Adult ; Humans ; Male ; Maxillary Sinusitis ; complications ; Nasal Polyps ; complications

Objective To study the optimal dose of esmolol for maintaining cardiovascular stability in patients with hypertension during tracheal extubation. Methods In post-anestheisa care unit, hypertensive patients after general anesthesia meeting the extubation criteria were included. Patients were divided into 2 groups according the age: group Ⅰ (>65 years old for the elderly hypertensive, 21 cases), and groupⅡ(≤65 years old for the non-elderly hypertensive, 22 cases). All the patients received esmolol bolus before sputum suction and tube extraction, and the tracheal extubation were extubated 2 minutes after esmolol bolus. The systolic blood pressure, diastolic blood pressure and heart rate were was recorded before tracheal extubation, 2 min after esmolol bolus, at the time of sputum suction extubation, 1 min after tracheal extubation, 3 min after tracheal extubation and 5 min after tracheal extubation. Esmolol dose was determined by the up and down method. Initial dose was 0.5 mg/kg, in accordance with the arithmetic dose (0.2 mg/kg) increasing or decreasing progressively. In negative results (the systolic blood pressure at extubation or 5 min after extubation ≥ 20% of the base, or the systolic blood pressure at sputum suction extubation>180 mmHg, 1 mmHg=0.133 kPa) esmolol dose increased progressively, and in positive results (the systolic blood pressure at extubation or 5 min after extubation<20%of the base) esmolol dose decreased progressively. When the crosspoint (from positive to negative result) reached 6, the study was terminated. Results The median effective doses of esmolol for maintaining cardiovascular stability in groupⅠand groupⅡwere (0.6 ± 0.1) and (0.8 ± 0.1) mg/kg. Conclusions Esmolol can maintain cardiovascular stability in patients with hypertension during tracheal extubation. Median effective dose decreases in older hypertensive patients.

Objective To investigate the effects of recombinant human augmenter of liver regeneration (rhALR) on renal inflammation in acute kidney injury (AKI) induced by renal ischemia reperfusion (IR). Methods SD rats were randomly divided into sham-operated group,IR group,rhALR1 group (100 μg/kg) and rhALR2 group (200 μg/kg).Both renal pedicles of rats were identified and occluded with microvascular clamps for 60 min to induce acute kidney injury (AKI).Blood urea nitrogen and serum creatinine levels were evaluated using a Hitachi 747 automatic analyzer. For histological examination, sections were stained with HE. The activity of myeloperoxidase (MPO) was detected by spectrophotometer.Expression of TNF-α,ICAM-1,MCP-1 was determined by Western blotting. Results Blood urea nitrogen,serum creatinine levels and the injury of kidney were improved significantly in rhALR group as compared with IR group (all P＜ 0.05).They were improved more significantly in rhALR2 group as compared to in rhALR1 group (all P＜0.05).The protein levels of TNF-α,ICAM-1,MCP-1 and the activity of MPO in kidneys from the sham-operated rats were low,and increased significantly after renal ischemia reperfusion injury (all P＜0.05).After treated with rhALR,the expression of TNF-α,ICAM-1,MCP-1 and the activity of MPO were decreased significantly in kidneys as compared to those in IR group (all P＜0.05),which decreased more significantly in rhALR2 group than those in rhALR1 group (all P＜ 0.05). Conclusions nhALR can protect kidneys from ischemia reperfusion injury in rats.The mechanism may be associated with the inhibition of renal inflammatory cells infiltration and down-regulated expressions of YNF-α,ICAM-1 and MCP-1 in the kidney.

Objective To retrospectively analyze the data of patients with T3N0-1M0 nasopharyngeal carcinoma (NPC) who underwent radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT), and to investigate the relationship between therapeutic modality and prognosis. Methods From January 2004 to December 2004, 781 patients with biopsy-proven newly diagnosed non-metastatic NPC were analyzed in Sun Yat-Sen University Cancer Center, who had MRI data of nasopharynx and neck. With restaged based on the Chinese 2008 staging system, 82 cases of T3N0-1M0 patients who were treated by RT alone or CCRT were enrolled. They were divided into group A (46 cases, RT) and group B (36 cases, CCRT). Results The clinical data was comparable between the two groups. The 5-year overall survival rate (OS) was 93.5 % (group A) and 100 % (group B)(P =0.046), while the 5-year disease-free survival rate (DFS) was 85.2 % (group A) and 91.7 % (group B) (P =0.498). N-Staging was the factor affecting the DFS. Stratified analysis showed that the 5-year OS of T3N0M0 patients was 94.7 % (group A) and 100 % (group B) (P =0.432), those of T3N1M0 patients were 92.6 %(group A) and 100 %(group B) (P =0.066), while the 5-year DFS was 73.7 % (group A) and 89.3 % (group B) (P =0.244). Multifactor analysis showed that CCRT was not the independent factor affecting the OS(HR =0.019; 95 % CI, 0 to 21.793), and N-stage was not the independent factor affecting the DFS (HR = 0.203; 95 % CI, 0.135 to 1.231×104). Conclusion For T3N0M0, NPC patients, CCRT is not superior to RT alone. Whether CCRT can improve survival of T3N1M0 NPC patients needs further study.

Objective To assess the efficacy and feasibility of neoadjuvant therapy of TPF regimen including docetaxel (TAX), cisplatin (DDP) and 5-fluorouracil (5-Fu) combined with concurrent DDP and radiotherapy (RT) in patients with local advanced nasopharyngeal carcinoma (NPC). Methods From April 2008 to May 2009, 40 patients with newly diagnosed UICC stage Ⅲ orⅣ local advanced NPC were enrolled. Patients were randomly assigned to group A(DDP every 3 weeks) and group B(DDP every week). Two cycles of induction chemotherapy with TAX 60 mg/m2 dl, DDP 60 mg/m3 dl and 5-Fu 600 mg/m2 dl-5 were given on a 3-weekly cycle, followed by RT and chemotherapy(group A: DDP 80 mg/m2 every 3 weeks for 2 times; group B: DDP 30 mg/m2 weekly for 6 times). Two-dimension conformal RT technique with 68-72 Gy/(34-36) fractions for 7 weeks was administered to the nasopharynx and 60-66 Gy/(30-33) fractions for 6-6.5 weeks to the node-positive area. Results 38 patients (78 Cycles) were evaluable for efficacy and toxicity. One patient in each group was excluded due to toxicity. 17 (17/19) patients of group A finished 2 cycles of planed DDP chemotherapy, while only 10 (10/19) patients of group B completed 6 weeks of planed DDP chemotherapy, 4 completed 5 weeks, 4 completed 4 weeks and 1 completed 2 weeks. Response to neoadjuvant TPF was as follows: 4 patients (10.5 %) achieved complete response(CR), 27(71.1%) achieved partial response(PR) and 7 (18.4 %) achieved stable disease (SD), so the overall response (CR+PR) rate was 81.6 %. After RT, 32 patients (84.2 %) achieved CR, 5 (13.2 %) PR and 1 (2.6 %) SD, so the overall response rate was 97.4 %. Conclusion TPF induction chemotherapy followed by concurrent DDP and RT is an effective regimen in the treatment of advanced NPC. Concurrent DDP chemotherapy on a 3-weekly cycle is recommended. Further study should be made to investigate how to increase the dose intensity of chemotherapy.

Objective To explore the in vitro isolation of ?2m-/Thy-1+ bone marrow-derived liver stem cells(BDLSCs) which bear double features of stem and liver cells from bone marrow stem cells(BMSCs)as so to provide suitable donor cells for the treatment of liver diseases by cellular transplant. Methods ?2m-/Thy-1+ BDLSCs were isolated by magnetic bead cell sorting(MACS) method from cholestatic rats in vitro,and cell purity was detected using flow cytometry.Liver associated phenotype markers were characterized by RT-PCR and immunofluorescence staining. Results BDLSCs isolated by MACS were purified and viable,and possessed hepatocyte-like features at gene and protein levels. Conclusion ?2m-/Thy-1+ BDLSCs are special subsets of BMSCs which may have promising potentials in the stem cell-based treatment of liver diseases.

Objective To study the gene expressions of nestin and stem cell factor(SCF)in neurons after ischemia-reperfusion injury in rat brain. Methods Thirty-six adult female rats were subject to left middle cerebral artery occlusion for 1.5h and different hours of reperfusion. In site hybridization was used to examine the expression of nestin and SCF mRNA in the rats subjected to 2h, 6h, 12h, 24h, 2d, 3d, 7d, 14d of reperfusion and sham-operation group (n=4). Results (1) Nestin expression in cortex, striatum and extraventricular zone was weak in the sham-operation group, and increased markedly in the ischemic hemisphere compared with sham-operation group except of reperfusion 2h in cortex, 2h, 6h in striatum, 2h, 6h and 14d in extraventricular zone. (2)SCF expression in cortex, striatum and extraventricular zone was weak in the sham-operation group, and increased markedly in the ischemic hemisphere compared with sham-operation group except of reperfusion 2h, 6h, 12h in cortex, 2h, 6h in striatum, 2h and 14d in extraventricular zone. Conclusion It is suggested that SCF expression might enhance the proliferation of neural stem cells following ischemia-reperfusion in rats.

OBJECTIVE:To establish the method for simultaneous determination of 5 saponins in Lonicerae Flos. METHODS:Using macranthoidin B as a reference,HPLC method was adopted to calculate the relative correction factor(RCF)of it to macran-thoidin A,dipsacoside B,macranthoside A and macranthoside B. The contents of above 4 saponins were calculated through RCF. Using the contents of saponins determined by external standard method as measured value,the calculated value was compared with measured value. RESULTS:The linear ranges of macranthoidin A,macranthoidin B,dipsacoside B,macranthoside A and macran-thoside B were 0.316-6.32 μg(r=0.9973),0.453-9.06 μg(r=0.9982),0.231-4.62 μg(r=0.9996),0.342-6.84 μg(r=0.9984) and 0.147-2.94 μg(r=0.9961),respectively. RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The recoveries were 97.74%-104.51%(RSD=2.37%,n=6)、96.70%-103.20%(RSD=2.37%,n=6)、96.12%-103.61%(RSD=2.45%, n=6)、98.80%-104.70%(RSD=2.32%,n=6)、99.21%-102.92%(RSD=1.39%,n=6),respectively. There was no statistical sig-nificance between calculated value and measured value(P>0.05). CONCLUSIONS:The method is simple,precise,stable and re-producible. It can be used for the determination of saponins in Lonicerae Flos.

Objective To explore the chromosome aberration of cervical cancers induced by human papillomavirus(HPV16)virus.Methods The change of change of chromosomes of Hela cells induced by HPV-16 infection HPV-16 in fection was detected by FISH.Results The integration sites of HPV-16 were not observed in Hela cells.But HPV16 virus was integrated on chromosomes 3.Conclusion HPV16 could cause chromosome 3 aberration in Hela cells and result in the occurance of cervical cancers.

Objective To identify the isolated rat bone marrow derived mesenchymal stem cells(MSCs),and evaluate the efficiency of adenoviral vector expressing human urokinase type plasminogen activator(uPA) in transfection of rat MSCs and its effect on proliferation of MSCs. Methods MSCs were isolated and purified by pasted wall purification,and were identified by immunicytochemistry.The transfection efficiency of uPA was detected by fluorescent microscopy,the expression of uPA in MSCs was detected by Western blotting,and the proliferation of MSCs was evaluated by MTT. Results The harvested MSCs exhibited the typical appearance of MSCs,and it was revealed by immunohistochemistry that the expression of MSCs markers CD29 and CD90 was positive,while that of CD34 and CD45 was negative.A tendency of increase in expression of green fluorescent protein(GFP) was observed with increase of multiplicity of infection(MOI).After transfection with AduPA for 72 h,the transfection efficiency reached(94.0?1.5)% at MOI of 80,and positive GFP cells could still be observed even after 7 d.The transfected uPA had no effect on the proliferation of MSCs. Conclusion MSCs are favourable genetic vectors to express uPA,and can be used for treatment of liver fibrosis.