Objective To investigate the protective effect of sevoflurane on acute intracranial hemorrhage craniotomy patients. Methods 60 acute intracranial hemorrhage craniotomy surgery patients were randomly divid?ed into control and experimental group of 30 patients under general anesthesia to have craniotomy. The patients in control group was operated by propofol and remifentanil as a inhalation anesthesia ,while patients in experimental group received sevoflurane ,propofol and remifentanil as a mixed anesthesia. Then intracranial pressure ,serum C?reactive protein(CRP),serum S?100β,NSE,IL?6 and TNF?α levels of different time points were deternmined. Results Serum CRP in experimental group were significantly decreased than the control group(P<0.05)1 d af?ter operation. T0~T3 levels of serum S?100β,NSE,IL?6 and TNF?α in two groups were both increased(P <0.05),and the experimental group was significantly lower than the control group(P < 0.05). The intracranial pressure of control group was significantly higher than the experimental group(P < 0.05). Conclusion Sevoflu?rane has a brain protective role in inhibiting acute inflammation in intracranial hemorrhage craniotomy patients.

Objective To analyze the relationship between pillow height and cervical intervertebral disc stress in lateral decubitus position of the human body using three-dimensional finite element method,and to provide the basis for appropriate pillow selection.Methods A cervical spine CT scan was performed on a normal male volunteer.The medical 3D image reconstruction software (Mimics),reverse engineering software (Geomagic Studio) and finite element software (MSC.Patran) were collectively used to establish three-dimensional finite element models of the whole cervical spine under three lateral decubitus conditions,includes pillow height of 10 cm (cervical spine leftward flexion),17 cm (cervical spine neutral),and 25 cm (cervical spine rightward flexion).Moreover,the finite element analysis and calculation of the three models were conducted.Results The Von-Mises stress,maximal principal stress and maximum shear stress of the model in cervical spine neutral (pillow height=17 cm) were all significantly lower than those of the cervical spine lateral model.Conclusions When the cervical coronal plane is in neutral position,the cervical discs can achieve the best stress distribution state.In lateral decubitus position of the human body,a appropriate pillow height should make the cervical vertebrae in neutral position.

Objective To investigate the serum levels and correlation between macrophage migration inhibitory factor (MIF) and regulated on activation normal T cell expressed and secreted cytokines (RANTES) in patients with chronic hepatitis B (CHB).Methods Forty-four CHB patients (CHB group)and 30 healthy controls (control group) were enrolled in this study.The venous blood was collected and serum MIF and RANTES levels were detected by enzyme-linked immunosorbent assay.Correlation between MIF and RANTES was analyzed in CHB group.Results The serum MIF and RANTES levels in CHB group were significantly higher than those in control group [(8.48 ± 1.70) μ g/L vs.(1.99 ± 2.38) μ g/L,(3.94 ±2.38) μ g/L vs.(0.33 ± 0.15) μ g/L,P =0.000].There was no correlation between MIF level and RANTES level(r =0.212,P＞ 0.05).Conclusions The serum MIF and RANTES levels are significantly increased in patients with CHB,but there is no correlation.The participation pathogenesis way of CHB is different.

Objective To explore the relationships between the sleep/wake-up patterns and temperament in preterm infants.Methods The developmental characteristics of sleep/wake-up patterns and temperament in preterm infants aged 4 months at corrected gestational age in their own home environments were described.The 23 relatively low-risk preterm infants were enrolled in this study.The sleep/wake-up data was collected with actigraphy.The temperament was assessed by Chinese Infant Temperament Questionnaire.Results Among the 23 infants,there were 13 coordinated difficult(D) type and 10 coordinated easy(E) type.The number of night wake-up in the coordinated D-type preterm infants[(2.78 ±0.01) times] were significantly more than that of coordinated E-type ones[(2.60 ± 0.03) times] (t =3.285,P =0.001).The longest continuous sleep time of coordinated D-type preterm infants [(4.20 ± 1.21) h] was significantly less than that of coordinated E-type ones[(4.41 ± 1.14) h] (t =3.374,P =0.001).There were no significant differences in daytime sleep duration,the number of naps,bedtime,sleep latency,nighttime sleep duration,the 24 hour sleep duration and morning awaking time between the two groups (all P ＞ 0.05).After the sex factor was controlled,there was a positive correlation between emotional nature and sleep latency at night (r =0.599,P =0.032).There was also positive correlation between persistence and the number of naps in daytime (r =0.439,P =0.035).Conclusions Preterm infants with different temperament types have different number of night wake-ups and the longest continuous sleep time.The emotional nature and persistence are associated with sleep latency at night and number of naps in daytime respectively.The parents of preterm infants should change their child rearing behaviors to improve sleep quality of the preterm infants.

Objective The onset and progression of lung cancer correlate closely to individual genetic background .This study evaluated the correlation between the onset risk of lung cancer and short tandem repeat (STR) polymorphisms in order to find a new pathway for investigating the pathogenesis of lung cancer . Methods Using PCR and electrophoresis on 15 STR loci , we studied the gene and genotype frequencies of peripheral vein blood specimens from 120 lung cancer patients and 156 healthy individuals in Nan-jing area.According to the differences in the allele distribution of the 15 STR loci, we evaluated the susceptive and/or resistant factors relevant to lung cancer . Results There were statistically significant differences between the lung cancer patients and healthy controls at alleles 10, 15.2, and 16 of the loci CSF1PO, D19S433, and D3S1358 (P<0.05, OR>1), as well as at alleles 14 and 14.2 of the loci CSF1PO and D19S433 (P<0.05, OR<1). Conclusion It is possible that alleles 10, 15.2 and 16 of the loci CSF1PO, D19S433, and D3S1358 are susceptive factors and alleles 14 and 14.2 of the loci CSF1PO and D19S433 are resistant factors relevant to lung cancer .

BACKGROUND: Microglia play an important role in immune surveillance in their quiescent state, but the role of the activated microglia is under discussion. OBJECTIVE: To analyze the mechanism of activated microglia in acute cerebral infarction. METHODS: Totally 96 male Kunming mice were selected and randomly divided into four groups, including transplantation, placebo, blank control and sham operation groups. Permanent occlusion of the middle cerebral artery was performed using suture method in the mice of the transplantation, placebo and blank control groups, followed by injection of microglia suspension via subclavian vein, medium containing the same volume of microglia, and nothing, respectively, at 12 hours after modeling. In the meanwhile, the same amount of microglia suspension was injected into the mice of the sham operation group. The Zea-longa scale and brain-derived neurotrophic factor expression at 12, 24 and 72 hours after modeling, the volume of cerebral infarction and the number of nerve cells positive for microtubule-associated protein-2 at 72 hours after modeling were detected. RESULTS AND CONCLUSION: The Zea-longa scale score was 0 point in the sham operation group, which was significantly lower than that in the other three groups at each time point after modeling (P < 0.01). The Zea-longa scores in the transplantation group were significantly lower than those in the placebo and blank control groups at 24 and 72 hours after transplantation (P < 0.01). The positive expression rate of brain-derived neurotrophic factor in the transplantation group was significantly higher than that in the other three groups after transplantation (P < 0.01). The sham group showed no infarction, while the size of cerebral infarction in the transplantation group was significantly lower than that in the placebo and blank control groups (P < 0.01), and the microtubule-associated protein-2 positive rate was significantly higher than that in the placebo and blank control groups (P < 0.01). These results manifest that the activated microglia can improve the survival rate of nerve cells, promote the recovery of cerebral nerve function and reduce the size of cerebral infarction.

[Objective]To explore the efficacy of T2* mapping for evaluating inflammatory activity in the patients with Crohn disease(CD).[Methods]A total of 98 CD patients underwent MR enterographywith T2*WI. T2* values were measured by put-ting regions of interest on the thickening bowel wall on T2*mapping. The activity of bowel segment was scored by magnetic resonance index of activity(MaRIA),to analyze the relationship between T2*values with CD activity.[Results]A total of 160 bowel segments were evaluated and includedinactive(MaRIA<7,n=26),mild(7≤MaRIA<11,n=23),and moderately-severe(MaRIA≥11, n = 111)active lesions. The differences in T2* values amongthese three groups were significant(all P < 0.05). T2* values of 160 bowel segments correlatedclosely withMaRIA(r=0.743,P<0.05). High accuracy of T2*values was shown for differentiating inac-tive from active CD(AUC=0.877)anddifferentiating inactive-mild from moderate-severe CD(AUC=0.848). The threshold T2*value of 20 ms allowed differentiation of mild from moderate-severe CD with74.5%sensitivity and 84%specificity.[Conclusions]T2*values, as thequantitative indexof T2*mapping,correlate well with CD activity and showsatisfiedefficacy for diagnosing inflammatoryactivity.

Objective To explore the diagnostic value of magnetization transfer imaging (MTI) and DWI for detecting intestinal wall property of crohn's disease (CD). Methods Forty four patients with CD were prospectively enrolled in the study, and MR enterography (MRE), MTI and DWI were performed. According to MRE findings, patients were divided into three subgroups:acute inflammatory group, chronic fibrotic group and combined inflammatory with fibrotic group. Intestinal wall T2WI signal, magnetization transmisson rate (MTR) and ADC value were measured on MRE, MRI and DWI imagings, respectively. The differences of MTR and ADC among the three groups were analyzed by one-way ANOVA;the differences of T2WI scores were analysed by Kruskal Wallis;the differences of MTR and ADC values between normal and pathological intestinal wall were analyzed by paired t test;ROC curve were used to evaluate the CD fibrosis and inflammation diagnostic efficiency of MTI ana DWI based on MRE signs. Results Among the 44 cases, 11 cases were in the acute inflammatory group, 18 cases were in the chronic fibrotic group and other 15 cases were in the combination group. The T2WI score, MTR and ADC among the three groups showed significant differences (all P<0.01).The mean MTR and ADC of pathological intestinal wall of the 44 cases were (40.77±6.05)%and (1.04±0.18)× 10-3mm2/s, and the adjacent normal bowel were (21.75±4.17)%and (1.97 ± 0.23) × 10- 3mm2/s, respectively. Moreover, the difference of the above values showed significant differences (t=19.12,-21.80 respectively, all P<0.01). There was a negative correlation between MTR and T2WI score (r=-0.71,P<0.01). While ADC value was positively correlated with T2WI score (r=0.80, P<0.01). Using ROC curve analysis to differentiate the CD fibrosis from acute inflammation, the area under the curve (AUC) of MTR and ADC were 0.97 and 0.96 ,respectively. Conclusions Both MTI and DWI can be used to assess the properties of intestinal wall, which has the same diagnostic efficacy to identify the acute inflammation and fibrosis.

OBJECTIVETo investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma.

METHODSA total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction, including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups.

RESULTSThere were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8±8.1) min vs. (61.1±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group.

CONCLUSIONJejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.

Adenocarcinoma ; surgery ; Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; pathology ; Gastrectomy ; methods ; Humans ; Jejunum ; pathology ; Operative Time ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; pathology

OBJECTIVETo study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy.

METHODSFrom January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups.

RESULTSFTS was associated with shorter time to bowel function return [(67.8±19.7) h vs. (90.0±20.6) h, P<0.01], shorter hospital stay [(13.5±3.0) d vs. (17.8±7.3) d, P=0.01], lower hospital cost [(23.8±3.7) thousand Yuan vs. (27.8±6.1) thousand Yuan, P<0.05], and less stress response (lower pain score, WBC count, C-reactive protein, all P<0.01). The postoperative complications including ileus, infection, anastomotic leakage were similar (all P>0.05).

CONCLUSIONFast track surgery decreases postoperative stress response and promotes recovery.

Aged ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome