Objective To investigate the effect of acute normovolemic hemodilution (ANH) combined with controlled hypotension (CH) on the extravascular lung water (EVLW) and oxygenation in elderly orthopaedic surgery patients.Methods Forty-five elderly orthopaedics surgery patients,23 males,22 females,aged 65-75 years old,ASA grade Ⅰ or Ⅱ,were randomly divided into 3 groups (n=15 each).Group A,served as control,received regular routine transfusion and intraoperative crystalloid fluids and colloidal liquid to add volume.Group B,namely ANH group,received normovolemic hemodilution till Hct reaching 30% after induction of anesthesia.Group C,ANH combined with CH group,received ANH with Hct reaching 30% after induction of anesthesia,and the patients were continuously pumped nitroglycerin combined with esmolol for controlled hypotension.The target mean arterial pressure controlled and cut by 30% below the basic value.We collected arterial blood for blood gas analysis at 5 points: before before induction of anesthesia (T1),immediately after ANH (T2),30 min after ANH (T3),30 min after CH (T4),immediately after surgery (T5).Meanwhile the MAP,HR,PaO2,SpO2,Hct,HCO3-,pH,cardiac index (CI),stroke volume variation (SVV),stroke volume index (SVI),extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI) were recorded.Blood loss,urine output after surgery and the operation time were also recorded.Results The volumes of autoblood removed had no significant difference between group B and group C,and no autoblood was removed in group A.The volume of blood loss in group C was significantly less than that in group A and group B (P<0.05).Six cases in group A,one case in group B and none in group C needed homologous allogeneic blood transfusion.Compared with T1,MAP,HR,CI,SVI and Hct were significantly decreased at T2-T5 (P<0.05),but all those are stable in the normal range.Compared with T1,SVV was significantly decreased at T2-T4 (P<0.05).Compared with T1,ITBVI,PaO2 and SpO2 were increased at T2-T5 (P<0.05),but all those are stable in the normal range.CI and SVI at T2 in group A was significantly lower than that in group B and C.Compared with group A and B,MAP at T4 in group C were significantly decreased and SVV at T4 in group C were significantly increased(P<0.05).Urine output,the operation time,EVLWI,HCO3-and pH in three groups had no significant difference.Conclusion Acute normovolemic hemodilution combined with controlled hypotension has an effect of saving blood in elderly patients,without any influence on the extravascular lung water and oxygenation,which can be used safely in elderly patients which they are monitored.

Objective:To investigate the association between dihyrofolate reductase(DHFR)gene rs1 1 742688 polymorphism and non-syndrom cleft lip with or without cleft palate (NSCL/P)in northest Chinese population.Methods:PCR-restriction fragment length polymorphism(PCR-RFLP)was used to identify the rs1 1 742688 polymorphism of DHFR gene of 220 NSCL/P patients(inclu-ding 1 38 core families)and 1 80 healthy controls.Hardy-Weinberg test and SPSS statistical software were used to calculate the data, OR and 95% confidence intervalarents.Results:In case-contral analysis,there was no significant difference in TT genotype of rs1 1 742688 between NSCL/P subjects and the controls(χ2 =0.439,P >0.05)in.Conclusion:The polymorphism of rs1 1 742688 in DHFR gene is not associated with NSCL/P in northest Chinese population.

OBJECTIVETo assess the value of X-ray stereotactic core needle biopsy (SCNB) in diagnosis of mammographic minimal lesions.

METHODSThirty-one cases with suspicious malignant lesions detected by mammography underwent breast biopsy using computer-assisted stereotactic system with spring-loaded biopsy guns and 16G core needles. All specimens underwent histopathologic examination. Surgical operations were performed in 24 cases after SCNB, and pathological findings of SCNB specimens were compared with those of surgical biopsy.

RESULTAmong 24 cases with surgical excision, 8 cases (33.3%) were confirmed as breast carcinoma, and the other 16 cases (66.7%) was benign breast lesions. The consistency rate of diagnosis with two methods was 87.5%.

CONCLUSIONAs a safe and effective diagnostic method, SCNB is preferred approach to differentiate between malignant and benign diseases of minimal breast lesions before surgery.

Adult ; Aged ; Biopsy, Needle ; methods ; Breast ; pathology ; Breast Diseases ; diagnostic imaging ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Mammography ; Middle Aged

Adenocarcinoma, Follicular ; pathology ; physiopathology ; Female ; Humans ; Kidney Diseases ; pathology ; physiopathology ; Kidney Neoplasms ; physiopathology ; Thyroid Neoplasms ; pathology ; physiopathology ; Young Adult

Objective To study the efficacy of late course accelerated fractionation(LCAF) radio- therapy in the treatment of nasopharyngeal carcinoma(NPC).The end-po s were local control,radiation-in- duced complications,factors influencing survival.Methods From December 1995 to April 1998,178 NPC patients were admitted for radiation treatment.The radiation beam used was ~(60)Co?or 6 MV X-ray.For the first two-thirds of the treatment,two daily fractions of 1.2 Gy were given to the primary lesion ,with an interval of≥6 hours,5 days per week to a total dose of 48 Gy/40 fractions,over a period of 4 weeks.For the last one third of the treatment,i.e.beginning from the 5th week,an accelerated hyperfractionation schedule was carried out.The dose per fraction was increased to 1.5 Gy,2 fractions per day with an interval of≥6 hours,the total dose for this part of the protocol was 30 Gy/20 fractions over 2 weeks.Thus the total dose was 78 Gy in 60 fractions in 6 weeks.Results All patients completed the treatment.Acute mucosi- tis:none in 2 patients,Grade 1 in 43,Grade 2 in 78,Grade 3 in 52,and Grade 4 in 3 patients.Local control rate:the 5-year nasopharyngeal local control rate was 87.7%,and the cervical lymph node local control rate was 85.7%.The 5-year distant metastasis rate was 26.1%,and 5-year survivals was 67.9%. Sixteen patients had radiation-induced cranial nerve palsy.Conclusions With this treatment schedule, patient's tolerance is good,local control and 5 year survivals are better than control groups of conventional fractionation and hyperfractionation radiotherapy.Radiation-related late complication does not increase.Ran- domized clinical trials are being carried out to further confirm the efficacy of LCAF for nasopharyngeal carci- noma.

Based on the electric field shielding and insulation technology, the single electrode dielectric barrier discharge ion source ( DBDI ) has the characteristics of uniform discharging, stability, and high ionization energy, and thus can be used to detect various samples with a large range of polarity. However, the ionization energy is too high to reduce the background signal noise, and thus affects the detection effectiveness to low polarity and low boiling point samples. To enhance the detection effectiveness to these samples, a method of eliminating electrons of single electrode DBDI by using external metal electrodes was developed in this study. Then, the single electrode DBDI was improved by an external needle electrode and an external metal net, respectively. The mechanism of those external metal electrodes was discussed, and the experimental studies were carried out. The results showed that the external metal net technology had an advantage in improving signal to noise ratio ( SNR ) , and the enhancement of SNR for the detection of isoprocarb, perfluorooctanoic acid and SudanⅢwas about 5-6 times. Based on the technology, a method for determination of Sudan Ⅲ in chili powder was developed. The recoveries, RSD and LOD were 83. 7%-94. 6% , 5. 6%-9. 0% and 23 mg/kg, respectively. The external metal electrode technique has broadened the detection range of single electrode DBDI to the field of low polarity, low boiling point and complex samples.

OBJECTIVETo develop an electronic system (software) for collecting and analyzing periodontal examination data, and preliminarily evaluate its clinical application.

METHODSThe contents and frame of electronic periodontal examination system were designed based on the aim and requirement of periodontal examination, and the software system was developed under the assistance from computer engineers. The electronic system was implemented for entry, storage, retrieval and output of clinical data and data conversion. A questionnaire survey was performed in 23 periodontists and 20 nurses to evaluate the clinical application of this software.

RESULTSAn electronic periodontal examination system was developed, which was used for entry, storage, retrieval and output of clinical data, and converting data into chart. Most nurses could handle this software after 15 minutes of training. Thirteen nurses and 17 periodontists recognized that clinical work efficiency could be improved by application of this software. Nineteen nurses and all periodontists agreed that this software could meet clinical requirements.

CONCLUSIONSThe electronic periodontal examination system can fulfill clinical requirements and is helpful for clinical treatment and research work.

Humans ; Information Storage and Retrieval ; Periodontal Index ; Software ; Surveys and Questionnaires

The long-term potentiation (LTP) in the hippocampal dentate gyrus and the plasma glucocorticoids level were observed in rats to study the effects of physical exercise on chronic stress-induced hippocampal damages. Eight-week spontaneous wheel running exercise could attenuate the suppression of LTP induced by 21-day restraint stress, and maintain the normal plasma glucocorticoids levels. It is suggested that long-term physical exercise may protect the hippocampus from stress-induced damages.
Animals ; Corticosterone ; blood ; Hippocampus ; physiopathology ; Long-Term Potentiation ; Male ; Motor Activity ; Rats ; Rats, Wistar ; Restraint, Physical ; Stress, Psychological ; blood ; physiopathology

OBJECTIVETo explore the feasibility of serial slices microscopic histological investigation for the elaborate evaluation of reproductive system malformations.

METHODSNewborn male mice prenatally exposed to different doses of subcutaneously given diethylstilbestrol (DES) from gestational day 9 to 17 were treated by fixing parts of the abdomen in situ and setting them to transected serial slices. All the slices were stained, studied under the microscope and serially recorded by software. The gubernaculum was morphologically analyzed and its location and size were measured.

RESULTSMorphologically, the gubernaculum could be identified clearly, its structure inhomogeneous from proximal to distal and dissymmetric from right to left. The environmental estrogen produced different effects on the morphology of the gubernaculum in different parts and most obviously affected its length.

CONCLUSIONPrenatal exposure to environmental estrogen has evident and general effects on the gubernacular development of newborn male mice. The morphological study with serial histological slices gives a precise and systematic evaluation of genital malformations.

Animals ; Animals, Newborn ; Carcinogens ; toxicity ; Diethylstilbestrol ; toxicity ; Female ; Gestational Age ; Male ; Mice ; Mice, Inbred Strains ; Pregnancy ; Prenatal Exposure Delayed Effects ; Testis ; anatomy & histology ; drug effects ; Urogenital Abnormalities ; chemically induced ; pathology

This study was purposed to establish a new quick and simple diagnostic method with high sensitivity and good specificity for idiopathic thrombocytopenic purpura (ITP) and to evaluate its significance. 240 platelet lysates (from patients with ITP, leukemia, MDS, and healthy adults, each of 60 cases) were randomly assigned to training set (120 cases) or validation set (120 cases), all of them were detected by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS), in order to identify the differentially expressed protein, the diagnostic model was established by means of artificial neural network (ANN), and was validated by blind test with SPSS 17.0. The results showed that 5 marked proteins significantly differentially expressed (P < 0.01), m/z of highly expressed proteins were 2234.30, 3476.36, and 7526.29, m/z of low expressed proteins were 4990.02 and 5152.39, respectively. The sensitivity and specificity of diagnostic model were 80.6% and 77.3% respectively. The area under the ROC curve consisting of the output value of artificial neura1 network was 0.837. Efficacy of the model was validated by means of blinded test. It is concluded that the ANN model is useful for clinical diagnosis of ITP on the basis of platelet protein fingerprint spectrum.
Adult ; Case-Control Studies ; Humans ; Neural Networks (Computer) ; Peptide Mapping ; Proteome ; analysis ; Proteomics ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; genetics ; metabolism ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods