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.

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.

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

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.

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.

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.

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.

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 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.