Objectives To investigate the effect of carbon dioxide pneumoperitoneum on postoperative cognitive dysfunction and the level of serum NSE and S-100β protein in female patients undergoing gynecological laparoscopy. Methods 60 ASA physical status Ⅰ patients were divided two groups, group Ⅰ received no insufflation andconventional abdominal surgery ( n = 30) and group Ⅱ received abdominal insufflation and gynecological laparoscopy ( n =30). MMSE was recorded at several different time points, including one day before operation, 1, 6, 24, 48, 72h after operation, and before discharge. Serum S-100β protein and NSE was measured by ELISA before the beginning of operation ( or carbon dioxide pneumoperitoneum) and 1h after operation (or carbon dioxide pneumoperitoneum). Results MMSE values at 1,6,24,48,72h decreased significantly in group Ⅱ (24. 67 ± 1.47,25.97 ± 1.50,26. 77 ± 1.61,27.07 ± 1.87,27.37 ± 2. 06) after operation, compared with group Ⅰ (27.63 ± 1. 33,27.27 ± 0. 87,28.37 ± 0. 85,28.73 ±0. 78,29. 23 ±0. 86, P <0. 01 ). And the baseline value (29. 17 ±0. 76) of serum S-100β[(0. 114 ±0. 012,0. 086 ±0. 009) μg/L] protein and NSE [( 13. 720 ± 1. 330,12. 093 ±0. 697) μg/L] increased significantly at 1h after operation in group Ⅰ and Ⅱ compared with before operation [(0. 035 ±0. 030,0. 035 ±0.024;5.753±0.889,5.831 ±0.967)μg/L, P <0.01]. Serum S-100 β protein[(0. 114 ±0.012) μg/L] increased significantly at 1h after operation in group Ⅱ, compared with group Ⅰ [(0. 086 ±0. 009) μg/L,P < 0. 05], whereas NSE showed not difference [( 12. 093 ± 0. 697,13. 720 ± 1. 330) μg/L, P > 0. 05].Serum of S-100β protein and MMSE were significantly correlated w group Ⅰ and Ⅱ ( r = 0. 6412,0. 8126, P <0.01). Serum NSE was not correlated with the MMSE score in group Ⅰ ( r =0.4397, P >0.05),whereas NSE and MMSE had significant correlation in group Ⅱ ( r = 0. 7111, P <0. 01 ). Conclusions Carbon dioxide pneumoperitoneum in patients with gynecological surgery might affect postoperative cognitive function, and MMSE score was negatively correlated with serum S-100β and NSE proteins.

Otjective To study whether there is the apoptosis of neural cells and the expressionof Bcl-2 protein in intracerebral hemorrhage (ICH) in model of rats, for the further understanding the mechanism of the delayed damage of the neural cells around the hematoma after ICH. Methods Fifty SD rats were randomly divided into 5 groups, ten in each. With the Group A as the control, the rest 40 were used to set up intracerebral hemorrhage model. The brains were taken out at 12th, 24th, 48th and 72th hours, respectively. Apoptosis cells were detected with terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL), and the expression of Bcl-2 protein was detected with immunochemical stainging methed (SP). Results In the control group, no apoptosis cells and Bcl-2protein were detected. In rest groups, the apoptosis cells and Bcl-2 protein were expressed in different degree.Apoptosis rates verified and corresponded with the time after ICH, with the peak at 48th -72th hour after hemorrhage.The peak rate of apoptosis cells was (24. 50± 2.69)% and Bcl-2 protein expression was (20. 76 ± 1.97)% . There was significant difference between the experimental groups and control (P＜0.05), and no linear relationship between the apoptosis rate and the expression of Bcl-2 protein. Conclusion Apoptosis may be an important factor in the secondary trauma of ICH. There is a time leg after hemorrhage. All this is instructive to clinical treatment in time. Bcl-2 protein keeps increasing in a certain time after hemorrhage, but not synchronize with the cell apoptosis. This indicates that bcl-2 has the effect to reduce the apoptosis of neural cells.

Objective To explore the changes of the cardiac enzymes in the critical patients after operation and to analyze their relationship with the patient's condition level and the prognostic.Methods Fittyseven critical patients after operation were enrolled to observation group,and 55 small operation patients acted as control group.Their cardiac enzymes in three days after operation were detected and compared.Results The cardiac enzymes of the observation group increased significantly when compared with the control group(aspartate aminotransferase (AST) (153.1 ± 211.0) U/L vs (54.7 ± 39.0) U/L,t =3.404,P ＜ 0.01) ; lactic acid dehydrogenase(LDH) (381.0 ± 216.1) U/L vs (194.6 ± 75.3) U/L,t =6.050,P ＜ 0.01) ; creatine kinase (CK) (882.9 ±630.7) U/L vs (130.1 ± 71.8) U/L,t =8.796,P ＜0.01) ;creatinine kinase,MB isoenzyme (CK-MB)(314.3 ± 164.2) U/L vs (164.9 ± 87.7) U/L,t =5.979,P ＜ 0.01) ; α-hydroxybutyrate dehydrogenas(α-HBDH) (410.1 ± 327.6) U/L vs (27.8 ± 36.3) U/L,t =8.605,P ＜ 0.01) ; The fatality ratio was 24.6％ (14/57) in the observation group.The cardiac enzymes of the survival group existed significant difference compared with the death group(AST:(81.3 ± 40.5) U/L vs (373.6 ±342.1) U/L,t =5.585,P ＜0.01) ;LDH:(303.6±134.0) U/Lvs (618.6±250.1) U/L,t=6.064,P＜0.01) ;CK:(658.5±328.0)U/Lvs (1572.0±829.4) U/L,t =6.001 P＜0.01) ;CK-MB:(303.2±184.3) U/Lvs (738.6±445.6)U/L,t=5.242,P＜0.01) ;α-HBDH:(254.1±118.6) U/Lvs (499.3 ±147.6) U/L,t=6.320,P＜0.01).Conclusion Elevated myocardiac enzymes are common in the critical patients after operation.The change of the cardiac enzymes is related with the degree of disease and the wound.

Actins ; genetics ; Adolescent ; Cardiomyopathy, Dilated ; genetics ; Child ; Child, Preschool ; Desmin ; genetics ; Female ; Humans ; Infant ; Male ; Mutation

Total hip arthroplasty (THA) is a vital therapeutic tool for hip terminal disease. Frequently, hidden blood loss exists in the postoperation, which seriously affect the postoperative rehabilitation of patients. It is urgent need to solve the problem that how to fundamentally prevent and reduce hidden blood loss after THA. Although THA has its own operational reason in blood loss, and also relates to a variety of risk factors, the mechanism of hidden blood loss is not clear. Tranexamic acid has a significant role in preventing perioperative blood loss, and the correlation of hidden blood loss and fibrinolytic mechanism would be confirm necessarily in the future,which will produce positive significance in completing the mechanism of hidden blood loss.
Arthroplasty, Replacement, Hip ; adverse effects ; Humans ; Postoperative Hemorrhage ; etiology

OBJECTIVETo detect the clinical value of the ECT bone scan in evaluating of the situation of infection control after hip knee arthroplasty.

METHODSThe clinical data were retrospectively analyzed in 62 patients, including 34 males and 28 females with an average age of 68.8 years old ranging from 65 to 74 years. The results of ECT bone scan, erythrocyte sedimentation rate, C-reactive protein were used to assess periprosthetic infection. The patients with positive ECT and ESR on CRP were considered to have periprosthetic infection; however, the patients with two or more negative, indexes were considered to have no infection.

RESULTSThe sensitivity, specificity, accurate rate of ECT were 75.0%, 88.9%, 87.1% respectively; ESR 50.0%, 72.2%, 69.4%; CRP 62.5%, 81.4%, 79.0%. The combination of the three methods were 87.5%, 96.3% and 95.2%,

CONCLUSIONCompared with ESR and CRP, ECT is a more effective way in the diagnosis of periprosthetic infection, which has great value and is worth popularizing.

Aged ; Arthroplasty, Replacement ; adverse effects ; Blood Sedimentation ; Bone and Bones ; diagnostic imaging ; C-Reactive Protein ; analysis ; Female ; Humans ; Male ; Prosthesis-Related Infections ; diagnostic imaging ; Retrospective Studies ; Tomography, Emission-Computed ; methods

Aged ; Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; drug therapy ; mortality ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Mastectomy, Segmental ; methods ; Sentinel Lymph Node Biopsy ; Survival Rate ; Tamoxifen ; therapeutic use

Objective To investigate the relationship between day-night rhythm of blood pressure and left ventricular hypertrophy(LVH) in the elderly with hypertension. Methods According to the result of ambulatory blood pressure monitoring,60 patients were divided into two groups of normal day-night rhythm(n=34) and abnormal day-night rhythm(n=26).All patients were performed ultrasonic cardiography.The interventricular septal thickness(IVST),the left ventricular end diastolic dimension(LVDd)and the left ventricular posterior wall thickness(LVPWT) were recorded,and the left ventricular mass(LVM) and the left ventricular mass index(LVMI) were calculated according to the Devereux formula. Results There were no significant differences in age,body mass index,serum total cholesterol,triglyceride,fasting blood glucose,24 h mean systolic blood pressure,24 h mean diastolic blood pressure,day time mean systolic blood pressure,day time mean diastolic blood pressure,IVST and LVDd between the the two groups.However,there were significant differences in night time mean systolic blood pressure,night time mean diastolic blood pressure,LVPWT,LVM and LVMI between the two groups(P

Background Experimental autoimmune uveitis (EAU) is a common animal model of uveitis.Natural killer (NK) cells have been confirmed to be a type of strong inflammation-causing cells,but its role in EAU is still studing.Objective This study was designed to explore the role and mechanism of NK cells in the pathogenesis of EAU.Methods Thirty-six SPF Lewis rats were randomly divided into expeimental control group and EAU 6-,9-,12-,16-,and 21-day groups (6 rats for each group).Rats in EAU group received subcutaneous injection interphotoreceptor retinoid binding protein (IRBP) combining 5 mg/ml tubercle bacillus with complete Freund's adjuvant (CFA) emulsion in foot pads,and then 400 ng pertussis toxin was intraperitoneally injected to extablish EAU models in the EAU 6-,9-,12-,16-,and 21-day group,and normal saline solution combined with CFA and 400 ng pertussis toxin was used in the same way in the experimental control group.The inflammatory response was observed by slit lamp daily after modeling and scored based on Caspi criteria.The eyeballs were extracted in 6,9,12,16 and 21 days after modeling for retinal histopathological examination,Immunofluorescent double-staining was employed to detect and locate the expression of NK cells in the retina.In addition,25 model rats were divided into EAU 0-,3-,6-,9-and 12-day groups,with 5 rats for each group,and eyeballs were extracted to prepare tissue homogenate.The expression of CXCL10 mRNA,and CXCL12 mRNA NK cell chemokines,in the tissue homogenate was assayed by real-time quantitative PCR.The use and care of the rats followed Regulations for the Administration of Affair Concerning Experimental Animal by State Science and Technology Commission.Results No inflammatory sign in ocular anterior segment of the rats was seen in the experimental control group.The expansion of rat iris vessels was found in the EAU 6-day group,and exudes and hypopyon of the anterior chamber occurred in the EAU 9-day group and the inflammation peaked in the EAU 12-day gorup.The rat retinal structure was normal in the experimental control group,and the arrangement disorder of retinal structure,the cell separation in outer nuclear layer and damage of photoreceptors were found under the optical microscope in different degree in various EAU groups,with the most serious change in the EAU 12-day group.Immunofluorescent double staining showed normally arranged nucleus in the experimental control group,and a lot of NK infiltration was seen in the EAU 6-day group and peaked in the EAU 9-day group.The expression level of CXCL10 mRNA in the EAU 9-day group was 34.298 ± 16.689,which was significantly higher than that in the EAU 3-,6-and 12-day group,respectively (1.390 ± 0.660,3.359 ± 2.581,4.711 ±1.387) (all at P＜0.01).No significant differences were found in the relative expression of CXCL12 mRNA among different EAU groups (F=2.851,P＞0.05).Conclusions Retinal NK cell infiltration occurs in the early stage of EAU,and the severity of NK cell infiltration is consistent with the inflammatory process and CXCL10 expression,suggesting NK cells play an important role in the early stage of EAU,and CXCL10 is an important chemokine of NK cells in EAU rats.

· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.