Ear Diseases ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging

Objective To investigate the reasonable and effective administration ofdexmedetomidine for thoracic surgery anesthesia.Methods Eighty ASA Ⅰ-Ⅱ patients,aged 18-60 years old scheduled for elective thoracotomy were randomly assigned to 4 groups(each 20 patients).Group A:dexmedetomidine before anesthesia induction + bupivacaine before closed thorax cavity.Group B:dexmedetomidine before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Group C:0.9％ sodium chloride before anesthesia induction + bupivacaine before closed thorax cavity.Group D:0.9％ sodium chloride before anesthesia induction + dexmedetomidine and bupivacaine before closed thorax cavity.Mean arterial pressure (MAP) and heart rate (HR) were measured before infusing dexmedetomidine or 0.9％ sodium chloride (T0),after infusing dexmedetomidine or 0.9％ sodium chloride (T1),instant time after intubation (T2) and 3 min after intubation (T3),5 min after intubation (T4).The scores of visual analogue scale(VAS) and the consumption of analgesics were compared.Results There was no significant difference including gender,age,weight and operation time among four groups (P ＞ 0.05).Compared with T0,MAP and HR were significantly decreased at T1 in group A and group B (P ＜ 0.05),and were significantly increased at T2 in group C and group D (P＜ 0.05).Respectively compared with group A and group B,MAP and HR were significantly increased at T2,T3 in group C and group D (P ＜ 0.05).The scores of VAS in group B [(2.47 ± 1.43) scores] and group D [(2.00 ± 1.68) scores] were lower than those in group A [(4.78 ± 1.26) scores] and group C [(4.88 ± 1.62) scores] after operation 12 h.The times of using postoperative analgesics in group B [(0.6 ± 0.4) times] and group D [(0.8 ± 0.1) times] were significantly less than those in group A [(1.3 ± 0.5) times]and group C [(1.5 ± 0.4) times] (P ＜ 0.05).Conclusions Intravenous dexmedetomidine before anesthesia induction can control the effect of double-lumen endobronchial tube responses and make hemodynamics stable.Intercostal nerve block with 0.5 μ g/kg bupivacaine and 0.375％ dexmedetomidine can enhance the analgesia effect and prolong the analgesia time.

Liver transplantation is a valid treatment option for select patients with Hepatocellular Carcinoma HCC and end-stage liver disease. However, in approximately 20% of patients, recurrent HCC is the rate-limiting factor for longterm survival. Despite identification of clinical parameters that may stratify patients at high risk and exhaustive preoperative staging, cancer recurrence is likely the result of microscopic extrahepatic disease. With a desperate donor organ shortage, locoregional ablation techniques and resection are being employed in patients on the waiting list to serve as a bridge to OLT. Further more, some have advocated aggressive surgical resection of isolated metastasis in both the liver and extrahepatic viscera. Whether these creative strategies confer a survival advantage is unknown, requiring longterm follow-up to determine their efficacy.

Humans ; Otorhinolaryngologic Surgical Procedures ; methods ; Quinolones ; therapeutic use ; Respiratory System Agents ; therapeutic use

Objective To investigate the dangers of heart failure to the mother and fetal,and the diagnosis and treatment of pregnancy complicated with heart failure. Methods The clinical data of the causes,timing,management and outcomes of 87 cases of pregnant women complicated with heart failure from March 1993 to January 2006 were analyzed retrospectively. Results ①Thirty-one cases(35.6%) of heart failure in pregnancy were caused by rheumatic heart disease,26(29.9%) by pregnancy-induced hypertension(PIH),16(18.4%) by congenital heart disease,and 14(16.1%) by peripartum cardiomyopathy.②The heart failure appeared at the average of(32.69?5.57) weeks.③The average terminal time of pregnancy was(34.66?4.52) weeks.④There were 79 newborns with 6 cases of twins,and the perinatal mortality was 8.6%(8 cases).Hysterotomy was performed in 6 cases in mid-pregnancy.The average weight of babies was(2419.56?786.08) g.⑤The maternal mortality was 6.9%(6 cases).(Conclusion The main) causes of heart failure in pregnancy are rheumatic heart disease,PIH and congenital heart disease.Although the standard management of pregnancy complicated with heart failure is inotropic agents,diurectics and vasodilators,the treatment should be individualized according to the specific etiology and with the consideration of the safety of fetus as well.Pinpointing the causes of heart failure in pregnant patients and treating accordingly may be conducive to reduce the maternal and perinatal mortality.

The etiology of reversible posterior leukoencephalopathy syndrome(RPLS)is more complex.Its pathogenesis has a lot of controversies,and its clinical manifestations are headache, nausea,vomiting,epileptic seizure,consciousness disturbance and visual abnormality.Neuroim- aging examinations have shown that diffuse symmetrical white matter edema is predominantly in the bilateral posterior brain regions.Clinical symptoms and neuroimaging changes can be recov- ered completely after timely and effective treatment.If the treatment is delayed,it may compli- cate with cerebral infarction or hemorrhage,and lead to irreversible damage.

Acupuncture Therapy ; Adult ; Amenorrhea ; chemically induced ; drug therapy ; Antipsychotic Agents ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy

In order to study the structure-function relationship in the protein which is incorporated with p-nitro-L-phenylalanine,the method of MD(Molecular Dynamics) simulation was established and successfully used in the analysis of protein which contains p-nitro-L-phenylalanine.The force field of CHARMM can only stimulate protein with natural amino acid in NAMD.Compared with phenylalanine,p-nitro-L-phenylalanine just has one more group of nitro.If the parameter of group of nitro was defined,the protein containing p-nitro-L-phenylalanine can be simulated.CGenFF-paramchem was used to calculate the energy and topological structure of p-nitro-L-phenylalanine' s new bonds (r),angles (θ),dihendrals (φ) and improper angle (ψ).And then the new defined parameter and topology information was input into the related parameter files and topology files in CHARMM.On the basis of correct parameter,NAMD can successfully simulate the modified BAFF(B lymphocyte stimulator) which contains p-nitro-L-phenylalanine.The changes in structure indicated that there might be new B cell epitopes.The temperature distribution of each frame in the process of dynamics stimulation was in accord with normal distribution,which proved the defined force field parameters was feasible.The RMSD of whole protein solution systemis 2.5.Calculate each resides' RMSF in BAFF,the RMSF of p-nitro-L-phenylalanine's residue is 3.7,which is obviously higher than that of the other residues in β-pleated sheet,and close to the loop rings,indicate that there might be variation in the area of p-nitro-L-phenylalanine residue and might produce new comformational epitopes.The results of MD stimulation will guide the immunogenicity experiments of p-nitro-L-phenylalanine modified proteins.

Objective To investigate the human leucocyte antigen (HLA) expression of ectopic endometrial epithelial cells in cases with endometriosis and its role in pathogenesis of endometriosis Methods By immunohistochemical analysis,HLA expression was observed in ectopic endometrial epithelial cells of 25 endometriosis patients Ectopic endometrial cells were cultured in vitro successfully and the expression of HLA were analyzed by flow cytometry in 10 out of the 25 patients Eutopic endometrium of 15 normal women were taken as control Results (1)Expression of HLA class Ⅰ molecule on ectopic endometrial epithelial cells of endometriosis measured by the immunohistochemical analysis was lower than those of controls, (4 0?0 5) score and (1 2?0 8) score respectively So was the expression rate by flow cytometry in vitro culture (63 38?11 88)% and (5 27? 2 88)% respectively ( P

Background and purpose:TGF-?/EGFR autocrine loop is markedly activated in wide malignant tumor. It is closely correlated with the tumorigenesis and development of different cancers. Our study is to investigate the biological behavior and signaling molecule changes in TGF- induced ovarian cancer cell line Caov-3, and to study the effect and molecular mechanism of the activation of TGF- /EGFR autocrine loop in ovarian cancer.Methods:The tetrazolium-based colorimetry assay was used to evaluate the cell growth treated by TGF-?. The vitro invasion assay was used to examine the invasiveness of Caov-3 treated by TGF-?.Expression of EGFR、 ERK1/2、PI3K、AKT、P70S6K were determined by western blotting.Results:Exogenous TGF-? enhanced significantly the proliferation and invasiveness of Caov-3 cells. The proliferation rate of Caov-3 was in a dose-dependent manner to TGF-? within the concentration of 0.5~25ng/ml.Exogenous TGF-? up-regulated the expression of EGFR、PI3K、AKT、P70S6K but not ERK1/2.Conclusions:The activation of TGF-?/EGFR autocrine loop could promote the growth,invasion and metastasis of ovarian cancer through PI3K/AKT/P70S6K signaling survival pathway.