Objective To study the effect of 3％ hypertonic saline(HS) and 20％ mannitol on cerebral oxygen metabolism in patients undergoing neurosurgery for supratentorial glioma.Methods 56 patients undergoing neurosurgery for supratentorial glioma were evenly divided into two groups.Group A(n =28) was treated by 3％ hypertonic saline(5.35ml/kg).Group B (n =28) was treated by 20％ mannitol(1 g/kg).CSFP was tested before hypertonic saline or mannitol infusion (T0),immediately (T1),15,30,60,120min after infusion (T2 ～5).Various blood-gas indexes were observed at To,T3 ～5.CaO2,CjvO2,Da-jvO2 and CERO2 were calculated.Results CSFP significantly dropped from T2 to T5 in both groups (P ＜ 0.05).Da-jvO2 and CERO2 were significantly reduced at T4～5 in both groups (P ＜ 0.05).There was no significant difference between the two groups.Conclusion 3 ％ HS is as efficient as 20％ mannitol in reducing intracranial pressure and improving cerebral oxygen metabolism in patients undergoing neurosurgery for supratentorial glioma.

Objective To determine the brain protective effects of inhalation anesthetic pretreatment in infants undergoing open-heart surgery under extracorporeal circulation (ECC).Methods Forty-five infants (no more than 3 years old) with congenital heart diseases who received surgical treatment were divided into 3 groups by table of random digit,sevoflurane pretreatment group (group S,15 cases),isoflurane pretreatment group (group Ⅰ,15 cases) and control group (group C,15 cases).In pretreatment group,all infants had been inhaled 1.0-1.5 MAC sevoflurane or isoflurane continually for over 60 min after intubation,while group C did not receive pretreatment.Blood samples were taken before (T1) and in 5 min after ECC (T2),occlusion of aorta (T3),30 min after ECC (T4),end ofECC (T4),and 6 and 24 h after the end of ECC (T6 and T7).Serum levels of S 100 β protein and neurone specific enolase (NSE) were measured by enzyme-linked immunosorbent assay.Results There was no significant difference in the serum levels of S100β protein and NSE among the 3 groups in T1 (P＞0.05).There was no significant difference in the serum levels of S100β protein and NSE in group S and group Ⅰ between T1 and T2-7 (P＞ 0.05).There was no significant difference in the serum levels of S100 β protein and NSE in T2-7 between group S and group Ⅰ (P ＞ 0.05).In group C,there were significant differences in the serum levels of S100 β protein in T4-6 and NSE in T4-7 than those in T1 (P＜ 0.05).In T4-6,the serum levels of S100 β protein and NSE in group S and group Ⅰ were significantly lower than those in group C [S100 β protein:(0.45 ± 0.31),(0.47 ± 0.35) μ g/L vs.(0.73 ± 0.31) μ g/L,(0.53 ± 0.33),(0.54 ± 0.36) μ g/L vs.(0.91 ± 0.30) μ g/L,(0.47 ± 0.34),(0.49 ±0.35) μ g/L vs.(0.79 ± 0.40) μ g/L,P ＜ 0.05； NSE:(3.26 ± 1.34),(3.32 ± 1.34) μ g/L vs.(7.20 ± 2.71)μ g/L,(5.57 ± 1.49),(5.61 ± 1.52) μ g/L vs.(7.68 ± 3.68) μ g/L,(2.29 ± 1.21),(2.34 ± 1.22) μ g/L vs.(9.46 ± 4.61) μg/L,P ＜ 0.05].Conclusion Sevoflurane or isoflurane pretreatment significantly decreases the serum levels of S100 β protein and NSE during open-heart operation in infants with ECC.

Long noncoding RNA ( lncRNA) is a functional RNA molecule longer than 200 nucleotides.They are involved in epigenetic, transcriptional and post-transcriptional modifications, playing an important role in gene expres-sion, chromatin remodeling, histone modification, X chromosome inactivation, genomic imprinting, protein folding and ac-tivity as well as other important biological events.Some studies have proven that lncRNAs are involved in the development of metabolic diseases.The changes of their expression levels may be new diagnostic markers and therapeutic targets.

Objective: To apply chromogenic in situ hybridization (CISH for detection of HER2 gene amplification in breast cancer tissues and to discuss some modifications of the CISH method. Methods: HER2 gene amplification was detected by CISH in 60 breast cancer specimens with an immunohistochemical score over 2+. The correlation between the results of IHC and CISH was analyzed. Our experience in CISH manipulation was summarized and optimization to CISH was discussed. Results: CISH identified gene amplification in 91% (40/44) specimens with an IHC score of 3+ and in 50% (8/16) specimens with an IHC score of 2+. The total concordance rate between IHC and CISH was 80% (48/60, P<0.01). The thickness of sections should be controlled within 4-5 μm; the denaturation should be complete; and the post-hybridization washing temperature and time were also very important and the temperature should be controlled at 70-75 °C. The dyeing time of hematoxylin should also be restrictedly controlled. Positive control should be set up in the experiment for high quality of the experiment. Conclusion: CISH has high concordance rate with IHC in examining HER2 amplification and it may be a new method for detection of HER2 gene. The thickness of the sections, the post hybridization washing temperature and time, and the time of hematoxylin dyeing should be strictly controlled.

Objective: To verify whether hot PBS washing after the enzymatic reaction between tyramine and horseradish peroxidase can improve the sensitivity and specificity of catalyzed signal amplification (CSA). Methods: Using 7 different types of primary antibodies and 2 tumor microarray system, we carried out En Vision, LSAB, Standard CSA, and modified CSA staining and compared their sensitivities and specificities. Results: The modified CSA method was the most sensitive one among the 4 methods, followed by standard CSA, En Vision, and LsAB method. The sensitivity of modified CSA method was 2-3 times higher than that of standard CSA. The 4 methods had similar background staining and had exact localization of cells. Conclusion: The modified CSA is more stable and sensitive than traditional CSA staining method.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Homeodomain Proteins ; biosynthesis ; genetics ; Humans ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Estrogen ; metabolism ; Transcription Factors ; biosynthesis ; genetics

AIM: To explore the nursing cooperation highlights of eight osteopetrosis patients underwent optic nerve decompression via transsphenoidal microsurgical approach instead of routine pathway, and to improve the quality of nursing cooperation. ·METHODS: We enrolled 8 cases ( left eye in 3 cases, right eye in 5 cases ) of osteopetrosis patients referred from the Eye Hospital of Wenzhou Medical University during February 2012 to November 2016. Patients received ophthalmic examinations including visual acuity and diagnostic imaging tests in pre-operation and post -operation. All eyes were performed surgical optic nerve decompression through endoscopic approach in assist of image guidance system. We retrospectively analyzed the clinical data and surgical cooperation procedure of these cases and summarized nursing cooperation experience. ·RESULTS:The operations of 8 patients were completed successfully without massive hemorrhage. Mean visual acuity improved from pre-operation (2. 5±2. 1) to post-operation (3. 4±1. 9). Cerebrospinal fluid leakage occurred in 1 patient and was instantly repaired during the operation. We performed the nursing strategy as postural drainage, condition monitoring and conscious assessment intra-and post-operation. ·CONCLUSION: It is the critical for this kind of surgery that both circulating nurse's high-skilled cooperation to the connection and operation of the navigation system, to treat with complication during the surgery, and scrub nurse's sufficient preparation of surgical instruments and consumables, proficient equipment delivery, meticulous management, use and maintenance of equipment.

Surgery is the mainstay treatment of the multidisciplinary therapy for gastric cancer. The majority of gastric cancer patients in China are diagnosed at the advanced stage. D2 lymphadenectomy is of clinical significance in China. The technical aspects of performing a D2 lymphadenectomy require a significant degree of training and expertise. In this article, the focus is on the dissection of lymph nodes including No.4Sb, No.5-6, No.8a, No.9-11, No.12a, and No.14-15.
Humans ; Lymph Node Excision ; methods ; Stomach Neoplasms ; surgery

OBJECTIVETo compare the therapeutic effect of Astragalus and Angelica Mixture (AAM) on treating CKD patients according to different CKD primary diseases, staging and TCM syndromes.

METHODSA multicentre, open-label, and self control clinical design was used, and thirty-two patients in line with inclusive criteria were recruited. Based on maintaining their previous basic CKD treatment, patients additionally took AAM (Astragalus and Angelica each 30 g), once a day, three months consisted of one therapeutic course. Serum creatinine (SCr), estimated glomerular filtration rate (eG- FR), 24 h urinary total protein (UTP), plasma albumin (ALB), hemoglobin (Hb), and changes of TCM syndrome factor integrals were compared before treatment, at the end of month 1, 2, and 3. The differences in the aforesaid indices were compared between CKD patients with different CKD primary diseases (chronic glomerulonephritis, chronic renal tubulointerstitial disease, hypertensive renal damage), different CKD stages (CKD 3 and CKD 4), and patients of qi-blood deficiency syndrome (QBDS) and non-QBDS.

RESULTSAAM could improve 78.12% (25/32) patients' renal function. Compared with before treatment, SCr decreased (12.08% +/- 10.11%), eGFR increased (21.14% +/- 18.55%), and ALB increased (2.76% +/- 1.97%) at the end of 3-month treatment (all P < 0.05). As for TCM syndrome factor integrals, compared with before treatment, the integrals for qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome decreased, while the integrals for dampness heat syndrome and turbid-toxin syndrome increased (all P < 0.05). There was no obvious difference in all indices except the integral for hypertensive renal damage patients of yin deficiency syndrome (P > 0.05). The SCr decreasing percent was 19.82% +/- 8.30% for patients of non-QBDS and 5.24% +/- 10.75% for patients of QBDS. The latter was higher with statistical difference (P < 0.05). As for TCM syndrome factor integrals, the integral differences of qi deficiency and blood deficiency were obviously higher in patients of QBDS, when compared with patients of non-QBDS (P < 0.05).

CONCLUSIONAAM could improve the renal function of CKD patients, elevate their ALB levels, and ameliorate associated qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome, especially for CKD patients of QBDS.

Adolescent ; Adult ; Aged ; Angelica ; Astragalus Plant ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Treatment Outcome ; Yin Deficiency ; drug therapy ; Young Adult

Objective To investigate the nerve recanalization and the motor function of hind legs after transplantation of peripheral nerve grafts treated with microsurgical technique at chronic spinal cord injury (SCI) in rats.Methods The SD rats were established into SCI model with improved Allen method.The rats were divided into two parts 12 weeks after the injury.In experimental group:by microsurgieal technique. the sural nerves were removed epineufium and transplanted into SCI lesion,control group rats were treated without any operation.Retrograde HRP tracing through sciatic nerve were practiced at 1 month,2 month,3 month after transplantation of peripheral nerve grafts.The morphological changes were observed at section of spinal cord and the motor functions of both hind legs of rat were detected.Results The morphology of the injured spinal cord sections turned better.Retrograde HRP tracing through sciatic nerve showed some HRP positive markers at the site of near rostral end of the nearly injured part at one month after transplantation and increased with the time going by.Motor function of hind legs of rats recovered significantly in transplantation groups.Conclusion Peripheral nerve grafts treated with mierosurgical technique have repairing effect on chronic spinal cord injury in rats.