Objective To evaluate the effects of biological rhythm disturbance on sedation induced by propofol in rats.Methods Thirty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each) using a random number table:circadian rhythm + administration during night-time group (group CN),circadian rhythm + administration during day-time group (group CD),biological rhythm+administration during night-time group (group BN),and biological rhythm+administration during day-time group (group BD).In CN and CD groups,the rats were fed for 2 weeks in the experimental boxes in a 12 (7:00-19:00):12 h (19:00-7:00) light:dark cycle.While the rats were fed for 2 weeks in the experimental boxes in a 24 h light cycle.Propofol 75 mg/kg was intraperitoneally injected at 14:00 in CN and BN groups,or at 22:00 in CD and BD groups.The duration of loss of righting reflex was recorded.At 20 min after recovery of righting reflex,the cognitive function was assessed.The latency of passive avoidance was measured at 6,12,24 and 48 h after training.Results Compared with group CN,the duration of loss of righting reflex was significantly shortened,and the latency of passive avoidance was prolonged at 12 and 24 h after training in group CD,and the duration of loss of righting reflex and latency of passive avoidance at 12 and 24 h after training were shortened in group BN.Compared with group CD,no significant change was found in the duration of loss of righting reflex,and the latency of passive avoidance was significantly shortened at 24 h after training in group BD.There was no significant change between BN group and BD group in the duration of loss of righting reflex and latency of passive avoidance.Conclusion Biological rhythm disturbance can counteract circadian rhythmproduced effects on sedation induced by propofol in rats.

AIM:To investigate the changes of choroidal thickness in patients with severe non-proliferative diabetic retinopathy (NPDR) after vitreous injection of ranibizumab,and to analyze the relationship between the thickness of choroid and the visual acuity of the patients.METHODS:Eighty patients with severe non-proliferative diabetic retinopathy were selected from January 1,2014 to January 1,2017.All patients were divided into observation group and control group according to the random number table,40 cases in each group.The control group was treated in a conventional manner,and the observation group was injected with ranibizumab in the vitreous.The thickness of the choroid in the macular area and the thickness of the retinal neuroepithelium in the macular area were compared between the two groups before and after treatment.The changes of the corrected visual acuity were analyzed at 1mo before and after treatment.The relationship between the thickness of the choroid and the thickness of the retinal neuroepithelium and the best corrected visual acuity were compared.The complications and adverse events were compared between the two groups after 6wk of treatment.RESULTS:The thickness of the choroid and the retinal neuroepithelium in the macular area before were 219.57± 51.24μm and 474.76 ± 95.56μm,respectively,in the observation group and the control group,217.56± 50.36μm and 473.27 ± 96.48μm,respectively.The thickness of the choroid and the thickness of the retinal neuroepithelium in the macular area after treatment were 180.15±42.06μm and 382.18±84.26,202.48±48.28μm and 407.88± 44.25μm,respectively.The difference between the two groups was statistically significant (P＜0.05).The best corrected visual acuity in the observation group and the control group were 0.47±0.19 and 0.53±0.25 respectively (P＜0.05).There was a positive correlation between the choroidal thickness and the best corrected visual acuity in the macular fovea (regression coefficient=1.12,S=0.48,OR=1.376,P＜ 0.05).There was a positive correlation between retinal neuroepithelial thickness and best corrected visual acuity in the macular area (regression coefficient =0.95,S=0.27,OR=1.020,P＜ 0.05).There were 2 eyes (5％) with subconjunctival hemorrhage,1 eyes (2.5％) of glaucoma,1 eyes (2.5％) of vitreous hemorrhage,0 of choroidal detachment,retinal detachment in 0 in observation group at 6wk after treatment.There were 4 eyes (10％) with subconjunctival hemorrhage,2 eyes (5％) of glaucoma,2 eyes of vitreous hemorrhage (5％),2 eyes of choroidal detachment (5％),retinal detachment in 2 eyes (5％) in the control group,and the difference between the two groups on the complications and adverse reactions was statistically significant (P＜0.05).CONCLUSION:The choroidal thickness of patients with macular edema in severe non-proliferative diabetic retinopathy is correlated with the best corrected visual acuity.Intravitreal injection of ranibizumab can effectively reduce the macular fovea choroidal thickness,reduce macular edema and improve vision,and less complications.

The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.
Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Stomach Neoplasms ; pathology

OBJECTIVETo study the clinical features, neuroimaging presentations, diagnosis and differential diagnosis, and operative warning events of the solid cerebellar hemangioblastoma.

METHODSThe clinical data of 48 patients with solid cerebellar haemangioreticuloma were retrospectively analysed. Preoperative examinations included CT and MRI in all patients, DSA in 20, preoperative embolization of feeding arteries of tumor in 16, a preoperative ventriculoperitoneal shunt was placed in 5 cases. The lesion distribution of 48 patients was as follows: 14 lesions were situated in the left hemisphere of cerebellum with an extent into the cerebellopontine angle in 2 cases, 12 in right hemisphere of cerebellum, 8 in superior vermis, 7 in inferior vermis, 6 in left subtentorium, 1 in left cerebellar tonsil.

RESULTSThe tumors of 48 patients were totally removed. One patient occurred normal perfusion pressure breakthrough during surgery, and gastrointestinal hemorrhage on the second day after operation. Other patients all were intra- and postoperatively uneventful. Except for autoinfusion, no patients transfused heterogenous blood. There were no operative mortality and serious complications in this series.

CONCLUSIONSThe solid cerebellar hemangioblastoma was benign neoplasm. Abiding by properly operative techniques, the optimal results can be obtained.

Adolescent ; Adult ; Angiography, Digital Subtraction ; Cerebellar Neoplasms ; diagnosis ; surgery ; Child ; Diagnosis, Differential ; Female ; Hemangioblastoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the oncological outcomes, functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). Provide clinical experience for application of SCPL. METHOD: A retrospective analysis of the 115 cases with laryngeal carcinoma accepted SCPL in our department from Jan 1996 to Dec 2004. Use the Kaplan-Meier method to analyze the patients'survival rate. Evaluate the value of reserve larynx function. RESULT: The 5-years survival rates and the decannulation rate was 80.8%, 99.1% respectively; and the average decannulation time was 22.25 days. The mean time of removal of gastric tube was 9.57 days. The function of CHEP was superior to CHP. The vocal function of 115 cases were all achieved in general communication. CONCLUSION SCPL get better oncological and functional outcomes and allows the preservation of the basic function of the larynx. It's a safe, effective technique and deserved to generalization.
Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; mortality ; pathology ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective: To examine the effects of ethyl pyruvate (EP) on mitochondrial dynamics and cell apoptosis in lipopolysaccharide (LPS)-induced human kidney-2 (HK-2) cells. Methods: HK-2 cells were divided into three groups: HK-2 cells were challenged with LPS (800 μg/L) for 24 hours as LPS group, or LPS mixed with EP (0.25 mmol/L) for 24 hours as EP group. Cells were incubated with normal saline for 24 hours as control group. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and intracellular adenosine triphosphate (ATP) were detected by enzyme linked immunosorbent assay (ELISA). JC-1 staining and Annexin V-fluorescein isothiocyanate/propidium iodide (FITC/PI) assays were used to evaluate mitochondrial membrane potential and cell apoptosis, respectively. Western Blot was used to evaluate the protein expressions of mitochondrial dynamics, including death-associated protein kinase 2 (DAPK-2), mitofusin (Mfn-1 and Mfn-2), and apoptotic associated biomarkers, including caspase-3, caspase-9, Bcl-2, Bcl-xL, cytochrome C (Cyt C), and DNA repair enzyme poly ADP-ribose polymerase (PARP). Results: Compared with the NC group, MDA, IL-6, TNF-α of LPS group were significantly increased, the expression of SOD, mitochondrial membrane potential and ATP level were significantly decreased, the expression of mitochondrial fission protein DAPK-2 was significantly increased, and mitochondrial fusion proteins Mfn-1 and Mfn-2 were significantly decreased, cell apoptosis and apoptotic protein caspase-3, caspase-9 and Cyt C were increased, and anti-apoptotic protein Bcl-2, Bcl-xL, PARP were significantly decreased. Compared with the LPS group, the oxidative activities and inflammatory factors above were inhibited in EP group [MDA (μmol/L): 12.35±2.21 vs. 45.95±1.76, SOD (kU/L): 54.68±1.42 vs. 40.73±1.60, IL-6 (ng/L): 67.87±2.61 vs. 338.92±20.91, TNF-α (ng/L): 19.23±1.80 vs. 180.69±6.51], mitochondrial membrane potential and ATP level were significantly increased [mitochondrial membrane potential: (99.43±0.25)% vs. (69.40±0.75)%, ATP (×10⁶ RLU): 0.19±0.01 vs. 0.12±0.05], the expression of mitochondrial fission protein was significantly decreased (DAPK-2/β-actin: 0.03±0.01 vs. 0.61±0.02), mitochondrial fusion proteins were significantly increased (Mfn-1/β-actin: 0.43±0.04 vs. 0.17±0.01, Mfn-2/β-actin: 0.201±0.004 vs. 0.001±0.001), percentage of cell apoptosis was significantly decreased [(5.25±0.17)% vs. (34.42±0.64)%], the expressions of apoptotic proteins were significantly decreased (caspase-3/β-actin: 0.25±0.15 vs. 1.76±0.01, caspase-9/β-actin: 0.09±0.02 vs. 1.52±0.12, Cyt C/β-actin: 0.001±0.001 vs. 0.350±0.030), and the expressions of anti-apoptotic proteins and PARP were significantly increased (Bcl-2/β-actin: 0.500±0.010 vs. 0.009±0.004, Bcl-xL/β-actin: 0.550±0.010 vs. 0.009±0.001, PARP/β-actin: 0.94±0.01 vs. 0.16±0.13), with statistically significant differences (all P < 0.05). Conclusions There are enhanced mitochondrial fission and diminished mitochondrial fusion in LPS-induced HK-2 cells. EP can protect mitochondria functions by regulate mitochondrial dynamics, and reducethe apoptosis of LPS-induced HK-2 cells.

OBJECTIVETo detect the expression of EGFR and p-ERK in nasopharyngeal carcinoma (NPC) and investigate their clinical significance.

METHODSImmunohistochemistry LSAB method was adopted to detect the expression of EGFR and p-ERK. Statistical analysis was performed using SPSS statistical software package (10.0) to correlate their expression with clinical characteristics and prognosis.

RESULTSPositive staining for EGFR was observed in 39 of 55 cases (70.9%). The EGFR expression was correlated with clinical stage and gender. EGFR expression was correlated with poorer overall survival (OS) and shorter time to progression (TTP). Positive staining for p-ERK was observed in 29 of 55 cases (52.7%). There was a statistically significant association between positive p-ERK expression and advanced clinical stage. Positive p-ERK expression was correlated with poorer OS, disease-free survival (DFS) and TTP. EGFR expression was correlated with the expression of p-ERK. On multivariate analysis, age over 50 years was an independent poor prognostic factor for NPC. Both EGFR and p-ERK were not independent prognostic factors for NPC.

CONCLUSIONExpressions of EGFR and p-ERK are detected in NPC. Their abnormally high expression signifies poor prognosis in NPC patients.

Age Factors ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mitogen-Activated Protein Kinases ; metabolism ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Staging ; Proportional Hazards Models ; Receptor, Epidermal Growth Factor ; metabolism ; Sex Factors ; Survival Rate

OBJECTIVETo study the airflow velocity, trace, distribution, pressure, as well as the airflow exchange between the nasal cavity and paranasal sinuses in a computer simulation of nasal cavity pre and post virtual endoscopic sinus surgery (ESS).

METHODSComputational fluid dynamics (CFD) technique was applied to construct an anatomically and proportionally accurate three-dimensional nasal model based on a healthy adult woman's nasal CT scans. A virtual ESS intervention was performed numerically on the normal nasal model using Fluent 6.1.22 software. Navier-Stokes and continuity equations were used to calculate and compare the airflow characteristics between pre and post ESS models.

RESULTS(1) After ESS flux in the common meatus decreased significantly. Flux in the middle meatus and the connected area of opened ethmoid sinus increased by 10% during stable inhalation and by 9% during exhalation. (2) Airflow velocity in the nasal sinus complex increased significantly after ESS. (3) After ESS airflow trace was significantly changed in the middle meatus. Wide-ranging vortices formed at the maxillary sinus, the connected area of ethmoid sinus and the sphenoid sinus. (4) Total nasal cavity resistance was decreased after ESS. (5) After ESS airflow exchange increased in the nasal sinuses, most markedly in the maxillary sinus.

CONCLUSIONSAfter ESS airflow velocity, flux and trace were altered. Airflow exchange increased in each nasal sinus, especially in the maxillary sinus.

Computer Simulation ; Endoscopy ; Humans ; Hydrodynamics ; Maxillary Sinus ; surgery ; Nasal Cavity ; surgery ; Paranasal Sinuses ; surgery

OBJECTIVESubtemporal transpetrosal ridge approach (STA) was introduced to remove the petroclival meningiomas with the simple, safe and minimal invasive character. It is suggested to replace the combined approach to reduce the morbidity and mortality.

METHODSSurgical anatomic study was done on 10 adult cadaver heads fixed in 10% formalin and 10 dry skulls. Ten cadaver heads were examined by bone-window CT scan pre and post-operation. The relationships of important anatomic structures and positions were measured and photographed.

RESULTSFor the STA, the important structures include Vein of Labbe, petrous bone and brain stem ventral space. The important data include the drilling space of the petrous ridge.

CONCLUSIONSSTA is an original approach to remove petroclival meningiomas. By drilling the petrous ridge, it allows the resecion of the tumor simple, safe and minimal invasive. It is suggested to replace the combined approach with STA to diminish the morbidity and mortality.

Adult ; Humans ; Meningeal Neoplasms ; surgery ; Meningioma ; surgery ; Microsurgery ; Neurosurgical Procedures ; methods ; Petrous Bone ; anatomy & histology ; surgery

BACKGROUNDUterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycin-lipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma.

METHODSOne hundred consecutive patients (aged 21 - 53 years, with 38 in average) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia, bulk-related symptoms, and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8 - 21 months (mean, 15 months).

RESULTSNinety-nine patients (99%, 99/100) were interviewed in their first menses circle after embolization, showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days.

CONCLUSIONSPLE is effective in the management of uterine leiomyoma, having superiority in alleviating postprocedure-related pain.

Adult ; Antibiotics, Antineoplastic ; administration & dosage ; Bleomycin ; administration & dosage ; analogs & derivatives ; Contrast Media ; administration & dosage ; Embolization, Therapeutic ; methods ; Emulsions ; Female ; Follow-Up Studies ; Humans ; Iodized Oil ; administration & dosage ; Leiomyoma ; therapy ; Middle Aged ; Uterine Neoplasms ; therapy ; Uterus ; blood supply