Objective To evaluate the protective effect of therapeutic hypercapnia on the lung during one-lung ventilation (OLV) in the patients undergoing pulmonary lobectomy.Methods Fifty patients of both sexes,aged 20-60 yr,with body mass index 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ,scheduled for elective pulmonary lobectomy,were randomly divided into 2 groups (n=25 each) using a random number table:control group (group C) and therapeutic hypercapnia group (group H).After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated in volume-controlled mode.The ventilator settings were adjusted during two-lung ventilation to maintain the end-tidal pressure of carbon dioxide (PETCO2) at 25-35 mmHg.Group H inhaled the mixture of CO2 (3％-6％) and O2 (70％-82％) during OLV to maintain PETCO2 at 50-60 mmHg.Group C inhaled O2 (70％-88％) during OLV to maintain PETCO2 at 25-35 mmHg.Anesthesia was maintained with inhalation of sevoflurane and intravenous infusion of remifentanil.Immediately before OLV and at 30 min after restoration of two-lung ventilation,the airway peak pressure,airway plateau pressure and lung compliance were recorded,arterial blood samples were collected for blood gas analysis,and broncho-alveolar lavage fluid (BALF) from the collapsed lung and venous blood samples were collected for determination of tumor necrosis factor-alpha (TNF-α),interleukin-1beta (IL-1β),IL-6,IL-8 and IL-10 concentrations in BALF and serum by enzyme-linked immunosorbent assay.Oxygenation index was calculated.Results Compared with group C,the airway peak pressure and airway plateau pressure were significantly decreased,the lung compliance was significantly increased,the concentrations of TNF-α,IL-1β,IL-6 and IL-8 in BALF were significantly decreased,and the concentrations of IL-10 in BALF were significantly increased at 30 min after restoration of two-lung ventilation (P＜0.05),and no significant change was found in the oxygenation index and concentrations of inflammatory factors in serum in group H (P ＞ 0.05).Conclusion Therapeutic hypercapnia can improve pneumodynamics and attenuate inflammatory responses,and has no significant difference clinically in improving oxygenation during OLV in the patients undergoing pulmonary lobectomy.

Objective To analyze the effect of health education on recurrence of acute pancreatitis in discharged patients. Methods All patients with acute pancreatitis accepted health education during the first hospitalization.92 patients were randomly allocated to the trial group and the control group.The trial group was kept on being treated with health education for 18 months after discharged form the hospital but the control group didn' t.Results The recurrence rate of trial group was 8.50% but the control group was 24.44%(P

Objective To investigate the relationship between family function and unhealthy mood in patients with vascular dementia (VD).Methods 120 VD patients were investigated by the Family APGAR index (APGAR),Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),and Mini-Mental State Examination (MMSE).Results 98 cases (81.7％) were in depression with anxiety.Family dysfunction was presented in 83.3％ of 120 VD patients.The mild and moderate cognitive impairment were present in 55.8％ and 44.2％.The score of MMSE,the total score and factors scores of APGA were negatively related to the score of HAMD and HAMA.The score of MMSE was positively related to the total score and factors scores of APGA.The family dysfunction,self-reported financial burden and cognitive disorder were the risk factors of unhealthy mood (OR＞1).Conclusions The results suggest that improvement of VD patients' family function,reducing the economic burden and enhancing cognitive function can possibly relieve the unhealthy mood of patients.

Objective To study the effect of three kinds of disinfection liquid,namely chlorine dioxide,silver ion and BIOCIDE,on sterilization of Legionella pneumophila.Methods The suspended quantified disinfection test was conducted by using 7 type of Legionella p neumophila,0.5 ml of bacterial suspension and 4.5 ml disinfection liquid were mixed for certain period, the normal saline was used as the control.1.0 ml of the above liquid or its dilution was incubated with BCYE for 72 h in CO_2 and 35 ℃,the colony count and sterilization rate were calculated.Results The sterilization rate of chlorine dioxide was 6.04%,7.87% and 18.18% at the sterilization time of 0.5,1 and 2.5 h respectively.The sterilization rate of silver ion was 52.61%,99.46% and 99.80% at the time of 0.5,1,1.5 and 2.0 h respectively.As for BIOCIDE,the sterilization rate was 25.28%,93.62%,96.60% and 99.81% at the time of 0.5,1,1.5 and 2 h respectively.Conclusion Compared with chlorine dioxide,silver ion and biological disinfectant has a better sterilization effect on Legionella pneumophila.

OBJECTIVETo study the clinicopathologic features and possible molecular mechanisms of adenoid cystic carcinoma with high-grade transformation.

METHODSFour cases of adenoid cystic carcinoma with high-grade transformation were enrolled into the study. Immunohistochemical study for smooth muscle actin, p63, p53 and Ki-67 was carried out. C-myc gene status was analyzed by fluorescence in-situ hybridization.

RESULTSThere were altogether 3 males and 1 female. The mean age of the patients was 55.5 years. Two patients died 17 months and 29 months after operation, respectively. One patient had distant metastasis 23 months after operation and was still alive at 26-month follow up. The remaining patient remained tumor free at 3-month follow up. High-grade transformation in adenoid cystic carcinoma presented either as poorly differentiated adenocarcinoma or undifferentiated carcinoma. Histologic examination showed sheets of pleomorphic tumor cells occupying more than one low-power field. The high-grade carcinoma cells showed increased nuclear-cytoplasmic ratio, prominent eosinophilic nucleoli and active mitosis (ranging from 8 to 25 per high-power field). Comedo necrosis was observed in 2 cases and multiple foci of calcifications in 3 cases. Immunohistochemical study demonstrated loss of myoepithelial differentiation, overexpression of p53 and high proliferative index by Ki-67. No c-myc translocation or copy-number changes were observed.

CONCLUSIONSHigh-grade transformation in adenoid cystic carcinoma is rare. The histopathologic features are rather distinctive and the biologic behavior is aggressive. C-myc gene mutation does not seem to play a key role in the pathogenesis.

Actins ; metabolism ; Adenocarcinoma ; genetics ; metabolism ; pathology ; Adult ; Aged ; Carcinoma ; genetics ; metabolism ; pathology ; Carcinoma, Adenoid Cystic ; genetics ; metabolism ; pathology ; Cell Transformation, Neoplastic ; Eye Neoplasms ; genetics ; metabolism ; pathology ; Female ; Follow-Up Studies ; Genes, myc ; Humans ; Ki-67 Antigen ; metabolism ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases ; genetics ; metabolism ; pathology ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; Maxillary Sinus Neoplasms ; genetics ; metabolism ; pathology ; Membrane Proteins ; metabolism ; Middle Aged ; Mutation ; Parotid Neoplasms ; genetics ; metabolism ; pathology ; Survival Rate ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo investigate the inhibitory effect of bone marrow mesenchymal stem cells (BMSCs) on E coliinduced prostatitis in rats.

METHODSBMSCs were isolated, cultured and amplified by the attached choice method. Fifty SD rats were randomized into five groups of equal number: normal control, acute bacterial prostatitis (ABP) , chronic bacterial prostatitis (CBP), ABP + BMSCs, and CBP + BMSCs, and the animals in the latter four groups were injected with E. coli into both sides of the prostate under ultrasound guidance for 1 - 14 days to induce ABP and for 4 - 12 weeks to induce CBP. The control rats were injected with the same amount of PBS. Two weeks after injection of BMSCs into the prostates, pathomorphological changes in the prostate were observed under the light microscope and the mRNA and protein levels of IL-1β and TNF-α determined by RT-PCR and ELISA, respectively, followed by statistical analysis with SPSS 18.0.

RESULTSHistopathological evaluation showed typical pathological inflammatory changes in the prostates of the rats in the ABP and CBP groups, including glandular structural changes, interstitial edema, inflammatory cell infiltration, and fibrous hyperplasia, which were all remarkably relieved after treated with BMSCs. The mRNA and protein levels of IL-β ([0.829 ± 0.121] and [271.75 ± 90.59] pg/ml) and TNF-α ([0.913 ± 0. 094] and [105.78 ± 19. 05] pg/ml) in the ABP and those of IL-1β ([0. 975 ± 0. 114] and [265. 31 ± 71. 34] pg/ml) and TNF-α ([0. 886 ± 0. 084] and [107. 45 ± 26. 11 ] pg/ml) in the CBP groups were significantly higher than those in the control rats ([0. 342 ± 0.087] and [45.76 17. 99] pg/ml, P <0. 05); ([0.247 ± 0.054] and ([19.42 ± 7. 75] pg/ml, P <0. 01) as well as than those in the ABP + BMSCs ([0. 433 ± 0. 072] and [51. 34 ± 22. 13] pg/ml, P < 0. 05 ) ; ( [0. 313 ± 0. 076] and [28. 38 ± 8. 78] pg/ml, P < 0. 01) and the CBP + BMSCs group ([0.396 ± 0.064] and [56.37 ± 21.22] pg/ml, P <0.05); ([0.417 ± 0.068] and [29.21 ± 10.22] pg/ml, P <0.01).

CONCLUSIONInjection of BMSCs can reduce E coli-induced prostatic inflammation reaction, which.may be associated with its reduction of inflammatory cell infiltration and the expressions of IL-1β and TNF-α in the prostate tissue.

Acute Disease ; Animals ; Bone Marrow Cells ; physiology ; Chronic Disease ; Escherichia coli Infections ; therapy ; Humans ; Interleukin-1beta ; genetics ; Male ; Mesenchymal Stromal Cells ; physiology ; Prostate ; metabolism ; Prostatitis ; metabolism ; microbiology ; therapy ; RNA, Messenger ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To analyze the mutations of causal genes in sixteen Chinese patients with suspicious Bartter syndrome,and follow up their treatment results.Methods Mutations were identified by the next generation sequencing and the multiplex ligation-dependent probe amplification (MLPA).Clinical and biochemical features at the first presentation as well as follow-up results were reviewed.Results 15 different CLCNKB gene mutations were identified in sixteen patients with BS,including 11 novel ones.A novel missense mutation and a novel small deletion were found from SLC12A1 gene.A novel gross deletion was found in CLCNKA gene.A recurrent missense mutation was identified from BSND gene.The whole gene deletion mutation of CLCNKB gene was the most frequent mutation (32％),and the rate of gross deletion was up to 50 percent in this group of Chinese patients.The most common clinical manifestations were development retardation (15/16),polydipsia and polyuria (15/16).All of the patients were detected with hypokalemia,hypochloremia and metabolic alkalosis.Indomethacin treatment had significant improvement to the stature and weight restoration.Conclusion The present study has found 19 mutations,including 14 novel ones,which enriches the human gene mutation database (HGMD) and provides valuable references to the genetic counseling and diagnosis of Chinese population.

Objective To observe ultrasonic and PET/CT features of malignant lymphoma after chemotherapy and to determine the value in assessment of lymphoma treatment response.Methods Seventy-seven lymph nodes in 32 patients were observed and measured with color Doppler ultrasound and PET/CT after chemotherapy comparing with pathologic results.Results Seventy-two lymph nodes were exactly certified by ultrasound(94.8%),and seventy-five nodes were exactly confirmed by PET/CT(97.4%).There were significant differences in L/S,blood supply type,Vmax,Vmin,RI(P＜0.05)between nodes groups with and without residual tumor.The PET/CT inspection demonstrates that lymph nodes with residual tumor was in the high metabolism condition.The positive nodes'index of ultrasound were connected with their metabolism condition.Conclusions The two methods all have high rate of accuracy.Ultrasound can be used as normal method in assessment of lymphoma treatment response.

0 05), respectively The 5 year survival rate was 38 7%( n =750) The 5 year survival rate of patients undergoing radical resection A and B ( n =561) was 49 9%, that of palliative resection was 5 3% The 5 year survival rate of D 0/D 1、D 2 and D 3/D + 3 lymph node dissection were 30 4% ( n =286), 59 9%( n =197) and 31 8%( n =267), respectively Of stage Ⅲ patients, the 5 year survival rate of D 2 and D 3/D + 3 lymph node dissection were 42 3% ( n =52), and 59 2% ( n =98), respectively ( P

Objective To study the change and the significance of T-lymphocyte immune function in peripheral blood in population living in arsenic-contaminated area. Methods Fifty-three cases of patients with arsenism symptoms were selected into experimental group, inhabitants who had no chronic arsenism symptoms into control group in the endemic area of Shuocheng District, Shuozhou City, Shanxi Province in 2006. Vein blood samples were taken and analyzed with SAP assay to measure the percentage of CD3+ ,CD4+ and CD8+ T-cells. Results It was found that the percentage of CD3+, CD4+, and CD4+/CD8+ [(41.89 ± 11.58)%, (25.60 ± 9.05)% and 1.02 ± 0.41] in the experimental group was lower than that in the control group [(68.38 ± 7.23)%, (39.17± 4.28)% ,1.69 ± 0.56, t = 13.61,18.72,14.79, all P < 0.05], while there was no statistical differences of CD8+ [(25.30 ± 6.85)%] compared to the control group[(23.54 ± 8.35)%,t = 3.07,P > 0.05]. The gender-related effect of arsenic on CD4+ and CD8+ was found by multiple linear step regression analysis(t = - 3.05, - 4.30, all P < 0.05). In case group, there were no statistical differences in CD3+, CD4+, CD8+ and CD4+/CD8+[(40.65±10.06)%, (24.48 ± 6.29)%, (24.52 ± 8.16)%,0.98 ± 0.25] between males and females [(43.07±12.96)%, (26.77±3.12)%, (26.50 ±9.32)%, 1.07 ±0.41, t = - 0.76,3.05,0.30,2.10, all P > 0.05]. Conclusions The immune function of T-lymphocytes of patients with chronic arsenism has been suppressed. It is of active significance to detect T-lymphocyte subpopulation in peripheral vein in patients with chronic arsenism aiming at estimating the function of cell immune and providing early diagnosis index.