Objective: To determine if different methods of anesthesia and analgesia will influence the incidence of early postoperative cognitive dysfunction (POCD) after non-cardiac surgery in the elderly. Methods: One hundred and three elderly patients undergoing elective abdominal surgery were randomly allocated to receive either general anesthesia followed with postoperative intravenous analgesia (general anesthesia group, 53 cases) or combined general-epidural anesthesia followed with postoperative epidural analgesia (combined general-epidural anesthesia group, 50 cases). Cognitive function was assessed preoperatively and 7 days postoperatively using a battery of nine neuropsychological tests. A postoperative deficit in any test was defined when decline by more than or equal to 20% of the preoperative value of that test occurred. Any patient showing deficit in 2 or more tests was defined as having postoperative cognitive dysfunction. Results: Ninety-two patients completed both preoperative and postoperative neuropsychological tests. On day 7, POCD occurred in 20/45 patients (44.4%) in the general anesthesia group and in 23/47 patients (48.9%) in the combined general-epidural anesthesia group. No significant difference was found between the two groups. Logistic regression analysis showed that short duration of education and operation of general surgery were independent risk factors of the occurrence of early POCD. Conclusion: Early POCD occurred in 46.7% of the elderly patients undergoing abdominal surgery. However, there was no significant difference between the effects of two different methods of anesthesia and postoperative analgesia on the incidence of POCD. Short duration of education and operation of general surgery were risk factors of early POCD.

Objective To study the induction of IL-6 on expression and activity of tissue factor (TF)in peripheral blood monocytes(PBMCs).Methods rhIL-6 100 ng/L and rhIL-6 100 ng/L+ rhIL-6 MoAb 10?g/L were used respectively to stimulate the PBMCs for 24 h,PBMCs without any stimulation as control group,to study the changes of antigen content,mRNA expression and the ac- tivity of the TF.Results The antigen content,mRNA expression and activity of TF were increased significantly in 100 ng/L rhIL-6 group as compared with rhIL-6 100 ng/L+rhIL-6 MoAb 10?g/L and control groups(P＜0.01).Conclusions rhIL-6 can induce the increase of antigen expression,activity and mRNA expression in PBMCs,and these effects can be suppressed successfully by rhIL-6 MoAb. This study demonstrated that there was potential relations between cytokines and thrombogenesis, which may play an important role the pathogenesis of chronic rejection.

The relationship between vascular endothelial growth factor-C (VEGF-C)/vascular endothelial growth factor receptor 3 (VEGFR-3) expression and clinicopathologic features of the patients with non-small cell lung cancer (NSCLC) was investigated. The expression of VEGF-C and VEGFR-3 was assessed in 65 patients with NSCLC by immunohistochemistry. The significance of VEGF-C and VEGFR-3 expression was analyzed statistically. The results showed that VEGF-C and VEGFR-3 were highly expressed in cytoplasm and membrane in lung cancer tissues with the positive rate being 55.4 % and 52.3 % respectively, while there was no expression in the normal lung tissues. The expression of VEGF-C was significantly increased in adenocacinoma as compared to other types of NSCLC (P<0.05). The VEGFR-3 expression was closely related with lymph node metastasis (P<0.01) and TNM stage (P<0.05). There was a positive correlation between the VEGF-C and VEGFR-3 expression in NSCLC patients (r=0.658, P<0.01). It is suggested that VEGFR-3 plays an important role in the lymphatic metastasis of NSCLC. The interaction between VEGF-C and VEGFR-3 may be deeply involved in the mechanism of lung cancer metastasis.

Nuclear factor(NF)-κB is widely expressed in various types of tissue cells. Abnormal activation of NF-κB signaling pathway can lead to the initiation and progression of asthma,chronic ob?structive pulmonary disease(COPD)and other lung inflammatory diseases,but inhibition of its activity can effectively alleviate the occurrence and development of these diseases. In this paper ,we review biological characteristics of NF-κB,role of NF-κB signaling in asthma,COPD and other inflammatory lung diseases,and potential application of NF-κB inhibitors in clinical treatment of these inflammatory lung diseases. It will provide a valuable reference for further study on pathogenesis,prevention,and control of lung inflammatory diseases.

Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; etiology ; Middle Aged ; Myelodysplastic Syndromes ; complications ; etiology ; Uterine Cervical Neoplasms ; complications ; drug therapy ; radiotherapy

Objective To investigate the clinical effect of loading dose of phenobarbital in neonatal hypoxic-ischemic encephalopathy(HIE).Methods Three hundred and fifty-six patients with neonatal HIE were randomly divided into treatment group and control group by systematic sampling,with 178 patients in each group.Two groups were given comprehensive therapy,with or without convalsions,early application of loading dose of phenobarbital in 20 mg/kg intramuscular injection,12 h beck to a maintenance dose 5 mg/(kg·d)in treatment group,while a conventional dose of phenobarbital in 5 mg/(kg·d)was used in control group after convulsion happened.Clinical effect of short-term and long-term were observed.Results The rates of eelampsia,choloplania and total effect was 11.2％(20/178),7.9％(14/178)and 87.1％(155/178)in treatment group,and 68.0％(121/178),50.6％(90/178)and 77.5％(138/178)in control group,there were significant differences between two groups(x2 =6.403,78.459 and 8.308,P ＜ 0.05).DQ score in treatment group was higher than that in control group(P＜ 0.05).The patients in two groups were followed up to age 18 months,the deformity rate in treatment group[7.9％(14/178)]was lower than that in control group[28.1％(50/178)],there was significant difference between two groups(x2 =29.085,P ＜ 0.05).Conclusion Loading dose of phenobarbital is very effective to treat neonatal HIE.

ObjectiveTo study exogenous surfactants disaturated phosphatidyl choline (DSPC) kinetics in full term infants with respiratory distress syndrome(RDS) who were treated with different dose of poractant alfa.MethodsOne hundred and twenty-two full term infants with RDS undergoing mechanical ventilation were divided into group A (80 cases) and group B (42 cases) by simple random method,who received 100 mg/kg or 200 mg/kg poractant alfa mixed with DSPC.Clinical manifestation and respiratory parameters were recorded,and DSPC half-life period and pool size and endogenous DSPC synthesis rate were calculated.ResultsFifty-six infants (70.0％) received a second dose after(25 ± 11) h and 18 infants (22.5％) received a third dose after(41 ± 11 ) h in group A.Twelve infants ( 28.6％ ) received a second dose after (33 ± 8) h and 2 infants (4.8％) received a third dose in group B.DSPC half-life period in group B was longer than that in group A[the fast:(32 ± 19) h vs.(15 ± 15) h;the second:(43 ±32) h vs.(21 ± 13) h],there was significant difference (P＜ 0.01 or ＜ 0.05).DSPC synthesis rate and pool size before the first and second doses had no difference between the two groups.But the oxygenation index at the first and the second dose in group B was less than that in group A,there were significant differences (P ＜ 0.01 or ＜ 0.05).ConclusionPoractant alfa given to full term infants with RDS at a dose of 200 mg/kg results in a longerDSPC half-life period,fewer retreatments,and better oxygenation index values.

Medical laboratories provide test data and consultation services and are engaged in ensuring test results being timely,accurate and reliable,which are satisfactory for their service recipients.A summary of the customer satisfaction theory and quality management system,and an analysis of problems found in the quality management of such laboratories,attempt to pinpoint underlying causes of service quality setbacks.Based on such studies,the quality management system is built in accordance with customer satisfaction theory and CNAS-CL02 Accreditation Criteria for the Quality and Competence of Medical Laboratories (ISO 15189:2007).Such efforts aim to continuously improve service quality and ensure customer satisfaction.

Objective To investigate the effect of dexmedetomidine on the cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Forty ASA Ⅱ or Ⅲ patients of both sexes,aged 43-64 yr,scheduled for elective cardiac valve replacement,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.6 μg/kg was injected intravenously over 15 min before induction of anesthesia,followed by infusion at 0.2μg· kg-1 · h-1 until the end of operation in group D.While the equal volume of normal saline was given in group C.Blood samples were obtained from the radial artery and jugular bulb for blood gas analysis before CPB,immediatelv after declamping of the ascending aorta,at the end of CPB and at 6 h after operation (T1-4).The arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The plasma concentrations of S-100β and neuron-specific enolase (NSE) in the blood samples obtained from the jugular bulb were measured at T1-4 and 24 h after operation.Results Compared with group C,the jugular venous oxygen saturation was significantly increased and Da-jvO2 and CERO were decreased at T2,3,and the plasma concentrations of S100β and NSE were decreased at T2-4 in group D (P ＜ 0.05).Conclusion Dexmedetomidine can decrease the cerebral O2 metabolic rate and reduce the cerebral injury in patients undergoing cardiac valve replacement under CPB.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.