Objective To explore the influences of Dexmedetomidine for laparoscopic cholecystectomy on stress reaction and hepatic/renal functions. Methods Totally 100 cases with laparoscopic cholecystectomy were divided into two groups:Dexmedetormidine group and Propofol control group (n=50 for each group) according to the different anesthetic methods.The hemodynamic change,stress reaction and hepatic/renal function were measured and analyzed. Results Heart rate [(85.7±13.4)times /min vs.(62.7±9.9) times/min; (81.3±14.9) times/min vs.(60.3±8.8)times/min,t=2.296,2.714,P=0.045,0.022] and mean artery pressure(MAP )[(86.3±11.9)mm Hg vs.(66.5+11.7) mm Hg; (88.6±15.6) mm Hg vs.(68.7± 12.3) mm Hg,t=2.653,2.240,P=0.024,0.049] immediately at trachea cannula and 1 min after trachea cannula were significantly increased in Propofol control group as compared with Dexmedetomidine group.In contrast to Propofol control group,epinephrine[(680.1±112.3) pmol/L vs.(576.1±83.1)pmol/L; (705.4±127.6)pmol/L vs.648.8±105.3) pmol/L,(689.6±123.4) pmol/L vs.(628.2±94.3) pmol/L,t=2.628,2.242,2.224,P=0.019,0.039,0.040],norepinephrine[(3953.6±514.6) pmol/L vs.(3695.1±196.2) pmol/L; (3967.2=514.9) pmol/L vs.(4367.1±565.7) pmol/L; (4095.8±415.1) pmol/L vs.(3813.4 ± 513.7) pmol/L, t =2.454, 2.500, 2.255, P =0.032, 0.030,0.045] and hydrocortisone [(796.6±198.7) nmol/L vs.(698.7±176.3) nmol/L; (835.5+217.2) nmol/L vs.(783.7±201.9) nmol/L; (822.4±203.3) nmol/L vs.(720.6±188.1) nmol/L,t=2.334,2.167,2.189,P=0.033,0.044,0.043] immediately at trachea cannula,1 min and 5 min after trachea cannula were decreased in Dexmedetomidine group.There were not significantly differences in hepatic/renal function between the two groups (P＞ 0.05). Conclusions Dexmedetomidine is safe and effective for laparoscopic cholecystectomy in view of more stable hemodynamics,less stress reaction,and non influence on hepatic/renal function.

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Objective To investigate the effects of mitogen-activated protein kinase p38(p38 MAPK)on CD3/CD28-stimulated T-cell proliferation and IL-2 expression which were enhanced by shockwaves.Methods Jurkat T cells or peripheral blood mononuclear cells(PBMC)were pretreated with the p38 MAPK-inhibitor(SB203580)(The Jurkat T cells or PBMC of the control groups were not pretreated with SB203580),then treated with shockwaves,and stimulated respectively with a suboptimal dose of anti-CD3 and anti-CD28 antibodies or PHA.Finally the IL-2 productions of Jurkat T cells or the proliferation of PBMC were respectively measured.The protein tyrosine phosphorylation of p38 MAPKin Jurkat T cells treated either with shockwaves or not was measured by Western blotting with anti-phosphotyrine antibodies(Thr180/Tyr182).The expressoins of p38 MAPK in Jurkat T cells treated either with shockwaves or not were determined by Western blotting with anti-p38 MAPK antibodies.Results Compared with negative control group without shockwave treatment,the 3H-TdR incorporation of the phytohemagglutinin-stimulated PBMC,which were treated with low dose shockwaves(LDSWs)of 100,150,200,250,300,330 impulses at(0.180?0.015)mJ?mm2,increased significantly(P

BACKGROUNDIt has been known that facilitative glucose transporter(GLUT) is the main carrier which intervenes the glucose uptake of cell,and there is a significant correlation between GLUT1 and cancer.The expression of GLUT1 in lung cancer has close relationship with the uptake of 18fluoro-2-deoxyglucose(FDG) of lung cancer,and the expression of GLUT1 is regulated by hypoxia inducible factor-1(HIF-1).The aim of this study is to investigate the relationship among expression of GLUT1,HIF-1α and the uptake of FDG in non-small cell lung cancer(NSCLC).

METHODSEighty-four patients with NSCLC were evaluated with FDG PET/CT before operation.The expression of GLUT1 and HIF-1α was detected immunohistochemically in lung cancer,and their expression level was assessed by the intensity of immunohistochemical staining.Correlation analysis was carried out among the expression level of GLUT1,HIF-1α and the value of standard uptake value(SUV) obtained from preoperative FDG PET/CT examination.

RESULTSThe range of average SUV(SUVave) of the eighty-four patients was 3.6-13.2,and the average value was 7.8±3.0.There was no significant correlation between the SUVave and the maximum diameter of the tumors,the TNM stage,pathological classification and the degree of differentiation.The positive rate of GLUT1 in the eighty-four patients was 95.2%(80/84).The average intensity of immunohistochemical staining was 4.4±1.3.The positive rate of HIF-1α in the eighty-four patients was 96.4%(81/84).The average intensity of immunohistochemical staining was 4.4±1.4.A highly significant positive correlation was found between GLUT1 expression and the SUVave(r=0.78,P < 0.01),and also between HIF-1α expression and the SUVave(r=0.73,P < 0.01).There was also a highly significant positive correlation between GLUT1 expression and HIF-1α expression(r=0.93,P < 0.01).

CONCLUSIONSGLUT1 protein and HIF-1α expressions are general in NSCLC tissues.GLUT1 may paly an important role in the glucose and FDG uptake of lung cancer cell,and HIF-1α might be one of the most important regulative factors of GLUT1 expression,which up-regulates the expression of GLUT1.

BACKGROUNDLung cancer is one of the most common malignant tumors in China. Surgical resection is still the first choice of treatment for most lung cancer patients. The prognosis of lung cancer after surgical treatment is correlated to many factors. One of them is nosocomial infection. This study is to investigate the distribution of the pathogens causing nosocomial infection and its correlative factors in patients with lung cancer.

METHODSOne hundred and thirteen cases that had hospital-acquired infection out of 1227 surgically treated patients with lung cancer were analyzed statistically.

RESULTSOf all the pathogenic species, the most prevalent species were Gram-negative bacteria with average positive detection of 64.03% (299/467). The second were Gram-positive bacteria (145/467, 31.05%) and the third were fungi (23/467, 4.92%). The results of drug sensitivity tests showed that all of strains had higher resistance rate. The rate of extended spectrum β-lactamases (ESBLs) and meticillin-resistant Staphylococcus (MRS) was very high. The incidence of nosocomial infection was seriously correlated with age, fatness, long smoking history, complicated diseases such as diabetes, damaged renal function and using time of mechanical ventilation over 24 hours.

CONCLUSIONSThe nosocomial infection of lung cancer patients after surgical treatment is seriously correlated with patient's age, fatness, long smoking history, complicated diseases such as diabetes, damaged renal function and using time of mechanical ventilation over 24 hours. More attentions should be paid to the pathogenic species and its correlative factors of nosocomial infection in lung cancer patients. The resistance of bacteria to the commonly used antibiotics is produced in various degrees. During clinical therapy with antibiotics, antibiotics should be selected according to the results of drug sensitivity tests. In order to reduce the production of drug-resistance, the appropriate use of antibiotics must be strengthened.

BACKGROUNDRecent researches have manifested that down-regulation of KAI1 relates to metastasis in various tumors, but its association with non-small cell lung cancer (NSCLC) and the mechanism for its down-regulation are not clear. The aim of this study is to investigate the expression of KAI1 in NSCLC and its relationship with clinicopathological characteristics and mutant P53 protein.

METHODSThe expression of KAI1/CD82 and mutant P53 protein was detected in 48 cases of NSCLC tissues by Western blot, and KAI1 mRNA was detected by RT-PCR method, with 20 cases of pulmonary benign disease tissues and normal lung tissues as control..

RESULTSThe positive rate of KAI1 mRNA was 52% in lung cancer group and 90% in control group, respectively (P < 0.01), KAI1/CD82 was 48% and 85% respectively (P < 0.01), and mutant P53 protein was 65% and 5% respectively (P < 0.01). The positive rate of KAI1 mRNA, KAI1/CD82 and mutant P53 protein closely related to the tumor stages, cell differentiation and lymph node metastasis status (P < 0.05 or P < 0.01). The expression of KAI1/CD82 highly related to KAI1 mRNA (P < 0.01) and mutant P53 protein (P < 0.05), while expression of KAI1 mRNA did not relate to mutant P53 protein expression (P > 0.05).

CONCLUSIONSThe down-regulation of KAI1 may relate to carcinogenesis, development and metastasis of NSCLC. Its reduction may occur mainly at transcriptional level and correlate with p53 in NSCLC. KAI1 and p53 might be helpful to predict the potential metastasis of NSCLC.

BACKGROUNDLymphatic dissemination is the main approach of metastasis in lung cancer, and it is also an important prognostic factor. The aim of this study is to explore the relationship between tumor size and lymph node metastasis in squamous cell carcinoma and adenocarcinoma of the lung.

METHODSA total of 240 patients diagnosed as squamous cell carcinoma and adenocarcinoma were studied. The relationship between tumor size and lymph node metastasis was analyzed.

RESULTSLymph node metastasis rate in maximum diameter (d)≤2cm, 2cm < d≤3cm, 3cm < d≤6cm, 6cm < d≤10cm, and d > 10cm groups was 50.0%, 35.1%, 52.8%, 52.1% and 71.4%, respectively. There was no correlation between tumor size and lymph node metastasis (r=0.10, P > 0.05). Lymph node metastasis occurred more frequently in adenocarcinoma (58.8%) than that in squamous cell carcinoma (42.9%) (P < 0.05). Mediastinal lymph node metastasis was found in 7 patients (16.3%) with d≤3cm, who were all diagnosed as moderate or poor differentiation.

CONCLUSIONSLymph node metastasis is not related to tumor size. Lymph node metastasis occurs more frequently in adenocarcinoma than it does in squamous cell carcinoma. Mediastinal lymph node metastasis can be found in tumor with d≤3cm, and differentiation grade may play an important role in lymph node metastasis.