BACKGROUND: Dexmedetomidine has been shown to fight against ischemia/reperfusion injury induced by tourniquets. OBJECTIVE: To study the effects of dexmedetomidine on the oxidative stress and inflammatory damage caused by tourniquet-induced ischemia/reperfusion injury. METHODS: Seventy-six patients scheduled for lower limb operation were randomized into two groups: patients in dexmedetomidine group were given the intravenous injection of 1 μg/kg dexmedetomidine for 10 minutes, followed by 0.5 μg/kg?h until the end of operation; while the controls were subjected to 0.9% saline injection at an equivalent velocity and volume. The levels of serum propanediol, lactic dehydrogenase, superoxyde dismutase, tumor necrosis factor-α, interleukin-6 and -8 were detected before tourniquet inflation, 10, 60 and 120 minutes after tourniquet release. RESULTS AND CONCLUSION: In both two groups, the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8 after tourniquet release were significantly higher and the serum superoxide dismutase level was significantly lower than those before tourniquet inflation (P < 0.05). Compared with the control group, dexmedetomidine significantly reduced the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8, and increased the serum superoxyde dismutase level after tourniquet release (P < 0.05). These results suggest that dexmedetomidine can attenuate the oxidative stress and inflammatory damage resulting from tourniquet-induced ischemia/reperfusion injury probably by up-regulating the serum superoxyde dismutase level, and down-regulating the serum levels of propanediol, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and -8.

Objective To explore the micresurgical techniques and outcome of tumors in jugular foramen and its around. Methods Eleven patients with jugular foramen tumors were operated through suboccipital-retrosigmoid approach (2 cases), jugular foramen approach (2 cases), temporal fossa approach (4 cases) and mastoid-cervical combined approach (3 cases). Results Nine tumors were totally removed and 2 were subtotally removed. Of those cases, there were 4 neurinoma, 4 paragangliome, I meningioma, 1 mucochondrosarcoma, and 1 low-differentiated carcinoma. Postoperative complications included transient cerebrespinal fluid leak(1 case) and new lower cranial nerve injury (2 cases). All cases were followed up for mere than 8 months. The postoperative hearing was improved in 1 case, stable in 6 cases, deteriorated in 4 cases. Postoperative facial paralysis of grade Ⅱ- Ⅲ occurred in 3 of 9 patients without facial paralysis, which recovered in half a year. Of 2 patients with facial paralysis before surgery, facial function was improved in 1 case and stable in 1 case. Conclusion Proper surgical approaches and micrceurgical techniques, which were adopted according to the types, the location, and the expansion of tumors, the function of facial nerve and lower cranial nerves, and hearing level, are good for reducing complications, exposing and removing jugular foramen tumors.

Objective To report 2 cases of Epstein-Barr virus-associated cutaneous lymphoproliferative disease (LPD) and to evaluate their relationship with chronic active Epstein-Barr virus (CAEBV) infection.Methods The clinical data on, laboratory examination findings in, treatment and therapeutic response of 2cases of LPD were analyzed. Results Both the patients had chronic intermittent fever, lymphadenopathy, recurrent lesions including papules, papulovesicles, necrosis and variola-like scar in light-exposed and unexposed areas. Pathologically, there was a dermal infiltrate of pleomorphic lymphoid cells with the involvement of perivascular area and some subcutaneous tissue. Immunohistochemical staining showed that most of the infiltrating lymphoid cells were positive for CD8, PCR revealed no TCR-γ gene rearrangement, and in situ hybridization for EBV was positive. The copy of EBV DNA was above the normal range in the peripheral blood from both patients. Clinical status was improved after glucocorticoid treatment. Conclusion The biologic behavior of LPD appears to be a chronic and indolent course and is closely associated with CAEBV.

BACKGROUND:Thoracolumbar spine as highly concentrated stress, often prone to vertebral fractures. With the further development of the biomechanics and anatomical structure of the spine, posterior open reduction and internal fixation with pedicle screw has been widely accepted by clinicians. OBJECTIVE:To explore the clinical results and safety of percutaneous pedicle screw fixation system (Viper system) used in thoracolumbar compression fractures. METHODS:We retrospectively analyzed 40 patients with thoracolumbar compression fractures from Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital and Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from January 2013 to February 2014. According to the type of graft, patients were randomly divided into experiment group and control group, with 20 patients in each group. They were respectively subjected to Viper percutaneous pedicle screw fixation system and open reduction and pedicle screw fixation. RESULTS AND CONCLUSION:Al vertebra got bone unions. Operative time and time to bone union were shorter in the experiment group than in the control group. Moreover, intraoperative blood loss was less in the experiment group than in the control group. Cobb’s angle, height percentage of leading edge and wedge angle were similar between the two groups. However, at 12 months after internal fixation, height percentage of leading edge was lower in the experiment group than in the control group. Visual Analogue Scale scores and Oswestry Disability Index were noticeably improved after fixation in both groups. Visual Analogue Scale scores and Oswestry Disability Index were lower in the experiment group than in the control group immediately after fixation. These results suggest that compared with open reduction and pedicle screw fixation, Viper percutaneous pedicle screw fixation system for thoracolumbar compression fractures can stably restore the structure and function of spine, and does not increase perioperative complications.

Objective To evaluate the effect of percutaneous transhepatic obliteration(PTO)of gastroesophageal varices in liver cirrhosis.Methods Fifty-six cirrhotic patients suffering from gastroesophageal varices were treated with PTO,including 35 during emergency bleeding,10 after stoppage of hemorrhage and 11 with severe gastroesophageal varices for prevention of bleeding.Results Catheterization and embolization of gastroesophageal varices were successfully performed in all 56 patients(100%).Bleeding stopped after PTO as an emergency treatment was achieved in 35 patients with upper gastrointestinal bleeding.Among them,PTO was performed in 11 patients for preventing variceal hemorrhage,gastroesophageal varices disappeared in 7 and alleviation was obtained evidently in 4.47 patients were followed up for 2-60 months with recurrent bleeding in 5,death in 4 on causes of rebleeding of alimentary tract(1 case),hepatic failure(1 case), hepatocellular carcinoma(2 cases).Conclusion PTO is a safe and effective treatment for gastroesophageal varices in cirrhotic patients and should be recommended extensively.

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Aged ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; Cell Cycle Proteins ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Neoplasm Staging ; Protein-Serine-Threonine Kinases ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

Objective To investigate the monitoring of the recurrent laryngeal nerve (RLN)function during thyroid surgery by recording the compound muscle action potential (CMAP) of lateral cricoarytenoid muscle(LCA) under block anaesthesia of the cervical plexus. Methods Nicolet Endeavor CR(Viasys Healthcare, USA) was applied for the intraoperative monitoring. A pair of needle electrodes were inserted into LCA to record CMAP, and a concentric electrode was used to intermittently stimulate the RLN for monitoring the RLN function during operation under block anaesthesia of the cervical plexus.Results In these 28 cases 31 RLNs were exposed during operation, CMAPs appeared with consistent latency when stimulation was applied at the exposed segment. The stimulating intensity threshold ranged from 0.2 to 1.6 mA. The average value was 0.96 mA. 25 of 31 showed CMAPs with consistent latency when stimulation was provided along the possible pathway of the unexposed segment. The stimulating intensity threshold ranged from 1.3 to 3.5 mA. The average value was 2. 03 mA. 6 of 31 did not evoked CMAP even though the maximal stimulating intensity was 5 mA. When these six nerves were exposured, compound muscle action potential were evoked consistently. All of the 28 patients had normal phonation function after surgery.Conclusions It is a safe, effective and feasible method to monitor the RL N function by recording the CMAP of lateral cricoarytenoid muscle under block anaesthesia of the cervical plexus.

Objective To investigate the mechanism and suppression effect of human cytomegalovirus (HCMV) on proliferation of megakaryocyte progenitors(CFU-Mk)in vitro.Methods Colony forming unit-assay was applied to observe the effect of HCMV-AD 169 strain on CFU-Mk of cord blood. The technique of PCR was used to demonstrate the existence of HCMV-AD 169 DNA in the colony cells of cultured CFU-Mk.Results 1.The number of CFU-Mk colonies in HCMV-infected groups decreased significantly compared with that of control group. The CFU-Mk formation was inhibited significantly after HCMV-AD 169 strain infection.The suppression effect showed a dose-dependent fashion: 46.7 % inhibition with 10 -1of HCMV, 29.7 % with 10 -2 and 14.5 % with 10 -3 in the CFU-Mix assay. The peak of CFU-Mk colonies (d16-18) was not significantly different between control group and experimental groups, but the duration of the CFU-Mk colonies in infected groups was significantly shorter than that in control group.2. HCMV-DNA was positively detected in the colony cells of viral infected group by PCR, while negative in control group.Conclusions HCMV-AD 169 strain may inhibit the differentiation and proliferation of CFU-Mk by infecting the hematopoietic progenitors. HCMV may cause the suppression of hematopoiesis by direct infection, which may be the main reason for HCMV infection associated with thrombocytopenia.

In this work, a rapid analysis method basing on ultraviolet spectroscopy was established for the determination of danshensu, protocatechuic aldehyde, rosmarinci acid, lithospermic acid and salvianolic acid B in the extraction process of Danhong injection. In the extraction process of Danshen and Honghua crude drugs, 44 extraction solution samples were collected and the contents of the five components were determined by HPLC analysis. The ultraviolet spectra of the samples were collected. Partial least square regression was used to establish the multivariate calibration models between the ultraviolet spectra and the contents of the five components. The results showed that the established models could predict the contents of the five components in the extraction solution accurately. The ultraviolet spectroscopy method established in this work can be used for rapid analysis of the intermediates of Danhong injection, which may be applied for the quality control in the manufacturing process.
Chemistry, Pharmaceutical ; standards ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Quality Control ; Salvia miltiorrhiza ; chemistry ; Spectrophotometry, Ultraviolet ; methods

OBJECTIVETo establish a method integrating multi-targets for determining critical process parameters of the manufacturing process of traditional Chinese medicine.

METHODThe ethanol precipitation process of Danhong injection was taken as an application case of the method established. Fractional factorial design of experiments were conducted. Mathematical models relating seven process parameters to ten targets in the ethanol precipitation process were established. Then the sums of the absolute values of the regression coefficients in the models were used to evaluate the criticality of process parameters.

RESULTWater content in the concentrate, ethanol concentration and ethanol consumption were identified as the critical process parameters.

CONCLUSIONThe method established can integrate multi-targets effectively for the evaluation of critical process parameters.