0.05) but CO, SV and CVP increased and SVR decreased significantly after AHH in both groups as compared with those before AHH. pH, Lac and COP did not change significantly after AHH. There was no significant difference in the volume of solution infused, blood loss, CO, SV, CVP and SVR between the two groups. Conclusion Age is not a primary factor negating the use of AHH. Under combined general-epidural anesthesia AHH with 6% hydroxyethyl starch (15 ml?kg-1 ) can be well tolerated by the elderly patients without cardiac and pulmonary disease.

35 % and the intraoperative blood loss was expected to be 800-1 600 ml. The operations were performed under combined general-epidural anesthesia. General anesthesia was induced with fentanyl 2-4 ?g?kg-1 , thiopentone 5 mg?kg-1 and succinylcholine 1.5mg? kg-1 and maintained with isoflurane inhalation and intermittent iv boluses of vecuronium. Epidural anesthesia was performed at T5-6 (thoracic surgery), T10-11 (upper abdominal surgery) or L3-4 (lower abdominal surgery) . A mixture of 0.1% lidocaine +0.2% dicaine was used for epidural block during operation. The patients were randomly divided into 2 groups: (1) ANIH group ( n = 18) and (2) AHH group ( n = 20) . Blood volume (BV) was calculated according to following formula: BV (ml) (male) = Height (cm)? 28.5 + Body weight (kg) ? 31.6 - 2 820,BV(ml) (female) = Height(cm)? 16.25 + Body weight (kg) ? 38.46 - 1 369. 1 000-1 200 ml of 6% HES (200/0.5) and 500 ml of lactated Ringer's solution (about 25%-30% of BV) were infused at a rate of 50ml?min-1 when induction of anesthesia was started in both groups. In group I (ANIH) 400-600 ml of blood (about 10%-15% of BV) was removed through radial artery before induction of anesthesia. The removed blood was reinfused at the end of surgery. Vital signs (BP,HR,CVP and ST-T changes) , Hct, oncotic pressure and arterial blood lactate concentration were monitored during operation. Results The vital signs were fairly stable during perioperative period in both groups. Transient hypotension developed in 16.7% (3/8 in group Ⅰ ) and 15.0% (3/20 in group Ⅱ ) of patients during induction of anesthesia. CVP was significantly elevated in both groups but the increase in CVP was significantly higher in group Ⅱthan that in group Ⅰ . In group Ⅰ (AN1H) moderate hemodilution was achieved (Hct = 29.9% 2.9%) while in group Ⅱ (AHH) only mild hemodilution was achieved (Hct = 32.9% ?2.9%) .Hct was significantly higher in group Ⅰ(31.5% ?5.1%) than that in group Ⅱ (27.7% ?3.6%) at the end of surgery. Blood loss was comparable between the two groups, and oncotic pressure and blood lactate level were within normal range in both groups. Conclusion ANIH is more effective and safer than AHH without obvious adverse effects, and can avoid exceedingly high CVP commonly seen in AHH. ANIH is a hemodilution technique of choice in the elderly patients.

BACKGROUND:Traditional distal femoral fixation plate screw breakage is relatively common. Designing good anatomical and attached fixation system is the key for clinical application.
OBJECTIVE:To perform finite element analysis in two states of motion of the minimal y invasive distal femoral fixation system, compare stress distribution of different parts in the same fixed way, different fixed methods and the same fixed parts of different motion states.
METHODS:Imaging data of a 34-year-old male patient weighing 68 kg with 33-C1 type fracture of distal femur were selected. CT data were input into Mimics 16.0 for reconstruction. PRO-E software was used to establish minimal y invasive internal fixation system with distal femoral locking plate. Data were introduced into reconstructed models of distal femur fracture in Mimics for grid division. Data were introduced into Ansys products 11.0 to construct finite element model, fix the surface of distal femur, and loaded 340 N on greater trochanter of femur. Stress distribution of each plate, screw hole and screw tail was analyzed in each group. Stress at the same region was compared in flexion and extension movement states.
RESULTS AND CONCLUSION:(1) Finite element models of anatomic locking plate for distal femur fracture fixation were successful y established, total y 43 536 units, 41 256 nodes. (2) With the steel segment gradual y down (S1-S5), the stress gradual y increased. A1-A5 with the increase in the number of screws, the stress gradual y increased, but A6 suddenly decreased. (3) According to the cloud atlas of stress, these were wel distributed except A1. From distal end to extremity of screw, the stress of screws increased. Among corresponding segments, significant differences in stress around the nail holes and steel segment stress were detected. Moreover, the steel stress was greater than the stress of corresponding segment of screw hole. (4) Results suggest that using anatomical locking plate and minimal y invasive internal fixation system for distal femur fracture in a variety of fixed modes and moving conditions, the stress of each part is less than the yield strength of the titanium al oy screw, so the fixed system wil not produce instantaneous deformation or fracture.

Objective To investigate the effect of isoflurane administered before ischemia on polymorphonuclear neutrophil (PMN) infiltration and expression of adhesion molecules in the lung injured by ischemia-reperfusion.Methods One-hundred and twenty male SD rats weighing 250-350 g were randomly divided into 4 groups ( n = 30 each) :Ⅰ sham operation group (S) ;Ⅱ I/R group in which hilum of left lung was clamped for 45 min and then undamped for reperfusion; Ⅲ Iso + I/R in which 1 MAC isoflurane was inhaled for 30 min before ischemia and Ⅳ Iso + S in which 1 MAC isoflurane was inhaled for 30 min without I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1 then tracheostomized and mechanically ventilated with 100% O2(VT= 10-15 ml?kg-1) . PaCO2 was maintained at 35-45 mm Hg. Right jugular vein and left carotid artery were cannulated for BP monitoring, blood sampling and fluid and drug administration. Anesthesia was maintained with ketamine 10 mg?kg-1?h-1 and vecuronium 0.1 mg?kg-1?h-1. 1 MAC isoflurane (1.38% in rats) was inhaled for 30 min before hilum of left lung was clamped with an atraumatic clamp. Left lung ischemia was maintained for 45 min then the left lung was released for reperfusion. MAP was monitored and blood gases were analyzed during experiment. The animals were killed at the end of 45 minute ischemia and at 30, 60 and 120 min reperfusion and left lung was removed for: (1) determination of W/D lung weight ratio, myeloperoxidase (MPO) activity and expression of ICAM-1 mRNA; (2) light and electron microscopic examination; (3) broncho-alveolar lavage (BAL). BAL fluid (BALF) was collected and the number of cells, percentage of PMN and total protein concentration in BALF and the expression of CD18 on PMN surface were determined. Results The W/D lung weight ratio, MPO activity and expression of ICAM-1 mRNA in the lung tissue, the percentage of PMN and TP concentration in BALF and the expression of CD18 on PMN surface were all significantly increased during reperfusion in I/R group but isoflurane pretreatment significantly attenuated the I/R induced increases. Histological examination showed that the I/R induced lung injury was also ameliorated by isoflurane pretreatment. Conclusion Inhalation of isoflurane before ischemia could protect the lungs against I/R injury by inhibiting the PMN infiltration and expression of ICAM-1 mRNA and CD-18.

Objective To investigate the significance of intensity modulated radiation therapy(IMRT)for spinal metastases during different target areas setting and evaluate the efficacy of pain relief before and after radiotherapy. Methods Forty-four cases of spinal metastases were treated with intensity modulated radiation therapy, including 18 males and 26 females; aging from 40 to 68 years with a mean of 56 years.Frankel grade before treatment: stage A in 2 patients, B in 2, C in 3, D in 3, E in 34. The target area was determined according to preoperative imaging, CT localization before radiotherapy and different anatomical characteristics of spinal cord segments. And then the intensity modulated radiation therapy was performed by means of 5-field irradiation. Prescription dose: 30-56 Gy, the average 40.5 Gy, the median dose of 40 Gy, 2-3 Gy/times, 5 times/week. Before and after radiotherapy for pain relief in patients, neurological function of spinal cord were compared and comprehensively evaluated. Results Among 44 patients undergone pain intensity modulated radiation therapy, 21 patients achieved complete remission, 17 achieved partial remission and 6 achieved minor effect, with a relief rate of 86.4% (38/44). Pain rating before treatment was not correlative with the state of pain relief. Evaluation of the effect of radiotherapy showed complete remission in 4 cases and partial remission in 33, no change in 7, with an efficiency rate of 84.1%(37/44). There was no relationship between pain relief with implant nails and implant bone cement. Ten patients with different degrees of neurological impairment before treatment were improved in Frankel grade after treatment. Conclusion IMRT can improve pain in patients with metastatic spinal tumors, and nerve dysfunction and other symptoms, which was not easy to result in radioactivity spinal cord and nerve injury.

The fragmentation pathways of two taxanes drugs have been studied in positive ion mode by Q-TOF with the advantages of high mass accuracy and high resolution analysis. The [M+H] + ions were observed by ESI-MS, from which the molecular weights were obtained. Using the protonated pseudo-molecular ions [M+H]+ as internal reference compounds, the accurate mass and element composition of the fragment ions were determined. The collision induced dissociation (CID) data of the [M+H] ions provided fragmentation pathways of related compounds. Results showed that the major cleavage pathways of paclitaxel and docetaxel were the same that the cleavage of C-O bond between the side chain and taxol skeleton easily occurred, then stripping of the functional groups on the parent ring. Some common fragments were formed, such as m/z 105.033 7, 291.137 3, 309.148 5, 327.159 7, 387.181 2 and 509.217 4, which would provide a basis for future qualitative and quantitative analysis of taxanes in vitro and in vivo.
Paclitaxel ; chemistry ; Peptide Fragments ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods ; Taxoids ; chemistry

To evaluate the protective effect of anti-digoxin antiserum on hypoxic injury myocardium and its mechanism.Methods It was observed that different concentration anti-digoxin antiserum effect on endogenous digitalis-like factor and cell membrane ATPase activity in hypoxic myocardium model.Results The level of endogenous digitalis-like factor was remarkably higher,cell membrane ATPase activity were remarkably lower in hypoxic group than those of normal group;anti-digoxin antiserum can resume membrane ATPase activity.Conclusion Rise of endogenous digitalis-like factor was basic of molecular biology of myocardial damage during myocardial hypoxia.Anti-digoxin antiserum has lightened myocardial injury and has protective effect on hypoxic myocardium by against effect of endogenous digitalis-like factor.

Objective To investigate the effect of Curcumin on rats with severe acute pancreatitis associated renal injury and explore the possible mechanisms.Methods A total of 72 rats were randomLy divided into sham-operated group(S group, n =24), severe acute panceratitis with renal injury group(M group, n =24) ,Curcumin-treated group(Cur group,n=24).The S and M groups were given 1.5 ml saline through intragastric administration 3 hours before operation,while the Cur group was fed with same amount of Curcumin diluent(200 mg/kg).The pancreas and pancreatic tail-segment was dissociated and the head of pancreas was occlused in rats to form the model,blood vessel forceps was loosed after 3 hours.All the rats were sacrificed at 12 h,24 h, 36 h and 48 h after modeling.The level of ascites, serum amylase, creatinine, blood urea nitrogen were detected and the pathological chang of pancreas was observed under light microscope.Take the right kidney for Superoxide Dismutase (SOD) determination and the expression of hypoxia inducible factor-1αmRNA in the right kidney was detected with realtime polymerase chain reaction (RT-PCR).Results Compared with Cur group, the level of ascites, serum amylase, creatinine, blood urea nitrogen in M group were significantly increased, but the activity of SOD, the express of hypoxia inducible factor-1αmRNA had a significant decline (P＜0.05).The tissue damage of pancreas and the kidneys became more serious.But a better performance was to be found in the function of the Cur group's kidney and pancreas, and the the difference was statistical significance (P ＜0.05).Conclusion Curcumin has a good protective effect on severe acute pancreatitis associated renal injury.It may be through up-regulation expression of HIF-1α mRNA and increase the activity of superoxidase dismutase, then reduce the cell apoptosis and necrosis of the kidney, improve the ability of the kidney to tolerate hypoxia.

Aim To evaluate the protective effect of anti_digoxin antiserum on hypoxic injury myocardium and its mechanism. Methods It was observed that different concentration anti_digoxin antiserum effect on endogenous digitalis_like factor and cell membrane ATPase activity in hypoxic myocardium model. Results The level of endogenous digitalis_like factor was remarkably higher, cell membrane ATPase activity were remarkably lower in hypoxic group than those of normal group; anti_digoxin antiserum can resume membrane ATPase activity.Conclusion Rise of endogenous digitalis_like factor was basic of molecular biology of myocardial damage during myocardial hypoxia. Anti_digoxin antiserum has lightened myocardial injury and has protective effect on hypoxic myocardium by against effect of endogenous digitalis_like factor.

Background Ultraviolet irradiation promotes cellular apoptosis by affecting the mitochondrial transmembrane potential,including human lens epithelial cells (LECs).Gene associated with retinoid-interferoninduced mortality-19 (GRIM-19),a cell death regulatory protein,is essential for the assembly and function of mitochondrial complex Ⅰ.However,whether LECs apoptosis induced by ultraviolet irradiation is related to GRIM-19 is still unclear.Objective The purpose of this study was to investigate the relationship between the apoptosis of human LECs caused by ultraviolet with GRIM-19 expression in vitro.Methods Human LEC line(SRA01/04)was cultured in α-MEM containing 10％ fetal bovine serum.The cells were exposed to ultraviolet ray at doses of 0,30,60,90,120 or 150 mJ/cm2 when cell growth reached the logarithmic phase and 80％ confluency.The rate of apoptosis of the cells was assayed using flow cytometry,and the level of expression and relative amount of GRIM-19 protein (GRIM-19/β-actin) were detected by Western blot.The relationship between apoptosis and the GRIM-19/β-actin value among the different treatment groups was compared using One-way ANOVA,and the correlation of LECs apoptosis rate and GRIM-19 expression level was assessed by Pearson linear analysis.Results A significant difference was found in the apoptosis rate among the different treatment groups(F=149.32,P＜0.01).Compared with the 0 mJ/cm2 ultraviolet irradiation group,the apoptosis rate of LECs was significantly increased in the 60,90,120 and 150 mJ/cm2 ultraviolet irradiation groups (q =17.02,-25.20,-29.41,-8.61,P ＜ 0.01).The expression of the GRIM-19 protein in the LECs suspension was enhanced by ultraviolet irradiation at 60,90,120 and 150 mJ/cm2.The relative expression of the GRIM-19 protein (GRIM-19/β-actin) was significantly different among the various groups (F=6.87,P＜0.05),and the GRIM-19/β-actin values in the 60,90,120,150 mJ/cm2 ultraviolet irradiation groups were elevated in comparison with the un-irradiated group(2.01±0.76,2.98± 1.80,3.97± 1.61,2.42± 1.28 vs.0.56±0.23),which showed statistically significant differences (q =4.12,-5.04,-7.09,-3.85,P ＜ 0.01).In addition,a positive correlation was seen between the rate of apoptosis and the expression of the GRIM-19 protein(r=0.71,P＜0.01).Conclusions GRIM-19 is expressed in normal human LECs.The apoptosis of human LECs accompanies the up-regulation of GRIM-19.The expression of GRIM-19 in LECs increases with ultraviolet irradiation in a doseindependent manner.