Objective To investigate the use of laryngeal mask airway (LMA) ProSeal for airway management during open heart surgery performed under CPB in children. Methods Seventy-six ASA Ⅱ and NYHA class Ⅰ or Ⅱ patients aged 3 months-8 yr, weighing 3.3-34.5 kg undergoing open heart surgery under CPB were randomly divided into 2 groups ( n = 38 each): tracheal intubation group (group T) and ProSeal LMA group (group P1). Tracheal tube and LMA were inserted after induction of anesthesia with 8% sevoflurane. The rate of successfultracheal intubation and LMA placement, placement time, peak airway pressure and side effects during and after surgery including hypoxemia, tachycardia, bradycardia, hypotension and hypertension, laryngesl edema, dysphagia, bucking, dyspnea and hoarseness were recorded. Results There were no significant differences in the rate of successftl tracheal intubation and LMA placement, peak airway pressure, bucking, dyspnea and hoarse voice between the two groups (P＞ 0.05). The LMA placement time was significantly shorter than tracheal intubation time and the incidence of laryngeal edema and dysphagia lower in group P than in group T ( P ＜ 0.05). Conclusion The LMA ProSeal can provide adequate ventilation during operation with less complications and can be used effectively for cardiac surgery performed under CPB in children.

We have investigated the effects of repairing knee osteochondral defects in rabbit by using porous polyamide 66/nano-Hydroxyapatite (PA66/n-HA) combination bone marrow mesenchymal stem cells (MSCs). Eighteen 6-month-old New Zealand rabbits were used to produce the models of 4 mm x 4 mm osteochondral defect in the middle trochlea groove of femur. These models were randomly divided into 3 groups: PA66/n-HA + MSCs Group (Group A), PA66/n-HA group (Group B) and Operation control-group (Group C) in which operation for osteochondral defects was performed but neither material nor cells were implanted. The materials in Group A were seeded with MSCs (5 x 10(5)) in vitro before being implanted in to defects. The materials in groups A and B were 0.5 - 0.8 mm lower than normal cartilage. The animals were killed 1 and 4 months after operation. We assessed the effects by means of macroscopic observation, HE staining, toluidine blue staining, immunohistochemistry assay for type I and type II collagen. Group A displayed a little effect at the 1 month, but at the 4th month, Group A showed better results,compared to Groups B and C. At this time point, the repair tissue of Group A was regular; it presented more metachromatic substance visualized by toluidine blue staining, and it expressed type II collagen(+ +) and type I collagen(+). These results demonstrate that the repair tissue in Group A is nearly hyaline cartilage. So we presume that porous PA66/n-HA provides biomechanical support, and at the same time, MSCs enhance the repair effects.
Animals ; Biocompatible Materials ; Bone Substitutes ; chemical synthesis ; Female ; Hydroxyapatites ; Implants, Experimental ; Knee Injuries ; surgery ; therapy ; Male ; Mesenchymal Stem Cell Transplantation ; Nanoparticles ; Nylons ; Porosity ; Rabbits

BACKGROUND: Glutamine synthetase (GS) and arginase 1 (Arg1) are widely used pathological markers that discriminate hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma; however, their clinical significance in HCC remains unclear. METHODS: We retrospectively analyzed 431 HCC patients: 251 received hepatectomy alone, and the other 180 received sorafenib as adjuvant treatment after hepatectomy. Expression of GS and Arg1 in tumor specimens was evaluated using immunostaining. mRNA sequencing and immunostaining to detect progenitor markers (cytokeratin 19 [CK19] and epithelial cell adhesion molecule [EpCAM]) and mutant TP53 were also conducted. RESULTS: Up to 72.4% (312/431) of HCC tumors were GS positive (GS+). Of the patients receiving hepatectomy alone, GS negative (GS-) patients had significantly better overall survival (OS) and recurrence-free survival (RFS) than GS+ patients; negative expression of Arg1, which is exclusively expressed in GS- hepatocytes in the healthy liver, had a negative effect on prognosis. Of the patients with a high risk of recurrence who received additional sorafenib treatment, GS- patients tended to have better RFS than GS+ patients, regardless of the expression status of Arg1. GS+ HCC tumors exhibit many features of the established proliferation molecular stratification subtype, including poor differentiation, high alpha-fetoprotein levels, increased progenitor tumor cells, TP53 mutation, and upregulation of multiple tumor-related signaling pathways. CONCLUSIONS GS- HCC patients have a better prognosis and are more likely to benefit from sorafenib treatment after hepatectomy. Immunostaining of GS may provide a simple and applicable approach for HCC molecular stratification to predict prognosis and guide targeted therapy.
Humans ; Carcinoma, Hepatocellular/metabolism* ; Sorafenib/therapeutic use* ; Liver Neoplasms/metabolism* ; Glutamate-Ammonia Ligase/metabolism* ; Hepatectomy ; Retrospective Studies ; Prognosis ; Neoplasm Recurrence, Local/surgery*