Ear Diseases ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging

Liver transplantation is a valid treatment option for select patients with Hepatocellular Carcinoma HCC and end-stage liver disease. However, in approximately 20% of patients, recurrent HCC is the rate-limiting factor for longterm survival. Despite identification of clinical parameters that may stratify patients at high risk and exhaustive preoperative staging, cancer recurrence is likely the result of microscopic extrahepatic disease. With a desperate donor organ shortage, locoregional ablation techniques and resection are being employed in patients on the waiting list to serve as a bridge to OLT. Further more, some have advocated aggressive surgical resection of isolated metastasis in both the liver and extrahepatic viscera. Whether these creative strategies confer a survival advantage is unknown, requiring longterm follow-up to determine their efficacy.

Objective To investigate the reasonable and effective administration ofdexmedetomidine for thoracic surgery anesthesia.Methods Eighty ASA Ⅰ-Ⅱ patients,aged 18-60 years old scheduled for elective thoracotomy were randomly assigned to 4 groups(each 20 patients).Group A:dexmedetomidine before anesthesia induction + bupivacaine before closed thorax cavity.Group B:dexmedetomidine before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Group C:0.9％ sodium chloride before anesthesia induction + bupivacaine before closed thorax cavity.Group D:0.9％ sodium chloride before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Mean arterial pressure (MAP) and heart rate (HR) were measured before infusing dexmedetomidine or 0.9％ sodium chloride (T0),after infusing dexmedetomidine or 0.9％ sodium chloride (T1),instant time after intubation (T2) and 3 min after intubation (T3),5 min after intubation (T4).The scores of visual analogue scale(VAS) and the consumption of analgesics were compared.Results There was no significant difference including gender,age,weight and operation time among four groups (P ＞ 0.05).Compared with T0,MAP and HR were significantly decreased at T1 in group A and group B (P ＜ 0.05),and were significantly increased at T2 in group C and group D (P＜ 0.05).Respectively compared with group A and group B,MAP and HR were significantly increased at T2,T3 in group C and group D (P ＜ 0.05).The scores of VAS in group B [(2.47 ± 1.43) scores] and group D [(2.00 ± 1.68) scores] were lower than those in group A [(4.78 ± 1.26) scores] and group C [(4.88 ± 1.62) scores] after operation 12 h.The times of using postoperative analgesics in group B [(0.6 ± 0.4) times] and group D [(0.8 ± 0.1) times] were significantly less than those in group A [(1.3 ± 0.5) times]and group C [(1.5 ± 0.4) times] (P ＜ 0.05).Conclusions Intravenous dexmedetomidine before anesthesia induction can control the effect of double-lumen endobronchial tube responses and make hemodynamics stable.Intercostal nerve block with 0.5 μ g/kg bupivacaine and 0.375％ dexmedetomidine can enhance the analgesia effect and prolong the analgesia time.

Objective To investigate the effects of shRNA produced by PCR on the suppression of the expression of exo- or endogenous genes. Methods The specific primers were designed, with which the shGFP-RNA and shFN-RNA were produced by PCR. The shGFP-RNA was transfected into 293T cell lines together with pEGFP plasmid, then the cells were detected by laser confocal microscopy 48h later. The shFN-RNA was transfected into rat mesenteric cell lines, then the cells were collected 48h later and the total RNA was extracted, which was reversely transcripted to cDNA. Then the expression level of FN mRNA was examined with real-time PCR, and the expression level of FN protein was examined with Western blot analysis. Results The results of laser confocal microscopy indicated that the EGFP could be successfully suppressed by shGFP-RNA produced by PCR; the results of real-time PCR and Western blot analysis revealed that FN expression level of the cells transfected with shFN-RNA was down regulated, and the level was much lower than those tansfected with independent shRNA (P

Objective To investigate the correlative factors that affect the outcome of pregnancy complicated with SLE and try to provide the best chance for conception, pregnant monitoring, prevent the deterioration of SLE and improve the perinatal quality.Methods Retrospect analysis of 79 cases of pregnancy complicated with SLE. Results The birth weight in the group of pregnancy with SLE was lower than that in the normal group. The outcomes (weight and gestational weeks) of pregnancy in multipara, and nephrolupus groups were poorer than those in primigravida, and in non nephrolupus. The outcomes of pregnancy with SLE in active stage at the beginning of conception were poorer than those in stationary or remission stage. Conclusions The results show that first of all, the activity of SLE should be controlled and patients should get conception under the guide of the obstetricians and physicians, multi pregnancy also should be avoided. Prednisone is one of the safe drugs for pregnant women to control the activation of SLE and to prevent from deterioration. Intensive monitors should be offered to pregnant women complicated with SLE to acquire a better pregnancy outcome.

Objective To investigate the human leucocyte antigen (HLA) expression of ectopic endometrial epithelial cells in cases with endometriosis and its role in pathogenesis of endometriosis Methods By immunohistochemical analysis,HLA expression was observed in ectopic endometrial epithelial cells of 25 endometriosis patients Ectopic endometrial cells were cultured in vitro successfully and the expression of HLA were analyzed by flow cytometry in 10 out of the 25 patients Eutopic endometrium of 15 normal women were taken as control Results (1)Expression of HLA class Ⅰ molecule on ectopic endometrial epithelial cells of endometriosis measured by the immunohistochemical analysis was lower than those of controls, (4 0?0 5) score and (1 2?0 8) score respectively So was the expression rate by flow cytometry in vitro culture (63 38?11 88)% and (5 27? 2 88)% respectively ( P

In order to study the structure-function relationship in the protein which is incorporated with p-nitro-L-phenylalanine,the method of MD(Molecular Dynamics) simulation was established and successfully used in the analysis of protein which contains p-nitro-L-phenylalanine.The force field of CHARMM can only stimulate protein with natural amino acid in NAMD.Compared with phenylalanine,p-nitro-L-phenylalanine just has one more group of nitro.If the parameter of group of nitro was defined,the protein containing p-nitro-L-phenylalanine can be simulated.CGenFF-paramchem was used to calculate the energy and topological structure of p-nitro-L-phenylalanine' s new bonds (r),angles (θ),dihendrals (φ) and improper angle (ψ).And then the new defined parameter and topology information was input into the related parameter files and topology files in CHARMM.On the basis of correct parameter,NAMD can successfully simulate the modified BAFF(B lymphocyte stimulator) which contains p-nitro-L-phenylalanine.The changes in structure indicated that there might be new B cell epitopes.The temperature distribution of each frame in the process of dynamics stimulation was in accord with normal distribution,which proved the defined force field parameters was feasible.The RMSD of whole protein solution systemis 2.5.Calculate each resides' RMSF in BAFF,the RMSF of p-nitro-L-phenylalanine's residue is 3.7,which is obviously higher than that of the other residues in β-pleated sheet,and close to the loop rings,indicate that there might be variation in the area of p-nitro-L-phenylalanine residue and might produce new comformational epitopes.The results of MD stimulation will guide the immunogenicity experiments of p-nitro-L-phenylalanine modified proteins.

Objective To investigate the dangers of heart failure to the mother and fetal,and the diagnosis and treatment of pregnancy complicated with heart failure. Methods The clinical data of the causes,timing,management and outcomes of 87 cases of pregnant women complicated with heart failure from March 1993 to January 2006 were analyzed retrospectively. Results ①Thirty-one cases(35.6%) of heart failure in pregnancy were caused by rheumatic heart disease,26(29.9%) by pregnancy-induced hypertension(PIH),16(18.4%) by congenital heart disease,and 14(16.1%) by peripartum cardiomyopathy.②The heart failure appeared at the average of(32.69?5.57) weeks.③The average terminal time of pregnancy was(34.66?4.52) weeks.④There were 79 newborns with 6 cases of twins,and the perinatal mortality was 8.6%(8 cases).Hysterotomy was performed in 6 cases in mid-pregnancy.The average weight of babies was(2419.56?786.08) g.⑤The maternal mortality was 6.9%(6 cases).(Conclusion The main) causes of heart failure in pregnancy are rheumatic heart disease,PIH and congenital heart disease.Although the standard management of pregnancy complicated with heart failure is inotropic agents,diurectics and vasodilators,the treatment should be individualized according to the specific etiology and with the consideration of the safety of fetus as well.Pinpointing the causes of heart failure in pregnant patients and treating accordingly may be conducive to reduce the maternal and perinatal mortality.

Humans ; Otorhinolaryngologic Surgical Procedures ; methods ; Quinolones ; therapeutic use ; Respiratory System Agents ; therapeutic use

The etiology of reversible posterior leukoencephalopathy syndrome(RPLS)is more complex.Its pathogenesis has a lot of controversies,and its clinical manifestations are headache, nausea,vomiting,epileptic seizure,consciousness disturbance and visual abnormality.Neuroim- aging examinations have shown that diffuse symmetrical white matter edema is predominantly in the bilateral posterior brain regions.Clinical symptoms and neuroimaging changes can be recov- ered completely after timely and effective treatment.If the treatment is delayed,it may compli- cate with cerebral infarction or hemorrhage,and lead to irreversible damage.