Objective To investigate the effects of small tidal volume combined with PEEP on extravascular lung water during one-lung ventilation (OLV) in patients undergoing thoracic surgery. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 45-80 yr undergoing esophagectomy for esophageal cancer were randomly assigned into 2 groups (n = 20 each):group Ⅰ IPPV (VT 9 ml/kg ,RR 12 bpm) and group Ⅱ IPPV +PEEP (VT 6 ml/kg, RR 15 bpm, PEEP 5 cm H-2O). FiO2 was 100% and I:E 1:2 in both groups. Anesthesia was induced with fentanyl 3-5 μg/kg, propofol 1.0-1.5 mg/kg and vecuronium 0.10-0.15 mg/kg and maintained with continuous infusion of propofol 4-7 mg· kg- 1 · h - 1 and vecuronium 0.07-0.08 mg- kg- 1 · h - 1 and intermittent iv boluses of fentanyl. Double lumen endobronchial tube was inserted. Correct position was confirmed by bronchoscopy. Right internal jugular vein was cannulated. A 4F thermodilution catheter was inserted into right femoral artery and connected to PICCO monitor. Extravascular lung water (EVLW), EVLW index (EVLWI),pulmonary vascular permeability index (PVPI), cardiac output (CO) and oxygenation index (OI) were recorded before anesthesia (T0, baseline), at 30 min of two lung ventilation (T1), 30 min and 1 h of OLV (T2, T3),before extubation (T4) and 18 h after operation (T5). Airway peak pressure (Ppeak) was recorded at T1-4. Results EVLWI and PVPI were significantly higher in group IPPV + PEEP than in group IPPV. There was no significant difference in Ppeak, CO and OI at any time point between the 2 groups. In group IPPV there was no significant change in EVLW and EVLWI during and after mechanical ventilation, while PVPI was significantly increased at T1 as compared with the baseline before anesthesia. In group IPPV + PEEP EVLW was significantly increased at T2 and PVPI was significantly increased at T1 and T2 compared with the baseline at T0. Conclusion OLV with IPPV + PEEP results in more EVLW and it exerts no significant effect on lung function.

Objective To investigate the degree of retinal development in preterm infants. Methods Flash electroretinography (ERG) was performed on 25 healthy preterm infants and 25 full-term ones, and the response of rod cells and cone cells and maximal mixed responses were recorded. The delitescence and amplitudes of a- and b-waves and the ratio of amplitudes of b-/a-wave of maximal responses were analyzed. Results Compared with the full-term infants, The delitescence of responses of rod cells in preterm infants was statistically longer (.t=11.007,P.=0.000) but without any significant changes of amplitudes (.t=1.836,P.=0.069); statistically longer delitescence (.t=2.44, P=0.010; (t=10.800,)P.=0.000) and lower amplitude (.t=5.804,P=0.000; t=5.809,P.=0.000) of a- and b-wave of maximal response were found in preterm infants group. In the response of cone cells, there were significant differences of the delitescence (.t=4.444,P.=0.000) and amplitude (.t=3.819,P.=0.000)of a-wave and delitescence of b-wave(.t=2.850,P.=0.005) between the two groups, and no statistical difference of amplitude of b-wave (.t=0.486,P.=0.628) between the two groups. The ratio of amplitudes of b-/a-wave of the maximal mixed response was not significantly different between the two groups ((.t=1.142,)P.=0.256). Conclusions The development of retinal function is slower in preterm infants than that in full-term ones.

Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

Objective:To study on effect of Jiantai Liquid on progesterone receptor(PR)in the uterus at the nidation stage in the mouse with disturbance of blastocyst nidation.Methods:The gestational mice were randomly divided into a normal group,a model group and a Chinese drug group.Mifepristone was used for inducing disturbance of blastocyst nidation in the mice,which were interfered with Jiantai Liquid.At the eighth week of pregnancy,the mice were killed and morphological changes of the endometrium were observed,and PR expression in the uterus was detected with immunohistochemical method and PR and PRmRNA expressions were detected with Western blot and PT-PCR methods.Results:The endometrium showed maldevelopment in the model group and normal development in the Chinese drug group,similar to the normal group;the gland,the PR expression range and intensity of PR expression in the interstitial substance in the Chinese drug group increased as compared with the model group(P0.05);expressions of PR protein and gene in the Chinese drug group were significantly higher than those in the model group(P0.05).Conclusion:Jiantai Liquid can promote development of the endometrium and improves blastocyst nidation via regulating expressions of PR and PRmRNA in the uterus in the mice with disturbance of blastocyst nidation.

Aim To study the effect of 2,3,4′,5-tetrahydroxystilbene-2-O-?-D glucoside(TSG) on vascular smooth muscle cells(VSMCs) proliferation induced by fetal bovine serum and explore the underlying mechanisms.Methods VSMCs were cultured from rat aorta using explant technique.VSMCs proliferation was analyzed by 5-bromo-2-deoxyuridine(Brdu) incorporation assay.Cell cycle phase distributions were determined by flow cytometry.The expression of proliferating cell nuclear antigen(PCNA) was evaluated by Western blot analysis.The level of intracellular reactive oxygen species(ROS) was estimated through fluorescence assay.The intracellular activities of superoxide dismutase(SOD),catalase(CAT),and glutathi one peroxidase(GSH-px) were measured using biochemical method.Results TSG in the experimental concentration 0.1～100 ?mol?L~-1 exhibited no apparent cytotoxocity.10 ?mol?L~-1 and 100 ?mol?L~-1 TSG significantly inhibited the proliferation of VSMCs induced by serum,cell cycle transition from G0/G1phase to S phase,PCNA expression in nucleus of VSMCs and level of intracellular ROS.100 ?mol?L~-1 TSG markedly increased the activities of SOD and GSH-px.Conclusions Certain concentration of TSG can prevent VSMCs proliferation effect mediated by serum;the mechanism about TSG effect may be associated with arresting G0/G1 to S progression,decreasing PCNA expression and improving the antioxidation of VSMCs.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.

ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in the evaluation of clinical pathological typing of advanced gastric cancer.MethodsFifty six patients who had been diagnosed as gastric cancer were examined using acoustic radiation force impulse.According to clinical pathological typing,all cases were divided into highly-moderately differentiated adenocarcinoma (14 cases) and non-highly-moderately differentiated adenocarcinoma (42 cases).A comparison with clinical pathologic results was made after surgery.The correlation of VTQ results and clinical pathological typing of gastric cancer was analyzed.ResultsThe VTQ value of highly-moderately differentiated adenocarcinoma was lower than that of non-highly-moderately differentiated adenocarcinoma [(1.49 ± 0.44) m/s vs (2.12 ± 0.45) m/s],with statistical significance( t =-4.53,P ＜0.05).According to the maximum area under the ROC curve,the cutoff value of VTQ was 1.795 m/s,the sensitivity and specificity were 78％ and 86％,respectively,the Youden's index was 0.64,and with high reproducibility(Kappa =0.81).ConclusionsVTQ could initial estimate the clinical pathological typing of advanced gastric cancer before operation.

Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective In order to know the effect of heating infusion for premature infants to pro-mote their restoration of physiological function. Methods Divided 160 premature infants who need infu-sion into the experimental group and the control group randomly, there were 80 cases in each group. Normal temperature infusion was used in the control group, while heating infusion was used in the experimental group, compared the body temperature, pluse, respiration, blood pressure, oxygen saturation and the blood ghcose between the two groups. Results There were significant difference about the indexes which had mentioned above between the two groups. Conclusions Heating infusion can effective promote the reha-bilitation of physiological function of premature infants.

Objective To explore the clinical value of double contrast-enhanced ultrasonography (DCUS) on evaluation of the chemotherapy effect in advanced gastric carcinoma. Methods A total of 21 patients with unresectable and received chemotherapy of advanced gastric carcinoma were examined using ultrasound after taking oral contrast agent and bolus injection of Sono Vue, and findings of DCUS of each patient before and after chemotherapy were compared. Results The thickness of lesions was slightly thinner than that after chemotherapy,but there was no significant difference ( P ＞0. 05). In addition, there was no significant difference in the basal intensity (BI), peak intensity (PI), arrive time (AT) and time to peak (TTP) of gastric carcinoma tissues after chemotherapy (P ＞0.05). While the enhanced intensity (EI) value of gastric carcinoma tissues after chemotherapy was significantly less than that before chemotherapy (P ＜0.05). Conclusions The EI value in gastric carcinoma tissues may be considered as a sensitive and effective index in assessing the therapeutic effect of the chemotherapy in patients with advanced gastric carcinoma.