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.

Adolescent ; Blood Vessels ; pathology ; Female ; Femur Head ; blood supply ; pathology ; Femur Head Necrosis ; pathology ; Humans ; Male

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 study the treatment effect of gonadotropin releasing hormone agonist?α( GnRH?α) different drug consolidation therapy time on endometriosis patients received endometriosis laparoscopic surgery?Methods Seventy cases endometriosis patients received endometriosis laparoscopic surgery in the People's Hospital of Meizhou from May 2012 to March 2014 were enrolled for study and randomly divided into 6 months group and 3 months group according to different time of GnRH?αtreatment?Then hormone levels, inflammatory mediators, follow?up condition and treatment outcome were compared between the two groups?Results The total effective rate of 6 months group was 97?14%( 34/35) ,significantly higher than that of 3 months group(80?00%(28/35)),the difference was significant(χ2 =5?081,P<0?05)?Serum follicle stimulating hormone( FSH) ,progesterone( LH) ,estradiol( E2) levels of 6 months group were significantly lower than 3 months group,the differences were significant((2?42±0?33) U/L vs?(3?79±0?42),(3?49±0?45) U/L vs?(5?12±0?60) U/L,(89?48±10?23) ng/L vs? (130?48±16?85) ng/L;t=15?174,12?858,12?305;P<0?05)?Serum TNF?α,IL?6,IL?8 levels of 6 months group were significantly lower than 3 months group,the differences were significant((18?48±2?23) ng/L vs?(31?49±4?05) ng/L,(14?45±2?18) ng/L vs?(23?49 ±2?95) ng/L,(35?29±4?52) ng/L vs? (58?49±7?28) ng/L;t=16?648,14?580,16?017;P<0?05)?The pregnancy rate,pain relief rate of 6 months group were significantly higher than 3 months group(51?43%(18/35) vs?22?86%(8/35),74?29%(26/35) vs?40?00%(14/35)),the recurrence rate was significantly lower than that 3 months group(8?57%(3/35) vs?31?43%(11/35)),the differences were significant(χ2=6?118, 8?400,5?714;P<0?05)?Conclusion 6 months GnRH?α treatment after laparoscopic surgery help to prevent disease relapse,and regulate hormone levels,inhibit inflammatory reaction,then improve the effect of treatment.

OBJECTIVETo explore the application of sinusitis mixture (SM) in endoscopic sinussurgery, thereby improving clinical curative rate of chronic sinusitis and nasal polyps.

METHODSA totalof 50 chronic sinusitis patients were equally assigned to the experimental group (nasal douching by SM)and the control group (nasal douching by Compound Sodium Chloride Injection). Mucosa tissue 0.1 cmbefore natural opening was collected before surgery, at week 4, 12, and 24 after surgery. Changes ofmucosa cilia cells, goblet cells, stroma of mucosal membrane, inflammatory cells, and mucous glandwere observed. The numbers of goblet cells in the upper epithelia and ciliated cells, as well as their ratioswere calculated.

RESULTSThere was statistical difference in cavity cleaning time, cavity mucosal epithelization time, numbers of goblet cells in the upper epithelia and ciliated cells, as well as their ratio between the two groups (t = -2.342, -2.015, -2.145, respectively; P < 0.05).

CONCLUSIONSM could effectively promote and accelerate cleaning and mucosal epithelization of functional endoscopic sinus surgery, and significantly promote mucosal ciliary structure and function recovery of ostium-meatus nasicomplex.

Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Endoscopy ; Epithelium ; pathology ; Humans ; Mucous Membrane ; cytology ; pathology ; Sinusitis ; surgery

Objective:To investigate the effects of tert-butyl hydroperoxide (TBH) on the expression of second mitochondria-derived activator of caspase (Smac) and X-linked inhibitor of apoptosis (XIAP) in mitochondrial pathway after cerebral ischemia/reperfusion injury in rats.Methods:From March to December in 2019, 45 healthy male Sprague-Dawley rats were randomly divided into sham-operation, model and TBH groups. Rat models of cerebral ischemia/reperfusion injury were established by ligation of the left carotid artery. Rat neurological function was evaluated to exclude the rats that failed in cerebral ischemia/reperfusion injury induction. Ten rats were left in each group. At 0.5 and 12 hours after cerebral ischemia/reperfusion injury, rats in the TBH group were treated by intragastric administration of 12.5 mg/kg TBH and those in the sham-operation and model groups were identically treated by intragastric administration of equal volume of 0.9% sodium chloride injection. After 24 hours of reperfusion, rat neurological function was assessed in each group. Then the rats were killed and the brains were harvested. Apoptosis of nerve cells was detected by terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) assay. The levels of superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the brain tissue were detected by enzyme-linked immunosorbent assay. XIAP- and Smac-positive cell count and protein expression were determined by immunohistochemical staining and western blot assay, respectively.Results:Rat neurological function score in the TBH group was significantly lower than that in the model group [(1.36 ± 0.49) points vs. (3.73 ± 0.97) points, t = 6.896, P < 0.001]. In the TBH group, a large number of apoptotic nerve cells were found in the ischemic cerebral cortex, but the number of apoptotic nerve cells in the TBH group was significantly smaller than that in the model group. In the model group, SOD level was significantly lower, MDA, TNF-α and IL-1β levels were significantly higher compared with the sham-operation group [SOD: (51.94 ± 3.46) U/mg vs. (70.68 ± 2.67) U/mg, t = 13.560, P < 0.001; MDA: (5.69 ± 0.78) nmol/mg vs. (1.20 ± 0.96) nmol/mg, t = 11.479, P < 0.001; TNF-α: (89.36 ± 9.84) pg/mg vs. (40.53 ± 4.35) pg/mg, t = 14.353, P < 0.001; IL-1β: (41.35 ± 6.79) pg/mg vs. (17.22 ± 2.31) pg/mg, t = 10.639, P < 0.001]. In the TBH group, SOD level was significantly higher, MDA, TNF-α and IL-1β levels were significantly lower compared with the model group [SOD: (51.94 ± 3.46) U/mg vs. (68.84 ± 5.03) U/mg, t = 8.754, P < 0.001; MDA: (5.69 ± 0.78) nmol/mg vs. (2.46 ± 0.48) nmol/mg, t = 11.153, P < 0.001; TNF-α: (89.36 ± 9.84) pg/mg vs. (57.64 ± 6.22) pg/mg, t = 8.617, P < 0.001; IL-1β: (41.35 ± 6.79) pg/mg vs. (23.84 ± 5.48) pg/mg, t = 6.346, P < 0.001]. XIAP- and Smac-positive cell count and protein expression in the model group were significantly greater than those in the sham-operation group [XIAP-positive cell count: (22.63 ± 4.37) vs. (12.39 ± 3.18), t = 5.992, P < 0.001, Smac-positive cell count: (47.58 ± 6.94) vs. (5.64 ± 1.35), t = 18.759, P < 0.001; XIAP protein expression: (0.53 ± 0.08) vs. (0.24 ± 0.05), t = 9.721, P < 0.001; Smac protein expression: (0.92 ± 0.15) > ( 0.36 ± 0.05), t = 11.200, P < 0.001 ]. In the TBH group, XIAP-positive cell count and XIAP protein expression were significantly higher and Smac-positive cell count and Smac protein expression were significantly lower compared with the model group [XIAP-positive cell count: (36.78 ± 5.26) vs. (22.63 ± 4.37), t = 6.543, P < 0.001, Smac-positive cell count: (31.74 ± 4.26) vs. (47.58 ± 6.94), t = 6.151, P < 0.001; XIAP protein expression: (0.79 ± 0.10) vs. (0.53 ± 0.08), t = 6.420, P < 0.001, Smac protein expression: (0.70 ± 0.09) vs. (0.92 ± 0.15), t = 3.977, P < 0.001]. Conclusion:TBH can effectively reduce neuronal apoptosis, oxidative stress and inflammatory reaction after cerebral ischemia/reperfusion injury, which may be related to the regulation of XIAP and Smac signaling pathways.

Objective:To explore the expression of TNF a and IL-10 in different layers of laryngeal tissues after laryngeal transplantation and its relationship with acute rejection.Methods:Laryngeal heterotopic transplantation was performed in Wistar and SD rats(Wistar→SD rats).The SD rats were divided into 4 groups:GroupⅠ:Sham control(receive no transplantation): GroupⅡ(receive transplantation,without cyelosporine A treatment);GroupⅢ(receive transplantation.with 5 mg?kg~(-1)?d cyelosporine A treatment):and GroupⅣ(receive transplantation.with 10 mg?kg~(-1)?d~(-1)cyelosporine A treatment).The transplanted larynx was harvested on 3,7 and 11 days after transplantation for pathological examination.The expression of TNF-?and IL-10 in different layers of grafts was detected immunohistochemically.Results:Pathological observation showed mild,moderate and severe acute rejection in GroupⅡandⅢon 3.7 and 11 days after transplantation,respectively:there was no obvious rejection in GroupⅣ.Immunohistochemical staining showed expression of TNF-?and IL-10 in GroupⅡ.Ⅲ.andⅣ,not in GroupⅠ.The ratios of the positive areas of TNF-?and IL-10 in the mucosal and submucosal layers were significantly higher than those in the muscle and cartilage layers of laryngeal tissues(P

Objective To investigate the changes of iodide uptake and the expression of thyroidspecific genes in poorly differentiated follicular thyroid carcinoma (FTC) cells after transfection of human TSH receptor (hTSHR) gene in vitro. Methods The recombinant eukaryotic expression plasmid PcDNA3. 1/hTSHR-cDNA was transformed into DH5a bacterial for amplification and then the recombinant plasmid was extracted. The recombinant was identified with PCR amplifying, restriction enzyme digestion analysis and DNA sequencing. The recombinant plasmid pcDNA3.1/hTSHR was transfected into FTC-133 cell line by lipofectin methodin vitro. Immunofluorescence, iodide uptake studies and real time-PCR were applied to detect target protein expression. Statistical analysis was performed with t-test using SPSS 13. 0 software. Results Kpn Ⅰ and Xba Ⅰ restriction enzyme digestion, PCR amplifying and DNA sequencing confirmed that pcDNA3. 1/hTSHR was successfully constructed. After transfection of the recombinant plasmid pcDNA3. 1/hTSHR-cDNA and the stimulation of hTSH, the tumor cells displayed the expression of hTSHR protein at cell surface and cytoplasm. The iodine uptake in pcDNA3. 1/hTSHR transfected cells was 2. 9 times higher than that of control(pcDNA3.1(+) transfected cells) group(t = 28.63, P ＜0. 01). The expression of TSHR,NIS, TPO and Tg (mRNA levels) in pcDNA3. 1/hTSHR transfected cells were also significantly elevated by 1.74 (t =5.959, P＜0.01), 7.2 (t =3.807,P＜0.05), 2.88 (t=4.769,P＜0. 01) and 2.67 times (t=6.388,P ＜0.01) respectively compared to those of the control group. Conclusion The study demonstrates that iodide uptake may be reactivated by hTSHR receptor gene transfection in poorly differentiated FTC cell.

Primary hypertension is one of the common chronic diseases, as well as the key disease for prevention and treatment by traditional Chinese medicine (TCM). The authors searched and analyzed RCTs studies on primary hyper-tension treatment with acupuncture in the PubMed. It showed that primary hypertension treatment with acupuncture abroad had high quality methodologies. However, the deficiencies of TCM theories in the treatment plan in these studies were the same as RCTs of acupuncture treatment design of other diseases. It may due to the insufficiency of TCM knowledge and culture differences of researchers aboard. Besides, the small sample amount, various interven-tions, no blank control, and the using of 24-hour ambulatory blood pressure most of the time, may difficult to objec-tively evaluate the clinical effect of acupuncture. Therefore, our research team will carry out high quality RCT stud-ies under the guidance of TCM theories of meridians and syndrome differentiation to further discuss the specificity of acupoints.

Objective To study the Gadolinium-enhanced MRI and diffusion weighted imaging (DWI) characteristics of the chondroid matrix-forming sarcomas.Methods Contrast-enhanced MRI and DWI were performed in 14 eases of chondroid matrix-forming sarcomas (10 chondrosarcomas,4 chondroblastic esteosarcomas) and 13 cases of other types of osteosarcomas.DWI was obtained with a single-shot echo-planar imaging (EPI) sequence using a 1.5 T MR imager with two different b values of 0 and 700 s/mm2.The apparent diffusion coefficient (ADC) values were obtained in GE Functiontool software.The contrast-enhancement pattern was evaluated and the ADC values of ehondroid matrix-forming sarcomas was compared with that of other types of asteosarcoma.Independent sample t-test was performed to evaluate the difference of ADC values between the group of chondroid matrix-forming sarcoma and the group of other types of osteosarcoma.In addition, nonparametrie test was used to assess the difference of ADC values between the chondrosareoma and the chondroblastic osteosarcoma.P value less than 0.05 was considered to represent a statistical significance.Results For 14 eases of ehondroid matrix-forming sarcomas, peripheral enhancement was found in all cases, septonodular enhancement was identified in 12 cases.While 13 eases of other types of osteosarcowas demonstrated heterogeneous enhancement.The mean ADC value of chondroid matrix-forming sarcomas [(2.56 ±0.35) × 10 -3 mm2/s] was significantly higher than that of other types of osteosarcoma [( 1.16±0.20) × 10-3 mm2/s] (t = 12.704,P <0.O1 ).There was no significant difference in the ADC value between the chondrosarcoma and the chondroblastie osteesarcama(Z =0.507 ,P =0.959).Conclusion Contrast-enhanced MRI and DWI can improve differentiation between chondroid matrix-forming sarcomas and other types of osteosarcomas.