Objective To investigate the effects of parecoxib pretreatment on the intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes,aged 25-64 yr,weighing 45-70 kg,with body height 156-178 cm,undergoing elective esophageal surgery,were randomly divided into 2 groups (n =20 each):normal saline group (group NS) and parecoxib group (group P).Parecoxib 40 mg (in normal saline 10 ml) was injected intravenously 30 min before anesthesia in group P,while the equal volume of normal saline was given instead of parecoxib in group NS.Anesthesia was induced with iv injection of propofol,fentanyl and rocuronium.Bronchial blocker was inserted after tracheal intubation and the correct position was confirmed by bronchoscopy.Anesthesia was maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of atracurium.HR,MAP,SpO2 and mean airway pressure (Pmean)were determined at 5 min of two-lung ventilation,at 40 min of one-lung ventilation,and at 30 min after re-expansion of the collapsed lung (T0-2).Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis.Intrapulmonary shunt (Qs/Qt) was calculated.Results There were no significant differences in hemodynamic parameters and Pmean between the two groups (P ＞ 0.05).PaO2 was significantly lower,while Qs/Qt was significantly higher at T1,2 than at T0 in groups NS and P (P ＜ 0.05).PaO2 was significantly higher,while Qs/Qt was significantly lower at T2 than at T1 in groups NS and P (P ＜ 0.05).Qs/Qt was significantly lower at T1,2 and PaO2 was significantly higher at T2 in group P than in group NS (P ＜ 0.05).Conclusion Parecoxib 40 mg injected intravenously at 30 min before anesthesia can reduce the intrapulmonary shunt during one lung ventilation in patients undergoing esophageal cancer resection.

Nei Jing says:Tian Qi connects Lung. Cough is closely associated with the seasons’change of climate which means four seasons and six pathogenic factors,so we must combine the clinical treatment of cough with the seasons’change of climate,which conduct an overall analysis of the illness and the patient's condition. It is favorable to drive out pathogenic Qi and restore healthy one.

Objective: To determine the inhibitory effects of anti-bone sialoprotein(BSP) antibody on human breast cancer cells adhering to bone matrix in vitro.Methods: Expression of BSP in 3 different cancer cell lines(bone seeking breast cancer cell MDA-MB-231-BO,lung adenocarcinoma cell SPCA-1 and colon carcinoma cell LOVO)was detected immunohistochemically.Cells adhering test was carried out to investigate the adhering of the 3 different cancer cell lines to mouse bone matrix in vitro and the inhibitory effect of anti-BSP antibody on MDA-MB-231-BO cells adhering to mouse bone matrix;Enzyme-linked immunosorbent assay was carried out for quantitative detection of TGF-?.Results: BSP immunostaining was positive in MDA-MB-231-BO cells and negative in SPCA-1 and Lovo cells.The number of MDA-MB-231-F10 cells adhering to mouse bone matrix was significantly more than SPCA-1 or Lovo cells(P

Objective: To investigate the relationship between obstructive sleep apnea hyponea syndrome(OSAHS) and brain vascular diseases in old patients.Methods: Fifty-two old patients with OSAHS were observed by polysomography,dynamic blood pressure measurement and nuclear magnetic resonance.Results: Compared with the healthy controls,the incidence of apoplexy was obviously higher in the severe OSAHS group and the rate of hypertension is significantly higher in both the moderate and severe groups.Conclusion: There are high incidences of hypertension and apoplexy in old patients with OSAHS.

ObjectiveTo study the expression and potential significance of NET-1 in endometrial carcinoma.Methods106 specimens after operation were selected.All specimens were stained with H.E.and immunohistochemistry.ResultsThe expression of NET-1 immunoreactivity were different in normal endometrium(43.8％ ),endometrial hyperplasia ( 79.2％ ) and endometrial carcinoma ( 100％ ) ( x2 =11.88,P ＜ 0.01 ).The expression of NET-1 in endometrial carcinoma was significantly higher than that in normal endometrium and simple endometrial hyperplasia ( x2 =36.14,10.86,P ＜ 0.01 ).The expression of NET-1 in endometrial hyperplasia was significantly higher than that in normal endometrium ( x2 =5.29,P＜ 0.05 ).There was a correlation between the expression of NET-1 and degree of endometrial lesions ( r =0.355,P ＜0.01 ).The expression of NET-1 was relative with differentiation (x2 =11.04,P ＜0.01 ; r =0.558,P ＜0.01),stages(x2 =11.04,P ＜0.01; r =0.558,P ＜0.01),depth of myometrial invasion (x2 =15.90,P ＜0.01 ; r =0.479,P ＜0.01),with or without metastasis in lymph node ( Z =-3.74,P ＜0.01 ),menopause condition ( Z.=-2.60,P ＜0.01).ConclusionsNET-1 may play an important role in carcinogenesis and progression of endometrial carcinoma.It might be a marker of biological behavior and reference for endometrial carcinoma gene therapy.

Objective To evaluate the diagnostic value of in vivo 1H-MRS in the hyper acute reaction stage of radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy. Methods Eighteen patients with nasopharyngeal carcinoma accepted radiotherapy for the first time. Bilateral temporal lobes in all cases were examined by conventional MRI and 1H-MRS before and after radiotherapy with radiation dose of 20 Gy, 40 Gy, and 60 Gy, respectively. MR image was performed with T_1-weighted gradient- and spin-echo, T_2-weighted spin-echo, fluid-attenuated inversion-recovery, and point resolution spectroscopy. The change of the spectroscopic morphology and the ratios of the metabolites were observed. Results There were no changes of signal in the temporal lobes with conventional MRI, but the peak height of NAA and Cho decreased obviously in the anterior half of the temporal lobes with 1H-MRS after radiotherapy. The post-radiotherapy changes of different metabolic peak in the anterior temporal lobes presented as two types: one type was that Cho and NAA peak were of the same height simultaneously. There were 20 locations (56%) of the 36 reaching the peak when accepting 20 Gy, 22 (61%) when accepting 40 Gy, and 13 (36%) when accepting 60 Gy, respectively. The other type was that Cho peak became the highest, whereas NAA peak was obviously lower and decreased to be the second highest. There were 4 locations(11%) of the 36 reaching the peak when accepting 20 Gy, 10 (28%) when accepting 40 Gy, and 23 (64%) when accepting 60 Gy, respectively. The ratio of Cho/Cr, NAA/Cr, and NAA/Cho decreased in the same position too. In addition, there was positive correlation between the ratios of the metabolites and the dose of radiotherapy.Conclusion 1H-MRS can be used to diagnose the radiation-induced injury of the brain in early acute reaction stage after nasopharyngeal carcinoma radiotherapy through reflecting histiocytic metabolism, and provide objective basis for pathology development and cellular metabolism study, also it can provide feasible projects for the clinic.

Objective:To study the Fanggan Decoction,s death prevention on mouse and inhibition effects on Influenza A virus in vivo.Methods:After setting up the model of mouse infected with Influenza A virus(H1N1),we observed the death prevention with Fanggan Decoction,done hemagglutination test and detected the dynamic contents of virus with Real-Time Fluorescence Quantitative RT-PCR.Results:Fanggan Decoction can prevent the death of infected mouse and delay the survival time.The death rate was 66.67%,33.33% and 25% respectively in low,middle and high dose of Fanggan Decoction groups and the average survival time was respectively 8.75 days,11.41 days and 12.33 days.Virus contents reached peak on the 5th day,while compared with the model group,virus contents were lower in each Fanggan Decoction groups,especial in the middle and high dose groups.Conclusion:Fanggan Decoction had good effect in inhibiting Influenza A virus,and can prevent the death of infected mouse,delay the survival time,while get better antivirus dose-effect relationship at double dose.

Objective:To evaluate the efficacy and safety of raltitrexed plus oxaliplatin combined with concurrent radiotherapy for advanced esophageal carcinoma. Methods:A total of 54 patients with stageⅡ/Ⅲadvanced esophageal carcinoma according to the clinical staging of esophageal carcinoma nonsurgical methods were treated with raltitrexed plus oxaliplatin combined with concurrent radiotherapy. The patients were irradiated with a dose of 60 Gy in 30 fractions. Two cycles of concurrent chemotherapy were adminis-tered during radiotherapy, with 100 mg/m2 oxaliplatin and 2.6 mg/m2 raltitrexed on d1 and d22. Results:The complete response rate was 16.7%(9/54), and the partial response rate was 68.5%(37/54). The total response rate was 85.2%. The no response and progression rate was 14.8%(8/54). The one-and two-year local control rates and overall survival rates were 75.4%, 57.3%and 70.4%(95%CI, 0.6-0.8), 46.6%(95%CI, 0.3-0.6), respectively. The incidence rates of radiation-induced esophagitis, leucopenia, acute diarrhea, neuro-toxicity were 100%, 72.2%, 16.7%, and 44.4%, of which 7.4%, 7.4%, 1.9%, and 0%were≥grade 3, respectively. Conclusion:Ralti-trexed plus oxaliplatin combined with concurrent radiotherapy can enhance the response rate and prolong the survival of patients with advanced esophageal carcinoma. The regime has mild toxicity and is worthy of further study in PhaseⅢ.

Objective To investigate pathogenic factors,clinical characteristics,pathological changes in 6 patients with localized or disseminated intestinal neuronal dysplasia(IND).Methods The clinical retrospective study was performed in 6 cases with localized and disseminated IND.Results In 6 patients,constipation and partial intestinal obstruction were the major symptoms.Preoperatively,dia-gnoses were revaluated as intestinal stenosis in 2 cases,long sigmoid in 2 cases and long-segment aganglionosis and total gastrointestinal IND in the rest 2 cases,respectively.Exploratory laparotomy was performed on all these patients.Pathological study suggested that 4 of them were localized IND,on whom enterectomy and intestinal anastomosis were performed successfully.However,2 cases of disseminated IND died postoperatively.Conclusions Disseminated IND may be caused by congenital factors,while localized IND by the acquired factors which including intestinal obstruction,local ischemia or inflammation.The surgical interventions are effective for localized IND,and intestine transplantation might be prospective treatment for disseminated IND.

Objective To evaluate the features of the encapsulated papillary thyroid carcinoma (EPTC) by ultrasound and histopathology.Methods The EPTC were classified into the following two types based on the shape,characteristics of the border,size of the nodule,echogenicity,a hypoechoic halo and microcalcification by ultrasound features:papillary carcinoma (PC) type and follicular tumor (FT) type.Results Of all the 33 cases,21 cases were PC type and 12 cases were FT type.The histopathological result of PC type was papillary carcinoma.PC type had a jagged border,an irregular tumor shape with marked hypoechogenicity by ultrasound.PC type were composed of papillae by histopathology,completely surrounded by a fibrous capsule with tumor cells having the nuclear features of papillary thyroid carcinoma,densely interstitial fibrosis and microcalcification;FT type had a smooth border,a regular shape (spherical to oval),isoechogenicity and a hypoechoic halo by ultrasound.FT type were completely or significantly composed of follicles by histopathology,completely surrounded by a fibrous capsule with tumor cells having the nuclear features of papillary thyroid carcinoma.Hypoechoic halo were more frequently observed in FT type than in PC type.The nodule size of FT type(1.8-7.0 cm)was larger than that of PC type(0.8-5.2 cm).Fine and multiple strong echoes were characteristically present only in PC type.Conclusion The EPTC have characteristic features that are similar to those of the benign follicular thyroid tumor by ultrasound.