Objective To observe the adverse reactions of acute stage and late stage in nasopharyngeal carcinoma patients after radiotherapy.Methods 89 patients were investigated in the outpatient department by form.The median follow-up time was 3 years (2-23 years).Results In the acute stage,the ratios of serious xerostomia [78.7 ％(70/89)],the ear reaction [66.3 ％ (59/89)] and nose impairment [64.0 ％ (57/89)] were very high.In the late stage 79.8 ％ (71/89) patients developed radioactive tympanitis,in which 53.9 ％ (48/89) patients induced hearing loss,42.7 ％ (38/89) patients developed dry nose or nasal excessive discharge.The rate of serious xerostomia was 11.2 ％ (10/89),66.3 ％(59/89) patients suffered from superficial and more serious caries.Conclusion The rates of the radioactive tympanitis and caries stayed high in the late stage of nasopharyngeal carcinoma patients after radiotherapy.Concurreut chemoradiotherapy is probable to increase or aggravate the incidence of adverse reactions in the acute stage,but don’t show an effect on the late stage reaction.

Objective To investigate the effect of vecuronium at different doses for induction of anesthesia on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods One hundred and seventeen patients,ASA Ⅰ or Ⅱ,aged 20-64 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into three groups:group Ⅰ (n =39),group Ⅱ (n =40) and group Ⅲ(n =38).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 μg/kg.Following BIS value at 40-50,vecuronium 0.05(ED95) or 0.10 mg/kg (2 × ED95)was intravenously injected in group Ⅰ or Ⅱ respectively,and the electromyographic (EMG) endotracheal tube was intubated under glidescope at 5 min after vecuronium administration.Group Ⅲ received sevoflurane inhalation and the EMG endotracheal tube was intubated following end-tidal sevoflurane concentration at 4％.Anesthesia was maintained with inhalation of sevoflurane in three groups.Cooper' s score and the success of attempt at endotracheal intubation were recorded.The recurrent laryngeal nerve-evoked EMG response was monitored to record the amplitude at 5 min intervals from 30 min to 70 min following surgery.Results The success rates of endotracheal intubation were 100％ in three groups,but the Cooper' s score of groups Ⅰ and Ⅱ was significantly higher than that of group Ⅲ (P ＜ 0.05),while there was no significant difference between groups Ⅰ and Ⅱ.In spite of the EMG amplitude being significantly decreased as compared with group Ⅲ,the EMG response was adequate for monitoring of recurrent laryngeal nerve in group Ⅰ.The EMG response was lost 30 min following surgery,and inadequate for neuromonitoring of recurrent laryngeal nerve 35-45 min following surgery in group Ⅱ.Conclusion Vecuronium 0.05 mg/kg (ED95)for induction of anesthesia may be helpful to provide satisfactory endotracheal intubation conditions,also not affect the monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery,which can be recommended as the optimal dosage.

Objective To explore the methods of thoracoscopic intrapleural perfusion hyperthermic chemotherapy(TIPHC)on diagnosing and treating malignant pleural effusion caused by lung cancer,as well as its effect.Methods From February 1999 to March 2006,seventy patients with malignant pleural effusion caused by lung cancer were randomly divided into therapeutic group(35 cases)and control group(35 cases).Pleural biopsy and TIPHC under general anesthesia with unilateral ventilation were performed in the therapeutic group,and intrapleural injection of cisplatin was administered in the control group after drainage of pleural effusion.The effect on malignant pleural effusion,the change for the concentration of carcino-embryonic antigen(CEA),cytokeratin-19 fragments(CYFRA21-1),neuron-specific enolase(NSE)and the side effect were compared before and after the treatment.Results The therapeutic group achieved total response rate of 100%,but only 54.3% in the control group,with significant difference(P

Objective To evaluate the diagnostic value of CT in the spondylolysis of lumbar spine and improve the technique of CT scan.Methods The CT appearances of the spondylolysis of lumbar spine were analyzed in 20 cases.Results CT could demonstrate the spondylolysis and its abnormal features that led to compress nerve root.Conclusion CT scan plays an important role in the diagnosis of the spondylolysis of lumbar spine and in selecting treat methods.Technique of CT scan improved can depict the specific feature of spondylolysis truely.

Objective:To evaluate the levels of interleukin 18(IL-18) mRNA in peripheral blood mononuclear cells(PBMCs),livers and spleens in monkey endotoxic shock models.Methods:Cynomolgus monkeys were injected i.v. with lipopolysaccharide(LPS) (2.8 mg/kg) to prepare the endotoxic shock models. The mRNA levels of IL-18 in PBMCs,livers and spleens were tested by fluorescence semi-quantitative realtime reverse transcription(RT)-PCR and compared with that of TNF-? and IL-1?.Results:IL-18 mRNA expression in PBMCs remarkably increased at 120 min after LPS administration, so did in livers and in spleens at the same time. mRNA levels of TNF-? in PBMCs peaked at 60 min after LPS injection, and also increased markedly at 120 min in livers and spleens. IL-1? mRNA levels peaked at 60 min in PBMCs, and did not change so much in livers and in spleens.Conclusion:IL-18 mRNA expression in PBMCs can be up-regulated by LPS, but changed latterly than TNF-? and IL-1? in endotoxic shock cynomolgus monkeys. It is presumed that IL-18 can be produced by PBMCs and liver Kupffer cells(maybe splenic macrophages),and TNF-? is produced by a variety of cells, but IL-1? in bloodstream mainly come from PBMCs after LPS challenge.

AIMTo investigate the effects of prostaglandin E 1 on apoptosis induced by hypoxia/reoxygenation in cultured neonatal rat cardiomyocy tes. METHODSThe models of hypoxia/reoxygenation were made with t he first generation of cultured cardiomyocytes. Hypoxia/reoxygenation apoptosis in cultured neonatal rat cardiomyocytes was studied by agarose gel electrophores is and Tdt-mediated dUTP nick end labeling(TUNEL). Bcl-2 and bax mRNA were det ected by in situ hybridization. RESULTSThe results of DNA electr ophoresis in the H/R group showed the typical DNA ladder. And the DNA ladder decreased gradually corresponding to the increased dose of PGE 1. The TUNEL staining showed that the total number of apo ptotic cells in the H/R group was much biger than that in PGE 1(0 127 ?mol?L -1 ) group. The results of in situ hybridization showed that the conten t of bcl-2 mRNA in H/R group was lower than control. And the content of bax mRN A showed a reverse result as bcl-2 mRNA. Compared with H/R group, the content o f bcl-2 mRNA was significantly higher after treatment with PGE 1(0 014 ?mol ?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 ). But the content of bax mRNA in PGE 1(0 014 ?mol?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 )groups was significantly lower than H/R group. CONCLUSI ONH/R injury can induce cardiomyocyte apoptosis. PGE 1 has obvious an ti-apoptotic effects on cardiomyocyte and the mechanisms are possibly by inhibi ting the expression of bax and increasing the expression of bcl-2.hein creaseddoseofPGE1 .TheTUNELstainingshowedthatthetotalnumberofapoptoticcellsintheH

Objective To investigate the effects of sevoflurane on renal ischemia-reperfusion (I/R) injury in rats and the role of Na+-2Cl--K+ cotransporter 1 (BSC1) and aquaporin 2 (AQP2) in it.Methods Twentyfour male Sprague-Dawley rats,aged 8-12 weeks,weighing 125-145 g,were randomly divided into 3 groups (n =8 each) ∶ sham operation group (S group),I/R group and sevoflurane group (Sev group).Renal ischemia was induced by occlusion of the renal artery for 45 min with atraumatic microclips followed by 24 h reperfusion.In group Sev,the rats inhaled 1 MAC (2.2％) sevoflurane,renal ischemia was induced after loss of consciousness and 1 MAC (2.2％) sevoflurane was inhaled for 1 h.The urine were collected at 24 h before I/R (T1) and 24 h of reperfusion (T2) for detection of urine specific gravity and creatinine (Cr) level.The urine volume was recorded.The endogenous creatinine clearance rate (Ccr) was calculated.Blood samples were taken from the irferior vena cava at T2 for determination of concentrations of serum blood urea nitrogen (BUN) and Cr and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO),malondialdehyde (MDA) concentration.The left kidney was removed for determination of MPO and SOD activities and MDA content and for microscopic examination and the pathological changes of the renal tubule were scored.The expression of AQP2 and BSC1 was detected by immunohistochemistry and Western blot.Results Compared with group S,the urine volume was enlarged,concentrations of serum BUN and Cr were significantly increased,urine specific gravity and Ccr were significantly decreased,MPO and MDA levels were significantly increased,SOD activity was significantly decreased,the pathological score was significantly increased,and the expression of AQP2 and BSC1 was down-regulated in groups I/R and Sev (P ＜ 0.05).Cer was significantly higher,conceutratious of serum BUN and Cr and MPO and MDA levels were lower,SOD activity was higher,the pathological score was lower,and the expression of AQP2 and BSC1 was higher in group Sev than in group I/R (P ＜ 0.05).Sevoflurane inhalation significantly attenuated the pathological changes.Conclusion Sevoflurane can attenuate renal I/R injury in rats through up-regulating the expression of BSC1 and AQP2.

This article reviews and summarizes the research data about vertebrobasilar dolichoectasia in recent years from the aspects of epidemiology,pathogeny,pathology,diagnosis,clinical manifestations,as well as its mechanism and treatment.

Objective To investigate the effect of rocuronium 0.3 mg/kg(ED95)for anesthesia induclion on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods Seventy-five patients,ASA Ⅰ or Ⅱ,aged 20-70 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into two groups:rocuronium group(groupⅠ,n=38)and sevoflurane group(group Ⅱ,n =37).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 ug/kg.After loss of eyelash reflex,group Ⅰ received rocuronium 0.3 mg/kg(ED95)and was intubated with the electromyographic(EMG)endotracheal tube under glidescope al 2 min after rocuronium administration.Group Ⅱ received sevoflurane inhalation and was endotracheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4％.Anesthesia was maintained with inhalation of sevoflurane in both groups.SP,DP,and HR were monitored continuously through the surgery.Cooper's score and the success of attempt at endotracheal intubation were recorded.Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 min intervals from 30 min to 70 min of surgery duration.Results SP,DP and HR remained within normal range in both groups.The success rates of endotracheal intubation were 100％ in both groups,but the Cooper' s score of group Ⅰ was significantly higher than that of group Ⅱ(P ＜ 0.05).Compared with group Ⅱ,the amplitude of EMG respouses was significantly decreased in group Ⅰ(P ＜ 0.05).However,the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve.Conclusion Rocuronium 0.3 mg/kg(ED95)for anesthesia induction can not only provide satisfied endotracheal intubation conditions,but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.

Aim To investigate the angiogenic promoting effect of Morinda officinalis How oligosaccharides(MOO) in the ischemic myocardium of rats after acute myocardial infarction(AMI).Methods 40 male Wistar rats were established into AMI model successfully and were randomly divided into 5 groups equally, i. e. the low, medium and high doses of MOO groups, the Shexiangbaoxin group and the model group. They were treated with different doses of the water fraction of the ethanolic extract of Radix morinda officinalis (0.7, 1.4, 2.8 mg·kg~(-1) ·d~(-1)), suspension liquid of Shexiangbaoxin Pill(30 mg·kg~(-1) ·d~(-1)) and distilled water with the same volume respectively.Besides, a sham operated group with 10 rats was set up for control. All rats were sacrificed after 6-week-treatment.The Ⅷ coagulation factor, vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) protein in ischemic myocardium of rats in each group were detected by immunohistochemistry assay.The microvessel density(MVD) was calculated. Gray values of protein expression of VEGF and bFGF in ischemic myocardium were calculated and analyzed by image analysis system.Results The MVD, the gray values of VGF and bFGF were higher in the medium and high doses of MOO groups than those in the model group(P <0.05), but still lower than those in the Shexiangbaoxin group(P <0.05). The MVD and the gray values of VEGF among 3 doses of MOO groups showed significant differences (P <0.05).Significant differences of gray value of bFGF were observed between small and middle doses of MOO groups, also between small and large doses of groups(P <0.05).Conclusion MOO can obviously promote angiogenesis in the ischemic myocardium of the rats after AMI.And up-regulating expressions of VEGF and bFGF protein in the ischemic myocardium may act as one of its angiogenic promoting mechanisms.