Objective To compare the efficacy of combined intravenous-inhalational anesthesia with propofol-fentanyl-sevoflurane in children undergoing minor surgery under spontaneous breathing with nasopharyngeal airway-face mask versus laryngeal mask airway (LMA).Methods Seventy-two children,scheduled for elective high ligation of indirect inguinal hernia,were randomly divided into 2 groups (n =36 each):nasopharyngeal airway-face mask group (group M) and LMA group (group L).Propofol 1.0 mg/kg and fentanyl 2.0μg/kg were injected intravenously.The spontaneous breathing was kept.After lass of consciousness,a face mask was placed for inhalation of pure oxygen at 2 L/min and 3 ％ sevoflurane.When BIS value reached 50-60,a size 2 LMA was inserted in group L and a nasopharyngeal airway was placed via the left nasal cavity and the face mask was held tightly and connected to the anesthesia machine in group M.Anesthesia was maintained with inhalation of 2％-4％ sevoflurane.Fentanyl 1 μg/kg was injected intravenously 5 min before skin incision.The concentration of sevoflurane was adjusted to maintain BIS value at 40-60 during surgery.Mean arterial pressure,heart rate,partial pressure of end-tidal carbon dioxide and pulse oxygen saturation were recorded before induction,at 3 min during induction,immediately after successful insertion of the airway,at skin incision,3 min after skin incision,and immediately after removal of the airway.The airway insertion time,success rate of insertion at first attempt,emergence time,and adverse reactions were recorded.Results Compared with group L,mean arterial pressure and heart rate were significantly decreased during airway insertion or removal,nasopharyngeal airway insertion time was shortened and the success rate of nasopharyngeal airway insertion at first attempt (100％) was increased,and the agitation score and incidence of obstruction of the upper respiratory tract were decreased in group M (P ＜ 0.05).Conclusion Combined inravenous-inhalational anesthesia with propofol-fentanyl-sevoflurane is easy to establish the airway,can maintain spontaneous breathing,has little influence on circulatory function and reduce complications during recovery from anesthesia in children undergoing minor surgery under spontaneous breathing with nasopharyngeal airway-face mask,and the efficacy is better than that with LMA.

Objective To evaluate the effects of different blood-saving strategies on postoperative cellular immune function in patients undergoing resection for liver cancers.Methods Sixty-six ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,with hepatocellular carcinoma classification G1-G3 and clinicopathological staging Ⅰ-Ⅳ,undergoing elective resection for liver cancers,were randomly divided into 3 groups (n =22 each) using a random number table:low central venous pressure group (L group),acutenormovolemic hemodilution group (A group),and acute normovolemic hemodilution combined with low central venous pressure group (AL group).Acute normovolemic hemodilution was performed after endotracheal intubation.Right jugular vein was cannulated for central venous pressure monitoring.Blood withdrawn from the radial artery at a rate of 25-40 ml/min was simultaneously replaced by iv infusion of the equal volume of 130/0.4 hydroxyethyl starch at the same rate until the target Hct (30％) was achieved.In A and AL groups,central venous pressure was maintained at 3-5 cm H2O during the procedure of liver parenchyma transection.Peripheral venous blood samples were taken before operation (T1,baseline) and on postoperative days 1,3 and 5 (T2-4) to determine the percentage of regulatory T-lymphocytes (CD4 + CD25 +,CD25 + Foxp3+),effective T-lymphocytes (CD8 +,CD4 + CD25-) and natural killer (NK) cells by flow cytometry.Results Compared with the baseline value at T1,the percentage of CD4 + CD25 +and CD25 + Foxp3+ was significantly decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T3,4,and the percentage of NK cells was decreased at T2 in A and AL groups,and the percentage of CD4 + CD25 +and CD25 + Foxp3+ was decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T4,and the percentage of NK cells was decreased at T2,3 in group L (P ＜ 0.05).Compared with L group,the percentage of CD4 + CD25 + and CD25 + Foxp3+ was significantly decreased at T3,the percentage of CD8 + was increased at T3,4,and the percentage of NK cells was increased at T3 in AL group (P ＜ 0.05).Conclusion Acute normovolemic hemodilution combined with low central venous pressure provides slighter inhibitory effect on the immune function of T-lymphocytes and NK cells in patients undergoing resection for liver cancers than either alone.

Objective: To determine quercetin and kaempferol in stamen neulumbinis by HPLC. Methods : Shim-pack CLC-ODS column was used. Mobile phase consisted of methanol-0.025% phosphate. UV detector wavelength was set at 370nm. Results : The chromatographic peaks of quercetin and kaempferol and other components were completely separated. The average recovery was 96.8% and RSD was 1.97%. Conclusion : The experiment provided new markers and a reliable method for the quality control of Stamen Neulumbinis.

In this study, we explored the feasibility of biotin-mediated modified polymeric micelles for pancreatic cancer targeted photodynamic therapy. Poly (ethylene glycol)-distearoyl phosphatidyl ethanolamine (mPEG2000-DSPE) served as the drug-loaded material, biotin-poly(ethylene glycol)-distearoyl phosphatidyl ethanolamine (Biotin-PEG3400-DSPE) as the functional material and the polymeric micelles were prepared by a thin-film hydration method. The targeting capability of micelles was investigated by cell uptake assay in vitro and fluorescence imaging in vivo and the amounts of Biotin-PEG-DSPE were optimized accordingly. Hypocrellin B (HB), a novel photosensitizer was then encapsulated in biotinylated polymeric micelles and the anti-tumor efficacy was evaluated systemically in vitro and in vivo. The results showed that micelles with 5 mol % Biotin-PEG-DSPE demonstrated the best targeting capability than those with 20 mol % or 0.5 mol % of corresponding materials. This formulation has a small particle size [mean diameter of (36.74 ± 2.16) nm] with a homogeneous distribution and high encapsulation efficiency (80.06 ± 0.19) %. The following pharmacodynamics assays showed that the biotinylated micelles significantly enhanced the cytotoxicity of HB against tumor cells in vitro and inhibited tumor growth in vivo, suggesting a promising potential of this formulation for treatment of pancreatic cancer, especially those poorly permeable, or insensitive to radiotherapy and chemotherapy.

Objective To verify the effectiveness of electrical impedance tomography (EIT) with multi-layer electrodes in gastric emptying measurement by simulation experiments using EIT with three-layer electrodes.Methods Firstly,EIT system with three-layer electrodes and gastric emptying measurement simulation equipment was designed and constructed to simulate gastric emptying process and obtain EIT reconstruction images.Secondly,the region where the electrical characteristic of gastric changes was selected as region of interest.Finally,the relative impedance change rate in region of interest for every image obtained from all three layers was consecutively recorded,then the gastric emptying curve was formed and gastric emptying time was calculated.Results There are obvious differences among the sharp of impedance change curves of interested region for three layers,and the gastric emptying time and process of each layer is also different from one another.It is suggested that the passing path and emptying manner of food in gastric emptying process reflected by EIT images varied from layer to layer.Therefore,the necessity and feasibility of using EIT with three-layer electrodes in gastric emptying measurement study is verified.Conclusions EIT with three-layer electrodes can provide more abundant information of gastric motility function associated with gastric emptying pathology and physiology state.It is likely to be a noninvasive,convenient and effective imaging method for the detection and evaluation research on gastric emptying and gastric motility.

BACKGROUND: Skin defect is commonly repaired by autologous skin graft, but in which, it is required healthy skin provider and it probably results in scarring deformity to various extents. The successful construction and clinical application of tissue-engineered skin (TE skin) mark the major breakthrough in treatment of skin defect.OBJECTIVE: To analyze the relationship between operation method and healing rate, through repair of skin defect with TE skin, to provide experimental evidence on clinical application of TE skin.DESIGN: Randomized controlled observation was designed.SETTING: Department of Oral and Maxillofacial Surgery, Teaching-Research Room of Histology and Pathology and Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University of Chinese PLAMATERIALS: The experiment was performed in Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University, in which 6 healthy York pigs were employed, of clean grade,aged varied from 2.5 to 3 months. 3 groups were randomized, named TE whole-layer group, TE dermal and auto-epidermal group and auto-graft group, 2 pigs in each group. 8 wounds were prepared in each pig, round in shape and 50 mm in diameter, 16 wounds in each group, totally 48wounds.METHODS: ①Preparation of TE whole layer and TE true skin. ② In TE whole-layer group: The whole layer of skin was cut off from fat layeralong the drawn line. When bleeding stopped thoroughly and the wound was covered with wet physiological saline gauze, TE whole-layer skin was collected and windowing was done on the skin for drainage. Physiological saline was used to rinsed away the culture solution on the surface of TE skin, and then, the cuticular layer was upward-covered the wound, avoiding gas vacuole between cuticular layer and wound. Single-layer oleic gauze, physiological saline gauze, aseptic dry gauze and elastic sponge cushion were covered successively, about 3-5 mm in thickness each layer. After routine dressing, elastic bandage was wrapped with compression terminally. ③ TE dermal and auto-epidermal group: The whole- layer skin was cut off with same method. Thin split-thickness skin (TIS) 0.1-0.2 mm was collected with drum dermanuring machine and soaked in physiological saline. The same method was used to collect the managed TE true skin and cover it on the wound, covering immediately on autoTTS. The rest management was same as TE whole-layer group. ④ Autograft group: The whole-layer skin was cut off and the fat tissue was removed, afterwards, it was re-grafted on the auto-wound, covered with various layers of dressing and bandaged with compression. ⑤ The survival case was determined if it was discovered no infection, necrosis and scaling of grafted skin, less than 3 mm in diameter when the wound was opened for changing fresh dressing each time, otherwise, the failed case was recorded. The survival rate in each group was analyzed statistically in 4 weeks after operation.MAIN OUTCOME MEASURES: Survival situation of grafted skin in 4weeks after operation in each group.RESULTS: In 4 weeks after operation, the survival rate of grafted skin was 75% in TE whole-layer group was 87% in TE dermal and auto-epidermal group and was 94% in auto-graft group. The results were similar basically in comparison among 3 groups (x2=-2.34, P ＞ 0.05).CONCLUSION: The effect of TE skin graft on repair of skin defect is near to that of auto-epidermal graft, testifying that the repair of skin defect with TE skin is feasible.

Objective To investigate the expression of SOX2 in gastric carcinoma and to analyze its relationship with clinicopathological features.Methods Immunohistochemistry method was used to detect the level of SOX2 in 67 cases of gastric carcinoma group and 30 cases of normal gastric mucosa group.Results The positive expression rate of SOX2 in gastric carcinoma group (52.24 ％) was obviously lower than that in normal gastric mucosa group (93.33 ％) (x2 =16.326,P ＜ 0.01).The SOX2 expression was significantly correlated with differentiation,the depth of invasion,lymph node metastasis and TNM stage of the tumor (all P ＜ 0.05).Conclusions The low expression of SOX2 may contribute to the early carcinogenesis of gastric carcinoma,and the expression level of SOX2 is closely related with lymph node metastasis and TNM stage.The expression level of SOX2 is a useful marker for predicting the prognosis of gastric carcinoma.

For the employment orientation of graduates in clinical medical major from three-year medical eduction,a curriculum system,which will be used to foster practical medical talented person for urban and rural communities,has been proposed in this paper.We will take measures,which not only further defines training target and requirement for the practical medical person from the short school system and guides students to alterate their ideological concept but also reconstructures new curriculum system and reforms teaching methods,to ensure the implementation of the training objectives

Objective To evaluate the clinical feasibility of quality assurance of helical tomotherapy intensity modulated radiation therapy (IMRT) through a series of clinical case studies. Methods Tomotherapy planning system was used to provide optimized IMRT treatment plans. To verify the dose of IMRT plans,the cylindrical Virtual Water phantom,0.056cm3 AISL, ion chamber and EDR2 film were used for getting the absolute and relative doses from tomotherapy IMRT planning. The film and ion chamber were placed into the phantom. The doses of the interesting points and isodose distribution of the axial plane were measured,then the results were compared with those from the calculation in planning system for verification. Before the irradiation,kVCT images of the phantom were registered by tomotherapy MVCT images. So the setup of phantom was guided for verifying the position. Results The isedose distribution (on the axial plane) measured by the film was well consistent with that calculated by tomotherapy planning system. The error between the measured dose and predicted dose in the measured points was less than 3%. The setup error of the phantom was able to be kept within 1 mm. There was 2 mm offset along the vertical direction of couch from the virtual isocenter to beam isocenter,which should be considered during the phantom/patient setup. Conclusions The procedures for quality assurance of tomotherapy IMRT are feasible in our experience. And helical tomotherapy IMRT QA system has been constituted.

Three dimensional electrical impedance tomography (3D-EIT) became an important branch of EIT recently. It is important to research imaging and image quality evaluation methods for single targets of different positions and multi-targets in 3D field. Using finite element subdivision method, 3D-EIT field was dispersed into cube unit in the present study for models with single target located in the center of field, middle of field, and near to the edge, respectively. For models with two targets and four targets near to the field edge, Tikhonov-Noser algorithm was adopted in image reconstruction. Imaging error function ER and structure similarity degree function SSIM were introduced to evaluate the reconstructed images. For the models with signal target, with the movement of the target from the center to the edge of the field, the value of ER increased and SSIM decreased, and reconstruction quality decreased. For the models with multi-targets near to the field edge, ER and SSIM increased and decreased respectively with the increase of target number, mage quality also decreased. Tikhonov-Noser algorithm is an effective 3D-EIT algorithm. ER and SSIM are adaptive for the characteristic of 3D-EIT images, and it can quantitatively evaluate the 3D-EIT imaging effect from the two perspective of imaging error and structure quality.
Algorithms ; Electric Impedance ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Tomography