Objective To compare the efficacy of sevoflurane combined anesthesia and propofol combined anesthesia in elderly patients undergoing abdominal surgery.Methods Sixty patients aged 65-80 yr scheduled for elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n = 30 each): sevoflurane group (group S) and propofol group (group P).Anesthesia was induced with TCI of sufentanil and propofol.The initial target effect-site concentration (Ce) of sufentanil was set at 0.25 ng/ml and initial target plasma concentration (Cp) of propofol set at 2.0 μg/ml,and then both concentrations were increased in 0.5 μg/ml increment when they reached the balance until loss of consciousness.Tracheal intubation was facilitated with rocuromitm 0.6 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration set at 1.0%-2.0%) in group S,TCI of prepofol (Cp set at 2-4 μg/ml) in groups P, and sufentanil by TCI ( Ce set at 0.15 ng/ml) and iv infusion of vecurenium 0.15 mg·g-1·h-1 in both groups. .BIS value was maintained at 40-60,and changes of MAP and HR were less than 30% of the baseline value in both groups.The use of vasoactive drugs during perioperative peried,time of awakening,extubation and consciousness were recorded and compared between the 2 groups.Results The usage rate of urapidil was significantly decreased,and the awakening time,extubation time and consciousness time shortened in group S compared with group P.Conclusion Sevoflurane-sufentanil combined anesthesia provides better hemodynamic stability and faster recovery than propofol-sufentanil combined anesthesia in elderly patients.

Objective To explore the mechanism of Xiao Chaihu decoction in t he treatment of endometriosis in rats.Methods The rat model of endometriosis w as established. Fas and Caspase- 3 protein expression in the eutopic endometriu m and eutopic endometrium were observed by immunohistochemical method.Results The protein expression of Fas and Caspase- 3 in ectopic endometrium of Xiao Cha ihu decoction group was higher than that in the eutopic endometrium, while the r esult in the control group was just the opposite. No significant difference was shown in Danazol group. Conclusion The therapeutic mechanism of Xiao Chaihu de coction for endometriosis may be related to the promotion the apoptosis of ectop ic endometrium tissue by increasing Fas protein expression.

Objective To evaluate the influencing factors for postoperative odynophagia in elderly patients undergoing intraoperative transesophageal echocardiography (TEE) examination for cardiac surgery.Methods A total of 96 patients with intraoperative TEE examination for cardiac surgery was divided into two groups:the elderly group (patients aged ≥65 years,n=60) and the young group (patients aged ＜ 65 years,n =36).Clinical data were retrospectively analyzed.Postoperative odynophagia was assessed by number rating scale (NRS) scores.Characteristics of postoperative odynophagia were compared between the two groups.Influencing factors for postoperative odynophagia were analyzed by multivariable logistic regression analysis.Results The incidence of postoperative odynophagia and the average NRS score were higher in the elderly group thanin the young group [88.3％ vs.66.7％,(2.6±1.7) vs.(1.4±0.9),P＜0.05 or 0.01].Multivariate logistic regression analysis showed that preoperative oral lidocaine plasmagel,oropharyngeal mucosal injury and duration of TEE insertion were independent influencing factors for postoperative odynophagia (all P＜0.01).Conclusions The incidence of postoperative odynophagia is higher and the degree of odynophagia is more serious in elderly patients undergoing intraoperative TEE examination for cardiac surgery.Postoperative odynophagia can be relieved by applying the preoperative oral lidocaine plasmagel,reducing oropharyngeal mucosal injury and shortening the duration of TEE insertion.

Adult ; Female ; Hematologic Tests ; Hexanes ; adverse effects ; Humans ; Male ; Occupational Exposure ; adverse effects ; Young Adult

Objective To study the effect of Taohongsiwu decoction(THSWD) on the VEGF expression and the micrangium regeneration of callus tissue in bone stump. Methods 65 Japanese rabbits were divided into four groups randomly, three groups were given orally with THSWD, Yandining tablet, distilled water respectively after the right radial bone fracture model was established by operation, and the other group served as control. At the 7th,15th,21th and 35th day after fracture, immunohistochemical method was used to detect the expression of VEGF, and the histochemical staining was used to detect the micrangium change of callus tissue in bone stump. Then the data were compared and analysed. Results VEGF expression level was higher in THSWD intvervening group than that in the other groups, and the decrease of VEGF expression was not obvious after the peak value at 15th day. The callus micrangium regeneration and the remodeling of callus in THSWD intervening group were better in all phase than those in the other groups. Conclusion THSWD could improve the VEGF expression of callus tissue, accelerate the micrangium regeneration in bone stump and promote the healing of fracture.

Objective To research the expression and clinical significance of SALL 4 gene in cervical cancer .Methods The ex-pression of SALL4 in 56 samples of cervical cancer and 35 samples of normal cervical tissues was detected by immunohistochemistry and RT-PCR ,and its relationship with the clinicopathological characteristics of cervical cancer was analyzed .Results The expres-sion of SALL4 mRNA was 2 .56 ± 0 .22 in cervical cancer tissues ,which was significantly higher than 0 .38 ± 0 .03 in the normal cer-vical tissues .the difference between them had statistical significance(t=58 .1 ,P<0 .01);the positive expression rate of SALL4 pro-tein was 80 .4% (45/56) in cervical cancer ,which was significantly higher than 11 .4% (4/35) in the normal cervical tissues (χ2 =41 .177 ,P<0 .01) .The positive expression of SALL4 in the cervical cancer tissues was correlated with the differentiation status of tumor ,which in the middle and high differentiation groups was lower than that in the low differentiation group (χ2 =4 .226 ,P=0 .039) ,but had no correlation with age ,International Federation of Gynecology and Obstetrics (FIGO) stage ,tumor size ,pathologi-cal type and lymph node metastasis(P>0 .05) .Conclusion SALL4 is highly expressed in the cervical cancer tissues and correlated with the tumor differentiation ,which might play an important role in the occurrence and development of cervical cancer .

Objective To investigate the feedback of eight-year program students to problem-based learning ( PBL ),and find out the existing problems and solutions.MethodsThe questionnaire survey was made in the eight-year program students.ResultsApplication of PBL could achieve good feedback.It helped to enhance the self-directed learning,expressing ability,accessing resource skill,and team spirit.ConclusionAlthough there are some problems in the practice of PBL,PBL is a good teaching method in eight-year program education.

Objective To investigate the release and intracellular localization of high mobility group box chromosomal protein 1(HMGBl)in the peripheral blood monocytes of rheumatoid arthritis(RA) patients and the inhibitive effect of thaiidomide.Methods 19 RA patients and 20 healthy controls were included in the study.Monocytes were separated from peripheral blood with Ficoll density gradient centrifugation.Monocytes were treated with 100 ng/ml tumor necrosis factor α(TNFa)or 100 ng/ml TNFα plus 40 μg/ml thalidomide and grown in an incubator at 37℃ with 5%CO,for 24 hours.The cuIture supernatants of the monocytes were collected.HMGB1 level in the culture medium was detected with Western blot.In addition,the intraceUular localization of HMGB1 in the fflonocytes was investigated with immunocytochemical analysis. Results Without stimulation. the release of HMGBl protein was significantly increased in the culture supernatants of peripheral blood monocytes from RA patients as compared with that from healthy controls(P<0.05).TNFα(100 ng/ml)did not further increase the release of HMGBl in the monocytes from the patients with RA.Thalidomide(40 μg/ml)could inhibit the release of HMGB1 in the monocytes from RA patients stimulated with TNFα(P<0.05).In the monocytes from RA patients,HMGBl was mainly localized in the nucleus.Treatment with TNFOL(100 ng/ml)for 24 hour resulted in a cytoplasmic translocation of HMGB1,which was inhibited significantly by thalidomide. Conclusion TNFα induces the release and cytoplasmic translocation of HMGBI in the peTipheral blood monocytes of RA patients and thalidomide inhibits the release and translocation of HMGB1.

Objective To determine the safety, pregnancy outcome and the affect on neonates in pregnant patients with systemic lupus erythematosus(SLE).Methods Sixty-two pregnant patients with SLE were evaluated retrospectively from 1999 to 2009 in our hospital. These patients were divided into two groups:selective pregnancy group and nonselective pregnancy group. The pregnancy outcomes, fetal outcomes, and lupus activity during pregnancy were compared between the two groups. The children of the SLE patients were followed up. Results There were 43 patients in the selective pregnancies group and 19 patients in nonselective pregnancies group. In the selective pregnancies group, lupus flare occurred in 10 pregnancies(23%), 35(81%)had a live birth, 7 had low birth weight infants and 7 had premature delivery; however, in the nonselective pregnancies group, lupus flare occurred in 16 pregnancies(84%), 13(68%) had abortion,6 had a live birth, but all neonates were low birth weight infants. The rates of lupus flare and pregnancy loss in the nonselective pregnancy group were higher than those of the selective pregnancy group(P＜0.05). None of the 22 children had SLE during the follow-up period. Conclusion Both selective and nonselective pregnancy may adversely affectmaternal and fetal outcomes, but patients with selective pregnancy have better outcomes either in lupus flare or maternal and fetal outcomes compared with those of the nonselective pregnancy.

Adult ; Aged ; Humans ; Middle Aged ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; Retrospective Studies