Objective To evaluate the effect of postoperative patient controlled epidural analgesia (PCEA) on respiratory function in patients aged over 65 years Methods 41 ASA Ⅰ Ⅱ patients (male 22,female 19)aged between 65 80 years, weighing 58 78kg, scheduled for upper abdominal surgery were divided randomly into two groups: control group(n=20)and PCEA group(n=21) Epidural block was performed at T 8 9 with an epidural catheter inserted cranially for 4 cm A test dose of 1 5% lidocaine 4 5ml was given via epidural catheter When epidural blockade was confirmed, general anesthesia was induced with diazepam 0 2mg?kg -1 ,etomidate 0 3 mg?kg -1 ,fentanyl 4?g?kg -1 and vecuronium 0 1mg?kg -1 ,and maintained with epidural 0 5% bupivacaine infusion (6 7ml/2h) combined with inhalation of low concentration of isoflurane and intermittent iv boluses of fentanyl and vecuronium For postoperative analgesia in control group intramuscular pethidine was given on demand; In PCEA group PCEA was used A loading dose of 3ml of 0 15% bupivacaine mixture (morphine 10mg and haloperidol 5mg/0 15% bupivacaine 100ml) followed by continuous infusion of 0 5 1ml/h Superimposed by boluses of 2ml with a lock out time of 25min The maximal amount of bupivacaine mixture was 8ml/h VAS, Bruggman′s comfort scale and Rawsay′s sedation score were evaluated BP, HR, respiratory rate (RR) and SpO 2 were measured and recorded every 30min 4 h after operation Vital volume, Forced vital capacity, forced expiratory volume (first second:FEV 1 0 ),PEEP, MMEF were measured before operation and on 1st,3rd,5th and 7th postoperative days Blood gas analysis was checked before operation, during operation (30min and 90min after induction of anesthesia) and the 1st,3rd, 5th and 7th postoperative days Results The total amount of narcotic in 72h was 11 36mg (morphine equivalent dose) in control group and 5 4mg in PCEA group VAS was higher in control group than PCEA group The postoperative respiratory function was significantly better in PECA group Conclusions In elderly patient after upper abdominal operation PECA can greatly improve the respiratory function with better analgesia

Objective To investigate the effect of chemotherapy on hepatic function in breast cancer patients with chronic hepatitis B virus (HBV) infection Methods In this study, 98 breast cancer patients received two to six courses of standard chemotherapy, alterations in hepatic function and blood HBV DNA level were measured and clinical symptom was observed Results (1) After two courses of chemotherapy, hepatic damage was observed in 36 84 % and 13 33% respectively in HBsAg positive and negative breast cancer patients ( P

Objective To investigate human papilloma virus(HPV) infection in normal endometrium, atypi-cal hyperplasia of endometrium and endometrial carcinoma. Methods By the nucleic acid hybridization,we detected 28 pairs of endometrial carcinomas, 21 pairs of atypical hyperplasia of endometrium. Normal endometrium from 16 pa-tients with uterine myomas were as control. Results HPV16/18 DNA was detected in 25 endometrial carcinoma and 2 atypical hyperplasia of endometrium and 1 normal endometrium. Conclusions Endometrial carcinoma HPV16/18 DNA were significantly higher than those infected with atypical endometrial hyperplasia and normal endometrium. Note the occurrence of endometrial cancer,the development may be associated with HPV infection.

Objective: To study the inhibition of antisense TRP1 on cell growth of malignant melanoma(MM) and explore a new way for therapy of melanoma. Methods: Antisense TRP-1 recombinant vector was constructed and transfected into MM cells. According to the results of MTT, cell growth curves were drawn and then clonogenic assay was performed in vitro. At last, tumorigenesis assay was undertaken in nude mice in vivo. Results: Cell proliferations of TRP-1 transfected MM cells were inhibited compared with the control cells. The results of clonogenic assay displayed the difference of clonogenic percentage between TRP-1 transfected MM cells (52% , P

Objective To explore the effects of tilted seat surface on front protraction of upper limb and postural adjustment while sitting in children with spastic cerebral palsy. Methods From 2010 to 2014, 15 children with spastic cerebral palsy (patients group) and 15 healthy children (control group) were recruited. They were asked to reach forward sitting on the tilted seat surface with different degrees (-15°, 0°, 15° ) to test the reaction time and movement time. The contraction times of rectus abdominis and back extensors were recorded and ana-lyzed. Results The reaction time and movement time were shorter, and the contraction rates of rectus abdominis and back extensors were lower in the degree with-15° than with 0° and 15° (P<0.001). There was no difference in reaction time between two groups (P>0.05), and the movement time was longer in the patients group than in the control group (P<0.001). The contraction rates were higher in the patients group than in the control group. Conclusion Anterior tilted seat surface may improve the front protraction function of upper limb and the postural adjustment in children with cerebral palsy.

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.