The mechanism of carcinoma occurrence is of multiform. One of the scheduled multi modality treatment is hyperthermia. Result of research indicates that hyperthermia can kills the tumor cells by affecting carcinogens, tumor suppressors and immunity. This review presents the current knowledge of hyperthermia on mechanism of therapeutic effects and the application in the treatment.

The mortality of septic shock has been reported high.Glucosteroid is widely used in patients with septic shock as one of the assistant therapies of septic shock.However the applied patients,the using time,the duration and the dose of glucosteroid remain controversial.Recently it is recommended using small dose in septic shock according to results of large scale clinical trials.We will review the studies of glucosteroid in septic shock in recent years here.

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

Objective To observe the effects of compound lidocaine cream on patients with tracheotomy during recovery from general anesthesia.Methods Fifty-four patients scheduled for radical oral cancer resection and tracheotomy under general anesthesia were randomly allocated into two groups:control group (group C,27 patients) and compound lidocaine cream group (group L,27 patients).Compound lidocaine cream was uniformly smeared on the airway segment of tracheotomy tube in group L,and no drug was coated on tracheotomy tube in group C.Hemodynamic parameters before induction (To),at the end of surgery(T1),at the moment of awake(T2) and 1 min after awake(T3),respiration recovery time,awake time,time spent in the postanesthetic care unit (PACU),coughing,and agitation after surgery were monitored.Results There were no difference in the operation time,sevoflurane inhale time,respiration recovery time and awake time between two groups (P ＞ 0.05).The time spent in the PACU in group L was less than that in group C [(27.3 ± 6.9)min vs.(34.9 ± 6.6) min] (P ＜ 0.05).The HR and MAP of T3 in group C were significantly higher than those ofT0 [(113.5 ± 18.0) bpm vs.(82.2 ± 13.1) bpm,(112.7 ± 15.7) mmHg (1 mmHg =0.133 kPa) vs.(87.5 ± 12.7) mmHg] (P ＜ 0.01).The HR and MAP of T3 in group L were lower than those in group C [(92.6 ± 12.8) bpm vs.(113.5 ± 18.0) bpm,(98.3 ± 13.5) mmHg vs.(112.7 ± 15.7) mmHg] (P ＜ 0.01 or P ＜ 0.05).Degree of coughing in group L was lower than that in group C (Z =-2.409,P ＜ 0.05).Degree of agitation in group L was lower than that in group C (Z =-2.013,P ＜ 0.05).Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream can effectively alleviate hemodynamics fluctuations,coughing and agitation after tracheotomy during recovery for general anesthesia.

Objective To investigate the expression of aquaporin-4 (AQP4) in contused brain and contralateral side and correlation of AQP4 level with brain edema.Methods A total of 70 health adult SD rats were divided into sham operation group (n =10) and brain contusion group (n =60) according to the random number table.Except for no impact in sham operation group,the remaining operations were the same in both groups.Ten rats in brain contusion group were separately sacrificed at 1,6,24,48 and 72 hours,and 7 days.Pathological changes in brain tissues of rats were detected and immunohistochemistry staining and Western-blot were used to measure AQP-4 expression.Results There were no abnormalities of brain tissue structure in sham operation group with AQP4 expressed mainly in glial cells and vascular endothelial cells.With respect to the injured side in brain contusion group,mixed brain edema that consisted of angioedema and cellular edema occurred along with tissue necrosis,massive inflammatory cell infiltration,and microgial proliferation.AQP4 was apparently expressed in gliocytes and vascular endothelial cells,which showed a fall at 1 hour,the lowest at 6 hours,the peak at 24 hours,slow fall at 48 hours,a second peak at 72 hours,and then a fall until 7 days.Level of AQP4 other than that at 1 hour had significant difference compared with sham operation group (P ＜ 0.01).Whereas the contralateral side in brain contusion group showed no pathological abnormalities at 1 hour,but cellular edema emerged at 6 hours followed by mixed brain edema mainly characterized as cellular edema at 24 hours,continued cellular edema but alleviated angioedema at 48 and 72 hours,and alleviated cellular edema at day 7.AQP4 was up-regulated in gliocytes and vascular endothelial cells,which decreased at 1 hour (1.313 ± 0.01),minimized at 6 hours (0.922 ± 0.03),peaked at 24 hours (2.848 ± 0.020),fell at 48 hours,peaked again at 72 hours (2.662 ± 0.02) and fell to almost normal level at day 7.By contrast with sham operation group,level of AQP4 had significant difference other than that at 1 hour and 7 days (P ＜ 0.01).Conclusions After brain contusion,angioedema and subsequent cellular edema emerge in the contused side.Pathological changes are delayed in non-contused side with cellular edema ahead of angioedema.Level of AQP4 is closely related with traumatic brain edema.

Objective To evaluate the effects of ischemic postconditioning on nuclear factor kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) expression during lung ischemia-reperfusion (I/R) injury in a dog model of cardiopulmonary bypass (CPB), and further investigate the pulmonary protection induced by ischemic postconditioning and the underlying mechanism.Methods Twelve adult mongrel dogs of both sexes, weighing 12-15 kg, were randomly divided into either CPB group or ischemic postconditioning group (IPO group) using a random number table, with 6 dogs in each group.CPB was established after the chest was opened in dogs anesthetized with pentobarbital sodium.Ischemic postconditioning was induced by 2 cycles of 5 min reperfusion followed by 5 min ischemia immediately after occlusion of the left pulmonary artery was released in group IPO.Before CPB (T1), before occlusion of the artery was released (T2) , and at 2 h after termination of CPB, lung specimens were obtained for examination of pathological changes which were scored (with light microscope) and for determination of the expression of NFκB and ICAM-1 (using Western blot) and wet/dry lung weight ratio (W/D ratio) in left lung tissues.Blood samples were collected from femoral arteries at T1 and T3 for blood gas analysis, and oxygenation index (OI), respiration index (RI) and dynamic lung compliance (Cdyn) were calculated.Results OI and Cdyn were significantly decreased, and RI was increased at T3 , and W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were increased at T2,3 than at T1 in the two groups.W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were significantly higher at T3 than at T2 in the two groups.Compared with group CPB, OI and Cdyn were significantly increased, and R1, W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were decreased at T3 in group IPO.Conclusion Ischemic postconditioning up-regulates the expression of ICAM-1 through inhibiting NF-κB activity, thus reducing lung I/R injury induced by CPB and improving the lung function in dogs.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Objective To investigate the expression and significance of Toll-like receptor 4(TLR4)in the uvea of endotoxin in- duced uveitis.Design Experimental study.Participants 12 Wistar rats were divided into two groups at random,a group(n=6)of endo- toxin induced uveitis(EIU)and a control group(n=6).Methods Cholera vibrio was injected into hind footpad and abdominal cavity in the EIU group.In the control group,cholera vibrio was replaced by PBS.Anterior segment of the rats eyes were observed by slit lamp microscope at 4h,10h,16h,24h after injection.Immunohistochemical staining was performed using polyclonal antibodies to TLR4 on the frozen sections of the eyes and uveal wholemounts at 24 hours after LPS injection.Main Outcome Measures The inflammation of anterior segment and the number of TLR4 positive cells in uveal wholemounts.Results The inflammation began at 4h after LPS injec- tion.Cellulose exudates were observed at 16h after injection.The positive-stained protein located in cellular membrane or cytoplasm. The number of TLR4 positive cells in EIU group is evidently higher than that in the control group.TLR4 positive cells were hardly de- tected in the frozen sections of eyes.Conclusion TLR4 expression increases in the EIU,which suggests that TLR4 probably participates in the formation and development of acute anterior uveitis.(Ophthalmol CHN,2008,17:48-51)

Objective To explore the effects of brain derived neurotrophic factors (BDNF) on concentrations of cerebral endogenous opioid peptides(EOP)in neonatal rats subject to with hypoxic ischemic brain injury (HIBI). Methods Seven day old Sprague Dawley rats were randomly divided into a HIBI+BDNF group (group A),a HIBI group (group B) and a sham operation group (group C). Models of HIBI were established by use of permanent ligation of the left common carotid artery followed by 2.5 hours ofinhalation of 8%O 2+92%N 2, then 0.5 ?g BDNF was injected into the parietal cerebral ventricle in group A immediately. Contents of dynorphin A 1 13 like, ? endorphin like and leu enkaphalin like immunoreactivities (ir DynA 1 13 , ir ? EP and ir LEK) in cortex and hippocampus were measured at 0, 60, 120 min after administration of BDNF. Results The concentrations of ir DynA 1 13 and ir ? EP in the cortex and hippocampus in group B were increased significantly than those in group C at most time points( P

AIM To observe the effects of different interval administration of exogenous brain derived neurotrophic factor (BDNF) on hypoxic ischemic encephalopathy in neonatal rats. METHODS BDNF (0 5 ?g) was microinjected intracerebroventricularly at 0, 1 and 4 h after the hypoxic ischemic encephal opathy in 7 d neonatal Sprague Dawley rats undergone by ligation of left common carotid artery followed by a 2 5 h inhalation of humidified 8% O 2+92% N 2 at 37℃ immediately after the injury, respectively. Changes of brain edema, levels of malondialehyde (MDA) and neuronal apoptosis at the left cortex and hippocampus were investigated 24 h after the injury. RESULTS The most prominent effect of BDNF was seen in 0 h group with a marked decreases in brain edema and levels of MDA and a significantly alleviated neuronal apoptosis while it was lowered obviously when administered at 4 h after the insult. CONCLUSION BDNF exerts a prominent protective effect on hypoxic ischemic encephalopathy in neonatal rats when given as early as possible after the injury rather than later administration.