Objective To investigate the relationship between the doses of epidural morphine administered for postoperative analgesia and postoperative urinary retention (POUR). Methods Sixty ASA Ⅰ patients aged < 20-56 yr undergoing atthroscopic knee operation under epidural anesthesia were randomly divided into 3 groups ( n = 20 each) : group Ⅰ and Ⅱ received epidural morphine 1 and 3 mg in 5 ml of normal saline (NS) respectively at the end of operation (group M1, M2 ); group Ⅲ received NS 5 ml instead of morphine (group C). Urinary retention was defined as the patient could not void, when bladder volume was ≥ 600 ml measured using ultrasound. Bladder urine volume was measured before anesthesia and at 4, 6, 8, 10 and 12 h after operation. The occurrence of urinary retention, the first postoperative voiding time, VAS scores and the incidences of vomiting and pruritus were recorded. Results The 3 groups were comparable with respect to age, M/F sex ratio, preoperative bladder urine volume, the amount of local anesthetic used during operation and duration. The incidences of urinary retention, vomiting and pruritus were 65%, 60% and 90% respectively in group M2 and significantly higher than those in the other 2 groups. The first postoperative voiding time was significantly longer in group M2 than in the other 2 groups. VAS scores were significantly lower in group M1 and M2 than in group C. There was no significant difference in VAS scores between group M1 and M2. Conclusion Epidural morphine increases the incidence of POUR in a dose-dependent manner, and 1 mg is the recommended dose.

Objective To evaluate the efficacy of uhrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway in patients undergoing total knee arthroplasty.Methods Forty ASA Ⅰ-Ⅲ patients of both sexes,aged 52-80 yr,weighing 67-94 kg,undergoing total knee arthroplasty under general anesthesia,were randomly divided into 2 groups(n=20 each).Group Ⅰ received combined intravenous-inhalational anesthesia with endotracheal tube.Group Ⅱ received lower extremity nerve block guided by ultrasound and then combined intravenous-inhalational anesthesia with laryngeal mask airway.HR was maintained at 50-100bpm,MAP was maintained at the preoperative baseline level(increase or decrease amplitude<20%of the baseline level)during operation and in pestanesthesia care unit(PACU)and vasoaetive drugs(atropine,esmolol,efedrina,urapidil or labetalol)were given when necessary.The patients received patient-controlled intravenous analgesia with tramedol and lornoxicam(background infusion 2 ml/h,bolus dose 1 ml,lockout interval 15 min)after operation and VAS score was maintained at≤2.The requirement for vasoactive drugs during operation and in PACU,PACU stay length,and consumption of analgesics and occurrence of nausea and vomiting within 24 h after operation were recorded.Results Compared with group Ⅰ,the requirement for all vasoaetive drugs during operation and for esmolol,urapidil and labetalol in PACU was significantly reduced,PACU stay length Was significantly shortened,and the consumption of analgesics and incidence of nausea and vomiting were significantly reduced in group Ⅱ(P<0.01).Conclusion Ultrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway provides better emcacy with fewer complications and less consumption of postoperative analgesics than general anesthesia with endotracheal tube in patients undergoing total knee arthroplasty.

Objective:To study the role of tetrodotoxin-resistant(TTX-R)human sodium channel of hNa v1.8 mRNA in trigeminal neuralgia (TN). Methods:The samples of affected trigeminal division(inferior alveolar nerve) and non-affected division(lingual nerve) were surgically obtained from six idiopathic TN patients to whom the drug therapy was not effective.The expression of hNa v1.8 mRNA was assessed by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with ?-actin as an internal control. A sample of great auricular nerve (from a patient who had to accept the combined radical neck dissection with glossectomy and hemimandibulectomy) and a sample of infraorbital nerve (from a patient who had to accept subtotal resection of maxilla) were used as the negative controls. Resoults:The relative amount of hNa v1.8 mRNA in the affected trigeminal divisions(1.233?0.324) was higher than that in the non-affected divisions(1.018?0.249), t=3.919,P=0.011. Conclusion:The higher expression of hNa v1.8 mRNA in the affected nerves of TN patients may play an important role in TN.

Objective To observe the effect of EGFR‐TKI combined with chemotherapy on the changes of serum insulin‐like growth factor1(IGF‐1)and anterior gradient‐2(AGR2)levels in the patients with advanced non‐small cell lung cancer(NSCLC) ,and to investigate whether IGF‐1 and AGR2 can serve as a potential indicator of the prognosis and efficacy of chemotherapy in NSCLC . Methods Sixty‐eight patients with advanced NSCLC were selected as the experimental group treated by EGFR‐TKI combined chemotherapy and 30 healthy people served as the healthy control group .(treatment group) .The levels of serum IGF‐1 and AGR2 before chemotherapy and at 3 weeks after chemotherapy were detected by ELISA .The influence of serum IGF‐1 and AGR2 levels on the prognosis was analyzed by using Kanplan‐Meier method .Results (1)The disease control rate(DCR)in the EGFR‐TKI com‐bined chemotherapy was 52 .9% ;(2)the level of serum IGF‐1 before treatment in the experimental group was (329 .35 ± 88 .13)μg/L ,which was significantly higher than (146 .36 ± 41 .27)μg/L in the healthy control group(P<0 .01);the level of serum AGR2 in experimental group was(16 .72 ± 6 .23)ng/mL ,which was significantly higher than (4 .38 ± 2 .17)ng/mL in the healthy control group(P<0 .01);serum levels of IGF‐1 and AGR2 after treatment were(211 .53 ± 52 .31)μg/L and (9 .72 ± 3 .56)ng/mL respec‐tively ,which were significantly lower than those before treatment (P<0 .01);serum IGF‐1 and AGR2 in NSCLC patients were pos‐itively correlated(r=0 .489 ,P<0 .01);(3)serum levels of IGF‐1 and AGR2 after chemotherapy were(128 .62 ± 48 .24)μg/L and (7 .22 ± 4 .27)ng/mL respectively ,which were obviously lower than(334 .23 ± 82 .11)μg/L and(18 .43 ± 6 .17)ng/mL before chem‐otherapy(all P<0 .01) .The Kanplan‐Meier analysis revealed that serum IGF‐1 and AGR2 levels in advanced NSCLC had an obvi‐ous influence on the prognosis .Conclusion Serum IGF‐l and AGR2 levels may have a potential clinical value to assess the therapeu‐tic efficacy of EGFR‐TKI combined chemotherapy and prognosis in advanced NSCLC .

BACKGROUND:Corneal stromal fibroblasts have been shown to express interleukin-8 in the stimulation of lipopolysaccharide. Different reactions of fibroblasts to lipoprotein or other inflammatory mediators may constitute different characteristics of different tissues in the inflammatory response. OBJECTIVE:To observe the inhibitory effect of IKK-2 receptor blocker TPCA-1 on human corneal stromal fibroblasts to secrete inflammatory cytokines, chemokines and cel adhesion molecules under the stimulation of lipopolysaccharide and its signal transduction pathway, to compare with dexamethasone, and to explore alternative or synergistic effects after their combination. METHODS:This study measured the secretion of interleukin-1, tumor necrosis factor alpha, interleukin-6, and interleukin-8 from cultured human corneal stromal fibroblasts under the action of basic state and lipopolysaccharide, and their changes after the intervention with IKK-2 receptor blocker TPCA-1 and dexamethasone. We also detected expression level of intercelular adhesion molecule-1 and interleukin-6 in cel surface, and verified the changes in expression levels of intercelular adhesion molecule-1, interleukin-6, and interleukin-8 from mRNA level, as wel as examined the expression of nuclear factor kappa B under above conditions.

Objective: Executive dysfunction is a typical characteristic of vascular cognitive impairment(VCI),with subcortical ischemia as its pathological basis.The aim of this study was to investigate the characteristics of event-related potential of visual-spatial working memory based on ischemic white matter lesions,and offer more electrophysiological evidence for the evaluation of VCI.Methods: We included in this study 24 patients with ischemic white matter lesions(13 mild and 11 severe cases) and 12 elderly healthy controls,and induced event-related potentials(ERP) of visual-spatial working memory from the delayed matching-to-sample task in all the participants.Results: Three waves were identified: N330,P420 and late negative component. On the two-ball-load,the N330 amplitude in the middle frontal,right frontal and occipital lobe was significantly smaller in the mild and severe lesion groups(P

Objective To evaluate the magneto-heating effect and cytotoxicity of the carbonyl iron powder as a feasibility for arterial embolization hyperthermia. Methods Different doses of carbonyl iron powder suspensions were prepared in vitro(10 mg/ml,100%;10 mg/ml,50%;or 64 g/L phenol solutions),and heated for 20 minutes in an alternating magnetic field(49.9,79.9,and 110.2 Oe).The influences of the doses of suspensions and currency of magnetic field on the heating effect were observed.Meanwhile,mouse fibroblast L-929 cells were cultured with the suspensions for 2,4,or 7 days.The morphology and relative growth rate(RGR) of the cells were determined by microscopy and MTT assay.The cytotoxicity of the suspensions was then classified. Results The heating ability of the carbonyl iron powder increased with the suspension concentration and the strength of the magnetic field.A optimal therapeutic temperature was achieved at 110.2 Oe with 60 mg/ml carbonyl iron powder suspension.The L-929 cells showed normal morphology after been treated by the carbonyl iron powder(10 mg/ml 100% solution and 50% solution) for 2,4 and 7 days with the 0-1 degree cytotoxicity.Conclusion The carbonyl iron powder has good heating effect under the alternating magnetic field,and is compatible with the tested cells.

Ojective To evaluate the therapeutic effect of conformal radiotherapy on metastatic hepatic cancer. Methods 10 cases of metastatic hepatic cancer (1 to 5 metastatic focus respectively) were treated with stereotactic radiotherapy from Septermber 1997 to April 2000. The clinical target volume(CTV) of tumor ranged from 0.6cm 3 to 232cm 3 (the mean 41.9cm 3), peripheral irradiation doses of planning target volume (PTV) ranged from 3.96Gy to 7.00Gy(the mean 5.26Gy)each time, cential irradiation doses of PTV were 6.3Gy～10.88Gy (the mean 7.89Gy) each time, once a day for 5～8 times totally. Results No patient died during therapy. KPS of patients normal condition were 20～90(54?25.90) before treatment and 30～100 (74?23.90) after treatment. Effect of entity tumor were as follows completely relaxed (CR) in two cases, partly relaxed (PR) in four cases, no change (NC) in three cases, progressed (PD) in one case. During follow-up period tasting 2 to 28 months 90% of the tumors were controlled (no progressive disease). 60% fo the tumors decreased in size or disappeared. Conclusions Stereotactic radiotherapy has better therapeutic effects on cases of metastatic hepatic cancer.

Phospholipase A_2 (PLA_2) inhibitor quinacrine was used to explore protective effect on multiple organ dysfunction (MOD) caused by intestinal ischemia-reperfusion (I/R) in rats. Gut I/R caused the increase of gut PLA_2 activity and induced endotoxemia and bacteriemia. Pretreatment with intravenous quinacrine 10mg?kg~(-1) attenuated bacteria and endotoxin translocation,markedly lowered the levels of thromboxane A_2 and prostacyclin I_2 in blood,and provided protection from the development of vital organs dysfunction. As a result,the survival rate in pretreatment group increased by 25%. The results demonstrate that gut I/R promotes gut barrier failure,then contributes to the development of MOD by allowing bacteria or endotoxin reaching the circulation. PLA_2 and PLA_2-dependent lipid mediators play an important role in the development of gut I/R injury and MOD. Intravenous quinacrine has protection against MOD resulting from gut I/R.