Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.

Objective To investigate the effects of hyperoxia on the expression of β-defensin-2 mRNA in the lungs in rats. Methods Forty 21-day old male SD rats weighing 50-60 g were randomly divided into 5 groups ( n = 8 each): control group breathing room air (group C) and 4 hyperoxia groups breathing high concentration of oxygen (92%-94% O2 ) for 12, 24, 48 and 72 h respectively (group H1-4 ). The animals were sarificed at the end of O2 breathing. The lungs were removed for microscopic examination and determination of wet/dry lung weight ratio and expression of β-defensin-2 mRNA (by RT-PCR), total NF-κB p65 protein and NF-κB p65 protein in cell nucleus (by Western blot analysis). The level of activation of NF-κB was calculated. Results The W/D lung weight ratio was significantly higher in group H3 and H4than in group C. The lung injury scores were significantly increased and β-defensin-2 mRNA expression was significantly down-regulated in group H1-4 as compared with groups in a duration of hyperoxia dependent manner. The level of activation of NF-κB was up-regulated in group H1-4 compared with group C and peaked at 48 h of hyperoxia (group H3 ). Conclusion Inhalation of high concentration of O2 can induce lung injury by down-regulating lung β-defensin 2 mRNA expression. NF-κB signal transductinn pathway may not be involved in the underlying mechanism.

Objective To investigate the clinical and pathological features of small cell carcinoma of the urinary bladder. Methods The pathological and clinical data of 9 cases of small cell carcinoma were analyzed retrospectively. There were 6 males and 3 females, ages 45 to 79 years (mean age, 62 years). Clinical manifestations of 7 cases included gross hematuria and dysuria, the other 2 cases experienced lower abdominal pain. The mean tumor size was 2.0 cm (ranged, 0.5 to 7.0 cm). Two cases had multiple tumors and 5 cases had single tumors. The growth pattern in 2 cases was diffuse growth in the whole bladder. In 4 cases tumor cells were found in urine cytology. All 9 patients underwent surgical treatment, including TURBt. Four patients were diagnosed as superficial tumors before operation. All the patients underwent regular theprubicine irrigation in the bladder. One case underwent additional intravenous chemotherapy for 3 cycles. Partial cystectomy was performed in 2 cases, with regular theprubicine irrigation in bladder and 1 case underwent intravenous chemotherapy for 2 cycles. Radical cystectomy was performed in 3 cases, with 2 cases undergoing intravenous chemotherapy after operation. Results Pathological findings showed that tumor cells were small and round in shape. These hyperchromatic nuclei showed limited cytoplasm with lack of nesting characters. CgA and NSE were positive in immunohistochemistry. The final diagnosis was small cell carcinoma, with 1 case accompanied with transitional cell carcinoma and 1 case accompanied with prostate cancer. One case showed high preoperative serum calcium (3.15 mmol/L) and low serum phosphate (0.61 mmol/L), which returned to normal 1 month after operation. Four cases who′s bladder was preserved were followed up, 3 cases were alive for 4, 9 and 25 months after operation. The 1 case who underwent intravenous chemotherapy was followed up for 24 months and there was no sign of relapse or metastasis. In all the 3 cases with radical cystectomy, 2 cases died 2 and 28 months postoperativly. Another case with adjuvant chemotherapy was followed up for 24 months without recurrence or metastasis. Conclusions Small cell carcinoma of the urinary bladder is highly malignant with poor prognosis. Radical cystectomy in combination with systemic chemotherapy has better efficacy. Retained bladder surgery with systemic chemotherapy is an alternative choice. The most important factors which influence the prognosis of the tumor are clinical stage and therapeutic methods.

Objective To explore the clinical and histopathological features of metanephric adenoma (MA). MethodsClinical and pathological data of 10 cases of MA were analyzed retrospectively.There were 4 males and 6 females,aged from 33 to 65 years,with an average of 45 years.2 patients had flank pain,4 patients had gross hematuria,and 4 patients were found by physical examination.The average diameter of tumor was 4.5 cm (2.5 - 8.0 cm).All patients were diagnosed as renal tumor by CT scan.9 patients underwent radical nephrectomy and 1 patient underwent partial nephrectomy. Results Pathological examination found that the tumors are composed of densely packed small uniform cells with regular nuclei that formed a tubular or adenoid pattern.Mitotic figures were absent or rare.4 patients were diagnosed as MA,2 cases were diagnosed as low-grade malignant MA,and 4 cases were diagnosed as MA with malignant component (2 cases of adenocarcinoma,1 case of chromophobe cell carcinoma,and 1 case of well differentiated papillary adenocarcinoma),7 cases were followed up for 22 months ( 10 to 34 months) without recurrence or metastasis. Conclusions MA is very rare benign renal tumor originating from epithelium,and a few are malignant,and some may contain malignant ingredients.Nephron-sparing surgery and radical nephrectomy are eligible for the treatment of MA.Considering the uncertainty of the biological behavior and cellular origin of MA,a long-term follow-up is necessary.

BACKGROUND: Belladonna drugs have been widely used in clinic in our country to improve microcirculation, or as a herbal anesthetic drug. However,there are few reports regarding the animal experiments on belladonna alkaloid against morphine addiction further OBJECTIVE: To observe the effects of belladonna alkaloid combined with morphine on morphine(Mor)-addicted mice so as to provide an experimental basis for development of belladonna to morphine addiction.DESIGN: A completely randomized-controlled study based on the experimental animals.SETTING: Laboratory of physiology of a medical college.MATERIALS: The study was performed at the Laboratory of Physiology of Medical Department of Hebei Engineering College from June 2004 to August 2004. Fifty 2-month old male healthy Kunming mice of clean grade with a body mass of(20±2) g were obtained from Experimental Animal Centre of Hebei Medical University.METHODS: According to evaluation index of dependence in Morphine-addicted animals, we chose pain threshold and naloxone-urged jumping response as items to observe. Fifty mice were randomly divided into 5 groups with 10 mice each, which were the control group (saline), the morphine group, the scopolamine(Sco)group, the anisodamine(Ani), atropine(Atr)group. The corresponding drugs or saline was administered by intraperitoneal (I. P.) injection once a day for 7 days. The pain threshold at 1 hour after I. P. Injection of drugs was observed from day 1 to day 7 by hot-plate method. Mice were given I.p. Injection of naloxone (Nal, 5 mg/kg ) 6hours after the last injection. The jumping times within 30 minutes were observed to evaluate the ,formation of the Morphine addiction.Nal-urged mice.RESULTS: The pain threshold of the mice in Morphine group was decreased significantly, and the jumping times and jumping rate were obviously increased compared with that of the control group( P ＜ 0.05 or P ＜ 0.01).The co-administration of Sco-Mor mixtures for 7 days significantly increased the pain threshold of Mor-dependent mice( P ＜ 0.01) and markedly decreased the jumping times and the jumping rate( P ＜ 0. 05) . Atr-Mor and Ani-Mor had a weak effect on the elevation of the pain threshold of Mor-dependent mice, but had strong effects on the decrease of the jumping times and the jumping rate( P ＜ 0. 01 ).CONCLUSION: Belladonna alkaloids all could antagonize Mor-dependence in mice at different degrees, which provide an important experimental evidence to develop belladonna drugs for preventing opium addiction.

Purpose To explore the correlation between normal pancreas and abdominal aorta in the peak enhancement (PE) and the shift time at the peak by applying the multislices spiral CT perfusion imaging.Materials and Methods Prospectively analyzed 62 patients who received enhancement CT examination for the superior or the middle abdomen,underwent optimum level CT perfusion imaging after plain scanning.These data were processed on a Vitreal 2.0 worker-station by using Toshiba body software package.The time-density curves (TDC) of the normal pancreas and the abdominal aorta were drawn,the PE and the shift time of PE were recorded and their correlation was analyzed.Results Compared with abdominal aorta,the mean value of PE of the normal pancreas was lower,and the difference was statistically significant [(111.94± 14.42)HU vs (351.83 ± 74.93)HU,P＜0.05],the mean difference was (246.10± 65.86)HU.Compared with abdominal aorta,the mean shift times of PE of the normal pancreas was latter,and the difference was statistically significant [(37.56±6.90) s vs (30.82±6.73) s,P＜0.05],the mean difference was (6.54±2.97)s.The PE and shift time of PE of the normal pancreas were positively and linearly correlated with that of abdominal aorta (r=0.438,r=0.379).Conclusion The PE of the normal pancreas is not synchronous with that of the abdominal aorta.The shift time of the former is usually 6～8 seconds slower than that of the latter.This provides a basis to find the PE of the normal pancreas in enhanced scan.

Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.

Objective To investigate the effects of melatonin on choline acetyltransferase (ChAT) in the hippocampus of rats after isoflurane anesthesia.Methods Sixty male SD rats weighing 390-440 g were randomized into five groups (n =12 each):control group (group C),1％ isoflurane group (group Ⅰ),1％ isoflurane + melatonin group (group IM),2％ isoflurane group (group J) and 2％ isoflurane + melatonin group (group JM).Rats in groups IM and JM received intraperitoneal injection of melatonin (10 mg/kg) for 7 days,and rats in other groups received normal saline.On the 7th day of injection,rats in groups Ⅰ and IM inhaled 1％ isoflurane for 4 hours,and rats in groups J and JM inhaled 2％ isoflurane for 4 hours.One day after anesthesia,all the rats began Morris water maze to assess the learning and memory ability,which was made for continuous 5 days.At the end of probe test,6 rats in each group were randomly selected,blood samples were collected to detect plasma melatonin level,and the hippocampi were removed to evaluate the expression and activity of ChAT.The other rats were sacrificed to perform immunofluorescence to detect ChAT in hippocampal CA1 region and dentate gyrus.Results The plasma melatonin level,and the expression and activity of ChAT were significantly lower in group Ⅰ than in group C (P ＜ 0.01).The escape latency was significantly longer,the probe time was significantly shorter,and the plasma melatonin level and the expression and activity of ChAT were significantly lower in group J than in group C (P ＜ 0.05 or 0.01).The escape latency was significantly shorter,the probe time was significantly longer,and the plasma melatonin level and the expression and activity of ChAT were significantly higher in group IM than in group Ⅰ (P ＜ 0.05 or 0.01).The escape latency was significantly shorter,and the plasma melatonin level and the ChAT activity were significantly higher in group JM than in group J (P＜ 0.05 or 0.01).Conclusion Melatonin can attenuate isoflurane-induced ChAT inhibition and thus improve the cognitive function of rats after isoflurane anesthesia.

Objective To investigate the effects of melatonin on choline acetyltransferase (ChAT) in rat hippocampus after isoflurane anesthesia. Methods Sixty male SD rats weighing 390 - 440 g were randomized into 5 groups (n = 12 each): control group (group C), 1% isoflurane group (group Ⅰ), 1% isoflurane + melatonin group (group IM) , 2% isoflurane group (group J) and 2% isoflurane + melatonin group (group JM) . In IM and JM groups, melatonin 10 mg/kg was administered intraperitoneally once a day for 7 consecutive days, while equal volume of normal saline was given intraperitoneally instead of melatonin in C, I and J groups. Groups Ⅰ and IM inhaled 1% isoflurane and groups J and JM 2% isoflurane for 4 h on 7th day. All the rats underwent Morris water maze test on the day after anesthesia for assessment of learning and memory ability (escape latency and probe time) . The training test was performed 4 times a day for S days. Six rats randomly selected from each group were sacrificed the end of the test. The blood samples were collected for detection of plasma melatonin level by ELISA.The brain tissues were removed for determination of the expression and activity of ChAT in hippocampus by Western blot or colorimetric assay. The left rats were selected and sacrificed for determination of the number of ChAT positive neurons in hippocampal CA1 region and entate gyrus by immunofluorescence. Results The plasma melatonin level and expression and activity of ChAT were significantly lower in group I than in group C ( P ＜ 0.01) . The escape latency was significantly longer, the probe time was significantly shorter, and the plasma melatonin level and expression and activity of ChAT were significantly lower in group J than in group C ( P ＜ 0.05 or 0.01) . The escape latency was significantly shorter, the probe time was significantly longer, and the plasma melatonin level and expression and activity of ChAT were significantly higher in group IM than in group Ⅰ ( P ＜ 0.05 or 0.01). The escape latency was significantly shorter and the plasma melatonin level and ChAT activity were significantly higher in group JM than in group J ( P ＜ 0.05 or 0.01) . The results of immunofluorescent staining showed that the number of ChAT positive neurons in hippocampal CA1 region and dentate gyrus wag consistent with the changes in the measured ChAT expression. Conclusion Melatonin can reduce isoflurane-mediated inhibition of ChAT expression and activity and thus improve spatial memory impaired by isoflurane anesthesia in rats.

Objective: To understand the energy and major nutrients intake of high school students in Shanghai, and to provide basis for formulating target nutritional interventions and health education. Methods: The probability-proportional-to-size sampling technique was used to select 19 high schools, from which 9 boys and 9 girls from same class were randomly recruited for each grade. A total of 900 high school students were surveyed on their energy and major nutrients intake. Results: The medians of intake of energy, protein, fat, carbohydrate, calcium, sodium, iron, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber were 2 353 kcal/d, 97.3 g/d, 95.4 g/d, 265.4 g/d, 602.1 mg/d, 4 373 mg/d, 24.3 mg/d, 495.6 μgRE/d, 1.08 mg/d,1.21 mg/d, 83.2 mg/d and 1.01 g/d, respectively. Among of them, the medians of intake of energy, calcium, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber for boys and girls were lower than reference standard(P<0.05). The medians of intake of energy and major nutrients in high school students who lived in countryside were less than those lived in suburban and urban(P<0.05), except carbohydrates and iron. The percentages of energy supplied byprotein, fat and carbohydrate were 16.9%, 37.2%and 46.0%, respectively. Conclusion The energy and calorigenic nutrients intake can meet the demand of daily consumption in high school students in Shanghai, but the intake of dietary fiber, some minerals and vitamins have a various degrees of deficiency. The proportion of energy supplied bycalorigenic nutrients is unbalanced.