Objective To explore the optimal method of anesthesia in radical resection of gastric cancer by comparing the effects of two anesthesia techniques on the balance of Th1/Th2 in order to provide evidence for clinical anesthesia manage-ment.Methods Forty patients who underwent elective radical resection of gastric cancer were randomized into two groups:in-halation anesthesia group(group S)and total intravenous anesthesia group(group P),in which sevoflurane and propofol were ad-ministered for the induction and maintenance of anesthesia,respectively.The general data of the patients were collected,the tis-sue type of tumors obtained and the fluid infusion and blood loss volumes recoded.The VAS score was obtained 1 h,6 h and 5 d after the surgery.Before the induction of anesthesia,6 h and 5 d after surgery,the blood samples were drawn to determine the serum levels of IL-1β,IFN-γ,TNF-α,IL-2,IL-6 and IL-10.Flow cytometry was used to detect the proportion of CD3+CD8-IFN-γ+ and CD3+CD8-IL-10+ cells and the Th1/Th2 ratio was calculated.Results The level of IL-6 was increased post-sur-gically in groups S and P(P<0.05).There were no significant changes in the levels of IL-1β,IL-2 and IL-10 in groups S and P and in the levels of TNF-αand IFN-γ,and the Th1/Th2 ratio in group S between before the induction of anesthesia and different time points after the surgery(P>0.05).The levels of TNF-αand IFN-γ,and the Th1/Th2 ratio were significantly increased in group P 5 d after the surgery(P<0.05).Conclusion Total intravenous anesthesia with propofol can enhance Th1 response and it is an ideal anesthetic method for radical resection of gastric cancer.

Objective:To investigate the difference of amplitude and duration in submental muscles and infrahyoid muscles activities during pharyngeal swallowing between normal adults and post-stroke dysphagia by using surface electromyography technique and analysis system.Method:The clinical data from 30 cases of PSD and 30 healthy controls were collected.ME6000-T8-type sEMG machine was used to collect sEMG of two groups in resting state,saliva swallow and wet swallow,and therefore calculate the average amplitude and duration.Result:①In resting state:there were no statistical difference in the average amplitude of submental and infrahyoid muscles between PSD group and control group(P＞0.05);In PSD group:statistical differences were not observed in the amplitude between submental muscles and infrahyoid muscles;In control group:there were no statistical difference in the average amplitude between submental muscles and infrahyoid muscles;②During dry swallowing:the results indicated that the average amplitude of submental and infrahyoid muscles in PSD group were significantly lower than that in control group;and the duration of submental and infrahyoid muscles was significantly lower with statistical difference(P＜0.05).③During wet swallowing(swallowing5ml water):the average amplitude of submental and infrahyoid muscles in control group were significantly higher than that in PSD group(P＜0.005);and the duration of submental and infrahyoid muscles were also significantly prolonger (P＜0.001);④Intra-group comparison:statistically differences were not observed in the amplitude and duration between submental muscles and infrahyoid muscles for both PSD group and control group(P＞0.05).Conclusion:sEMG could be used as a non-invasive、simple、rapid tool in detecting the sEMG activities of related muscles during pharyngeal swallowing.The average amplitude and duration of submental and infrahyoid muscles can not only preliminarily screen and evaluate swallowing function,but also reflect the complexity and the elevation persistence time of the hyoid bone and the larynx in elevation movement,which were used to evaluate the neuromuscular function and predict the risk of aspiration of patients.

This article introduced the biological characteristics of N-methyl-D-aspartate (NMDA), and reviewed the relationship be-tween NMDA receptor and neurological disease, including cerebral trauma, cerebral ischemia, epilepsy, neuropathic pain, depression and Al-zheimer disease.

Objective To investigate the expression of H1 protein in the prefrontal cortex of comatose rats which have suffered traumatic brain injury (TBI) after electrical stimulation of the median nerve (MNS).Methods Seventy-two Sprague-Dawley rats (weighing 250 to 300 g) were randomly divided into a stimulated group (MNS+ TBI),an antagonist group (MNS+TBI+OXR1 antagonist),a model group (TBI) and a control group,with 18 rats in each group.Traumatic brain injury was modeled in all of the rats except those of the control group.After the modeling,the stimulated group was given MNS,the antagonist group was provided with MNS and an OXR1 injection,and the model group was given MNS with a current intensity of 0.One hour after the experiment,the consciousness of each rat was evaluated using a double-blind method.Animals were sacrificed at 6,12 and 24 hours after the intervention and brain tissue was removed.H1 protein expression was examined using immunohistochemistry.Results One hour after the experiment,significant differences were observed in the consciousness of the 4 groups,with the 18 rats of the control group on consciousness level one.Thirteen rats in the stimulated group exhibited a righting reflex,compared with 9 in the antagonist group and 5 in the model group.Immunohistochemistry showed that H1 expression was strongest in the stimulated group,followed by the antagonist,control and model groups.The H1 expression was highest at 24 hours after the experiment,followed by that at 6 h and 12 h,but those differences were not statistically significant.Conclusion Median nerve electrical stimulation might modulate wakefulness after traumatic brain injury by promoting H1 expression via orexin-A in the prefrontal contex.

Objective To observe the effects of neuromuscular electrical stimulation (NMES) at different frequency on post-stroke pharyngeal dysphagia.Methods Forty-five stroke survivors with pharyngeal dysphagia were randomly divided into treatment group 1,treatment group 2 and treatment group 3,eachof 15 patients.Patients in the treatment group 1,2 and 3 received NMES once,twice and three times a day respectively.All the 3 groups were given conventional swallowing training.The swallowing function classification was conducted before treatment,as well as 1,2 and 4 weeks after the treatment.Before and 2 weeks after the treatment,X-ray examination of swallowing (VFSS) was taken to assess the swallowing function,and the average treating days of the 3 groups were compared.Results The swallowing function classification showed that in treatment group 1 and 2,significant improvement was observed at this time point than that at the previous time point (P＜0.05).In treatment group 3,after 1 and 2 weeks of treatment,significant improvement was found compared to those previously,but there was no difference between after 2 weeks and 4 weeks of treatment.At the same time points,the treatment group 2 and 3 showed higher efficiency than the group 1 (P＜0.05).And compared with the treatment group 2,the treatment group 3 showed higher efficiency after 1 and 2 weeks of treatment (P＜0.05),but there was nosignificant difference after 4 weeks of treatment.Two weeks after the treatment,the average VFSS scores of all groups were significantly higher than those before the treatment (P＜0.05) and that of treatmentgroup 2 (7.600± 1.793) and 3 (8.900± 1.636) was significantly higher than that in treatment group 1 (6.700±1.873),as was that of group 3 compared to group 2.Compared with the treatment group 1 and 2,the average treatment days decreased significantly in treatment group 3 (P＜0.05).Conclusion NMES is effective in treating pharyngeal dysphagia after stroke.And within a certain range (1 to 3 times every day),with the increasing of daily treatment frequency,the effectismore significant and the average time of treatment shortens.

Multi-tragets are used for deep brain stimulation (DBS) to promote wakefulness, such as midbrain, thalamus, hypothalamus, etc. Lateral hypothalamic area may be one of the most potential tragets.

Objective:To investigate the expression of 5-HT 2A receptor in the prefrontal cortex of traumatic brain injuryinduced coma rats after median nerve electrical stimulation.Method:A total of 72 SD rats (weighing 250-300g) were randomly divided into 4 groups:a stimulationgroup,an antagonist group,a sham-stimulation group and a control group.This traumatic brain injury model was established by a weight-drop head injury,and we evaluated the change of behavior through the six classical levels of consciousness.The animals were sacrificed and their brain tissues were removed at 6,12,and 24 hours after injury.5-HT 2A protein expression was examined by immunohistochemistry.Result:Thirteen rats exhibited righting reflex in the stimulation group.In the antagonist group,9 rats exhibited righting reflex.5 rats in the sham-stimulation group had the same response.The mean rank of consciousness degree were degree 9.50 in the control group,degree 52.75 in the sham-stimulation group,degree 37.61 in the stimulation group,degree 46.14 in the antagonist group.Comparison among groups presented an increasing consciousness degree:control group＜stimulation group＜antagonist group＜sham-stimulation group(P＜0.01).Resuits from immunohistochemistry showed that significant differences in the 5-HT 2A expression among the four groups (sham-stimulation＜control＜antagonist＜stimulation))(P＜0.05),and a within-group comparison showed that the 5-HT 2A expression level was as follows:6 hours＜24 hours ＜12 hours(P＜0.05).Conclusion:Median nerve electrical stimulation might modulate wakefulness by promoting the 5-HT 2A expression via orexin-A in the prefrontal cortex of rats with traumatic brain injury-induced coma.

Objective To explore the effect of vagus nerve stimualtion on wake-promoting and the expression of 5-hydroxytryptamine (5-HT) 2A receptor in the prefrontal contex of coma rats with traumatic brain injury. Methods 72 Sprague-Dawley rats were randomly divid-ed into control group, sham-stimulated group, stimulated group and antagonist group with 18 rats in each group. Traumatic brain injury mod-el was established by a weight-drop head injury. The antagonist group was injected with SB334867, and both the antagonist group and the stimulated group received vagus nerve stimulation. Their behaviors were recorded. And immunohistochemistry technique was used to detect the expression of 5-HT2A receptor in the prefrontal cortex. Results 12 rats in the stimulated group, 9 in the antagonist group and 4 in the sham-stimulated woke up. The expression of 5-HT2A receptor from low to high was ranged as the control group, the antagonist group, the sham-stimulated group and the stimulated group (χ2=11.464, P=0.009). Conclusion Vagus nerve stimulation could raise consciousness in co-ma rats after traumatic brain injury, which may be related to up-regulating the expression of 5-HT2A receptor.

Humans ; Neoplasms ; genetics ; immunology ; therapy ; RNA Interference ; RNA, Small Interfering ; RNA-Induced Silencing Complex

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.