Objective To evaluate the patient-controlled paravertebral block (PCPB) in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in patients.Methods Forty-one ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-64 yr,with body mass index of 20-25 kg/m2,of TNM staging Ⅰ or Ⅱ,undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope,were randomly divided into 2 groups using a random number table:PCIA group (n =21) and PCPB group (n =20).PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In PCPB group,the patients received paravertebral injection of 0.2％ ropivocaine 5 ml at T5 level on the affected side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0.75％ ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose,with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤ 3,and analgesia lasted until 50 h after operation.Before induction of anesthesia (baseline),at end of operation,and at 1,3 and 5 days after operation,peripheral venous blood samples were collected to determine the levels of regulatory T cells,natural killer cells and natural killer T cells (by flow cytometry) and plasma concentrations of interleukin-10 and transforming growth factor-β (by ELISA).Results Compared with group PCIA,the level of regulatory T cells was significantly decreased,the levels of natural killer cells and natural killer T cells were increased,and the plasma concentrations of interleukin-10 and transforming growth factor-β were decreased at 1 and 3 days after operation,and no significant change was found in the rate of cellular immune function decline after operation in group PCPB.Conclusion PCPB provides no significant difference clinically in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in the patients.

AIM: To study the effect of Lomerizine on the activity of P-glycoprotein (P-gp) in the bloodbrain barrier(BBB) and search for novel effective P-gp inhibiting agent against multidrug resistance. METH-ODS: Rhodamine123 (Rh123) was used to examine the activity of P-gp and RT-PCR to study the mdr mRNA expression in cultured rat brain microvessel endothelial cells (RBMECs). RESULTS: Lomerizine could increase the cellular Rh123 in RBMECs in a concentration-dependent manner. RT-PCR indicated that lomerizine could not down-regulate the expression of mdr mRNA. CONCLU-SION: Lomerizine can reverse multidrug resistance in the blood-brain barrier by inhibiting the activity of P-gp.KEY WORDS lomerizine; P-glycoprotein; bloodbrain barrier; RT-PCR

Objective To investigate the altered expression of TLR4 in alveolar macrophages of diabetic rats after lipopolysaccharide (LPS) stimulation and the effect of these changes on defending the infection. Methods Thirty-two male Wistar rats were divided into 4 groups, group A: the control group; group B: the diabetic group; group C: the LPS stimulated group; and group D: the diabetic group with LPS stimulation. TLR4 in alveolar macrophages were measured by immunocytochemistry, RT-PCR and Western blot analysis. Results The expressions of TLR4 in group B and group C were higher than that in group A (P < 0. 001). The expression of TLR4 in group D was obviously higher than that of group B and group C (P < 0.001). Conclusion The expression of TLR4 of diabetic rats was higher than that of normal rats and became more higher after LPS stimulation, which is indicated that diabetic bodies were in the proinflammatory state, the mechanism remains to be explored in detail.

Objective To evaluate the accuracy and clinical practicality of DNA chip in comparison with serology in typing of human leukocyte antigen A (HLA-A) in Han's individuals of donor-recipients of transplantation. Methods 120 peripheral blood samples were obtained from donor-recipients of transplantation. Each sample was divided into two parts and HLA-A antigens were identified by DNA chip in one part and by serology in another. Samples in which the HLA-A typing results by these 2 methods were discordant were verified by polymerase chain reaction with sequence specific primers (PCR-SSP). Accuracy and clinical practicability of both methods were compared according to the typing results. Results Serological typing for HLA-A took 3 h, while DNA chip typing 4. 5-5 h. 112 samples have been typed successfully. Typing results were same in 91 samples and discordant in 21 cases. The verified results showed that DNA chip made 2 incorrect typing and the error rate was 2%. Meanwhile, serology made 19 mistakes, consisting of 5 antigens being incorrectly interpreted and 14 "blanks" turning out to be definable alleles. The discrepancy rate was 17 %. Conclusions DNA chip typing for HLA-A is suitable for clinical application in Chinese Han's population with a greater precision than serology. It may replace the serology in future after being improved and perfected.

[Objective]To analyze the early diagnosis and treatment of the popliteal artery injury associated with the dislocation and fracture of the knee.[Method]A total of 71 cases of popliteal artery injury associated with the dislocation and fracture of the knee were treated from March 1998 to May 2005.Properative(vascular examization) and operative(methods of arterial repair,venous repair-ligation,anticoagulation-thrombolytic therapy,fracture reduction and internal fixation,fasciotomy) treatment were studied.[Result]Totally 15 cases were primary amputation and 56 cases were performed vascular repair and the fractures and dislocations were reduced and fixed by internal or external fixation.Two cases had thrombosis at the repaired site confirmed by Doppler and had to perform second operation to remove thrombus and repair the popliteal by autograft of the saphena magna vein.At the follow-up,2 cases had chronic osteomyelitis and 2 cases had traumatic arthritis.[Conclusion]It is postulated that a rational and prompt diagnosis and treatment of popliteal artery injury associated with dislocation and fracture around the knee would decrease the adverse effects of ischemia and reduce the overall morbidity.

[Objective] To investigate the relationship between the body constitution and the syndromes of the bronchiectasis patients and provide the basis for the clinical treatment.[Methods] Col ected 80 out-patients and in-patients of bronchiectasis in the first affiliated hospital of Zhejiang Chinese Medical University from May 2011 to March 2012. Al patients met with the inclusion criteria, adopted the standardization of physical scale for physical identifica-tion and dialectical type and analyzed the relationship between constitution and syndrome.[Results] ①The gentleness type, qi-deficiency type and yin-defi-ciency type were more popular in the bronchiectasis, fol owed by the phlegm-wet type, wetness-heat type, yang-deficiency type and qi-depression type. The special inherited type and blood-stasis type were very rare. ②The syndrome of phlegm heat obstructing lung was the top one in the Chinese tradi-tional medical syndromes(48.75%).The frequency of liver-fire attacking lung syndrome, hyperactivity of fire due to yin deficiency syndrome and qi-yin de-ficiency syndrome were 21.25%, 18.75% and 11.25% respectively. ③From different body constitution distribution of TCM syndromes in patients with bronchiectasis, it could be found:gentleness type, qi-deficiency type, yang-deficiency type, phlegm-wet type and wetness-heat type were most presented as phlegm-heat stasis lung syndrome. Patients with qi-deficiency type were most presented as qi-yin deficiency syndrome .Patients with Yin deficiency type were always performed as hyperactivity of fire due to yin-deficiency syndrome. Patients with lung qi-stasis type were liver-fire invading lung syn-drome.[Conclusion] Phlegm-heat stasis syndrome was the main syndrome in patients with bronchiectasis. It conformed to the pathological characteristics of deficiency essence with virtual reality. Different body constitutions decided the different traditional Chinese medical syndromes after the disease onset.

OBJECTIVE:To observe the efficacy and safety of aerosol inhalation recombinant human interferon α1b in the treat-ment of bronchiolitis in children. METHODS:60 children with bronchiolitis were randomly divided into low-dose group,high-dose group and control group. All children were given tracheal suctioning,phlegm dispersing and other symptomatic treatment. Based on it,low-dose group was given recombinant human interferon α1b 1-2 μg/(kg·times),adding into 3 ml 0.9% Sodium chloride injec-tion,compression aerosol inhalation,twice a day;high-dose group was given recombinant human interferon α1b 3-4 μg/(kg·times), adding into 3 ml 0.9% Sodium chloride injection,compression aerosol inhalation,twice a day;control group was given ribavirin 10-15 mg/(kg·d),adding into 5% Glucose injection at ratio of 1∶1 by intravenous infusion,once a day. The treatment course for all groups was 5-7 d. Clinical efficacy,disappearance time of cough,respite,rale and three depressions,hospitalization time and incidence of adverse reactions in all groups were observed. RESULTS:Disappearance time of cough,respite,rale and three depres-sions and hospitalization time in high-dose group were significantly shorter than low-dose group and low-dose group shorter than control group,the differences were statistically significant(P<0.05). Total effective rate in high-dose group was significantly high-er than low-dose group and low-dose group higher than control group,the differences were statistically significant (P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on conventional treatment,both efficacy and safety of aerosol inhalation recombinant human interferonα1b in the treatment of bronchiolitis in children are good.

8 cases of Hallermann-streiff syndrome were found trom 1980 to 1988. Two of them had been followed up for 7 years. The patients consisted of 6 males and 2 females at 8-32 years of age. The clinical manifestations were as follows : ① dsycephaly with bird face and ; ② congenital cataract or aphakic in all cases; ③ dental anomaly in 7 cases; ④nanism in 4 cases and the fontanel frontalis (maior) of 1 casc (case 7, males 32 years of age, height 1. 23 m, weight 29. 5 kg) was not closed, ⑤ atrophy of skin in 7 cases whosc skin appeared shine and thin, particularly on the nose top, and one or two areas of alopecia appeared in 3 of 6 cases, ⑥ hypotrichosis in 8 cases and ⑦ bilateral microphthalmia in 6 cases. ① and ② were significant for the diagnosis of Hallemann-Streiff syndrome.

AIM: To study the clinical curative effect of 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy for cataract and vitreoretinal diseases.METHODS: Retrospective analysis of 92 patients (99 eyes),including 49 male (53 eyes),43 female (46 eyes) with mean age was 57.1±1.9 years,in our hospital for cataract and vitreoretinal treatment of the disease from February 2013 to February 2016.All patients underwent 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy.Curative effect and complications were observed.RESULTS: Combined surgical procedures were carried out smoothly.posterior capsule rupture did not occurred.seven eyes were filled with BSS fluid,46 eyes with C3F8,49 eyes with intraocular lens at phase Ⅰ,21 eyes placed intraocular lens when silicone oil was removed.The visual acuity improved in 84 eyes (85%),unchaged in 15 eyes (15%).Postoperative complications included transient high intraocular pressure in 18 eyes (18%),anterior chamber reaction in 7 eyes (7%) and corneal edema in 8 eyes (8%).CONCLUSION: The 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy is a safe and effective surgical method with less injury,fewer complications.

Objective:To examine the polymerization shrinkage stress of three universal hybrid composite resins by photo-elastic analysis.Method:Epoxide resin disks (d=80 mm,h=4 mm) with a cylindrical cavity (d=4 mm) in the middle were prepared.Composite resins of Charisma,TPH Spectrum and Esthet-X were respectively filled in the cavities for the formation of specimens.Eight specimens were made for each resin.The resin specimens were light cured for 40 s by Dentsply QHL75 Curing lite. Polymerization contraction stress was calculated based on the diameter of the isochromatic rings of first order obtained from the diameter of epoxide resin specimen at 1,2,3,4,5,10,20 and 30 min,1,24 and 48 h after curing. The statistical analysis was carried out with the Wilcoxon test.Results:Polymerization contraction stress rised rapidly in the first 10 min after curing. 1 and 24 h after curing the shrinkage stress(MPa) of Charisma were 2.893 6?0.1 and 4.190 4?0.1,while that of Esthet-X were 2.291 7? 0.1 and 3.143 9? 0.3 ,respectively.The shrinkage stress values of TPH spectrum was between those of Charisma and Esthet-X 24 h after curing. 79% specimens showed shrinkage stress releasing during 24 and 48 h after curing.Conclusion:The rates of the shrinkage stress of the three studied resin composites are different.