Objective To compare the efficacy of sevoflurane inhalation and remifentanil-propofol anesthesia in patients undergoing total gastrectomy. Methods Forty ASA class Ⅰ or Ⅱ patients with gastric cancer were divided into sevoflurane inhalation anesthesia (group S) and remifentanil-propofol intravenous anesthesia(group P), with 20 cases each. Perioperative hemodynamic veriables, bispectral index (BIS) values and end-tidal concentration of sevoflurane were continuously monitored. The time of recovery from anesthesia and adverse reactions of anesthesia were recorded as well. Results Compared with those before anesthesia, BP and HR were significantly decreased (P< 0. 05). The depth of anesthesia in both groups was maintained well with BIS in 45-60 and vital signs were stable during operation. The recovery from anesthesia was quicker in group P than that in group S. The incidences of restlessness and couphing were obviously lower in group P than those in group S (P<0.05). Conclusion Either sevoflurane inhalation or remifentanil-propofol intravenous anesthesia can be used safely in total gastrectomy.

Objective To compare the therapeutic effects of three operative procedures,removal of armpit skin,minimally-invasive aspiration and small transverse incision in the treatment of osmidrosis.Methods Retrospective review was conducted in the treatment of osmidrosis for near ten years.Three methods were compared in the indication,feature and effectiveness.Results A total of 459 cases (123 males and 336 females) of osmidrosis were treated with the three methods.Satisfactory rates of the three methods were 98%,96% and 97%.respectively.Recurrence was found in 7 cases.Conclusions Modified procedure of minimally invasive aspiration has advantages of quick recovery,less complications and satisfactory results.It is the first choice for patients with mild and moderate osmidrosis.Bat for male patients with severe or recurred osmidrosis,treatments are surgical removal of the skin with armpit hairs and suture method.

Objective To investigate the effect of nicardipine on the hepatic blood flow in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty-six patients of both sexes,aged 30-64 yr,weighing 50-90 kg,with New York Heart Association Ⅱ or Ⅲ,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective mitral or aortic valve replacement,were randomly divided into either nicardipine group (group P,n =13) or control group (group C,n =13) using a random number table.Transesophageal echocardiography was used to measure the indexes of blood flow in the hepatic vein.Nicardipine 0.2-0.5 μg · kg-1 · min-1 was infused intravenously starting from beginning of CPB,and the infusion was stopped at termination of CPB in group P.After induction of general anesthesia,at 30 min after beginning of CPB,at 10 min before termination of CPB,and at 30 min after termination of CPB,the diameter of the right and middle hepatic veins (DR and DM),blood flow index in the right hepatic vein (QIR),blood flow index in the middle hepatic vein (QIM),and total blood flow index in the hepatic vein (QIR+M) were recorded,and the percentage of QIR+M in cardiac index (CI) (QIR+M/CI) or in QICPB (QIR+M/QICPB) was calculated.Before operation,and at 1 and 2 days after operation,blood samples were obtained from the median cubital vein for determination of total bilirubin,alanine aminotransferase,and aspartate aminotransferase (AST) levels in serum.Results Compared with group C,the serum levels of AST at 1 day after operation and serum levels of AST at 1 day after operation were significantly decreased (P＜0.05),and no significant change was found in DR,DM,QIR,QIM,QIR+M,QIR+M/CI and QIR+M/QICPB at each time point in group P (P＞0.05).Conclusion Nicardipine (0.2-0.5 μg · kg-1 · min-1) infused intravenously during CPB exerts no effect on the hepatic blood flow,and it is not related to the improvement in hepatic function in the patients undergoing cardiac valve replacement.

Objective To evaluate the effect of sevoflurane-based anesthesia on the interventricular synchronization in the patients undergoing coronary artery bypass grafting (CABG) with cardiopuhnonary bypass (CPB).Methods Twenty-four Amnerican Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 52-75 yr,with body mass index of 17-31 kg/m2,with body surface area of 1.7-2.2 m2,of New York Heart Association Ⅱ or Ⅲll,with left ventricular ejection fraction (LVEF) ≥45％,scheduled for elective CABG with CPB,were divided into 2 groups (n=12 each) using a random number table:propofol combined with remifentanil anesthesia group (group C) and sevoflurane combined with propofol and remifentanil anesthesia group (group S).After induction of general anesthesia,the patients were en-dotracheally intubated and mechanically ventilated.Anesthesia was maintained by Ⅳ infusion of propofol,remifentanil and cisatracurium,and the cerebral state index value was maintained at 40-60.In group S,the patients inhaled sevoflurane (the end-tidal concentration was 1.80％ for 50-59 yr and 1.60％ for 60-75 yr) for 60 min starting from 15 min after termination of CPB.After induction of anesthesia and before splitting of sternum,immediately before inhaling sevoflurane and at 30 and 60 min of sevoflurane inhalation,heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width and interventricular mechanical delay were recorded,and the occurrence of interventricular dyssynchrony was recorded.Results There were no significant differences between group C and group S in the heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width,interventricular mechanical delay or incidence of interventricular dyssynchrony (P＞0.05).Conclusion Sevoflurane-based anesthesia exerts no marked effect on interventricular synchronization in the patients undergoing CABG with CPB.

Objective To observe expressions of mRNA for Par-4 and WT1 in bone marrow cells from acute leukemia patients and non-leukemia patients, and to approach the correlation between CR rate and Par-4, WT1 expression level. Methods To detect Par-4 and WT1 mRNA expression level in bone marrow cells from 78 acute leukemia patients and 23 non-leukemia patients by means of Real-time Fluorescent Quantitation RT-PCR. Results FQ-RT-PCR result showed that Par-4 mRNA was expressed in bone marrow cells from 78 acute leukemia patients and 23 non-leukemia patients. Compared with control groups, the expression levels of Par-4 mRNA were significantly suppressed (9.35×10-4±8.4×10-5, P ＜0.05). Compared with initial treatment groups and relapse groups, the expression levels of Par-4 mRNA in remission groups were significantly up-regulated (1.26×10-3±1.1×10-4) but were still significantly lower than that in control groups (3.25×10-3±2.9×10-4). There was no significance difference between initial treatment groups and relapse groups. No apparent association was found between Par-4 expression level and CR rate (P ＞0.05). WT1 gene was overexpressed in bone marrow cells from acute leukemia patients(2.98× 10-3±2.1×10-4), but the expression levels of WT1 mRNA were significantly lower in bone marrow cells from control groups (7.25×10-5±6.7×10-6,P ＜0.05). Compared with initial treatment groups and relapse groups, the expression levels of WT1 mRNA in remission groups were significantly down-regulated (6.86×10-4±5.2× 10-5) but were still significantly higher than that in control groups. There was no significant difference between initial treatment groups and relapse groups.There was significant difference between different WT1 expression levels and CR rates (P ＜0.05). Conclusion The result of FQ-RT-PCR testing confirmed that Par-4 mRNA expression is lower, while WT1 is higher in acute leukemia. Par-4 and WT1 gene present mutually exclusive expression patterns. There was no apparent association between Par-4 expression level and CR rate.

Objective To compare the biomechanical stability of the multiaxial inter-vertebral and vertebral pedicle screw fixation in vertebral fracture fixation of the spinal fracture model. Methods Six lumbar fracture models were made on fresh calf lumbar spine specimens at L1 -L5 to compare the stability of four transpedicular multiaxial screws and six transpedicular multiaxial screws by examining the range of motion (ROM) in flexion, extension, lateral bending and torsion. Results Biomechanical experiment found that four multiaxial screws transpedicular fixation specimen exhibited a significantly larger ROM in flexion and extension than the intact specimens; while six multiaxial transpedicular screw fixation specimen exhibited a smaller ROM than the intact specimens (t =4. 844,P ＜0. 01 ;t =3. 722,P ＜0.05 ). The ROM of six multiaxial transpedicular screw fixation specimen was significantly smaller than that of four multiaxial transpedicular screw fixation specimen in flexion, extension, lateral bending and rotation ( P ＜ 0. 01 ). Conclusions Compared with four multiaxial transpedicular screw fixation, six multiaxial transpedicular screw fixation exhibits a significantly larger stability in flexion, extension, lateral bending and rotation, as provides theoretical basis for treatment of thoracolumbar fractures with pedicular screw fixation.

Objective To explore the safety and efficacy of small margin in nephron sparing surgery for early localized renal cell carcinoma (RCC). Methods A total of 325 cases of RCC with normal contralateral kidney and staged as Tla were retrospectivly studied.According to the margin size,125 cases were with surgical margin ≤ 5 mm (group ≤ 5 mm),102 cases with margin 6-9 mm (group 6-9 mm) and 98 cases with margin ＞ 10 mm (group ＞ 10 mm).The margin size and status was pathologically evaluated and clinical results including local recurrence,distant metastasis and overall survival rate were followed up and comparatively analyzed. Results None of the patients had positive surgical margins.The mean and median margin sizes were 2.2 and 2.0 mm for group ≤ 5 mm,6.7 and 6.0 mm for group 6-9 mm and 11.8 and 12.0 mm for group ＞ 10 mm.The difference was statistically significant (P=0.025).The mean and median follow-up time for all the patients were 79 and 83 months (range 15-132 months),with 69 and 73 months (range,15-130 months) for group ≤ 5 mm,83 and 86 (range,17-132 months) for group 6-9mm and 82 and 82 (range 60-103 months) for group ＞ 10 mm.Three patients in group ≤ 5 mm,5 in group 6-9 mm and 2 in group ＞ 10 mm died of no-cancer related disease during follow-up.One patient in group ≤ 5 mm (0.74％) experienced ectopic recurrence in the same kidney and one in group 6-9 mm was detected local recurrence in situ (0.98％).No distant metastasis was detected in all the patients.The overall 5-year survival rate for patients in groups ≤ 5mm,6-9 mm and ＞ 10 mm were 99.2％,99.0％ and 98.0％,respectively.(Kaplan-Meier survival analysis,Log Rank,x2 =1.511,P=0.470). Conclusions Small margin in nephron sparing surgery is safe and effective in treating RCC with stage T1a,which provides excellent renal function preservation,favorable long-term progression-free survival rate,and is not associated with an increased risk of local recurrence.

Objective To discuss the effects of silencing of iASPP gene on human bladder cancer cells. Methods RNAi silencing of iASPP gene in bladder cancer cell 5637 and T24 cells were used by lentiviral mediated interfering short hairpin RNAs. Cell proliferation was tested by MTT assay, and rate of colony was tested by colony formation assay. Cell cycles were tested by using fluorescence-activated cell sorting. Results Down-regulation of iASPP could inhibit the growth and proliferation of human bladder cancer cells (P＜0.05). iASPP know-down could decrease the colony formation of 5637 and T24 cells (P＜0, 05). Knocking down of iASPP in 5637 and T24 cells showed cell arrested at G1. Conclusions Silencing of iASPP gene could inhibit proliferation and colony formation of bladder cancer, iASPP might be an important target for gene therapy of bladder cancer.

Objective To explore the changes of Par-4 and WT1 genes expression during human leukemic K562 cells apoptosis induced by arsenic trioxide (As2O3). Methods After the K562 cells were treated with arsenic trioxide (2-10 μmol/L) for 24-72 hours, cell survival rate was evaluated by MTT assay and apoptosis was analyzed using flow cytometry. The expressions of mRNA and protein for par-4 and WT1 were tested by Real-time quantitative reverse transcriptase polymerase chain reaction (RQ-RT-PCR) method and Western blotting in K562 cells with various concentrations of arsenic trioxide at different time points. Results After the K562 cells were treated with As2O3 of different concentrations, arsenic trioxide could efficiently inhibit the growth of K562 cells and induce apoptosis with the increase of As2O3 concentration. The same time, the mRNA and protein expressions of Par-4 were up-regulated, while the mRNA and protein expression of WT1 were down-regulated. Conclusion Arsenic trioxide could inhibit the growth of K562 cells and induce apoptosis. Par-4 and WT1 genes could participate in the apoptosis of K562 cells induced by arsenic trioxide.

Objective To investigate the effect of MHA-bBMP implantation combined with limited contacted titanium net duct fixation on femoral shaft bone defect in rabbits.Methods A total of 48 rabbits were divided into experimental group(treated with bionic bone MHA-bBMP plus titanium net duct) and control group(treated with iliac autograft plus titanium net duct).The rabbit femoral shaft bone defect model was established by cutting 10mm bone fragment off.After operation,bionic bone MHA-bBMP/iliac autograft was implanted into the bone defect area and fixed with limited contacted titanium net duct.The general condition,serum alkaline phosphates,X-ray,histopathologic and electron microscopic examinations were performed.Results The fixation stability of titanium net duct in the two groups was good.The bone defect in the two groups was repaired.The phosphates,X-ray,histopathologic and electron microscopic examinations in the two groups were not significantly different.Conclusion The limited contacted titanium net duct can provide a reliable fixation effect on the graft and bone defect ends.Induction bone formation activity of MHA-bBMP is comparable to the iliac autograft.