Objective To investigate the effects of different general anesthesia protocols on immune function in patients with oral malignant tumor. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective radical operation for oral malignant tumor were randomly divided into 3 groups ( n = 20 each): group Ⅰ total intravenous anesthesia (TIVA); group Ⅱ combined intravenous-inhalational anesthesia (IV-INH) and group Ⅱ inhalational anesthesia (INN). Anesthesia was induced and maintained with propofol and remifentanll in group Ⅰ; with sevoflurane,propofol and remifentanil in group Ⅱ and with sevoflurane and remifentanil in group Ⅲ. Peripheral venous blood samples were taken at 30 min before (To) and 1 h (T1), 3 h (T2 ) and 5 h (T3) after induction of anesthesia, the end of operation (T4 ) and at 24 h (T5 ), 48 h (T6 ) and 72 h (T7) after operation for determination of the percentages of T lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+/CD8+ ratio). Natural killer (NK) cells (CD16+ ,CD56+ ) and B lymphocyte (CD19+ ) with flow cytometer. Results The percentages of CD3+ , CD4+ , NK cells, B lymphocyte and CD4+/CD8+ ratio were significantly decreased during and after operation at T1-5 in all groups and the percentges of CD3+ ,CD4+ ,NK cells and CD4+/CD3+ ratio were decreased at T6 in groups Ⅱ and Ⅲ as compared with the baseline values before anesthesia at To. The percentage of CD4+ cells and CD4+/CD8+ratio were significantly lower during anesthesia at T2,3,6 in group Ⅱ than in group Ⅰ . The percentages of CD4 +and NK cells and CD4+/CD8+ ratio were significantly higher after operation at T4,5 in group Ⅱ than in group Ⅲ.The percentages of CD3 + , CD4 + , NK cells and CD4 +/CD8 + ratio were significantly lower at T2-6 in group Ⅲthan in group Ⅰ . Conclusion TIVA with midazolam, propofol and remifentanil has less impact on immune function than inhalational and combined intravenous-inhalational anesthesia in patients with oral malignant tumor under-going elective radical operation.

Objective:To investigate the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)parameters in differentiating musculoskeletal tumors with different behaviours of pathological findings before therapy.Methods:A total of 34 subjects of musculoskeletal tumors were in-volved in this retrospective analysis.DCE-MRI was performed using a fat-saturated 3 D VIBE (volumetric interpolated breath-hold exam)imaging sequence with following parameters:FA,10 degree;TR/TE, 5.6/2.4 ms;slice thickness,4.0 mm with no intersection gap;field of view,310 mm ×213 mm;ma-trix,256 ×178;voxel size,1 .2 mm ×1 .2 mm ×4.0 mm;parallel imaging acceleration factor.The ac-tuation time for the DCE-MRI sequence was 255 s with a temporal resolution of 5 s and 40 image vo-lumes.Using pathological results as a gold standard,tumors were divided into benign,borderline and malignant tumors.Toft’s model was used for calculation of Ktrans (volume transfer constant),Ve (extra-vascular extracellular space distribute volume per unit tissue volume)and Kep(microvascular permeability reflux constant).Those parameters were compared between the lesions and the control tissues using paired t-tests.The one-way analysis of variance was used to assess the difference among benign,border-line and malignant tumors.P values <0.05 difference was statistically significant.Results:Based on the WHO Classification of Tumours of Soft Tissue and Bone(2012)criteria,34 patients were divided into three groups:1 1 for benign tumors,12 for borderline tumors,and 1 1 for malignancies.Compared with control tissues,Ktrans and Kepshowed no difference,but Ve was increased in benign tumors,Kep showed no diffe-rence,butKtransandVewereincreasedinborderlinetumors, Ktrans,KepandVewereincreasedin malignant tumors.Ktrans(P<0.001 )and Kep (P<0.01 )were significantly higher in malignant tumors than in benign and borderline tumors,but did not show any difference between benign tumors and border-line tumors.Ve was significantly higher in malignant tumors than in benign (P<0.05),but did not show any difference between malignant and borderline tumors,benign tumors and borderline tumors (P >0.05 ).Conclusion:DCE-MRI technique is useful to evaluate the pathological behaviour of musculoske-letal tumors.The quantitative analysis of DCE parameters in conjunction with conventional MR images can improve the accuracy of musculoskeletal tumor qualitative analysis.

Objective To compare the effects between propofol and sevoflurane on NK cells and B lymphocytes in patients undergoing radical operation for tongue cancer.Methods Forty patients (male 25 cases,femal 1 5 cases,aged 44-67 years,ASA Ⅰ or Ⅱ)undergoing elective radical operation for tongue cancer were randomized into 2 groups:group P received 2.0-2.5 mg/kg propo-fol,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for induction and 4-6 mg · kg- 1 · h- 1 propofol, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance; group S received 8 %sevoflurane with 5 L/min fresh gas flow,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for in-duction and 2 %-3 % sevoflurane, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance. Peripheral venous blood samples were taken at 3 0 min before (T0 )and 1 h (T1 ),3 h (T2 )and 5 h (T3 )after induction of anesthesia,the end of operation (T4 )and at 2 4 h (T5 ),4 8 h (T6 )and 7 2 h (T7 )after operation for determination of the percentages of NK cells (CD3 - CD1 6 + 5 6 + )and B lymphocytes(CD3 - CD1 9 + )by the flow cytometer.Results Compared with T0 ,the percentages of CD3 - CD1 6 + 5 6 + and CD3 - CD1 9 + in two groups were significantly decreased at T1-T5 (P <0.0 5 ),and the percentage of CD3 - CD1 6 + 5 6 + in group S was significantly decreased at T6 (P <0.0 5 ).The percentage of CD3 - CD1 6 + 5 6 + in group S were significantly lower than that in group P at T2-T6 (P < 0.0 5 ).There were no significant difference in the percentages of CD3 - CD1 9 +between two groups at the same time points.Conclusion Compared with sevoflurane,propofol can maintain a higher percentage of NK cells,and was helpful to maintain the immune function in patients undergoing radical operation for tongue cancer.

Objective To study the Gadolinium-enhanced MRI and diffusion weighted imaging (DWI) characteristics of the chondroid matrix-forming sarcomas.Methods Contrast-enhanced MRI and DWI were performed in 14 eases of chondroid matrix-forming sarcomas (10 chondrosarcomas,4 chondroblastic esteosarcomas) and 13 cases of other types of osteosarcomas.DWI was obtained with a single-shot echo-planar imaging (EPI) sequence using a 1.5 T MR imager with two different b values of 0 and 700 s/mm2.The apparent diffusion coefficient (ADC) values were obtained in GE Functiontool software.The contrast-enhancement pattern was evaluated and the ADC values of ehondroid matrix-forming sarcomas was compared with that of other types of asteosarcoma.Independent sample t-test was performed to evaluate the difference of ADC values between the group of chondroid matrix-forming sarcoma and the group of other types of osteosarcoma.In addition, nonparametrie test was used to assess the difference of ADC values between the chondrosareoma and the chondroblastic osteosarcoma.P value less than 0.05 was considered to represent a statistical significance.Results For 14 eases of ehondroid matrix-forming sarcomas, peripheral enhancement was found in all cases, septonodular enhancement was identified in 12 cases.While 13 eases of other types of osteosarcowas demonstrated heterogeneous enhancement.The mean ADC value of chondroid matrix-forming sarcomas [(2.56 ±0.35) × 10 -3 mm2/s] was significantly higher than that of other types of osteosarcoma [( 1.16±0.20) × 10-3 mm2/s] (t = 12.704,P <0.O1 ).There was no significant difference in the ADC value between the chondrosarcoma and the chondroblastie osteesarcama(Z =0.507 ,P =0.959).Conclusion Contrast-enhanced MRI and DWI can improve differentiation between chondroid matrix-forming sarcomas and other types of osteosarcomas.

Objective To established a diagnostic methods to idenfity Niemann-Pick disease type C (NPC) in China. Methods Two patients aged 5 and 20 years respectively who presented progressive neurologic regression and splenomegaly were subjected to filipin staining of cultured skin fibroblasts and genetic analyses of NPC1 gene. Results Although there were differences in onset ages and clinical presentations, filipin staining of the cultured skin fibroblasts confirmed the clinical diagnosis of NPC, showing an intense punctate pattern of fluorescence concentrating around the nuclei, consistent with the accumulation of unesterified cholesterol in NPC cells. Genetic sequence analysis further verified the results of filipin staining. The case 1 was compound heterozygous for M1142T(3425T＞C),R1186H(3557T＞C)and case 2 for Q88H(264G＞T),469_470insGT.The latter 2 mutations were novel, and the possibility of polymorphisms was not supposed by analyzing 134 DNA samples obtained form normal controls. Conclusions Filipin stainning of the cultured skin fibroblasts is a reliable method to clinically diagnose NPC with a sensitivity. Genetic diagnose should be performed where genetic analysis is allowed.

Objective To evaluate the choice of early diagnosis method of primary ureteral neoplasms in or-der to improve the ratio of clinical diagnosis. Methods 28 cases with primary ureteral neoplasms were retrospectively analyzed. Ultrasonic examination, IVU, retrograde urogram, spiral CT, MRI, ureteroscopy and exfoliative cell examina-tion of urine were compared in this study. Results The most useful methods of detecting tumors preoperation were retrograde urogram, spiral CT, MRI, ureteroseopy. All the 28 patients underwent surgical treatment. Among them, nephroureterectomy and bladder cuff or partial resection were performed in 19 cases. Postoperative pathology showed transitional cell carcinoma in 27 cases,and adenoma in 1 case. 8 cases were T1-2 tumours. Of the 14 cases during 1990 ～1999 period, 1,5,3,2,2 and 1 cases had survival time of 1,2,3,4,5 and 6 years ,respectively. Of the 14 cases during 2000～2007,4 were lost to follow-up;2 survived for 3 years and 2 for 1 year;the other 6 who have survived near 5 years have been followed till now. Conclusions To improve the early diagnosis rate,B-ultrasonic examination, IVU,retrograde urogram,3D spiral CT and MRI examination were necessary in the early stage. The patients should be opeiated as early as possible after diagnosis.

objective To introduce the design concept and structure of a new type of lumbar intervertebral fusion cage ,and to e-valuate its biomechanical properties .Method A partially bioasorbable interbody fusion cage(PBIFC) made of nano hydroxyapatite and poly amino acid /calcium sulfate copolymer materials was developed .Range of motion(ROM ) ,compressive load ,and pull-out test on flexion ,extension ,lateral bending ,and torsion moment on fresh calf L3/L4 specimens of functional spinal union were carried out of iliac bone group ,PBIFC group ,and nano hydroxyapatite/polyamide 66(nHA/PA66) group .Result Of each movement ,the ROM value of iliac bone group are higher than the other two groups ,the difference was statistically significant (P<0 .05) ,and the ROM value of nHA/PA66 group are higher than PBIFC group ,but no statistical difference(P>0 .05) .The pull-out strength of PB-IFC group are higher than iliac bone group ,and the difference was statistically significant (P<0 .05);The pull-out strength of PB-IFC group is lower than the traditional group ,but no statistical difference(P>0 .05) .The compressive load of iliac bone group was lower than that of two cage group ,the difference was statistically significant (P<0 .05) .The compressive load of PBIFC group is slightly lower than the traditional group ,but no statistical difference(P>0 .05) .Conclusion With good implant stability ,pull-out resistance ,and compression resistance performance ,PBIFC can meet the biomechanics requirements of clinical implant .

Objective To analyze the CT and magnetic resonance imaging (MRI) manifestations of the pelvic osteosarcoma. Methods The CT and MRI manifestations of 15 cases with pelvic osteosarcoma from January, 2013 to December, 2015 proved by histology were ret-rospectively analyzed. Results There were 10 males and 5 females in them. The median age was 27.0 years. Ilium was involved in 11 cases. A mixed lytic/sclerotic pattern of bone destruction was found in 11 cases, and the sclerotic type in 2 cases, the osteolytic type in 2 cases. Ra-dial periosteal reaction was found in 5 cases and immature bone formation in 8 cases. Soft tissue masses were seen in 13 cases. MRI showed enhancement in 15 cases and the CT showed no enhancement in 2 cases with sclerotic type. Conclusion The typical imaging manifestations of pelvic osteosarcomainclude mixed lytic/sclerotic appearance, radial periosteal reaction, soft tissue masses and immature bone formation.

Objective To observe the clinical efficacy of stage treatment withTiao He Ying Wei(regulating Ying-nutritional and Wei-defensive qi) needling in treating insomnia.Method A hundred insomnia patients presenting difficulty falling asleep were randomized into group A1 and B1, 50 cases each; 100 insomnia patients presenting difficulty maintaining sleep were randomized into group A2 and B2, 50 cases in each group; 100 insomnia patients presenting early-morning awakening were randomized into group A3 and B3, 50 cases each. Group A1, A2 and A3 were treated withTiao He Ying Wei needling, while group B1, B2 and B3 were treated with conventional medication. The Symptoms score and cerebral blood flow indicators were observed before and after the intervention.Result After the treatment, the symptoms scores were significantly changed in each group (P<0.05). The improvement of symptoms score in group A1 was superior to that in group B1 (P<0.05); the improvement of symptoms score in group A2 was superior to that in group B2 (P<0.05); the improvement of symptoms score in group A3 was superior to that in group B3 (P<0.05). The cerebral blood flow indicators (middle cerebral artery, posterior cerebral artery, anterior cerebral artery, and basilar artery) were significantly changed after the treatment in group A1, A2 and A3 (P<0.05). After the treatment, there were significant differences in comparing the cerebral blood flow indicators between group A1 and B1, A2 and B2, and A3 and B3 (P<0.05).Conclusion Stage treatment withTiao He Ying Wei needling can improve the sleep quality of insomnia patients.