It has long been concerned about the mechanism , pathology and toxicology of anaesthetic involving drug addiction and its influence on human body .In recent years , as a short non-coding RNA negatively regulating the genes in cells , MicroRNAs (miRNAs) may turn out to be a focus issue which is related to apoptosis , metabolism, inflammation, and tumorigenesis.This article illuminates the influence on gene expression introduced by common anaesthetics and the interaction between gene and its target site . Analyzing the potential medical applications of miRNA , this article reviews the correlation between miRNAs and anaesthetic to provide new evidences in this emerging field .

18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) and bone marrow biopsy (BMB) have high consistency in the detection of lymphoma bone marrow infiltration (BMI).18F-FDG PET/CT has a high sensitivity to Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL) BMI,while the sensitivity of indolent NHL is low.Since 18F-FDG PET/CT may appears false positive or false negative,so it can not replace the conventional BMB.We can carry out a BMB under the guidance of 18F-FDG PET/CT,which can greatly improve the detection rate of BMI.

Infection can complicate different stages of acute pancreatitis.The probability of infection is related to the existence and extent ofpancreatic necrosis: up to 30% of patients with pancreatic necrosis develop infection.The timing of infection is variable and usually peaks in the second to fourth week after the onset of pancreatitis.IPN(infected pancreatic necrosis)is the most common type of secondary pancreatic infection.Infectious complications in severe acute pancreatitis are associated with considerable morbidity and mortality.Antimicrobial therapy is one of the fundamental elements of therapy.Diagnosis of secondary pancreatic infection is challenging and radiologic characteristic (air bubble sign) and CT guided fine-needle aspiration (FNA) are reliable diagnostic strategies.Antibioticuse should be rational in terms of a rational indication, a rational spectrum, and a rationalduration.Prophylactic antibiotics are not beneficial in improving prognosis.The only rational indication for antibiotics is documented infection.The empirical antibiotics should cover common microbials of hospital-acquired intra-abdominal infection and with good pancreatic penetration.Also, fungal infections are often present in thesepatients, and early diagnosis and antifungal coverage should be considered.Duration is in fact largely determined by the presence and efficacy of source control.When there is no or minimal residual infection left after a source control procedure, a duration of 7 to 10 days is probably sufficient.On the other hand, if the source of infection has not been removed completely, prolonged courses until the residual necrosis has been sterilized are necessary.

Angiotensin II ; metabolism ; Animals ; Male ; Muscle, Skeletal ; Muscular Atrophy ; etiology ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley

Objective To analyse the maternal and perinatal morbidity after 40 weeks and postdate pregnancy,and to research suitable time of labor induction. Methods Clinical data of 357 pregnant women after 40 weeks with normal menstrual period were analysed.They were divided into four groups according to the different weeks of gestation. Results There were no significant difference in the four groups for maternal and perinatal morbidity,the rate of spontaneons labor,the degree of cervical repine and the successful rate of labor induction.The successful rate of artificial rupture of membranes was higher in the groups with Bishop score ≥6(P

ADAM Proteins ; blood ; ADAMTS13 Protein ; Adult ; Case-Control Studies ; Female ; Fluorescence Resonance Energy Transfer ; Humans ; Male ; Middle Aged ; Purpura, Thrombotic Thrombocytopenic ; blood ; diagnosis ; Young Adult

Objective To evaluate the effect of controlled decompression on complications such as delayed intracranial hematoma,acute encephalocele and cerebral infarction in patients with severe traumatic brain injury.Methods Pubmed,Cochrane Library,Wanfang data,VIP and CNKI wcrc searched for related literaturc about controlled decompression (treatment group) and traditional surgical methods(control group) for severe traumatic brain injury.The data that met the inclusion criteria were extracted,and analyzed statistically using the Review Manager 5.3.Results A total of 12 studies were included in this meta-analysis,with respective 730 patients in control group and 908 patients in treatment group.Controlled decompression versus traditional treatment methods reduced incidence of delayed intracranial hematoma (RR =0.55,95％ CI 0.44-0.70,P ＜ 0.01),acute encephalocele(RR =0.42,95％ CI 0.32-0.53,P ＜ 0.01) and cerebral infarction (RR =0.42,95％ CI 0.32-0.55,P ＜0.01).Conclusion Applied to treat severe traumatic brain injury,controlled decompression exhibit significantly lower rate of delayed intracranial hematoma,acute encephalocele and cerebral infarction than traditional methods.

Objective To assess and compare the roles of plasma concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis and treatment of septic acute kidney injury (AKI) in adult Surgical critically ill patient . Methods One hundred patients were divided into two groups ,the group of 63 cases of AKI and AKI group of 37 cases ,plasma NGAL and Cystatin C level of the 2 groups were determined by the method of enzyme‐linked immunosorbent (ELISA) ,latex en‐hanced immune turbidimetry (PETIA) respectively on arrival in the surgical intensive care unit(SICU) (T0 ) and 24 h after arrival in SICU(T1 ) .Results Compared with patients in non AKI group ,both plasma NGAL and Cystatin C level of patients in AKI group on T0 and T1 increased significantly ,the difference between the two groups had significant statistical difference (P<0 .01);Although ,plasma NGAL on T1 performed less well (AUC=0 .69) ,with a threshold value of 92 ng/mL(70 .3% sensitivity ,57%specificity) .Plasma NGAL showed significant discrimination for AKI diagnosis (AUC=0 .85) with a threshold value of 65 .95 ng/mL(81 .8% sensitivity ,76 .2% specificity) on T0 .Both plasma Cystatin C on T0 and T1 worked well for the diagnosis of AKI (AUC=0 .90 ,0 .88 ,thresholds 1 .49 and 1 .47 mg/L ,respectively) ,with diagnostic sensitivity of 89 .2% ,82 .5% respectively ,speci‐ficity of 83 .8% ,76 .2% respectively .Conclusion Plasma NGAL and Cystatin C are useful markers in predicting AKI in surgical critically ill patients ,the early diagnosis value of plasma Cystatin C for AKI is better than plasma NGAL on arrival in the surgical intensive care unit .

Objective To evaluate feasibility of high frequency jet ventilation (HFJV) during trachea and carinal reconstruction. Methods Ten patients with lung cancer ,scheduled for elective trachea and carinal reconstruction ,were intubated with double lumen tube following routine anesthesia induction. A HFJV tube (ID=3mm) was inserted 3cm into main bronchus. HFJV was applied ,with the respiratory rate of 120/min,I:E=1:2 and drive pressure of 0.15-1.20MPa, after cut off the main bronchus of the opposite side. Blood gas analysis was made before the operation, 15min following one-lung ventilation, 5, 10, 20 min following HFJV and 15min following one-lung ventilation,respectively.Results PaO 2 was significantly higher following HFJV than that one-lung ventilation (P

Objective To investigate the effects of different positions of the patients mechanically ventilated under general anesthesia on respiratory mechanics during one or both lung ventilation before thoracotomy.Methods Twelve ASA Ⅰ or Ⅱ patients of both sexes (8 males, 4 females) aged 33-63 years weighing 62-85 kg scheduled for general thoracic surgery were studied. The preoperative lung function of the patients was normal. The patients were premedicated with intramuscular pethidine, promethazine and atropine. Anesthesia was induced with fentanyl, droperidol, midazolam, propofol and vecuronium. Left-sided double-lumen tube was inserted and correct placement was confirmed using a fiberoptic bronchoscope inserted through the bronchial lumen. Anesthesia was maintained with propofol and vecuronium infusion. The magnitude of neuro-muscular blockade was monitored by stimulation of radial nerve with TOF pulses. T4/T1 was maintained at 0 during study. The patients were placed in supine, left and right lateral position. In each position both lungs, left and right lung were ventilated for 10 min respectively. The non-ventilated bronchial lumen was open to the air during one-lung ventilation. The ventilatory parameters were kept unchanged during the study (VT = 8-10 ml?kg-1 , RR = 12 bpm, I:E = 1:2). Pressure-volume loop (P-V loop), peak airway pressure (Ppeak), airway resistance (Raw), total compliance (CT) (lung and thorax) and PETCO2 were measured and recorded at the end of each 10 min ventilation using S/5 monitor ( Datex-Ohmeda Finland) . Results During both lung ventilation Ppeak was significantly increased and CT was significantly decreased in left and right lateral position as compared with supine position ( P