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.

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.

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.

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.

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 observe the effect of H shaped decalcified bone grafting on spinal fusion and anti conglutination by posterior approach and to evaluate its values in the application in spinal posterior approach surgery. Methods Total laminectomy was performed on 23 cases of severe spinal stenosis and 31 cases of intraspinal tumor for decompression. Thorough decompression of the nerve roots was performed on the former following total laminectomy while exploration and excision of the neoplasm were done on the latter. Then, H shaped decalcified bone grafts were inlaid between spinous processes and transverse processes to cover the lamina defection and overlap the adjacent segments in all cases. At last, the spinal internal fixation or plaster external fixation were used to stabilize vertebral segments according to the economic status of patients. The average time of follow up was 21 months (18～31 months). Results All patients got successful segmental spinal fusion within 8 months. Clinical symptoms were obviously alleviated in 43 cases at the end of follow up but symptoms recurred 12 months after operation in other 11 cases(all were tumor patients). Conclusion H shaped decalcified bone graft is valuable in spinal fusion and anti conglutination in spinal posterior approach surgery.

AIM To study the protective effects of prostaglandin E 1 on hypoxia/reoxygenation injury in cultured neonatal rat myocytes. METHODS The hypoxia/reoxygenation injury model of cultured neonatal rat myocardial cells was developed. The activities of plasma superoxide dismutase (SOD) were measured by the method of xanthine oxidase and the contents of serum malonicaldehyde (MDA) were determined by the method of thiobarbituric acid. The activities of dehydrogenase in mitochondria were detected by MTT assay. The activities of LDH in culture were also evaluated. CONCLUSION PGE 1 has protective effects on the cultured neonatal rat myocardial cells injured by hypoxia/reoxygenation. The mechanisms are related to its antioxidation effects.