Objective: To observe the clinical effect of heat-sensitive moxibustion on abdominal distension following laparoscopic cholecystectomy. ＜br> Methods: A total of 240 cases were randomly allocated into an observation group and a control group according to their admission sequence, 120 in each group. Cases in the observation group were treated with conventional care, glycerol enema and heat sensitive moxibustion, whereas cases in the control group were only treated with conventional care and glycerol enema. Then the passage of gas by anus within 24 h and improvement of abdominal distension were observed in both groups. ＜br> Results: There were statistical differences in the emergence time of bowel sounds and the initial passage of gas by anus between the two groups (bothP＜0.05). The therapeutic effect in the observation group was better than that in the control group (P＜0.05) . ＜br> Conclusion: Heat-sensitive moxibustion has reliable effect for abdominal distension following laparoscopic cholecystectomy.

Objective To investigate the efficacy of auricular plaster therapy for post-laparoscopic cholecystectomy nausea and vomiting. Methods Two hundred and forty laparoscopic cholecystectomy patients were randomly allocated to treatment and control groups, 120 cases each. Both groups received routine nursing care. In addition, the treatment group received auricular plaster therapy. The incidence of nausea and vomiting was observed in the two groups.Results The incidence of nausea and vomiting was 46.7% in the treatment group and 60.8% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Auricular plaster therapy can relieve postoperative nausea and vomiting in laparoscopic cholecystectomy patients.

Exosomes are membrane vesicles released into the extracellular environment upon exocytic fusion of multivesicular bodies with the cell surface. As a result of initial studies showing that exosomes display signal and immune factors,a particular interest has emerged in their use as a cellular vehicles for stimulation of immune responses in vivo.In recent years,on the base of the knowledge of the biological properties and functions, exosomes have been rebuilt and bound to different kinds of immunological stimulators as a result to enhanced antitumor funotions.In this paper,the related methods,immunological stimulators and the properties of man-made exosomes are mainly reviewed.

Objective To expand the NKT cells in vitro and to determine the cytokine releasing of NKT cells during proliferation.Methods Several kind of methods were established to expand TCRV ?24 +/TCRV ?11 + NKT cells from PBMC or purified T lymphocyte.The levels of IL 4,IFN ?and TNF ? of NKT cells were determined by flow cytometry.Results After 19 days' expansion,the largest number of NKT cells increased (23.0?16.7)?10 3 times and the largest ratio of NKT cells to total T lymphocyte was (25.5?7.2)%.The ratio of TCRV ?11 + NKT cells that secreted IL 4,IFN ?and TNF ? was higher than the TCRV?11 T lymphocytes.Conclusion TCRV ?24 +/TCRV ?11 + NKT cells can be expanded in vitro with ? Galcer presented by CD 1d molecule.The NKT cells can also be expanded from PBMC because the monocyte lineage cells within PBMC can express CD 1d molecule and present specific glycolipids like ? Galcer to them.

Objective To investigate whether human monocyte-derived dendritic cells (DCs) can express p210 Bcr-Abl protein and induce antigen-specific CTL responses in vitro after transfection with total RNA of K562 cells (K562-RNA).Methods Immature DCs were derived from human peripheral blood monocytes after 5 day incubation in the presence of GM-CSF and IL-4. The cells were then transfected with K562-RNA using electroporation or DOTAP lipofection. To verify the successful transfection of DCs with K562-RNA, Bcr-Abl fusion gene expression was determined by RT-PCR and Western blot. The immune phenotypes of the DCs were analyzed by flow cytometry. CTL cytotoxicity was assayed by propidium iodide (PI) stain and flow cytometry. The amount of DCs, CD1a expression and purity of DCs were measured by FACS.Results Bcr-Abl fusion gene appeared in the DCs after transfection with K562 cell total RNA. But 24 hours later, the Bcr-Abl mRNA from the K562-RNA transfected DCs disappeared, while the cells were expressing p210 Bcr-Abl protein. The transfected DCs could significantly promote T lymphocytes to kill the target K562 cells. We found that PBMC can be induced to DC in culture medium containing human plasma, suggesting a potential for clinical application.Conclusion Human dendritic cells transfected by K562 total RNA can induce effective p210 Bcr-Abl protein-specific immune responses, which might broaden the spectrum of possible DC-based clinical applications.

Objective To probe into the effect of the enteral nutrition added with lactobacillus on gastric bacteria of rats with severe brain injury. Methods Severe brain injury was made in rats that were then fed with enteral nutrition (3-9 entire nutrients), lactobacillus (3-9 entire nutrients + lactobacillus) and synbiotics (3-9 entire nutrients + lactobacillus + fiber) respectively. Gastric body and gastric antrum mucosa were collected at day 1, 3 and 7 after injury to detect the change of the gastric bacteria. Results DCCE analysis showed less bacteria in sham operation group. On the first day after severe brain injury, the flora bands were increased remarkably but the number of bacteria was decreased in three groups. The similarity of denaturing gradient gel electrophoresis ( DGGE) map patterns was 65% , 64% and 53% respectively in the enteral nutrition group, lactobacillus group and synbiotics group, with no significant difference in regard of the diversity index. On the third day after severe brain injury, the flora bands showed a tendency of decrease, with the similarity of denaturing gradient gel electrophoresis (DGGE) map patterns for 72% , 58% and 62% respectively. The richness and diversity of total bacteria in the lactobacillus group was remarkably lower than that in the enteral nutrition group and synbiotics group (P＜0.01). On the seventh day after SHI, the flora bands were decreased in three groups, with the minimum number of the bacteria. The similarity of denaturing gradient gel electrophoresis ( DGGE) map patterns was 61% , 51% and 58% respectively, with higher richness and diversity of total bacteria in the synbiotics group compared with the other groups. Conclusion Lactobacillus can help improve gastric bacteria disturbance of rats with severe brain injury. In the meantime, addition of the lactobacillus is better than addition of the synbiotics.

Objective To study the effect of magnetic field on serum activity of superoxide dismutase (SOD), content of malon-dialdehyde (MDA)and content of nitric oxide (NO)in patients undergoing operation for pituitary Tumor. Methods Sixteen ASA Ⅰor Ⅱ patients undergoing pituitary tumor surgery under general anesthesia were randomly divided into 2 groups (n=8 each): magnetic field group (M) and control group (C). Patients in magnetic field group were exposed in 150 mT magnetic field during the operation period.Blood samples were taken from radial artery for determination of serum SOD,MAD and NO before induction of anesthesia(T_0, baseline),after induction(T_1),70 min after induction(exposed in magnetic field for 60 min) (T_2)and 130 min after induction (exposed in magnetic field for 120 min) (T_3). Results There was no significant difference between the two groups in age, sex (M/F ratio),body weight,body height,duration of operation and duration of anaesthesia.The serum activity of SOD and content of NO were significantly higher at T_3 in group M than that in group C,and the serum content of MDA was lower at T_3 in group M than that in group C. Conclusions The magnetic field not only increases serum SOD activity and the content of NO in patient undergoing operation for pituitary tumor,but also reduces the content of MDA in them.

Objective To study the influence of probiotics on the gut microflora,digestive enzymes and small intestinal propulsive rate of rats with severe head injury. Methods The rat model of severe head injury was prepared, SD rats were randomly divided into group A (enteml nutrition) , group B (enteral nutrition plus probiotics) , and group C (normal diet) . The intestine mucesa and faeces were collected on the third day,7th day and 14th day after head injury in order to detect gut microflora,digestive enzymes and small intestinal propulsive rate. Results Compared with group C, the number of Lactobacillus and Bacillus bifidus group in group A and group B declined in two weeks after trauma, however, the number of Escherichia coli increased significantly. Bacillus bifidus amounts of group A were significantly lower than that of group B at every time point, the diversity of Escherichia coli was opposite. No difference was seen in content of Lactobacillus 7 days after trauma in group A and B. The level of disaecharidases, Na+- K+- ATPase and small intestinal propulsive rate declined significantly at every time point, compared with group C.Though the contents of digestive enzymes was higher in group B than that of group A, and small intestinal propulsive rate was higher in group A and B than that in group C, but the two groups showed no difference. Conclusions Probiotics can alleviate the in-testine microflora disorder,modulate the activities of digestive enzymes, therefore lessen malabsorption of rats with severe head injury.

Objective To study the feasibility and reliability of median nerve somatosensory evoked potential monitoring in neurosurgery around the brain stem. Methods in selected 43 patients SEP N20, waveforms were recorded after stimulation of left and right median nerves respectively. Anesthesia was maintained with intravenous anesthetics throughout the operation. As soon as N20 waveform changed significantly, the surgeon was informed and the operative procedure was modified whenever possible. Results SEP waveforms were almost stable during maintaining with total intravenous anesthesia (TIVA). Within 43 cases, SEP waveform of & patients significantly changed. In these cases, SEP of 5 patients returned to normal gradually and no further neurologic dysfunction happened postoperatively. The other 3 cases did not recover, and postoperative neurologic complications happened. There was no false-negative or false-positive result. The correlation between intraoperative SEP changes and postoperative neurologic alterations was significant statistically. Conclusions SEP recording is a reliable technique for intraoperative monitoring during neurosurgery around the brain stem. TIVA is helpful for SEP monitoring.

ve In order to improve the reliability of somatosensory evoked potentials (SSEP) monitoring during anesthesia, we compared the effects of three commonly used volatile anesthetics on SSEP to choose suitable volatile anesthetic and determine the appropriate end-expiratory concentrations which have least effects on SSEP monitoring. Methods Sixty ASA I - II patients undergoing elective intracranial surgery were randomly divided into three groups: group A received enflurane; group B isoflurane and group C desflurane. The demographic data including age, body weight, height and sex were not significantly different between the three groups. In addition to SSEP, ECG, BP, SpO2, PET CO2 and end-tidal concentration of inhalation anesthetic were monitored. The SSEP electrodes were placed on N13 on the neck and N20 on the scalp. Before experiment the patient was asked to lie quietly for 10 min, then the patient started breathing 100% O2 and fresh-gas-flow (FGF) was set at 5 L/min. Median nerve on one side was stimulated and SSEP waves from cortex and cervical spinal cord were recorded as baseline tracing before anesthesia. The concentration of inhalation anesthetic was gradually increased from 0 to 0.3, 0.5, 0.75, 1.0 and 1.5 MAC. Each concentration was maintained for 15 min and SSEP waves were recorded. During experiment if the patient developed respiratory depression, oral airway was inserted and assisted ventilation was performed to maintain PETCO2 at 35-45minHg. If the patient developed hypotension, fluid was infused at an increased rate and vasopressor was given if necessary to maintain normal BP (baseline ? 20 % ) . Results The three volatile anesthetics did not change N13 latency and amplitude. Increasing concentrations of enflurane, isoflurane and desflurane were associated with graded reduction in N20 amplitude and increase in N20 latency and N13-N20 interpeak latency. Conclusions The results suggest (1) cortical SSEPs are moresensitive to the volatile anesthetics than subcortical SSEPs, (2) end-tidal concentration of enflurane less than 0.75 MAC is compatible with effective SSEP monitoring, whereas the end-tidal concentration of isoflurane or desflurane compatible with effective SSEP monitoring was less than 1.0 MAC. Enflurane has greater effect on SSEP than isoflurane and desflurane.