AIM: To study the effect of the subretinal fluid (SRF) on proliferation of retinal pigment epithelium (RPE) cells and retinal glial (RG) cells and associated activation and translocation of protein kinase C (PKC) as well as the application of PKC inhibitor.MTEHODS: RPE and RG cells were disintegrated to obtain PKC activity of cytoplasm and cellular membrane after being treated by the subretinal fluid (SRF) from the different stages of PVR patients (grade B and C) or being treated with PKC specific activator [phorbol-12-myris-tate-13-acetate (PMA)] or normal vitreous or DMEM culture medium. PKC activity in cytoplasm and cellular membrane was measured using radioactive isotope 32P labeling in a specific reaction of phosphorylation on PKC substrate. In addition, the PKC inhibitor, dequalinium chloride, was used to pretreat the RPE and RG cells before the cells exposed to SRF or PMA or normal vitreous. 3H-TdR (tritiated thymidine) was used to measure the levels of proliferation of RPE and RG cells with or without the activation and translocation.RESULTS: SRF and PMA promoted the proliferation of RPE and RG cells. SRF and PMA activated PKC in the cytoplasm of RPE and RG cells and the activated cytoplasm PKC translocated to the cellular membrane of RPE or RG cells. The cell proliferation or PKC activation or translocation were not equally active in RPE as in RG cells. However, PKC inhibitor which attenuated the cell proliferation did not show significant difference on inhibition of RPE and RG cell proliferation. (P ＞0.05).CONCLUSION: SRF can lead to the activation and translocation of PKC in RPE and RG cells, which promote the proliferation of RPE and RG cells. Dequalinium chloride can inhibit PKC activation and translocation hence slow down the cells proliferation.

Objective To investigate the clinical effect of protective technique for intercostal nerve in the application of esophageal cancer surgery.Methods Seventy cases of esophageal and cardia cancer patients with thoracic operation were randomly divided into observation group and control group,and each group was 35 cases.Patients in the observation group were treated with improved protective technique of intercostal nerve during operation,and patients in the control group using the traditional methods of operation for treatment.All patients were treated with intramuscular injection of morphine analgesia drugs after operation.Results The pain score of every time point analgesia patients in the observation group (VAS score) was significant difference from that in the control group (t =3.041,2.854,1.827,2.156,1.965,2.706,P＜ 0.05).The incidence of adverse reactions of analgesia,the incidence of painless patients of postoperative 30 d and 60 d,morphine dosage,chest tube indwelling time and the average hospitalization time in observation group were 0,42.86％,68.57％,(10.6±5.2) mg (4.0±1.6) d,(17.6±4.5) d,and the control group were 17.14％,20.0％,34.29％,(22.8±7.6) mg,(4.8±1.8) d,(20.4±5.8) d (x2=4.56,4.24,8.24,t=7.838,1.965,2.257,P＜0.05).Conclusion The improvement protective technique for intercostal nerve in esophageal cancer surgery,not only can reduce thoracotomy acute postoperative pain,but also reduce the happening of the CPP.Meanwhile,the analgesic effect is good.It is proved with a simple operation,less adverse reaction,conducive to disease recovery after esophageal cancer surgery,indicating that it has clinical popularization value.

Objective To compare medical students' learning curve between Macintosh laryngoscope and optical laryngoscope in endotracheal intubation and to decide which one is more suitable for novice personnel.Methods Totally 26 interns after being trained by experienced anesthesiologists were enrolled in this study.They performed intubation on 6 patients by using both Macintosh laryngoscope and optical laryngoscope ( each laryngoscope for 3 patients) under the supervision of experienced anesthesiologists.The sequence of laryngoscope was determined by computer-generated random number list.Results Totally 149 patients who were ready to receive surgery under general anesthesia were enrolled in this randomized crossover controlled study.Duration of intubation was significantly shorter in Airtraq group (78 -± 33 ) s than in Macintosh group (114 ± 32) s,P ＜ 0.001.Intubation success rate was significantly higher in Airtraq group than in Macintosh group ( 87.8％ vs.66.7％,P ＜ 0.05 ).Conclusions With the advantages of rapid learning curve,higher intubation success rate and shorter intubation duration,Airtraq laryngoscope is easier to master for novice personnel.

Objective To determine the placental transfer of epidural levobupivacaine for cesarean section. Methods Sixty parturients (ASA ⅠorⅡ) aged 24-35 yr weighing 60-80 kg undergoing elective cesarean section under epidural anesthesia were studied. Epidural anesthesia was performed at L1,2 or L1,3 interspace. The catheter was advanced 3 cm cephalad into the epidural space. A test dose of 0.5% levobupivacaine 5 ml with 1:200 000 epinephrine was injected. If there were no signs of subarachnoid injection in 5 min, 9-12 ml of 0.5% levobupivacaine was administered twice at 5 min interval. Arterial blood samples were taken from the double- clamped umbilical cord segment at delivery for determination of blood pH. Apgar scores at 1 and 5 min after birth were recorded. Blood samples were taken from maternal and umbilical vein for determination of plasma levobupivacaine concentration by high performance liquid chromatography ( HPLC). Results The pH of the umbilical arterial blood was ≥ 7.25. The Apgar scores at 1 and 5 min after birth were ≥ 7.0. The levobupivacaine concentration of maternal and umbilical venous blood was 0.35±0.24 and (0.24 ±0.21) μg/ml respectively at the time of delivery. The ratio of umbilical and maternal venous blood levobupivacaine concentration was 0.7 ± 0.3. Conclusion Epidural levobupivacaine can cross the placenta during cesarean section. The ratio of umbilical and maternal venous blood levobupivacaine concentration is 0.7.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Massage ; Middle Aged ; Young Adult

Objective To compare the effect of establishment of Coronary angiography model in minipigs with right femoral Judkins catheter and 5F universal catheter .Methods Ninteen minipigs were randomized into two groups with right femoral Judkins catheter (ten minipigs)and 5F universal catheter(nine minipigs). Success rate,operation time,X-ray irradiation time were observed .Results The success rate, operation time ,X-ray irradiation time after Coronary angiography in right femoral Judkins catheter group was 100%,(5.68 ±3.53 ) min,(20.84 ±2.45 ) min,in 5F universal catheter group was 88.8%,(6.98 ± 4.13 )min,(26.23 ±8.45 )min.This difference was signifficant( P <0.01).Conclusion Coronary an-giography in minipigs with right femoral Judkins catheter has the advantage of high success rate , less opera-tion time, X-ray irradiation time , is more suit to coronay anatomy of the minipig .

Objective In the heart,autophagy is important for the turnover of organelles at low basal levels under normal conditions,but is upregulated in response to stresses such as ischemia/reperfusion and in cardiovascular diseases such as heart failure. It can prevent the heart from injury under stress conditions. This study was designed to test the hypothesis that autophagy would be upregulated in the myocardium of children with cyanotic congenital cardiac defects. Methods Eighteen children with cyanotic (n=10) or acyanotic cardiac defects (n=8) who were admitted in our hospital from October 2008 to April 2009 and received surgical treatment were investigated. Samples from the right ventricular myocardium taken immediately after aortic clamping were morphologically studied with transmission electron microscopy for the ultrastructure. Microtubule-associated protein 1 light chain 3 (LC-3) was detected by Western blot analysis in the obtained samples. Results Children with cyanotic cardiac defects had higher oxyhemoglobin saturation before operation than those with acyanotic cardiac defects. Electron microscopy showed that the former group had more mitochondria,disordered arrangement,swollen endoplasmic reticulum and typical autophagosomes in the myocardial cytosol. LC3-II were significantly elevated in patients with cyanotic compared with those with acyanotic congenital cardiac defects (P

Objective To study the mechanism of NS1619 on airway remodeling in asthmatic mice. Methods A total of 24 healthy female BALB/c mice were randomly divided into 3 groups:the control group, the oval albumin (OVA) group (the asthma group) and the NS1619 group (the intervention group), 8 mice in each group. Asthma group was induced with OVA, chal-lenged by continuous inhalation with 5%OVA from day 19 to 23, then changed to 3 times per week from day 24 to 55. Interven-tion group was inhaled with NS1619 (30μmol/L) before OVA. Control group was given with normal saline. The thickness of air-way smooth muscle and the area of collagen deposition in lung tissue slices were observed by HE and Masson staining, measured by a computer assisted image analysis system. The concentration ofα-smooth muscle actin (α-SMA) in cells was detected by immunohistochemistry. The expression of platelet derived grouth factor-BB, PDGF-BB (PDGF-BB) in serum was measured by immunosorbent assay. Results Compared with the asthma group, the pathologic changes of lung tissue, the thickness of airway smooth muscle and collagen deposition in the group treated with NS1619 were signiifcantly decreased (P<0.05). Compared with the asthma group, the levels ofα-SMA in cells and PDGF-BB in serum in NS1619 treated group were signiifcantly decreased (P<0.05). Conclusions NS1619 partly inhibited airway remodeling in asthmatic mice, partially by down-regulating the expres-sion level ofα-SMA and PDGF-BB.

AIM: To study the curative effect for patients with age related cataract and shallow anterior chamber after phacoemulsification.METHODS: Totally 38 patients (38 eyes) with age related cataract and shallow anterior chamber were selected and divided into two groups according to the depth of the anterior chamber, as mild shallow anterior chamber group (2-2.5mm) 23 eyes, high risk shallow anterior chamber group (<2.0mm) 15 eyes.Thirty-eight patients (38 eyes) with age related cataract with normal anterior chamber were as control group at the same period.All the patients received the operations by the same doctor and were followed up for 3mo.The observed items included visual acuity before and after operations, intraocular pressure, anterior chamber depth, corneal endothelial cell density and complications.RESULTS: There were no significant difference on visual acuity, intraocular pressure and corneal endothelial cell density between the two groups before operations (P>0.05).The visual acuity improved significantly after operation in both groups (P<0.05).Intraocular pressure after operation decreased significantly in both groups (P<0.05).Anterior chamber depth increased significantly after operation in both groups (P<0.05).Corneal endothelial cell density decreased significantly in both groups (P<0.05).There were no significant difference on anterior chamber depth, intraocular pressure and corneal endothelial cell density between the two groups at different time point after operations (P>0.05).Posterior capsular rupture occurred in shallow anterior chamber group in 1 eye, suspensory ligament rupture in 1 eye.Posterior capsular rupture and suspensory ligament rupture occurred none in normal anterior chamber group.Postoperative corneal edema occurred in 10 eyes (26%) in shallow anterior chamber group, which occurred in 3 eyes (8%) in normal anterior chamber group.The difference on the incidence was significant (P <0.05).CONCLUSION: Phacoemulsification should be taken timely for patients with age related cataract and shallow anterior chamber.The postoperative visual acuity can be improved and the anterior chamber depth can increase.The operation is safe and effective for those patients.