Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

Objective To investigate effect of dexmedetomidine sedation anesthesia on perioperative hemo-dynamics and heart rate variability in patients with hypertension .Methods 50 cases with selective laparoscopic chol-ecystectomy were randomly divided into Group A ( dexmedetomidine sedation ) and Group B ( saline control ) ,25 cases each group .Low-frequency ( LFnu ) , high-frequency ( HFnu ) , LF/HF, LFnu ( LF/TP ×100%) , HFnu ( HF/TP × 100%)and total-power(TP)were recorded at the time points of baseline (T0),immediately after administration(T1), immediately after anesthesia induction (T2),1 min after anesthesia induction (T3),5 min after anesthesia induction (T4)and 10 min after anesthesia induction (T5).NIBP and HR were recorded at the points of T0 ~T5.Results Compared with T0 or Group A,there was an increase in SBP and HR at T2~T4(P<0.05)in Group B.Heart rate variability changes showed that Lfnu [(66.3 ±7.8),(64.5 ±6.0),(65.3 ±6.5)],LF/HF[(1.9 ±0.7),(1.7 ± 0.5),(1.7 ±0.8)],TP[(2 283 ±472),(2 197 ±310),(2 108 ±256)]decreased significantly at T2-T4(tLFnu=5.16,4.15,4.40,tLF/HF=4.55,4.24,3.49,tTP=3.27,1.71,0.96,P<0.05) in Group A,while there was no significant change in Group A .Conclusion Dexmedetomidine sedation may have less influence on hemodynamics and automomic nerve ,which be an useful analgesic adjuvanct for the patients undergoing selective laparoscopic chole -cystectom.

BACKGROUND: The curative effect is satisfactory for adult patients with spasticity of lower limbs treated with selective posterior rhizotomy and peripheral nerve micro diminution. But how to improve the strength of relevant muscle is the key factor to accelerate recovery of motor function during rehabilitation training.OBJECTIVE: To observe the effect of muscle stimulating instrument on the recovery of muscle strength and the improvement of motor function of adults with spasticity of lower limbs during rehabilitation training.DESIGN: Case analysis.SETTING: Department of Neurosurgery, China-Japan Friendship Hospital of Beijing Ministry of Public Health.PARTICIPANTS: Totally 49 adults with spasticity of lower limbs were selected from Department of Neurosurgery, China-Japan Friendship Hospital of Beijing Ministry of Public Health from January 2000 to May 2002.There were 37 males and 12 females aged from 19-48 years. Totally 21patients treated with muscle stimulating instrument were determined as treatment group and other 28 patients were determined as control group during rehabilitation training.METHODS: One day after operation, conventional rehabilitation training was performed on patients in the treatment group and the control group.Patients in the treatment group were also treated with muscle stimulating instrument three times a day with each for 30 minutes for totally 7 days as a course. There was a three-day interval between treating courses and the rehabilitative time lasted for 6 months. Before rehabilitation training, indexes of patients in the two groups, such as ankle extension, knee flexion and muscle strength of thigh adductor, were recorded and the improvement of muscle strength after 3 and 6 months was followed up.MAIN OUTCOME MEASURES: Average strength of relevant muscle before and after 3-month and 6-month rehabilitation training.RESULTS:Totally 49 patients entered the final analysis.①After 3-month and 6-month treatment, indexes of ankle extension, knee flexion and muscle strength of thigh adductor were increased at various degrees.②During 3-month and 6-month treatment,indexes of ankle extension,knee flexion and muscle strength of thigh adductor in the treatment group were obviously higher than those in the control group [3-month treatment:(4.2±0.8), (3.7±0.7) degrees; (4.3±0.7), (3.8±0.7) degrees; (4.0±0.7), (3.5±0.5)degrees; 6-month treatment: (4.5±0.6), (3.9±0.7) degrees; (4.6±0.7), (4.0±0.5)degrees; (4.4±0.7), (4.0±0.6) degrees, (P ＜ 0.05 or P ＜ 0.01)].CONCLUSION: The combination of rehabilitation training and muscle stimulating instrument can accelerate the recovery of muscle strength and motor function in adults with spasticity of lower limbs after microsurgical treatment.

Objective To investigate the expression of fragile histidine triad (FHIT) gene in cervical carci-noma and relationship with its clinical-pathological implication. Methods The expression of FHIT was detected by immunohistochemistry SP method in 42 cases of cervical carcinoma and 13 cases of adjacent tissue. Results 47.6% (20 of 42) of cases expressed FttIT in the tumor cells,and 92.3% (12 of 13) of cases of the adjacent tissue were present. There was a significant positive correlation between cervical carcinoma and adjacent tissue(P <0.01). The positive rates of FHIT in high and middle desrees of differentiation were significantly higher than that in low degree of differentiation(54.2% vs 38.9%). Tumors with lymph node metastases(45.9%) had loss FHIT protein expression than those without metastasis(60.0%) (P <0.05). The FHIT expression between Ⅰ and Ⅱ stage,the difference was significant(55.0% vs 45.5%) (P < 0.05). Conclusion FHIT gene plays an improtant role in the occurrence and development of cervical carcinoma. It is suggested that FHIT can be a useful marker for predicting invasion and metas-tasis ability of cervical carcinoma.

Objective To investigate the risk factors related with postoperative complications following radical gnstrectomy for gastric cancer in cirrhotic patients. Methods In this study, 1474 cases underwent radical gastrectomy for gastric carcinoma in the past six years and the postoperative complications were retrospectively reviewed. The risk factors related with postoperative complications of cirrhotic patients were analyzed by Logistic regressive analysis. Results The postoperative morbidity rates of the 2 groups with or without liver cirrhosis were 51.22% and 23.94% (X2 = 15.955, P<0.01), and the mortality rate was 7.32% and 0.91% (P = 0.009), respectively. The main complications of the group with liver cirrhosis were postoperative aseites (5 cases), hepatic failure (4 cases), wound infection or dehiscence (4 cases), intra-abdominal infection (4 cases), etc, and three patients in the group died from extensive bleeding, jejunal fistula and hepatic failure respectively. Univariate Logistic analysis revealed that age (OR = 1.277, 95% CI:0.991 ～ 1.646), preoperative nscites (OR = 20.900,95% CI: 2.349 - 185.933), the albumin level (OR =0.160,95% CI:0.041 ～ 0.629), Child classification (OR = 9.500,95% CI: 1.046 ～ 86.261), portal hypertension (OR = 4.000,95% CI: 1.057 ～ 15.138), esophageal variees (OR = 4.400,95% CI: 1.095 ～ 17.676), transfusion (OR =3.714,95% CI: 1.021 ～ 13.511) and blood loss (OR = 1.442, 95% CI:1.023 ～ 2.034) were the main factors associated with postoperative complications of the group with liver cirrhosis. Muhivariable Logistic analysis showed that preoperative ascites (OR = 19.213,95% CI: 1.569 ～ 231.255), Child classification (OR = 12.661,95% CI: 0.721 ～ 222.458), esophageal varices (OR =6.008,95% CI:0.857 ～42.097) and blood loss (OR = 1.574,95% (7,1:0.938 ～ 2.640) were the independent risk factors. Conclusion Gastrectomy for gastric carcinoma in cirrhotic patients engenders considerably high postoperative mortality and morbidity. Preoperative ascites, Child classifation, esophageal variees and intraoperative blood loss were factors closely related with postoperative complications.

[Objective]To observe the guidance effect of software Minics for the operation on sacroiliac fracture.[Method]30 models of articulatio sacroiliaca were detected by X-ray and helical CT to three-reconstruction and divided into three groups randomly,each group had 10 models.The fractures of group A were fixed by K-wires screws according to direction of software Minics on data of helical CT.The fracrures of group B were fixed by K-wires screws guided by video X-ray equipment.And thoes group C were fixed by K-wires screws according to the direction X-ray and helical CT.the fixation effects were estimated by biomechanical and anatomy index.[Result]There were significant differences between groups A,B and group C on the mechanical intensity and anatomy location(P0.05).[Conclusion]Software Minics can be used for the instruction of operation on sacroiliac fracture.

Objective To investigate the mechanism of Chinese herb in preventing recurrence of ulcerative colitis. Methods One hundred and three UC patients were divided into treatment group and control group randomly. The treatment group was treated by Chinese herb and the control group was treated by Sulfasalazine. After treated for three months, fifty three full remission patients were followed-up. CD4+, CD8+ and CD3+ cell count were performed and influence of Chinese herb on recurrence was observed. Results Either the cell count of CD3+, CD4+ and CD8+ or the percentage of CD8+ in the peripheral blood was significantly higher in recurrence group than those in the control (P

Objective To evaluate the effect of fast track surgery on immunologic functions and clinical outcome in patients with gastric cancer during perioperative period. Methods Thirty-six gastric cancer patients receving radical operation were randomly divided into two groups: fast track group (18, fast track surgery) and conventional management group (18, non-fast track surgery). Serum levels of IgA、IgM、 IgG and C reaction protein (CRP) in 36 patients were assayed preoperatively and postoperatively on 1st, 3rd, 7th day. The postoperative hospital stay, duration of fever, inhospital expense, postoperative time of flatus and postoperative complications were recorded respectively. Results On the postoperative 3rd day, serum levels of IgA [(1.57 ± 0. 40) g/L vs. (1.27±0.49) g/L, P <0. 05],IgG[(9.99 ± 2. 12) g/L vs.(8.53±2. 15)g/L, P<0.05]and IgM [(0.92 ± 0.18) g/Lvs. (0.78 ± 0.20) g/L, P<0.05]in patients of fast track group were significantly higher than those in patients in non-fast track group. On the postoperative 1 st, 3rd , 7th day, serum levels of CRP [d1 (56 ± 10) g/L vs. (79 ± 9) g/L,P < 0. 05];d3[(140±15) g/L vs. (170±15) g/L, P<0.05)];d7 [(52±11) g/L vs. (78±12) g/L,P<0.05]in patients of fast track group were significantly lower than those in patients in non-fast track group. The duration of fever [(2. 4 ± 0.9) d vs. (3.8 ± 0. 8) d, P < 0.05], passage of gas by anus [(3. 1 ± 0. 8) d vs. (4.4±0.7) d,P<0.05], time of hospitai stay [(6.3 ± 1.2) d vs. (8.2 ± 0.9) d,P<0.05]and treatment expense in patients of fast track group[(25 260 ± 2910) $ vs. (30 651 ± 3578) $ ,P <0. 05]were also significantly lower than those in non-fast track group (P < 0. 05). Patients in fast track group had no more complications than those in non-fast track group (P > 0. 05). While discharged from hospital, the quality of life score [(14. 8 ± 1.9) vs. (16. 1 ± 1.6), P < 0. 05]in patients of fast track group was significantly higher than that in patients in non-fast track group (P < 0. 05). Conclusions Fast track surgery mitigates the immunologic impairment of gastric cancer patients during perioperative period, and accelerates postoperative rehabilitation.

Objective To evaluate the effect of clinic-pathological variables on prognosis and recurrence of the aged women suffered from borderline epithelial ovarian tumors. Methods The clinical and follow-up data of 102 cases were analyzed retrospectively. Univariate and multivariate logistic regression analysis were used to assess independent prognosis and recurrence factors.Results The postoperative accessory treatment, peritoneal implantation and lymph nodes metastasis could influence the 5-year survival rate(χ2=19.311, 11.054, 18. 559, all P＜0.01). The surgery procedure, peritoneal implantation, lymph nodes metastasis and microinvasion could influence the recurrence rate(χ2=23.606, 23.583, 25.774, 23.583, all P＜0.01). The logistic regression model showed that the postoperative accessory treatment and peritoneal implantation were the two independent prognosis factors (OR=0.060, 35.319, all P＜0.01). The surgery procedure,peritoneal implantation and microinvasion were the three independent factors affecting recurrence(OR =0.001, P＜0.05;OR=60.952, P＜0.05;OR=88.874, P＜0.01). Conclusions The early standard treatment on borderline epithelial ovarian tumors of the aged women have an excellent prognosis, the risk of recurrence remains in some patients. We emphasize that these patients with highrisk factors should be main surveillance population.

Objective To investigate the value in MR spectrum of diagnosis and grading of gliomas.Methods 36 cases of patient with gliomas who confirmed by histopathologic findings or clinical follow-up were collected. Using a GE Signa EXCITE HD 3.0T super conduct MR unit, all the cases of patients were performed conventional MR scan and multi-voxel with 2-D multi-voxel PRESS 144 ms. Functool software was used for post-processing of spectrum. The ratios of NAA/Cr, NAA/Cho, Cho/Cr were measured in the solid part of masses, circum of tumors and contralateral parenchyma respectively. The result was processed by the statistical method. Results The statistical analysis was exacted by SAS 8.2 software. In the solid part of masses, there were significant differences between low-grade gliomas and high-grade gliomas in the ratios of Cho/Cr, Cho/NAA、NAA/Cr and MI (P ＜0.05), but in peritumoral edema, there were significant differences in the ratios of Cho/Cr, NAA/Cr (P ＜0.05), and no significant differences in the ratios of MI (P ＜0.05).Conclusion 1H-MRS is very important and useful in the evaluation of gliomas. It has made it possible to exactly evaluate the grade of gliomas combined with other imagings.