Objective To investigate the effects of remifentanil-indueed controlled hypoteusion (CH) on the cerebral oxygen metabolism in patients undergoing radical operation for gastric cancer. MethodsForty-two ASA Ⅰ or Ⅱ patients (26 male, 16 female) aged 30-64 yr with body nuts index < 30 kg/m2 undergoing elective radical operation for gastric cancer were randomly divided into 3 groups (n = 14 each): group R remifentanil-induced controlled hypotension; group N sodium nitroprusside-induced CH and group C normal BP. Radial artery was cannulated for continuous BP monitoring and blood sampling. A catheter was inserted into right internal jugular vein and advanced cephalad until jugular bulb for blood sampling. MAP, HR, ECG and SpO2were continuously monitored. Anesthesia was induced with midazolam 0.1 mg/kg, fentanyl 5 μg/kg, propofol 2 mg/kg and vecuronium 0.08 mg/kg and maintained with isoflurane (end-tidal concentration 1. 1% ), iv infusion of propofol (50-100 μg·kg-1·min-1 ) and remifentanil (0.1 μg·kg-1·min-1) and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 12 bpm, I: E 1:1.5) after tracheal intubation. End-tidal CO2was maintained at 30-35 mm Hg. CH was started after abdomen was opened. In group R the remifentanil infusion rate was increased from 0.1 μg·kg-1·min-1 in 0.05 μg·kg-1·min-1 increment every minute until the1 μg·kg-1min-1 in 0.5 μg·kg-1·min-1 increment every minute until the desired BP was achieved. MAP was reduced to 70% of the baseline value but never below 50 mm Hg. CH induction time and BP recovery time were recorded. Arterial and jugular bulb venous blood samples were obtained before induction of anesthesia (T0), immediately before induction of CH (T1), at 10 and 30 min of CH (T2,3) and 20 min after termination of CH (T4). The arterial and jugular bulb venous O2content difference (Da-jvO2) and cerebral O2extraction rate ( CERO2) were calculated. The difference between arterial and jugular bulb venous blood lactic acid concentration (Da-jvL) was also calculated. Results The CH induction time and BP recovery time were significantly longer in group R than in group N, but BP was stabler during CH in group R than in group N. Compared with group C, Da-jvO2, CERO2and Da-jvL were significantly decreased in group R, while CERO2and Da-jvL were significantly increased in group N. Conclusion Remifentanil can effectively induce CH and reduce cerebral O2consumption in patients undergoing radical operation for gastric cancer.

0bjective To analyze the factors related tO the changes of liver pathology in hepatitis B e antigen (HBeAg) negative chronic hepatitis B (CHB) patients.Methods Two hundred and eighty-eight HBeAg negative CHB patients were enrolled.Bivariate Pearson correlation was employed to analyze the correlation of different age,gender,alanine aminotransferase (ALT) level,the immunohistochemistry results of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) in liver tissue with hepatitis B virus (HBV) DNA level,changes of liver pathology.Results The inflammation grades and fibrosis stages of livertissuesinmale were 1.72±1.23 and 1.71±1.24,respectively;1.25±1.39 and 1.21±1.40 in female,respectively,which were significantly different (t=2.398,t-2.551;both P40 years old were all significantly higher than those<40 years old(t一2.060,t一2.536,t=2.808;all P<0.05).In patients with normal ALT levels,75 cases (52.03%) showed HBV DNA level≤1×103 copy/mL,56(38.89%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was significantly correlated(r:O.244,P-O.004).In patients with elevated ALT 1evels,42 cases (31.57%) showed HBV DNA level≤1×10s copy/mL,89 (66.92%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was not significantly correlated (r=0.007,P=0.939) .The inflammation/fibrosis of liver tissues,HBV DNA levels in patients with both HBsAg and HBcAg positive in liver tissues were significantly higher than those in other patients (P

Objective To study effects of low molecular weight heparin on liver fibrosis and the serum levels of TGF-?_1 in patients with chronic hepatitis B virus.Methods 45 patients with chronic hepatitis B virus were randomized into control group(the routine strategy)and trial group(the routine strategy + low molecular weight heparin).The period of treatment is 3 weeks.Serum hepatic fibrosis indices before and after heparin treatment were examined by RIA,the levels of serum TGF-?_1 before and after heparin treatment were examined by ELISA.Results Hepatic functions became significantly better in trial groups,serum PⅢP and type IV collage levels and the levels of serum TGF-?_1 in trial group decreased significantly after treatment.Conclusions The mechanism of anti-fibrosis action of LMWH may inhibited production of TGF-?_1 in patients with HBV.

Objective To compare the size of ablation lesions created by normal saline enhanced radiofrequency ablation (NS-RFA) and dilute hydrochloric acid enhanced radiofrequency ablation (HCl-RFA), explore their affecting factors, and observe the morphological manifestations of the ablated lesions.Methods NS-RFA and HCl-RFA were performed on 30 excised porcine livers with 9 different combinations of durations (5, 10, 15, and 20 minutes), temperatures (83, 93, 103, and 113 ℃ ) and powers (20, 30,and 40W). For each ablated lesion, the longitudinal and transverse diameters were measured, and volumes calculated. Multifactor analysis of variance was used to analyze the affecting factors of the size of ablated lesions. Macroscopic and microscopic morphological characteristics of lesions were observed. Results ( 1 )NS-RFA lesion volumes under 9 combinations were ( 3.53 ± 0. 34 ), (6. 41 ± 0. 42 ), ( 10. 69 ± 0. 37 ),(11.40±0.51), (3.20±0.23), (6.59 ±0.50), (12.11 ±0.70), (11.12 ±0.52), (11.81 ±0. 64) cm3, respectively. HCl-RFA lesion volumes under 9 combinations were ( 11.97 ± 1. 00), (28.72 ±0.99), (59.45 ±1.33), (105.65 ±2.40), (13.64±0.60), (29.70±0.58), (59.22±1.32),( 57. 22 ± 3.99 ), ( 59. 74 ± 2. 18 )cm3, respectively. The size differences of ablation zones caused by different types of ablation ( F = 948.9 ) ( main factor), durations ( F = 269. 3 ) and temperatures ( F =214. 6) (covariates) were statistically significant (P ＜ 0. 01 ), whereas which caused by power ( F = 0. 2 )(covariate) was not statistically significant (P ＞ 0. 05 ). (2)At gross examination, all ablation lesions were elliptical in cross section and there were three zones in NS-RFA induced lesions and five zones in HCl-RFA induced lesions. At microscopic examination of NS-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , a few of deformed and ruptured liver cells in zone Ⅱ. The shape of the most of the liver cells in zone Ⅲ was normal. At microscopic examination of HCl-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , classical coagulation necrosis in zone Ⅱ and Ⅲ, widened hepatic sinusoids lossened junction of hepatocytes and some hepatocytes detached into sinusoids in zones Ⅳ. The liver cells in zone V were normalexcept a small amount of hepatoeytes with pyknosis, karyorrhexis and karyolysis. Condusion Compared with NS-RFA, HCl-RFA can produce lager ablation zones. The duration and temperature were the factors that affected the size of ablation zone. HCl-RFA lesions typically showed coagulation necrosis at microscopical examination.

Objective To construct a stably-performing and high-efficiency regeneration system of Gynostemma pentaphyllum and lay a foundation for the gene transformation of it.Methods The blades of five-leaf G.pentaphyllum were used as the explants and cultured in MS media with different portions of hormone to induce fascicled-bud,root and plantlet regeneration.Results The medium suitable for inducing the blade differentiation of G.pentaphyllum was MS+6-BA 1.0 mg/L and for the frequency of blade differentiation could reach 40%.The cultural medium MS+6-BA 1.0 mg/L was suitable for the sub-multiplication of fascicled-bud and the medium 1/2 MS for root inducement and the plantlet regeneration.Conclusion A stably-performing acceptor system of the direct differentiation for Agrobacterium tumefaciens mediated gene transformation of G.pentaphyllum blades is constructed.