Objective:This study aims to evaluate the effect of an elevated preoperative neutrophil to lymphocyte ratio (NLR) on outcome after comprehensive staging laparotomy or optimal tumor debulking surgery for epithelial ovarian cancer (EOC) and determine the value of the NLR as an independent prognostic prediction marker. Methods:A total of 80 women with primary EOC and with complete clinical and pathological information documented at the time of surgery were selected for this study. The optimum cut-off value of the preoperative NLR was identified through receiver operator characteristic (ROC) curve, and the patients were then classified into two groups: low and high NLR group. Univariate and multivariate analyses were performed to assess the prognostic effect of the preoperative NLR patients who underwent comprehensive staging laparotomy or optimal tumor debulking surgery. The levels of expression of CD68 were measured through immunohistochemistry. Results:The optimal cut-off value of the NLR was 3.8. The preoperative NLR differed significantly in the FIGO stage between the low NLR group (NLR ≤3.8) and the high NLR group (NLR>3.8), but no discrimination was observed in other parameters. The mean follow-up time was 45 months, and the post-operative 1-and 3-year survival rates were 93.7%and 60.0%, respectively. The preoperative NLR>3.8 and stageⅢ/Ⅳwere all risk factors for poor overall and disease-free survival. Multivariate analysis revealed the patients with high NLR (P<0.05) and stage Ⅲ/Ⅳ (P<0.05) had prognostic significance for poor overall survival. The number of CD68-positive tumor-associated macrophages was significantly higher in the high NLR group than in the low NLR group (54.65 ± 8.78 and 41.78 ± 9.10, respectively; P<0.001). Conclusion: An elevated blood preoperative NLR indicates poor prognosis in patients with EOC. Preoperative NLR may function as an important independent prognostic factor for patients with EOC.

Objectives To determine the significance of serum total bile acid (TBA) in the diagnosis and treatment of infantile hepatitis syndrome. Methods Serum TBA and other liver function related items were determined with automatic enzymatic assay techniques in 67 with infantile hepatitis syndrome patients (age 26 days～7 months) and 100 normal infants (age 20 days～1 year). Results In the control group, the serum TAB level was 0～11.3 ?mol/L. TBA level was abnormal in 89.5% patients and the values were 0.5～226.0 ?mol/L ?s =(79 5?54.3) ?mol/L]. The difference was significant between the two groups. The TBA levels were well related to those of ALP, DBIL and ? GT and TBA was better than others in sensitivity and specificity. . The difference was significant between the two groups. The TBA levels were well related to those of ALP, DBIL and ? GT and TBA was better than others in sensitivity and specificity. Conclusion Serum TBA level is important in evaluating the diagnosis, treatment, and prognosis of infantile hepatitis syndrome.

Objective To explore the effect of ginseng combined with transplantation of bone marrow mesenchymal stem cells(BMSCs)on functional recovery of rats with spinal cord injury(SCI). Methods Forty-eight female Wistar rats were randomly assigned to following four groups(n=12 per group):the sham operation group was treated by opening the vertebral lamina and exposing spinal cord without SCI;the SCI model group was reproduced by using improved Allen bump method and afterwards no treatment was given;methyl prednisolone(MP)group was treated by MP pulse treatment after SCI,including intravenous injection of MP 30 mg/kg immediately after SCI and 4 hours later the same injection was repeated,and then the same intravenous injection 2 times daily,3 days in total;The ginseng+BMSCs group was treated by orally taking ginseng ultra-microgranules 300 mg/kg after SCI,twice a day for 20 days and BMSCs 5μL(concentration 1×107 cell/μL)transplantation was carried out in SCI region on the 7th day after SCI. In the above 4 groups,the ethological observation(BBB scores)was done regularly and on the 30th day after operation,silver staining was applied to investigate the changes of spinal cord,and neuro-electrophysiological tests including somatosensory evoked potential(SEP)and motor evoked potential(MEP)were performed. Results In sham operation group,after surgery the movement of both hind limbs became temporarily sluggish and on the 7th day their functions recovered to approximately normal. In SCI model group,after injury paralysis of both hind limbs occurred,while in the MP group and ginseng+BMSCs group,different degrees of functional recovery of the injured limbs developed,and the recovery in ginseng + BMSCs group was more significant. Compared with sham operation group,after surgery the BBB score was reduced markedly at various time points in SCI model group;compared to the SCI model group,the BBB scores in MP and ginseng+BMSCs groups were increased significantly,especially more remarkable in ginseng+BMSCs group(all P<0.05),and beginning from the 12th day after operation,the difference became obvious (5.23±1.22 vs. 3.61±1.03, P<0.05). Histological detection showed that in sham operation group,the structure of spinal cord was complete,neurons distributed evenly in the gray matter and a large number of silver staining positive nerve fibers paralleled to each other and arranged regularly;in SCI model group,fragmented construction was present and the defects of gray and white matters were prominent. Compared with the SCI model group, the extents of tissue necrosis in MP and ginseng + BMSCs groups were ameliorated. The neuro-electrophysiological tests demonstrated that in SCI model group,the loss of normal wave form occurred. Compared with SCI model group,in MP and ginseng+BMSCs groups,after treatment latent periods(ms)were shortened prominently in different degrees of SEP and MEP,and their peak-to-peak values(mV)were increased obviously;the improvement in potential in ginseng+BMSCs group was greater than that in MP group〔SEP:latent period(ms):3.31±0.36 vs. 4.66±0.33, peak-to-peak value(mV):0.10±0.01 vs. 0.05±0.01,MEP:latent period(ms):3.40±0.13 vs. 4.24±0.31, peak-to-peak value(mV):41.12±0.56 vs. 16.46±2.83,all P<0.05〕. Conclusion A combined treatment of ginseng and BMSCs transplantation can effectively promote the recovery of neural function for rats with SCI.

Objective To investigate the clinical application value of Quadrant system combined with percutaneous pedicle screw fixation for treatment of lumbar degenerative disease.Methods The clinical data of 40 patients who sufferred from lumbar degenerative disease,were randomly divided into two groups:Quadrant system combined with percutaneous pedicle screw fixation to do discectomy and intervertebral bone graft fusion as invasive group (n =20),traditional posterior lumbar interbody fusion as conventional group (n =20).The operation time,length of incision,blood loss,postoperative drainage,JOA score of preoperation and postoperation,and effect (reforming Macnab standard) between two groups were recorded and compared.Results Operations were all well done in two groups.The operation time in invasive group was longer than that in traditional group [(147.3 ± 8.9) min,(136.7 ± 10.2) min,t =3.5,P ＜ 0.05].The length of incision [(3.65 ± 0.68) cm,(1 1.11 ± 1.29) cm,t =22.88,P ＜ 0.05)],blood loss [(205.00 ± 63.04) mL,(270.50 ± 77.58) mL,t =2.93,P ＜ 0.05],postoperative drainage [(90.3 ± 10.8) mL,(180.6 ± 1 3.9) mL,t =22.96,P ＜ 0.05] and days in hospital [(16.9 ± 2.0) days,(18.9 ± 2.1)days,t =3.05,P ＜ 0.05] in invasive group were all less.than those in traditional group (P ＜ 0.05).All cases had been followed up for 6-18 months,average of 13 months.There were no significant differences in excellent and good rate (reforming Macnab standard) between two groups in the last following up (P ＞ 0.05).There were no significant differences of JOA scores in preoperation [(12.0 ± 1.7) points,(11.0 ± 1.5) points,P ＞ 0.05],postoperative half a year [(22.0 ± 2.3) points,(21.0 ± 2.5) points,P ＞ 0.05],and postoperative one year [(23.0 ± 1.9) points,(22.0 ± 2.0) points,P ＞ 0.05].Conclusion Quadrant system combined withpercutaneous pedicle screw fixation is a safe,effective and minimally invasive surgical technique in treating lumbar degenerative disease.Compared with conventional group,invasive group has advantages such as less injury,less blood loss,simple operation,and good curative effect,which should be popularized.

Objective To evaluate the effect of methylprednisolone on hepatic ischemia-reperfusion (I/R) injury in the patients undergoing hepatolobectomy.Methods Sixty ASA physical status Ⅱ or Ⅲ patients,aged 30-64 yr,weighing 45-75 kg,scheduled for elective hepatolobectomy,were randomized to control group or methylprednisolone group (n =30 each).After induction of anesthesia,methylprednisolone 500 mg (in 100 ml of normal saline) was infused intravenously at 5 ml/min before skin incision in group M.Anesthesia was induced with propofol,fentanyl and cisatracurium.The patients were endotracheally intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mmHg.Anesthesia was maintained with 1％-3％ sevoflurane inhalation,remifentanil infusion,and intermittent iv boluses of fentanyl and cisatracurium.MAP was maintained at 70-100 mmHg and HR at 50-90 bpm.At 10 min before induction of anesthesia,and on postoperative day 1,3 and 5,venous blood samples were collected for determination of the plasma levels of alanine aminotransferase (ALT),aspartate amminotransferase (AST),total bilirubin (TBIL),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results Compared with group C,the plasma levels of ALT,AST and TBIL were significantly decreased on postoperative day l and 3,and the plasma concentrations of TNF-α and IL-6 were decreased on postoperative day 1,3 and 5 in group M.Conclusion Methylprednisolone can reduce hepatic I/R injury in the patients undergoing hepatolobectomy and inhibition of systemic inflammatory responses is involved in the mechanism.

Objective To evaluate the role of nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidase in bupivacaine-induced injury to neurons.Methods SH-SY5Y cells were seeded in 96-well culture plates at a density of 5× 104 cells/well and randomly divided into 3 groups (n=24each) using a random number table:control group (group C),bupivacaine group (group B),and apocynin (NADPH oxidase inhibitor) + bupivacaine group (group A+B).The cells were cultured in a serum-free medium in group C.The cells were cultured in a serum-free medium containing 1 mmol/L bupivacaine in group B.In group A + B,the cells were cultured for 30 min in a serum-free medium containing apocynin 100 μmol/L,and then cultured in a serum-free medium containing 1 mmol/L bupivacaine.At 2,4 and 6 h of incubation,the cells in 6 wells of each group were selected to evaluate the cell viability by MTS assay.At 4 h of incubation,the cells in 6 wells of each group were selected to detect reactive oxygen species (ROS) level by flow cytometry.Results Compared with group C,the cell viability was significantly decreased at 4 and 6 h of incubation,and the production of ROS was increased at 4 h of incubation in group B (P＜ 0.05).Compared with group B,the cell viability was significantly increased at 4 and 6 h of incubation,and the production of ROS was decreased at 4 h of incubation in group B (P＜0.05).Conclusion NADPH oxidase is involved in bupivacaine-induced injury to neurons.

Objective To determine the potential impact of superantigens produced by skin-colonizing Staphyiococcus aureus in patients with atopic dermatitis and eczema. Methods Of 117 patients with atopic dermatitis and 199 with eczema, 140 Staphyiococcus aureus strains were isolated from the skin specimens. Superantigens were detected with reverse passive latex agglutination. Results Among 140 Staphyiococcus aureus strains, 60 (42.9%) produced superantigens, among which 43 produced one kind of superantigens only and 17 produced at least two kinds. Of strains isolated from atopic dermatitis, 51.5% produced superantigens and no significant difference was seen in superantigen production between lesional and non-lesional strains in atopic dermatitis. Of strains isolated from eczema patients, 34.7% (all were lesional strains) produced superantigens. The positive rates of total superantigens, lesional superantigens and toxic shock syndrome toxin-1 production were all higher in the strains from atopic dermatitis than in those from eczema. Conclusions Superantigen production by skin-colonizing Staphyiococcus aureus probably plays a more important role in atopic dermatitis than that in eczema. However, further studies are necessary to validate its importance.

Objective To study the association of human leukocyte antigen classⅡ(HLA-Ⅱ) alleles with genetic susceptibility and resistance to advanced hepatosplenic schistosomiasis japonica. Methods The allelic types of HLA-DRB1, DPA1, DQA1 and DQB1 were detected by polymerase chain reaction with sequence-specific primers (PCR-SSP) technique in 46 patients with advanced hepatosplenic schistosomiasis, characterized with extensive liver fibrosis. Another 43 subjects with chronic schistosomiasis were used as control. The statistical significance of differences in allelic frequencies was determined by ? 2 test. Results The frequencies of HLA-DRB1*04, DPA1*0103, DQA1*0601, DQB1*0201 in advanced patients were markedly higher than those in control group, while the frequencies of HLA-DQA1*0501 and DQB1*0601 in control group were higher than those in advanced patients. Conclusion The study indicated that HLA-DRB1*04, DPA1*0103, DQA1*0601 and DQB1*0201 showing a positive, statistically significant (P

Objective To determine the median effective doae (ED50) for motor block after intrathecal ropivacaine and bupivacaine. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 18-64, weighing 46-75 kg, undergoing elective urological surgery under combined spinal-epidural anesthesia, were randomized into 2 groups ( n = 30each) receiving intrathecal 0.5% ropivacaine and 0.5% bupivacaine respectively. The ED50 was determined by up-down sequential allocation. The initial dose was 4 mg. Each time the dose increased/decreased by 1 mg. Efficacy was determined by the occurrence of any motor block in either lower extremity (modified Bromage scale > 0)within 5 or 10 min after the spinal injection. Results The intrathecal ED50 for motor block was 6.68 mg for ropivacaine (95% confidence interval 6.27-7.13 mg) and 4.07 mg for bupivacaine (95% confidence interval 3.56-4.47mg) . The relative motor blocking potency ratio was ropivacaine/bupivacaine 0.61. Conclusion The potency of intrathecal ropivacaine is lower than that of bupivacaine for motor block.

Objective To investigate the effect of mild hypothermia on the expression of hypoxia-inducible factor-1α (HIF-1α) and glucose transporter-1 (GLUT-1) in a rat model of chronic cerebral ischemia-reperfusion.Methods Thirty-six female SD rats weighing 170-210 g were randomly divided into 3 groups (n = 12 each):sham operation group (group S), normal body temperature group (group NT ) and mild hypothermia group (group MH). Arterio-venous fistula was established by end-to-end anastomosis between the right common carotid artery and right external jugular vein for 6 weeks followed by reperfusion. In group MH, mild hypothermia was induced at the initiation of reperfusion and the rectal temperature was reduced to 31.5-32.5 ℃. In group S and NT, the rectal temperature was maintained at 37-38 ℃. Six rats in each group were sacrificed at 3 and 48 h of reperfusion. The brains were immediately removed for determination of the expression of HIF-1α, GLUT-1, HIF-1α mRNA and GLUT-1 mRNA and microscopic examination. Results Compared with group S, the expression of HIF-1α and HIF-1α mRNA at 3 and 48 h of reperfusion and GLUT-1 mRNA at 3 h of reperfusion was up-regulated, while the expression of GLUT-1 and GLUT-1 mRNA at 48 h of reperfusion was down-regulated in group NT (P ＜ 0.05).Compared with group NT, the expression of HIF-1α and HIF-1α mRNA at 48 h of reperfusion and HIF-1α mRNA and GLUT-1 mRNA at 3 h of reperfusion was down-regulated, while the expression of GLUT-1 and GLUT-1 mRNA at 48 h of reperfusion was up-regulated in group MH (P ＜ 0.05).Microscopic examination showed that the injury to the ultrastructure of blood-brain barrier was significantly attenuated in group MH compared with group NT. Conclusion Mild hypothermia can attenuate chronic ischemia-reperfusion injury by down-regulating the expression of HIF-1α and up-regulating the expression of GLUT-1.