Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.

Objective To study the clinical value of virtual segmentectomy based on three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic segmentectomy for early-stage lung cancer. Methods Totally 18 patients received thoracoscopic segmentectomy from July 2015 to July 2016 were performed virtual segmentectomy based on 3D-CTBA. The preoperative planning depended on the simulation result. Results All of the 18 cases(1 right Sl, 2 right S3, 3 right S6, 1 right S8 +9, 1 right S9 + 10, 3 left S1 +2 +3, 3 left S4 +5, 4 left S6 segmentectomies)were received thoracoscopic segmentectomy successfully. The mean operation time and intraoperative blood loss were (126.8士19.4) mins and(76.6±21.4) ml respectively. Pathological examination revealed no residual tumor cells at the surgical margins and no lymph node metastases in any patients. The actual surgical margins were all larger than 2 cm(2.37±0.39)cm. Conclusion Virtual segmentectomy based on 3D-CTBA can non-invasively visualize the relationship between the safe margin and segmental vessels and bronchi. It facilitates the preoperative planning of suitable segmentectomy procedure for patients with early-stage lung cancer.

Objective To assess the ability of quantitative ultrasound index to predict the severity of CCl4?induced liver fibrosis in a rat model us?ing logistic regression analysis. Methods In a rat model of 40%CCl4?induced liver fibrosis,ultrasound detected the portal vein diameter,blood flow velocity,and Young's modulus. The degree of hepatic fibrosis was determined using a light microscope after hematoxylin and eosin staining of tissue. Results Portal vein diameter and Young's modulus were useful predictors of the severity of liver fibrosis,with statistical significance(P<0.05). Young's modulus was most effective with an R2 value 0.788. Young's modulus combined with the distal diameter of portal vein effectively improved the predictive ability,showing an R2 value 0.821. Conclusion Young's modulus is the most predictive index to assess the severity of liver fibrosis. A combination of multiple indices can improve the ability to predict the severity of liver fibrosis.

Objective To analyze the expression of extracellular matrix metalloproteinase inducer (CD147)and phosphatase and tensin homolog deleted on chromosome ten(PTEN)in non small cell lung cancer (NSCLC) ,and to explore the correlations be‐tween expressions of CD147 and PTEN and those with clinicopathological factors .Methods The expressions of CD147 and PTEN proteins in tissues of 64 cases of patients with NSCLC and 10 cases of normal paracancerous tissues were determined by using im‐munohistochemical SP method .The correlations between expressions of CD147 and PTEN with clinicopathological factors were ana‐lysed ,as well .Results The expression of CD147 in NSCLC tissues(75 .00% )was significantly higher than that in paracancerous tissues(0 .00% ,P<0 .05) .The expression of CD147 was strongly associated with degrees of differentiation ,lymph node metastasis and TNM stage(P<0 .05) .The expression of PTEN in NSCLC tissues (32 .81% )was significantly lower than that in paracancerous tissues(80 .00% ,P<0 .05) .Expression of PTEN was strongly associated with TNM stage (P<0 .05) .Spearman correlation analy‐sis shown that CD147 expression was negatively correlated with PTEN expression (r= -0 .442 ,P<0 .05) .Conclusion The abnor‐mal expression of CD147 and PTEN might play an important role in the malignant progression of NSCLC .

Objective To analyze the radiographic characteristics of right hand X-ray film of adult patients with Kaschin-Beck disease (KBD) in Qinghai Province, to understand the most affected locations in adult KBD. Methods According to the criteria of KBD diagnose (WS/T 207-2010), 111 cases of patients were taken X-ray films of right hands. Joint space narrow, joint deformity, subchondral sclerosis, osteophyte, coarse and irregularity of joint, marginal retraction sign and capsule changes were chosen as the descriptive indexes, and these indexes were analyzed with SPSS 17.0. Results A total of 111 cases adult patients with KBD were examined right hand by X-ray, abnormality on X-ray film were 103 cases, the abnormal rate was 92.79%. The most affected fingers were Ⅱ- Ⅳphalanx bones, Ⅱphalanx bones accounted for about 92.23% (95/103), Ⅲ phalanx bones accounted for about 99.03% (102/103), and Ⅳ phalanx bones accounted for about 99.03% (102/103). There was significant difference of the abnormality between th e proximal phalanx and the middle phalanx among the Ⅱ - Ⅳ phalanx bones(χ2=79.33, P<0.05). Abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the proximal phalanx were 212, 7, 134, 47, 15 and 115 in Ⅱ - Ⅳ proximal phalanx, respectively; while the abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the middle phalanx were 77, 37, 137, 26, 19 and 126 in Ⅱ - Ⅳmiddle phalanx, respectively. Conclusion The Ⅱ - Ⅳ phalanx bones of right hand are the most affected locations in adult KBD.

Freshwater crabs (Sinopotamon denticulatum) were examined for metacercariae. Cats and dogs were also examined for Paragonimus infection. Questionnairing was carried out on health knowledge and behaviors among local residents in a village of Baokang County, Hubei Province. Results showed that the infection rate of Paragonimus skrjabini metacercariae in Sinopotamon denticulatum was 20.5% (46/214), with 15.6% (20/128) in a mining area and 30.2%(26/86) for the non-mining area respectively ( ?2=6.5, P0.05). Questionnairing showed that dogs and cats were with the habit of foraging and defecating at streams and children had the habits of eating raw or under-cooked crabs. The natural and ecological environments are in favor of the life cycle of P. skrjabini.

Objective To evaluate the effect of dexmedetomidine on receptor-interacting protein 1 (RIP1) signaling pathway during brain injury after cardiac arrest and resuscitation in pigs.Methods Twenty-one healthy domestic male white pigs,weighing 33-41 kg,were divided into 3 groups (n =7 each) using a random number table method:sham operation group (group S),cardiac arrest-resuscitation group (group CA-R) and dexmedetomidine group (group D).Ventricular fibrillation was electrically induced and untreated for 8 min followed by 5 min of cardiopulmonary resuscitation to establish the model of brain injury after cardiac arrest and resuscitation in anesthetized domestic white pigs.Dexmedetomidine was infused via the femoral vein in a loading dose of 0.5 μg/kg at 5 min after successful resuscitation,followed by an infusion of 0.5 μg · kg-1 · h-1 for 6 h in group D.The equal volume of normal saline was given instead in S and CA-R groups.The concentrations of neuron-specific endase (NSE) and S-100β protein in serum were measured at 1,3,6 and 24 h after resuscitation (T1-4).Neurologic deficit score (NDS) was evaluated at T4.The animals were sacrificed at T4,brains were removed and cerebral cortex tissues were obtained for determination of the expression of RIP1,RIP3 and mixed lineage kinase domain-like protein (MLKL) by Western blot.Results Compared with group S,the serum concentrations of NSE and S-100β protein were significantly increased at T1-4,the NDS was increased at T4,and the expression of RIP1,R1P3 and MLKL in cerebral cortex tissues was up-regulated in CA-R and D groups (P＜0.05).Compared with group CA-R,the serum concentrations of NSE and S-100β protein were significantly decreased at T3,4,the NDS was decreased at T4,and the expression of RIP1,RIP3 and MLKL in cerebral cortex tissues was down-regulated in group D (P＜0.05).Conclusion The mechanism by which dexmedetomidine reduces brain injury after cardiac arrest and resuscitation may be related to inhibiting the activation of RIP 1 signaling pathway in pigs.

Objective:To summarize the anesthesia management of living small bowel transplantation.Methods:Severn patients undergoing living and allogeneic small bowel transplantation for the first time were selected.The intraoperative hemodynamics, indexes of blood gas analysis, body temperature and blood transfusion and volume of liquid infused were analyzed.Postoperative outcomes were tracked.Results:Six cases survived and were successfully discharged from hospital successfully, and one patient died.In the operation room, 71% patients were successfully extubated after surgery.Compared with the values during anatomical separation period, Hb during vascular anastomosis and intestinal reconstruction periods and concentration of Ca 2+ during intestinal reconstruction period were significantly decreased, and the blood glucose concentration during vascular anastomosis period were increased ( P<0.05 or 0.01). Compared with the values during vascular anastomosis period, the blood glucose concentration was increased significantly during intestinal reconstruction period ( P<0.05). Crystalloid solution (57±30) ml/kg and colloid solution which mainly containing 20% albumin (15±13) ml/kg were infused mainly during anatomical separation and vascular anastomosis periods in all the patients. Conclusion:The condition of successful living small bowel transplantation is fully evaluation and preparation before surgery.Intravenous-inhalational anesthesia combined with transverses abdominis plane block and rational infusion of colloid solution with vasoactive drugs to maintain hemodynamics stability and monitor blood gas, body temperature, active adjustment of electrolytes and internal environment and stable body temperature can be helpful in maintaining perioperative stable vital signs during the perioperative period, removing the tracheal tube early at the end of surgery, and reducing the development of postoperative complications in patients undergoing living small bowel transplantation.

Objective To evaluate the effect of dexmedetomidine postconditioning on cardiac function after cardiac arrest-cardiopulmonary resuscitation in swine.Methods Twenty-eight healthy male white swine,weighing 33-41 kg,were divided into 4 groups (n=7 each) using a random number table:sham operation group (group S),cardiac arrest-cardiopulmonary resuscitation group (group CA-CPR),lowdose dexmedetomidine postconditioning group (group LDP) and high-dose dexmedetomidine postconditioning group (group HDP).Ventricular fibrillation was electrically induced and left untreated for 8 min,and then cardiopulmonary resuscitation was initiated and continued for 5 min.At 5 min after successful resuscitation,dexmedetomidine was infused via the femoral vein at a loading dose of 0.25 μg/kg followed by an infusion of 0.25 μg · kg-1 · h-1 for 6 h in group LDP,and dexmedetomidine was infused via the femoral vein at a loading dose of 0.50 μg/kg followed by an infusion of 0.50 μg · kg-1 · h-1for 6 h in group HDP.The equal volume of normal saline was given in S and CA-CPR groups.At 1,3,6 and 24 h after resuscitation,stroke volume (SV) and global ejection fraction (GEF) were measured using PiCCO,and the concentration of cardiac troponin Ⅰ (cTnⅠ) in serum was also measured by enzyme-linked immunosorbent assay.At 24 h after resuscitation,the animals were sacrificed,hearts were removed and myocardial tissues were obtained for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents (by enzyme-linked immunosorbent assay),malondialdehyde (MDA) content (by thiobarbituric acid method),and superoxide dismutase (SOD) activity (using xanthine oxidase method).Results Compared with group S,the SV and GEF were significantly decreased,the cTnⅠ concentration in serum and contents of TNF-α,IL-6 and MDA in myocardial tissues were increased,and the activity of SOD in myocardial tissues was decreased in CA-CPR,LDP and HDP groups (P＜0.05).Compared with group CA-CPR,the SV and GEF were significantly increased,the cTnⅠ concentration in serum and contents of TNF-α,IL-6 and MDA in myocardial tissues were decreased,and the activity of SOD in myocardial tissues was increased in LDP and HDP groups (P＜0.05).Compared with group LDP,the SV and GEF were significantly increased,the cTnⅠ concentration in serum and contents of TNF-α,IL-6 and MDA in myocardial tissues were decreased,and the activity of SOD in myocardial tissues was increased in group HDP (P＜0.05).Conclusion Dexmedetomidine postconditioning can improve cardiac function after cardiac arrest-cardiopulmonary resuscitation in swine,and the mechanism may be related to inhibiting inflammatory responses and oxidative stress responses.

Humans ; Microglia ; Spinal Cord ; Neuralgia ; Hyperalgesia