Objective:To investigate the effect of nutrition intake,body mass index(BMI),age of delivery,pregnancy time of pregnant women on birth weights of neonates.Methods:The conditions of 237 pregnancy women from January.1st 2007 to June 1st 2007 in one hospital of Chongqing were analyzed retrospectively.There were 3 cases of fetal death,8 cases of artificial abortion among them,so the practical cases number was 226.Indexes of nutrition intake,body mass index,age of delivery, pregnancy time of pregnant women and birth weights of neonates were recorded and performed for statistical analysis.Results: The pregnant women with high total energy and tat intake,high BMI and post-term birth had higher risk of delivery of heavier infants or even macrosomia.The protein and carbohydrate intake,age of delivery of pregnant women wouldn't affect on birth weights of neonates.Conclusion:The total energy and fat intake,body height,body weight and pregnancy time of pregnant women will affect on the birth weights of neonates.

Primary central nervous system lymphoma (PCNSL) is a rare type of malignant lymphoma which originates in the central nervous system without spreading to other systems. It is more predisposable to immunodeficient individuals. However, an increase in the incidence of PCNSL has been also observed in the healthy population in recent years. PCNSL has short phase of clincal release, and easy to relapse with poor prognosis. Some studies have shown that relative prognostic factors were associated with age, performance status, the radiotherapy and chemotherapy modalities, the response to early adminstration of the glucocorticoid,tissue pathologic type and the molecular biologic marks.

Objective To compare tacrolumus (FK506) with cyclosporine A (CsA) in clinical application to organ transplantation.Methods The literature in recent years has been reviewed and compared. Results FK506 was a powerful immunosuppression with a mechanism of action similar to that of CsA, but significantly superiori to CsA in terms of prophylaxis and treatment of allograft acute rejection, delay of chronic rejection, and withdrawal of steroid in early period. The cardiovascular mortality and chronic graft nephropathy (CGN),such as hypertension and hyperlipidemia were less frequently seen in FK506-treated patients and FK506 also had an acceptable safety profile, including a low incidence of hypertrichosis,gingival hyperplasia and infections.However, CsA had been showed a better result in prevention of posttransplantation diabetes mellitus (PTDM ) and more economic agent than FK506. Pharmacokinetic studies showed CsA in the form of Sandimmun Neoral showed less inter- an intrapatient variability than FK506.Meanwhile, the combination of MMF and FK506 or CsA has been proved effectively with excellent graft and patients survival. Conclusion FK506 and CsA are safe and effective long term maintenance immunosuppressive agents in organ transplantation with wonderful prospect.

Objective To evaluate the curative effect in treatment of hepatic metastases tumor with poorly blood supply through superselective transcatheter nutrient arterial full chemoembolization.Methods 75 cases of hepatic metastases tumors with poorly blood supply were treated by full chemoembolization through superselective transcatheter nutrient arterial infusion under DSA guided.Results After treatment 2～3 months,CT scans showed that totally 202 tumors in 75 cases,the tumors were fully filled with lipiodol in 189,large part in 11 and not well in 2.159 tumors were obviously shrunk,41 tumors were shrunk part,2 tumors were not obviously shrunk.The survival rate in 6 months,12 months,24 months,36 months and 3～5 years was 100%(75/75),85.3%(64/75),55%(41/75),42.7%(32/75)and 20%(15/75)respectively.Conclusion The transcatheter superselective nutrient arterial full filling chemoembolization for hepatic metastases tumor with poorly blood supply is a effective therapy.

Objective To explore the correlation of cognitive impairment with ischemic strokeinducing cerebral artery,in order to predict and find the correlations between different cognitive dysfunction and different intracranial arterial occlusion.Methods We used Montreal Cognitive Assessment (MoCA) to evaluate neuropsychological statuses in the 250 patients,who developed first time acute myocardial infarction for 2 weeks.MoCA scores and other neuropsychological cognitive assessment scores were recorded.Patients were grouped by the location of intracranial arterial occlusion.The neuropsychological cognitive assessment results were analyzed between groups.Results Middle cerebral artery occlusion was correlated with impairments of visual spatial/executive,attention,language and memory (B=-1.875 ～-1.094,P＜0.05).Anterior cerebral artery and vertebral basilar artery occlusion had correlations with attention impairment (B =-3.977,B =-1.833,P＜0.01).Posterior cerebral artery occlusion could cause visual spatial/executive,language and memory impairment(B=-1.714 ～-1.095,P＜0.05).No correlation of cognitive impairment characteristics with anterior choroidal artery occlusion was found.Conclusions Different arterial occlusion can cause different characteristics of impairment in cognitive function,which can help to predict cognitive impairment after sub-acute stroke.It suggests that some cognitive assessments must be conducted in sub-acute stroke management.

The robotic surgical system can provide a stable, clear and magnified three-dimensional view, filter the surgeon's hand tremor, and hold robotic arms with multiple degrees of freedom to ensure flexible and stable operations, which overcomes the shortcomings of traditional laparoscopy. Although the robotic surgical system has been widely used in surgical fields such as urology, obstetrics and gynecology, its role in hepatic surgery has not been fully recognized. In this article, based on the relevant literatures and their own experience, the authors briefly discuss the indications of the application of robotic surgical system in liver surgery, safety and efficacy of robotic liver resection, learning curve of robotic hepatectomy, difficult robotic hepatectomy, the cost of robotic liver resection and other issues.

To examine the role of glycogen synthase kinase 3 (GSK-3) in the apoptosis of pancreatic beta-cells to better understand the pathogenesis and to find new approach to the treatment of type 2 diabetes, apoptosis was induced by oleic acid (OA) in INS-1 cells and the activity of GSK-3 was inhibited by LiCl. The PI staining and flow cytometry were employed for the evaluation of apoptosis. The phosphorylation level of GSK-3 was detected by Western blotting. The results showed that OA at 0.4 mmol/L could cause conspicuous apoptosis of INS-1 cells and the activity of GSK-3 was significantly increased. After the treatment with 24 mmol/L of LiCl, a inhibitor of GSK-3, the OA-induced apoptosis of INS-1 cells was lessened and the phosphorylation of GSK-3 was increased remarkably. It is concluded that GSK-3 activation plays an important role in OA-induced apoptosis in pancreatic beta-cells and inhibition of the GSK-3 activity can effectively protect INS-1 cells from the OA-induced apoptosis. Our study provides a new experimental basis and target for the clinical treatment of type-2 diabetes.
Apoptosis/*drug effects ; Cell Line ; Fatty Acids, Nonesterified/*pharmacology ; Glycogen Synthase Kinase 3/*metabolism ; Insulin-Secreting Cells/*cytology ; Oleic Acid/pharmacology ; Phosphorylation

This paper reviewed the epidemiology, pathogenesis of post-ischemic-stroke cognitive impairment and the correlation analysis between the lesion and cognitive impairment under imaging guidance.

AIM: To observe the efficacy, feasibility and safety of endovascular stent-grafts in treating aortic dissection.METHODS: Six patients with aortic dissecting aneurysm (3 males and 3 females, aged 32-67 years, average of 50 years old) were selected from Department of Cardiology, First Affiliated Hospital of Gannan Medical College between March 2005 and March 2006. They were diagnosed by transthoracic magnetic resonance imaging (MRI) and aortic angiography, and as type Ⅲ aortic dissecting aneurysm according to Debakey typing. The tumor diameter was ranged from 3.2 to 4.3 cm. The informed consent was obtained from all patients. Two weeks after the onset, the blood pressure was control between 90-110 and 60-70 mm Hg and heart rate at 60-65 times/min, then the straight circular and bifurcated stents, the product of Yuhengjia Company, composed of single naked membrane, straight circular and bifurcated stents made of nickel-titanium memory alloy, and cover of domestic artificial blood vessel were implanted with the patients generally anesthetized. The aortic dissection and general condition of patients after operation were observed with angiography, and the patient recovery condition was examined by spiral CT at postoperative months 3 and 12.RESULTS: All 6 cases were involved in the result analysis.①The diameters of stents for the patients were appropriate. The angiography showed that the thoracic aortic dissection in 4 cases disappeared, and thrombogenesis was found in false lumen; the thoracic aortic dissections in 2 cases disappeared, however, a little contrast agent was found in false lumen, but the blood flow was very slow. The general condition of all patients was good with stable vital signs, all patients discharged after 7-10 days.②CT results at 3 month after operation suggested that the original false lumen significantly contracted, and the true lumen restored to normal level. In case 3, there was mural thrombus in the distal stent that connected with stent vessel wall, and the thrombus hyperplasia was not obvious during follow up. At 12 months after operation, there was no distinct alteration in the stent location and appearance, and the life quality of patients was significantly improved.CONCLUSION: Endovascular stent-grafts are effective and safe in treating aortic dissection.

Objective To evaluate the effect of dexmedetomidine alternative to propofol administered in general anesthesia on maintainance and recovery in patients undergoing gynecologic laparoscopy.Methods One hundred and twenty patients undergoing gynecologic laparoscopy,were divided into group C,D1 and D2 with 40 cases each by random digits table method.Group C received propofol 100 μ g / (kg min) and remifentanil 0.10-0.25 μ g / (kg min) intravenous infusion,group D1 received propofol 100 μ g/(kg min),remifentanil 0.10-0.25 μ g/(kg min) and dexmedetomidine 0.2 μ g/(kg h) intravenous infusion,while group D2 received dexmedetomidine 2.0-3.0 μ g / (kg h) and remifentanil 0.10-0.25 μ g/ (kg min).Cis-atracurium was given on time to maintainance of anesthesia.The heart rate (HR),mean arterial pressure (MAP) were recorded at the following time points:arriving at operating room (To),anesthesia induction (T1),intubation (T2),skin incision (T3),pneumoperitoneum (T4),10 min after pneumoperitoneum (T5),20 min after pneumoperitoneum (T6),the end of operation (T7),discharge from post anesthesia care unit(T8) and the first postoperative day (T9).The time of emergence,extubation and duration in post anesthesia care unit were recorded too.Ramsay scale and Riker Sedation-Agitation Scale on emergence,extubation and discharge from post anesthesia care unit and post anesthesia recovery score at T9 were also recorded.Results The MAP in group D2 was higher at T3 to T7 time-points than that in group C and group D1 [(93 ± 10),(99 ± 11),(94 ± 13),(95 ± 10),(91 ± 10) mm Hg (1 mm Hg =0.133 kPa) vs.(88± 11),(90± 10),(87±9),(86±9),(83±8)mmHgand (87±9),(90± 10),(86±8),(85 ±7),(83 ± 7) mm Hg],there were significant difference (P ＜ 0.05).There were no significant difference among groups on the HR at each time point and the time of emergence,extubation and duration in post anesthesia care unit (P ＞ 0.05).Ramsay scale was lower on emergence and Riker Sedation-Agitation Scale was higher on emergence and extubation in group C than that in group D1 and group D2 [(3.7 ± 1.3) scores vs.(4.0 ± 0.9),(4.2 ±0.9) scores,(3.1 ± 1.0) scores vs.(2.8 ±0.6),(2.7 ±0.9) scores,(3.3 ±0.7) scores vs.(3.2 ± 0.4),(3.0 ± 0.5) scores],there were significant differences (P ＜ 0.05).Riker Sedation-Agitation Scale was higher on extubation in group D1 than that in group D2(P ＜ 0.05).Post anesthesia recovery score at T9 in group D2 was apparently increased compared with that in group C and group D1 [(108 ± 10) scores vs.(93 ± 13),(93 ± 15) scores] (P ＜ 0.05).Conclusions Dexmedetomidine 2.0-3.0 μ g/ (kg h) administered in general anesthesia on maintainance in gynecologic laparoscopy can improve the quality of extubation and promote postoperative recovery without prolonging extubation time,but have a influence on hemodynamic changes at early stage of pneumoperitoneum.