Objectives　To study of the method for isolation and transplantation of mouse islets. Methods　The method for isolation of mouse islets described by Gotoh G was modified. The solution of digestion was injected not through the common bile duct but through gallbladder. Soybean trypsin inhibitor and BSA were added into the digestive and Ficoll separation solutions. Results　The yield of islets was increased from 41.7±13.2 to 266.5±32.1(P<0.01). Islet viability was more than 95!%. Among the purified islets, there was no exocrine tissue but few ductal fragments. Conclusions　By the improved method, digestive solution could be injected into pancreas without inverted microscope, which made manipulation easier and more successful. Having avoided the digestive effect of trypsin on islets, the yield of islets was increased and good repetitiousness was obtained.

Objective To investigate the analgesic effects of intrathecal dexamethasone injection on pain induced by chronic compression of dorsal root ganglion in mouse.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion ( CCD), 40 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 5 groups:Sham-operation group ( Sham group, n = 8 ), Control group ( CCD group, n = 8), Dexamethasone group ( D group, n = 8), Akt inhibitor V group (A group, n = 8 ) and Dexamethasone plus Akt inhibitor Ⅳ group (DA group, n = 8 ).Rats in D group, A group or DA group were intrathecally treated with dexamethasone (100μg/kg) ,Akt inhibitor Ⅳ (0.6μg/10μl) or dexamethasone ( 100 μg/kg) plus Akt inhibitor Ⅳ (0.6 μg/10 μl) on Day 3,13 after CCD respectively, while rats in C and Sham group received Vehicle (10% DMSO).Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on 3 d before and 3 d,4 d,7 d,10 d,13 d,14 d and 15 d after operation.Results Compared with Sham group,both PWMT (P＜0.01) and PWTL (P＜0.01) were significantly decreased after CCD surgery on the ipsilateral side.After dexamethasone and Akt inhibitor were respectively intrathecally injected at 3 postoperative day,PWMT (7.33 ± 1.03 ) g, (5.67 ± 1.03 ) g, (2.67 ± 1.03 ) g (P ＜0.01 ) ,PWTL( 16.47 ±0.46)s, ( 14.48 ±0.84) s, ( 10.82 ±2.21 ) s(P＜0.01 ) ,then decreased gradually,and intrathecally injected again at 13 postoperative day, PWMT ( 7.33 ± 1.03 ) g, ( 5.67 ± 1.03 ) g, (2.33 ± 0.81 ) g (P ＜0.01 ), PWTL( 16.44 ±0.90) s, ( 14.01 ±0.82)s, ( 10.22 ± 1.28)s (P＜0.01).Coadministration dexamethasone and Akt inhibitor exhibit significant synergies, postoperative 4 d PWMT( 10.83 ± 2.04)g, (2.67 ± 1.03 )g (P ＜0.01),PWTL(19.11 ±2.01)s,(10.82 ±2.21)s (P＜0.01);14 d PWMT (7 ±0.82)g,(2.33 ±0.81)g (P ＜ 0.01 ), PWTL( 17.16 ± 1.14)s, ( 10.22 ± 1.28 ) s (P ＜ 0.01 ).Conclusion Intrathecal high-dose dexamethas one or PKB / Akt inhibitors can effectively improve pain behavior response induced by chronic compression of dorsal root ganglia,combination of these two drugs could generate significant synergies, and the effection is more obvious, more durable.

Objective To evaluate the effect of dexmedetomidine on quality of wake-up test in the patients undergoing posterior osteotomy correction surgery.Methods Ninety-seven patients of both sexes,aged 17-59 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 18.5-25.0 kg/m2 and global kyphosis angle＞60°,scheduled for elective posterior osteotomy correction surgery under general anesthesia,were randomly divided into 2 groups using a random number table:control group C (n=46) and group D (n =51).In group D,dexmedetomidine 1.0 μg/kg was infused over 15 min before induction of anesthesia,and group C received the equal volume of normal saline instead.Anesthesia was induced with iv midazolam,propofol,fentanyl,vecuronium and dexamethasone in C and D groups.Mechanical ventilation was performed after tracheal intubation.Anesthesia was maintained with infusion of cisstracurium,propofol and remifentanil.Dexmedetomidine 0.3 μg · kg-1 · h-1 was infused throughout the surgery in group D,and meanwhile normal saline was given throughout the surgery in group C.The anesthetic drugs for maintenance except dexmedetomidine were discontinued at the beginning of the wake-up test.The wake-up time was recorded and the wake-up quality was assessed.Ramsay sedation scores and Riker sedation-agitation scale scores were also recorded when all the patients were successfully awakened.The development of cardiovascular events during wake-up test and intraoperative awareness was recorded.Results The wake-up quality was significantly higher,Riker sedation-agitation scale scores were lower,Ramsay sedation scores were higher,the incidence of nausea and vomiting was lower,and no significant change was found in wake-up time in group D.No intraoperative awareness was observed in the two groups.Conclusion Dexmedetomidine can raise wake-up quality without prolonging wake-up time and with stable hemodynamics and fewer side effects in the patients undergoing posterior osteotomy correction surgery.

Objective To investigate the clinical efficacy of target fire red-hot needling in treating articular deformity due to rheumatoid arthritis.Methods Ninety-six rheumatoid arthritis patients with articular swelling and deformity were randomly allocated to treatment and control groups, 48 cases each. The treatment group received target scattered fire red-hot needling and the control group, conventional acupuncture. After two courses of treatment, pre-/post-treatment changes in the self-reported pain score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immunoglobulins (IgA, IgG and IgM) were observed in the two groups and the clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 89.6% in the treatment group and 50.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment groups (P<0.05). There were statistically significant pre-/post-treatment differences in ESR, CRP, and IgG in the treatment groups (P<0.05). There were statistically significant post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment and control groups (P<0.05).Conclusion Target fire red-hot needling is an effective way to treat articular deformity due to rheumatoid arthritis.

Objective To discuss the relationship between BMP-2 protein and possible mechanism and to compare the postive rate of two different imaging examinations in evaluating the epiphyseal plate involved by osteosarcoma.Methods Radiographic and MRI features of epiphyseal plate extension by osteosarcoma confirmed by pathology in 36 cases were analysed retrospectively.The expression of BMP-2 was detected with immunohistochemical SABC method in different part of specimen.Results The diagnostic accurate rate in evaluating the epiphyaeal plate extension from osteosarcoma by X-ray and MRI was 44.44% and 100% respectively.The positive reactive rate of BMP-2 in tumor body,epiphyseal plate soak district,normal epiphyseal plate and normal tissue nearby the tumor was 88.89%(32/36),99.44%(34/36),10.00%(1/10) and 20.00%(2/10) respectively.Conclusion MRI is more sensitive to radiography in evaluating the epiphyseal plate involved by osteosarcoma,the higher positive reactive rate of BMP-2 protein is correlated to the epiphyseal plate extension of osteosarcoma.

Objective To evaluate the effects of total intravenous anesthesia without muscle relaxants on motor evoked potential (MEP) monitoring during scoliosis surgery.Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-25 yr,scheduled for posterior spinal fusion surgery,were randomly divided into 2 groups with 25 patients in each group: muscle relaxants combined with total intravenous anesthesia group (group Ⅰ) and total intravenous anesthesia without muscle relaxant group (group Ⅱ).In both groups,a loading dose of dexmedetomidine 1 μg/kg was infused over 20 min,followed by infusion at 0.2 μg· kg-1 · h-1.After the loading dose of dexmedetomidine was given,anesthesia was induced,the patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil 0.2μg· kg-1 · min-1 and propofol 80-120 μg· kg-1 · min-1.The bispectral index value was maintained at 40-60.Train of four stimulation of ulnar nerve was used to monitor the neuro-muscu-lar block.Cisatracurium was infused at 0.5-1.5 μg·kg-1 ·min-1,T1 was maintained at 45％-55％,and the infusion was stopped 30 min before the isolation of paraspinal muscles was completed in group Ⅱ.MEP were monitored and recorded during the period when the administration of the muscle relaxation was stopped,and the degree of muscle relaxation was assessed by the surgeon.The successful wake-up test was recorded.Results The incidence of successful MEP monitoring was significantly higher in group Ⅱ than in group Ⅰ (P ＜ 0.05).There was no significant difference in the degree of muscle relaxation between the two groups (P ＞ 0.05).All the patients were successfully woken up.Conclusion Total intravenous anesthesia without muscle relaxants can provide satisfactory muscle relaxation for scoliosis surgery and increase the probability of successful MEP monitoring simultaneously.

Objective To evaluate the effects of lateral position on fiberoptic bronchoscope (FOB)-guided orotracheal intubation under general anesthesia in the patients with ankylosing spondylitis.Methods Forty-five patients with ankylosing spondylitis, aged 19-63 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were divided into 2 groups using the random number table: group supine position (group S, n=22) and group lateral position (group L, n=23).After induction of general anesthesia, orotracheal intubation was performed under the guidance of FOB.Intubation time, catheterization time, intubation condition and intubation-related complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) were also recorded before anesthesia induction, immediately before intubation, immediately after onset of intubation, and at 2 and 4 min after intubation.Results The success rates of intubation were both 100％ in the two groups.Compared with group S, the intubation time and catheterization time were significantly shortened, the success rates of intubation and catheterization at first attempt were increased, MAP and HR were decreased immediately after onset of intubation, and no significant change was found in intubation-related complications in group L.Conclusion Lateral position can raise the success rate of FOB-guided orotracheal intubation under general anesthesia with shorter operation time, it is helpful in stabilizing hemodynamics during intubation, and intubation-related complications are fewer in the patients with ankylosing spondylitis.

Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.

Diaphragm is the principal respiratory muscle.Diaphragm dysfunction resulting from mechanical ventilation,chronic cardiopulmonary disease,medicine,cardio-thoracic surgery,septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay.Traditionally,the method of assessment of diaphragm structure and function was invasive,lacking specific,and was difficult to be used bedside.A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate,safe and noninvasive method of quantification of diaphragm structure and function.This article reviews the related researches of technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic structure and function,which may possibly result in timely identification of patients with diaphragm dysfunction and improve the assessment of recovery from diaphragm weakness.

Objective To study the methods and effects of endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Methods The study included 15 patients with unilateral thyroid benign nodules.A transversal subclavicular incision 2~3 cm in length was made.Endoscope-assisted partial thyroidectomy was performed through the subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Results The operation was accomplished successfully in all the 15 patients.The operation time was 40~80 min(mean,50 min) and the intraoperative blood loss was 10~50 ml(mean,20 ml).No surgical complications occurred.The patients were discharged from hospital on 3~4 postoperative days.Follow-up observations in the 15 patients for 1~12 months(mean,7 months) revealed no recurrence.Conclusions Endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle has the advantages of minimal invasion,little blood loss, low complication rate,quick recovery,and good cosmetic results.