Central Nervous System Neoplasms ; secondary ; Humans ; Neoplasm Metastasis ; Neuroblastoma ; pathology

Objective To discuss the effectiveness of endoscopic frontal sinus surgery through the agger nasi cell. Methods Twenty-seven patients with chronic frontal sinusitis were treated with endoscopic frontal sinus surgery. The frontal sinus was opened by resecting the agger nasi cell. Results The frontal sinus were opened successfully in all the patients. No complications occurred except periorbital bruising in 3 eyes. Nasendoscopy showed that the frontal sinus drainage pathway was normal after the operation. During a 6-month follow-up, the symptoms of the frontal sinus disappeared in 18 of the patients, improved in 7, and were not changed in 2. Conclusions Endoscopic frontal sinus surgery through the agger nasi cell is effective for chronic frontal sinusitis.The method is worth being widely used.

Objective To investigate the effects of different doses of sufentanil on the minimum alveolar concentration (MAC) of sevoflurane for sedation in patients undergoing bronchoscopy. Methods ASA physical status I orⅡpatients of both genders, aged 20 ~ 65, undergoing bronchoscopy under general anesthesia,were randomly divided into 4 groups (n=20 each):control group (group C) and different doses of sufentanil groups (Sl, S2 and S3 groups). Sufentanil 0.1, 0.2 and 0.3 μg/kg in 5 mL of normal saline was intravenously infused before induction of anesthesia in groups of SI S2 and S3 respectively. While 5 mL of the normal saline was given instead in the group C The patients were mechanically ventilated after insert laryngeal mask. Anesthesia was maintained with inhalation of sevoflurane. Each time the concentration of sevoflurane at end expiration increased/decreased in the next patient depending on the concentration of sevoflurane at end expiration with which the former had no cough. The ratio between the two consecutive concentrations was 1.1. The middle point between the positive response and negative response served as a crossover pair. After at least 7 independent crossover pairs were observed in each group. The MAC and 95%confidence interval of sevoflurane were calculated. The time of anesthesia induction and analepsis was recorded. Results The MAC (95%CI) of sevoflurane was 3.0%(2.8%~3.3%), 2.3%(2.1%~2.5%), 1.9%(1.6% ~ 2.2%) and 1.6% (1.3% ~ 1.9%) in groups of C, S1, S2 and S3 respectively. The MAC of sevoflurane was significantly lower in groups of S1, S2, S3 than in the group C, and in groups S3 than in the group S1 (P<0.05). The time of anesthesia induction was significantly shorter in groups of S2, S3 than in the group C and significantly longer in groups S3 than in the group C. Conclusion Sufentanil of 0.1, 0.2, 0.3 μg/kg can significantly decrease the MAC of sevoflurane in patients undergoing bronchoscopy in a dose-dependent manner.

Gas Chromatography-Mass Spectrometry ; Solvents ; analysis ; chemistry ; Volatile Organic Compounds ; analysis ; chemistry

Objective To explore the molecular and cell signal transduction mechanism of Astragalus mongholicus polysaccharides (ASP) on macrophage. Methods After stimulating RAW264.7, the change in value of NF-κB was determined by Western blot. The induction of NO and secretion of TNF-α by ASP in macrophage was observed with or without inhibitor of NF-κB using Griess method. Moreover, protein levels of TNF-α secreted by macrophage were investigated with ELISA in respond to ASP. Results 4 h after stimulation by 100 μg/ml ASP, the concentration of NF-κB in nucleus increased significantly, peaked at 6 h. 16 h after stimulation by 100 μg/ml ASP, the activity of iNOS[(23.54±2.41) U/mg protein; P<0.01], producton of NO [(18.9±1.5)μmol/L, P<0.01] and level of TNF-α[(81.2±16.7)pg/ml, P<0.0l] in macrophage were improved markedly. Blocking NF-κB with inhibitor results in decreased levels of NO and TNF-α. Conclusion The results suggest that NF-κB play an important role in induction of NO and TNF-α by ASP in macrophage.

In Chongqing Medical University,Introduction to Clinical Medicinewas first launched in 2002. In this article, based on the summary of 2014 to 2015, we summarized respectively from teaching material construction, evaluation system with combination of formative assessment and summative assess-ment, network support platform, teaching quality monitoring system, and student questionnaire survey and evaluation. Through the study of the course, 99.5% (836/840) of the students think their team conscious-ness and cooperation ability were improved, 94.2% (791/840) of the students consider this course can im-prove their innovative ability of self-learning, 87.0% (731/840) of the students think it is beneficial to the improvement of their self expression ability and more than 78.0% of the students think they have achieved the goal of early clinical contact, expanding knowledge, and enhancing the basic professional quality.

Objective To observe the effects of malt extract on prolactin expression and morphology of mammary tissue in hyperprolactinemia rats. Methods Metoclopramide hydrochloride was injected subcutaneously to establish hyperprolactinemia model. Sixty rats were divided into normal control group, model control group, bromocriptine group, high-dose, middle-dose and low-dose malt extract groups. Except normal control group, hyperprolactinemia model was established in the other groups. Bromocriptine (0. 389 mg·kg-1 ·d-1 ) was given to bromocriptine group. Malt extract (7. 98, 15. 96 and 31. 92 g·kg-1 ·d-1 ) was administered in low-dose, middle-dose and high-dose malt extract groups. Equal volume of purified water was given to normal control group and model control group. After 30 days of administration, PRL positive cell number of rat hypophysis was counted. RT-PCR was used to measure hypophysis PRL mRNA expression, and morphology of mammary tissues was observed by immunohistochemical method. Results PRL positive cell number was (2. 4±0. 3), (21. 7±0. 8), (3. 8± 0. 5), (4. 5±0. 4), (6. 7±0. 5) and (15. 8±1. 2) in normal control group, model control group, bromocriptine group, high-dose, middle-dose and low-dose malt extract groups. PRL mRNA expression level was (0. 31±0. 02), (1. 58±0. 06), (0. 45± 0. 04), (0. 49±0. 03), (0. 61±0. 04), and (0. 95±0. 09), respectively. As compared with normal control group, hypophysis PRL positive cell number and PRL mRNA expression level of high-dose and middle-dose malt extract group were increased significantly (P<0. 01), and hyperplasia of mammary glands appeared. As compared with model control group, hypophysis PRL positive cell number and PRL mRNA expression level of high-dose and middle-dose malt extract group was decreased significantly (P<0. 01), and hyperplasia of mammary glands was alleviated obviously. Conclusion Malt extract can effectively treat hyperprolactinemia and inhibit hyperplasia of mammary glands through significantly decreasing the expression of hypophysis prolactin in hyperprolactinemia rats.

BACKGROUND:Tissue-engineered bone in the treatment of large bone defects has obvious advantages especial y when the autologous ilium transplantation is limited, which can effectively fil bone defects.
OBJECTIVE:To investigate the rationality of intramedul ary nailing support and tissue-engineered bone fil ing in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone.
METHODS:Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedul ary nailing support and tissue-engineered bone fil ing.
RESULTS AND CONCLUSION:Al of the seven patients underwent more than 8 months of fol ow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, al the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedul ary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basical y completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedul ary nailing support and tissue-engineered bone fil ing for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term fol ow-up, with good hip function activities.

Objective To determine the median effective target plasma concentration (Cp50) of remifentainil inhibiting body movement evoked by puncture during brachial plexus block in pediatric patients.Methods Pediatric patients of both sexes,aged 5-12 yr,who grown normally,scheduled for elective forearm or hand surgery,were enrolled in this study.Children were premedicated with oral midazolam 0.2 mg/kg at 30 min before anesthesia.The initial target Cp of remifentainil was 5.0 ng/ml.The target Cp was determined by up-and-down sequential method.Each time Cp increased/decreased by 20％ in the next patient depending on the response of the previous patient to puncture.The ratio between the two successive concentrations was 1.2.The puncture was performed after the target effect-site and plasma concentrations were balanced.Body movement was defined as puncture-induced movement of truncus,limbs and/or head and neck.The Cp50 and 95 ％ confidence interval of remifentainil were calculated by Dixon method.Results Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block was 3.9 ng/ml,and 95 ％ confidence interval was 3.6-4.2 ng/ml.Conclusion Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block is 3.9 ng/ml in pediatric patients.

Objective To analyze molecular evolution of carbapenemase KPC-12 and its binding free energies with β-lactams.Methods Class A beta-lactamases were divided into 2 clusters:those with carbapenemase activities and those without.Minimum Evolution method in MEGA4.1 software was used to analyze molecular evolution of class A beta-lactamases with carbapenemase activity,including KPC-2 to KPC-13,SFC-1,SME-1,IMI-1,NMC-A,and class A beta-lactamases without carbapenemase activity,including TEM-1,SHV-1.Then,tertiary structure of KPC-12 was predicted by homology modeling as reported in SWISS-MODEL database depending on tertiary structure of KPC-2.Moreover,DOCK module in ArgusLab 4.1 software was used to perform molecular docking of KPC-12 to 10 kinds of beta-lactams substrates,and the binding free energies (△ G) were calculated.Results Molecular evolution between KPC-12 and KPC-2 was the closest.The top three decline in binding free energies of β-lactams were penicillin G sodium salt (△G =-8.45149 kcal/mol),ertapenem (△G =-8.36383 kcal/mol) and ampicillin (△G =-8.19326 kcal/mol),while the last two decline in binding free energies of β-lactams were aztreonam (△G =-6.50614 kca]/mol) and clavulanic acid (△G =-6.88533 kcal/mol).Conclusion Carbapenemase KPC-12 has high catalytic activities to penicillin G sodium salt,ertapenem and ampicillin,while has low catalytic activities to aztreonam and clavulanic acid.