Objective To evaluate the effects of deliberated hypotension combined with acute hypervolemic hemodilution (AHH) on safety,operation time, blood loss,postoperative hemoglobin (Hb) and hematocrit (Hct) of the patients undergoing endoscopic nose surgery.Methods Twenty ASA grade I to II patients undergoing selective endoscopic nose surgery were divided randomly into two groups: control group (n=10) and hypotensive group (n=10). All patients received general anesthesia. In the hypotensive group, AHH was accomplished with infusion of HAES and lactated Ringer's solution after endotracheal intubation and before operation. Deliberated hypotension was induced and maintained with nitroprusside 0 5～3 0?g?kg -1 ?min -1 iv. Operation time, intraoperative blood loss, postoperative hemoglobin (Hb) and hematocrit (Hct) and hemodynamics during operation were recorded and compared between the both groups.Results Operation time was about 44% shorter in the hypotensive group than that in the control group. Blood loss was significantly lower in the hypotensive group than that in the control group (P

With high incident of cancer and chronic disease, it is more and more important to develop palliative care; as developing later, there is neither unified palliative care mode and related policy, nor mature assessment collaboration in China. It pointed out that Australia as an advanced country with stable development of palliative care and assessment collaboration, called palliative care outcomes collaboration (PCOC). It expatiated the PCOC on structure,function and operation. China should learn from the mode of Australia palliative care assessment and management collaboration, find references to improve and further develop Chinese palliative care assessment collaboration.

Objective To investigate the relationship between Methotrexate (MTX) and its cognitive dysfunction,and to explore the possible mechanism of neurotoxicity induced by MTX.Methods Thirty healthy male SD rats weighting 180-220 g were divided into 3 groups using random number table:control group,60 mg/kg MTX (MTX60) group and 100 mg/kg MTX (MTXt00) group,with 10 rats in each group.The rats in MTX60 group,MTX100 group received 60 mg/kg MTX and 100 mg/kg MTX,respectively.The rats in control group accepted the same volume of 9 g/L saline injection as MTX group.Spatial memory of rats was evaluated by using Morris water maze test at different time points after pretreatment with MTX.After the Morris water maze test,the hippocampus were harvested and the expressions of C/EBP homologous protein (CHOP),cysteinyl aspartate specific proteinase 12(caspase-12) and cleave cysteinyl aspartate specific proteinase 3 (cleaved caspase-3) were detected by using Western blot.Meanwhile,cell apoptosis and pathological change of hippocampal neurons were detected by terminal dexynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) assay and HE staining respectively.Results In the Morris water maze test,the time in platform quadrant of rats in MTX60 group and MTX100 group was shorter than that of rats in control group during probe training [(27.30 ±3.98) s and (21.63 ±4.22) s vs (33.30 ±6.31) s,F =13.94,P ＜0.05],and the time in target quadrant of MTX100 group was shorter than that of MTX60 group (P ＜ 0.05).Compared with the control group,there were degenerated neurons in hippocampus cornu ammonis 1 (CA1) area in MTX60 group and MTX100 group.The number of TUNEL-positive cells of the hippocampus CA1 area increased significantly in MTX60 group and MTX100 group rats [(4.72 ±0.12)％ and (9.12±0.12)％ vs (1.11 ±0.49)％,F=95.272,P ＜0.05],and the TUNEL-positive cells of rats in MTX100 group were more than those of MTX60 group (P ＜ 0.05).The expressions of CHOP,caspase-12 and cleaved caspase-3 also increased compared with the control group (CHOP:2.98 ±0.31 and 4.15 ±0.61 vs 0.38 ±0.12,F =232.74,P ＜ 0.05;caspase-12:0.33 ±0.04 and 0.43 ±0.06 vs 0.14 ±0.02,F =120.70,P ＜ 0.05;cleaved caspase-3:0.35 ± 0.04 and 0.44 ± 0.06 vs 0.05 ± 0.03,F =198.64,P ＜ 0.05),and the protein expression levels of rats in MTX100 group were higher than MTX60 group (all P ＜ 0.05).Conclusions MTX can induce cognitive impairment in rats,and endoplasmic reticulum stress mediated hippocampal neurons apoptosis may play an important role in the mechanism of MTX-induced cognitive impairment in rats.

Objective To assess the length of stay,early complication and cost of treatment in radical cystectomy (RC) patients with different Charlson Comorbidity Index Score (CCI).Methods A prospective study of a total of 102 patients who underwent RC between March 2012 and August 2014 in Center for Research of Urology in Yunnan Province,China.They were divided into three groups:69 cases in CCI=0 or 1group,19 cases in CCI=2 group,14 cases in CCI≥3 group.Comorbidities were graded according to CCI,and each patient was followed-up for 3 months after RC.Length of stay,early complications and treatment cost were analyzed by statistics.Results A total of 102 patients were analyzed.There were obvious differences with respect to length of stay,early complication and cost of treatment comparing patients in each CCI group,H=20.722,6.025,and 7.047,P＜0.05.The incidence of diversion-related early complications in patients with different CCI showed significant difference,H=7.100,P＜0.05,however,the non diversionrelated early complications did not show significant difference between patients with different CCI,H=2.590,P＞0.05.Conclusions Patients with different CCI showed difference in the length of stay,early complication and cost of treatment in RC patients with different CCI.CCI≥3 might help to identify patients at risk for early complications after RC,especially in the orthotopic urinary diversion operation.Patients' complication should be evaluated standardized before operation and these should be included in patients' consideration.

Objective To investigate the biological function of IFN-λ in 7 human esophageal carcinoma cells. MethodsThe gene expression of IL-28α, IL-10β and antiviral molecule was examined with PCR. The MHC molecules expression and the profiles of cell cycle were analyzed with flow cytometer. Cell proliferation was evaluated with MTT assay. ResultsAll of esophageal carcinoma cells express the gene of II-28α and IL-10β. IFN-λ induced or augmented the gene expression of antiviral molecules, 2′5′-OAS and MxA. IFN-λ enhanced the MHC class Ⅰ molecule expression. IFN-λ inhibited the growth of esophageal carcinoma cells through the regulation of cell cycle distribution. ConclusionEsophageal carcinoma cells express the IFN-λ receptor complex. IFN-λ has the antiviral, anti-proliferative and immunoregulation activity.

Objective To investigate the risk factors for childhood acute leukemia complicated with streptococcus mitis bacteriaemia and to explore a better therapeutic regimen of antibiotics.Methods Seventy-eight cases of childhood acute leukemia complicated with bacteriaemia hospitalized in Zhujiang Hospital of Southern Medical University from January 2012 to December 2016 were collected,among them there were 8 cases (10.26％) caused by streptococcus mitis.The susceptible factors,clinical manifestations,drug susceptibility,treatments and outcomes of 8 cases of streptococcus mitis bacteriaemia were summarized and analyzed.Results All of 8 cases were attacked during the agranulocytosis phase lasting for more than 1 week after chemotherapy for acute leukemia.Four cases of them had been exposed to the third-generation cephalosporins for more than 7 days,and 5 cases exposed to proton pump inhibitor (PPI) for more than 10 days.The incidence of remittent fever,shiver,stomatitis and pneumonia was 100.0％ (8/8 cases),62.5％ (5/8 cases),62.5％ (5/8 cases) and 62.5％ (5/8 cases),respectively.And severe pneumonia occurred at a rate of 37.5％ (3/8 cases).The sensitivity to Linezolid,Vancomycin,Penicillin and Cefotaxime was 100.0％,100.0％,37.5％ and 25.0％,respectively.Five of the 7 cases treated with Meropenem had a fever 3 days later and then they took Linezolid as a replacement according to the drug sensitivity.One case was treated with Cefoperazone-Sulbactam.The duration time of fever,positive blood culture,agranulocytosis and course of antibiotics therapy was 1-19 d(10.4 d on average),4-22 d(13.4 d on average),10-30 d (21.6 d on average),9-26 d (18.3 d on average),respectively.Among 3 patients with severe pneumonia,1 patient received the respirator assisted ventilation for 1 week.Conclusions Streptococcus mitis is one of the major causes of severe infection among children with acute leukemia.Agranulocytosis after chemotherapy,stomatitis,exposure to PPI and antibiotics may be the risk factors for streptococcus mitis infection.Fever,stomatitis,respiratory and digestive symptoms are the common clinical manifestations.Streptococcus mitis is resistant to Penicillin and Cefotaxime,but sensitive to Linezolid,which can shorten the course of infection and improve the outcomes.Thus,Linezolid may serve as an optional therapy for streptococcemia mitis bacteriaemia.

OBJECTIVE:To optimize the extraction technology for organic acids in Crataegi fructus. METHODS:Based on sin-gle factor test,using liquid-solid ratio,extraction time and ethanol volume fraction as independent variables,extraction yield of or-ganic acids as dependent variable,central composite design-response surface method was used to optimize the extraction technology of organic acids in Crataegi fructus. RESULTS:The optimal extraction technology was as follow as liquid-solid ratio of 18.5:1, adding 75% ethanol,reflux extraction twice,2.0 h each time. Average extraction yield of organic acids in verification test was 5.22%(RSD=2.70%,n=3),with 1.75% relative error of the predicted value(5.13%). CONCLUSIONS:Optimized extraction technology for organic acids in Crataegi fructus is simple,with good reproducibility and predictability.

With the emergence of avian flu, influence A virus and other diseases, the development of rapid, real-time, label-free biological sensors has become increasingly significant at the early detection and clinical diagnoses of various diseases. Single-walled carbon nanotubes (SWNTs) have unique one-dimensional structure, special electrical properties, good biocompatibility and size compatibility, so that the SWNTs have great potential uses in the biosensor fields due to these advantages. This article reviews recent examples of carbon nanotubes field-effect transistor (CNTFET) as a label-free biosensors for detecting a variety of biological macromolecules, such as protein, enzyme, DNA, cancer, virus, carbohydrate and so on.
Animals ; Biosensing Techniques ; instrumentation ; trends ; DNA ; chemistry ; Humans ; Nanotubes, Carbon ; chemistry ; Proteins ; analysis ; Transistors, Electronic

Objective To investigate the precipitating factors,clinical manifestations,magnetic resonance imaging (MRI) features and prognoses of children with posterior reversible encephalopathy syndrome (PRES) during the treatment of hematological diseases,and to improve the understanding of the diseases.Methods A total of 9 children with PRES,admitted to our hospital from January 2012 to December 2016,were chosen.The clinical data,including precipitating factors,clinical manifestations,MRI features and prognoses,were retrospectively analyzed.Results (1) Precipitating factors:6 patients with acute lymphoblastic leukemia occurred PRES during remission induction therapy (6/9,66.7％) and 3 occurred PRES during oral cyclosporine A after hematopoietic stem cell transplantation or autoimmune diseases (3/9,33.3％).(2) Clinical manifestations:all of them were acute onset,and the main symptoms were seizures (8/9,88.9％) and hypertension (7/9,77.8％);some patients suffered from headache,vomiting,visual disturbances,disturbance of consciousness and poor mental symptoms.(3) Features of head MR imaging:the lesions were mainly located in the parietal-occipital lobe,showing patchy long T1 and long T2 signals,and bilateral imperfect symmetry;FLAIR imaging showed high signal distinctly,and other parts of brain could also been involved in.(4) Prognoses:7 children (77.8％) recovered well,one (11.1％) left frequent seizures during 2 years of follow up,one (11.1％) left mental retardation.Conclusion Methotrexate,cyclosporine A and other agents are important incentives in children with PRES during the treatment of hematological diseases;seizures and hypertension are the main clinical manifestations;MR imaging is important in diagnosing the disease;and PRES is not completely reversible.

OBJECTIVE: To study the indication and the methods of hypopharyngeal and esophageal reconstruction in the surgical treatment of cervical esophageal carcinoma with laryngeal function preservation. To explore the reasons of err inhaling after gastric-pharyngeal anastomosis and its prevention and treatment. METHOD: Clinical data of nine patients who underwent surgical treatment of cervical esophageal carcinoma with laryngeal function preservation from 1998 to 2006 were analyzed retrospectively. The patients without preoperative hoarseness included two cases of pure cervical esophageal carcinoma, six cases of cervical esophageal carcinoma involved hypopharynx and one cases of cervical-thoracic esophageal poly primary malignant carcinoma. Eight patients were carried out total laryngeal function preservation and one patient was carried out partial laryngeal function preservation. The methods of hypopharyngeal and cervical esophageal reconstruction included gastric-pharyngeal anastomosis (seven patients), free forearm flap (one patient) and pectoralis major myocutaneous flap (one patient). RESULT: Good laryngeal function in four patients, moderate laryngeal function in two patients and bad laryngeal function in three patients. Everyone in seven patients underwent gastric-pharyngeal anastomosis had a very degree of gastric countercurrent, temporalitive disappearance of cough reflex and err inhaling, five of them laryngeal paralysis. The higher anastomosis gob, the heavier err inhaling. One patient with free forearm flap died of lethal haemorrhage. One patient with pectoralis major myocutaneous flap occurred anastomosis gob stricture. CONCLUSION Patients with pure cervical esophageal carcinoma and cervical esophageal carcinoma involved hypopharynx less than 1 cm from the entrance of esophagus are feasible to undergo total laryngeal function preservation operation, while elder patients with cervical esophageal carcinoma involved hypopharynx more than 1 cm from the entrance of esophagus are feasible to undergo partial laryngeal function preservation operation or no laryngeal function preservation operation instead of total laryngeal function preservation operation. Err inhaling is nearly relevant to the disorder of deglutition function of the pharynx-esophagus and err inhaling prevention function of the larynx.
Adult ; Aged ; Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Laryngectomy ; methods ; Larynx ; surgery ; Male ; Middle Aged ; Neck ; Retrospective Studies ; Stomach ; surgery