Objective To observe the anagesia effectof PCIA (patient-controlled intravenous analgesia)with flurbiprofen anddezocine on obstructivesleep apnea sydrome (OSAS)patients under-going uvula palatopharyngoplasty.Methods Sixty OSAS patients,aged 26-59 years,using PCIA af-ter UPPP were randomly divided to three groups (n=20 each):patients in group FD started the PCIA with flurbiprofen 1 mg/kg+dezocine 0.4 μg/kg+Azasetron in 100 ml saline after surgery, while these in group D with dezocine 0.4μg/kg+Azasetron,group S with sulfentanyl 2μg/kg+Aza-setron (background infusion 2 ml/h,single lose 0.2 ml/h,load doses 5 ml/h,lock time 15 min)VAS scores of 1,2,6,12,24,48 h after surgery and the incidence of nausea,vomiting,drowsiness,pruri-tus,were recorded.Results All group patients showed good pain relieve.There were no significant differences in VAS scores observed in three groups.The side effect incidence for group FD,D and S was 5%,10% and 30%.Conclusion PCIA with flurbiprofen and dezocine can provide good anagesia effect and mild side effects on UPPP patients.

Objective The study aimed to investigate the effect of lipoxin A4 (LXA4) on lipopolysaccharide (LPS)?induced oxidant stress in human renal tubular epithelial cells (HK2 cells) and possible underlying mecha?nisms. MethodsHK2 cells were divided into three groups: Control ,LPS and LPS+LXA4 groups. After cells were treated with indicated conditions,morphological changes were observed. The expressions of Nrf2 were detected by immunofluorescence and cells were collected for RT?PCR experiments.Results HK2 cells seemed disrupted and necrotic with the administration of LPS. However ,LXA4 could prevent cells from injury induced by LPS. LPS decreased Nrf2 expression and promoted it to translocate to cytoplasm ,while LXA4 could increase its expression and promote it to translocate to nucleus. Moreover ,LPS could decrease Nrf2 and its downstream molecule mRNA expressions,but LXA4 could reverse this effect. Conclusion Our results demonstrated that LXA4 effectively inhibit?ed HK2 cell oxidant stress via Nrf2 pathway.

Objective To observe the effect of cardiac massage by subdiaphragmatic compression (D-CPR) on the length of time required from cardiac arrest (CA) to restoration of spontaneous circulation (ROSC),hemodynamics,rate of ROSC,survival rate of 6 h,level of Caspase3 in myocardial cells and apoptosis index (AI) of myocardial cells and compare the effect of standard cardiac massage by chest compression (S-CPR) on those variables in order to choose the more effective resuscitation method for the patient with CA during abdomen operations.Methods A total of 32 healthy New Zealand rabbit were randomly (random number) divided into two groups,namely S-CPR group and D-CPR group (n =16 in each group).All of rabbits were anesthetized with ketamine and Shumianxin (a kind of hypnotics) by intraperitoneal injection,subsequently tracheotomy was made for endotracheal intubation,and right internal jugular vein was catheterized for monitoring central venous pressure (CVP) and left common carotid artery was for indwelling cannula to monitor arterial blood pressure.Lead-2 of ECG was placed.After laparotomy and vital signs of rabbits stabilized for 5 minutes,the endotracheal tube was clamped at the end expiration for 8 minutes to make asphyxial cardiac arrest model.The effects of two different methods were observed and compared in respects of changes in hemodynamics、length of time elapsed from CA to ROSC、ROSC rate and the survival rate in 6 h.The level of Caspase3 in myocardial cells and AI of myocardial cells were detected by using immunohistochemistry staining method and TUNEL,respectively 6 hours after successful resuscitation.Results ①The length of time consumed fiom CA to ROSC in D-CPR group was shorter than that in S-CPR group (P ＜0.05) ②Coronary perfusion pressure (CPP) and MAP 15 minutes after CPR were higher in D-CPR group than those in S-CPR group (P ＜ 0.05).③SBP and DBP after ROSC were higher in D-CPR group than those in S-CPR group.④ROSC rate in D-CPR group was significantly higher than that in S-CPR group (81％ vs.43％,P ＜0.05).⑤Survival rate in 6h in D-CPR group was substantially higher than that in S-CPR group (75％ vs.25％,P ＜ 0.05).⑥HE staining showed that severe myocardial damage manifesting in edema of myocardial cell,indistinguishable cell boundary,and patchy necrosis with infiltration of scanty inflammatory cells were found in S-CPR group.While in D-CPR group,mild myocardial damage in form of slight cellular edema and distinctive cell boundary was observed.⑦Level of Caspase3 in myocardial cells in terms of integrated optical density (IOD) of postive Caspase3 cells was substantially lower in D-CPR group than that in S-CPR group (P ＜ 0.05).⑧Apoptosis index (AI) of cells was lower in D-CPR group than that in S-CPR group (P ＜ 0.05).Conclusions ①The hemodynamics in D-CPR group was more stable than that in S-CPR.group,and D-CPR increased CPP,MAP,ROSC rate and survival rate in 6h,improving achievement of successful resuscitation.②D-CPR was more effective in terms of shortening the length of time for restoration of spontaneous circulation、decreasing level of Caspase3 in myocardial cells、decreasing apoptosis index of myocardial cells and ameliotating myocardial damage from ischemic repeffusion injury.

Purpose To analyze the imaging manifestations of solitary fibrous tumors (SFT) so as to improve its diagnosis. Materials and Methods The CT and MRI findings of 24 patients with SFT confirmed pathologically were analyzed retrospectively and compared respectively with their pathological results in terms of lesion's location, size, shape, density (signal), type of enhancement and relationship with the surrounding tissues. Seven patients underwent MRI scan, 5 were with enhanced scan; 17 patients were carried out plain CT scan and 11 were with enhanced CT scan. Results The lesions in the 23 cases were solid and 1 was solid and cystic. Through the imaging diagnosis, 20 cases were diagnosed as benign tumors, 2 cases were diagnosed as malignancies, and 2 benign tumors were misdiagnosed, which showed that the diagnose accordance rate was 91.7%(22/24). On plain CT scans, 5 lesions (maximum diameter<4 cm) showed homogeneous density; 7 cases (maximum diameter>5 cm) showed heterogeneous density, 4 of which had calcification and 7 had necrosis; the shapes were round-like or lobulated. On enhanced CT scans, 5 cases presented progressive enhancement pattern, 5 cases showed fast-in and slow-out pattern, 1 case showed slight enhancement pattern. On MRI scan, 4 cases of the solid part of tumors showed isointensity signals on T1WI and isointensity or slight hyperintensity signals on T2WI, 3 cases showed isointensity or low signals on T1WI and low, isointensity or slight hyperintensity signals on T2WI, and slight hyperintensity signal on DWI, the solid part of tumors were strongly enhanced. Two malignant tumors presented features like heterogeneous density, unclear boundary, invasive growth and progressive enhancement pattern. The pathological findings demonstrated that the tumor tissues mainly consisted of spindle cells with rich fibers and vessels. Conclusion The imaging findings of benign and malignant SFT have certain features, malignant SFT have invasive growth signs. The obvious progressive enhancement of solid component which shows isointensity and hyperintensity on T1WI or T2WI may be helpful in the diagnosis of SFT; however, the final diagnosis should be confirmed with histopathology.

Objective To explore the value of preoperative D-dimer in patients with gastric cancer in judging gastric cancer metastasis and assessing prognosis.Methods Clinicopathological data of 132 patients with gastric cancer in the First Affiliated Hospital of Anhui Medical University between Jan.2010 and Jan.2011 was analyzed retrospectively in this study.All patients were divided into two groups according to the cutoff value (1.465 mg/L)of D-dimer and the relationships between D-dimer and clinicopathological data were determined by chi-square test.Moreover,the association of preoperative D-dimer and the prognosis was analyzed by Kaplan-Meier analysis and Log-rank test.Univariate and multivaritate Cox model were used to analyze the factors which might affect the survival of the patients and significant independent factors.Results A total of 132 patients were enrolled in this study in accordance with the inclusion criteria.D-dimer was positively correlated with the depth of invasion (x2 =4.996,P ＜ 0.05),age (x2 =4.311,P ＜ 0.05) and distant metastasis of gastric cancer (x2 =16.641,P ＜0.01),but not with thc gcndcr,lymph node metastasis,tumor size,the degree of differentiation and TNM stage (P ＞ 0.05).The mean D-dimer level was (1.39 ± 0.7) mg/L in distant metastasis patients and (0.97 ±0.83) mg/L in non distant metastasis patients (P =0.023),the mean plasma D-dimer level in patients alive at the 5 years after the surgery was (0.78 ± 0.58) mg/L,which was significantly lower than the amounts determined for the deceased patients (0.75 ± 0.58) mg/L (P ＜ 0.01).The Kaplan-Meier curves showed that the patients with gastric cancer had a longer time in the low D-dimer group than in the high D-dimer group,showing a significant difference between the two groups (P ＜ 0.01).Univariate analysis showed that the overall survival rate was significantly correlated with the gender,D-dimer,tumor size,the depth of invasion,lymph node metastasis and TNM stage (P all ＜ 0.05).The D-dimer was proved to be independent risk factor for the prognosis of gastric cancer by multivariate analysis(P ＜ 0.05).Conclusion According to the analysis,D-dimer may be valuable biomarker for metastasis patients,besides,D-dimer was an independent prognostic factor for patients with gastric cancer.

AIM To observe the effects of the combination of heparinoid, aspirin and losartan on the experimental vascular intima hyperplasia induced by squeezing carotid artery in rats. METHODS Rats except the normal control group were under operation after two days oral administration once a day. At the second hour after injury, blood coagulation time(CT), time of arterial thrombus formation by electrical stimulus(ATFTES) and the level of TXB_2 in plasma were measured. At the fourteenth day after the surgery, the following indexes were examined: intima/media ratio, intima area ratio, PDGF-B and PCNA immunohistochemistry in carotid artery. RESULTS CT, TATFES increased and the level of TXB_2 decreased in the groups of Hep, Asp and Hep+Asp. The PDGF-B content, the positive ratio of PCNA and the inti- ma/media ratio also decreased in the groups of Hep, Asp, Los, Hep+Asp, Hep+Los and Asp+Los. Compared with single drug or two drugs combination, PDGF-B, positive ratio of PCNA, intima/media ratio and intima area ratio decreased significantly in the group of three drugs combination( P

Objective To investigate the prognostic factors and influencing factors of lymph node ratio (LNR) in patients with Siewert Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective case-control study was conducted.The clinicopathological data of 444 patients with Siewert Ⅱ and Ⅲ AEG who were admitted to the First Affiliated Hospital of Anhui Medical University between January 2010 and January 2011 were collected.All the 444 patients underwent radical D2 lymph node dissection,extent of lymph node dissection was inferior mediastinum,around the esophageal hiatus and celiac lymph node.Follow-up usingtelephone interview and outpatient examination was performed to detect patients' prognosis once every 3 months within 2 years postoperatively,once every 6 months from 2 vears to 5 years postoperatively and once every 12 months after 5 years up to October 2016.Observation indicators:(1) follow-up and survival situations;(2) univariate and multivariate factors analysis affecting prognosis of patients with Siewert Ⅱ and Ⅲ[AEG;(3) univariate and multivariate factors analysis affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG.The survival curve and rate were respectively drawn and calculated by the Kaplan-Meier method.The univariate analysis and multivariate analysis were respectively done using the Log-rank test and the COX regression model.Results (1) Follow-up and survival situations:all the 444 patients were followed up for 1-81 months,with a median time of 52 months.The 1-,3-,5-year overall survival rates of 444 patients were respectively 93.2％,60.3％ and 45.7％.(2) Factors analysis affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG:results of univariate analysis showed that tumor diameter,tumor differentiation,invasion depth of tumor,pN staging and staging of LNR were related factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG,with statistically significant differences (x2 =12.332,5.898,36.045,38.847,46.464,P＜0.05).Results of multivariate analysis showed that invasion depth of tumor and staging of LNR were independent factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG [RR =1.393,1.411,95％ confidence interval (CI):1.137-1.708,1.106-1.801,P＜0.05].(3) Factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG:results of univariate analysis showed that tumor diameter,tumor differentiation and invasion depth of tumor were related factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG,with statistically significant differences (x2=20.077,12.618,36.586,P＜0.05).Results of multivariate analysis showed that tumor diameter,tumor differentiation and invasion depth of tumor were independent factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG (OR=0.684,0.688,0.788,95％ CI:0.485-0.965,0.505-0.936,0.687-0.903,P＜0.05).Conclusions The invasion depth of tunor and staging of LNR are independent factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG.Tumor diameter,tumor differentiation and invasion depth of tumor are independent factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG.

Objective To investigate the effects of lipoxygenase inhibitor NDGA on expression of 5-LOX and its apoptosis related genes in HepG2 cell line.Methods The expression of 5-LOX and apoptosis related genes hTERT,bcl-2 and bax mRNA was determined by reverse transcriptasepolymerase chain reaction (RT-PCR).Results After 25,50,100,200 μmol/L NDGA treatment for24,48 h,the expression of 5-LOX of HepG2 cell decreased,but the expression of bax was up-regulated and the expressions of bcl-2 and hTERT mRNA were down-regulated,(P＜0.05 compared with the control group).The decrease in the expression of 5-LOX,hTERT and bcl-2 in HepG2 cell was negtively correlated with the dose duration of action of NDGA.Conclusion In vitro,5-LOX is expressed highly in HepG2 cell.Overexpression of 5-LOX may be related to the progression of hepatocellular carcinoma,NDGA can significantly decrease the expression of 5-LOX,up-regulate of bax and downregulation of bcl-2 and telomerse.Lipoxygenase might be a novel therapeutic target for the hepatocellular carinoma.

Objective To observe the expressions of OPN, COX-2 and CyclinD1 in breast infiltrating carcinoma and evaluate their relationships with clinic pathological features. Methods Expression of the above three indexes were detected from 70 breast cancinoma patients by immunohistochemistry. The relationships among them and clinicopathological features were analyzed. Results The positive expression rates of OPN were 78.8% in cases (≤45 years old) and 73.0% in cases (> 45 years old); the positive expression rates were 79.3%(tumor diameter ≤ 3 cm) and 73.2% (tumor diameter > 3 cm); the positive expression rates were 77.8%, 73.8% and 78.9% in cases ofⅠgrade, Ⅱgrade and Ⅲ respectively, the positive rates had no statistical significances(P > 0.05). The expression rates of OPN in cases of breast infiltrating carcinoma without and with axillary node metastasis were 62.5% and 93.3%, in cases at stage Ⅰ~Ⅱ and Ⅲ ~Ⅳ were, 68.0% and 95.0% respectively, the positive rates had statistical significances(P < 0.05). The expression of OPN was negatively correlated with ER and PR while positively correlated with CerbB2, COX-2 and CyclinD1. Conclusions OPN plays an important role in the invasion and metastasis of breast carcinoma coordinated with COX-2 and CyclinD1.

Objective To study the efficacy and safety of caspofungin for the invasive furlgal infection in hematopathic neoplasms patients.Methods The retrospective study of effeacy,influencing factors and adverse reaction in 64 patients with hematopathic neoplasms have been treated with capofungin from January 2007 to February 2009.The SPSS13.0 software Was used for statistic analysis.Results The overall efficacy in 64 patients was 54.7%.The median of effective time for patients with fever and non-fever were 1(1-10) day and 12.5(2-30) days,respectively.There were no significant difference in age,detection of fungus,duration time of neutropenia,hematopoietic stem cell transplant,sraft versus host disease,immunoppressive agents,CT scans,loading dose of caspofungin and salvage therapy between two groups.Drug-related toxicities was low and reversible. Conclusion This study strongly supported caspefungin as an option for empiric and salvage antifungal therapy,and therapeutic effect of caspefungin was not influenced by immune state,neutrophils and CT scans,drug-related toxicities was low.