Objective:To investigate the value of preoperative slight decline of the pulmonary function in predicting postoperative cardiopulmonary complications (PCC) after left total pneumonectomy of lung cancer patients to guide the clinical surgery of lung can-cer. Methods:Clinical data of 200 lung cancer patients after left total pneumonectomy were retrospectively analyzed. These patients were divided into two groups (PCC and non-PCC) based on the incidence of postoperative cardiopulmonary complications within 1 month after the cancer resection. The relationship between the preoperative slight or moderate to severe reduction of pulmonary func-tion and postoperative complications was explored. The correlation between the preoperative slight decline of the pulmonary function index and PCC was also analyzed. Results:Among the 200 patients, 35, 45, and 120 demonstrated normal, slightly, and moderately to severely reduced pulmonary functions, and 28.6%, 53.3%, and 62.5% showed PCC within 1 month after the surgical resection (χ2=12.611, P=0.002). Significant differences in the slightly reduced pulmonary function parameters MVV% (70% ≤ MVV<80%) and FEV1%(70%≤FEV 1%<80%) were observed between those without and with complications (P=0.028 and 0.014). Further analysis indicated no significant difference between the patients with preoperative slight reduction of FEV1%only or of MVV%only (P>0.05). However, statistically significant differences were observed when both FEV1%and MVV%were slightly reduced (χ2=6.598, P=0.010). Conclusion:The preoperative slight reduction values of FEV1%and MVV%were the risk factors in predicting PCC after left pneumo-nectomy in lung cancer patients. The slightly reduced FEV1%or MVV%alone cannot influence PCC. Both slightly reduced FEV1%and MVV%were the risk factors of PCC. Perioperative management should be strengthened for these patients to lower the incidence of PCC.

Objective In order to explore the effects of trauma on MAC and its mechanism, the changes in MAC of sevoflurane and plasma ? endorphin were investigated in state of trauma. Methods Twenty New Zealand rabbits were randomly divided into control group and trauma group. MAP,CVP, P ET CO 2 and ECG were monitored continuously. The MAC of sevoflurane was measured in the two groups. In trauma group, the left femur of rabbits was fractured combined with parenchyma damage.Plasma ? endorphin concentration was assaied at various times in two groups. Results MAC of sevoflurane was 2 2%?0 2% in control group and 1 7%?0 2% in trauma group. Trauma induced increase of plasma ? endorphin concentration significantly 5min and 30min after trauma,? endorphin concentration increased by 44% and 52% in trauma group, respectively. Conclusions MAC of sevoflurane in rabbits is 2 2%?0 2%.Trauma can reduce MAC of inhalational anesthetic significantly. The endogenous ? endorphin releasing enormously induced with trauma may be one of the mechanisms to decrease MAC of inhalational anesthetics.

Objective To investigate the inhibitory effects of intensive insulin on myocardium expression of tumor necrosis factor alpha(TNF-?)in severely burnt rats and its correlative mechanism.Methods In eighteen SD rats the right jugular vein and the left ventricle were cathetetized,and were divided into three groups randomly:(1)the sham burn group,the rats were treated by sham burn;(2)the burn group,the rats were inflicted with 30%TBSA Ⅲ degree burn,and then given fluid resuscitation routinely;(3)the intensive insulin group,the rats received intensive insulin treatment after burn,and the liquid volume given was equal to the burn group.The level of plasma glucose contents,the left ventricular systolic pressure(LVSP)and left ventricular end-diastolic pressure(LVEDP)were recorded at 1,2,3,4,5,6h after burn,and animals were sacrificed at 6 hours after burn.The level of TNF-? in myocardium tissue was assayed by ELISA,and mRNA expression was determined by real-time PCR.Western blot was used to detect I?B? phosphorylation and degradation in left ventricle tissue.Meanwhile,burn serum-challenged cardiomyocytes were also used to detect the levels of insulin and LY294002,a specific insulin activation inhibitor,on the phosphorylation of I?B?.Results The animals showed stress hyperglycemia after burns,the function of heart was damaged(LVSP degraded and LVEDP increased),the level of TNF and the expression of mRNA in the myocardium increased apparently,I?B? phosphorylation and degradation increased in left ventricle tissue and burn serum-challenged cardiomyocytes.Given the intensive insulin treatment to keep the blood glucose level between 4.5 to 5.2 mmol/L,the function of heart was significantly improved,the level of TNF-? was apparently lowered,and the I?B? phosphorylation and degradation were significantly decreased.LY294002 could abolish the inhibitory effect of insulin,and it acted on the I?B? phosphorylation on burn serum-challenged cardiomyocytes model.Conclusion Intensive insulin may decrease the activation of NF-?B through diminishing the I?B? phosphorylation and degradation,which inhibit the transcription and expression of TNF-? in myocardial cell,and improve the heart function accordingly.

To prepare an experimental caprine model of tibia bone diaphyseal defect used in tissue engineering and defect repair with the tissue engineering method, 27 Chinese caprines were divided into 3 groups: blank, control, and test. The 20mm left tibia diaphyseal defect of each caprine was made and fixed with plates. The blank group was not filled with coral hydroxyapatite (CHAP) or bone marrow stroma cell (BMSc). The control group and the experimental group were filled with CHAP and CHAP/BMSc respectively. The results of three groups were evaluated by X ray examination, optical density index of X ray film and histology 4, 8, 12 weeks after operation. The biomechanical characteristics of the specimens of the CHAP group and the CHAP/BMSc group were tested by three point bending test 12 weeks after operation.The results showed that the optical density indices of X ray film of the blank group were not significantly different 4, 8, 12 weeks after operation and indices of the CHAP group were significantly smaller than those of the CHAP/BMSc group ( P

Objective To investigate the expression and clinical significance of CXC chemokine receptors 1 and 2 (CXCR1 and CXCR2) and CXCL8 in peripheral blood mononuclear cells (PBMCs) and liver biopsy tissues from patients with primary hepatocellular carcinoma (PHC).Methods Serum specimens were collected from 36 patients with PHC, 30 patients with liver cirrhosis and 28 healthy subjects.Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to measure the expression of CXCR1, CXCR2 and CXCL8 at mRNA level in PBMCs.Streptavidin-perosidase (SP) immunohistochemistry was used to detect the expression of CXCR1, CXCR2 and CXCL8 at protein level in liver biopsy tissues.Levels of C-reactive protein (CRP), alpha-fetoprotein (AFP) and ferritin (FER) in the serum specimens were detected by chemiluminescence immunoassay.Then the correlations between these markers were analyzed.Results All of the results showed that the expression of CXCR1, CXCR2 and CXCL8 at mRNA level in PBMCs from the PHC group were higher than those of the healthy control group (P<0.01) as well as those of the liver cirrhosis group (P<0.05).Up-regulated expression of CXCR1, CXCR2 and CXCL8 in patients with PHC were associated with the depth of tumor invasion, lymph node or distant metastasis, clinical stage and levels of CRP, AFP and FER in serum (P<0.05).The expression of CXCR1, CXCR2 and CXCL8 at protein level in liver biopsy tissues were also significantly increased in the PHC group in comparison with those of the healthy control group as indicated by the result of SP immunohistochemistry (P<0.05).Conclusion Levels of CXCR1, CXCR2 and CXCL8 in the patients with PHC are significantly increased and positively correlated with the levels of AFP, FER and CRP in serum, suggesting that the signal transduction process mediated by CXCR1, CXCR2 and their common ligand CXCL8 may play a key role in the pathological process of PHC.This study may provide a potential new strategy for immune intervention in hepatocellular cancer.

Objective:To investigate the expression levels of CXCR1,CXCR2 and their common ligand CXCL8 in peripheral blood mononuclear cells (PBMCs) and liver biopsy from the patients with hepatitis B related hepatocellular carcinoma and their clinical significances.Methods:Quantitative real time polymerase chain reaction (qRT-PCR) was used to detect the mRNA levels of CXCR1,CXCR2,CXCL8 in the peripheral blood mononuclear cells of thirty-six hepatitis B related hepatocellular carcinoma and the protein levels of CXCR1 and CXCR2 and CXCL8 in liver biopsy were detected by SP immunohistochemical method.The level of C-reactive protein in serum was determined by chemiluminescence immunoassay respectively.Then,the correlations between CRP and the mRNA of CXCR1,CXCR2 and CXCL8 were analyzed.Results:The mRNA levels of CXCR1 (0.952 7±0.197 2),CXCR2 (0.896 9±0.173 0),CXCL8 (1.771 9±0.248 9) in the PBMCs of hepatitis B related hepatocellular carcinoma were significantly higher than those in controls (P＜0.01).And the protein levels of CXCR1,CXCR2 and CXCL8 were also obviously increased in liver biopsy of hepatitis B related hepatocellular carcinoma (P＜0.05).In addition,there was positive correlations between the level of serum C-reactive protein and the mRNA expression of CXCR1 (r =0.54,P＜0.01),CXCR2 (r =0.49,P＜0.01),CXCL8 (r =0.63,P＜0.01).Conclusion:The levels of CXCR1,CXCR2 and CXCL8 significantly increased in hepatitis B related hepatocellular carcinoma patients and positively correlated with serum CRP,suggesting that CXCR1,CXCR2 and their common ligand CXCL8 signal transduction process may play a key role in the pathological process of hepatitis B related hepatocellular carcinoma,which may provide a new direction for the immune intervention therapy of hepatocellular carcinoma.

rdial interstitial fibrosis.

Objective To compare the effect of 5-fluorouridine(5-FUR) prodrug liposome on the cell proliferation and apoptosis in HEP-2 cells.Methods MTT assay was used to investigate the cell proliferation after 5-FU or 5-FUR prodrug liposome at the dose of 3.0,0.6,0.12 or 0.024 ?g/ml was added into the culture medium of HEP-2 cells for 72 h.Flow cytometry(FCM) was used to measure the cell cycle when the cells were treated with 0.17 ?g/ml 5-FU or 0.05 ?g/ml 5-FUR prodrug liposome for 72 h.The apoptosis of cells treated with 0.05 ?g/ml 5-FU or 5-FUR for 48 h were assayed with FCM.Results The IC50 of 5-FU on HEP-2 cells was 300% higher when compared with 5-FUR prodrug liposome.Treated with 5-FU and 5-FUR prodrug liposome respectively,HEP-2 cell lines were both arrested at S stage.the apoptosis rate of HEP-2 were(10.35?1.33)% and(21.57?0.11)% respectively.Conclusion Compared with 5-FU,5-FUR prodrug liposome inhibits the cell proliferation of HEP-2 cells more significantly,arrests more cells at S phase,and improves cell apoptosis.

Objective We aimed to compare the critical thinking ability between clinical nurses and college nursing students at different grades so as to provide scientific references for reform in nursing education and nursing practice. Methods A total of 287 clinical nurses and 656 nurses in grade one and grade three underwent the investigation by adopting Chinese version of critical thinking disposition inventory (CTDI-CV). Results The total scores of CTDI-CV of nursing students in grade one, nursing students in grade three and clinical nurses were (292.82±26.41), (284.71±26.20) and (290.58±24.87). Statistical difference existed between these groups. The scores of open-mindedness, inquisitiveness and maturity of judgement of nursing students in grade one and grade three were higher than that of the clinical nurses, while the scores of systematicity and self-confidence of critical thinking were less than that of the clinical nurses. Conclusions The current nursing education system needs further reform. At the same time we should also promote the transform of modern clinical nursing model.

Objective To evaluate the perioperative nursing and its efficacy in the blepharocoloboma reconstruction with island flap of frontal branch of superficial temporal artery. Methods A retrospective nursing experience was summarized in 5 patients undergoing blepharocoloboma reconstruction with island flap of frontal branch of superficial temporal artery. We paid attention to the mental nursing of patients besides the routine nursing.The growth of skin flap was scrupulously oberved and gave selective disposal when untoward problems occurred. Results The skin flap survived in four cases and epidermis necrosis with flap basis survive took place in one case.The color and quality of survived skin flap was similar to adjacent skin which could effectively protect eyeballs.No severe complications occurred. Conclusions Effective mental nursing and health instruction before operation and careful observation and nursing of skin flap after operation proved to be pivotal for successful operation.