Objective To explore the relationship between metabolic syndrome(MS) and cerebral stroke type,complication and prognosis.Methods Clinical data of 568 cerebral stroke patients with MS(MS group) and 209 cerebral stroke patients without MS(no-MS group) were compared and analyzed.Results In MS group,the incidence of cerebral infarction was significantly higher(93.0%) than that in the no-MS group(85.2%)(P

Objectives:To observe the characteristics of rocuronium bromide in cirrhotic patients. Methods:Six healthy patients and six patients with hepatic cirrhosis undergoing intraabdominal operation were studied. Rocuronium 0.6 mg/kg was given to all of the patients,and the twitch high of adductor pollicis muscle was recorded using NMT mechanosensor (Datex Ohmeda). The time of onset, T 1 Maximum depression, the clinical duration of initial dose, the clinical duration of repeated maintenance doses and the spontanous recovery index were observed. Results:The time of onset was markedly prolonged in the cirrhotic compared with the healthy group( P

Objective To characterize the molecular changes and their significance in pathogenesis of esophageal squamous cell carcinomas from the elderly patients (≥60 years old) at high risk area of esophageal cancer in Linzhou, Henan Province. Methods Immunohistochemical method(ABC) and histopathological method were applied to examine the expressions of P53 and Rb proteins in esophageal squamous cell carcinomas and the relationship of the expressions with the lesions and age distribution was analyzed. Results Positive immunostaining rate for P53 was much higher in esophageal cancer tissue of the elderly patients(27/33, 82%) than that of the young patients (10/43, 23%) ( P

Objective To summarize the clinical characteristics and investigate the prognostic factors of primary duodenal carcinoma.Methods The clinical data of 122 patients with primary duodenal carcinoma who were admitted to the Shengjing Hospital Affiliated to China Medical University from November 2007 to May 2013 were retrospectively analyzed.All the patients received different operations according to the characteristics of tumors.Primary duodenal carcinomas of patients were confirmed by the postoperative pathological diagnosis.All the patients were followed up by outpatient examination, telephone interview and correspondence till November 30,2014.The treatment process, results of imaging examination and laboratory examination and postoperative survival were recorded.The clinical features, diagnostic criteria, therapeutic regimens and prognostic factors were analyzed.The survival rate and survival curve were analyzed and drawn by the Kaplan-Meier method.The univariate analysis was done using the Log-rank test, and multivariate analysis was done using the COX regression model.Results Among the 122 patients with primary duodenal carcinoma, jaundice as the first symptom was detected in 57 patients, abdominal pain and upper abdomen discomfort in 37 patients, gastrointestinal obstruction in 14 patients,anorexia and reduction of body weight in 4 patients, gastrointestinal hemorrhage in 3 patients, diarrhea in 3 patients, pyrexia in 3 patients and abdominal mass in 1 patient.The positive rates of CT examinations, endoscopic examinations, magnetic resonanced cholangio-pancreatography (MRCP), B-ultrasound examinations and upper gastrointestinal contrast examinations were 69.67％ (85/122), 85.56％ (77/90), 79.76％ (67/84), 12.73％ (7/55) and 75.00％ (36/48), respectively.Among the 122 patients, anemia was detected in 48 patients,positive fecal occult blood test in 94 patients, increasing level of CA19-9 in 71 patients, increasing level of CEA in 22 patients and increasing level of AFP in 9 patients.The tumors located at the descending part of duodenum,duodenal bulb and horizontal part of duodenum were detected in patients of 86.07％ (105/122), 7.37 ％ (9/122) and 6.56％ (8/122), respectively.The mean diameter of tumors was 2.3 cm (range, 1.0-15.0cm).All the 122 patients received operation.Pancreaticoduo-denectomy was performed in 100 patients, including combined with jejunostomy in 17 patients, pylorus-preserving pancreatoduodenectomy in 7 patients, segmental resection of duodenum and gastrojejunostomy in 5 patients, local resection of duodenal papilla in 6 patients and palliative gastrojejunostomy in 11 patients.Nineteen patients with complications were cured by symptomatic treatment.Of the 122 patients, adenocarcinoma, carcinoid tumor, lymphoma, small cell carcinoma, intraepithelial neoplasm combined with differentiated rhabdomyoma and with undifferentiated rhabdomyoma were detected in 116, 2, 1, 1,1 and 1 patients, respectively.The Ⅰ , Ⅱ , Ⅲ and Ⅳ stage of tumors were detected in 10, 4, 74 and 34 patients.There were 100 patients without lymph node metastasis, 13 patients with 0 ＜ metastatic lymph node ratio (MLR) ≤0.2, 4 patients with 0.2 ＜ MLR≤0.4 and 5 patients with MLR ＞ 0.4.One-hundred and twelve of 122 patients were followed up for 1-70 months with a median follow-up time of 20 months.The postoperative survival time, a median of survival time, postoperative 3-and 5-year survival rates were 1-70 months, 18 months, 36.6％ and 13.5％ , respectively.The results of univariate analysis showed that the lymph node metastasis, differentiated grade of tumor, MLR and with invasion of pancreas were risk factors affecting the prognosis of patients (x2 =8.465, 57.355, 16.232, 20.112, P ＜ 0.05).The multivariate analysis showed that the low-differentiation of tumor, invasion of pancreas, lymph node metastasis and MLR ＞ 0.4 were independent risk factors affecting the prognosis of patients (RR =3.330, 3.718, 2.623, 95％ confidence interval: 1.861-5.956, 1.292-10.696,1.624-4.236, P ＜ 0.05).Conclusions Most of the primary duodenal carcinomas are located at the descending part of duodenum without specific clinical symptoms in the early stage.The joint usage of assistant examinations can improve the diagnostic rate of primary duodenal carcinoma, and surgery is mainly therapeutic method.The low-differentiation of tumor, MLR ＞ 0.4 and invasion of pancreas are independent risk factors affecting the prognosis of patients.

Objective To analyze the second time blood screening results of ALT deferred donors,and to evaluate the importance of alanine aminotransferase(ALT) testing on the improvement of blood safety.Methods The ALT testing results of 565 360 blood donors from Feb.2006 to Jan.2008 of Shanghai Blood Center were studied retrospectively.The screening results and donation intervals of such donors who delayed their donation just because of their former unqualified ALT level were also analyzed.Results A total of 32 042 donors(5.67%) failed in ALT testing among 565 360 donors.And 3 395 ALT deferred donors participated the second time blood donation,among which 2 205(64.95%) passed the blood screening tests,while the other 1 190(35.05%) failed.Among the 1 190 unqualified blood donors,1 151(33.90%)failed again in ALT testing,and 11(0.32%) in Syphilis,12(0.35%) in HBsAg,7(0.21%) in anti-HCV and 1 in anit-HIV(0.03%).Meanwhile,donors failed both in ALT testing combined with HBsAg,anti-HCV,and anit-HIV sero-converted were 1(0.03%),2(0.06%) and 1(0.03%),respectively.And 72.64% of ALT deferred donors participated the second time blood donation within 6 months.The average donation intervals of donors with qualified ALT level but sero-converted were 140 days(from 24 to 267 days),and those with both unqualified ALT level and sero-converted were 158 days(from 91 to 220 days).Conclusion Before the new methods such as NAT were applied to blood donation screening system,ALT test could prevent the window-period failure of ELISA screening so as to improve the blood safety.

Objective: To compare setup errors between patients using the customized Klarity AccuCushion® with a thermoplastic fixation mask and patients using a thermoplastic fixation mask or vacuum fixation cushion alone while receiving radiotherapy. Methods: A total of 66 patients with head and neck (H&N) tumors (n=27) or thoracic and abdominal tumors (T&N) tumors (n=39) were included during Jaurnary 2018 to December 2019. 15 H&N cancer patients using only a single head-neck-shoulder mask were categorized into group A; 12 patients using a customized Klarity AccuCushion® and head-neck-shoulder mask were categorized into group B. Among T&A cancer patients, 19 patients using only a vacuum fixation cushion were classified into group A; the remaining 20 patients using a customized Klarity AccuCushion® and thermoplastic fixation mask were classified into group B. Cone-beam computed tomography was performed, and the setup errors were evaluated. The setup errors in the left-right (LR) direction, superior-inferior (SI) direction, anterior-posterior (AP) direction, and for rotation were compared between groups A and B. Results: Among H&N cancer patients, the setup errors in group B in the LR direction, SI direction, and for rotation were 0.06±0.06 cm, 0.08±0.07 cm, and 0.12±0.17°, respectively, which were smaller than those in group A (0.10±0.11 cm, 0.13±0.14 cm, and 0.25±0.47°, respectively). The differences in setup errors in the LR direction, SI direction, and for rotation were significant between the two groups (P<0.05), while no significant difference was found in setup errors in the AP direction (P>0.05). For T&A cancer patients, significant differences were found in setup errors between the two groups (P<0.05) in the LR direction (group B vs. group A: 0.10±0.08 cm vs. 0.14±0.12 cm) and for rotation (group B vs. group A: 0.09 ± 0.18° vs. 0.22 ± 0.39°). No significant differences were observed in the setup errors in the SI and AP directions. Conclusions: Compared with the immobilization techniques using only a thermoplastic mask and only a vacuumed fixation cushion, the technique using a customized Klarity AccuCushion® with a thermoplastic fixation mask can improve repeatability, stability, and setup errors in radiotherapy.

A gas chromatographic method has been developed for determining glycerin concentrations of both therapeutic and physiological levels in serum. The linear relationship was obtained in the range of 1.6-800 ug/ml and the coefficient variations determined within a day and between days were 2.2% and 2.4% respectively. Recoveries of glycerol from serum were about 87%.

ObjectiveTo investigate the effect of different reference vessel groups on CT perfusion in patients with nasopharyngeal carcinoma (NPC) after radiation therapy,and explore the feasibility of substitution of reference vessel.MethodsThirty patients with NPC after radiation therapy were divide into two groups,recurrence group ( n =19) and fibrosis group ( n =11 ).All patients underwent CT perfusion scans,and the CT parameters were calculated with different arterial input and vein output in order to study their differences.The vessels were internal carotid artery-internal jugular vein( ICA-IJV group),external carotid artery-retomandibular vein (ECA-RTV group)and external carotid artery-internal jugular vein( ECAIJV group) respectively.The differences of the CT parameters between local recurrence group and fibrosis group were compared among the various vessel groups by rank sum test.With the help of receiver operating characteristic curve (ROC),the diagnostic efficiencies were compared by the area under the ROC curve (AUC).ResultsIn ICA-IJV group,ECA-RTV group and ECA-IJV group,bloood flow(BF) of local recurrence group were 201.88,439.59,252.23 ml · min-1 · 100 g-1,while BF of fibrosis group were 98.96,180.50,106.55 ml · min-1 · 100 g-1.Blood volume (BV) of local recurrence group were 6.71,12.39,6.70 ml/l00 g,while BV of fibrosis group were 2.35,4.76,2.95 ml/100 g.Mean transit time (MTT) of local recurrence group were 1.66,1.50,1.56 s,while MTT of fibrosis group were 2.13,1.96,1.79 s.Permeability surface (PS) of local recurrence group were 19.31,36.39,15.22 ml · min- 1 ·100 g-1,while they were 16.58,29.08 ,16.63 ml · min-1 · 100 g-1 in the fibrosis group.The differencesof BF and BV between the local recurrence group and fibrosis group were statistically significant in each vessel group (P ＜ 0.05 ) but MTT and PS showed no significant difference( P ＞ 0.05 ).In ICA-IJV group,the AUC of BF,BV,MTT,PS were 0.909,0.947,0.677,0.703,respectively.BF,BV,MTT,PS in ECA-RTV group were 0.938,0.967,0.648,0.679 respectively,and those in ECA-IJV group were 0.861,0.890,0.641,0.656 respectively.However,AUC of BF and BV of three groups all had significant difference ( P ＜ 0.01 ).ConclusionsBoth BF and BV values calculated by three pairs of reference vessels had enough diagnosis efficiency for local recurrence and fibrosis,so all of the three groups of vessels may substitute each other in CT perfusion.

Objective To study the effect of hypothermia on cerebral mitochondrial respiratory function and ultrastructure after traumatic brain injury(TBI). Methods Sprague-Dawley rats were subjected to moderate brain injury by using lateral fluid-percussion(LFP)and randomly divided into sham operation group,normothermic TBI group(rectal temperature for 36-37℃)and hypothermic TBI group(rectal temperature for 31-32℃ lasting for two hours).The ipsilateral brains were dissected and homogenized brain tissues were extracted to obtain mitochondfia by density-centrifugation and speed-centrifugation at 2,24 hours and at days 3 and 7 after TBI.The mitochondrial uhrastructure was studied by electron microscope.The indices of respiratory control rate(RCR)and P/O ratio of mitochondrial respiratory function were measured after oxygen consumption was determined with a Clark-type electrode.Results The mitochondrial uhrastructure of normothermic TBI group was damaged severely while that of hypothermic TBI group kept relatively integrated.The RCR and P/O ratio were markedly decreased two hours after TBI and reached the lowest level at the 24th hour(P＜0.01).At day 7,RCR kept at a lower level compared with sham operation group but P/O ratio recovered to normal.Change of RCR was similar in hypothermie TBI group and normothermic TBI group.However,RCR of the hypothermic TBI group was significantly higher than that of the normothermic TBI group within three days after TBI.In the meantime,P/O ratio recovered to normal three days after TBI. Conclusion Hypothermia can improve cerebral mitochondrial respiratory function and protect the mitochondrial structure after TBI.

Objective To evaluate the effect of butorphanol combined with dexmedetomidine on postoperative hyperalgesia induced by remifentanil in patients.Methods One hundred and twenty patients,of ASA physical status Ⅰ or],aged 20-64 yr,weighing 45-88 kg,undergoing elective gynecological laparoscopic surgery,were randomly allocated into 4 groups (n =30 each) using a random number table:control group (group C),butorphanol group (group B),dexmedetomidine group (group D) and dexmedetomidine + butorphanol group (group B+D).In group D,dexmedetomidine 1.0 μg/kg was infused at 10 min before induction of anesthesia,followed by continuous infusion at 0.7 μg·kg 1·h-1 until the end of operation.In group C,the equal volume of normal saline was given instead before skin incision.In group B,butorphanol 20 μg/kg was injected immediately before skin incision.In group B+D,dexmedetomidine 0.5 μg/kg was infused at 10 min before induction of anesthesia,followed by continuous infusion at 0.5 μg· kg-1 · h-1 until the end of operation,and butorphanol 15 μg/kg was injected immediately before skin incision.Anesthesia is induced with iv midazolam 0.05 mg/kg,sufentanyl 0.2-0.3 μg/kg,rocuronium 0.7 mg/kg and propofol 2.0 mg/kg.After tracheal intubation,all the patients are mechanically ventilated,and PETCO2 was maintained at 35-45 mmHg.Anesthesia was maintained with iv infusion of remifentanil 0.3 μg · kg-1 · min 1 and propofol 4-6 mg·kg 1·h-1 and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS value was maintained at 40-60.Patient-controlled intravenous analgesia (PCIA) with sufentanil was used after operation,and VAS score was maintained ≤ 3.At 30 and 60 min and 6,12,24 and 48 h after operation,the sufentanil consumption was recorded.The development of bradycardia and hypotension during operation and postoperative nausea and vomiting,dizziness and somnolence was recorded.Results Compared with group C,the sufentanil consumption and incidence of nausea and vomiting were significantly decreased in B,D and B+D groups,the incidence of dizziness and somnolence was increased in group B,and the incidence of bradycardia and hypotension was increased in group D.There was no significant difference in sufentanil consumption between B,D and B+D groups.The incidence of dizziness and somnolence was significantly lower in group B + D than in group B.The incidence of bradycardia,hypotension and somnolence was significantly lower in group B + D than in group D.Conclusion Butorphanol combined with dexmedetomidine provides better efficacy than either alone in reducing postoperative hyperalgesia induced by remifentanil in patients.