Objective To evaluate the efficacy and safety of 0.75% ropivacaine versus 0.75% bupivicaine for combined spinal and epidural anesthesia(CSEA) for cesarean section. Methods Forty primiparae(ASA Ⅰ-Ⅱ) scheduled for elective cesarean section were divided into two groups: ropivacaine group received 0.75% ropivacaine 1 .2-1 . 4ml(9-10. 5mg) for spinal anesthesia and bupivicaine group received same amount of 0.75% bupivicaine. During operation when spinal analgesia was inadequate, 1.6% lidocaine was supplemented via epidural catheter. Blood pressure , heart rate and SpO2 were monitored. Sensory block(pin prick), motor block(modified Bromage scale), quality of analgesia and relaxation of abdominal wall were assessed. Apgar score of the neonates and umbilical artery blood gas as well as side effects were recorded. Results There was no significant difference between the two groups in age, height, body weight of the patients and duration of operation. The height of block was comparable between the two groups but the onset time was longer and duration of block was shorter in ropivacaine group. Analgesia and muscle relaxation were satisfactory and Apger score was 10 at 1 mm and 5mm in both groups. Blood gas values were within normal range in both groups. Motor block was weaker with ropivacaine than that with bupivacaine(P

Objective To study the effect of vascular endothelial growth factor (VEGF) containing fibrin glue(FG) on re-endotheliazation, cell proliferation and intimal hyperplasia in a canine model of carotid artery endothelium injury. MethodsThe effect of FG/VEGF/heparin versus FG alone treatment was evaluated at the time point of 10, 30, and 90 days by measuring the intima/media (I/M) ratio and cell proliferation by BrdU incorporation using immunohistochemistry. EC coverage was determined by SEM. ResultsCompared with normal saline control, FG/VEGF/heparin treatment significantly increased EC coverage at day 10 and at day 30 (P

Objective:To observe acid-base and biochemical changes in clinical orthotopic liver transplantation with veno-venous bypass.Method,Seven patients receiving orthotopic liver transplantation, veno-venous bypass was undergone in anheptic phase.The acid-base and biochemical parameters were monitored during operation. Result:Compared to preoperation,pH decreased a little in each phase,BE and SBC slightly decreased 60 min following bypass and during skin closure. Compared to before bypass,pH had no changes during bypass and new liver phases. The serum Ca~(2+) level decreased and serum glucose level elevated in each phase,The temperature gradually decreased during operation. The serum K~+ level was transiently elevated from 3.17mmol/L to 3.53 mmol/L early after the heptic revascularizaton. Conclusion:With the application of the veno-venous bypass technique,the hazard of acid-base and biochemical changes can be reduced during orthotopic heptic transplantation.

Surgery combined with postoperative stereotactic radiosurgery (SRS) can improve the overall survival and becomes one of main treatments for resectable brain metastases. Compared with postoperative SRS, preoperative SRS (Pre-SRS) has theoretical advantages of reducing the dissemination of active tumor cells into the treatment cavity during surgery, reducing radiation dose, reducing radiation to surrounding normal brain tissue, and ensuring successful implementation of perioperative treatment, etc. Recent clinical studies have confirmed that Pre-SRS can reduce local recurrence rate and the incidence of radiation necrosis (RN) and leptomeningeal metastasis (LMM). Moreover, the indications, dose fractionation, and combined therapy remain to be confirmed by more prospective studies. In this article, research progress in Pre-SRS for resectable brain metastases was reviewed.

OBJECTIVETo investigate the association of microcystin (MC) in drinking water with the incidence of colorectal cancer.

METHODSThe study was designed as a retrospective cohort. Eight townships or towns were randomly selected as the study sites in Haining City of Zhejiang Province, China. 408 cases of colon and rectum carcinomas diagnosed from 1977 to 1996 in the study sites were included, and a survey on types of drinking water of these patients was conducted. Samples of different water sources (well, tap, river and pond) were collected separately and microcystin concentrations were determined by indirect competitive ELISA method.

RESULTSThe incidence rate of colorectal cancer was significantly higher in population who drank river and pond water than those who drank well and tap water. Compared to well water, the relative risk (RR) for colorectal cancer was 1.88 (tap), 7.94 (river) and 7.70 (pond) respectively. The positive rate (> 50 pg/mL) of microcystin in samples of well, tap, river and pond water was 0, 0, 36.23% and 17.14% respectively. The concentration of microcystin in river and pond water was significantly higher than that in well and tap water (P < 0.01). Spearman rank correlation analysis showed that in the study sites, the microcystin concentration of river and pond water was positively associated with the incidence of colorectal cancer (rs = 0.881, P < 0.01).

CONCLUSIONSThe types of drinking water are positively associated with the incidence of colorectal cancer in the study sites, and this may be related to microcystin contamination of drinking water. Further biological study is needed to support the possible causative role of mycrocystin in carcinogenesis of colon and rectum.

Bacterial Toxins ; toxicity ; Carcinogens, Environmental ; toxicity ; China ; epidemiology ; Cohort Studies ; Colorectal Neoplasms ; chemically induced ; epidemiology ; Female ; Humans ; Male ; Microcystins ; Peptides, Cyclic ; toxicity ; Retrospective Studies ; Water ; chemistry ; Water Pollutants, Chemical ; toxicity ; Water Supply ; standards

OBJECTIVETo explore the changes of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and angiogenesis, and the effects of bFGF, angiotensin converting enzyme inhibiter(ACEI) benazepril on the angiogenesis in acute myocardial infarction (AMI) model of rabbits, and to provide a probable evidence for the treatment of AMI.

METHODSAMI model was established by ligating anterior descending branch of coronary artery of Japan-Sino hybridization white rabbits. The postoperative rabbits were randomly divided into 6 groups and each group was treated with different drugs. Groups 1 and 2 were treated with normal saline (NS) for 28 and 14 days (d), group 3 and 4 with bFGF for 28 and 14 d, groups 5 with benazepril for 14 d, and group 6 with benazepril and bFGF for 14 d respectively. The rabbits were killed on the 14th or 28th d and their hearts were excised, sectioned and stained with HE, Masson trichrome to observe VEGF, bFGF and CD(34) under a microscope, which were quantified with a computer-assisted morphometry.

RESULTSCompared with group 1, the granulation tissue of infarction zone (IZ) in group 2 freshened up, and the capillary density (CD) in IZ was increased (P = 0.002). The CD in the IZ as well as VEGF and bFGF in groups 3 and 4 were increased respectively (P = 0.011-0.037). In group 5 the changes of VEGF and bFGF were not found in the IZ and the border zone (BZ) while CD was significantly increased (35.4% and 25.6%, P = 0.036 and 0.037). Compared with group 2, the CD in the IZ and BZ of group 6 was significantly increased (63.4% and 44.3% P = 0.007 and 0.007), meanwhile VEGF and bFGF were increased. Compared with group 5, only VEGF was increased.

CONCLUSIONIntravenous bFGF may increase VEGF and bFGF significantly, thus promoting the angiogenesis in the IZ and BZ in cardiac infarction as VEGF and bFGF are the potent angiogenic growth factors. Benazepril may promote angiogenesis in the IZ and BZ in cardiac infarction, but its mechanism is irrelative to the expression of VEGF and bFGF. The combination of benazepril and bFGF may promote, to some extent, the expression of VEGF and bFGF, but their effect on angiogenesis has not been found.

Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; Animals ; Benzazepines ; metabolism ; pharmacology ; therapeutic use ; Coronary Circulation ; drug effects ; Coronary Vessels ; drug effects ; metabolism ; Disease Models, Animal ; Fibroblast Growth Factor 2 ; metabolism ; therapeutic use ; Myocardial Infarction ; metabolism ; Neovascularization, Physiologic ; Rabbits ; Time Factors ; Vascular Endothelial Growth Factor A ; metabolism ; therapeutic use

OBJECTIVETo evaluate the efficacy of sequential enteral nutrition support in patients with severe cerebral stroke.

METHODSForty-nine patients with severe cerebral stroke met the inclusion criteria were randomly divided into sequential enteral nutrition group (Group A, n=24) and conventional enteral nutrition group (Group B, n=25). Patients in Group A received short-peptide-based enteral nutrition support first, then gradually transferred to intact protein enteral nutrition. Meanwhile, patients in Group B constantly received intact protein enteral nutrition support. The nutritional indexes and the rate of complications were compared between two groups.

RESULTSThe nutritional indexes were decreased in both groups within 4 weeks after admission, but the decreasing levels of hemoglobin and albumin in Group A were significantly lower than those in Group B (P<0.05), and the incidence of infections and gastrointestinal hemorrhage in Group A was also lower than that in Group B (P<0.05). However, there were no significant differences in body weight, BMI, triceps skinfold thickness, biceps circumference, arm muscle circumference between two groups (P>0.05).

CONCLUSIONSequential enteral nutritional support can improve the nutritional status and decrease the incidence of complications in critical patients with cerebral stroke.

Aged ; Aged, 80 and over ; Enteral Nutrition ; methods ; Female ; Humans ; Male ; Middle Aged ; Stroke ; therapy

OBJECTIVETo investigate the relationship between six-transmembrane epithelial antigen of the prostate (STEAP) expression and the histologic grading of prostatic carcinoma (PCa).

METHODSDifferent prostatic tissues and non-prostatic tumors, 131 cases of PCa, 164 cases of benign prostate hyperplasia (BPH), and 56 cases of non-prostatic malignancies, were analyzed for the expression of STEAP by using STEAP monoclonal antibody and SP immunohistochemical staining. The positive area unit (PU) was introduced to describe the intensity of STEAP expression.

RESULTSThe prostatic tissues of all but 3 cases of PCa and 5 cases of BPH were stained positively, while all of the non-prostatic tumors were stained negatively. There was a significant negative correlation between the STEAP expression and the histologic grading of PCa.

CONCLUSIONSTEAP can be a prognostic marker of PCa and a potential therapeutic target in PCa.

Antigens, Neoplasm ; analysis ; genetics ; Humans ; Immunohistochemistry ; Male ; Oxidoreductases ; Prostatic Neoplasms ; diagnosis ; immunology ; pathology

Objective To evaluate the value of medical treatment in the management of SAP.Methods From January 2000 to December 2011,a total of 1064 cases out of 931 SAP patients were admitted and retrospectively analyzed.The etiologies,severity score,complication rates,therapies,effectiveness and costs of those SAP cases were summarized.Results There were 559 males and 372 females with a mean age of (51 ± 15)years old.The main cause was biliary tract disease (58.3％),followed by fat-rich diet (31.2％),hyperlipidemia (13.6％) and alcohol (7.1％).At the time of admission,95.5％ of SAP patients presented with level D disease according to Balthazar CT severity index,26.0％ had a Ranson score ≥3 and 30.1％ had an APACHE Ⅱ score ≥ 8.There were 42.7％ cases complicated with systemic inflammatory response syndrome (SIRS).Acute lung injury and acute respiratory distress syndrome (ARDS),acute kidney injury,shock or heart failure,acute liver dysfunction,and diffuse intravascular clotting (DIC)occurred in 24.0％,8.1％,5.4％,3.2％,and 1％ of all patients,respectively.Other complications of SAP included abdominal cavity bleeding (n =17),pseudocyst bleeding (n =9),pancreatic abscess (n =78) and gastrointestinal fistula (n =33).Totally 25 (2.3％) patients died in hospital and 36 (3.4％) patients were discharged against advice,with an overall treatment success rate of 94.3％.The mean hospital stay was (23.7 ± 19.2) d,and the average cost was 52.3 thousands of RMB.Conclusions A comprehensive treatment pathway relying on medical treatment,focusing on organ function support and assisted by miniinvasive intervention may improve the treatment success rate of SAP,which is worth of further application.

OBJECTIVETo estimate the impact of copying on the indoor air quality, and to investigate whether ozone emitted during such a process induces pathological oxidative stress and potential oxidative damage in the bodies of operators.

METHODS67 copying operators (CO) and 67 healthy volunteers (HV) were enrolled in a random control study, in which levels of lipoperoxide (LPO) in plasma and erythrocytes, and levels of vitamin C (VC), vitamin E (VE) and beta-carotene (beta-CAR) in plasma as well as activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined by spectrophotometric methods.

RESULTSCompared with the HV group, the average values of LPO in plasma and erythrocytes in the CO group were significantly increased (P<0.0001), while those of VC, VE and beta-CAR in plasma as well as those of SOD, CAT and GPX in erythrocytes in the CO group were significantly decreased (P<0.0001). Pearson product-moment correlation analysis showed that with increase of ozone level in copying sites and duration of exposure to ozone, the values of LPO in plasma and erythrocytes in the bodies of operators were gradually increased,while those of VC, VE, beta-CAR, SOD, CAT and GPX were decreased in the same manner. Odds ratio (OR) of risk of biochemical parameters reflecting potential oxidative damage of the copying operators ranged from 4.440 to 13.516, and 95% CI of OR was from 2.113 to 34.061. Reliability coefficient (alpha) of the biochemical parameters used to reflect the potential oxidative damage of the operators was 0.8156, standardized item alpha=0.9929, P<0.0001.

CONCLUSIONFindings in the present study suggest that there exist a series of free radical chain reactions and pathological oxidative stress induced by high dose ozone in the operators, thereby causing potential oxidative and lipoperoxidative damages in their bodies.

Adult ; Copying Processes ; Erythrocytes ; Female ; Humans ; Male ; Occupational Exposure ; Odds Ratio ; Oxidants, Photochemical ; analysis ; toxicity ; Oxidative Stress ; Ozone ; analysis ; toxicity ; Risk Assessment