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.

ObjectiveTo study the relationship between depression and physical self and related factors of head and neck cancer patients (HNCPs).MethodsOne hundred and twenty-eight HNCPs were assessed with self-rating depression scale,physical self scale,negative physical self scale and symptom checklist-90 (SCL-90).SPSS 16.0 was used to analyze the data.ResultsThe evaluation of appearance,sport characters and figure characters were significantly different between sexual groups,the average physical self scale level of the male patients was higher than that of the females (3.33 ± 0.56 vs.2.87 ± 0.32,P ＜ 0.05).The appearance,sport characters,figure characters and sexual characters of physical self-concept were significantly different between age groups,the body satisfaction scale from higher to lower were under 45 years old patients,beyond 60 years old,between 46 and 59 years old.ConclusionThe evaluation of appearance is reversely correlated with the score of SCL-90,the evaluation of short,appearance and fat in negative physical self are positively correlated with the score of SCL-90.

ObjectiveTo explore the clinical effect of video-assisted thoracoscopic surgery(VATS) for chronic empyema. Methods74 patients with chronic empyema were divided into experimental group and control group,control group was given decorticationoflung,and experimental group was given VATS. ResultsThe duration of chest tube drainage, hospitalization and complications in experimental group was significantly better than that in control group,it showed better clinical effect. ConclusionFor part of patients without the serious disease change of chronic empyema, if the surgery indication could be controlled strictly, the VATS was considerable.

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.

BACKGROUND: Nitric oxide in the central nervous system is involved in controlling the sympathetic outflow. The authors' recent data show that the reduction of nitric oxide in the rostral ventrolateral medulla (RVLM)enhanced the cardiac sympathetic afferent reflex (CSAR) evoked by stimulating the cardiac sympathetic afferent nerves in rats with chronic heart failure (CHF).OBJECTIVE: To further investigate the effect of nitric oxide in the RVLM on modulating the CSAR evoked by epicardial chemical stimulation in rats with CHF.DESIGN: Randomized controlled experiment.SETTING: Department of Physiology, Nanjing Medical University, and Department of Cellular and Integrative Physiology, University of Nebraska College of Medicine.MATERIALS: This study was carried out in the Department of Physiology, Nanjing Medical University from July 2003 to May 2004. A total of 52male Sprague-Dawley rats weighing 360-420 g were used, and were randomly divided into chronic heart failure group and control group with 23 in each group.METHODS: The rats were carried out either sham surgery or the left coronary artery ligation. Six to eight weeks later, all rats were anesthetized with α-chloralose and urethane and baroreceptor denervated and vagotomized. The CSAR was evoked by epicardial application of bradykinin (BK, 0.04 μg and 0.4 μg in 2.0 μL) to mimic the effect of chemical stimulation on the heart in the CHF state. The renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and during elicitation of the CSAR. Cannulae were inserted into the RVLM for microinjections.croinjection of MeTC, a nitric oxide synthase inhibitor, into the RVLM on Effects of epicardial pretreatment with lidocaine on the CSAR in CHF rats.infarction of (30.6±2.0) % of the left ventricular (LV) surface. The systolic arterial pressure, pulse pressure, left ventricle peak systolic pressure and maximum of the first differentiation of left ventricular pressure were decreased and the left ventricular end-diastolic pressure was significantly ininto the RVLM had no significant effects on the CSAR in rats with CHF,of SNAP (50 nmol) into the RVLM inhibited the CSAR in both sham rats ventricle abolished the CSAR evoked by epicardial application ofBK on the same area.CONCLUSION: Nitric oxide in the RVLM inhibits the CSAR evoked by epicardial application of BK in normal rats and CHF rats, and the reduction of nitric oxide in the RVLM led to the augmentation of the CSAR in CHF rats.

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 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.

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.

Objective To investigate the expression of interleukin-17 (IL-17) and matrix metalloproteinase-9 (MMP-9) in non-small cell lung cancer (NSCLC) and their relationship with pTNM staging.Methods IL-17 and MMP-9 expressions in cancer and adjacent tissues were detected from 102 cases of NSCLC by immunohistochemistry.x2 test was used to compare the ratio of their relationship with the pTNM stage.Results IL-17,MMP-9 expression rates in NSCLC cancer were 73.53 ％ (75/102),60.78 ％ (62/102)respectively,IL-17,MMP-9 expressions in different TNM stages were statistically significant correlated (P ＜ 0.05) respectively.The expression of IL-17 and MMP-9 in NSCLC tumor tissue were related statistically (P ＜ 0.05),and adjacent tissues were not related (P ＞ 0.05).Conclusion IL-17,MMP-9 in NSCLC tissues were significant increased,both may be involved in invasion and metastasis of NSCLC,IL-17 and MMP-9 were correlated in NSCLC tumor tissue but not in adjacent tissues.

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.