ObjectiveTo investigate the effects of norepinephrine on oxygen metabolism and postoperative outcomes in the elderly patients undergoing fluid-restored abdominal surgery.MethodsAfter hospital ethics committee approval,and written informed consent was obtained from all patients,40 elderly patients,aged ＞ 64 yr,with a body mass index of 18-24 kg/m2,undergoing elective colorectal surgery,were randomly divided into 2 groups (n =20 each):routine fluid administration group (group A) and restricted fluid administration group (group B).In group A,lactated Ringer's solution was given routinely.Lactated Ringer's solution was given at a rate of 5 ml· kg- 1 · h- 1 and small dose of norepinephrine was infused intravenously at 0.01-0.03 μg· kg- 1 · h - 1 simultaneously during the surgery,and MAP was maintained ≥65 mm Hg in group B.Intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl starch 130/0.4.Before the surgery ( baseline),1 and 2 h after beginning of the surgery,and while leaving postanesthesia care unit,mean arterial pressure (MAP),heart rate (HR),cardiac index (CI) and central venous pressure (CVP) were recorded,and arterial and central venous blood samples were drawn for blood gas analysis.Oxygen delivery index (DO2 I ),oxygen consumption index (YO2I) and oxygen extraction ratio (ERO2) were calculated.The gastric mucosal pH was determined before the surgery and 1 h after beginning of the surgery.Blood samples were taken form the peripheral vein to determine the concentration of Hb,serum albumin,blood urea nitrogen (BUN) and creatinine (Cr) concentrations before the surgery and 1 day after the surgery.The extubation time,duration of stay in hospital,the time when the patients passed the flatus,pulmonary complications,gastrointestinal complications,and wound infections were recorded.ResultsCompared with group A,CI,Hb,ScvO2 and DO2I were significantly increased,CVP and ERO2 were decreased during the surgery,the concentrations of Hb and serum albumin were significantly increased,1 day after the surgery,and the incidence of pulmonary complications and wound infections was significantly decreased after the surgery in group B (P ＜ 0.05 ).There were no significant differences in gastric muscosal pH,the indexes of renal function,extubatiotn time,the time when the patients passed the flatus,duration of stay in hospital and the incidence of gastrointestinal complications between the two groups ( P ＞ 0.05).ConclusionWhen small dose of norepinephrine is used to treat perioperative hypotension induced by fluid restriction,it can increase oxygen delivery,and reduce the incidence of postoperative complications,and has no adverse effects on gastrointestinal microcirculation and oxygen consumption in the elderly patients undergoing colorectal surgery.

Objective To study the relationship of Dll-1/Notch signal transduction pathway with the pathological characteristics of colorectal cancer and the effect on proliferation and apoptosis of colorectal cancer cells. Methods We assessed Notchl and Dll-1 protein levels in 63 cases of colorectal cancer and adjacent normal tissue by Western blotting.SW480 cells were treated with DAPT (γ-secretase inhibitor) at different treating times.MTT assay and flow cytometry were used to measure the proliferation and apoptosis of SW480 cells,seperately.The expression of the intracellular domain of Notch (NICD),Hes-1 and Bcl-2 were measured by Western blotting.Statistical methods were used including independent samples t test,paired sample t test and single factor analysis of variance. Results Notch1 and Dll-1 protein level increased in colorectal cancer tissues compared with adjacent normal mucosa,the mean values were 1.75-fold and 2.21-fold,respectively(t =2.554,P =0.012 and t =3.565,P =0.005).Also we found that the overexpression of Notch1 and Dl1-1 was related to the differentiation( t =2.463,P =0.017 and t =2.390,P=0.019),staging(t =2.675,P =0.007 and t =2.310,P =0.021) and lymph nodes metastasis(t =2.229,P =0.021 and t =2.210,P =0.023) of colorectal cancer.Treating SW480 cell with Notch pathway inhibitor (γ-secretase inhibitor,DAPT) resulted in growth inhibition,apoptosis induction and there was downregulation of NICD and Bcl-2 expression along with the treating time. Conclusions Overexpression of Notch1 and Dll-1 is related to the pathological characteristics of colorectal cancer.Blockade of Notch1 signal pathway may inhibit cell proliferation and induce cell apoptosis of colorectal cancer,as well as inhibit the expression of Bcl-2.

Objective To investigate the correlation between serum antinuclear antibody (ANA) expression and clinicopathologic characteristics as well as the prognosis in colorectal cancer patients.Methods Analysis was performed for 198 cases with histologically proven adenocarcinoma of colorectal cancer who underwent curative resection from January 2009 to December 2010.There were 113 males and 85 females,average age of 63.9 (22 to 92) years.Serum ANA expression was detected by indirect immunofluorescence.Chi-square test was used to analyze the relationship between clinicopathological features and serum ANA expression,Kaplan-Meier analyses were used to compare DFS between ANA positive and negative group,multivariate analysis was used to measure the impact of confounding variables on survival.Results Positive serum ANA was detected in 51 (25.76％) of the 198 patients,higher than that of the control group 8％ (4/50).By univariate analysis,we found that serum ANA positive was related to age ＜ 65 years (x2 =4.87,P =0.027 3),tumor size ≥5 cm (x2 =5.56,P =0.018 3),invasion depth (x2 =325.89,P ＜0.000 1) and tumor course≥5 months (x2 =5.43,P =0.019 8) respectively,and not related to gender,tumor location,tumor differentiation,lymph node and distant metastasis (P ＞ 0.05).Multivariate analysis identified that only invasion depth of tumor led to serum ANA expression significantly.Conclusions Tumor invasion depth impacts on serum ANA expression significantly,while the expression has no correlation with the prognosis of colorectal cancer.

Objective:To observe the expression patterns of miR-195 and DLL4 in colorectal cancer, and to explore the relationship between miR-195 and DLL4 and clinicopathological parameters and prognosis of patients with colorectal cancer.Methods:The relative expression of miR-195 in 56 colorectal cancer tissues was detected by real-time fluorescent quantitative PCR the expression of DLL4 protein and tumor microvessel density (MVD) were detected by bloting and immunohistochemistry. Colon cancer cell line SW480 was treated with miR-195. The expression of DLL4, Jagged1, (the intracellular domain of notch, NICD), CyclinD1, Hes1, Bcl-2 and NF-kB were detected by bloting.Results:The expression level of DLL4 protein in colorectal cancer tissues was significantly higher than that in normal intestinal mucosa (30/56 vs.16/56, t=5.323, P=0.018). The expression level of miR-195 was significantly lower than that in normal intestinal mucosa (36/56 vs.20/56, t=2.371, P=0.008). The expression of DLL4 was negatively correlated with the expression of miR-195 ( r=- 0.881, P=0.015) , which was closely related to the differentiation degree, lymph node metastasis and TNM stage . The prognosis of patients with high expression of DLL4 was significantly worse than that with low expression of DLL4 ( P=0.013). The prognosis of patients with low expression of miR-195 was worse than that with high expression of miR-195 ( P=0.009) . Conclusion:The antagonistic expression of miR-195 and Notch might be closely related to the occurrence and development of colorectal cancer, which can be used as a new reference index for prognosis of colorectal cancer.

Objective To investigate surgical technique and clinical efficacy of Sky bone ex- pander kyphoplasty in the treatment of osteoporotic vertebral body compression fractures.Methods Eighteen cases with osteoporotic vertebral body compression fractures were treated with Sky bone expander kyphoplasty from August 2004 to November 2005.Under the local anesthesia,3.5-5ml of bone cements were injected into each pathologic vertebral body through unipedicle approach after reduction procedure was done with Sky bone expander.Results The postoperative follow-up ranged from 3 to 11 months, with an average of 4.5 months.Back pain was effectively relieved after the operation in all cases.No complications occurred.Conclusion The Sky bone expander kyphoplasty has the advantages of safe- ty,easy operation,minimal invasion,effective restoration of the vertebral body height and fast relief of pain.

Objective:To observe the therapeutic efficacy of acupuncture plus Tai Ji Quan (Tai Chi) in recovering the neurological function and treating depression state in post-stroke depression patients,together with a 12-month follow-up.Methods:A total of 105 eligible post-stroke depression patients were randomized into an acupuncture plus Tai Ji group (53 cases) and a control group (52 cases) based on their visiting sequence.The patients all received routine treatment and rehabilitation training for stroke.In addition,the control group was given oral administration of citalopram hydrobromide tablets,1 month as a course of treatment,for 3 courses in total.Meanwhile,the acupuncture plus Tai Ji group received acupuncture and practiced Tai Ji Quan,for 1 month and 12 months respectively.Before the intervention,after 1-month intervention and 12 months later,the National Institute of Health stroke scale (NIHSS),Barthel index (BI) and Hamilton depression rating scale (HAMD) were adopted for efficacy evaluation.Results:Prior to the intervention,there were no significant differences in HAMD,NIHSS and BI scores between the two groups (all P＞0.05);after 1-month intervention,there were significant between-group differences in NIHSS,BI and HAMD scores (P＜0.05 or P＜0.01);the 12-month follow-up revealed significant between-group differences in NIHSS,BI and HAMD scores (all P＜0.01).In the treatment of stroke,the total effective rate was 84.4％ in the acupuncture plus Tai Ji group,significantly higher than 68.9％ in the control group (P＜0.05);in the treatment of depression,the total effective rate was 86.7％ in the acupuncture plus Tai Ji group,significantly higher than 77.8％ in the control group (P＜0.05).Conclusion:Acupuncture plus Tai Ji Quan can produce a significant efficacy in improving the limb motor function and depression in post-stroke depression patients.

Cause of Death ; Cerebrospinal Fluid Rhinorrhea ; etiology ; mortality ; Head Injuries, Penetrating ; etiology ; mortality ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Sphenoid Sinus ; surgery

In order to make sure whether Panax notoginseng is sensitive to chloridion and guide fertilization in planting of P. notoginseng, the effects of the different proportion of potassium chloride (KCl) and potassium sulfate (K2SO4) on the yield, quality of P. notoginseng were studied. The results showed that K fertilizer significantly improved the growth of P. notoginseng and increased the biomass per plant or per pot and the content of N, P, K and the content of saponin. In cases of conditions such as potassium, and the effects of K2SO4 on increasing the petiole length, leaf size, rhizome length, root length, and content and accumulation of Ginsenoside Rg1 were better than those of KCl. While compared with K2SO4, KCl was more conducive to augmenting height, root width, the biomass of shoot, rhizome, root and the content of Ginsenoside Rb1 and Rd. There was not remarkable difference in agronomic characters, biomass and the content of N, P, K among KCl, K2SO4 and the combination of KCl and K2SO4. However, the content of saponin of the treatment with combination of KCl and K2SO4 was significant higher than that of single KCl or K2SO4 treatments. K fertilizer significantly increased yield and the content of saponins. And P. notoginseng was not sensitive to chloridion. KCl increased the yield and the content of saponins of P. notoginseng as well as K2SO4, and the combination treatment was superior to single treatment. It is recommended that the KCl should be adopted in production, to reduce the cost of potash fertilizer.
Agriculture ; Fertilizers ; analysis ; Panax notoginseng ; chemistry ; growth & development ; Potassium Chloride ; analysis ; metabolism ; Quality Control ; Soil ; chemistry ; Sulfates ; analysis ; metabolism

Objective:To investigate the characteristics of health-related risky behaviors in adolescents with bipolar disorder.Methods:Fifty adolescents aged 12 -18 years,fulfilled the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision(ICD-10)criteria for bipolar disorder(29 in depressive state, 19 in manic state,and 2 in mixed state)and 100 healthy-matched controls were recruited.Their health-related risky behaviors were assessed using the Questionnaire for Adolescents Health-related Risky Behavior Inventory (AHRBI) and the Questionnaire for Adolescents Health-related Risky Behavior Inventory for Parent (AHRBI-P).Results:The bipolar group had higher AHRBI scores in the total scale and six subscales than controls,including Aggression and Violence (AV),Health-Compromising Behavior (HCB),Rule Breaking (RB),Unprotected Sex (US),Self-injury and Suicide (SS),and Smoking and Drinking(SD)[Total scores,55.5(38,119)vs.46(38,65);P <0.05].Besides, the scores of 26 items of bipolar group were all higher than controls(Ps <0.05).The scores in the total scale and six subscales had no difference between AHRBI and AHRBI-P.According to the partial correlation analysis (de-pressive state =0;manic state =1),the AHRBI and AHRBI-P scores of Self-injury and Suicide subscale were nega-tively associated with the episode state (r =-0.32,-0.33;Ps <0.05).The AHRBI scores of'destroy properties'which belongs to the Aggression and Violence subscale were positively associated with the episode state (r =0.32, P <0.05).Conclusion:The adolescents with bipolar disorder have more health-related risky behaviors than the healthy adolescents.The depressive patients have higher risk of suicide.While,the risky behavior of destroying properties tend to occur among the manic patients.

Objective To investigate the parental origin for a rare case of complete hydatidiform mole and coexisting fetus and to discuss its diagnosis and differential diagnosis.Methods Tissues from the fetus,mole and placenta were collected and pathology analysis and chromosome analysis were done.The DNA from the fetus,mole and parents' peripheral blood leukocytes was amplified with five short tandem repeat (STR) markers (D4S2460,D18S488,D21S2039,DXS1205 and DYS219) at the same time to confirm the parental source of the hydatidiform.Results (1) Casereport:A 27-year-old woman,gravida 1,para 0,was found high risk for neural tube defects at 20 weeks of gestation.At 24+5 weeks of gestation,ultrasound examination demonstrated a normal fetus,a normal placenta and a huge mass with a multicystic appearance attached to the placenta with an obvious demarcation.The fetus died at 26 weeks of gestation.Serum human chorionic gonadotropin-β(β -hCG) level decreased obviously during the first two weeks after artificial induction,but elevated at the third week,and β-hCG titers fell to normal after 2 courses of chemotherapy.Fetus autopsy showed no structure abnormality.Histopathologic examination of the hydatidiform showed swelling of chorionic villi with hyperplasia of the trophoblast and formation of central cisterns suggesting of a twin pregnancy consisting of a complete hydatidiform mole and coexisting fetus.(2) Genetic analysis:The karyotype analysis of the normal placental villi was 46,XY; the cell cultures of fetal cartilage tissue and hydatidiform were failed.STR analysis showed that the fetus was diploid from biparental source;the mole was androgenetic source.And the mole had locus both from Y and X chromosome of the father,so it was heterozygous.It was suggested that this case was derived from one single oocyte fertilized with three spermatozoas.Conclusions STR analysis could be used to confirm the diagnosis of complete hydatidiform mole and coexisting fetus and to find the pathogenetic rnechanism.