Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

OBJECTIVETo study the clinicopathological characteristics of papillary cystadenoma of the epididymis.

METHODSUsing routine pathology and immunohistochemistry, we observed the surgically obtained samples from 2 cases of papillary cystadenoma of the epididymis, analyzed their pathological features and clinical presentations, and reviewed the related literature.

RESULTSThe 2 patients were both adult males. The tumors typically manifested as painless swelling in the epididymis, with occasionally dull pain and tenesmus in 1 of the cases. Pathologically, the lesions exhibited three morphological features, i. e., dilated ducts and small cysts surrounded by fibrous connective tissue, adenoid papillary hyperplasia into the cysts embraced by fibrovascular stroma, and acidophil substance present in the cysts. Immunohistochemistry showed that the tumors were strongly positive for CK8/18, CK7, and EMA, but negative for CK20, CEA, MC, Calretenin, P53, P63, SMA, VHL, and CD10, with the positive rate of Ki-67 <1%. Follow-up visits revealed good prognosis in both cases.

CONCLUSIONPapillary cystadenoma of the epididymis is a rare benign tumor in the male urogenital system, which may be accompanied by the VHL syndrome. Surgery is the first choice for its treatment.

Adult ; Cystadenoma, Papillary ; chemistry ; pathology ; Epididymis ; Genital Neoplasms, Male ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Male ; von Hippel-Lindau Disease

Adenocarcinoma ; pathology ; surgery ; Aged ; Carcinoma, Signet Ring Cell ; pathology ; surgery ; Cell Differentiation ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Paneth Cells ; pathology ; Stomach Neoplasms ; pathology ; surgery

Objective To explore the correlation between hyperuricaemia and blood pressure, and blood lipid and glucose. Methods By using simple cluster sampling, 2 branch units from PetroChina Changqing Oilfield Company were selected, and all the 720 subjects with hyperuricaemia (HUA) were assigned to the HUA group; another 620 participants with normal uric acid (UA) level into the normal group. The correlation between blood uric acid and blood pressure,and blood lipid and glucose was assessed by Logistic regression. Results The odds ratio (OR) of those who had 1,2 or 3 abnormal status of hypertension,hyperlipidemia and impaired fasting glucose in the HUA group were much higher than the normal group (OR values were 4. 036,2. 562, and 4. 174, respectively). Logistic regression showed that male, systolic blood pressure ( SBP), GLU, total cholesterol ( TC), triglyceride ( TG), low-density lipoprotein cholesterol (LDL-C) were risk factors of H UA ( OR values were 7. 736,2. 309,1.721,2. 761 and 1. 411,respectively) ,while high-density lipoprotein cholesterol (HDL-C, OR = 0. 211 ) was a protective factor of HUA. Conclusions Gender,blood pressure and blood lipid may have correlation with blood UA. Multiple risk factors should be considered to improve the effectiveness of health education and health promotion.

Purpose To investigate the clinicopathological and immunohistochemical features of primary small cell carcinoma of the cervix ( SCCC) and its prognosis. Methods 18 cases of primary cervical small cell carcinoma were evaluated by histopathology, in si-tu hybridization and immunohistochemistry and relevant literatures were reviewed. Results The age of the patients ranged from 30 to 69 years ( mean age, 40 years) . Major clinical manifestation was irregular colporrhagia. Colposcopy often revealed a cervical mass or cervical erosion. Microscopically, the tumor cells were small and round and arranged in a solid distribution. The cell had little cyto-plasm and increased karyoplasmic ratio with deeply stained granular chromatin and increased pathological mitosis. Immunohistochemi-cally, the tumor cells were often positive for CKpan, variable positive for Syn, NES, CgA, CD56 and p16. HPV 16/18 were positive in 4 cases. Conclusion SCCC is a neuroendocrine tumor of high malignancy and poor prognosis with a possible pathogenesis of HPV 16/18 infection. CKpan, Syn, CgA, NSE and CD56 are useful markers for the diagnosis of SCCC.

ObjectiveTo analyze the disc working zone of intervertebral foramens (ⅣF) for percutaneous posterolateral approach to the lumbar disc with dissection and measurement of adult cadaveric spine speciments.MethodsTwenty-five lumbar IVFs of cadaveric spines(age:45-65 years; body height:150-176 cm) were studied.The heights of the intervertebral space at the most posterior margin (h) and the angles between the nerve root and the plane of the disc (β) at the sagittal plane and the distance from the nerve root to posterolateral margin of disc(d) were measured.The distances from nerve root to the lateral edge of articular process at the plane of the inferior endplate of the upper vertebra (a1) and the plane of the superior endplate of the vertebra below(a2) were measured.We also measured the distance between the nerve root and the dura at two planes of the vertebra endplate(b1,b2) after removing the lamina and articular processes.ResultsThe disc in the ⅣF is contained in the trapezoid shaped zone at the sagittal plane or the coronal plane.The parameters of two trapezoids are displayed:h is (7.0±1.1) mm; β is 77.6°±8.4°; d is (3.4±2.3)mm; a1 is (9.4±2.2) mm; a2 is (10.8±4.6) mm; b1 is (9.9±2.7) mm; and b2 is (17.7±2.1) mm.All values increase as the level goes down except the value of β,which decreases.ConclusionThe disc working zone of ⅣF is a complicated three-dimensional structure changed from the Kambin's triangle,which could be simulated by construction of two trapezoid on sagittal and coronal planes.The anatomic study of the structure is able to help the clinical transforaminal managements of the lumbar disc.For example,the dimension of working cannula could be figured out by the height of the intervertebral space.The angle of the needle inserted is affected by the distance from nerve root to the disc in this structure.

Objective To observe the expression of matrix metalloproteinases(MMP)-1,MMP-3 and iNOS in cartilage of experimental rabbit osteoarthritis at different time intervals after anterior cruciate ligament transection(ACLT)operation.The aim of this study is to provide the theoritical evidence for using ACLT rabbit model in Osteoarthritis(OA)research.Methods Unilateral ACLT was performed on 27 randomly selected while rabbits and underwent unilateral arthrotomy was performed on the other 9 white rabbits as the control group.Nine randomly selected white rabbits in experimental group were killed and 3 white rabbits in the control group at 4th,8th and 12th week respectively.Cartilage degradation of femoral condyles was evaluated macr-oscopically,mRNA expression level and protein expression level of MMP-1,MMP-3 and iNOS was measured by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry respectively.Results Forepart OA cartilage degradation was observed at the 4th week and became more severe at the 8th week after ACLF.Afterpart cartilage degradation was evident at the 12th week after ACLT while cartilage still remained normal in the control group,mRNA expression level and protein expression level of MMP-1.MMP-3 and iNOS were increased at the 4th week and became higher gradually at the 8th,12th week after ACLT compared with the control group.Expression distribution of MMP-1,MMP-3 and iNOS bad different patterns respectively.Conclusion It is suggested that the process of OA cartilage degradation can be simulated by ACLT model and MMP-1,MMP-3 and iNOS may be good markers in therapeutical research of OA.

Objective To evaluate the dose distribution in clinical target volume (CTV) and organs-at-risk (OARs) in three dimension therapy plans in patients with squamous cell carcinoma of tongue receiving postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT) by dosimetric study. Methods Thirty-five patients with squamous cell carcinoma of tongue were divided into CRT group(n=17) and IMRT group(n=18). All patients underwent head-and-neck immobilization with a thermoplastic mask and planning CT scan, and target volume and OARs were contoured. Dose calculation and plan optimization were performed. All three dimension plans passed quality assurance before treatment. The dosimetry of therapy plans with IMRT or CRT in target volume and OARs dose distribution was compared by dose-volume histogram (DVH), conformity index (CI) and homogeneous index (HI). Results There were significant differences in D95 (isodose line to cover 95 percent target volume), CI, HI, minimum dose and maximum dose in CTV of therapy plans between patients with IMRT and CRT(P < 0.01), and there was no significant difference in mean dose of CTV(P > 0.05). The radiation dose on salivary glands (both parotid glands and contralateral submandibular gland) in patients with IMRT was significantly lower than that in patients with CRT(P < 0.01). Conclusion Compared with dose distribution of CRT plans, there are more advantages in improving dose distribution at the target volume and sparing salivary glands in IMRT therapy plans in patients with squamous cell carcinoma of tongue.

Abstract: Objective　To investigate the pollution of paralytic shellfish poisons (PSP) in shellfish sold in Hainan Province from 2018 to 2021. Methods　From 2018 to 2021, the content of 10 paralytic shellfish poisons including saxitoxin (STX), neosaxitoxin (neoSTX), gonyautoxins 1 (GTX1), gonyautoxins 2 (GTX2), gonyautoxins 3 (GTX3), gonyautoxins 4 (GTX4), gonyautoxins 5 (GTX5), decarbamoylsaxitoxin (dcSTX), decarbamoylgonyau toxins 2 (dcGTX2) and decarbamoylgonyau toxins 3 (dcGTX3) in 7 kinds of shellfish commonly sold in 13 cities and counties in Hainan province was analyzed. Results　The detection rate of PSP in 360 shellfish samples was 10.3%. Among them, the highest detection rate of STX was 5.83%, followed by GTX2 detection rate of 4.17%; the detection rate of neoSTX and GTX3 were both 1.67%; the detection rate of GTX1 was 1.39%. None of the five PSP, GTX4, GTX5, dcSTX, dcGTX2 and dcGTX3, were detected. Four types of PSP were detected in fanscallops, two were detected in oysters, mussels and Scapharca subcrenata, only one was detected in scallops, and no toxin contamination was detected in clams and razor clams. A single sample of fanscallops detected a maximum of 4 PSP, and a single sample of oysters, scallops, mussels and Scapharca subcrenata detected a maximum of 1 PSP. The equivalence of PSP in all samples was ND-155.6 μg/kg.The annual detection rate of PSP from high to low was: 20.0% in 2020, 15.6% in 2019, 5.3% in 2018, and 2.0% in 2021, and none of the samples tested exceeded the standard. Continuously detectable STX in 2018-2020, all PSP that could be detected in 2018 were STX. In 2019, in addition to STX detected in scallops and Scapharca subcrenata, neoSTX was also detected in oysters, mussels and Scapharca subcrenata. In 2020, PSP was only detected from scallops, and GTX2 could be detected in all positive specimens, while 5 STX, 5 GTX1 and 6 GTX3 were detected. Only GTX2 detected from scallops in 2021. STX was detected in shellfish sold in 12 cities and counties, GTX2 can be detected in 10 cities and counties, neoSTX can be detected in 5 cities and counties, GTX1 and GTX2 were detected in 4 cities and counties respectively. Shellfish sold in Wenchang and Lingshui markets can detect 5 types of PSP. Conclusion　Some types of shellfish on the market in Hainan are contaminated with some kind of PSP pollution risks, and it is necessary to strengthen the supervision of PSP in marketed shellfish.

This study is to determine the content of three alkaloids and establish the HPLC fingerprint of "Jianlian" Nelumbinis Plumula. The HPLC method of content determination was as follows: Thermo C18 (4. 6 mm x 250 mm, 5 μm) was conducted with acetonitrile-sodium dodecyl sulfonate solution-acetic acid (56: 43: 1) at a flow rate of 1.0 mL x min(-1). The monitoring wavelength was set at 282 nm and the column temperature was 35 degrees C. The method of HPLC fingerprint was as follows: Agilent ZORBAX SB-Aq C18 (4.6 mm x 250 mm, 5 μm) was conducted with gradient elution of methanol and water at a flow rate of 0.8 mL x min(-1), the monitoring wavelength was set at 282 nm and the column temperature was 35 degrees C. Similarities evaluation and hierarchical clustering analysis were applied to demonstrate the variability of 12 batches of "Jianlian" Nelumbinis Plumula samples. The results demonstrated that 11 batches showed good similarity on chemical constituents. The method could well display the chemical information of "Jianlian" Nelumbinis Plumula. It was simple, reliable and could be used for the chemical quality control of "Jianlian" Nelumbinis Plumula.
Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Nelumbo ; chemistry ; Quality Control ; Seeds ; chemistry