Objective To investigate the effects of anesthesia on plasma level of endothelin(ET) and atrial natriuretic polypeptide (ANP) in patients undergoing upper abdominal surgery. Methods Thirty ASA Ⅰ -Ⅱ patients(14 male, 16 female), aged 31-68 years and weighing 41-82kg, undergoing elective upper abdominal surgery were divided into three groups with ten patients in each group: Ⅰ desflurane group,Ⅱ isoflurane group and Ⅲ propofol group. The patients were premedicated with intramuscular phenobarbital sodium O.1g and atropine 0.5mg. Anesthesia was induced with midazolam 0.lmg?kg-1, propofol 1 mg?kg-1, vecuronium .015mg?kg-1 and fentanyl 4?g?kg-1 . After intubation the patients were mechanically ventilated and PET CO2 was maintained with 1.0 MAC desflurane in group I or 1.0 MAC isoflurane in groupⅡ or propofol infusion at 60-70 ?g ?kg-1?min-1 in groupⅢ and vecuronium infusion at l-2?g?kg-1?min-1 . ECG, HR, BP, SpO2, PETCO2, end-tidal concentration of desflurane or isoflurane, tidal volume (VT), total compliance ( C?), Pplat, Ppeak were monitored during anesthesia. Blood samples were taken from peripheral vein before anesthesia(T1 ), after induction(T2), 10 min(T3), 50 min(T4) after skin incision and at the end of surgery(T5 ) for determination of plasma levels of ET and ANP by radioimmunoassay. Results (1) There was no significant difference in plasma levels of ET between group Ⅰ and Ⅱ , but ET level decreased significantly during isoflurane inhalation. (2) There was no significant change in plasma ANP level during anesthesia in group I but plasma ANP level decreased significantly at 50 min after skin incision in group Ⅱ and increased significantly at the end of operation in group Ⅲ . (3) MAP decreased significantly after induction in the three groups.Conclusions Anesthesia induced with propofol and maintained with isoflurane could be anesthesia of choice patients with airwayhyperreactivity in terms of plasma ET level which is a strong bronchial constrictor.

Aim To investigate the reversal effect of GP on the activity of P-gp in MDR-associated tumor cells and to develop a useful approach to inhibit the drug efflux in MDR-associated tumor cells.Methods MTT assay was used to detect the effect of GP on the cytotoxicity of cisplatin(DDP),vincristine(VCR) and doxorubicin(DOX).Flow cytometry was used to determine the influence of GP on the intracellular accumulation of DOX.Results GP synergistically increased the cytotoxity and the intracellular accumulation of DOX in K562/DOX cells;GP also increased the cytotoxity of DDP,DOX,and VCR in A549/DOX cells.However,the effect was relatively weak.Conclusion GP could increased the cytotoxity and the intracellular accumulation of chemotherapeutic drugs in MDR-associated tumor cells.GP may be a promising MDR modulator.

OBJECTIVE: To evaluate the utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies. METHOD: Fifteen patients with recurrent branchial cleft anomalies (fistula and cyst) undergoing functional neck dissection were retrospectively analyzed. RESULT: Complications included 2 incisions secondary healing, 1 postoperative choking persisting for 1 months and 1 Horner's syndrome. There was no recurrence after a follow up from 2 months to 6 years,except 2 cases were lost to follow-up. CONCLUSION Functional neck dissection is an effective and safe surgical management for recurrent second and third branchial cleft anomalies(fistula and cyst).
Adolescent ; Adult ; Branchial Region ; abnormalities ; surgery ; Child ; Female ; Humans ; Male ; Neck ; surgery ; Neck Dissection ; methods ; Recurrence ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the optimal surgical approach for resecting infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor. The aim of this study is to enhance therapeutic effect and reduce complications and sequelae. METHOD: Sixty-six patients with infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor were analyzed retrospectively from 1998-2004, including complains, symptoms, physical signs; histodiagnosis, image examinations and surgical approaches. RESULT: No recurrence was found in fifty benign tumor cases after 2 to 5 years, while in 16 cases with malignant tumor, four patients died in one year, 8 cases died in 2 to 4 years, and only 4 patients' survival time exceeded 4 years. CONCLUSION Extended maxillectomy is suitable for resecting primary carcinoma of maxillary sinus invading pterygomaxillary fossa, infratemporal fossa and /or parapharyngeal space tumor. also midface degloving approach is suitable for nasal primary cavity, nasal sinuses, nasopharynx and/or pterygomaxillary fossa tumor and localized malignant tumor. Trans-cervical combining mandibular split swing approach is suitable for parapharyngeal space tumor invading pterygomaxillary fossa and/or infratemporal fossa tumor. Trans-cervical jaw combining mandibulotomy is suitable for resecting parapharyngeal space, infratemporal fossa tumor for invading lateral skull base and pterygomaxillary fossa tumor.
Adult ; Aged ; Craniotomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Retrospective Studies ; Skull Base Neoplasms ; surgery

OBJECTIVE: To investigate the expression of COX-2 in both molecule and protein levels in laryngeal squamous cell carcinoma and the relationship between its intensity and histological grade, clinical stage and lymphoma metastasis. METHOD: By using emi-quantify RT-PCR and Immunohistochemistry, the expression of the COX-2 mRNA and COX-2 protein in laryngeal squamous cell carcinoma and polyp of vocal cord were examined. RESULT: Compared with the polyp of vocal cord tissue, the expression level of COX-2 mRNA and COX-2 protein in human laryngeal squamous cell carcinoma were significantly increased (P < 0.01). The intensity of COX-2 mRNA and protein expression increased as the laryngeal squamous cell carcinoma progresses developed. CONCLUSION COX-2 is high expressed in human laryngeal squamous cell carcinoma, and it may play an significant role in the growth, invasion and metastasis of human laryngeal squamous cell carcinoma. A combination of emi-quantify RT-PCR and immunohistochemistry is sensitive and specific for laryngeal neoplasms detection.
Adult ; Aged ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cyclooxygenase 2 ; genetics ; metabolism ; Female ; Humans ; Laryngeal Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; RNA, Messenger ; genetics

Summary: The expression of CD44v6 and its relationship with the development, progress, invasion and metastasis of laryngeal carcinoma was investigated. The expression and content of CD44v6 mRNA in tissuess were detected by both RT-PCR and FCM which were respectively extracted from normal laryngeal mucosa, leukoplakia of larynx, laryngeal papilloma, polyp of vocal cord, tissues of laryngeal carcinoma, metastatic and nonmetastatic lymph nodes of neck, and tissues close to carcinoma. The outcome of RT-PCR indicated that the expression rate of CD44v6 mRNA involved in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was the highest (90 %-100 %) compared with that of leukoplakia of larynx, laryngeal papilloma, tissues close to carcinoma by 0.5 cm (55.56 %-60.00 %) and that of normal laryngeal mucosa, polyp of vocal cord, nonmetastatic lymph nodes and tissues close to carcinoma by 1.0 cm was the lowest ( 13.33 %-20 %). The result from FCM was highly consistent with that from RT-PCR. It was suggested that CD44v6 was closely related with the development, progress, invasion and metastasis of laryngeal carcinoma. The outcome from the tissues close to carcinoma by different distance could do help to the determination of incisal edge in surgery abstractly.

Tsutsugamushi disease is an acute infectious disease caused by Rickettsia. Occasionally it has been reported in Macau, China. Critical cases are rare. Because the clinical manifestations of tsutsugamushi disease are non-specific and diverse, if not diagnosed and treated in time, the disease may progress to multiple organ dysfunction syndrome (MODS), severe acute respiratory distress syndrome (ARDS), and even death. A patient with tsutsugamushi disease complicated by MODS was admitted to the intensive care unit (ICU) of Kiang Wu Hospital in Macau, China on September 30, 2021. Combined with the history of outdoor activities (exposure to chigger mite larvae), clinical symptoms and signs (characteristic eschar of tsutsugamushi disease was found on the abdominal skin), related laboratory examinations (Weil-Felix test: negative). Diagnosis of tsutsugamushi disease with MODS. After admission, the patient was treated by anti-infection, correction of coagulation dysfunction, tracheal intubation and mechanical ventilation, noradrenalin to maintain blood pressure, continuous renal replacement therapy (CRRT), but the condition didn't improve significantly. We initiated veno-venous ECMO (VV-ECMO), which was initially setted blood flow to 5 L/min (70 mL·kg -1·min -1), rotate speed to 3 500 rpm, fractional concentration of inspired oxygen (FiO 2) to 1.00. Heparin was used as anticoagulant and activated coagulation time (ACT) was kept between 180 and 200 seconds. Meanwhile the speed of fluid removal in CRRT was adjusted. After 9 hours of ECMO support, the oxygenation improved, the blood flow of ECMO was reduced to about 4 L/min (58 mL·kg -1·min -1), rotate speed to 3 000 rpm. The patient's condition improved after 4 days of ECMO treatment and her ECMO flow rate and FiO 2 could be decreased gradually. On hospital day 5, ECMO was removed. Eight days on mechanical ventilation, the patient was successfully weaned and extubated. On day 11 of hospitalization, weaned the CRRT and turned to intermittent hemodialysis. The patient was transferred out of ICU due to her stable condition on the 12th day hospitalization. After that, her spontaneous urine output increased gradually. The functions of various organs returned to normal. After 36 days of hospitalization, she recovered and was discharged.

We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≽ 140 mmHg or diastolic blood pressure ≽ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88-0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11-1.16) in participants with zinc intake ≽ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.
Adult ; Humans ; Cohort Studies ; Zinc ; Diet ; Hypertension/epidemiology* ; Eating ; China/epidemiology*