Objective To explore the relationship of perioperative INVOS cerebral oxygen saturation (rSO2) and postoperative cognition function alteration of geriatric patients under combined intravenous and volatile anesthesia with creatine phosphate disodium to provide guidance for clinical anesthesia. Methods Sixty ASA I-II patients aged >60 years scheduled for selective abdominal surgeries or surgeries on lower limb were enrolled in the study. The patients were randomly divided into 3 groups of 20 patients: creatine phosphate disodium group 1 (CPD1), creatine phosphate disodium group 2 (CPD2), control group (C). All the patients were not premedicated with atropine 0.5mg until entering the operation room. Anesthesia was induced with intravenous infusion of propofol, fentanyl and cisatracurium slowly, and maintained by inhalational anesthetics sevoflurane 1 MAC plus intravenous infusion of propofol (6-8mg·kg-1·min-1) and remifentanyl (0.2-0.4μg·kg-1·min-1), and intravenous bolus cisatracurium (0.07-0.10mg·kg-1). After tracheal intubation, all the patients were mechanically ventilated with PETCO2 in the normal range. rSO2 was continuously monitored and recorded during the operation. The Mini-Mental State Examination (MMSE), Trailmaking Test and Grooved Pegboard Test were used to access cognitive function 24h before surgery and 4, 8, 12, 24h after surgery. Results (1) There were no significant differences in general status between the three groups (P>0.05). (2) The scores of MMSE, Trail-making Test and Grooved Pegboard Test were not different 24h before the operation between the three groups (P>0.05). (3) The scores of cognitive tests were higher in group CPD2 and group CPD1 than in group C (P<0.05), but the rSO2 was identical for the three groups (P>0.05). Conclusion CPD can reduce the occurrence of postoperative cognitive dysfunction in geriatric patients under combined intravenous and inhalational anesthesia.

OBJECTIVETo assess the risk factors for vulvar dystrophy.

METHODSAn epidemiological study was carried out. Data on 100 cases with vulvar dystrophy was reviewed and face to face interviewed with a uniform questionnaire including the manner of work, environmental temperature, habit of eating, mood, underwear wearing, autoimmune diseases, marriage, menstrual age, the quantity of menses, orders of pregnancy, and labor trauma of vulvar during delivery, vulvitis and urethritis ect. Univariable analysis and multivariate logistic regression analysis were carried out with 1:1 case-control methodology.

RESULTSMultiple conditional logistic regression analysis showed that vulvar dystrophy was positively associated with hot food (OR = 2.55, 95% CI: 1.24 - 5.25), mood (OR = 4.27, 95% CI: 1.96 - 9.29), order of pregnancy (OR = 3.37, 95% CI: 2.11 - 5.40), vulvitis (OR = 6.74, 95% CI: 2.66 - 17.09) and urethritis (OR = 11.02, 95% CI: 1.01 - 120.19). Vulviitis or urethritis increased 6.74 or 11.02 times the incidence of vulva dystrophy. Anger or nervous state contributed to the incidence of vulva dystrophy (OR = 4.27). Addict to hot food and order of labor also increased risk ratio for 2.55 and 3.37 times, respectively.

CONCLUSIONThe risk factors of vulvar dystrophy were: addict to hot food, often holding a angry or nervous state, increase of labors, having vulvitis and urethritis.

Diet ; Emotions ; Female ; Humans ; Multivariate Analysis ; Parity ; Risk Factors ; Vulvar Lichen Sclerosus ; etiology

OBJECTIVETo study the effect of maxillary sinus floor elevation by the Frialit-2 Bone Condenser for implantation.

METHODS11 patients underwent sinus floor lift by The Frialit-2 Bone Condenser and were inserted 14 implants. The time of following up was 10 - 21 months.

RESULTSThere were no implant loose or lost, no clinical complaint of maxillary sinus area, and X-ray exam showed well osseointegration.

CONCLUSIONSThe Frialit-2 bone condenser can be used for lifting sinus floor, and the sinus elevation without lateral access allows the insertion of implants with no additional surgical stress for the patients.

Alveolar Process ; surgery ; Bone Transplantation ; Dental Implantation ; methods ; Dental Implants, Single-Tooth ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; surgery

To investigate the resources of medicinal plant, such as wild Apocynum, supervised classification based on Principal Component Analysis (PCA) and texture feature were used to monitor wild medicinal plants from image captured by ZY-3 and World-view-2 and compare which satellite Image are more appropriate to monitor the wild medicinal plants. The research results shows that: for more complex growth conditions wild medicinal plants Apocynum, high-resolution images Worldview-2 is more suitable for its remote identification, the low-resolution satellite ZY-3 can only recognizes the wild medicinal plants which distributed intensively. If the study target distribution is more intensive and larger scale, and cultivated type medicinal plants, the use of satellite ZY-3 in low resolution remote sensing data to identify the target can be a good choice, it is not necessary to buy high-resolution data, in order to avoid waste of expenditure, for the scattered distribution, the high-resolution satellite imagery data may be indispensable to identify targets.
Apocynum ; chemistry ; growth & development ; China ; Conservation of Natural Resources ; Geographic Information Systems ; Plant Dispersal ; Plants, Medicinal ; chemistry ; growth & development ; Remote Sensing Technology ; methods

OBJECTIVE: To investigate the incidence of job burnout in policemen in female drug rehabilitation center and its correlation with self-efficacy and social support. METHODS: The General Condition Inventory,Maslach Burnout Inventory General Survey,Perceived Social Support Scale and General Self-Efficacy Scale were used to evaluate the mental health status of 254 policemen of female drug rehabilitation center. RESULTS: The scores of policewomen in emotional exhaustion dimension were higher than those of policemen( P < 0. 01). The policemen with length of service ≤15 years had the lower scores in emotional exhaustion and depersonalisation dimension than those with length of service > 15 years( P < 0. 05).The scores of ordinary policemen in emotional exhaustion dimension were hight than those of vice-officer level policemen( P < 0. 01). Policemen who were in contact with patients with acquired immune deficiency syndrome had higher scores in emotional exhaustion dimension than those who were not in contact with patients( P < 0. 05). Partial correlation analysis showed that the scores of 3 dimensions of job burnout( emotional exhaustion,depersonalization and lower sense of personal achievement) were negatively correlated with general self-efficacy( P < 0. 05). Emotional exhaustion was negatively correlated with social support and other related dimension scores( P < 0. 01). The depersonalization dimension score was negatively correlated with total score of social support,and the dimension scores of family support,friend support and other support( P < 0. 01). CONCLUSION: The job burnout of policemen working in female drug rehabilitation center are different by gender,length of service,position and different types of job. The correlation exists among job burnout,self-efficacy and social support in a certain degree.

OBJECTIVETo verify the rate of diagnostic fitting between the clinic and the indentification-aided for diagnosis and differential diagnosis system, for emerging infections diseases (EID) established.

METHODS314 cases of 49 kinds of contagious diseases diagnosed and another 186 patients with fever who not diagnosed were tested by the system.

RESULTSPreliminary verification was made in 314 cases diagnosed which classified to 49 kinds of contagious diseases of infectious diseases and the results showed that the coincidence rate of clinical diagnosis and first diagnosis of this system was 61.9%; the suggestive rate of first three diagnoses was 78.1%, and that of first five diagnoses was 86.6%. The diagnosis of another 186 patients with fever were diagnosed by the system and the results showed that the coincidence rate of clinical diagnosis and first diagnosis was 59.7%; the suggestive rate of first three diagnoses was 77.9%, and that of first five diagnoses was 85.4%.

CONCLUSIONSThe system can accurately suggest impossible diagnosis and differential diagnosis, and be useful for our medical work.

Clinical Laboratory Techniques ; Communicable Diseases, Emerging ; diagnosis ; Diagnosis, Differential ; Evaluation Studies as Topic ; Fever ; Humans ; Software

OBJECTIVETo evaluate the effects of autologous tumor vaccines in preventing recurrences of hepatocellular carcinoma (HCC).

METHODSFrom March 1999 to June 2003, 80 patients with HCC undergoing resections were randomly assigned into a tumor vaccine group (n=40) and a control group (n=40). Tumor vaccines, consisting of formalin-fixed HCC tissue fragments, biodegradable sustained-releasers of granulocyte-macrophage-colony stimulating factor, interleukin-2, and an adjuvant, were developed. Every vaccine group patient received 3 vaccinations at a 2-week interval and the control group just received the adjuvant. Delayed-type-hypersensitivity (DTH) test and recurrent rates were analyzed.

RESULTSEight patients of the vaccine group and five patients of the control group were lost in the follow-up. Thirty-two patients completed the tumor vaccine procedure and no essential adverse effects occurred. 23/32 patients developed DTH responses against the fragments of HCC. The follow-up averaged 34.3 months (from 15 to 55 months). 1-, 2-, 3-year recurrence rates of the vaccine group were 12.6%, 35.9% and 54.0%, respectively; 1-, 2-, 3-year recurrence rates of the control group were 31.6%, 61.3% and 72.1%, respectively. The recurrent rate was significantly better in the tumor vaccine group than in the control group (P = 0.037).

CONCLUSIONSAutologous tumor vaccine is a promising adjunctive modality to prevent recurrence of human HCC.

Adult ; Aged ; Cancer Vaccines ; therapeutic use ; Carcinoma, Hepatocellular ; surgery ; therapy ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; therapeutic use ; Humans ; Interleukin-2 ; therapeutic use ; Liver Neoplasms ; surgery ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Vaccination

OBJECTIVETo investigate the expression and its significance of retinoic acid receptor-beta (RAR-beta) in colorectal cancer.

METHODSRAR-beta was detected by immunohistochemistry methods and carcino-embryonic antigen (CEA) was tested by chemiluminescence immunoassay methods in normal tissues, paracancerous tissues and colorectal cancer tissues of 60 patients with colorectal cancer treated from January 2006 to January 2007. Above-mentioned data, together with the clinicopathological data of these 60 patients, were analyzed to figure out the expression and its significance of RAR-beta in colorectal cancer.

RESULTSThe expression rate of RAR-beta in tumor tissues (48%) was significantly lower than those in both normal tissues (87%) and paracancerous tissues (87%) (P < 0.05). And its expression was also significant lower in patients with lymph node metastasis (32%) and patients with advanced cancer (TNM stage III and IV) (29%) than in those without lymph nodes metastasis (60%) and those with early stage cancer (stage I and II) (69%). There was no significant differences among well, mildly and poorly differentiated cancer tissues. The CEA level rose in 20 patients, and its rising rate was remarkably higher in patients with lymph node metastasis (48%) and in patients with advanced cancer (52%) than those without lymph node metastasis (23%) and in early stage(14%).

CONCLUSIONSThe expression of RAR-beta decreases significantly in cancer tissues in patients with colorectal cancer, which may be related to the carcinogenesis of colorectal cancer; and its decreasing degree is correlated negatively with the lymph node metastasis and advanced clinicopathological stage. The expression level of RAR-beta may be a new prognostic indication of patients with colorectal cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Receptors, Retinoic Acid ; metabolism ; Young Adult

OBJECTIVETo investigate the changes in transforming growth factor beta 1 (TGF-beta1)/Smads signaling pathway in rats with chemical hepatocarcinogenesis.

METHODSFresh diethylnitrosamine (DENA) solution was administered in SD rats to induce hepatocellular carcinoma (HCC). The protein expressions of TGF-beta1, phosphorylated Smad2, Smad4 and Smad7 were detected in these rats with immunohistochemistry, and the mRNA expression of Smad4 was evaluated with RT-PCR.

RESULTSCirrhotic nodules occurred in the rats 8 weeks after DENA treatment, and HCC nodules were found 16 weeks after the treatment. In the normal liver tissue, very low levels of TGF-beta1 and Smad4 expressions, low Smad7 expression and high phosphorylated Smad2 expression were detected. The development of liver cirrhosis was accompanied by increased expressions of TGF-beta1, Smad4 and Smad7 but at 8 weeks after DENA treatment, the expression of phosphorylated Smad2 was significantly decreased, followed then by gradual increment till nearly the normal level. Twenty-two weeks after DENA treatment, Smad4 expression in liver tissue decreased markedly as compared with the levels at 8 and 16 weeks. The expressions of Smad4 and phosphorylated Smad2 in the HCC tissue was significantly lower than those in normal liver tissue.

CONCLUSIONHepatocarcinogenesis involves very complex mechanisms, can can be related partially to the decreased Smad4 and phosphorylated Smad2 expression and TGFbeta1 and Smad7 overexpression in advanced stage of liver cirrhosis.

Animals ; Diethylnitrosamine ; Liver Neoplasms, Experimental ; chemically induced ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Smad2 Protein ; metabolism ; Smad4 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

OBJECTIVETo investigate the value of vascular resection and reconstruction in resection of hilar cholangiocarcinoma.

METHODSThe clinical data of 17 patients with hilar cholangiocarcinoma received resection in combination with vascular resection and reconstruction from January 2000 to September 2009 was retrospectively analyzed. Among the 17 patients, 6 underwent portal vein segmental resection and end-to-end anastomosis, 3 underwent portal vein wedge resection, 1 underwent hepatic artery ligature, 2 underwent hepatic artery segmental resection and end-to-end anastomosis, 1 underwent portal vein arterialization, 1 underwent portal vein wedge resection and hepatic artery ligature simultaneously, 2 underwent portal vein segmental resection and hepatic artery segmental resection and end-to-end anastomosis simultaneously, 1 underwent portal vein segmental resection and right hepatic artery and gastroduodenal artery end-to-end anastomosis simultaneously.

RESULTSFour patients died and the mortality was 4/17. Three patients died of renal dysfunction followed with multiple organ dysfunction and 1 patient died of sepsis shock. Among the 13 survive patients, 6 had a smooth postoperative recover and 7 developed complications: 3 had bile leakage, 1 had respiratory failure, 1 had cholangitis due to obstruction of U tube, 1 had abdominal infection and thrombosis in portal vein system and 1 had portal vein stenosis and liver abscess. Follow-up investigation showed that the median survival time was 18 months and four patients still alive.

CONCLUSIONSCombination of vascular resection and reconstruction in the resection of hilar cholangiocarcinoma may help to improve the resection rate but still have a high postoperative risk. The complications of renal dysfunction should be alert during the postoperative observation. The procedure of hepatic arterial reconstruction may help to reduce postoperative morbidity.

Adult ; Aged ; Bile Duct Neoplasms ; surgery ; Cholangiocarcinoma ; surgery ; Female ; Hepatic Artery ; surgery ; Humans ; Male ; Middle Aged ; Portal Vein ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Treatment Outcome ; Vascular Surgical Procedures