Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective To study the effect of NP regimen plus concurrent irradiation on cancer cell survival of human lung adenocarcinoma.Methods A549 and H1299 cells were served as the experimental objects and they were divided into irradiation group (A group),and vinorelbine tartrate injection plus cisplatin with concurrent radiotherapy group (B group).According to the different irradiation doses A group and B group were divided into A-0,A-4,A-8 group and B-0,B-4,B-8 group.MTT was performed to measure the effect of NP regimen plus concurrent irradiation on the cell proliferation,and FACS was used to detect the effect of NP regimen plus concurrent irradiation on apoptosis and P-gp expression.Results Except the cell inhibition rate of B-0 group and A-0 group had no significant difference,the cell inhibition rate of B-0,B-4 and B-8 group at 6,12,24 and 48 h were significantly lower than those of A-0,A-4 and A-8 group.The apoptosis rate of A-8 group [(45.34 ±4.77)％] was significantly higher than that of A-4 group [(20.19 ± 3.76)％] (t =7.17,P =0.006),the apoptosis rate of A-4 group was significantly higher than that of A-0 group [(4.01 ± 0.95)％] (t =7.23,P=0.019).The apoptosis rate ofB-8 group [(51.12 ± 3.37)％]was significantly higher than that of B-4 group[(36.18 ± 4.73)％] (t =3.59,P =0.037),the apoptosis rate of B-4 group was significantly higher than that of B-0 group [(14.78 ± 2.37)％] (t =9.00,P =0.003).The apoptosis rate of B-0 group [(14.78 ± 2.37)％] was significantly higher than that of A-0 group [(4.01±0.95)％] (t =7.31,P =0.018),the apoptosis rate of B-4 group was significantly higher than that of A-4 group (t =4.58,P=0.020),but there was no significant difference between B-8 group and A-8 group (t =1.71,P =0.185).The S cycle percentage of cells in B-0,B-4 and B-8 groups were significantly higher than those of A-0,A-4 and A-8 group (P ＜0.05).There were no significant differences among the P-gp fluorescence intensity of A-0,A-4 and A-8 group (P ＞ 0.05).The P-gp fluorescence intensity of B-0 group was significantly lower than that of A-0 group (t =-3.45,P =0.041),the P-tp fluorescence intensity of B-4 group was significantly lower than that of A-4 group(t =-5.85,P =0.010).The P-gp fluorescence intensity of B-8 group was significantly lower than that of A-8 group (t =-8.07,P =0.015).The P-gp fluorescence intensity of B-4 group was significantly lower than that of B-0 group (t =-8.07,P=0.015),and there was no significant difference between the mean fluorescence intensity of B-4 group and B-8 group (t =-3.56,P =0.071).Conclusion NP regimen plus concurrent irradiation could significantly inhibit the proliferation and apoptosis of human lung cancer cells,and decrease the expression of P-gp in lung cancer cells.

Objective To evaluate the CT and MRI findings and their diagnostic value of central nervous system complications of leukemia (CNSCL). Methods The CT and MRI findings of 18 adult patients with CNSCL proved by clinical features or pathology were retrospectively analyzed. Among 18 cases,7 were acute lymphocytic leukemia, 10 acute non-lymphocytic leukemia and 1 chronic myelomonocytic leukemia. Eleven cases underwent plain CT scan with one of them also receiving contrast-enhanced CT scan enhancement, 16 cases underwent plain MR scan with 11 of them receiving contrast-enhanced MR scan.Results Intracranial lesions in 14 cases: (1)intracranial hemorrhage was found in 7 cases, including intracerebral hematoma in 4 cases, micro-haemorrhage in 2 cases, and intracerebral hematoma accompanying by multiple intracerebral micro-haemorrhage foci in 1 case. All cases with intracerebral hematoma showed multiple lesions, which demonstrated high-density on CT images, and low or mixed signal on T1 WI, high- or intermediate signal with low-signal rim on T2 WI and ring enhancement or no evident enhancement. Microhaemorrhage manifested as multiple mini-mottling and strip hypointense foci on susceptibility weighted imaging, on which the detection rate of micro-haemorrhage foci was much higher than that on CT and other sequences of MRI. Among the 7 cases, one also had cerebral infarction and one subarachnoid hemorrhage.(2) Intracranial mass was found in 5 cases, among which two appeared as masses under or bestride cranium in the left frontal region with hypointensity on T1 WI, mixed signal on T2WI, strong homogeneous enhancement and dural tail sign;one showed a mass in saddle area, with high density on CT, slightly low signal on T1WI, high signal on T2WI and heterogeneous enhancement; one case displayed a mass near lateral ventricle with iso-intensity on T1 WI and T2WI and strong homogeneous enhancement; and one case manifested as cystic mass in the left fronto-apical lobe, with thick wall and ring enhancement (3)Obstructive hydrocephalus was found in 1 case, manifesting dilation of ventricles above the aquaeductus mesencephali. (4) Meningopathy was found in 1 case, manifesting diffuse thickening of meninges with strong homogeneous enhancement on MRI. Pathological changes of spinal canal was found in 4 cases among which two showed para-spinal mass involving vertebral canal and causing bone destruction of adjacent ribs; one case showed fusiform mass posterior to vertebral canal with high and intermediate signal on T1 WI and low and iso-signal on T2WI without enhancement; one showed zonale leison in thoracic cord with high signal on T2WI and fluid attenuated inversion recovery. Conclusion The radiologic manifestations of adult CNSCL are various and the role of CT and MRI for the diagnosis of CNSCL may complement each other. SWI is suggested as routine examination for patients of leukemia, in whom intracerebral lesions were suspected in order to find micro-haemorrhage as early as possible and reduce the risk of intracerebral hematoma occurrence.

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied.

Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.

OBJECTIVETo estimate the diagnostic accuracy of magnetic resonance(MR) in restaging of rectal cancer after preoperative chemoradiotherapy(CRT).

METHODSComprehensive search of literature concerning the diagnosis of MR for rectal cancer after preoperative CRT was performed from databases of PubMed, EMbase, OVID and WOK. Sensitivity and specificity of MR on restaging of rectal cancer after preoperative CRT were investigated by SAS and MetaDiSc software.

RESULTSThirteen articles including 749 patients were enrolled in this meta-analysis. For T3-T4 stage, sensitivity of MR was 82.1%(95%CI:67.9%-90.9%), specificity was 53.5%(95%CI:39.3%-67.3%), and diagnostic odds ratio(DOR) was 5.34(2.73, 6.59). For lymph node involvement, sensitivity of MR was 61.8%(95%CI:50.7%-71.8%), specificity was 72.0%(95%CI:61.3%-80.7%), and DOR was 4.33(95%CI:2.84-6.59). For circumferential resection margin(CRM) by MR, pooled sensitivity was 85.4%(95%CI:60.5%-95.7%), specificity was 80.0%(95%CI:57.4%-92.3%), and DOR was 27.62(95%CI:13.03-58.55).

CONCLUSIONSRestaging accuracy of T3-T4 and lymph nodes involvement of rectal cancer after preoperative CRT by MR is not high. MR may be a good method to make reassessment of CRM. To avoid overtreatment for T0-T2, negative lymph node and circumferential resection of rectal cancer, restaging by MR after preoperative CRT is important.

Chemoradiotherapy ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Neoplasm Staging ; Rectal Neoplasms ; pathology ; therapy