Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Objective To isolate and identificate a specific new gene highly related to human bladder cancer and to investigate the carcinogenesis mechanism and genetic susceptibility. Methods Normal bladder epithelia and cancer tissue collected from 8 cases of primary bladder transitional cell carcinoma were studied using the high performance?sensitive technique of mRNA differential display.The differential fragments were found by comparing with genetic expression. 6 of them were reamplificated?cloned?sequenced,and performed the autoploidy index in the public database of genbank. Results (1)37 differential fragments have been isolated.36 of which are expressed or highly expressed in cancer tissues,but not so or lowly expressed in normal tissues;while it has been expressed in 1 normal tissue but not in the cancer tissue.(2)Results of indexing:1 is homologous to TBX3 (T box gene),autoploidy 99%.1 is homologous to cl.Ca4 gene (member 4 of Calcium activated chloride channel gene family), autoploidy 99%.1 is homologous to Cu,Zn SOD gene (Cu,Zn superoxide dismutase),99%.The remaining fragments are not homologous to unknown sequences in the public database of genbank,assigned as YHHQ1,XHL,LHX. Conclusions (1)It is verified at genetic level the relation between the conment's increasing of Cu,Zn SOD in bladder cancer derived tissue and the occurrence,advance of bladder cancer.(2)The relation between TBX3,cl.Ca4 gene and human carcinoma has been observed.(3)YHHQ1 may be the new candidate of anti oncogene related to bladder cancer.XHL and LHX may be the new candidates of oncogene related to bladder cancer.

Objective To investigate the efficacy of ventral bladder mucosa onlay graft urethroplasty for the management of panurethral stricture.Methods From August of 2005 to July of 2013,11 cases of panurethral stricture were treated by ventral bladder mucosa onlay graft urethroplasty.The median age of the patients was 53 years (22-72 year),The median stricture length was 15 cm (12-18 cm).The patient was placed in the lithotomy position,Penile urethra was exposed by circumcoronal incision and degloving of skin,Bulbar urethra was exposed by inverted Y-shaped perineal incision.The strictured urethral segment was then opened ventrally in the midline up to at least 1 cm proximally into the healthy urethra.An appropriate size bladder mucosa graft was harvested,and was quilted to the splited urethra edge,the graft width was 1.5-2.0 cm.Two F10 fenestrated silicone catheters were left as urethral stents,a suprapupic cystostomy tube was left.The urethral stent was removed 4 weeks postoperatively.Follow-up was performed every 3 months for the first year,and annually thereafter.Success was defined as normal voiding with a maximum flow rates ≥ 15 ml/s,and the patients required no further instrumentation,including dilation or urethrotomy.Results The mean follow-up was 18 months (range,9-36 months),the overall success rate was 10/11.One patient developed urethral meatus stenosis 3 months postoperatively,and was managed by meatal dilatation.Conclusion Ventral bladder mucosa onlay graft urethroplasty can be used for the management of panurethral stricture,Bladder mucosa is an alternative substitution for complex urethral reconstruction.

Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cystic Fibrosis ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

Child ; Congresses as Topic ; Humans ; Pediatrics

Equipment Failure ; Female ; Heart Ventricles ; pathology ; surgery ; Humans ; Middle Aged ; Pacemaker, Artificial

China ; Hepatectomy ; methods ; Humans ; Liver Transplantation ; methods ; Living Donors

Child ; Congresses as Topic ; Humans ; Pediatrics

Atherosclerosis ; diagnosis ; metabolism ; Biomarkers ; Humans ; Proteomics

Objective To investigate the relationship of matrix metalloproteinases(MMP?3 and MMP?9)and the tissue inhibitor TIMP?1 with left ventricular hypertrophy(LVH)in patients with primary hypertension. Methods Totally 140 patients with primary hypertension and 132 healthy controls were included. Matrix metalloproteinase?3(MMP?3),matrix metalloproteinase?9(MMP?9)and tissue inhibitor metalloproteinase?1 (TIMP?1)were measured. All subjects were taken echocardiography examination ,then left ventricular mass index(LVMI)was calculated. Re?sults MMP?3,MMP?9,TIMP?1(488.32±100.32 vs 314.59±99.78;340.56±43.21 vs 290.15±33.98;389.16±57.53 vs 243.45±62.31;P<0.001) and LVMI(113.7±9.9 vs 88.3±10.4,P<0.001)in patients with primary hypertension were significantly higher than those in controls. In a multiple stepwise regression analysis with LVMI as the variable,it was found that age,SBP,MMP?3,MMP?9 and TIMP?1 were main determinants for LVMI (r2=0.78,P<0.001). 3. Patients with primary hypertension were divided into two subgroups according to LVMI,i.e.,hypertension with LVH (group A)and hypertension without LVH(group B). SBP,MMP?3,MMP?9 and TIMP?1(178±31 vs 166±25;490.14±99.13 vs 405.56±53.12;340.56±43.21 vs 290.15±33.98;393.45±47.69 vs 301.58±39.57;P<0.05)of group A were significantly higher than those of group B. Conclusion MMP?3,MMP?9 and TIMP?1 are influencing factors for LVH in patients with primary hypertension.