OBJECTIVETo evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.

METHODSFifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.

RESULTSAfter hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).

CONCLUSIONEA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

Acupuncture Analgesia ; methods ; Adolescent ; Adult ; Aged ; Anesthesia, General ; Arteries ; Blood Pressure ; Electroacupuncture ; methods ; Endoscopy ; Female ; Gastric Mucosa ; surgery ; Heart Rate ; Humans ; Hypotension, Controlled ; Interleukin-1 ; Interleukin-6 ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; Young Adult

Objective To evaluate the efficacy and safety of ESHAP regimen,as a salvage regimen, in treating patients with relapsed or refractory aggressive NHL.Methods 38 patients with relapsed or refrac- tory aggressive NHL were selected to be treated by ESHAP regimen.Results The 38 patients received ES- HAP regimen with a range of 2～6 cycles. The total RR was 55.3 % with complete response(CR)rate of 26.3 %.The major toxicity was myelosuppression with infection,which was tolerable.Conclusion ESHAP regimen is one of safe and effective salvage regimens for the patients with relapsed or refractory aggressive NHL.

Objective To investigate the influence of hypothermia during reperfusion on acute pulmonary edema(APE)after liver transplantation in patients with chronic severe hepatitis. Methods Between February 2002 and December 2006,108 consecutive patients of chronic severe hepatitis underwent liver transplantation. Patients suffering from postoperative APE(APE group)were compared with those without APE(NAPE group)on hypothermia during reperfusion. We evaluated the impact of hypothermia on requirement of red blood cells and/or fresh-frozen plasma, and prothrombin time in neo-liver phase. Results Forty-one out of these 108(37.96%)cases were complicated with APE. Compared with NAPE group, patients in APE group have significant lower core hypothermia(t=2.413,P=0.018),longer hypothermia duration(＞5 min)(39.02%,x2=143.40).Longer pmthrombin time(t=2.884,P=0.005)and larger amount of blood transfnsion were observed in APE group. Patients with hypothermia were prone to accompanied with longer PT in neo-liver phase(28.03±8.45)min vs (24.12±5.89)min, t=2.553,P=0.012),larger requiting of RBC transfusion(2786.96±1266.47)ml vs(2129.41±805.90) ml, t=2.364,P=0.026)and fresh-frozen plasma(2121.74±676.19)ml vs (1768.24±685.08) ml, t=2.201,P=0.030).Conclusions Low core hypothermia during neo-liver reperfusion contributes to the development of APE in patients with chronic severe hepatitis undergoing liver transplantation. Prolonged PT and large amount of blood transfusion may be involved in this complication.

Objective To establish a new congenic inbred mouse strain carrying and expressing EGFP and Foxn1nugene for cancer research including human glioma as well .Methods According to criterion of GB14923-2010, the male Foxn1nu nude mice backcross the female C57BL/6-Tg (CAG-EGFP) transgenic mice for 10 times, Then identify the phenotype using the methods and equipment as below: fluorescent flashlight and matching glasses; multifunction vivo imager; fluorescence microscopy.Results The congenic inbred mouse strain named Foxn1nu.B6-CAG-EGFP/SU ( Soochow University ) .All the 14 biochemical loci are homozygous and same with Balb/c mouse in addition to the Pep3 loci (“b” type instead of “a” type).Peripheral blood lymphocyte count shows the lymphocytes occupy 15%of nucleated cells;T lymphocytes occupy 0.3%, meet the requirement of inbred strain of EGFP nude mice .Conclusions Established a new congenic inbred strain -Foxn1nu.B6-CAG-EGFP/SU which both express EGFP stably, and own immunodeficiency with lack of T lymphocytes .The phenotype “b” of biochemical loci “Pep3” is the unique characteristic that distinguish SU to Foxn1nu.

Objective To learn the current status of job burnout and influencing factors for nurses from infectious disease hospital.Methods The Chinese version MBI -HSS was used to survey 218 nurses from infectious disease hospital,and linear regression was used to analyze the influencing facters of job burnout.Results A total of 210 questionairs were cocleted.The incidence of severe occupational job burnout was 22.38%,and the score of emotional exhaustion (EE), depersonalization (DP),personal accomplishment (PA)was(22.82 ±9.98),(6.48 ±5.20),and (35.20 ±8.82), respectively.Regression analysis demonstrated that the main influencing factors were entering the isolation ward, opportunity for infectious diseases ,disinfection damage,fear of occupational exposure and concern on family infection(P <0.05).Conclusion The status of job burnout of nurses in infectious disease hospital is not optimistic.There is a positive relationship with the working environment,occupational exposure.Managers need to explore an effective way to ease the job burnout of nurses,and to stabilize the nursing team.

OBJECTIVETo evaluate electroacupuncture on the efficacy and the safety of gastric and systemic functional recovery in patients with carbon dioxide pneumoperitoneum undergoing gynaecological laparoscopic surgery.

METHODSSixty patients undergoing gynaecological laparoscopic surgery were randomly divided into a regular anesthesia group (group A) and a combination electroacupuncture anesthesia group (group B), 30 cases in each group. The group A were treated with regular general anesthesia, and on the basis of general anesthesia, the group B were treated with electroacupuncture at bilateral Zusanli (ST 36) and Liangqiu (ST 34) by continuous wave and a frequency of 2 Hz 30 minutes before the surgery until the end of the operation. Sedation scale by Ramsay, nausea, vomiting and mental state scores of postoperative were evaluated and compared between the two groups.

RESULTSCompared with the group A, the sedation scale (1.19 +/- 0.56 vs 1.96 +/- 0.90), nausea score (0.59 +/- 0.80 vs 1.81 +/- 0.88), vomiting score (0.48 +/- 0.94 vs 1.89 +/- 0.93) and mental state score (0.96 +/- 0.73 vs 1.69 +/- 0.75) were all decreased significantly in the group B (all P < 0.01).

CONCLUSIONCombination electroacupuncture anesthesia can relieve postoperative irritable, nausea and vomiting, improve mental state after the operation and promote the gastric and systemic functional recovery. It is a good method for the adjustment of carbon dioxide pneumoperitoneum during laparoscopic surgery.

Adult ; Electroacupuncture ; Female ; Genital Diseases, Female ; surgery ; Gynecologic Surgical Procedures ; adverse effects ; Humans ; Laparoscopy ; adverse effects ; Middle Aged ; Postoperative Complications ; physiopathology ; therapy ; Postoperative Period ; Recovery of Function ; Young Adult

Objective To determine the impact of uric acid changes on kidney function in middle-aged and elderly women with normal renal function.Methods Serum uric acid and estimated glomerular filtration rate(eGFR) were studied by prospective cohort analysis in 1152 middle-aged and elderly Dalian women with serum uric acid<7 mg/dl, estimated glomerular filtration rate(eGFR)≥90 ml·min-1·(1.73 m2)-1, and age>45 years old.Results The analysis of variance (ANOVA) of clinical indices between baseline and follow-up data showed that an eGFR was decreased after three years in both middle-aged and elderly women even with normal serum uric acid.Compared with those in the lowest guartile subgroup, a significant drop of eGFR to less than 90 ml·min-1·(1.73 m2)-1 was seen in those with the highest guartile of baseline serum uric acid group (OR=1.707, 95%CI 1.192-2.443, P=0.003).Furthermore, there were positive correlations between changes in the levels of serum uric acid and eGFR, and linear regression analysis showed that, as the change level of serum uric acid increased, the change level of eGFR declined(β=1.562, 95%CI 1.050-2.075, P<0.01], and the changing degree of uric acid increase is independent risk factors refor eGFR reductions.Conclusion Reduction in eGFR level is inversely related to serum uric acid in perimenopausal and postmenopausal women.However, our study showed that, women with serum uric acid level ranging from normal, slight increase, and relatively high levels, the increasing degrees of uric acid are independent risk factors responsible for the changing degree of eGFR reduction.

Adult ; Aged ; Amifostine ; therapeutic use ; Benzene ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; chemically induced ; drug therapy

OBJECTIVETo investigate the expression and distribution of intrahepatic CD4+ CD25+ regulatory T cells in immuno-tolerant and immuno-clearance phase of patients with chronic hepatitis B.

METHODSThe expression of FoxP3 was detected in 19 cases of immuno-tolerant phase and 12 cases of immuno-clearance phase by immunohistochemistry. The relation between the intrahepatic expression of FoxP3 and the clinicopathological features were analyzed.

RESULTSThe positive signal of FoxP3 is located in nuclear of lymphocyte and mainly aggregated in portal areas as well as occasionally scattered in hepatic sinusoids. The expression of intrahepatic FoxP3 in the group of immuno-tolerant phase was significantly increased than those in normal control (P < 0.01), and greatly decreased than those in immuno-clearance phase (P < 0.01). No correlation was observed among the expression of intrahepatic FoxP3, ALT, levels of HBV DNA, HBeAg positive, in patients of immuno-clearance phase, respectively. There were significant differences between immuno-tolerant phase and immuno-clearance phase age, ALT, TBIL, PTA, HBV-DNA and detection of HBeAg but not in sex and family history of HBV infection.

CONCLUSIONCD4+ CD25+ regulatory T cells may play important roles in the clearance of HBV as well as in liver inflammation and injury during chronic HBV infection.

Adolescent ; Adult ; CD4 Antigens ; immunology ; Female ; Forkhead Transcription Factors ; genetics ; immunology ; Gene Expression ; Hepatitis B virus ; immunology ; Hepatitis B, Chronic ; genetics ; immunology ; virology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology ; Young Adult

OBJECTIVETo analyze the clinical characteristics of bone metastasis of malignant tumors.

METHODSThe clinical data and survival time of 355 patients with bone metastasis of malignant tumors were retrospectively analyzed.

RESULTSThe bone metastasis occurred more frequently in men (male:female = 1.45:1). The most common primary tumors were lung cancer in men and breast cancer in women. The thoracic vertebrae, ribs, lumbar vertebrae and pelvic were frequently involved metastatic sites and the multiple bone metastasis was common (83.4%). The main symptom was pain (75.2%). Local masses, disfunctions, pathologic fracture and paraplegia occurred in a few patients while many patients were asymptomatic (22.0%). The most frequent radiographic manifestation was the osteolytic bone destruction (82.2%). Integrated treatments were taken, including chemotherapy, hormonal therapy, biological therapy, radiotherapy, surgery, bisphosphonate analgetics, etc. The clinical benefit rate in pain relief was 98.5% and the effective rate was 72.2% in radiographic imaging. The median survival time was 13.9 months. Among them, it was 34.9 months in prostate cancer and 4.6 months in hepatocellular carcinoma. The survival time was longer in bone metastasis without other organ metastasis. There was no significant difference between the single and multiple bone metastases regarding the survival time.

CONCLUSIONIt is important to master the clinical features of bone metastasis of malignant tumors for early diagnosis and treatment, and to improve the quality of life and prolong the survival time.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; diagnosis ; secondary ; therapy ; Breast Neoplasms ; pathology ; Carcinoma, Hepatocellular ; pathology ; secondary ; Combined Modality Therapy ; Female ; Humans ; Liver Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain ; etiology ; Pain Management ; Prostatic Neoplasms ; pathology ; Quality of Life ; Retrospective Studies ; Survival Rate ; Young Adult