Objective:To explore the effects of dexmedetomidine on the blood glucose,tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) in perioperative patients with neurosurgery.Methods:50 patients with meningioma who were ready to accept craniotomy in department of neurosurgery of our hospital from February 2016 to November 2016 were enrolled,they were randomly divided into research group and control group,with 25 patients in each group.The research group was given DEX 1.0 μg/kg at 10 min before anesthesia,which was added in 0.9％ sodium chloride injection 50 mL,the injection was finished in 10 min,then the DEX change to the rate of 0.5 μg/kg/h.Control group was given 0.9％ sodium chloride injection with constant rate and volume.Record heart rate (HR),mean arterial pressure (MAP) and blood glucose,serum TNF-α,IL-6 levels of the two groups at 10min before anesthesia(T1),after the anesthesia (T2),the beginning of surgery(T3),1 hour after the surgery beginning(T4),the end of surgery(T5).Results:Compared with T1,HR of the two groups at T2 and T3 raised significantly,but research group was lower than control group(P＜0.05);In research group,compared with T1,MAP at T3 raised significantly;in control group,compared with T1,MAP at T3 and T4 raised significantly,but MAP of research group at T3 and T4 were lower than control group (P＜0.05).Compared with T1,blood glucose of the two groups at T2,T3,T4 and T5 raised sig-nificantly,but the research group at same points were lower than control group (P＜0.05).Serum TNF-α,IL-6 levels of control group at T2,T3 and T4 were significantly higher than T1 (P＜0.05),which in research group at different time points had no significant change (P＞0.05),and were lower than control group at T2,T3 and T4 (P＜0.05).Conclusion:DEX could maintain stable hemodynamics,antiinflammation,inhibit elevated blood glucose,so as to reduce the inflammatory response and stress response in patients with neurosurgery,then it could promote these patients postoperative recovery.

OBJECTIVETo evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.

METHODSFrom March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.

RESULTSThere was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01).

CONCLUSIONThe modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

Adult ; Arthrodesis ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Subtalar Joint ; surgery

Objective To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with asymptomatic severe carotid artery stenosis.Methods The patients with asymptomatic severe carotid stenosis (stenosis ≥ 70％) were enrolled in the study.The cognitive function evaluation was performed before CAS,1 and 3 months after procedure respectively with mini-mental status scale (MMSE),digital span (DS),Chinese auditory learning test (CALT),judgment of line orientation test (JLOT),and verbal fluency test (VFT),including attention,memory,visual spatial function,and frontal fluency function.Results A total of 26 patients with asymptomatic severe carotid artery stenosis who performed CAS were enrolled,18 were males and 8 were females (aged 52 to 79 years,mean 64.19 ±6.76 years),and the years of education was 9.84 ± 3.29 years.Eighteen patients had left carotid artery stenosis and 8 had contralateral carotid artery stenosis.CAS was performed successfully in all patients,and no complications occurred.Compared with the CAS before procedure,all the cognitive functions were improved significantly at 1 and 3 months after procedure (all P ＜0.01),however,there was no significant difference between 1 and 3 months after procedure (all P＞ 0.05).Conclusions CAS may improve cognitive function in patients with asymptomatic severe carotid artery stenosis,and it was more obvious in the early postoperative period.

The effect of amygdalin joint hydroxysafflor yellow A (HSYA) on the endplate chondrocytes derived from intervertebral discs of rats induced by IL-1beta and the possible mechanism were studied and explored. Chondrocytes were obtained from endplate of one-month SD rat intervertebral discs and cultured primary endplate chondrocytes. After identification, they were divided into normal group, induced group, amygdalin group, HSYA group and combined group. CCK-8 kit was adopted to detect the proliferation of the endplate chondrocytes. FCM was measured to detect the apoptosis. Real-time PCR method was adopted to observe the mRNA expression of Aggrecan, Col 2 alpha1, Col 10 alpha1, MMP-13 and the inflammatory cytokines IL-1beta. The protein expression of Col II, Col X was tested through immunofluorescence. Compared with the normal group, the proliferation of the endplate chondrocytes decreased while the apoptosis increased (P < 0.05). With down regulation of the mRNA expressions of Aggrecan, Col 2 alpha1 and up regulation of the mRNA expressions of Col 10 alpha1, MMP-13, IL-1beta (P < 0.05), the protein expression of Col II decreased while the protein expression of Col X increased. Compared with the induced group, amygdalin group, HSYA group, the combined group could inhibit the apoptosis and promote the proliferation (P < 0.05). They could increase the mRNA expressions of Aggrecan and Col 2 alpha1 while decrease the mRNA expressions of Col 10 alpha1, MMP-13 and IL-1beta (P < 0.05). They could also enhance the protein expression of Col II while reduce the protein expression of Col X. The effect of the combined group was significantly better than that of amygdalin and HSYA. Amygdalin joint HSYA could inhibit the degeneration of the endplate chondrocytes derived from intervertebral discs of rats induced by IL-1beta and better than the single use of amygdalin or HSYA.
Amygdalin ; pharmacology ; Animals ; Apoptosis ; Cells, Cultured ; Chalcone ; analogs & derivatives ; pharmacology ; Chondrocytes ; drug effects ; Collagen ; metabolism ; Drug Synergism ; Interleukin-1beta ; Intervertebral Disc ; cytology ; Quinones ; pharmacology ; Rats

Objective This study assesses a feasible and safe volume threshold for chest tube removal following a VATS lobectomy.Methods The study included 168 consecutive patients who underwent VATS lobectomy or bilobectomy with two insicion between August 2012 and February 2014.Eligible patients were randomized into 3 groups:Group A (chest tube removal at the drainage volume of 150 ml/d or less.n =49) ; Group B (chest tube was removed when the drainage volume was less than 300 ml/d.n =50) ; Group C(chest tube removal when the drainage was less than 450 ml/d.n =51).And there were 18 patients who were excluded.All patients got the same postoperative care with a clinical pathway,and all patients were followedup 7 days after discharge from hospital.The time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic,incidence of complications and thoracocentesis were measured.Results There were no statistically significant differences among 3 groups with general information and incidence of complication (P ＞ 0.05).And there were statistically significant differences between Group A and Group B with the time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic(P ＜ 0.05).But there were no statistically significant differences between Group A and Group B with incidence of thoracocentesis(P ＞0.05).Analysis of data showed no statistically significant differences between Group B and Group C with postoperative hospital stay,postoperative VAS values and dosage of analgesic (P ＞ 0.05),but there were statistically significant differences for incidence of thoracocentesis (P ＜ 0.05).Conclusion A 300 ml/d volume threshold for chest tube removoal after VATS lobectomy is feasible and safe,and it can bring more advantages than the 150 ml/d volume threshold.On the other hand,a 450 ml/d volume threshold for chest tube removoal after VATS lobectomy may increase the risk of thoracocentesis.

Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.

Objective To explore the mechanism of anti-tumor effects of transferring tumor-specif-ic lymphocytes obtained from pre-immunized BALB/c mice with inactive rolL-21 tumor vaccine (mIL-21-Sp2/0)to syngeneic mice, associated with mIL-21 tumor vaccine immunization, in the condition of cyclo-phosphamide (Cy)-induced lymphopenia. Methods Activated lymphocytes of spleen and lymph nodes ob-tained from pre-immunlzed syngeneic mice with irradiated mIL-21-Sp2/0 cells were infused into BALB/cmice treated with Cy 2 days before, subsequently vaccinated with mlL-21 tumor vaccine, after 7 days, chal-lenged with Sp2/0 tumor cells, observed the growth of tumor of mice. T lymphocyte subsets differentiation was measured by flow cytometry (FCM) analysis. The proliferation and cytotoxie activities of activated lym-phocytes were analyzed by FCM, respectively, staining with CFSE and 7-AAD. The number of IFN-γ-secre-ting cells was evaluated by ELISPOT. Results The lymphopenic mice were transferred with activated lym-phocytes and inoculated with raiL-21 tumor vaccine might provide superior anti-tumor immunoprotection, re-tard tumor growth of the mice. The proliferating capabilities and killing rate of transferred tumor Ag-specific lymphocytes enhanced obviously, the number of IFN-γ-secreting cells was significantly higher compared with the control groups. Conclusion Under Cy-induced lymphopenia condition, tumor Ag-specific lymphocytes sensitized by raiL-21 tumor vaccine were transferred to mice and immunized with mlL-21 tumor vaccine at the same time, benefit the proliferation of transferred effective cells and immune cells itself, assist to form and sustain special anti-tumor effects.

Objective To investigate the traffic capacity of ambulances in Beijing,and to explore factors and methods to resolve this problem.Method A survey on all the ambulances on-duty in Beijing from 17th August to 17th September 2006 was conducted by questionnaires.Results The average speed of ambulances in Beijing was 32.07 km/h.There were statistically significant differences in terms of the areas and time, respectively.Conclusions The traffic jam of Beijing was serious.The traffic capacity of ambulances was far from being ideal,which restricted the operation of 120 ambulances.It is difficult to satisfy the needs of Beijing 2008 Olympic games and it is time for the relevant authorities to search for appropriate methods and solve this problem.

Objective To investigate the characteristic of regional amplitude of low frequency fluctuation (ALFF) in the brain of adolescents with online game addiction during the resting state.Methods The ALFF method was employed to explore the local features of spontaneous brain activity in adolescents with online game addiction (n =26) and healthy controls (n =23) during resting-state by Resting-State fMRI Data Analysis Toolkit.Results Compared with healthy controls,adolescents with online game addiction showed increased ALFF values in the anterior cingulate cortex (ACC),left middle cingulate cortex (MCC),bilateral caudate,right pallidum,bilateral parahippocampal gyrus,and right insula.It was noteworthy that the ALFF values of the right caudate (r =0.4437,P =0.0232) and right parabippocampal gyrus (r =0.5227,P =0.0062) were positively correlated with the duration of online game addiction.Conclusion The abnormal spontaneous neuronal activity properties during the resting state were revealed in the brain regions of adolescents with online game addiction.And the abnormalities may become more significant as the disease progresses.

Aged ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Rotator Cuff ; surgery ; Rotator Cuff Injuries