Search

Background: Patients undergoing carotid endarterectomy for extracranial internal carotid artery stenosis are at risk of cerebral ischemia/hypoperfusion. Criterion recommended by European and American committees to determine whether to place a shunt consisted of a decline in transcranial Doppler ultrasonography-measured middle cerebral artery blood flow velocity (MCBFV) to < 30% to 40% of intraoperative preclamp value., Objective: To assess the discriminative power of the bispectral index (BIS)-Vista monitor for detecting a 40% decline in MCBFV with cross-clamping., Methods: In 20 patients undergoing carotid endarterectomy under remifentanil/propofol anesthesia, BIS-Vista data, MCBFV, and pulsatility index from bilaterally mounted BIS-Vista and transcranial Doppler monitors were continuously recorded., Results: Coefficient of determination revealed good correlation (r = 0.763) between ipsilateral BIS-Vista and MCBFV after cross-clamping. BIS-Vista exhibited a high discriminative power of 0.850 (95% confidence interval, 0.455-0.966) area under the receiver-operating characteristic curve in detecting an ipsilateral 40% MCBFV decline. Two-way analysis of variance (location by time) suggests that BIS-Vista exhibited a global decline; ie, both BIS-Vistas declined when 1 carotid on either side was clamped because there was no significant interhemispheric difference (P = .112) in mean BIS-Vista values over time., Conclusion: Although we demonstrated good correlation and high discriminative power of the BIS-Vista monitor in depicting a MCBFV decline that could serve as indicator of decline in cerebral activity, BIS-Vista cannot be considered a reliable indicator of cerebral ischemia/hypoperfusion that could replace transcranial Doppler monitoring to determine whether a shunt is to be placed.

Objective: To explore the feasibility of combining human patient simulator (HPS) drivers with micro-division teaching during primary resident training by George Miller' medical education step-wised principle of goal and competence., Method: The 20 residents from department of anesthesia who are less than 3 years in clinical training were randomized into two Groups. The all residents in Group T received HPS training, and no HPS training in Group N. In simulation system, we designed 8 programmed critical and emergency events. We disassembled and quantified the programmed design and training process with Micro-division teaching principle. The training mode was run by test-feedback-self-analysis-instructor guide-summarize-re-practice-retest. The feedback assessment from all residents were collected after finishing HPS training., Results: The training score in Group T was much higher than Group N (P < 0.05)., Conclusions: The training mode with HPS is an accessory teaching means because it can improve clinical thinking and skill training of primary resident.

Objective: To understand the environmental risk factors on attempted suicide in patients with major depression, and to study the interaction between factors as single nucleotide polymorphism(SNP) of TPH2 gene rs7305115 associated to attempted suicide in major depression., Methods: Paired case-control study on 215 suicide attempters with major depression (92 male, 123 female) and molecular biological techniques were used to study the relation between TPH2 gene rs7305115 SNP,interrelated environmental factors and the rate of attempted suicide. Controls were paired with cases according to the same gender, similar age (no more than 3 years) and from the same district., Results: There were remarkably significant differences in gene types and gene frequency between case and control groups (P < 0.001). Data from multivariate conditional logistic regression model analysis showed that hopelessness, negative life-events and family history of suicide were relationship of attempted suicide in patients with major depression with OR values as 0.33 (95% CI: 0.22-0.99), 7.68 (95% CI: 5.79-13.74), 6.64 (95% CI: 2.48-11.04), 2.98 (95% CI: 1.17-5.04) respectively. There was no first level interaction between any of the two risk factors., Conclusion: Results from the study supported the idea that hopelessness, negative life-events and family history of suicide were risk factors of attempted suicide in major deprbssion while TPH2 gene rs7305115 A/A might be the protective factor.

As a novel member of the IAP (Inhibitor of apoptosis protein) family, survivin was observed to be expressed in most human cancerous cells. Fusion protein TATm-survivin (T34A) has drawn considerable attention because it is a potential anti-tumor protein that can be transduced into cancer cell with the help of HIV-TAT domain. In this study, the cDNA encoding survivin was cloned by RT-PCR from human breast cancer cell lines B-Cap-37. An expression vector of pRSET-B-HIV-tatm-survivin (T34A) was constructed by PCR after survivin (T34A) was mutated by site-directed mutagenesis. Subsequently, the resultant plasmid was transformed into E. coli BL21 (DE3). Recombinant HIV-TATm-Survivin (T34A) protein was expressed efficiently with 0.5mM IPTG as inducer, reaching a yield of 650mg/liter (as inclusion body) in fermentation culture. The inclusion bodies were solubilized, refolded and purified to a purity of 96% by ion exchange chromatograghy and size-exclusion chromatography. Remarkable effects of the purified recombinant HIV-TATm-Survivin (T34A) on the morphology of cell line SW1990 and B-Cap-37 were observed after being administrated for 4h. MTT assay showed recombinant HIV-TATm-survivin (T34A) protein could inhibit significantly cell proliferation of SW1990 and B-Cap-37 and SSMC-7721 in vitro. Apoptosis rate and cell circle of SW1990 and B-Cap-37 that had been treated with target protein (final concentration 30 microg/mL) were detected with flow cytometry. Results revealed that more than 65% cancer cells were arrested at G1 phase. The study suggested that TATm-survivin (T34A) protein was a hopeful protein drug in the treatment of cancers by facilitating apoptosis of cancer cells. Key words recombinant HIV-TATm-Survivin (T34A), expression and purification, pro-apoptosis bioactivity, SW1990 and B-Cap-37 cancer cell lines