groups (P>0.05)., Conclusion: For patients with liver cancer, monitoring the depth of anesthesia with Narcotrend on microwave coagulation can contribute to lower dosage of propofol and shorten duration of recovery during total intravenous anesthesia with propofol and fentanyl.

Objective: To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension., Methods: Multi-stage random sampling technique was used to choose 15,540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software., Results: The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI> or =28 kg/m2) were 4.50 (95% CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95% CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference > or =85 cm in male or 80 cm in female) were 2.62 (95% CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (ORs) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33), 2.08 (95% CI: 1.84-2.35), 1.85 (95% CI: 1.60-2.14), 1.58 (95% CI: 1.38-1.81), 1.49 (95% CI: 1.32-1.69) and 1.15 (95% CI: 1.05-1.27), respectively., Conclusion: The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.

Background & Objective: Tumor-induced acute airway stenosis is a medical emergency. Metal airway stent implantation can relieve dyspnea of patients suffering from this symptom and provide time for their further treatment. This study was to investigate the clinical application, efficacy, and complication management of tracheal stent implantation for the treatment of tumor-induced acute airway stenosis., Methods: Nickel-titanium (Ni-Ti) alloy stent implantation was performed under the guidance of fiber-optic bronchoscopy in 52 patients with tumor-induced acute airway stenosis., Results: Stent implantation was successful in all 52 patients. Dyspnea in all patients was significantly relieved. Values of arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and Karnofsky performance status (KPS) changed from (7.74+/-0.99) kPa, (5.37+/-0.39) kPa, and (68.85+/-8.08) preoperatively to (11.12+/-0.61) kPa, (4.58+/-0.30) kPa, and (84.62+/-5.03) postoperatively (P<0.01). The three-year survival rate was higher in lymphoma group than in lung cancer or esophageal cancer group. Postoperative complications were properly managed in all cases after symptomatic treatments., Conclusions: Tracheal stent implantation is an effective palliative treatment for acute dyspnea caused by local tumor compression or tumor invasion of large airways. It can rescue patients at risk for airway obstruction, improve the quality of life in terminal cancer patients, and provide further treatment opportunities for them.

Background & Objective: Percutaneous radiofrequency ablation (PRFA) is a new and effective microinvasive operation for small hepatocellular carcinoma, but the effect of local anesthesia or single analgesic injection as regular anesthesia is unsatisfied. This study was to evaluate the efficacy and safety of continuous intravenous infusion of remifentanyl combined with propofol as total intravenous anesthesia during PRFA., Methods: Sixty patients scheduled for PRFA were randomized into remifentanyl group (R) and fentanyl group (F). Each group contained 30 patients. Group R received remifentanyl infusion at the dose of 0.1 microg x kg(-1) x min(-1) by micro pump; group F received bolus intravenous injection of fentanyl at 1.5 microg x kg(-1) before operation. Anesthesia was maintained with propofol. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SPO2), respiration rate (RR), partial pressure of carbon dioxide in artery (PaCO2) and recovery time were measured and recorded by monitor. The limb movement, apnea, body movements, and chest wall rigidity were recorded during operation., Results: The recovery time of group R was significantly shorter than that of group F [(5.0+/-1.8) min vs. (10.7+/-3.0) min, P<0.001]; the total consumption of propofol was less in group R than in group F [(172.0+/-37.3) mg vs. (330.3+/-61.2) mg, P<0.001]. Group R had less cases with limb movement (5 cases vs. 12 cases) but more cases with apnea (12 cases vs. 6 patients) as compared with group F., Conclusions: Total intravenous anesthesia with remifentanyl and propofol for PRFA is safe and reliable. Respiratory depression should be monitored instantly and strictly.

Background & Objective: The elderly esophageal cancer patients undergoing esophagectomy are increasing now. How to protect their cardiac functions and reduce perioperative mortality and morbidity of cardiac events is an urgent problem to be solved. Prophylactic beta-blockers have been recently applied during surgery. This study was to evaluate the beneficial effects of metoprolol on perioperative cardiac function of elderly esophageal cancer patients., Methods: The esophageal cancer patients, no less than 65 years old, scheduled for elective esophagectomy were enrolled, and randomized into metoprolol group and control group. The patients of metoprolol group received metoprolol to control heart rate from anesthesia induction to 72 h after operation. Perioperative hemodynamic data were recorded at time points of baseline, drug administration, 2 min after induction, intubation, 4 min after intubation, incision, thoracic exposure, 60 min after incision, 10 min before the completion of operation, the completion of operation, extubation, and 15 min after extubation. The serum level of cardiac troponin T (cTnT), the occurrence of perioperative cardiac events and postoperative sinus tachycardia were also recorded., Results: Compared with preoperative values, systolic arterial pressure was significantly higher at intubation (P<0.05), heart rate was significantly faster at intubation and extubation (P<0.05) in control group; while the hemodynamic data had no obvious changes in metoprolol group (P>0.05). The serum level of cTnT was elevated in 3 patients of control group within 3 days after operation, and remained normal in all patients of metoprolol group (P=0.237); cardiac events occurred in 6 patients of control group (including 2 cases of myocardial ischemia and 4 cases of atrial fibrillation), but didn't occur in metoprolol group (P=0.024). No myocardial infarction and death occurred in the 2 groups during operation. The occurrence rate of tachycardia was significantly higher in control group than in metoprolol group (15 cases vs. 6 cases, P<0.05)., Conclusion: Metoprolol can reduce the occurrence of perioperative cardiac events and postoperative tachycardia in the elderly esophageal cancer patients undergoing esophagectomy, and restrain the effects of tracheal intubation or extubation on heart rate and blood pressure.

Objective: To investigate the secular trend of infection rate, risk factor exposure rates for nosocomial pneumonia (NP), and to evaluate the nosocomial infection surveillance and control programs efficacy in an university hospital from 1993 to 2000., Methods: All 126 665 hospitalized patients from 1993 to 2000 were studied for NP. The independent risk factors for NP were analyzed by using case-control study method and logistic regression technique. The time-specific rates for NP and risk factor exposure were calculated annually., Results: The infection rates for NP were decreased by 50% from 1.20% in 1993 to 0.60% in 2000. The logistic regression analysis showed that the independent risk factors for NP were immunosuppressive therapy (OR = 2.72), chemotherapy (OR = 2.17), cancer (OR = 1.45), chronic obstructive pulmonary disease (COPD, OR = 1.88), ICU (OR = 3.18), coma (OR = 3.26), tracheotomy (OR = 14.95), hemodialysis (OR = 5.12), bone or lumbar puncture (OR = 1.82). The time-trends for exposure rates of COPD and bone or lumbar puncture were slightly decreased, however those for the others and the synthetic risk factors were not changed significantly., Conclusion: The infection rates for NP were significantly decreased in the case of no change for exposure rates of risk factors for NP, this suggests that the nosocomial infection surveillance and control programs were effective for lowering infection rate for NP in this hospital.

Background & Objective: Ulinastatin is a kind of broad- spectrum hydrolase inhibitors purified from urine of healthy males.There was no data showing whether ulinastatin could affect alveolar inflammatory reactions.This study was designed to investigate the changes of pulmonary alveolar interleukin-8 during one lung ventilation (OLV) in surgery and the effects of ulinastatin on alveolar IL-8., Methods: Sixty patients,ASA II- III,who underwent lobectomy, were randomly divided into two groups [30 patients in each group,surgery group(II) and control group (I)].Patients in surgery group were treated with ulinastatin 5,000 u/kg preoperatively. Alveolar IL-8 was harvested by bronchoalveolar lavage at 0, 1, and 2 hours after one lung ventilation and at the end of surgery. The changes of concentration of IL-8 in bronchoalveolar lavage fluid were analyzed statistically., Results: (1)Alveolar interleukin 8 was significantly higher at 2 hours after OLV [(160.85+/-46.58)ng/L] than before OLV [(128.26+/-35.35)ng/L] in control group. The results indicated that OLV and/or the stimulation of surgery could induce the pulmonary inflammatory reaction. (2)The concentrations of alveolar IL-8 at 2 hours [(140.32+/-41.25)ng/L] after OLV and at the end of surgery [ (156.74+/-43.58) ng/L] were significantly lower in surgery group than those in control group [(160.85+/-46.58)ng/L and (172.41+/-52.60)ng/L] respectively(P< 0.05)., Conclusion: Ulinastatin could alleviate the pulmonary alveolar inflammatory reactions in OLV.

Background & Objective: Morphine has been proved to inhibit human immune system, and large dose of fentanyl also decrease the activation of natural killer cells. This study was designed to investigate the effects of different doses of fentanyl on T-lymphocyte subpopulations and natural killer cells during esophageal cancer surgery under general anesthesia., Methods: Forty-five patients with esophageal cancer were randomly divided into 3 groups (I, II,III) with 15 cases in each group respectively. The doses of fentanyl in three groups were 5, 10, and 20 microg/kg, respectively. Central venous blood samples (6 ml) were collected before anesthesia, 24 hours and 48 hours after the operation, respectively. Monoclonal antibodies assay was used to identify T cells and NK cells., Results: The counts of CD3(+) (T%) (Group I 50.30+/-8.42, Group II 48.53+/-9.62, GroupIII 46.58+/-8.56), CD4(+) (T%) (Group I 30.04+/-7.24, Group II 28.67+/-7.52, Group III 26.65+/-6.55),and NK cells (Group I 3.26+/-1.62, Group II 3.01+1.56, GroupIII 3.01+/-1.54) in three groups decreased significantly at 24 hours after surgery (P< 0.01). The decrease at 48 hours after surgery were more significant in groupIII (CD3(+) 48.89+/-9.82, CD4(+) 22.64+/-6.02, NK Cells 3.41+/-1.88) than in group I(CD3(+) 57.32+/-9.13, CD4(+) 35.62+/-5.98, NK cells 5.96+/-1.08) and group II(CD3(+) 55.62+/-10.21, CD4(+) 34.24+/-6.85, NK cells 6.04+/-1.09) (P< 0.05). There was no statistical significance in the counts of CD3(+), CD4(+), and NK cells between the time of 48 hours after the operation and preoperation in group I and group II., Conclusion: Fentanyl, as a kind of opiate drug, could contribute to the immunosuppression, and large-dose fentanyl administration would be more effective in suppression of immunity function than small dose fentanyl.

Background & Objective: Morphine is a widely used analgesic in management of postoperative pain with well documented analgesic properties and side effects. Tramadol, a new synthetic mu-opioid receptor agonist, little is known about its efficacy and side effects when administered in epidural for pain relief. The aim of this study is to compare the efficacy and side effects of tramadol, morphine versus their combination for postoperative analgesia., Methods: One hundred and twenty patients undergoing abdominal cancer surgery were assigned to one of three groups randomly, tramadol group (Group T, n = 40), morphine group(Group M, n = 40) and combination of tramadol and morphine group(group T + M, n = 40), for postoperative analgesia. In group T, 12 mg/kg tramadol and 0.125% bupivacaine 100 ml were used for 48 h postoperative analgesia. In group M, 0.12 mg/kg morphine and 0.125% bupivacaine 100 ml; and in group T + M, 6 mg/kg tramadol, 0.12 mg/kg morphine and 0.125%. Bupivacaine 100 ml were used for postoperative analgesia. Efficacy was assessed by comparing visual analogue scale(VAS), Bruggman comfort score (BCS), global satisfaction score (GSS) at several time points over 48 hours. Possile adverse events were recorded., Results: There is no significant difference among three groups in VAS, but in group T, there are more patients whose VAS > 5 score than those in group M and group T + M. BCS; GSS in group T + M are lower than that in group T and group M. The occurrence rate of nausea and vomiting in group T + M are lower than that in group M., Conclusions: The efficacy of tramadol in epidural postoperative analgesia is similar to that of morphine, but varied from patient to patient, so the dose of tramadol should be individualized. Combination of tramadol and morphine can provide effective analgesia for postoperative pain and cause little adverse effect, especially reduce the occurrence rate of nausea and vomiting.

Background and Objective: Midazolam is a useful drug used preoperatively because it can produce anxiolysis and sedation. This study compared the propofol requirements and haemodynamic effects during anaesthetic induction using propofol with premedication of midazolam or luminal., Methods: Thirty patients (aged 20-65, ASA I-II) undergoing tumor surgery were randomly assigned into 2 groups (group M and group L): group M, receiving 0.5 mg atropine and 0.05 mg/kg midazolam; group L, receiving atropine and 2 mg/kg phenobarbital sodium 30 min before induction as premedication. Anesthesia was induced with propofol at the rate of 30 mg.kg-1.h-1 to achieve enough depth of anesthesia to intubate. Induction time, total propofol dosage, blood pressure, heart rate were recorded before and after induction, and after intubation. Awaken time was also recorded., Results: The time of induction and the propofol dosage in group M (2.8 +/- 0.37 min and 79.9 +/- 15.3 mg) were significantly (P < 0.05) less than that in group L (3.3 +/- 0.54 min and 98.9 +/- 17.4 mg). Blood pressure was unchanged in M group after propofol induction and after the intubation. Heart rate change was much less in group M (P < 0.05)., Conclusions: The results indicate that midazolam compered to phenobarbital sodium as premedication could reduce the usage of propofol, and also provide stable cardiovascular state during propofol induction.