Objective To observe the influences of different anesthesia methods or adjuvant chemotherapy on hemorheological parameters in patients with cervical cancer.Methods Sixty pa-tients with cervical cancer were equally randomized into two groups.Patients in group A received three courses of chemotherapy preoperatively while those in group B did not.The patients of group A and B were divided respectively into two subgroups,combined epidural general anesthesia group (groups A1 and B1),general anesthesia group (group A2 and B2).Blood samples were taken for the hemorheological measurement at 5 min before induction of anesthesia,60 min after induction of anes-thesia and at the end of surgery.Results Red cell deformability index (EDI)was significantly lower in group A than that in group B;Erythrocyte rigidity index (ERI)and blood viscosity were higher in group A compared with those in group B (P <0.05).In groups A1 and B1,EDI,plasmic viscosity packed ERI,and ERI were all lower than those before anesthesia induction (P < 0.01 );while in groups A2 and B2 Hct decreased.Conclusion The patients of cervical cancer after chemotherapy showed some hemorheological changes characterized by a lowered EDI.Combined general and epidural anesthesia can significantly improve the above parameters.

Objective To analyze the efficacy of rosuvastatin on the patients with hyperlipidemia and hypertension.Methods From March 2011 to June 2012,112 cases with hyperlipidemia and hypertension in our hospital were enrolled in this study.Patients were randomly divided into treatment group and control group (56 patients,each).Patients in control group were treated with oral amlodipine 5 mg/d.Patients in treatment group were treated with oral rosuvastain 10 mg/d and oral amlodipine 5 mg/d.One month after the treatment,the levels of blood pressure,total cholesterol (TC),tryglyceride (TG),low density liporotein (LDL-C),high density lipoprotein cholesterol (HDL-C),high sensitivity C-reactive protein (hsCRP) were determined.The occurrence of adverse effects were observed.Results One month after treatment,systolic blood pressure and diastolic blood pressure were significantly decreased in both two groups compared with pre-treatment [Control group:(135.2±9.51)mm Hgvs.(59.2±7.3)mm Hg,(88.8±5.2)mm Hg vs.(99.5±8.3)mm Hg,t=4.95,2.87; Treatment group:(130.2±5.5)mm Hg vs.(160.3±9.3)mm Hg,(86.7± 10.2)mm Hg vs.(99.7±8.3)mm Hg,t=5.03,2.94,all P＜0.01],but more declines were found in treatment group than in control group(t=3.96,3.42,both P＜0.001).The levels of LDL-C,TG and TC were significantly decreased in both two groups compared with pre-treatment [Control group:(2.64±0.72)mmol/L vs.(3.97±0.84)mmol/L,(1.89±0.25)mmol/L vs.(2.56±0.45)mmol/L,(4.23±0.56)mmol/L vs.(7.36±0.48)mmol/L,t=2.58,3.03,2.36,P=0.013,0.004,0.022;Treatment group:(1.75 ± 0.68) mmol/L vs.(3.85 ± 0.79) mmol/L,(1.71 ± 0.18) mmol/L vs.(2.63±0.42)mmol/L,(3.18±0.47)mmol/L vs.(7.20±0.56)mmol/L,t=2.77,3.16,2.59,P=0.008,0.003,0.012,respectively],but more declines were observed in treatment group than in control group(t=6.73,4.37,10.70 respectively,all P＜0.05).The HDL-C concentrations were increased in both two groups compared with pre-treatment [Control group:(0.97±0.26)mmol/L vs.(0.75±0.31)mmol/L,t=2.89,P=0.006; Treatment group:(1.09±0.23)mmol/L vs.(0.72±0.24)mmol/L,t=3.01,P=0.004],but more increment were observed in treatment group than in control group(t=2.59,P＜0.05).The hsCRP concentration was significantly reduced in treatment group compared with pre-treatment [(1.32±0.17) mg/L vs.(4.97±0.13) mg/L,t=4.40,P＜0.001].There were no significant differences in liver and kidney function between the two groups.Serious adverse effects were not found.Conclusions Rosuvastatin combined with routine antihypertensive therapy can effectively decrease the levels of serum LDL-C,TG,hsCRP; increase serum HDL-C concentration and blood pressure can be effectively controlled.

Objective To explore the changing trend of Ia on monocyte, lymphocyte apoptosis rate, TNF-α and IL-6 in abdominal aorta of burned rats with delayed resuscitation and the influence of application of carbachol on them. Methods Adult male Wistar rats were randomly divided into normal control group(n =8), scald group(n =48) and scald with carbachol treatment group(n =48). In latter two groups, rats were inflicted with 30% total body surface area (TBSA) full-thickness scald and delayed fluid resuscitation. All scald rats were sacrificed at the 6th hours or 1st, 2nd, 3rd, 7th, 14th day after scald, with 8 rats at each time point. Expression of Ia antigen on monocyte and lymphocyte apoptosis rate were determined by direct immunofluorescence on a flow cytometer, and TNF-α and IL-6 was measured by ELISA. Results Expression of la on monocyte was obviously lower than that of controls. The lowest levels were recorded on the 6th hours and 1st day after scald. Subsequently, Ia was elevated gradually, but still lower than that of normal rats(P <0. 01). After administration of carbachol, Ia expression was obviously promoted, compared with the simple scald group (P <0. 01). Lymphocyte apoptosis rate, TNF-α and IL-6 was higher than that of controls(P <0. 01). After administration of cavachol, , lymphocyte apoptosis rate and TNF-α and IL-6 was obviously down-regulated on the 6th hours, 1st day, 2nd day and 3rd day after scald injury, compared with the simple scald group (P < 0. 01 or 0. 05). Conclusion After severe burn with delayed fluid resuscitation, there is a low la expression, high lymphocyte apoptosis rate and increased releasing of proinflammatory cytokine. Immune function was suppressed. Carbacho] could improve the immune function of scald rats with delayed fluid resuscitation.

Objective To compare the treatment effect of autologous blister skin grafting with ReCell autologous chromocyte grafting on cicatricial depigmentation caused by deep burn.Methods Thirty-four patients with cicatricial depigmentation caused by deep burn who were admitted into hospital from May 2012 to February 2015 were included in this study.The total 61 depigmentation areas were randomly divided into two groups;32 areas from 18 patients were treated with autologous blister skin grafting,and the other 29 areas from 16 patients were trea-ted with ReCell autologous chromocyte grafting.In the autologous blister skin grafting treated group,epidermis from the depigmentation area was removed by grinding with a BY-II AM type epidermal graft vitiligo treatment equipment.Then the autologous blister skin was harvested with the suction blistering method and grafted onto the wound of depigmentation area.In the ReCell autologous chromocyte grafting treated group,split-thickness skin flap was harvested by electric dermatome.Then the donor skin was processed into chromocyte suspension with the ReCell assay kit and evenly sprayed onto the depigmentation areas.The wound healing time and the pigment recovery 3 months after surgery were observed.Results The wound healing time of autologous blister skin grafting treated group was significantly shorter than that of ReCell autologous chromocyte grafting treated group (P <0.05 ).The effective rate of pigment recovery 3 months after surgery in autologous blister skin grafting treated group was markedly higher than that of ReCell autologous chromocyte grafting treated group(P <0.05 ). Conclusion The autologous epidermal grafting treatment using grinding and suction blistering method is simple and easy to perform,marked-ly effective,with no suture scar and low surgical risk,thus serving as a promising and ideal therapeutic method for burn scar depigmentation.

Objective By combined application of endoscopic and microscopic vivisection-pronged approach,forms a three-dimensional morphological observation through focusing on an observation of structure of various signs, imaging features, morphology and measuring in vivo data, which are concerned with expansion of transsphenoidal approach. This will provide expansion of transsphenoidal approach with an intuitive morphological imagines,detailed anatomical parameters,accurate imaging data,viviperception and data measurement. Methods 80 patients were recruited for investigation, preoperative measurement of the size of the patient' s nose,height of nasal columella,the plane angle among bridge of nose,inner canthal of eyes and nose columella,and the length of bridge of nose.in the operation,measure the distance from nasal columella to aperture of sphenoidal sinus; observe the shape of aperture of sphenoidal sinus; measure the longest and the shortest distance between aperture of sphenoidal sinus; observe the shape of septum of sphenoidal sinus,three uplift and the relationship among them,as well as the color and texture of the tumor.Measure sphenoid sinus wall,screening room,sellar floor,extent of slope resection,operating space,as well as observation & study of selection and repairing of skull base reconstruction materials. Results The shape according to the discretion of the column is divided into butterfly saddle nose, normal nose, eagle nose and acromegaly hypertrophy nose.The nostrils shape is kidney form,ball form,snow humanoid formand triangle form.The butterfly saddle biggest digging distance:between the cavernous sinus is( 18.9±2.51 ) mm,from saddle nodules to slope is(19.2 ±2.67) mm.After tumor resection,the transsphenoidal observation space is forward to former group of ethmoid sinus,back to the slope. Conclusion The measurement data might be benefit for selecting of speculum, evalution of placing depth on speculum and operation position and sellar floor opening range. It would also make it possible for a safer, minimally invasive and effective surgery by avoid damage to the internal carotid artery,cavernous sinus or cranial nerve.

Objective To observe the application of the mini-mental status examination (MMSE)cognitive assessment in the patients with brain glioma before and after surgery. Methods Using MMSE,36 pastients with primary brain glioma were subjected to the cognitive assessment before surgery, after surgery,and 3 monthsr after surgery. Results The quantitative cognitive assessments with MMSE before surgery revealed the hidden cognitive dysfunction patients.The quantitative cognitive assessments after surgery showed that surgeons might need to protect the non-function area and to form the idea of cognitive function in patients with glioma.Conclusion MMSE assessment is a simple,understandably,and convenient method having good compliance of patient. It may be effectively used to assess cognitive impairment for patients with glioma and worth being studied continuously and used widely in the clinic practice.

Objective: To evaluate the efficacy of 3LL/GM-CSF tumor vaccine combined with pacilitaxel chemotherapy in treatment of mice bearing transplanted Lewis lung carcinoma. Methods: The tumor vaccine 3LL/GM-CSF was prepared by infecting Lewis lung carcinoma cell line 3LL with adenovirus encoding GM-GSF. Mice model of Lewis lung carcinoma was established by subcutaneous injection of 2?104 3LL cells into C57BL/6(H-2b)mice. The sensitivity of Lewis lung carcinoma cell line-3LL to the treatment of pacilitaxel was detected in vivo and in vitro. The mice tumor model was first treated with pacilitaxel chemotherapy and then with 3LL/GM-CSF, or first with 3LL/GM-CSF and then with pacilitaxel. Tumor growth and the long-term survival of mice were observed after treatment. The immune memory and cytotoxicity against target cells were studied in the mice. Results: Pacilitaxel at 100 nmol/L killed 32.10% 3LL cells after 24 hour in vitro; but pacilitaxel at 5-25 mg/kg only had a poor effect on growth of 3LL cells in vivo. The tumors rebated in 70% of mice treated with pacilitaxel chemotherapy and 3LL/GM-CSF vaccination successively, and the survival of these mice was obviously longer than that of pure pacilitaxel chemotherapy group (70.0 days vs 27.5 days). The killing rate of 3LL/GM-CSF after pacilitaxel chemotherapy was 41.35% on day 3. Meanwhile, the survival mice could resist the re-attack of 3LL cells (2?104). We also noticed that first treatment with 3LL/GM-CSF and then pacilitaxel chemotherapy had no effect on tumors. Conclusion: Application of tumor vaccine shortly after pacilitaxel chemotherapy can induce specific immune responses and prolong the survival of experimental mice, which provide a basis for future clinical practice.

OBJECTIVETo primarily evaluate the effects of ulinastatin on immune function of patients with severe burn injury.

METHODSForty patients with severe burn admitted to our ward from March 2013 to October 2015, conforming to the study criteria, were divided into conventional treatment group (CT, n=20) and ulinastatin treatment group (UT, n=20) according to the random number table and patient's consent. After admission, patients in group CT received antishock treatment, antibiotic treatment, debridement, skin grafting, and nutrition support, etc. On the basis of the above-mentioned treatment, patients in group UT received intravenous drip of ulinastatin from first day after admission twice a day, with a dosage of 8×10(5) U every time, for 7 days in addition. Peripheral venous blood samples were collected from patients in groups CT and UT on post treatment day (PTD) 1, 3, 5 and 7, respectively. Twenty healthy volunteer were selected as health control group (HC), and peripheral venous blood samples were collected on the first day of the study. Percentage of CD4(+) CD25(+) regulatory T lymphocytes (Tregs) was determined by flow cytometer. The proliferative activity of T lymphocytes was detected by microplate reader (denoted as absorbance value). Content of interleukin 2 (IL-2) in culture supernatant of T lymphocytes, and content of IL-4 and γ interferon (IFN-γ) in serum were detected by enzyme-linked immunosorbent assay. Expression of human leukocyte antigen-DR (HLA-DR) on CD14(+) monocytes was determined by flow cytometer. Data were processed with analysis of variance for repeated measurement, chi-square test, and LSD-t test.

RESULTS(1) Compared with that of volunteer in group HC, the percentage of CD4(+) CD25(+) Tregs of patients in group CT was significantly increased from PTD 1 to 7 (with t values from 13.303 to 26.043, P values below 0.01). Compared with that in group CT, the percentage of CD4(+) CD25(+) Tregs of patients in group UT was significantly decreased on PTD 5 and 7 (with t values respectively 8.317 and 15.071, P values below 0.01). (2) The proliferative activity of T lymphocytes of patients in group CT on PTD 1, 3, 5, and 7 was respectively 0.71±0.11, 0.61±0.15, 0.54±0.12, and 0.67±0.17, which was significantly lower than that in group HC (1.21±0.22, with t values from 8.686 to 11.957, P values below 0.01). The proliferative activity of T lymphocytes of patients in group UT on PTD 3, 5, and 7 were respectively 0.81±0.11, 0.85±0.14, and 1.08±0.13, which was significantly higher than that in group CT (with t values from 4.808 to 8.568, P values below 0.01). (3) Compared with those of volunteer in group HC, content of IL-2 in culture supernatant of T lymphocytes of patients in group CT was significantly decreased from PTD 1 to 7 (with t values from 8.073 to 9.288, P values below 0.01), content of IL-4 in serum of patients in group CT was significantly increased from PTD 1 to 7 (with t values from 18.926 to 41.451, P values below 0.01), and content of IFN-γ in serum of patients in group CT was significantly decreased from PTD 1 to 7 (with t values from 4.543 to 27.659, P values below 0.01). Compared with those in group CT, content of IL-2 in culture supernatant of T lymphocytes of patients in group UT was significantly increased from PTD 3 to 7 (with t values from 6.507 to 8.869, P values below 0.01), content of IL-4 in serum of patients in group UT was significantly decreased from PTD 3 to 7 (with t values from 6.922 to 8.843, P values below 0.01), and content of IFN-γ in serum of patients in group UT was significantly increased on PTD 5 and 7 (with t values respectively 5.369 and 13.521, P values below 0.01). (4) The percentages of CD14(+) monocytes with positive expression of HLA-DR of patients in group CT on PTD 1, 3, 5, and 7 were respectively (28±6)%, (25±7)%, (25±7)%, and (39±10)%, which were significantly lower than the percentage of volunteer in group HC [(87±8)%, with t values from 16.323 to 25.645, P values below 0.01]. The percentages of CD14(+) monocytes with positive expression of HLA-DR of patients in group UT on PTD 3, 5, and 7 were respectively (40±6)%, (42±9)%, and (49±10)%, which were significantly higher than those in group CT (with t values from 3.071 to 7.324, P values below 0.01).

CONCLUSIONSOn the basis of CT, additional ulinastatin intervention can decrease CD4(+) CD25(+) Tregs percentage, improve the immune function of T lymphocytes and T helper cells, and increase expression of HLA-DR on CD14(+) monocytes of patients with severe burn injury, thus improve the immune function of patients.

Burns ; drug therapy ; immunology ; Cells, Cultured ; Debridement ; Enzyme-Linked Immunosorbent Assay ; Glycoproteins ; therapeutic use ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; metabolism ; Interleukin-4 ; blood ; Monocytes ; immunology ; Skin Transplantation ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo observe the effects of ulinastatin on immune function of splenic CD4(+) T lymphocytes and CD4(+) CD25(+) regulatory T lymphocytes (Tregs) and content of high mobility group box 1 (HMGB1) in peripheral blood of severely burned rats, and to analyze the possible mechanisms.

METHODSNinety-six male SD rats were divided into sham injury group, burn group, and ulinastatin group according to the random number table, with 32 rats in each group. Rats in sham injury group were sham injured on the back by immersing in 37 ℃ warm water for 12 s. Rats in burn group and ulinastatin group were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burn) on the back by immersing in 94 ℃ hot water for 12 s. Immediately after injury, rats in each group were intraperitoneally injected with saline (40 mL/kg), meanwhile rats in ulinastatin group were intraperitoneally injected with ulinastatin (4×10(4) U/kg), once per 12 h, till post injury hour 72. Eight rats of each group were respectively selected on post injury day (PID) 1, 3, 5, and 7 to collect abdominal aortic blood samples. Serum content of HMGB1 was detected by enzyme-linked immunosorbent assay (ELISA). And then, rats of the 3 groups were sacrificed immediately to collect spleens and separate CD4(+) CD25(+) Tregs and CD4(+) T lymphocytes. Flow cytometer was used to detect positive expression rates of cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and forkhead-winged helix transcription factor p3 (Foxp3) in CD4(+) CD25(+) Tregs. Content of IL-10 in culture supernatant of CD4(+) CD25(+) Tregs, and content of interleukin 2 (IL-2), IL-4, and γ interferon (IFN-γ) in culture supernatant of CD4(+) T lymphocytes was detected by ELISA. The proliferative activity of CD4(+) T lymphocytes was determined by microplate reader. The sample number of above-mentioned experiments was 8 at each time point in each group. Data were processed with analysis of variance of factorial design and LSD test.

RESULTS(1) Compared with that in sham injury group, serum content of HMGB1 of rats in burn group was significantly increased from PID 1 to 7 (with P values below 0.01). Compared with that in burn group, serum content of HMGB1 of rats in ulinastatin group was significantly decreased from PID 1 to 7 (with P values below 0.01). (2) Compared with those in sham injury group, the positive expression rates of CTLA-4 and Foxp3 in CD4(+) CD25(+) Tregs and content of IL-10 in culture supernatant of CD4(+) CD25(+) Tregs of rats in burn group were significantly increased from PID 1 to 7 (with P values below 0.01), peaking on PID 3 [(65±10)%, (76±10)%, and (28.2±4.4) pg/mL respectively]. These 3 indexes of rats in sham injury group on PID 3 were (45±7)%, (46±7)%, and (11.2±2.3) pg/mL respectively. Compared with those in burn group, the positive expression rates of CTLA-4 and Foxp3 in CD4(+) CD25(+) Tregs and content of IL-10 in culture supernatant of CD4(+) CD25(+) Tregs of rats in ulinastatin group were significantly decreased from PID 1 to 7 (P<0.05 or P<0.01), reaching the nadir on PID 7 [(43±6)%], PID 1 [(50±8)%], and PID 7 [(12.4±3.4) pg/mL] respectively. These 3 indexes of rats in burn group on PID 7, 1, and 7 were (58±8)%, (71±9)%, and (19.7±2.8) pg/mL respectively. (3) Compared with those in sham injury group, the content of IL-2 and IFN-γ in culture supernatant of CD4(+) T lymphocytes of rats was significantly decreased, while the content of IL-4 in culture supernatant of CD4(+) T lymphocytes of rats was significantly increased in burn group from PID 1 to 7, with P values below 0.01. Compared with that in burn group, the content of IL-2 and IFN-γ in culture supernatant of CD4(+) T lymphocytes of rats was significantly increased, while the content of IL-4 in culture supernatant of CD4(+) T lymphocytes of rats was significantly decreased in ulinastatin group from PID 1 to 7, P<0.05 or P<0.01. (4) Compared with that in sham injury group, the proliferative activity of CD4(+) T lymphocytes of rats in burn group was significantly decreased from PID 1 to 7 (with P values below 0.01). Compared with that in burn group, the proliferative activity of CD4(+) T lymphocytes of rats in ulinastatin group was significantly increased from PID 1 to 7 (with P values below 0.01).

CONCLUSIONSUlinastatin can weaken the immunosuppressive function mediated by splenic CD4(+) CD25(+) Tregs in severely burned rats, and improve proliferative function and secretory function of splenic CD4(+) T lymphocytes, which may be attributed to the inhibiting effect of ulinastatin on the release of HMGB1 in large amount.

Animals ; Burns ; drug therapy ; CTLA-4 Antigen ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Glycoproteins ; pharmacology ; HMGB1 Protein ; blood ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-2 ; metabolism ; Interleukin-4 ; metabolism ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spleen ; drug effects ; T-Lymphocytes, Regulatory ; cytology ; drug effects

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.