Objective To investigate the effects of thoracotomy on pulmonary surfactant(PS).Methods 10 patients with esophageal cancer were treated with surgery.Bilateral bronchoalveolar lavage were performed after intubation preoperatively and before removal of the cannula postoperatively.Saturated phosphatylcholinide(SatPC),Total phospholipids(TPL),Total proteins(TP) were determined in bronchoalveolar lavage fluid(BALF).The ratio of SatPC/TPC and SatPC/TP were regarded as PS activities.Right lateral lung was control group.Results There were no difference in SatPC/TPL and SatPC/TP of bilateral lung at preoperation,SatPC/TPL showed no statistical diference at postoperation. But at postoperation,SatPC/TP(6.09?1.53)% of the left lung was decreased,as compared with the right SatPC/TP(7.89?2.32)% (P

10%, and the polyethylene liner wear rate was calculated according to offset distance of femoral head, which was measured on AP X-ray. Results 11 hips were revised winth 5 years post-operation, and 66 hips were revised within 6-12 years. The majority of revisions were done between 7 to 9 years post-operation. The causes for revision were analyzed based on X-ray films. There were prosthesis loosening in 42 hips, severe osteolysis in 43, hips mild osteolysis in 12 hips. All prosthesis liners wore in different degree. Except for some factors that probably affected the results, such as 18 cases of cup malposition, 6 cases of acetabular dysplasia with acetabular bone graft and 2 cases of trauma, 2 cases of dislocation, there were 49 revisions probably due to prosthetic reason. The liner wear rate was (0.26?0.10)mm/y. No good ongrowth bone was found on the surface of the cups taken off from the patients. Conclusion This HA coated cup has a good medium term result, and poor long-term result. The main causes for acetabular cup revision rate are the acetabular dysplasia, malposition of acetabular prosthesis, high liner wear rate and osteolysis related to too many screws.

At present,the diagnosis of gastric cancer and precancerous changes mainly depends on the histological examination of biopsy samples.Confocal laser endomicroscopy could enable realtime observation of tissue,cellular,and subcellular structure of gastrointestinal tract,and differentiate normal,hyperplastic,and neoplastic mucosa.Confocal laser endomicroscopy has shown the superiority and value in in vivo diagnosis of gastric cancer and precancerous changes, including atrophic gastritis,intestinal metaplasia,and intraepithelial neoplasia,et al.This article reviewed the advances in studies of the diagnosis of gastric cancer and precancerous changes by confocal laser endomicroscopy.

Mammalian target of rapamycin (mTOR) signaling pathway,one of the most important cellular signaling transduction pathways,regulates cell survival,proliferation,transdifferentiation,migration and cell cycle by influencing the activation state of various effector molecules in the downstream.Abnormal regulations of these machanisms are closely related to the tumorigenesis and progression of colorectal cancer (CRC).Currently,mTOR inhibitors have been approved in clinical trials of CRC and have made some progress.

Objective To compare the clearing effect between combination use of mosapride and polyethylene glycol (PEG) and polyethylene glycol only for colonoscopy preparation of patients with constipation caused by functional diseases.Methods A total of 212 adult patients who underwent colonoscopy examination were recruited to this randomized single blinded controlled study.Patients in control group received 3 liters of PEG only,whereas patients of experimental group received 10mg mosapride 30min before 3liter PEG.The patients were surveyed for the tendency of constipation.Experimental variables including time of first defecation and completion of bowel cleansing,defecation frequency,and degree of discomfort during colonoscopy preparation were recorded.Results The times of first defecation and completion of bowel cleansing of experimental group were shorter than those of control group ( P ＜ 0.05 ),but there were no significant differences in defecation frequency,the degree of discomfort and the bowel cleansing quality between 2 groups ( P ＞ 0.05 ).The percentages of patients with constipation in control and experimental groups were 26.61％ and 26.67％,respectively.The defecation frequency and the degree of discomfort of constipative patients were similar in both groups ( P ＞ 0.05 ).The time of first defecation and time of completion of bowel cleansing of constipative patients in experimental group were shorter than those in control group ( P ＜ 0.05 ).The bowel cleansing quality of constipative patients in experimental group was better than that of control group ( P ＜ 0.05 ).There was no difference in defecation frequency and adverse reaction between 2 groups (P ＜ 0.05).Conclusion Combination of mosapride and PEG for colonoscopy preparations of patients with functional constipation tends to shorten times of first defecation and completion of bowel cleansing,and to increase the bowel cleansing quality.

Objective To discuss the antitumor mechanism preliminarily by observing effects of Celastrus orbiculatus extracts (COE) on vascular endothelial growth factor (VEGF) mRNA and protein expression in hepatoma (Hepal-6) cells of mice.Methods Hepa1-6 cells were treated with COE at different nontoxic concentration (0, 10, 20, 40, 80, and 160 μg/mL) for 16 h. The mRNA and protein expressions of VEGF were detected by reverse transcription-PCR and Western Blotting,respectively. Results COE significantly inhibited VEGF expression at both mRNA and protein levels in a dose-dependent manner. Conclusion COE can inhibit VEGF expression in Hepa1-6 cells, therefore suggest that VEGF could be chosen as an therapeutic target for COE in the context of cancer chemoprevention and anticancer therapy.

Objective To explore epicanthus correction by transverse incision method and concurrent double-eyelid incision operation.Methods The transverse straight-line incision was performed in new inner canthus to the original canthal corner point; after the original inner canthus corner point was reached,the oblique-line parallel incision was performed along the lower eyelid so that full subcutaneous separation was obtained on the upper and lower incision; the malpositioned isomerous orbicular muscle and thickened tissue were released and excised so that the epicanthus skin was naturally restored; the superficial head of the inner canthus ligament was folded and sutured when necessary ; after small cat ears at the temporal side of the inner canthal incision was removed,routine double eyelid plasty was then performed,but the double eyelid and the inner canthus incisions were not continuous.Results The procedures were clinically applied in 258 cases and followed up for 3-18 months,showing that the epicanthus has disappeared,new inner canthus was in good appearance,the scar was not obvious,recurrence of the epicanthus was not found and double eyelids were beautiful in appearance.Conclusions The epicanthus correction by transverse incision and concurrent double-eyelid plasty is a simple and ideal approach for correction of single-edged eyelid with epicanthus and it is worthy of clinical promotion.

Objective To investigate the effect of dexmedetomidine and small dose of ketamine on the hyperalgesia and brain-derived neurotrophic factor (BDNF) mRNA in the spinal cord of rats with neuropathic pain.Methods Forty-five male Sprague-Dawley rats,weighing 240-270 g,were randomly divided into 5 groups (n =9 each):sham operation group (group S),spinal nerve injury (SNI) group,ketamine group (group K),dexmedetomidine group (group D) and dexmedetomidine + ketamine group (group K+ D).The animals were anesthetized with intraperitoneal 10% chloral hydrate 400 mg/kg.SNI was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve in groups SNI,K,D and K + D.In S group,the sciatic nerves and its branches were only exposed but not ligated.In groups D,K and K + D,dexmedetomidine 40 μg/kg (2 ml),ketamine 10 mg/kg (2 ml) and mixture of dexmedetomidine 20μg/kg + ketamine 5 mg/kg (2 ml) were injected intraperitoneally,respectively,once a day for 21 consecutive days starting from 24 h after successful SNI surgery.While the equal volume of normal saline 2 ml was injected instead in S and SNI groups.The paw withdrawal threshold to mechanical stimuli (PWT) was measured at 1 day before surgery,and 3,7,14 and 21 days after surgery.Three rats were sacrificed after measurement of pain threshold at 1 day before surgery,and 7 and 21 days after surgery and the lumbar segments (L4-6) of the spinal cord were removed for determination of BDNF mRNA expression in spinal dorsal horn by real time PCR.Results Compared with group S,the PWT was significantly decreased,and the expression of BDNF mRNA in spinal dorsal horn was up-regulated after surgery in groups SNI,K,D and K + D (P ＜ 0.05).The PWT was significantly higher,and the expression of BDNF mRNA in spinal dorsal horn was lower after surgery in groups K,D and K + D than in group SNI,and in group K + D than in groups K and D (P ＜ 0.05).Conclusion The combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain,and direct or indirect inhibition of BDNF mRNA expression in spinal dorsal horn is involved in the underlying mechanism.

Objective To evaluate the effects of sevoflurane preconditioning on caveolin-3 expression during myocardial ischemia-reperfusion (I/R) in rats.Methods Healthy male Wistar rats,aged 6-8 weeks,weighing 250-300 g,were anesthetized with intraperitoneal pentobarbital 30 mg/kg and heparin 1 000 IU/kg.Their hearts were excised and perfused with K-H solution in a Langendorff apparatus.Thirty isolated rat hearts were randomly assigned into 3 groups (n =10 each) using a random number table:control group (group C),I/R group and sevoflurane preconditioning group (group SP).After 30 min of equilibration,group C was continuously perfused with K-H solution for 90 min,group I/R underwent 30 min of ischemia followed by 60 min of reperfusion,and group SP was perfused with K-H solution saturated with 2％ sevoflurane for 10 min followed by 5 min washout with K-H solution,then underwent 30 min of ischemia followed by 60 min of reperfusion.HR,left ventricular enddiastolic pressure (LVEDP),+ dp/dtmax and-dp/dtmax were recorded at the end of equilibration,immediately before ischemia and at 30 and 60 min of reperfusion.Myocardial specimens were obtained from the cardiac apex for microscopic examination.Myocardial specimens were obtained from the left ventricle for determination of caveolin3 expression.Results Compared with group C,+ dp/dtmax and-dp/dtmax were significantly decreased immediately before ischemia,and HR,LVDEP,+ dp/dtmax and-dp/dtmax were decreased at 30 and 60 min of reperfusion in groups I/R and SP,and caveolin-3 expression was down-regulated in group I/R and up-regulated in group SP (P ＜ 0.05).Compared with group I/R,HR,LVDEP,+ dp/dtmax and-dp/dtmax were significantly decreased immediately before ischemia and increased at 30 and 60 min of reperfusion,and caveolin-3 expression was up-regulated in group SP (P ＜ 0.05).The pathological changes were significantly attenuated in group SP as compared with group I/R.Conclusion The mechanism by which sevoflurane preconditioning attenuates myocardial I/R injury in rats may be related to up-regulation of myocardial caveolin-3 expression.

Low-triiodothyronine syndrome is a condition characterized by decreased total serum T 3 and free T3 , along with in-creased serum reverse triiodothyronine but normal levels of thyroxine and thyrotropin .However , it is not caused by the thyroid gland diseases.The latest research progress of mechanisms , diagnosis and clinical significance , and therapy strategy of low T 3 syndrome is reviewed in this paper .