Objective To evaluate the effects of different blood-saving strategies on postoperative cellular immune function in patients undergoing resection for liver cancers.Methods Sixty-six ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,with hepatocellular carcinoma classification G1-G3 and clinicopathological staging Ⅰ-Ⅳ,undergoing elective resection for liver cancers,were randomly divided into 3 groups (n =22 each) using a random number table:low central venous pressure group (L group),acutenormovolemic hemodilution group (A group),and acute normovolemic hemodilution combined with low central venous pressure group (AL group).Acute normovolemic hemodilution was performed after endotracheal intubation.Right jugular vein was cannulated for central venous pressure monitoring.Blood withdrawn from the radial artery at a rate of 25-40 ml/min was simultaneously replaced by iv infusion of the equal volume of 130/0.4 hydroxyethyl starch at the same rate until the target Hct (30％) was achieved.In A and AL groups,central venous pressure was maintained at 3-5 cm H2O during the procedure of liver parenchyma transection.Peripheral venous blood samples were taken before operation (T1,baseline) and on postoperative days 1,3 and 5 (T2-4) to determine the percentage of regulatory T-lymphocytes (CD4 + CD25 +,CD25 + Foxp3+),effective T-lymphocytes (CD8 +,CD4 + CD25-) and natural killer (NK) cells by flow cytometry.Results Compared with the baseline value at T1,the percentage of CD4 + CD25 +and CD25 + Foxp3+ was significantly decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T3,4,and the percentage of NK cells was decreased at T2 in A and AL groups,and the percentage of CD4 + CD25 +and CD25 + Foxp3+ was decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T4,and the percentage of NK cells was decreased at T2,3 in group L (P ＜ 0.05).Compared with L group,the percentage of CD4 + CD25 + and CD25 + Foxp3+ was significantly decreased at T3,the percentage of CD8 + was increased at T3,4,and the percentage of NK cells was increased at T3 in AL group (P ＜ 0.05).Conclusion Acute normovolemic hemodilution combined with low central venous pressure provides slighter inhibitory effect on the immune function of T-lymphocytes and NK cells in patients undergoing resection for liver cancers than either alone.

Objective To compare the efficacy of combined intravenous-inhalational anesthesia with propofol-fentanyl-sevoflurane in children undergoing minor surgery under spontaneous breathing with nasopharyngeal airway-face mask versus laryngeal mask airway (LMA).Methods Seventy-two children,scheduled for elective high ligation of indirect inguinal hernia,were randomly divided into 2 groups (n =36 each):nasopharyngeal airway-face mask group (group M) and LMA group (group L).Propofol 1.0 mg/kg and fentanyl 2.0μg/kg were injected intravenously.The spontaneous breathing was kept.After lass of consciousness,a face mask was placed for inhalation of pure oxygen at 2 L/min and 3 ％ sevoflurane.When BIS value reached 50-60,a size 2 LMA was inserted in group L and a nasopharyngeal airway was placed via the left nasal cavity and the face mask was held tightly and connected to the anesthesia machine in group M.Anesthesia was maintained with inhalation of 2％-4％ sevoflurane.Fentanyl 1 μg/kg was injected intravenously 5 min before skin incision.The concentration of sevoflurane was adjusted to maintain BIS value at 40-60 during surgery.Mean arterial pressure,heart rate,partial pressure of end-tidal carbon dioxide and pulse oxygen saturation were recorded before induction,at 3 min during induction,immediately after successful insertion of the airway,at skin incision,3 min after skin incision,and immediately after removal of the airway.The airway insertion time,success rate of insertion at first attempt,emergence time,and adverse reactions were recorded.Results Compared with group L,mean arterial pressure and heart rate were significantly decreased during airway insertion or removal,nasopharyngeal airway insertion time was shortened and the success rate of nasopharyngeal airway insertion at first attempt (100％) was increased,and the agitation score and incidence of obstruction of the upper respiratory tract were decreased in group M (P ＜ 0.05).Conclusion Combined inravenous-inhalational anesthesia with propofol-fentanyl-sevoflurane is easy to establish the airway,can maintain spontaneous breathing,has little influence on circulatory function and reduce complications during recovery from anesthesia in children undergoing minor surgery under spontaneous breathing with nasopharyngeal airway-face mask,and the efficacy is better than that with LMA.

Objective To investigate the treatment effects of dahuang gancao decoction on lung Injury complicated by acute necrotizing pancreatitis and explore its mechanism. Methods 90 Wistar rats were randomly divided into 3 groups, namely sham-operated group (SO), ANP group (ANP), dahuang gancao decoction treatment group (DG). 4% sodium taurocholate was injected into the pancreatic duct to induce ANP. Dahuang gancao decoction(0.25 g/ml) 0.6 ml/100 g weight was gavaged in the DG group, the same volume of normal saline was gavaged in the SO and ANP group, which was repeated 12 h later. After 6 h, 12 h, 24 h, all rats were sacrificed, pancreas and lung tissues were harvested to observe the pathological changes and the pathological changes were scored. IL-6, IL-10, TNF-α levels of serum and lung tissue were measured,and the changes of toll-like receptor 4 (TLR4) expression in lung tissue was determined by immunohistochemical method. Results 12 h after ANP induction, the serum levels of IL-6 in SO, ANP, DG group were (14.4±4.0)pg/ml, (171.4 ±41.3)pg/ml, (156.9 ±34.7)pg/ml; the serum levels of IL-10 were (13.7 ±4.5)pg/ml, (120.5 ±23.7)pg/ml, (148.3 ±44.4)pg/ml; the serum levels of TNF-α were (22.4 ±4.7)pg/ml, (261.3 ±51.4)pg/ml, (235.3 ±45.9)pg/ml; the lung tissue levels of IL-6 were (257.3 ±55.9)pg/ml,(2578.3 ±403.0)pg/ml,(2370.0 ±491.0)pg/ml; the lung tissue levels of IL-10 were (80.8 ±20. 8)pg/g, (642.0 ± 107.3)pg/g, (695.3 ± 151.7) pg/g, the lung tissue levels of TNF-α were (207.6 ±98.6)pg/g, (1769.1 ±635.6) pg/g, (1401.1 ±450.5) pg/g; the pancreas pathological scores were 0, 7.00 ±1.33, 6.30 ± 0.95; the lung pathological scores were 0, 6.30 ± 1.42, 5.60 ± 0.97; the expressions of TLR4in lung tissue were 0.09 ± 0. 03, 0.59 ± 0. 09, 0. 52 ± 0. 08. The values in the ANP and DG groups were significantly higher than those in SO group (P < 0. 01 ); except for IL-10, all values in the DG groups were significantly lower than those in ANP group (P < 0.05); there was a positive association between lung and pancreas scores (r =0.807, P<0.01), and lung score was positively associated with the expression of TLR4(r = 0.519, P < 0.01 ). Conclusions Dahuang ganeao decoction may quickly improve lung injury complivated by ANP. The mechanism may involve inhibiting the expression of TLR4 and down-regulating the expression of IL-6, TNF-α, up-regulating the. Expression of IL-10.

OBJECTIVE: To assess the diagnostic value of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detecting residual/recurrent nasopharyngeal carcinoma. METHOD: The literatures published between January 1990 and September 2013 were searched in PubMed, EM-BASE, EBSCO, Web of Science, CBM, CNKI, VIP and Wanfang databases. Two researchers independently selected studies, extracted data and assessed the quality of included studies according to the QUADAS tool. Summary sensitivity, specificity, diagnostic odds ratios (DOR), and receiver-operating characteristic (SROC) curves were obtained using Meta-Disc software. Subgroup analysis was also conducted. RESULT: Twenty-six studies were included in this meta-analysis, involving 1203 patients. The pooled sensitivity, specificity and DOR were 0. 92 (95% CI:0.89-0.94), 0. 87 (95% CI:0.84-0.90) and 51. 10 (95% CI:34.29-76.15), respectively. The area under the curve (AUC) and Q index estimate for PET/CT were 0. 9494 and 0. 8897, respectively. The results of subgroup analysis showed no significant differences between subgroups(P>0.05). CONCLUSION In a word, 18F-FDG PET/CT performed well for diagnosis of residual/recurrent nasopharyngeal carcinoma, with relatively high sensitivity and specificity.
Carcinoma ; Fluorodeoxyglucose F18 ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; diagnostic imaging ; Positron-Emission Tomography ; ROC Curve ; Radiopharmaceuticals ; Recurrence ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Meridians in human body were classified as white meridian and black meridian according to Tibetan medicine.Season and environment,improper diet,toxic heat and trauma were recognized as main reasons damaging the white meridian in Tibetan Medicine,leading to the emerge of white meridian disease induced by Long (one of the three factors) and blood disorder.White meridian disease in Tibetan medicine involved a series diseases,such as many clinical diseases,due to the damage of white meridian system caused by pathogenic factors.Stroke also belonged to white meridian disease.Drugs and treatments were selected based on the nature of disease such as cold and heat,onset,thelocation of disease and the three factors (Chi Ba,Long and Pei Gen).It was the fundamental principle of the treatment rules of white meridian disease in Tibetan medicine,namely,prescribing medication with the rule of diagnosis and treatment,comprehensive analysis of the causes of diseases and mastering the change law of diseases and syndromes in clinic.

This paper is aimed to assess the diagnostic value of MRI versus 99 Tcm-methylene diphosphonate (99 Tcm- MDP) bone scan (BS) for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tc"m-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio (DOR), drew the summary receiving operating characteristic (SROC) curve, and measured the area under curve (AUC) and Q value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0. 95 (95% CI 0. 90~0. 98) and 0. 67 (95% CI 0. 58~0. 75), respectively. The pooled specificity was 0. 97 (95% CI 0. 94~0. 99) and 0. 88 (95% CI 0. 83~0. 91), respectively. The pooled DOR was 402.99 (95% CI 119. 05 ~1364. 15) and 23. 85 (95% CI 1. 32~431. 48), respectively. The AUC was 0. 990 1 and 0. 624 1, respectively. The Q was 0. 958 7 and 0. 593 8. It can well be concluded that MRI is more effective than 99 Tcm-MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.
Area Under Curve ; Bone Neoplasms ; diagnosis ; secondary ; Humans ; Magnetic Resonance Imaging ; Male ; Prostatic Neoplasms ; pathology ; ROC Curve ; Sensitivity and Specificity

Procedure of a bioelectric signal collection system for vivo critter is introduced in this paper. It is easy to measure the bioimpedance in the tip of appliance, when puncture into the tissue, especially puncture into the bone tissue. We can get a judgment on the position of appliance, thereby achieve assistance on the clinic operation.
Biopsy, Needle ; instrumentation ; Bone and Bones ; physiology ; Electrophysiological Phenomena ; Equipment Design ; Specimen Handling ; instrumentation

OBJECTIVE: To evaluate the effects of artificial dermis combined with negative pressure wound therapy on repairing wound aft er resection of cutaneous malignant tumor in elderly. METHODS: The clinical data of 34 hospitalized patients with cutaneous malignant tumor from July, 2009 to February, 2014 were retrospectively analyzed. The patients received local enlarged excision, artificial dermis covered wounds and 12-16 days of negative pressure wound therapy plus a free skin graft transplant on the surface with an artificial dermis. Recovery and complication aft er operation were assessed. RESULTS: All wounds were restored successfully with good appearance. None severe infection happened. CONCLUSION Artificial dermis combined with negative pressure wound therapy can repair wound efficiently aft er cutaneous malignant tumor resection was performed for old patients.
Aged ; Dermis ; Humans ; Negative-Pressure Wound Therapy ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Neoplasms ; surgery ; Skin Transplantation ; Skin, Artificial ; Wound Healing

Objective To investigate the relationship between neonatal asphyxia and meconium and fetal heart rate monitoring. Methods A total of 675 cases of newborns born birth selected from January 2012 to July 2013 in our hos-pital were retrospective analyzed, neonatal asphyxia were 131 cases, according to the degree of asphyxia they were di-vided into two groups, the mild asphyxia group had 75 cases, the severe asphyxia group had 56 cases. According to whether had meconium and the degree they were divided into four groups, the amniotic fluid clear group had 26 cases, degree Ⅲ neonatal pollution group had 31 cases, degree Ⅱ neonatal pollution group had 48 cases, degree Ⅰ neonatal pollution group had 26 cases. Results The neonatal asphyxia rate of neonatal pollution group was significantly higher than amniotic fluid clear group, the difference was significant (P<0.05). The fetal heart monitor newborns abnormal in-cidence of the amniotic fluid clear group were significantly higher than varying degrees of neonatal pollution groups, the difference was significant (P<0.05). The incidence of abnormal fetal heart monitor newborns of degree Ⅲneonatal pol-lution group, degree Ⅱ neonatal pollution group and degree Ⅰ neonatal pollution group were lower in turn, there was significant difference among three groups(P<0.05). Conclusion Neonatal asphyxia, meconium and fetal heart rate moni-toring correlation larger obstetric clinicians want to pay close attention to the whole process of childbirth, the incidence of neonatal asphyxia is significantly reduced.

Objective To study the treatment for orthodontic traction of the impacted tooth with glass ionomer cement to improve adhesion efficiency. Methods A total of 46 orthodontic traction of the impacted tooth cases (46 bonded or-thodontic attachments impacted teeth pulled) were selected from March 2005 to December 2012 with traction of im-pacted tooth in our hospital of stmatology department, 46 orthodontic patients were divided into two groups randomly.Following closed-eruption surgery. Experimental group were bonded with glass ionomer cement, the control group with enamel adhesive resin. Compared the failure rates for the first time and after half months. Results The success rate of the first bond, the experimental group was 100%, the control group was 52%. The expulsion rate after half months,0 for the experimental group, the control group was 25%. Initial success rate and after half months expulsion rates were significantly different between the two groups (P<0.01). Conclusion Impacted teeth should be routinely applied glass ionomer cement bonded orthodontic attachments to improve the success rate and reduce postoperative loss rate, to avoid the second surgery.