Mild hypothermia significantly increases perioperative complications,such as adverse myocardial outcomes,coagulopathy,infection and delayed recovery.So it is important to maintain the core temperature above 36 ℃.Redistribution is the major cause of hypothermia during the first hour of intravertebral or general anesthesia.There are many methods to protect patients from hypothermia including passive insulation and active warming.Forced-air and electric heating pad are currently the most effective noninvasive choices.The contribution of intravenous fluids heating to patients' temperature is limited but it should be performed when large volume is required.

OBJECTIVETo study the types of matrix metalloproteinases (MMPs) involved in dentin bonding interface degradation.

METHODSDentin slices were prepared and treated with two adhesive systems (Single Bond 2 or Clearfil S3 Bond). The dentin surface was bonded with composite resin. All specimens were immersed in sterile artificial saliva for 0 or 6 months, and their micro-shear bond strength (muSBS) were measured. The fracture modes were observed through field emission scanning electron microscope (FE-SEM). Dentin slices with 4 mm x 3 mm x 1 mm dimensions were prepared. The slices were divided into three groups according to the treatment modes (negative control, Single Bond 2, and Clearfil S3 Bond). All specimens were stored in sterile artificial saliva for 0 or 6 months. The concentrations of MMP-1, -2, -3, -8, and -9 of each group were detected through fluorescent microsphere immunoassay.

RESULTSThe muSBS of both adhesive systems significantly decreased after storage aging. Significant differences in failure modes within the four groups tested in this study were observed. Compared with the negative control, the concentrations of MMP-1 and MMP-3 in different adhesive groups showed no significant difference after storage aging. However, the concentrations of MMP-2, -8, and -9 in Single Bond 2 group and the concentrations of MMP-8 and -9 in Clearfil S3 Bond group significantly decreased after 6 months of storage aging.

CONCLUSIONSignificant degradation occur in the dentin bonding interface of both adhesive groups under 6 months aging challenge. The concentrations ofdentinal MMP-2, -8, and -9 significantly decrease after treatment with adhesives and aging, indicating that these MMPs have an important function in dentin bonding interface degradation.

Objective To summarize the main points of nursing the patients during small incision minimally invasive cardiac surgery.Methods Two hundred and seventy-one patients underwent small incision minimally invasive cardiac surgery during April 2010 and December 2010.The cooperative nursing was performed.Results The patients went well with the operations,with the average extracorporeal circulation time of(117.3±47.1)min and aorta blocking time of(82.6±32.1) min.All of the patients were discharged,without postoperative complications.(6.8±2.6)d.Perioperative and after discharge with no deaths.Postoperative recovery and no postoperative complications,were recovered and discharged without any complications.The postoperative hospital length of stay was(6.8±2.6)d.Conclusions The minimally invasive cardiac surgery is effective and safe.The preoperative health education and intraoperative nursing cooperation are critical for the operative success.

Objective To study the role of bone marrow mesenchymalstem cells in recovery process of hepatocyteinjury and to explore the possible mechanism. Methods BMSCs and primary generation of hepatocytes were cultured and identified. A model of hepatocyte injure was established. Liver cell proliferation at different conditionswas detected by MTT method. Hepatocytes were added with BMSCs,baxinhibitor and mixture of BMSCs and baxinhibitor for co?cultured.Expressions of TGF?β1,bcl?2,and baxwere detected by Westernblot and real?time PCR. Results BMSCs and primary generation of hepatocyte were successfully cultured and identified, and a model of hepatocyte injury was successfully established. MTT tests revealed that the OD value of the mixture wassignificant higher in BMSCs and HGF co?culture group than in BMSCs co?culture group or HGF co?culture group;there was no significant difference between BMSCs co?culture group and HGF co?culture group,while both groups were significant higher than control group. The MTT tests also revealed that the OD value of the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while the OD value was significant higher in both groups than in the control group. Westernb lot and real?time PCR results revealed that the value of TGF?β1 and bax in the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while both groups had a significant higher value than the control group. The value of Bcl?2 in the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while both groups had a significant lower value than the control group. Conclusions BMSCs can promote hepatocyte proliferation during the recovery process of hepatocyte injury,BMSCs and HGF promote liver cell proliferation have synergy effect,the effect of BMSCs probably through regulate TGF?β1/bcl?2(bax)correlation pathway.

Objective To observe the effect of comprehensive rehabilitation on the recovery of knee joint function in old patients severe burned in lower extremity. Methods 49 patients severe burned in lower extremity were randomly divided into observation group (n=25) and control group (n=24). The control group accepted routine rehabilitation, while the observation group accepted comprehensive rehabilitation. They were assessed with the range of motion (ROM) of knee flexion/extension, 45 m-walking, stair activity, Functional Independence Measure (FIM) and muscle strength 3 months after rehabilitation. Results The active and passive ROM of knee, stair activity, FIM score and muscle strength improved more in the observation group than in the control group (P<0.05). Conclusion Comprehensive rehabilitation promotes the recovery of knee function of old patients with severe burn in lower extremity.

Objective Aggressive fibromatosis is a rare kind of soft tissue tumor and was evaluated by few large studies. This study was to evaluate the clinical characteristics and identify the prognostic factors of this disease. Methods One hundred and forty-two patients with aggressive fibromatosis treated from January 1983 to August 2009 in Tianjin Medical University Cancer Hospital were retrospectively reviewed.The prognostic value of clinical and treatment factors was analyzed. Univariate analysis was performed with Log-rank test and Multivariate analysis was performed with Cox regression model. Results The follow-up rate is 93.7% and the median follow up time was 54 months (range,6 -208 months). Sixty-three patients had a minimum follow up time of 5 years and 6 patients had a minimum follow up time of 10 years. The male/female ratio was 1/1.84. The disease was most popular in women aged from 18 to 35 years old. The disease frequently occurred in the trunk (55.6%) and extremity (31.7%). All patients received surgery,and 46 received radiotherapy. The 5-year and 10-year local recurrence rates were 24. 4% and 31.1%,respectively. The 5-year and 10-year overall survival rates were both 99. 3%. Univariate analysis revealed that factors correlated with local recurrence were tumor size ( χ2 = 4. 37, P = 0. 037 ) and margin status (χ2 = 12. 36,P =0. 002). Multivariate analysis revealed that margin status was an independent risk factor (RR = 2. 219; χ2 = 9. 47,P = 0. 002) and radiotherapy was an independent protective factor ( RR = 0. 360;χ2 = 4. 95, P = 0. 026 ) for disease recurrence. When radiotherapy was delivered, the 10-year local recurrence rate decreased from 70. 1% to 20. 7% in patients with positive margin ( χ2 = 4. 22, P = 0. 040 )and decreased from 19.8% to 10.4% (χ2= 0.90, P= 0.344) in patients with negative margin.Conclusions Radical resection is the mainstay of treatment for aggressive fibromatosis. Postoperative radiotherapy can reduce the recurrent rate for patients with positive margin. In patients with negative margin,the role of radiotherapy should to be further evaluated in large clinical trials.

Objective To evaluate the effect of dexmedetomidine on hippocampal neuronal apoptosis in endotoxemic rats.Methods Twenty-four pathogen-free male Sprague-Dawley rats,aged 6 weeks,weighing 200-250 g,were randomly divided into 3 groups(n=8 each)using a random number table:control group (group C),endotoxemia group (group E),and dexmedetomidine group (group D).Dexmedetomidine 50 μg/kg was injected intraperitoneally,and lipopolysaccharide 5 mg/kg was injected via the caudal vein 30 min later in group D.Normal saline 2 ml was injected intraperitoneally,and lipopolysaccharide 5 mg/kg was injected via the caudal vein 30 min later in group E.Normal saline 2 ml was injected intraperitoneally,and normal saline 2 ml was injected via the caudal vein 30 min later in group C.At 12 h after the model was successfully established,Morris water maze test was used to assess the cognitive function.The escape latency,swimming distance and frequency of crossing the original platform were recorded,and the swimming speed was calculated.The rats were then sacrificed,and hippocampi were harvest for determination of neuronal apoptosis (by TUNEL) and expression of glucose-regulated protein 78 (GRP78),CAAT/enhancer-binding protein homologous protein (CHOP) and caspase-12 (by immunohistochemistry).The apoptosis index (AI) was calculated.Results There was no significant difference in the swimming speed between the 3 groups (P＞0.05).Compared with group C,the escape latency and swimming distance were significantly prolonged,the frequency of crossing the original platform was significantly decreased,and the AI was significantly increased,and the expression of GRP78,CHOP,and caspase-12 was significantly up-regulated in E and D groups (P＜0.05).Compared with group E,the escape latency and swimming distance were significantly shortened,the frequency of crossing the original platform was significantly increased,and the AI was significantly decreased,and the expression of GRP78,CHOP,and caspase-12 was significantly down-regulated in group D (P ＜ 0.05).Conclusion Dexmedetomidine reduces cognitive dysfunction probably through reducing hippocampal neuronal apoptosis mediated by endoplasmic reticulum stress in endotoxemic rats.

Objective: To investigate the effect and safety of interleukin-2 combined with cisplatin in the treatment of malignant pleural effusion.Methods: Totally 86 patients with malignant pleural effusion were randomly divided into the observation group (44 cases) and the control group (42 cases).The control group was treated with cisplatin, and the observation group was treated with interleukin-2 additionally.The treatment course was 3 weeks.The ascites relief, quality of life, survival status and tumor markers before and after the treatment, and the adverse drug reactions were compared between the groups.Results: The total ascites remission rate and the effective rate in the observation group were significantly higher than those in the control group (P<0.05).Compared with those before the treatment, CEA, CA19-9 and CA450 decreased significantly after the treatment in both groups (P<0.05), those in the observation group were significantly lower than those in the control group (P<0.05).After the treatment, the physiological function, physiological occupation, emotional function, body pain and the other life quality scores in the observation group were significantly higher than those in the control group (P<0.05).The 24-month survival rate in the observation group was significantly higher than that in the control group (P<0.05).There were no significant differences in adverse drug reactions between the groups (P>0.05).Conclusion: Interleukin-2 combined with cisplatin can effectively relieve ascites and improve quality of life, which can also prolong the survival time of patients.

Objective To investigate the relationship and mechanism of the serum vitamin D levels with insulin sensitivity and adipokines APN,RBP4,visfatin and TNF-α in patients with gestational diabetes mellitus(GDM). Methods A total of 101 patients with gestational diabetes( GDM group) and 50 pregnant women with normal blood sugar( control group) were recruited to detect the serum levels of correlative biochemical indexes,APN,RBP4,visfatin,TNF-α and 25OHD3 using an HPLC method. Twenty-four patients in the GDM group diagnosed with vitamin D deficiency(<25 nmol·L-1 ) were randomized to receive either 1,25(OH) 2D3(0. 25 μg·d-1) orally or no treatment. Serum levels of correlative biochemical indexes were detected after 1 month. Results GDM patients had 25OHD3 levels significantly lower than the control group(P<0. 05),APN levels lower than the control group,and RBP4,visfatin,TNF-α levels significantly higher than the control group(all P<0. 05). After 1 month of 1,25(OH) 2D3 treatment,HOMA-IR increased,while HOMA-β decreased. APN levels was positively correlated(r= 0. 526) with 25OHD3;RBP4,visfatin,TNF-α decreased and were negatively correlated with 25OHD3( r values were -0. 272,-0. 153,-0. 072). Conclusion Vitamin D can reduce the adipokines RBP4,visfatin,TNF-α,increase APN,and thus play a protective role for gestational diabetes.

In this study, UPLC-MS/MS was adopted to determine the contents of five ephedrine alkaloids (Norephedrine, Norpseudoephedrine, Ephedrine, Pseudoephedrine, Methylephedrine) in plasma and urine in rats after the combined administration of Ephedrae Herba-Gypsum Fibrosum and calculate relevant pharmacokinetic parameters, in order to discuss the effect of the combined administration of Ephedrae Herba-Gypsum Fibrosum on plasma pharmacokinetics and urinary excretion characteristics. According to the results, after being combined with Gypsum, the five ephedrine alkaloids showed similar pharmacokinetic changes, such as shortened t(max), accelerated absorption rate, but reduced AUC(0-t) and V(z)/F, which may be related to the increase in urine excretion. Besides, Gypsum was added to enhance C(max) of Pseudoephedrine and prolong MRT(0-t) of Methylephedrine, so as to enhance the anti-asthmatic effect of Ephedrae Herba and resist the toxic effect of Norephedrine and Ephedrine. This study proved the scientific compatibility of Ephedrae Herba-Gypsum Fibrosum and provided a reference for studies on the prescription compatibility regularity and relevant practices.
Alkaloids ; blood ; pharmacokinetics ; urine ; Animals ; Calcium Sulfate ; pharmacokinetics ; Drugs, Chinese Herbal ; pharmacokinetics ; Ephedra ; chemistry ; Male ; Rats ; Rats, Sprague-Dawley ; Urine ; chemistry