Objective To compare the fibrinolysis in the patients undergoing nasal polypectomy under different methods of anesthesia.Methods Forty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective nasal polypectomy,were randomized into 2 groups (n =20 each) using a random number table:propofol-based anesthesia group (group P) and sevoflurane-based anesthesia group (group S).Venous blood samples were taken before induction of anesthesia (T1),at 30 min after the beginning of operation (T2),and at the end of operation (T3) for determination of the levels of plasma cortisol,adrenocorticotropic hormone (ACTH),D-dimer (DD),tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1).Results Compared with the baseline value at T1,the plasma cortisol and ACTH levels were significantly decreased at T2,and no significant change was found at T3 in the two groups,and there was no significant difference between the two groups.The plasma DD,t-PA and PAI-1 levels were significantly higher at T2,3 than at T1.Compared with group P,the plasma DD and t-PA levels were significantly decreased at T2,3,while the plasma PAI-1 level was increased at T2.3 in group S.Conclusion Propofol-based anesthesia provides higher degree of enhancement in fibrinolysis than sevoflurane-based anesthesia and it is more suitable for the patients undergoing nasal polypectomy.

The paper sums up experience in offering medical assistance to earthquake and tsunami victims in Algeria,Iran and Indonesia and discusses ways of strengthening cooperation between various rescuing teams and enhancing the efficiency and level of medical assistance,including exchanging medical assistance information in a timely and fast manner,jointly setting up emergency care stations in areas that could make use of the functions of the field hospitals,jointly conducting sanitation and anti-epidemic activities,resuming the treatment functions of clinics,grass-roots hospitals and large hospitals,and training medical workers.By strengthening cooperation between various international rescue teams,it is possible to bring into full play the advantages of each team,effectively use medical resources,and speed up the reconstruction of the medical systems in the disaster-stricken areas.

Objective To investigate the expression of c-Jun N-terminal kinase (JNK) and p38MAPK in autogenous vein graft during vascular remodeling. Methods Autogenous vein graft model was established in 80 Wistar rats. Vein graft samples were harvested at 6th hour, day 1, day 3, day 7, day 14, day 28, day 42 and day 56. Gene expression of JNK and p38MAPK were measured by reverse transcription-PCR and in situ hybridization. Western blot and immunohistochemistry were used to detect the protein expression and phosphorylation of JNK and p38 MAPK. Apoptosis of VSMCs was studied by TUNEL. Results The expression of JNK mRNA and p38 mRNA reached the highest level on the second week (26?10)% and (59?26)% respectively, P

Objective To investigate the effect of survivin antisense oligodeoxynucleotides(ASODN) on(intimal) hyperplasia(IH) in vein graft in rats.Methods Autogenous vein graft model was established in 60 Wistar rats by transplanting the interior jugular vein to common jugular artery using microsurgical technique.The rats were divided into 5 groups according to different processing methods,including survivin ASODN 50?g and 200?g,scramble ODN 200?g,control group and lipoectin+pluronic group.Vein graft samples were harvested at 1 or 2 weeks after surgery and histomorphologic methods were used to compare the degree of IH.Survivin mRNA was measured by RT-PCR.Western blotting and immunohistochemistry methods also were used to detect the expression of survivin and PCNA.Apoptosis of VSMC was dectected by TUNEL.Results IH was evident within 1 to 2 weeks after vein grafting,but was markedly inhibited by 50?g of survivin ASODN(P

Objective To study the effect of antisense RNA retroviral vector of mTOR on the proliferation of vascular smooth muscle cells(VSMC).Methods The conservative region of mTOR gene was inserted into pLXIN reversedly,then the vector was packaged in PT67 cells by transfection with lipofectamine and(transfected) to VSMC.The efficiency of antisense inhibition was verified,and the changes of p70S6k and(4E-BP1) were also determined at the same time.The proliferation activity was determined by flowcytometry and MTT.Results After the vector was successfully transfected to the cells.pLXIN-A-mTOR vector could(efficiently) decrease mRNA and protein expression of mTOR and p70S6k of the cell,while the expression of 4E-BP1 increased significantly.The cell cycle and proliferation activity of VSMC was also stunned in phase G_1.Conclusions The mTOR antisense retroviral vector,pLXIN-A-mTOR,has been constructed(successfully),which can significantly inhibit the proliferation of VSMC.

Objective To study the expression of mammalian target of rapamycin (mTOR) in autogenous vein graft. Methods Autogenous vein graft model was established in 64 Wistar rats. Graft vein was harvested 6 hours, 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 6 weeks and 8 weeks after transplantation. mTOR mRNA was measured by RT-PCR and in situ hybridization. Western blotting and immunohistochemistry methods were used to detect the expression of mTOR. PCNA expression was detected. Results The vein graft mRNA and protein expression of mTOR increased soon after transplantation. mTOR mRNA reached the peak 1 to 2 weeks after surgery [(48?18)% and (33?11)% respectively, P

BACKGROUND:Traumatic or iatrogenic dural defects can cause persistent cerebrospinal fluid leakage, even progressing to life-threatening purulent meningitis. In patients with meningitis combined with cerebrospinal fluid leakage, most antibiotics are unable to enter the cerebrospinal fluid, as the cerebrospinal fluid is a good medium for bacteria and there is the presence of blood-brain barrier. So meningitis presents with acute onset, rapid development and infection difficult to control. OBJECTIVE:To evaluate the outcome of continuous lumbar subarachnoid drainage plus intrathecal administration of antibiotics for postoperative cerebrospinal fluid leakage combined with meningitis after biomaterial repair of dural defects. METHODS: A retrospective study was carried out to review the 12 cases of cerebrospinal fluid leakage combined with meningitis among 126 of 2 266 cases who developed cerebrospinal fluid leakage (5.56%) undergoing spinal surgery from June 2008 to June 2013. During the operation, dural defects were directly sutured or repaired with autologous fascial sheet. Al cases underwent thorough debridement and intravenous injection of sensitive antibiotics folowed by continuous lumbar drainage and intrathecal administration of sensitive antibiotics (usualy vancomycin), and then the incision was closed at stage I. RESULTS AND CONCLUSION:The cerebrospinal fluid leakage was found in the 12 cases at 24-72 hours after surgery, averagely 48 hours; the infection was found at 812 days days after surgery, averagely 9.5 days. Headache and fever were significantly relieved at the 2nd day of intrathecal administration of antibiotics, and intracranial infection disappeared at 7-14 days after continuous lumbar drainage. Biochemical test of the cerebrospinal fluid and routine examination were done thrice, and the results were al normal. No bacterial growth was found in bacterial culture test, and the drainage tube was removed. There was no intraspinal infection, intracranial hypotension headache and hernia caused by the drainage tube. These findings indicate that autologous fascia repair combined with continuous lumbar subarachnoid drainage plus intrathecal administration of antibiotics is an effective method in the treatment of cerebrospinal fluid leakage with meningitis.

BACKGROUND:Spinal canal decompression reduction fixation combined with bone graft fusion has been extensively applied in the clinic. Bilateral pedicle screw assisted interbody fusion and unilateral pedicle screw assisted interbody fusion are main methods to treat degenerative lumbar spinal stenosis and lumbar spondylolisthesis. OBJECTIVE:To compare early clinical therapeutic effects of bilateral and unilateral pedicle screw assisted interbody fusion in elderly patients with spinal stenosis and degenerative spondylolisthesis. METHODS:A total of 60 elderly patients with spinal stenosis with degenerative lumbar spondylolisthesis were selected, including 37 males and 23 females, at the age of 60 to 78 years old. They were divided into two groups, and subjected to decompression of spinal canal. In the treatment group (n=30), patients received unilateral pedicle screw assisted interbody fusion. In the control group (n=30), patients received bilateral pedicle screw assisted interbody fusion. After treatment, they were folowed up for 1 year. The recovery of joint function was assessed using Japanese Orthopaedic Association scores in both groups. Simultaneously, complications were recorded. RESULTS AND CONCLUSION:Japanese Orthopaedic Association scores were 25.7±1.9 and 25.8±1.8 in the treatment and control groups, respectively, and no significant difference was found between groups. In the treatment group, three cases affected lower limb numbness and two cases suffered from dural tear, with the incidence of complication of 17%. In the control group, three cases affected lower limb numbness and three cases suffered from dural tear, with the incidence of complication of 20%; no significant difference was detected between the two groups. No adverse reaction related to bone graft was found in the two groups. These results confirm that bilateral or unilateral pedicle screw assisted interbody fusion in treatment of degenerative lumbar spondylolisthesis with spinal stenosis obtained good therapeutic effects.

Objective To evaluate the clinical factors of recurrent intracranial aneurysm with endovascular embolization.Methods DSA was performed in 70 cases with 74 intracranial aneurysms after endovascular embolized treatment,of them,8 cases(9 aneurysms)were detected having recurrent.The geometry form of aneurysms,embilized method,material of endovascular embolization and DSA images pre-and post-embolized were analysed.Results In all recurrent intracranial aneurysms,five located at posterior communicating artery,two at anterior communicating artery and two at the first crotch of right middle cerebral artery.Four were wide-necked aneurysms,five were irregular aneurysms in form.Before recurrence,three aneurysms were embolized completely,six were proportion occlusion.Conclusion Aneurysms localized at the branching region of artery,being wide-neck,large,irregular form and residual neck are facility factors for intracranial aneurysm recurrence after endovascular embolization.

OBJECTIVE:To analyze the utilization of drug included in the army of rational medicine directory in a military sanatorium in 2009.METHODS:To extrac convalescent medication data from a military sanatorium "military sanatorium information system",and analyze the drug use situation.RESULTS:The first 6-bit key role of drug consumption was the circulatory system drugs,anti-microbial drugs,a major role in the central nervous system drugs,clinical subjects medication,a major role in the respiratory system drugs,a major role in the digestive system drugs.CONCLUSION:The drug use of the military sanatorium for the convalecents basically matches the spectrum of convalecent disease.