Objective To investigate the relationship between intraoperative cerebral oxygen saturation (rSO2) and postoperative cognitive dysfunction with near-infrared cerebral oximeter (INVOS 5100) in patients operated under inhalational combined intravenous anesthesia, and to determine the critical rSO2 value below which postoperative cognitive dysfunction may occur. Methods Sixty ASAⅠ-Ⅱ patients of both sexes were selected, aged 62-80yr, weighed 58-77kg, scheduled for elective abdominal surgery or surgery on the low limb. All the patients were divided into three groups according to their educational background: in group Ⅰ were the illiterate and uneducated patients (n=20);group Ⅱ the primarily educated patients (<6yr education) (n=20), and group Ⅱ the well educated patients (>6yr education) (n=20). Each group was further divided into isoflurane and sevoflurane subgroups (n=10 in each subgroup). All patients received no pre-medication. Anesthesia was induced with intravenous atropine 0.3mg, propofol 1.0-1.5mg kg-1, fentanyl 2-3μg*kg-1 and vecuronium 0.1-0.2mg*kg-1, and maintained with isoflurane or sevoflurane inhalation(0.9-1.1 MAC) supplemented with intermittent i.v. boluses of fentanyl, and recorded after entering room (baseline) (T0), after O2 inhalation (T1), after induction of anesthesia (T2), after skin incision (T3), during operation (T4), the end of surgery (T5), and awaking (T6). Mini-Mental State Examination (MMSE) was performed before anesthesia and 1, 4, 8, 12 and 24h after surgery. BP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of inhalational anesthetics were continuously monitored during anesthesia. Results In all three groups rSO2 was significantly lower during operation (T4) and at the end of surgery (T5) than baseline (T0) (P<0.05). In all patients the MMSE scores at 1h after operation were significantly lower than the baseline value (P<0.05). The MMES scores in all patients significantly declined within 1-4h after surgery, and the cognitive function recovered at 4h after surgery in 85% patients. The critical values of rSO2 below which postoperative cognition dysfunction may occur were: 45 (group Ⅰ), 47 (group Ⅱ) and 49 (group Ⅲ) for isoflurane anesthesia subgroups;47 (group Ⅰ), 48 (group Ⅱ) and 50 (group Ⅲ) for sevoflurane subgroups. Conclusion The perioperative rSO2 should be maintained up to above 50% to reduce the incidence of postoperative cognitive dysfunction under inhalational combined intravenous anesthesia.

Objective To study the effect of inhalational anesthetics on brain cortices under inhalational and intravenous combined anesthesia. Methods 45 patients were randomly divided into isoflurane group (n=15), sevoflurane group (n=15) and desoflurane group (n=15). The narcosis was maintained with inhalational and intravenous combined anesthesia. The EEG non-linear parameters including approximate entropy (ApEn) and correlation dimension (D 2 ) were recorded during operation periods. BP, HR, and SpO 2 were monitored routinely. Results Comparing with that at entrance to the operating room, the EEG activities of frontal and temporal cortices after anesthesia were more suppressed than other cortices. Comparing with that at entrance to the operating room, ApEn and D 2 were significantly declined in the three experimental groups (P

Objective To study effect of propofol on different areas of brain cortex under total intravenous propofol and fentanyl anesthesia. Methods 20 patients were randomly divided into propofol 8mg/(kg?h) group (n=10) and 10mg/(kg?h) group (n=10). The anesthesia was maintained by total intravenous propofol and fentanyl anesthesia. The EEG non-linear parameters, i.e. approximate entropy (ApEn)and correlation dimension (D 2), were recorded during perioperative periods. BP, HR, SpO 2 were monitored routinely. Results Compared with that at entry of OR, the EEG activities of frontal, parietal, and temporal cortices after anesthesia were more inhibited than that of other areas in both groups. Also EEG non-linear parameters were lower significantly after anesthesia in both groups compared with those at entry of OR (P

Objective To evaluate the possibility and efficiency of nanoparticles as a new vector in vascular endothelial growth factor (VEGF) gene transfection. Methods Nanoparticle-VEGF (Np/VEGF)complex was prepared with poly (D, L-lactide-co-glycolide) (PLGA) loading VEGF165 gene using the multiple emulsion (w/o/w) technique. The envelopment efficiency and size of the complex were determined. Rat myocardial cells were cultured in vitro, and the Np/VEGF was transfected into the cultured myocardial cells. Then RT-PCR and ELISA were used to evaluate whether the Np/VEGF increased the level of gene expression. Four New Zealand rabbits were used, the suspension of Np/VEGF was injected into myocardial tissue of rabbits after thoracotomy. 96h after the operation, the tissue sections of the implant sites were observed with transmission electron microscope (TEM) to determine the process of nanoparticles as vectors for gene transfer to cardiac myocytes. Results The envelopment efficiency and size of the Np/VEGF complex thus prepared were 1.87% and 25-300nm respectively. RT-PCR and ELISA showed that VEGF gene could be successfully transfected into myocardial cells by nanoparticle, and NP/VEGF significantly enhanced gene transfection efficiency, and it was more effective than plasmid. 96h after the operation, a great number of nanoparticles were observed in myocardial cytoplasm and nucleus with TEM, and many nanoparticles began to dissolve and degrade, suggesting that the DNA was released slowly from the nanoparticles localized in the cytoplasmic compartment, and was then transferred into the nucleus. Conclusions NP/VEGF can act as a vector to transfect VEGF gene in vitro and in vivo, it significantly enhanced gene transfection efficiency, and it was more effective than plasmid.

Objective To investigate the effects of propofol sedation on different areas of cerebral cortex and memory during operation performed under epidural anesthesia using EEG non-linear monitor and determine the critical value of approximate entropy, the EEG non-linear parameter, without implicit memory.Methods Ten ASA I or II patients of both sexes aged 42-56 yr weighing 59-73 kg undergoing elective abdominal or lower limb operation under epidural anesthesia were enrolled in the study. The patients were unpremedicated. After correct placement of epidural catheter was confirmed, a mixture of 2% lidocaine and 0.3% tetracaine 13-15 ml was injected via the catheter. Propofol was then infused i.v. at 6 mg?kg-1?h-1 for sedation. BP, HR and SpO2 were continuously monitored. The EEG non-linear monitor (ZN16E) was used. The sensors were placed on frontal (FP1 , FP2 ) , temporal (T3 , T4 ), parietal (C3 , C4 ) and occipital ( O1 , O2 ) regions. Approximate entropy and topographic map of approximate entropy were recorded before and during propofol infusion. Sedation scores (OAA/S, 1 = deep sleep, 5 = alert) were assessed during operation The patients' explicit and implicit memory scores were estimated by Process Dissociation Procedure during anesthesia sedateon Results The approximate entropy was significantly decreased during propofol sedation compared to the baseline value before sedation. OAA/S score were maintained at 1 during operation. The explicit and implicit memory scores were significantly decreased during propofol sedation compared to the baseline scores before anesthesia sedation( P

Objective To test thyroid-stimulating hormone (TSH) suppress GLUT4 expression and translocation by stimulating TNF-α secretion in 3T3-L1 adipocytes via a cAMP-PKA pathway.Methods 3T3-L1 preadipocytes were induced to differentiate into adipocytes.The adipocytes were treated with bovine TSH,Forskolin,H89 and Rapamycin,respectively.The concentration of TNF-α in the cell culture medium was measured by ELISA.The level of GLUT4 mRNA in adipocytes was assessed by real time polymerase chain reaction.Protein levels of GLUT4 in total cell lysates and plasma membrane lysates were quantified by Western blotting.Results Incubating 3T3-L1 adipocytes with TSH markedly increased the concentration of TNF-α in medium in a time-and dosedependent manner (P ＜ 0.05); meanwhile,the levels of GLUT4 mRNA and total and plasma membrane GLUT4 protein were decreased in a dose-dependent manner (P＜0.05 or ＜0.01).H89 and rapamycin could block the above effects respectively (326.7±43.2 vs.341.9±12.0,P＞0.05).However,there was no statistical difference in the TNF-α levels between stimulation with 1 μmmol/L forskolin versus 0.04 μmmol/L bovine TSH (481.9± 28.4 vs.522.7± 36.2,P＞0.05).Conclusions TSH can down-regulate GLUT4 expression and translocation in 3T3-L1 adipocytes by stimulating TNF-α secretion through a cAMP-PKA pathway.

Objectives:To study the enzymatic changes and protective effects of ciliary neurotrophic factor (CNTF) on neurons in spinal cord injury (SCI).Methods:SD rats were subjected to incomplete SCI with modified Allen methods.Activities of acetylcholinesterase (AChE) and acid phosphatase (ACP) in spinal cord were quantitatively measured preoperatively,and 3,7,14 days after SCI.Results:AChE activity decreased gradually after injury.ACP activity increased 3 days after injury,and reached peak on the 7th day,then recovered gradually.The rats treated with CNTF showed relatively smooth change of the 2 kinds of enzymes.Conclusions:CNTF plays a role in protecting the spinal cord neurons against injury.

Objective To observe the effect of polyethylene terephthalates (PET) coated with 58S bioactive glass on graft-bone healing.Methods The PET coated with 58S bioactive glass was used in experimental group,and uncoated PET was used as a control.The coating solution was made of 20％ bioactive glass powder and 80％ gelatin powder (by weight).In our vitro study,4×104/ml MT3T3-E1 cells were cultured in 24-well plates with the coated or uncoated PET,and the MTT and ALP were tested at 1,3,5 days to show the proliferation and the activity of the cells.The SEM and the X-ray photoelectron spectrometer were adopted to analyze the surface characteristics of the fiber.In our vivo study,24 skeletally mature New Zealand white rabbits were randomly divided into two groups,the 58S-PET group and the PET group.Both groups underwent a surgical procedure to establish a tibia-articular tendon-bone healing model.Mechanical examination and histological assay were taken to verify the coating effect in vivo.Results The 58S-PET group showed significantly differences in both the MTT and ALP tests at each time point (3,5 days) compared with the PET group.In the animal experiments,the maximum load increased by time in both groups.At 6 weeks,the load-to-failure was significantly higher in the 58S-PET group [(61.70±6.95) N]than that of the PET group [(45.21±9.78) N].At 12 weeks,the load-to-failure was also significantly higher in the 58S-PET group [(89.25±9.50) N]than that of the PET group [(71.38±6.26) N].In the histological assay,it was found that there was new bone formation in the indistinct interface between the graft and the host bone in both groups at 6,12 weeks,and a stronger binding was seen in the 58S-PET group than in the PET group.Conclusion The 58S-PET could enhance the proliferation and activity of the osteoblast and therefore promote the new bone formation and subsequently leads to a positive effect on tendon-bone healing.

Objective To discuss the impact of nursing intervention on self- care ability and health behavior of cancer patients with indwelling PICC in order to improve their life. Methods 218 cases of cancer patients with PICC catheter were randomly divided into the intervention group (107 patients)and the control group (111 patients),the control group were treated with conventional care, the intervention group was treated with targeted cognitive intervention by the PICC nurse specialists on the basis of conventional care. Interventions included improving health knowledge, self-concept, self-care responsibility and self-care skills in four areas, the intervention lasted 3 months. A questionnaire survey was conducted before and after intervention. Self-care skills and health behavior levels were compared between the two groups. Results Self-care skills and health behavior levels of the intervention group were significantly higher thanthose of the control group after intervention. Conclusions Targeted interventions can effectively improve the self-care capacity of outpatient oncology patients with PICC catheter and improve their health behaviors.

Objective To analyze the reasons of abnormal extubation for the chemotherapy patients with PICC,and put forward preventive measures. Methods A retrospective investigation was carried out about the reasons for abnormal extubation in 583 chemotherapy patients with PICC in our hospital from December 2007 to September 2009. Results There were 63 cases of abnormal extubation in 583 patients, accounted for 10.8% of the total number. The reasons of abnormal extubation included: catheter-related infection, misplacement,prolapse, dilapidation and fracture, catheter occlusion,thrombosis and abandoning treatment. Conclusions Complications caused by PICC are the main reasons for abnormal extubation. Important care measures to prevent and deal with kinds of complications timely can reduce the incidence of abnormal extubation.