Objective To investigate the effect of parecoxib on intrapulmonary shunt during one-lung yentilation in patients undergoing esophageal cancer operation. Methods Forty-five ASA Ⅰ orⅡ patients of both sexes aged 47-57 yr weighing 42-59 kg undergoing esophageal cancer resection were randomly divided into 2 groups:control group (group C,n = 23) and parecoxib group (group P,n = 22). Left radial artery and right internal jugular vein were cannulated for MAP and CVP monitoring and blood sampling. Parecoxib 40 mg in 10 ml of normal saline was injected iv slowly before induction of anesthesia in group P while in group C normal saline 10 ml was injected instead of parecoxib. Anesthesia was induced with TCI of propofol (Ce 4 μg/ml) and sufentanil (Ce 0.3 ng/ml). Insertion of double lumen tube was facilitated with rocuronium 0.9 mg/kg. Correct position of the double lumen tube was verified by fiberoptic bronchoscopy. Anesthesia was maintained with TCI of propofol and sufentanil and intermittent iv boluses of cis-atracurium. BIS was maintained at 50-55 during operation. MAP, HR, CVP,mean airway pressure were monitored and recorded after induction of anesthesia (To), at 15, 30 min and 1 h of OLV (T1.2.3) and 30 min and 1 h after re-expansion of the collapsed lung (T4.5). Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt (Qs/Qt) was calculated.Results There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs/Qt during onelung ventilation between the two groups. Conclusion Parecoxib has no effect on hypoxic pulmonary vasoconstriction during one-lung ventilation in patients undergoing esophageal cancer resection.

Objective To evaluate the effects of dexmedetomidine on the expression of tumor necrosis factor-α(TNF-α) and intercellular adhesion molecule-1 (ICAM-1 ) during cerebral ischemia-reperfusion (I/R ) in rats .Methods Thirty-six male Sprague-Dawley rats , aged 8-12 weeks ,weighing 280-320 g ,were randomly divided into 3 groups ( n= 12 each ):sham operation group (group S ) , cerebral I/R group (group I/R ) and dexmedetomidine group (group D ) .The animals were anesthetized with 10% chloral hydrate 3.5 ml/kg .The focal cerebral ischemia was induced by middle cerebral artery occlusion using a nylon thread with rounded tip inserted into internal carotid artery and advanced cranially until resistance was met .In group D ,dexmedetomidine 3μg/kg was injected intravenously immediately after beginning of ischemia ,followed by infusion at 3μg·kg-1 ·h-1 for 120 min ,while the equal volume of normal saline was given in group I/R .Four rats from each group were chosen at 24 ,48 and 72 h of reperfusion , and blood samples were taken from the left ventricle to determine the concentrations of serum S100B protein .The rats were then sacrificed and the brains were removed to determine the expression of TNF-αand ICAM-1 in brain tissues .Results Compared with group S ,the concentrations of serum S100B protein were significantly increased , and the expression of TNF-α and ICAM-1 in brain tissues was up-regulated in I/R and D groups ( P<0.05) .Compared with group I/R ,the concentrations of serum S100B protein were significantly decreased , and the expression of TNF-α and ICAM-1 in brain tissues was down-regulated in group D ( P<0.05 ) .Conclusion The mechanism by which dexmedetomidine reduces the cerebral I/R injury is related to down-regulation of TNF-αand ICAM-1 expression in rats .

Background and purpose:The non-small cell lung cancer (NSCLC) has been the highest disease incidence in lung cancer, sputum cytology diagnosis has become an important adjunct to the early diagnosis of lung cancer. The purpose of this study was to investigate the value of thinprep cytological and immunocytochemical method in differentiatial diagnosis of exfoliated cells of malignant sputum in NSCLC. Methods:Sputum samples were detected with thinprep cytology test, a total of 530 cases suspicious tumor cells and malignant tumor cells sputum specimens were randomly selected in continuous paraffin-embedded sections, respectively, NSCLC tumor cell markers CK7, CK5/6, TTF-1, P63, EMA were evaluted by immunocytochemical staining. Results:Of the 530 cases of malignant sputum, these were confirmed 265 cases of lung adenocarcinoma, 246 cases of squamous carcinoma, 19 cases of adeno-squamous carcinoma. Moreover, TTF-1 and CK7 were signiifcantly higher expressed in adenocarcinoma, the positive rates were 92.45%(245/265) and 91.70%(243/265);CK5/6 and P63 were signiifcantly higher expressed in squamous carcinoma, the positive rates were 97.15% (239/246) and 99.59% (245/246). Conclusion: Liquid-based cytology combined with immunocytochemistry had important clinical value in classification and identification of sputum samples, the combination of CK7, CK5/6, TTF-1, P63, EMA can be used for classiifcation and identiifcation of malignant sputum samples between NSCLC, is worthy of promoting in clinical cytopathology diagnosis.

Objective To explore the clinical characteristics of localized peritoneal mesothelioma by the retrospective analysis of the clinical data and its relationship with asbestos exposure.Methods A total of 22 cases with localized peritoneal mesothelioma confirmed by pathological test and they were selected as our subjects in the Central Hospital of Cangzhou from Jan.2007 to Dec.2012.The information of all cases was collected.The incidence,asbestos exposure history,clinical manifestations,imaging studies,pathological type,immunohistochemistry and tumor markers of peritoneal mesotheliom patients were recorded or measured.Results Of 22 cases,female accounted for 68.18％.The periods from onset symptoms to treatment time was from 2 days to 1 year with an average of 83 days.Clinical symptoms were verified including localized abdominal pain (11 cases,50.00％),abdominal mass (8 cases,36.36％),abdominal distension (6 cases,27.27％),ascites (10 cases,45.45％).Patient was with increased platelet and carcinoma antigen 125.Abdominal computerized tomography showed that local mass was seen and 12 cases were with asbestos spot.Ultrasound-guided peritoneal biopsy was confirmed as the main diagnostic method followed by Laparotomy.Epithelial type was the main pathological type (19 cases,86.36％),following the fleshy tumor type and mixed type.Eighteen cases had asbestos exposure history.Conclusion Localized peritoneal mesothelioma is a rare disease.However,the incidence is high in the current region due to asbestos exposure.Abdominal pain and local mass are the main clinical symptoms,and the main pathology is epithelial typeas well as surgery is the main therapy.

Objective To develop an information gathering soft-ware platform for spleen system inquiry of TCM, and to discuss the practicability and feasibility of applying computer technology to standardizing management of TCM inquiry data. Methods Based on the TCM Spleen System Inquiry Scale, combined with clinical practice of TCM diagnosis and treatment, an inquiry information gathering soft-ware platform for TCM spleen system was designed. The platform was interfaced with B/S structure, and in the use of computer programming languages, the platform possessed the good functions of data collection, storage, query, export and print, etc. In addition to this, by calling the correct algorithm, it contents users with analysis and statistics on the target data set. Results The platform designed has been initially equipped with the functions of collecting, storing, inquiry, deleting, modifying, exporting and printing the inquiry-based four diagnostic data for TCM spleen system diseases. And to some extent, it also achieves standardization and objectification of the collection of TCM Spleen System Inquiry Scale. Conclusion It is practicable and feasible to applying computer technology into standardizing management of TCM inquiry informations. Besides, it could act as the direction for the research of TCM four diagnostic data in the future.

ObjectiveTo investigate whether CD4+ CD25+ CD127dim/- regulatory T lymphocytes (Treg) can induce the proliferation of hepatic stellate cells (HSC) and expression of fibrosis-related factors on HSC in vitro and further to explore the mechanism of Treg inducing fibrogenesis. MethodsHSC LX-2 cells were subcultured.CD4+ CD25+ CD127dim/- cells were purified using magnetic cell separation. The HSC were co-cultured with Treg by direct contact or by Transwell system in vitro. The HSC cultured alone was used as control. Cell proliferation was measured by CCK-8 assay.The expression of transforming growth factor (TGF)-β1 was detected by enzyme-linked inmunosorbent assay (ELISA), and the expressions of hyaluronic acid (HA) and precollagen Ⅲ (PC Ⅲ ) were detected by radio immunoassay (RIA). The data were analyzed by LSD-t test. ResultsHSC proliferation was strongest when Treg∶ HSC= 1.5∶ 1. The absorbance in direct contact co-culture group and Transwell system co-culture group was (0. 713±0. 032) cpm and (0. 735±0. 028) cpm, respectively, both of which were higher than that in control group [(0. 677 ± 0. 029) cpm](t = 5. 4003 and 8. 7878,respectively; both P＜0. 01). The concentrations of TGF-β1 in the supernatant were (781. 59 ±76.45) pg/mL and (813. 53±60. 62) pg/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were significantly higher than that in control group [(722.51±59. 66) pg/mL](t = 4.0014 and 6. 1653, respectively; both P＜0.01).The concentrations of HA were (433. 575±27.90) ng/mL and (445.40±23.73) ng/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were higher compared to that in control group [-(415. 83±19.44) ng/mL](t =3. 3124 and 5. 5231, respectively; both P＜0.01). Likewise, the concentrations of PCⅢ were (21. 93± 1.71) and (23. 125± 1.87) ng/mL in direct contact group and Transwell group, respectively compared to (20. 10± 1.49) ng/mL in control group (t = 4. 8082 and 7. 9436, respectively; both P ＜ 0.01).Furthermore, the absorbance,concentrations of TGF-β1, HA and PC Ⅲ in Transwell co-culture group were all higher compared to direct contact group (t = 3. 3875, 2.1639, 2. 2107 and 3.1354, respectively; all P＜0. 05).ConclusionsThe cell proliferation and the expressions of fibrosis-related factors in HSC increase greatly after co-cultured with CD4+ CD25+ CD127dim/-Treg. Therefore, Treg may play an important role in inducing liver fibrogenesis.

AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.

Objective To detect the level of CD64 and serum procalcitonin (PCT ) and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis (SBP) .Methods Participants were categorized in‐to three groups including liver cirrhosis with SBP(45 patients) ,liver cirrhosis without SBP(93 patients) and health personnel(50 persons) .CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay .The li‐mosis vein blood samples were obtained from the patients with SBP at the time of 24 h after admission ,before antibacterial drugs use and 7 days after the effective treatment of antibacterial drugs .The CD64 and serum PCT were detected with the limosis vein blood samples .At the same time ,the complete blood count ,liver ,kidney and blood coagulate functions were tested .The participants in other two groups were detected the CD64 ,serum PCT ,complete blood count ,liver ,kidney and blood coagulate functions at the same time .Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls (P< 0 .01) .ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95 .5% ,93 .8% and 96 .1% ,85 .2% respectively .Conclusion CD64 and serum PCT can be determined as the im‐portant indicator in early diagnosis and efficacy criterion .

Objective To explore the clinical features of patients with surgical malignant peritoneal mesothelioma.Methods From April 2008 to November 2012,the clinical data of 14 patients with surgery and pathologically diagnosed malignant peritoneal mesothelioma were retrospectively analyzed.Results Among the 14 patients,13 cases had a history of asbestos exposure.There were 10 cases with abdominal pain,seven cases with bloatting,and one case with intermittent vaginal bleeding.There were 13 cases with asbestos plaques,14 cases with organ infiltration,nine cases with little or no ascites,one case with mild lymph nodes enlargement in peritoneal cavity,but no case was found with distant metastasis.There were three cases with diffuse type and 11 cases with localized type.Serum CA125 level increased in seven cases.Seven cases received postoperative chemotherapy,and the average survival time was five months after surgery.To the closing date,two patients with localized peritoneal lesions are still alive.Conclusions The incidence of the group of patients with malignant peritoneal mesothelioma is closely related to the contact with asbestos.Localized type is the dominant type,without lymph nodes enlargement and distant metastases.Survival rate may improve in patients with early surgery.

BACKGROUND:Little data have been available concerning function features of arterial elasticity in patients with chronic kidney disease at 2-5 stage not undergoing dialysis.Studies have demonstrated that carotid-femoral pulse wave velocity(PWVcf) can be used to evaluate arterial elasticity.OBJECTIVE:To explore the changes and influential factors of PWVcf in patients with chronic kidney disease.DESIGN,TIME AND SETTING:A non-randomized controlled experiment was performed at the Department of Nephrology,Peking University Third Hospital from January to August 2006.PARTICIPANTS:166 patients with chronic kidney disease and 28 health persons were selected from Peking University Third Hospital.METHODS:The patients were divided into 3 groups based on the Kidney/Dialysis Outcomes Quality Initiative(K/DOQI) guideline for chronic kidney disease:mild group(at stage 1 to 2),moderate group(at stage 3) and severe group(at stage 4 to 5);the healthy people served as control.Body mass,blood pressure,PWVcf and biochemical indicators were determined to calculate glomerular filtration rate and compare the differences.One-way and multiple regression analyses were used to explore related factors of PWVcf.MAIN OUTCOME MEASURES:PWVcf and influential factors.RESULTS:Compared with control group,the patients had significantly higher levels of systolic blood pressure,diastolic blood pressure,pulse pressure and PWVcf(P