Objective To compare the effect of midazolam pretreatment on propofol sedation using closed-loop target-controlled infusion (TCI) between two age groups - the adult and the aged. Methods Forty-eight ASA Ⅰ-Ⅱ patients of both sexes weighing 45-81 kg undergoing elective lower abdominal or lower extremity operation under epidural anesthesia were divided into two age groups : (A) the adult group (18-39 yrs) and (B) the aged group (66-79 yrs). The two groups were further divided randomly into 2 subgroups : midazolam subgroup ( n=12) received midazolam 0.04 mg?kg-1 10 min before propofol TCI and placebo subgroup ( n = 12) received normal saline instead of midazolam 10 min before propofol TCI. The patients were unpremedicated. An intravenous line was established before operation, which was connected to a TCI system comprising a Graseby 3500 infusion pump and a closed-loop TCI automatic control system. BP, HR, SpO2 and BIS were continuously monitored during operation. During epidural anesthesia the patients were sedated with propofol administered by TCI. The initial target blood concentration of propofol was set at 1.5?g?ml-1 . The level of sedation was assessed by OAA/S scale (5 = alert,0 = no response to prodding). The target blood propofol concentration was then increased or decreased in 0.5?g?ml-1 increment to maintain OAA/S score at 3. The BIS value at this level of sedation (OAA/S=3) was used as feedback in controlling TCI of propofol. The induction dose and the total dose of propofol, induction time and emergence time (OAA/S=5) were recorded. Results Midazolam premeditation significantly reduced the induction dose and total dose of propofol, shorten the induction time and prolonged the emergence time compared with placebo in both groups, especially in the aged group (P

Along with the wide application of cadaveric donor kidney transplantation (CDKT), most transplantation centers face the shortage of cadaveric donors. Living donor kidney transplantation (LDKT) has been successfully applied with remarkable advantages over CDKT. Human leukocyte antigen matching generally is not an important problem in non-related LDKT. Even with 6-locus mismatch, the effectiveness of LDKT is still superior to non-mismatch CDKT. Although LDKT donor has extremely low mortality and incidence of complications, the safety of LDKT donor is becoming a research highlight. In addition, many social problems are involved in LDKT, which should be deliberately considered during clinical practice.
Adolescent ; Adult ; Aged ; Graft Survival ; immunology ; Humans ; Kidney Transplantation ; adverse effects ; ethics ; methods ; psychology ; Living Donors ; Middle Aged ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Female ; Hepatopulmonary Syndrome ; diagnostic imaging ; etiology ; Humans ; Liver Cirrhosis ; complications ; diagnostic imaging ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Radionuclide Imaging ; Radiopharmaceuticals ; Technetium Tc 99m Aggregated Albumin

Objective:To evaluate the clinical outcome of botulinum A toxin(BTX-A)injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia(DESD)after spinal cord injury(SCI). Methods:A total of 38 urodynamic examination-confirmed DESD patients,male 31 and female 7,with an average age of (36.5?17.8)years old,were included in this study.200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites(1 ml per site)of the external sphincter via a 5F flexible cystoscopic needle.On the second day,9 patients(BTX-A+baclofen group)were randomly selected for baclofen oral administration,3/d for 3 months; the other 26 patients were taken as control.Urodynamic examination was repeated in all patients 4 weeks later;the voiding diary and urodynamic outcomes were compared before and after treatment.The adverse and toxic effects were observed in the patients who were followed up for 2-9 months.Results:One month after treatment the voiding and storing functions of bladder were improved to different degrees,with the mean maximum uroflow rate(Qmax),the mean urine volume,the mean maximal cystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly(all P

Aim The effect of tetrandrine on TGF-?1 mRNA expression in glomerulosclerosis rat was observed. Methods The rats were randomly divided into four groups, such as the normal control group (sham operative rat), glomerulosclerosis model group,tetrandrine group and amlodipine group. The expression of TGF-?1 mRNA was analyzed by Northern blot hybridization. Results The expressions of TGF-?1 mRNA in two treating groups were much lower than untreated model group. There were no difference between these two treating groups. Conclusion Tetrandrine can decrease the expression of TGF-?1 mRNA in glomerulosclerosis rat induced by unilateral renctomy plus adriamycin.

Foreign Bodies ; diagnostic imaging ; surgery ; urine ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Radiography ; Urinary Bladder ; diagnostic imaging ; surgery ; Urinary Retention ; diagnostic imaging ; etiology ; surgery ; urine

This study was purposed to investigate the acute myeloid leukemia with complex karyotype t(2;21;8)(p12;q22;q22) (AML-M(2)) by using morphologic, immunologic, cytogenetic and molecular biologic classification technique (MICM) and to analyze the MICM characteristics of AML-M(2) and their diagnostic significance. The FAB typing of bone marrow cells (BMCs) was performed by Wright-Giemsa staining and histochemical staining of BM smears; the immunophenotype of leukemic cells was detected by flow cytometry; the karyotypes of chromosome samples prepared by short-term (48 hours) conventional culture of fresh BMCs were analyzed by RHG banding technique; the FISH signaling in mitotic metaphase was determined by dual color and dual fusion AML/ETO probe and chromosome painting probe, and was compared with results of conventional cytogenetic assay; the AML/ETO fusion transcripts were detected by nested RT-PCR. The results indicated that the bone marrow smears of case 1 showed extremely hyperplasia with myeloblasts in which a ratio of eosinophilic granulocytes and monocytes increased. Case 2 accorded with AML-M(2b) in which abnormal increase of myelocytes mainly appeared. The complex karyotype t(2;21;8)(p12;q22;q22) was detected by cytogenetic analysis combined with FISH in both two cases and AML1/ETO fusion transcripts were found by RT-PCR as well. The immunophenotype assay showed high co-expression of CD34 and HLA-DR accompanied with CD19 and CD56 expressions. It is concluded that application of MICM has an important significance for correct diagnostic typing of AML-M2 with complex karyotype variant of t(8; 21)(p12;q22;q22).
Adult ; Chromosomes, Human, Pair 2 ; Chromosomes, Human, Pair 21 ; Chromosomes, Human, Pair 8 ; Female ; Humans ; Immunophenotyping ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; immunology ; Male ; Middle Aged

OBJECTIVETo evaluate the short-term effect and experience of Nuss procedure on 120 cases of patients with pectus excavatum.

METHODSThoracoscopy assisted Nuss procedure with different ways of anesthesia were applied to 120 cases of patients with pectus excavatum, including 7 cases of recurrence after traditional surgical procedure (6 cases) and Nuss method (another one). The patients ranged in age from 2.5 to 43 (mean 14.1) years and in Haller index from 2.91 to 29. Of the 120, 73 had symmetric and 47 had asymmetric pectus excavatum. The Nuss procedure is performed with general anesthesia and a convex steel bar is inserted under the sternum with thoracoscopy through small bilateral thoracic incisions. The steel bar is inserted with the convexity facing posteriorly, and when it is in position, the bar is turned over, thereby correcting the deformity.

RESULTSThe operation was successfully accomplished without severe complications in all the 120 cases. The mean operative time was 58 minutes and the mean volume of blood loss was 30 ml. 103 patients had one bar inserted while the other 17 cases with more extremely diffuse depression required 2 or even 3 bars to get a satisfactory correction. Such methods as modifications to the fixing points and the shape of the bar, partial osteotomy, were developed to deal with asymmetric ones.

CONCLUSIONThe Nuss procedure is a minimally invasive technique for correction of pectus excavatum. It can lead to a satisfactory outcome and surgical time is less.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Funnel Chest ; surgery ; Humans ; Male ; Orthopedic Procedures ; methods ; Thoracoscopy ; Young Adult

OBJECTIVETo investigate the expression of telomerase in various lesions of adrenal cortex.

METHODSBy autoradiography-based telomeric repeat amplification protocol, telomerase expression was detected in 36 samples of adrenocortical lesions, including 29 cases adrenocortical adenoma (8 Cushing's syndrome, 17 aldosteronism and 4 nonfunctional adenomas), 5 cases of hyperplasia of adrenal cortex (presented with Chushing' syndrome), 2 cases adrenocortical carcinoma, and 4 samples of normal adrenal cortex.

RESULTSOf the 40 samples, 2 cases of adrenocortical carcinomas had telomerase expression, and the others had no telomerase expression detected.

CONCLUSIONSNo significant telomerase expression was found among different endocrine functional benign adrenocortical lesions. Telomerase expression may be used as an important marker of malignant adrenocortical tumor.

Adrenal Cortex ; enzymology ; Adrenal Cortex Neoplasms ; enzymology ; Adrenocortical Adenoma ; enzymology ; Biomarkers, Tumor ; analysis ; Cushing Syndrome ; enzymology ; Humans ; Telomerase ; analysis ; biosynthesis ; genetics

OBJECTIVETo retrospectively investigate the distribution in kidney transplantation for fifteen years in Peking Union Medical College Hospital.

METHODSWe conducted a descriptive research counting up the number of patients who received kidney transplantation each year in our hospital during 1995 and 2010.

RESULTSThe first kidney transplantation in our hospital occurred in the 1960s. The number of kidney transplantation increased until reaching a maximum of 47 grafts in 2001; since then the number fell.

CONCLUSIONSWith the decreased number of kidney transplantation, we have realized the shortage of transplantable organs is very serious. The continuing transplant shortage requires major efforts to expand the donor pool. Donation after cardiac death offers the potential to enlarge the donor pool, but we need to strictly control the criteria for potential donors.

China ; Humans ; Kidney Transplantation ; methods ; statistics & numerical data ; trends ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Time Factors ; Tissue Donors ; statistics & numerical data ; Tissue and Organ Procurement ; statistics & numerical data ; trends ; Treatment Outcome