Objectives To explore the optimal startup time of patient controlled intravenous analgesia (PCIA) in aged patients after thoracotomy for pulmonary lobectomy.Methods The 67 aged patients after thoracotomy for pulmonary lobectomy from January to December 2008 were randomized divided into two groups:PCIA was startup immediately after waking (instantly group) or after removal tracheal intubation (delayed group).The analgesia efficacy,cardiopulmonary function and side effect were evaluated at the awake time,12,24 and 48 hours after surgery respectively.Result Both of VAS scores at 12 hours after surgery and oxygenation index at 48 hours after surgery had significant difference (P<0.05) between the two groups.The analgesia efficacy was better in the instantly group.There was no significant difference on the duration of mechanical ventilation and side-effect rates between the two groups.No patient suffered from respiratory depression.Conclusion The early use of PCIA in aged patients after thoracotomy for pulmonary lobectomy can gain better pain control and oxygenation effect.

Objective To study the effects of biofeedback combined with the fixed functional appliance in the modification of mandible in patients with Angle Class Ⅱ malocclusion and retruded mandible.Methods A Iotal of 30 orthodontic patients were divided into two groups,all patients with retruded mandible and normal maxilla,ANB>6°,aged from 9 years and three months to 14 years and 11 months.All patients were treated with Forsus fixed functional appliance combined with MBT straight-wire appliance.Muscular activity of the superficial masseter muscle before,during,and after treatment.was evaluated by assessing the average integrated eleetromyogram (EMG) .The biofeedback was performed during functional treatment in the study group,the muscular activity of the superficial masseter muscle was turned into the signal which can be read and seen by patients,and the patient can control the muscular activity of the superficial masseter muscle in a certain extent under the help of instrument.After 6 weeks fixed functional appliance treatment,the biofeedback treatment was performed in the study group with the help of instrument and trained for 10 times,and the patients could trained by themselves for 20 minutes everyday.Results The biofeedback treatment was able to regulate the muscular activity of the masseter muscle and prevent the return of muscle function and the tendency to seat the condyle back toward the fossa,maintain the treatment effect;after biofeedback treatment the decreased postural EMG activity in the masseter muscle was steady,but without statistical significance (P>0.05).Conclusion The biofeedback treatment can maintain the muscular activity of the masseter muscle effectively,enhance the effect of functional treatment and keep the stability of the mandibular position.

Objective To investigate the effect of intermittent pneumatic pressure pump on the formation of deep venous thrombosis of lower extremity in elderly patients undergoing thoracotomy. Methods Fifty patients undergoing thoracic surgery were managed with intermittent pressure inflation pump besides general preventive measures. The pre-and postoperative blood flow in the lower extremity and incidences of deep venous thrombosis were compared. Result The differences in blood flow in the lower extremity and incidences of deep venous thrombosis were not statistically significant (P>0.05). Conclusion Intermittent pneumatic pressure pump can promote pulsatile blood flow in the lower extremity so as to effectively prevent formation of deep venous thrombosis in elderly patients after thoracotomy.

Objective To complete the large international cooperation nursing research project Adapting a Smoking Cessation Intervention Distance Learning Program to Educate Nurses in China(CRN-HSQ) cooperating with International Society of Nurses in Cancer Care (ISNCC).Methods The contact team was formed,convenience sampling method was used to choose 350 clinical nurses in our hospital.They were trained and investigated by web-based education mode.Results The contact team finished the project tasks smoothly.The satisfaction degree of research object with the contact team was high.Conclusions Establishment of contact team is good for shortening the information flow path,reducing the information transmission error,increasing the research objects' confidence and reducing the research objects turnover.It is very helpful for project with long period and large number of research objects.

Objective To observe the relationship between plasma level of homocysteine(HCY) and ischemic stroke in young and middle-aged adults,explore the clinical signficance concerning the occurrence and development of ischemic stroke in young and middle-aged adults.Methods The plasma homocysteine level of 132 young and middle-aged adults patients with ischemic and 86 control peoples were measured by means of enzymatic cycling assay.Results The plasma homocysteine level in ischemic stroke was higher than that in control group( P ＜ 0.01 ).The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group of young and middleaged adults.The plasma homocysteine level and the infarcted focus was positively linearly correlated.Conclusion Hyperhomocysteinemia is a risk factor of ischemic stroke among young and middle-aged adults.The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group.The plasma homocysteine level can reflect the size of the infarcted focus and the degree of disease,and the plasma homocysteine level should serve as a kind of regular examination or as an index intervention can be taken,all of which are great importance to prevent ischemic stroke and reduce its morbilily.

Objective To evaluate the clinical outcome of transesophageal echocardiography(TEE) in guiding and monitoring min-invasive transthoracic hybrid procedure for intracristal ventricular septal defects (VSD) using eccentric occluders.Methods 13 patients with intacristal VSD successfully underwent the min-invasive hybrid procedure using eccentric occluders were analyzed retrospectively.They were all carefully examined by transthoracic echocardiography (TTE) preoperatively and were diagnosed as intracristal VSD.There were no obvious aortic valve prolapse and no severe regurgitation.The entire process was guided and monitored by TEE.The condition of VSD occlusion was assessed by immediate postoperative TEE.Results All cases were occluded successfully.The results of postoperative TEE showed that the occluder was coincided closely with the edge of VSD,no aortic valve regurgitation worsen.2 had tiny residual left-to-right shunt (＜1.5 mm),which disappeared 1 and 3 months respectively after operation.No occluder dislocated followed-up at 6 months to 2 years postoperatively,and no major complications occurred.Conclusions The min-invasive hybrid procedure for intracristal VSD using eccentric occluders guided and monitored by TEE is easy to manipulate,which is safe,less invasive,and has excellent early-term results.

OBJECTIVETo explore the new mechanism of propranolol for treatment of hemangioma and the effects of propranolol on proliferation of hemangioma-derived mesenchymal stem cells ( Hem- MSCs).

METHODSWe isolated Hem-MSCs from hemangioma in the proliferating phase by their selective adhesion to plastic culture dishes. Immunofluorescence staining was used to examine the expression of marker antigens in Hem-MSCs. Human umbilical vein endothelial cells(HUVECs) were used as control. Indiuction of multi-lineage differentiation including osteogenesis and adipogeneis was performed with appropriate medium to identify the multi-lineage differentiation potential. MTT cell counting was used to observe the effects of different concentrations of propranolol on proliferation of Hem-MSCs.

RESULTSHem- MSCs were fibroblast-like morphology. All of them expressed vimentin, most expressed α-SMA,CD133, some expressed Glutl, and none of them expressed VEGF. Osteogenic, adipogenic differentiations of Hem- MSCs were induced successfully. Effects of low concentration of propranolol on proliferation of Hem-MSCs were not obvious, while high concentration of propranolol can inhibit the proliferation of Hem-MSCs.

CONCLUSIONSThe cells we isolated from hemangioma are Hem-MSCs. High concentration of propranolol can inhibit the proliferation of Hem-MSCs.

Adipogenesis ; Antigens ; metabolism ; Cell Differentiation ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelium, Vascular ; cytology ; Fibroblasts ; cytology ; Hemangioma ; pathology ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Osteogenesis ; Propranolol ; pharmacology ; Umbilical Veins ; Vimentin ; metabolism

OBJECTIVETo evaluate the feasibility of integrating cancer gene therapy with therapeutic effect evaluation using siRNA-loaded nano-scale microbubbles (siRNA-NBs).

METHODSsiRNA-NBs were prepared by hetero-assembly of polymeric siRNA micelles and liposomal microbubbles, and the particle sizes and surface potentials were examined with dynamic light scattering. The distributions of cy3-labled siRNA in the tumor tissues were evaluated using confocal laser scanning microscopy. A siRNA targeting the anti-apoptosis gene SIRT2 was designed and its gene silencing effects was tested in vivo using siRNA-NBs with ultrasound exposure. The therapeutic effect of the loaded siRNA-NBs was evaluated by contrast-enhanced ultrasonography.

RESULTSThe siRNA-NBs had a mean diameter of 400.7 ± 30.5 nm with a weak positive charge of +8.8 ± 0.8 mV. With ultrasound exposure, siRNA-NBs effectively delivered cy3-siRNA into the cytoplasm of cancer cells and caused SIRT2 suppression and cell apoptosis in tumor tissues, resulting in significantly suppressed tumor growth. In addition, contrast-enhanced ultrasonography of siRNA-NBs provided good imaging quality to allow real-time observation of blood supply during gene therapy.

CONCLUSIONSAs a novel ultrasound contrast agent, siRNA-NBs make possible the integration of tumor gene therapy and therapeutic effect evaluation for cancer.

Apoptosis ; Contrast Media ; Gene Silencing ; Genetic Therapy ; Humans ; Liposomes ; Micelles ; Microbubbles ; Neoplasms ; therapy ; Particle Size ; Polymers ; RNA, Small Interfering ; Sirtuin 2 ; genetics ; Ultrasonics

OBJECTIVETo summarize the management of infant vascular tumors with Kasabach-Merritt phenomenon (KMP) and to evaluate the effect of drug combined with sclerotherapy.

METHODSFrom Feb. 2007 to Nov. 2014, 25 cases with KMP, who underwent drug therapy combined with sclerotherapy, were retrospectively studied. Oral corticosteroids (2 mg/kg per day) was used as the first-line therapy on all of the patients and intravenous vincristine (1.5 mg/m2 every week) was added when the platelet counts didn't recover obviously after 2-3 weeks. After the recovery of the platelet counts, the patients were admitted for sclerotherapy (average, 4.56 sessions per case) with 100% alcohol (1-3 ml per session), Lauromacrogol (1.25-5 ml per session) and betamethasone (0.25-1 ml per session). All the patients were followed up for 42 months ( range, 9 months to 6.5 years). Therapeutic outcomes were assessed by evaluating platelet counts, size of lesion, function of trunk and limb.

RESULTSAll the 25 cases got obvious recovery in the platelet counts [average, (94.3 ± 18.5) x 10(9)/L] after drug therapy, of which 16 were treated by single oral corticosteroids for 4-7 weeks and 9 were treated by corticosteroids plus intravenous vincristine for 2-5 weeks. Meantime, 11 cases received platelet transfusions, of which 3 were coupled with gamma globulin intramuscularly. During the first admission, each of the 25 cases received 1-4 sessions of sclerotherapy (average, 2.6 sessions each case). One week after the sclerotherapy, the platelet counts returned to (167-312) x 10(9)/L (average, (258.5 ± 34.4) x 10(9)/L). The hemoglobin and blood coagulation function returned to normal within 1-5 weeks. Meanwhile the mental condition, appetite, body weight, sleeping were greatly improved. The size of the lesions decreased gradually after the combined therapy including 13 cases within 3-12 months and 13 cases within 13-36 months. Long term follow-up indicated that only 1 case need treatment for recurrent decrease of platelet counts, and all of the 25 cases kept the normal weight, height, immunity as well as the growing development.

CONCLUSIONSOral corticosteroids plus intravenous vincristine combined with sclerotherapy is a reliable management with high cure rate, short course and minor side-effect.

Administration, Oral ; Betamethasone ; administration & dosage ; Combined Modality Therapy ; methods ; Ethanol ; administration & dosage ; Glucocorticoids ; administration & dosage ; Humans ; Infant ; Injections, Intravenous ; Kasabach-Merritt Syndrome ; blood ; therapy ; Platelet Count ; Polyethylene Glycols ; administration & dosage ; Retrospective Studies ; Sclerotherapy ; methods ; Vincristine ; administration & dosage

Objective To evaluate the feasibility of integrating cancer gene therapy with therapeutic effect evaluation using siRNA-loaded nano-scale microbubbles (siRNA-NBs). Methods siRNA-NBs were prepared by hetero-assembly of polymeric siRNA micelles and liposomal microbubbles, and the particle sizes and surface potentials were examined with dynamic light scattering. The distributions of cy3- labled siRNA in the tumor tissues were evaluated using confocal laser scanning microscopy. A siRNA targeting the anti-apoptosis gene SIRT2 was designed and its gene silencing effects was tested in vivo using siRNA-NBs with ultrasound exposure. The therapeutic effect of the loaded siRNA-NBs was evaluated by contrast-enhanced ultrasonography. Results The siRNA-NBs had a mean diameter of 400.7 ± 30.5 nm with a weak positive charge of+8.8 ± 0.8 mV. With ultrasound exposure, siRNA-NBs effectively delivered cy3-siRNA into the cytoplasm of cancer cells and caused SIRT2 suppression and cell apoptosis in tumor tissues, resulting in significantly suppressed tumor growth. In addition, contrast-enhanced ultrasonography of siRNA-NBs provided good imaging quality to allow real-time observation of blood supply during gene therapy. Conclusions As a novel ultrasound contrast agent, siRNA-NBs make possible the integration of tumor gene therapy and therapeutic effect evaluation for cancer.