Objective To compare the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients using differentanesthetic methods.Methods Ninety-three ASA Ⅱ or Ⅲ patients,aged ≥ 65 yr,weighing 45-67 kg,scheduled for artificial femoral head replacement,were randomly divided into 2 groups:general anesthesia (group G,n =47) and combined spinal-epidural anesthesia group (group S-E,n =46).In group G,anesthesia was induced with iv injection of midazolam 0.1 mg/kg,propofol 2 mg/kg,fentanyl 3-5μg/kg,and vecuronium 0.1 mg/kg,and maintained with continuous infusion of propofol 2-3 mg· kg-1 · h-1,intermittent iv boluses of fentanyl 1 μg/kg and vecuronium 0.04 mg/kg and inhalation of 1.5％-2.0％ isoflurane.In group S-E,hyperbaric 0.5 ％ ropivacaine 2 ml was injected into the subarachnoid space over 20 s,the patients were kept in the original position for 15 min,the level of anesthesia was simultaneously adjusted to below T8 on the operated side,and 0.5 ％ ropivacaine 3-5 ml was injected into the epidural space when needed during operation.Cognitive function was assessed by mini-mental state examination at 24 h before anesthesia and 24 and 72 h after operation.Venous blood samples were collected for determination of plasma amyloid-beta levels by ELISA.Results Compared with group G,the incidence of POCD at 24 h after operation and level of plasma amyloid-beta were significantly decreased in group S-E (P ＜ 0.05).Conclusion Elderly patients are more likely to develop POCD under general anesthesia than under combined spinal-epidural anesthesia.

Objective To investigate the effects of exogenous glial cell derived neurotrophic factor (GDNF)on colon glial cells in slow transit constipation (STC ) rats,and to explore the optimal concentration of GDNF in order to provide evidence for intestinal neurotrophic therapy in the treatment of STC.Methods A total of 132 SD rats were divided into STC group and control group,66 rats in each group.STC rats were established by feeding with rhubarb.Six rats were randomly selected from either groups to verify whether STC model was successfully established.And the left 120 rats of two groups were randomly divided into six subgroups:STC group one to group six and control group one to group six,ten rats in each group,which were untreated,injected through tail vein with saline,and 0.001 ,0.010, 0.050,0.100 μg/L GDNF 2 mL respectively for one week.The expression of Sox-8 at protein level of either group were detected by Western blotting.Independent sample t test was performed for statistical analysis.Results After treated with 0.001 μg/L GDNF (STC group three),there was no significant
difference in expression level of Sox-8 between STC group three and STC group one (13.38 ±0.70 vs 13.39±0.45 ,t = 0.042,P = 0.969 ).After treated with 0.010 μg/L GDNF (STC group four),the difference in expression level of Sox-8 between STC group four and STC group three was significant (21 .11 ±2.56 vs 13.38±0.70,t=5 .040,P <0.01).After treated with 0.050 μg/mL GDNF (STC group five),the expression level of Sox-8 was higher than that in STC group four (31.86±1.57 vs 21.11±2.56,t=-6.198,P <0.01 ).The Sox-8 expression of untreated,saline treated,0.001 and 0.050 μg/L GDNF treated STC rats (STC group one,two,three and five)were lower than those of the corresponding control groups (t= 3.394,12.103,10.302,- 6.120,all P < 0.05 ).Conclusion Exogenous GDNF could increase Sox-8 expression in colon tissue of STC rats,an increase in the number of colon glial cells could repair enteric nervous system,and 0.050 μg/L was the optimal concentration.

Objective To investigate role of interleukin-1?(IL-1?),interleukin-8(IL-8),tumor necrosis factor-?((TNF-?)) and insulinlike growth factor-1(IGF-1) in meconium aspiration syndrome(MAS) in newborns.Methods The concentrations of(IL-1?),IL-8,TNF-? and IGF-1 in peripheral serum were detected in 32 newborns with MAS and 15 normal newborns by radio-immunity at the first,the third and seventh day after being born.Correlations between IGF-1 and changes of IL-1?,IL-8,TNF-? was analyzed.Results Compared with control group,the concentration of IL-1?,IL-8 and TNF-? increased significantly in newborns with MAS in three days after being born(all P0.05).On the other hand, the concentration of IGF-1 in newborns with MAS was obviously lower than that of normal newborns one week after birth.The concentration of IGF-1 showed negative correlations with that of IL-1?,IL-8 and TNF-?(r=-0.67,-0.61,-0.73 all P

ObjectiveTo discuss the effect of neonatal behavioral neurological assessment (NBNA) and developmental screening test (DST) on newborns with hypoxic ischemic encephalopathy (HIE). MethodsNBNA was performed for 60 newborns with HIE within 12-14 days and DST was also performed at 6th month after birth.ResultsMild and severe degree HIE newborns with low NBNA scores had unfavorable prognosis. Conclusions NBNA and DST can provide evidence for early interference for newborn's HIE.

Objective:To investigate the curative effect and safety of Stoppa approach combined with iliac fossa approach in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture, and to provide a scientific evidence for its application in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture.Methods:Sixty-three patients with coxafossa anterior column or coxafossa dual column bone fracture were selected;among them 32 cases were treated with stoppa approach combined iliac fossa approach(Stoppa group),and 31 patients were treated with ilioinguinal approach(control group).The intraoperative blood loss volume,the operaton time,the reset quality of fracture and hip joint function after operation of the patients in two groups were evaluated.Results:The intraoperative blood loss volume of the patients in Stoppa group was lower than that in control group, and the difference was statistically significant (P<0.05).The operation time of the patients in Stoppa group was shorter than that in control group, and the difference was statistically significant (P<0.05).The reset quality of fracture of the patients in stoppa group was higher than that in control group, and the difference was statistically significant (P<0.05).The hip joint function of the patients in Stoppa group was higher than that in control group, and the difference was statistically significant (P<0.05).Conclusion:Stoppa approach combined with iliac fossa approach is an effective method in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture with sufficient exposure and tiny tissue damage.Stoppa approach combined with iliac fossa approach in the treatment of the patients with coxafossa anterior column or coxafossa dual column bone fracture has the advantages of shorter operative time,less blood loss, higher rate of anatomic reduction,and good joint function.

BackgroundMonocyte chemotactic protein-1 (MCP-1)plays an important role in the tumor,inflammation,diabetic retinopathy and other neovascular disease,but the expression and the role of MCP-1 in the oxygen induced retinopathy(OIR) model have rarely been reported. Objective This study was to investigate the expression of MCP-1 in the retina development of newborn mouse and in mouse models with OIR.Methods C57BL/6J newborn mice were divided into two groups and 60 mice in each group.Mice in OIR group were exposed to 75％ oxygen for 5 days and then to room air.All mice in normal control group exposed to room air only.Ten mice in each group were randomly chosen and sacrificed at postnatal 5,7,12,14,17,21 days.The expression of MCP-1 in mouse retina was detected with the method of immunohistoehemistry and reverse transcription polymerase chain reaction(RT-PCR).Results MCP-1 positive cells were seen in normal mouse retina.Up-regulation of MCP-1 positive cells was detected both in 12 days in normal control group and in 14 days in OIR group.MCP-1 mRNA was detected in mouse retina at 5 days,and a transient up-regulation of MCP-1 mRNA was observed in 12 days in normal control group.MCP-1 mRNA in OIR group significantly increased in 14 days in comparison with the normal control group( P =0.028,P =0.001 ). Conclusions Expression of MCP-1 is detectable in whole retinal development procession of mice.A transient up-regulation of MCP-1 expression is detected in the critical period of retinal vascular development in mice models with OIR,which is closely related to the retinal vascular development and progression of retinal new vessels.

· AIM: To study the in situ relative intraocular position of the iris-claw phakic intraocular lens (PIOL)for high myopia using an anterior chamber optical coherence tomography (AC OCT)prototype.· METHODS: Six PIOLs (11.50 to 22.00D lens powers) were implanted in phakic myopic eyes. Using AC OCT, tomography was taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens.· RESULTS: Preoperative anterior chamber depth ranged from 3.27 to 3.91 mm and the postoperative endothelial-optic distance measured 2,07 to 2,24 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.82 to 1.32 mm. Several tomography revealed the position of the PIOL on the iris, The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL.· CONCLUSION, The original anterior chamber depths were reduced by 36,1% to 44.6% after implantation. This study of 6 eyes revealed that tomography taken by AC OCT are useful in verifying the intraocular position of the PIOL within the anterior chamber. Adequate space was maintained between the iris-fixated phakic intraocular lens and the corneal endothelium, angle, and crystalline lens.

Cell Membrane ; metabolism ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Proto-Oncogene Proteins c-kit ; analysis

Animals ; Bone and Bones ; drug effects ; Dental Cements ; chemistry ; pharmacology ; Rats ; Tooth ; drug effects

We report one case of pediatric acute myeloid leukemia type 2 (AML-M2) who presented with karyotypic aberration of trisomy 21 with the t(5;ll) chromosomal translocation.The patient achieved complete remission after two cycles of chemotherapy of daunorubicin,cytarabine and etoposide.Then,follow-up cytogenetic analysis from bone marrow cell cultures demonstrated a normal karyotype of 46,XY.After 9 years,the patient relapsed and the karyotypic abnormalities of trisomy 21 with t(5;ll) reappeared.It was concluded that trisomy 21 with t(5;11) is a new unfavorable cytogenetic aberration in AML-M2.