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.

With the kernel of efficacy, "Xiaohe Silian" was a pattern and method for new drug discovery which was constituted with "metabolism-efficacy, toxicity-efficacy, quality-efficacy and structure-efficacy". Its connotation was in keeping with traditional Chinese medicine (TCM) clinical pharmacy. This paper systematically summarized the research method of new drug discovery practice process for TCM. To avoid western drug like in TCM new drug discovery, we carried out combination analysis with TCM clinical pharmacy. The correlation analysis between basic elements of "Xiaohe Silian(n) and TCM clinical pharmacy was studied to guarantee this method could integrate closely with TCM clinic from all angles. Hence, this method aimed to provide a new method for TCM new drug discovery on the basis of TCM clinical pharmacy with insisting on holistic view of multicomponent study, kinetic view of metabolic process when the curative effect occurred and molecular material view of quality control and structure-activity exposition.
Drug Discovery ; methods ; Drug Therapy ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Humans ; Medicine, Chinese Traditional

OBJECTIVETo evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) for renal calculi.

METHODSBetween January, 2004 and January, 2007, 316 patients (212 men and 104 women) with renal stone underwent ESWL. The correlations of the patients' age, gender, body mass index (BMI), disease course, pain, hematuria, stone size, location, side, number and hydronephrosis to the outcome of the treatment was analyzed. The treatment success was defined as complete clearance of the stones or residual stone fragments <0.4 cm, and ESWL was considered unsuccessful with residual stones>0.4 cm.

RESULTSThe overall success rate was 75.3% (238/316) in these patients. Significant difference in stone clearance rates was observed in patients with stone size of 0.5-1.0 cm (90.3%, 167/185), 1.0-2.0 cma(69.6%, 55/79), and >2.0 cm (30.8%, 16/52) (P<0.05). The success rates differed significantly between cases of pelvic stones (83.1%, 118/142) and those of caliceal stones (69.0%, 120/174) (P<0.05). But in cases of caliceal stones, the success rates were comparable between cases with stones at the upper calyx (71.7%, 43/60), middle calyx (68.9%, 31/45), and lower calix (66.7%, 46/69) (P>0.05). Patients with single stones had significantly higher success rate (82.9%,170/205) than those with multiple stones (61.3%, 68/111) (P<0.05). The patients' gender, age, disease course, pain, hematuria, stone side and hydronephrosis did not produce significant impact on the outcome of the treatment (P>0.05).

CONCLUSIONStone size, location and quantity are significant independent factors affecting the outcome of ESWL for renal stones.

Adolescent ; Adult ; Aged ; Female ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

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