Objective To investigate the expression of homocysteine and cystatin C in the serum of patients with different types of malignant tumors.Methods 120 patients with malignant tumors were divided into group A (gastric cancer),group B (esophageal canler),group C (liver cancer) and group D (nasopharyngeal carcinoma) according to the type of disease,25 healthy volunteers were selected as control group.Enzyme-linked immunosorbent (ELISA) was used to measure serum homocysteine and cystatin C levels in four groups of patients.Results Homocysteine level of group A,group B,group C and group D were (19.71 ± 3.40)μmol/L,(23.27 ± 9.57)μ mol/L,(21.37 ±0.38) μmol/L and (16.27 ± 1.24) μmol/L,which were significantly higher than those of the control group (all P ＜ 0.05).Cystatin C levels of group A,group B,group C and group D were (19.71 ± 3.40) mg/L,(19.71 ±3.40) mg/L.(19.71 ± 3.40) mg/L and (19.71 ± 3.40) mg/L,which were significantly higher than those of the control group (all P ＜ 0.05).Serum homocysteine and cystatin C levels of gastric cancer positively correlated with carcinoembryonic antigen (CEA) level(r =0.9643,0.9842).However,serum homocysteine and cystatin C levels of esophageal cancer,liver cancer and nasopharyngeal carcinoma had no correlation with serumCEA level.Conclusion Cystatine C and homoeysteine have potential clinical value on the diagnosis of malignant tumors.

Objective To research the anesthetic effect of ropivacaine compounding with dezocine on brachial plexus block.Methods From January 2011 to September 2013,180 cases upper extremity surgery patients were selected and divided into group A,group B and group C in Nanyang Central Hospital.Patients in group A received 25 mL 0.4%ropivacaine injection for brachial plexus block;based on group A,group B was injected 10 mg dezocine to assist anesthesia;group C received a mixture of 25 mL 0.4% ropivacaine and 10mg dezocine injection.The anesthetic effect and adverse reactions of the patients in three groups were recorded and compared. Results The onset of anesthesia of group C was(17.43 ±1.53)min,which was the shortest of three groups,but there were no significant differences.The duration of sensory blockade and duration of analgesia was(8.22 ±1.63)h and (11.33 ±1.90)h,which were all longer than group A and group B,and there was significant differences(P<0.05);the visual analogue scale(VAS) scores of group C at each time before surgery was the shortest,but there were no significant differences.The VAS scores of group C at 1 h,6 h,12 h and 24 h after surgery were all lower than group A and B,and there were no significant differences.Conclusion Ropivacaine compounding with dezocine on brachial plexus block can improve the effect of anesthesia,extend the duration of analgesia.

Acute rejection is one of the serious early postoperative complications after liver transplantation.Many studies have shown that acute rejection was mainly mediated by T cells,while humoral factors were responsible for chronic rejection.However,accumulating evidences have demonstrated that humoral immune factors also played an important role in early acute rejection and usually resulted in severe adverse events.Here we clarify the role of humoral immunity in liver transplant rejection,which may help guide the clinical management of such patients with humoral rejection after liver transplantation.

Pancreatic head carcinoma could easily invade the neighboring vessels due to its own biological features and anatomical location,which increases the technique difficulty and risk,leading to low resection rate.Recently,with the progress on the surgical techniques and perioperative management,and the emergence of neoadjuvant chemoradiation,vascular invasion is no longer the surgical contraindications and pancreaticoduodenectomy combined with vascular resection has saved many patients ' lives.However,the preoperative assessment,the timing of surgery,the vessel management during the surgery,and the prevention and treatment of the postoperative complications remain controversial.In order to achieve a clear understanding on the application of pancreaticoduodenostomy combined with vascular resection,here we review the recent publications and share the experiences on pancreaticoduodenectomy with portal and/or superior mesenteric vein resection from our center,which may help improve the safety and resection rate of pancreatic carcinoma and enhance the overall therapeutic efficacy of treating pancreatic cancer.

Objective To investigate the effects of fentanyl and remifentanil on the viability of human adenocarcinoma cell line A549.Methods Human adenocarcinoma A549 cells cultured in logarithmic growth phase were seeded in 75 ml culture bottles or 96-well plates.After being cultured for 24 h,the cells were randomly divided into 9 groups (n =30 each):4 fentanyl groups (groups F1-4 ),4 remifentanil groups (groups RF1-4 ) and control group (group C).Groups F1-4 were exposed to fentanyl with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.Groups RF1-4 were exposed to remifentanil with the final concentrations of 0.5,5.0,50.0 and 500.0 ng/ml respectively.The viability of the cells was determined by methyl thiazolyl tetrazolium assay after being incubated for 24,48 and 72 h.The cell cycle progression and apoptosis were determined by flow cytometry after being incubated for 24 h.Results Compared with group C,the viability of A549 cells were gradually decreased at 72 h of incubation,the proportion of the cells in S phase was gradually decreased at 24 h of incubation,and the proportion of the cells in G2/M phase and apoptotic rate were gradually increased in groups F2-4 and in groups RF2-4 ( P ＜ 0.05).Conclusion Fentanyl and remifentanil with the final concentration ≥5 ng/ml can inhibit the viability of human adenocarcinoma cell line A549 in a dose-independent manner by inducing cell apoptosis and cell cycle arrest in G2/M phase.

Objective To investigate the effects of a new c-Met inhibitor SU11274 on apoptosis and motility of c-Met-positive basal-like breast cancer cells MDA-MB-231. Methods The concentrations of SUl1274 were set to 0,0.1,1,10 and 20 μmol/L.Morphological change of apoptotic cells was analyzed by Hoechst33342,MitroTrackerRed and Yo-pro-1 staining.The apoptotic rate of MDA-MB-231 cells were determined by Annexin V/PI double-staining. The expression of apoptosis related proteins (Bcl-XL,Caspase-3 and PARP) and phosphorylation levels of c-Met and Akt were analyzed by Western blot.The capability of motility were measured by wound-healing assay and chemotaxis assay. Results After treatment by SU11274( 10 μmol/L) for 48 h,shrinking apoptotic cells of MDA-MB-231 was observed by flurescent microscope and nuclear fragmentation was seen.Annexin V/PI double-staining showed SU11274induced apoptosis of MDA-MB-231 cells (P ＜ 0.05 ),and the apoptotic rates were (7.3 ± 0.9) ％,( 14.1 ±0.6) ％,(35.5 ± 4.4) ％ and (48.2 ± 5.3 ) ％,respectively.SU11274 downregulated the expression of Bcl-XL and promoted the dissection of Caspase-3 and PARP in a dose dependent relationship.SU11274 prolongs the wound-healing time,decreases the migration cell count (P ＜ 0.05 ) and effectively inhibits the phosphorylation of c-Met and its downstream key proteins Akt in a dose-dependent manner.Conclusions C-Met inhibitor SU11274 induces apoptosis and inhibits the motility of c-Met-positive basallike breast cancer cell line MDA-MB-231,probably through inhibiting phosphorylation of c-Met/PI3K/Akt.

Objective To evaluate the effect of chemotherapy on sedation with propofol in breast cancer patients.Methods One hundred female patients,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,scheduled for elective modified radical mastectomy,were divided into 2 groups (n =50 each) according to whether receiving neoadjuvant chemotherapy before operation:non-chemotherapy group (group Ⅰ) and neoadjuvant chemotherapy group (group Ⅱ).The breast cancer patients received operation directly in group Ⅰ.The breast cancer patients received neoadjuvant chemotherapy in group Ⅱ.Epirubicin 75-100 mg/m2 was injected intravenously on 1st and 2nd days,docetaxel 75 mg/m2 was injected intravenously on 3rd day,and 3 weeks were considered as 1 course of treatment.The patients received operation at 3 weeks after the end of 4 courses of treatment in group 1.Anesthesia was induced with propofol given by target-controlled infusion and the target plasma concentration of propofol was 3.5 μg/ml.The time for loss of consciousness and consumption of propofol at loss of consciousness were recorded.Results Compared with group Ⅰ,the time for loss of consciousness was significantly shortened,and the consumption of propofol at loss of consciousness and BIS value were decreased in group Ⅱ.Conclusion Chemotherapy can enhance propofol-induced sedation and promote the onset of propofol in breast cancer patients.

Objective To evaluate the effect of sleep dysfunction on sedation induced by propofol in the patients undergoing radical mastectomy.Methods One hundred breast cancer patients,aged 25-60 yr,with body mass index of 19-23 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective modified radical mastectomy,were randomly divided into 2 groups according to sleep quality.The patients with global Pittsburgh Sleep Quality Index (PSQI) score ≤7 served as regular sleep quality group (Ⅰ group,n =59).The patients with global PSQI score ＞ 7 served as sleep dysfunction group (group Ⅱ,n =41).Anesthesia was induced with propofol given by target-controlled infusion (target plasma concentration of 3.5 μg/ml),and then with remifentanil 4 μg/kg and rocuronium 0.6 mg/kg after loss of consciousness.The consumption of propofol at loss of consciousness was recorded.Results Compared with group Ⅰ,the consumption of propofol at loss of consciousness was significantly decreased in group Ⅱ.Conclusion Sleep dysfunction can enhance propofol-induced sedation in the patients undergoing radical mastectomy.

Objective:To evaluate the improved efficacy of nalbuphine combined with propofol in artificial abortion.Methods:One hundred American Society of Anesthesiologists physical status Ⅰor Ⅱ patients, aged 20-43 yr, weighing 50-80 kg, undergoing elective artificial abortion, were divided into 2 groups ( n=50 each) using a random number table method: propofol group (group P) and nalbuphine combined with propofol group (group NP). Phloroglucinol 40 mg was intramuscularly injected at 15 min before surgery.Propofol 2.0 mg/kg was intravenously injected in group P. In group NP, nalbuphine 0.1 mg/kg was intravenously injected, and 2 min later propofol 2.0 mg/kg was intravenously injected.The operation was started after the eyelash reflex disappeared.When operation was affected due to the body movement occurred during operation, an increment of propofol 0.5 mg/kg was given.Visual analogue scale (VAS) score was used to assess the degree of uterine contraction pain during the awake period and the highest degree of uterine contraction pain during the recovery period.The consumption of propofol, development of adverse effects and surgeon′s satisfaction with the anesthetic effect were recorded. Results:Compared with group P, the consumption of propofol was significantly reduced, VAS scores during the awake period and the highest VAS score during the recovery period were decreased, the incidence of body movement that affected operation was decreased (16%/2%), and the surgeon′s satisfaction with the anesthetic effect was increased in group NP ( P<0.05). No adverse cardiovascular events and respiratory depression during operation and postoperative nausea and vomiting was found in the two groups. Conclusion:Intravenous injection of nalbuphine 0.1 mg/kg combined with propofol 2.0 mg/kg can be safely and effectively used for the comfort medical treatment of artificial abortion, and the combination has a significant optimized effect than propofol alone.

OBJECTIVEIn order to minimize lead pollution and to protect the identified individuals with high blood lead level from lead contamination, an epidemiological study was carried on children living around the village and township-owned lead industries in Tianying town.

METHODSEnvironmental monitoring: lead levels in air, soil, drinking water and crops were measured. Biological monitoring: 959 children aged 5 - 12 years were selected from villages where the lead smelters located near the residential areas and the battery disassembling was done in some families. The control children (207 pupils) were from other villages without lead exposure. Blood lead, ZnPP and teeth lead were determined. Height, weight and head circle of children and IQ scores were measured.

RESULTSThe environment was seriously polluted. The average lead concentrations in air and soils were 8.5 times and 10 times of the MACs (national health standard) respectively. Eighty-five per cent the air samples with lead concentrations higher than the national health standard. Local crops and wheat at farmers' home were also contaminated by lead dust, with. Lead content being 24 times higher than the standard. The mean blood lead and ZnPP levels of children lived in the polluted areas were 496 microgram/L and 9.41 microgram/g Hb respectively. The lead exposure caused adverse effects on children's IQ and physical development.

CONCLUSIONIt is necessary to remove and reduce currently active sources of lead pollution in the community and to increase public awareness of potential health effects of lead exposure.

Air Pollutants ; analysis ; Child ; Child Development ; drug effects ; Child, Preschool ; China ; Crops, Agricultural ; chemistry ; Environmental Monitoring ; methods ; Environmental Pollution ; adverse effects ; analysis ; Female ; Health Status ; Humans ; Industrial Waste ; adverse effects ; analysis ; Lead ; adverse effects ; blood ; Male ; Soil Pollutants ; analysis ; Suburban Health ; standards ; Urban Health ; standards