ObjectiveTo compare the clinical efficacy and safety of anesthesia induction between inhalation of sevoflurane and intravenous injection of propofol for laryngeal mask airway (LMA) insertion in elderly patients.Methods40,ASA physical grade Ⅰ ～ Ⅱ patients scheduled to receive elective total knee arthroplasty were allocated to 2 groups at random. Patients in group one( G1 ) received intravenous induction of propofol infusion by a targetcontrolled infusion system which was set at the effect-site concentration of 4.0μg/ml,while patients in group two(G2)received inhalational induction with sevoflurane using vital capacity manoeuver at the target of end-expiratory concentration of 3.0％. We observed the whole procedure of anesthesia induction and LMA insertion, while recording the changes in hemodynamic state and occurrence of adverse events. ResultsMore than 85％ patients achieved LMA insertion at first attempt using either induction manoeuver. Although consciousness loss time in G1 was 39. ls longer than G2, there was no difference in anesthesia induction time for LMA insertion between these two groups. Contrary to a significant decrease in MAP following induction for patients in G1, there appeared hemodynamically stable in patients of G2,while apnea also significantly seldom occurred in G2 as compared to G1 (20％ vs 85％ ,P ＜0. 05).ConclusionAs compared to intrvenous induction with propofol, inhalation induction with sevoflurane provided a valuable alternative for LMA insertion in adults.

BACKGROUND: Previous experiments have shown that transforming growth factor-?1 (TGF-?1),matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) play an important role in chronic allograft nephropathy,but the mechanisms remains unclear. OBJECTIVE: To investigate the expression and significance of TGF-?1,MMP-2 and TIMP-1 in the renal tissues of chronic allograft nephropathy and normal renal tissues. DESIGN,TIME AND SETTING: A histological and morphological control observational experiment of cytology was performed at Pathological Laboratory of the 175th hospital from June to October 2008. PARTICIPANTS: The transplanted renal tissues extracted from 24 patients with chronic allograft nephropathy were used in the experiment,and the normal renal tissues in 10 patients were assigned as controls. METHODS: Immunohistochemical staining was performed in all the renal tissues. All the renal tissues were fixed with formaldehyde and embedded by paraffin wax. Then the sections were prepared with a thickness of 3 ?m,and were then closed with normal non-immune serum. Subsequently,the sections were incubated as follows: primary antibody,secondary antibody,streptavidin peroxidase complex,and diaminobenzidine (DAB),followed by HE counterstaining. The sections were cleared and coverslipped. MAIN OUTCOME MEASURES: The expressions of TGF-?1,MMP-2 and TIMP-1 in the renal tissues were observed by immunohistochemical staining. The relationships among TGF-?1,MMP-2 and TIMP-1,as well as between them and the grade of chronic allograft nephropathy were analyzed. RESULTS: Qualitative analysis: The TGF-?1,MMP-2 and TIMP-1 showed strongly positive expressions in the cytoplasm and membrane of renal tubular epithelial cells in transplanted renal tissues. Quantitative analysis: There were significant differences in expression of TGF-?1,MMP-2 and TIMP-1 between in transplanted renal tissues and in normal renal tissues (P

Objective To facilitate standing and walking after rehabilitation training by designing and using individualized ischial weight bearing orthosis for patients with various conditions of the lower limbs. Methods An orthosis with ischial support was ordered and tailored according to the condition of the patient's affected lower limb. Adaptive standing and walking training were administered daily. The functional recovery after the assembly of the orthosis was observed. Results The patients' standing and walking ability improved significantly after the training with the ischial weight bearing orthosis. The standing time was significantly longer than without the orthosis, and the walking distance was notably increased. Conclusion An ischial weight bearing orthosis has a significant effect on the recovery of standing and walking capability.

To evaluate multi-slice computer tomography (MSCT) in mediastinal lymph node metastasis of T1 and T2 non-small cell lung cancer (NSCLC). Methods:A total of 32 patients with T1 and T2 NSCLC from February 2004 to October 2012 were selected. Preoperative MSCT assessment of mediastinal lymph nodes was performed on basis of the pathological results. Results:Lymph nodes with diameters of≥10 mm were evaluated, and the sensitivity and specificity of the MSCT mediastinal lymph node me-tastases were 82.4%and 92.4%, respectively. Lymph node size, primary tumor location, and visceral pleural invasion showed statistical significance in forecasting mediastinal lymph node metastases (P<0.05). Conclusion:MSCT can be used for the effective evaluation of mediastinal lymph node metastasis, lymph node size, and position of primary tumor. and visceral pleural invasion of the tumor had a higher risk of mediastinal lymph node metastasis.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Hyaluronic Acid ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging

Objective To find out the weakness in the emergency nursing for burst group accidents, and then building a normative nursing program which have included framework and 4 stages. Methods Using the method of Fish-Bone Drawing to analyzed the nursing courses in 22 burst accidents within the past 4 years retrospectively. Results After using the normative nursing program, nurses have known their own working targets and responsibility, which can apply the nursing care effectively and orderly. Conclusion The application of emergency nursing program is a kind of quick and proper nursing method, which can improve the patients' prognosis effectively.

Objective To observe the histopathologic and ultrastructural characteristics of cornea and adjacent conjunctiva in Mooren’s ulcer. Methods The samples of limbal and central cornea and adjacent bulbar conjunctiva taken from active Mooren’s ulcer after lamellar keratoplasty were cut into paraffin sections and ultrathin sections and observed by light and transmission electron microscopy. The samples taken from patients of a Terrien’s marginal degeneration and a bacterial corneal ulcer were used as controls. Results Chronic inflammation including lymphocytes and plasma cells infiltrating existed in bulbar conjunctiva and sclera of Mooren’s ulcer. Limbal corneal epithelium, Bowman’s membrane, anterior stroma and adjacent superficial sclera melted and the inferior stromal collagen disorganized. The epithelial basement membrane of ulcer progressive edge had been destroyed while the epithelium and stroma kept quiescent. Lymphocytes infiltrated in conjunctiva and corneal epithelium of Terrien’s marginal degeneration with normal epithelial basement membrane, while Bowman’s membrane was destroyed. The epithelial basement membrane of bacterial corneal ulcer was intact. Conclusion Bulbar conjunctiva may act as a local lymph node of Mooren’s ulcer. Epithelial basement membrane of Mooren’s ulcer may have some abnormality as it was invaded first during ulcer progressing and it’s valuable to have a further study.

Objective To study the DCE-MRI findings of laryngeal and hypopharyngeal carcinoma.Methods 26 new patients di-agnosed laryngeal and hypopharyngeal cancer by pathology were collected and took DCE-MRI before therapy.The TIC type,ADC value,peak time (Tpeak),peak signal enhancement percentage (SERmax),positive enhancement integral(PEI),maximum slope of increase(MSI)and maximum slope of decrease(MSD)were obtained respectively.These semi-quantitative parameters of primary cancer,normal pharyngeal tissue and the same layer neck muscles were compared and P <0.05 was considered statistical signifi-cance.Results The TIC types for primary tumor including type Ⅰ(5),type Ⅱ(6),type Ⅲ(1 5),a significant difference of Tpeak、MSI、MSD were observed(P < 0.05 )no difference in ADC values (P > 0.05 )was found.Different b values (b = 300 s/mm2 , 500 s/mm2 )for ADC values were significantly different.There was statistical significance in semi-parameters among the primary cancer,normal pharyngeal wall tissue and the same layer neck muscles.Setting MSI value 58.32 threshold to distinguish abnormal and normal tissues,sensitivity and specificity both were 84.6%.Conclusion DCE-MRI can reflect morphology and signal differences among neck muscles,normal and abnormal laryngeal and hypopharyngeal tissues,providing help for diagnosis of primary carcino-ma.

Objective To study incidence of deep vein thrombosis (DVT) in the acute phase and follow-up period after stroke, and to investigate risk factors of DVT. Methods This was a prospective study at multi-centers. Ultrasonography was used for detecting DVT on both lower extremities in all patients at 10-14 days after the onset of stroke. All patients were followed up for 6 months after discharge. The incidence of DVT was examined in the acute phase and in the follow-up period of stroke. A variety of patient and treatment related factors were compared between stroke patients with DVT and without DVT to identify DVT risk factors. Results The incidence of DVT in the acute period of stroke was 4. 49%. Among DVT patients, 51.6% patients presented clinical DVT symptoms. By multiple factors logistic regression analysis,age ( ≥70 years, OR = 1.63, 95% CI 1.08-2. 84), bedridden( OR =4. 85, 95% CI 2.65-9. 68 ), wells score ≥ 2 ( OR = 3.96, 95% CI 1.86-7. 86 ), lower limbs NIHSS score ≥ 3 ( OR = 4. 56, 95% CI 2. 07-8. 85 ), high D-dimer ( OR = 3.45, 95% CI 2. 01-8. 52 ), low BI scores ( OR = 2. 98, 95% CI 1.52-6. 47 ), rehabilitation therapy ( OR = 1.82, 95% CI 1.22-3.43 ) and anticoagulant therapy ( OR =1.91,95% CI 1. 34-4. 92 ) were independent risk factors of DVT in the acute phase of stroke. Among them, the rehabilitation therapy and anticoagulant therapy were protective factors. The incidence of DVT in the follow-up periods was 1. 51%. Age ( ≥ 70 years, OR = 1.82, 95% CI 1.21-3.98 ), bedridden after discharge( OR = 5. 12, 95% CI 2. 82-11.32), lower limbs NIHSS score ≥3 ( OR = 4. 25, 95% CI 2. 11-7. 87), low BI score( OR = 2. 18, 95% CI 1.18-6.23 )at the time of discharge and DVT in acute period (OR =3.81,95%CI 1.87-7.48)were independent risk factors of DVT in the follow-up period of stroke.Conclusions Stroke patients, particularly old-aged stroke patients, are a high-risk group of developing DVT. 48.4% DVT patients had no clinical DVT symptoms but were diagnosed only by ultrasonography.There are multiple independent risk factors of DVT after stroke. It is necessary to monitor and prevent DVT in the stroke patients with the risk factors. The rehabilitation therapy and anticoagulant therapy may decrease incidence of DVT.

To investigate the effects of oleanolic acid (OA) on the proliferation, migration and the formation of tube-like structure in human vascular endothelial cells (HUVECs). MTT assay, flat plate scarification, Transwell plates and matrigel-induced tube formation assay were performed to detect the effects of OA on proliferation, migration and tube formation. MTT assay showed that the inhibition rates of HUVECs treated with 60 and 100 microg x mL(-1) of OA for 24 h were 19% and 83% respectively. Treatment of HUVECs significantly inhibited the cell migration in a dose-dependent manner. The vascular indexes of HUVECs treated with 40 and 60 microg x mL(-1) OA were 33% and 20% respectively. Western blotting analysis showed that treatment of the cells with OA significantly attenuated the expression and secretion of VEGF. Additionally, VEGF could in part reverse the effects of OA on migration and tube formation of HUVECs. In conclusion, OA inhibits the proliferation, and VEGF plays an important role in OA induced decreased migration and tube formation of HUVECs.