Objective To evaluate the blood-saving efficacy of acute hypervolemic hemodilution (AHH)-hemostatics-intraoperative blood salvage (IOBS) in patients undergoing orthopedic surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, scheduled for elective orthopedic surgery under general anesthesia with an expected blood loss of 800 ml or more, were randomly divided into 4 groups ( n = 30 each) : AHH + IOBS + hemostatics group; IOBS + hemostatics group; AHH + IOBS group; AHH + bemostatics group. AHH was induced with 6% hydroxyethyl starch 130/0.4 15 ml/kg infused iv at a rate of 40 ml/min immediately after tracheal intubation until the time of immediately before skin incision, IOBS was performed immediately before skin incision. Intravenous hemocoagulase 2 kU and im hemocoagulase 1 kU were injected 10 min before skin incision. The total volume of fluid intake and output, HR, MAP and CVP were recorded during the operation. Vein blood samples were taken for determination of Hb, Hct, platelet counts (Plt), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration (Fib) .Results CVP was significantly lower in IOBS+ hemostatics group than in AHH + IOBS + hemestaties group ( P < 0.05), while no significant difference in CVP was found between AHH + IOBS and AHH + IOBS + hemostatics group and between AHH + hemostatics and AHH +IOBS + hemostaties group (P > 0.05). The volume of blood loss was significantly higher in AHH + IOBS group, and the allogenic blood transfusion volume was significantly higher, while the percentage of the patients without allogeneie blood transfusion and without FFP transfusion lower in AHH + hemostatics group than in AHH + IOBS + hemostatics group ( P < 0.05 or 0.01 ), but there were no significant differences in the above parameters between IOBS + hemostatics group and AHH + IOBS + hemostatics group ( P > 0.05). Hb, Hct, Plt and Fib were significantly higher in IOBS + hemostatics group than in AHH + IOBS + hemostafics group( P < 0.05), but there were no significant differences in the above parameters between AHH + IOBS and AHH +IOBS + hemostatics group and between AHH + hemostatics and AHH + IOBS + hemestatlcs group (P > 0.05 ). Conclusion The blood-saving efficacy of AHH-bemostatics-IOBS is good in patients undergoing orthopedic surgery and it is a safe technique.

Objective To compare the effects of hypertonic saline,acetic acid and acetic acid-hypertonic saline(AAHS) solution on the ablated volume produced by hepatic radiofrequency ablation(RFA) in rabbits in vivo,and to determine the optimal synergist for radiofrequency ablation.Methods Thirty big-ear white rabbits were equally divided into group A(RFA alone),group B(RFA with 36% NaCl injection),group C(RFA with 50% acetic acid injection),group D(RFA with 50% AAHS injection),group E(50% AAHS injection alone),and group F(36% NaCl injection alone),with five rabbits in each group.Follow-up exam with CT scanning was made.The experimental rabbits were sacrificed by stages.The livers were collected and fixed in 10% formalin.Both the longitudinal and transverse diameter of the necrosis lesion produced by radiofrequency ablation were measured,the results were compared among groups.Results The difference in the lowest impedance value between group A and other groups was statistically significant(P 0.997).The persistent time of group A was significantly shorter than that of both group B and group D(P

This article analyses the measures concerning how to improve the quality and ensure the effect of pre-graduate practice on the enlarging of enrollments of GDPU.By discussing the multi-aspects of pre-graduate practice,such as integrating concentrate practice with decentralization practice,setting up the steady practice base,double-tutor system,strengthening the monitor of practice,multi-model of practice,in combination with industry,education and research etc.the article explores the approach to the reform of mode of the pre-graduate practice.

ObjectiveTo evaluate the effects of two kinds of hemocoagulases, Reptilase and Baquting, on coagulation function during neurosurgical operation.Methods60 patients scheduled for craniotomy were randomly allocated into 4 groups to receive either normal saline as control (Group Ⅰ, n=15), Baquting 2 kU (Group Ⅱ, n=15), Baquting 4 kU (Group Ⅲ, n=15) or Reptilase 2 kU (Group Ⅳ, n=15) after propofol and isoflurane general anesthesia and before hypervolumic hemodilution with 6% HAES-steril 1000 ml. The blood samples were drown for testing routine blood parameters (Hb, HCT, PLT, RBC, etc.), coagulation parameters (PT, TT, APTT, INR, FIB), and sonoclotactivated clotting time (SonACT), rate of clot formation (CR) and platelet function (PF) using Sonoclot coagulation & platelet function analyzer before anesthesia, after anesthesia, at 20 min (HAES 500 ml infused), 40 min (HAES 1000 ml infused) and 120 min after the test drug was given, at the end of operation, and 24 h after operation.ResultsThere were an obvious prolongation or decrement in almost all parameters in all patients and restored to normal in the first day after operation. But the trends showed less changes in PT, TT, APTT, FIB, PF, CR in every Baquting and Reptilase groups compared with Group Ⅰ.ConclusionMedium hemodilution, coagulation and platelet dysfunctions happened during neurosurgical operation. Hemocoagulase can only partly but not significantly reverse the changes of hemostatic abilities in every group.

The PET tracer 5-([11C]methyloxy)-L-tryptophan (5-(11)CMTP) was prepared by nucleophilic fluorination and alkylation reaction via a two-step procedure in order to develop specific tumor probe. The biodistribution and microPET imaging of 5-(11)CMTP were executed. The results unveiled that the overall radiochemical yield with no decay correction was (14.6 ±7.2) %, the radiochemical purity was more than 95% and high uptake and long retention time of 5-(11)CMTP in liver, kidney and blood were observed but low uptake in brain and muscle were found, furthermore, high uptake of 5-(11)CMTP in tumor tissue was observed. It seems that 5-(11)CMTP will be a potential amino acid tracer for tumors imaging with PET.

Objective To explore the levels of IL-1β,IL-6 and tumor necrosis factor α (TNF α) in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage and their relationship with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).Methods The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and TNF α in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were measured with enzyme-linked immunosorbent assay (ELISA).Results The levels of IL-1β,IL-6,and TNFα in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were significantly higher than those of control group (P ＜ 0.05),but the increased time of these cytokines was different.Three cytokines in serum and the cerebrospinal fluid levels of IL-1β and IL-6 but not TNFα were significantly related to SIRS and MODS.Condusions The increased cytokine levels in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage may be related to SIRS and MODS,and the measurement of IL-1β,IL-6,and TNFαin serum,and IL-1β and IL-6 in cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage can be useful to predict and treat SIRS and MODS.

Objective To explore a method for repairing the appearance and function of the cheek aesthetic unit.Methods A single volume of 100 ml to 150 ml of tissue expander was implanted at the lower edge of the injury area on the cheek.The first injection was performed 5 days after the operation and twice a week after the injection.It took an average of about 4 months to complete the expansion,with 3-5 times over expanded.The lesions were resurfaced with the expanded flaps,and long term follow-up was observed for flap survival.Results 17 cases of cheek lesions had been successfully reconstructed,with the color,texture of the expanded flaps well matched to the surrounding skin after 3-12 months follow-up.The facial expression functions and configurations were satisfied.Conclusions Excessive expansion of the prefabricated skin flap of the jaw and neck can repair the cheek aesthetic unit successfully,which is a practical method and meets the needs of aesthetic unit repair.

Objective To investigate the protective effect of n-butanol extract from the roots of Potentilla anserina (NP) on hypoxic hippocampal neurons in neonatal rats.Methods Primary cultured hippocampal neurons were pretreated with different concentration of NP (0.25,0.0625,and 0.0156 mg/mL) before incubation in a low oxygen (0.1％) environment for 4 h.Cell viability was evaluated by Trypan blue staining assay.Lactate dehydrogenase (LDH) released by neurons into the medium was measured.The activity of superoxide dismutase (SOD) in cell cytosol was determined using nitroblue tetrazolium.Morphological changes and mitochondrial function were observed by transmission electron microscopy.Results Hypoxic injury could decrease the cells viability of neuron,enhance LDH release (P ＜ 0.05),decrease SOD activity,and increase mitochondrial injury.Pretreatment with NP significantly increased cell viability,decreased LDH release (P ＜ 0.05),promoted SOD activity (P ＜ 0.05),and remarkably improved cellular ultra-microstructure compared with the model group.Conclusion NP could protect the primary hippocampal neurons from hypoxic injury by attenuating mitochondrial cell death.

ObjectiveTo analyze the clinicopathological features and prognosis of gastric cancer patients with metastatic nodules of perigastric soft tissue. MethodsIn this study,1025 cases of gastric cancer received radical resection.According to the metastasis of perigastric soft tissue,patients were divided into metastatic group ( group MP,n =334 ),non-metastatic group ( group NMP,n =691 ).The clinicopathological features and prognosis were compared between the two groups. ResultsIn group MP,the ratio of upper,middle,lower,total gastric cancer was 25.8％,22.0％,51.4％,0.9％ and the ratio in group NMP was 33.2％,21.3％,41.3％,4.2％ respectively,showing significant higher ratio of upper and total gastric cancer in MP group(P =0.000). In group MP 47.3％ cases with tumor size ≥5 cm,significantly higher than that in NMP group(27％ ) (P =0.000).Lymph node metastatic ratio between 21％ -40％ and 41％ -100％ was found in 24.4％ and 37.3％ in MP group respectively,significantly higher than that of 12.9％,10.8％ in NMP group(P =0.000).20.1％ cases had distal metastasis in group MP,significantly higher than that of 4.1％ in group NMP(P=0.000).In group MP and NMP group,the ratio of Borrmann infiltration typing was 82.1％ vs.64.6％,the ratio of positive CEA was 21.2％ vs.11.4％,the ratio of lower or undifferentiation typing was 78.7％ vs.64.2％,all with significant difference (P =0.000 ). COX regression analysis showed the infiltration depth,organic invasion,lymph node metastatic ratio,M staging,Borrmann typing,metastatic nodules was the independent prognostic factors.Prognosis was significantly poorer in the cases with perigastric soft tissues than without ( P =0.000 ).Stratified analysis showed that irrespective of tumor size,infiltration depth,lymph node metastatic ratio,CEA value,Borrmann typing,differentiation degree,the mean survival time was significantly shorter in MP group than that in group NMP(P ＜ 0.005).In cases without distal metastasis,the prognosis was significant poorer in group MP than that in group NMP ( P =0.000 ),however,there was no significant difference between two groups in cases without distal metastasis ( P =0.076).ConclusionsPerigastric soft tissue metastasis was common in gastric cancer,more frequently seen in tumor ≥5 cm,or with organic invasion,lymph nodemetastaticration ≥ 21％, distalmetastasis, Borrmanninfiltrationtyping, loweror undifferentiation typing,positive CEA. Perigastric soft tissues metastasis was the independent prognotic factor for gastric cancer.

AIM:To evaluate the effect of lipoic acid ( LA) on LPS-induced Parkinson disease ( PD) model of mice.METHODS:Female C57BL/6 mice of 10-month-old were randomly divided into saline control group , PD group and LA group.The PD mouse model was induced by intranasal instillation of LPS .Assays of tyrosine hydroxylase , microglia and nuclear factor kappa B ( NF-κB) were performed by the methods of immunohistochemistry and Western blotting .RE-SULTS:Intranasal LPS instillation exhibited basic characteristics of PD model .However, LA administration significantly improved motor dysfunction , protected dopaminergic neurons from damage , and inhibited NF-κB activation in inflammatory microglia in the substantia nigra area of the brain .CONCLUSION:LA may exert a profound neuroprotective effect by an-ti-neuroinflammatory reaction to arrest the progression of PD .