Objective To evaluate the effect of dexmedetomidine combined with continuous positive airway pressure (CPAP) on the oxidative stress and inflammatory responses during one-lung ventilation (OLV) in the elderly patients undergoing radical surgery for esophageal carcinoma.Methods One hundred and twenty ASA physical status Ⅱ or Ⅲ patients,aged 65-80 yr,with body mass index 18-25 kg/m2,scheduled for radical surgery for esophageal carcinoma,were randomly divided into 4 groups (n =30 each) using a random number table:control group (group C),dexmedetomidine group (group D),CPAP group (group P) and dexmedetomidine combined with CPAP group (group DP).After induction of anesthesia,the patients were endotracheally intubated and then mechanically ventilated.At the beginning of skin incision,OLV was performed instead.In D and DP groups,a loading dose of dexmedetomidine 0.3 μg/kg was infused starting from 10 min before incision,followed by infusion at a rate of 0.3 μg·kg-1 ·h-1 untill the chest was closed.CPAP 2 cmH2O was used on the non-ventilated side during OLV in P and DP groups.Immediately before incision,at 90 min of OLV,at the end of operation and on 1 day after operation,venous blood samples were obtained for determination of the serum malondialdehyde (MDA),interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) concentrations.The development of complications was recorded at 1 and 7 days after operation.Results Compared with group C,the incidence of hyoxemia during operation and pulmonary atelectasis and infection after operation was significantly decreased in the other three groups,the incidence of hyoxemia and pulmonary atelectasis and infection after operation was decreased,and the serum concentrations of MDA,IL-6 and TNF-α were decreased in group DP (P ＜ 0.05).Compared with D and P groups,the serum concentrations of MDA,IL-6 and TNF-α were significantly decreased,and the incidence of pulmonary atelectasis and infection after operation was decreased in group DP (P ＜ 0.05).The incidence of hyoxemia during operation was significantly lower in group DP than in group D (P ＜ 0.05).Conclusion Dexmedetomidine combined with CPAP can alleviate the oxidative stress and inflammatory responses more effectively and is more helpful in improving prognosis than either alone during OLV in elderly patients.

Objective To evaluate the efficacy of intermittent ventilation performed in lungs on the operated side for prevention of reexpansion pulmonary edema after pulmonary resection.Methods Forty patients of both sexes,aged 16-32 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective thoracoscope-assisted pulmonary resection,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and intermittent ventilation performed in lungs on the operated side group (group Ⅴ).After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.After correct positioning was confirmed by fiberoptic bronchoscopy,one-lung ventilation was performed instead.One-lung ventilation was performed routinely in group C.In group Ⅴ,the lung on the operated side was ventilated intermittently for 30 s with the tidal volume set at 2 ml/kg and respiration rate at 20 bpm,the bronchial tube was then opened,and the process was repeated at 10 min intervals until the diseased tissues were removed.After resection of diseased tissues,the specimens of normal tissues around the area were obtained for determination of the expression of aquaporin 1 (AQP-1) and AQP-5 in lung tissues.The development of pulmonary atelectasis,hyoxemia and reexpansion pulmonary edema was recorded within 24 h after surgery.Results Compared with group C,AQP-1 and AQP-5 expression was significantly up-regulated,the incidence of atelectasis and reexpansion pulmonary edema was decreased within 24 h after surgery,while no significant change was found in the incidence of hyoxemia in group Ⅴ.Conclusion Intermittent ventilation performed in lungs on the operated side can effectively prevent the development of reexpansion pulmonary edema during one-lung ventilation in the patients undergoing pulmonary resection.

Objective To evaluate the effect of creatine phosphate on the myocardial injury induced by lung ischemia-reperfusion (I/R) in rats.Methods Twenty-four male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-350 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),I/R group,and I/R+creatine phosphate group (group CP).Lung I/R was induced by clamping the left hilum of lung for 0.5 h with a non-invasive microvascular clip followed by mechanical ventilation and 2.0 h of reperfusion.Creatine phosphate 6.6 mg · kg-1 · min-1 were infused intravenously at 30 min before ischemia in group CP,while the equal volume of normal saline was administered in group I/R.At 2.0 h of reperfusion,blood samples were obtained from the right ventricle for determination of the serum concentration of cardiac troponin I (cTnI).Myocardial specimens were obtained from the apex for microscopic examination and for determination of the levels of myocardial superoxide dismutase (SOD),malondialdehyde (MDA),and myeloperoxidase (MPO).Results Compared with group S,the serum cTnI concentrations,MDA content,and MPO activity were significantly increased,and the SOD activity was significantly decreased in I/R and CP groups (P＜0.05).Compared with group I/R,the serum cTnI concentrations,MDA content,and MPO activity were significantly decreased,and the SOD activity was significantly increased in group CP (P＜0.05).Myocardial injury was significantly attenuated in group CP as compared with group I/R.Conclusion Creatine phosphate can attenuate the myocardial injury induced by lung I/R in rats,and the mechanism is related to decrease in damage caused by lipid peroxidation.

Objective To investigate the effect of dexmedetomidine on the damage to the nonventilated lung in the patients undergoing one-lung ventilation (OLV).Methods Forty patients of both sexes, aged 18-64 yr, with body mass index of 18-25 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective radical surgery for lung cancer under general anesthesia, were randomly divided into either control group (group C) or dexmedetomidine group (group D) with 20 in each group.After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.After correct positioning was confirmed by fiberoptic bronchoscopy, dexmedetomidine was infused for 20 min as a dose of 0.5 μg/kg, followed by an infusion of 0.5 μg · kg-1 · h-1 until the moment of tumor resection.The equal volume of normal saline was given in group C.Immediately after the beginning of OLV, at 60 min of OLV, and immediately after the end of OLV, the specimens of normal lung tissues around the tumor were obtained for microscopic examination of pathologic changes which were scored, and for determination of the expression of hypoxia-inducible factor-1 alpha (HIF-1α) and heme oxygenase-1 (HO-1) by Western blot.Results Compared with group C, the pathological score was significantly decreased on the non-ventilated side immediately after the end of OLV, and the expression of HIF-1α and HO-1 in the lung tissues on the non-ventilated side was up-regulated in group D (P＜0.05).Conclusion Dexmedetomidine can mitigate the damage to the non-ventilated lung in the patients undergoing OLV, and the mechanism is associated with up-regulated expression of HIF-1α and HO-1.

As a kind of the plant tissue cultures, hairy root culture is characterized by rapid growth without exogenous hormones source and high yield of secondary metabolites, which attracted the attention of scholars in resent years. This work systematically summarized the research of medicinal plant hairy roots, including the mechanism, current situation of medicinal plant hairy roots, and their applications.
Cell Culture Techniques ; Plant Roots ; chemistry ; genetics ; growth & development ; metabolism ; Plants, Medicinal ; chemistry ; genetics ; growth & development ; metabolism

Objective To investigate the correlation between hepatitis B induced cirrhosis glucose metaboliam disorders and hepatitis B immune related indexes,to analyze the epidemic characteristics in the local region.Methods 128 cases with hepatitis B induced cirrhosis were divided into the NGT group,IGR group and DM group,according to 75g oral glucose tolerance test(OGTT).Results The difference of waist size,and body mass index data in the three groups had statistically significant difference( F =22.71,24.62,all P ＜ 0.05 ).As the aggravating of glu cose metabolism disorder,the positive rate of HBsAg,HBeAg and former S1 antigen of NGT group,IGR group and DM group were gradually raised,and the differences were statistically significant ( F =17.35,21.47,19.37,all P ＜0.05).Conclusion There was positive correlation between virus infection in patients with hepatitis B induced cirrhosis and glucose metabolism disorder.There were intimate connection between the epidemiological factors such as age,waist size,weight,and body mass index and glucose metabolism disorder in patients with hepatitis B induced cirrhosis.

Objective To evaluate the effect of tranilast on neointimal proliferation and remodeling of rabbit iliac artery after balloon injury.Methods Twenty four rabbits were randomly divided into 3 groups including sham-operated group, control group, and treatment group. Balloon catheter was used to induce injury to the iliac artery of rabbits in control group and treatment group. Tranilast was given to the rabbits in treatment group (300 mg?kg -1) once a day from 3 days before operation to 28 days after operation, and then local vessels were harvested for pathological analysis and immunohistochemical staining. Automatic image analysis system was used to detect the changes of intimal thickness, medial thickness, luminal area, external elastic lamina (EEL) cross-sectional area and the proliferation index of proliferating cell nuclear antigen (PCNA). Results The intimal thickness was decreased in treatment group compared with control group. The luminal area and EEL cross-sectional area were significantly larger in treatment group than those in control group. No significant difference was found between treatment group and control group in medial thickness. The proliferation index of PCNA was significantly reduced in treatment group compared with control group. Conclusions Tranilast signifcantly inhibited neointimal hyperplasia and prompted compensatory artery dilation during remodeling of rabbit iliac artery after balloon injury. The effect on neointimal hyperplasia may be partly attributed to the inhibition of vascular smooth muscle cell proliferation.

Whether three genes [?-aminolevulinic acid dehydratase (ALAD) gene, Vitamin D receptor (VDR) gene and hemochromatosis gene] can make certain individuals more vulnerable to lead are discussed. Polymorphisms of ALAD gene have been associated with the accumulation and distribution of lead in the blood, bone and internal organs in humans and animals. VDR gene has been implicated in the control of calcitriol levels in serum, which normally regulates calcium absorption and can in turn affect lead levels. Hemochromatosis gene, associated with a disease that leads to excessive iron accumulation, may also influence the absorption of lead.

2*!cm. Conclusions Large invasive and metastatic carcinoid tend to be malignant, and the prognosis is usually poor, with which a radical resection may help.

Objective To investigate the multiple factors correlated to femoral head necrosis in patients over 45 years old with femoral neck fractures after closed reduction and cannulated screws fixation.Methods Three hundred patients with femoral neck fracture were admitted from May 1999 to May 2004 and treated by closed reduction and internal fixation with cannulated screws.We analyzed the multiple factors:age,gender,Garden classification,follow-up time,procedure delay,quality of reduction,time of full-weight-loading,fixation removal, and preoperative traction.Multiple correlation factors were analyzed by SPSS10.0 statistic system.Results Complete case records were documented in 99 cases who were followed up for an average of 24.5 months(range,8 to 60 months).Femoral head necrosis occurred in 15 cases(15.2%).Time of femoral head necrosis was 8 to 50 months after operation.The combination of quality of reduction,preoperative traction,age,and age?fixation re- moval was found to have the most significant influence on femoral head necrosis after internal fixation for femoral neck fractures.Conclusions Good reduction is the most important factor correlated to the outcome of a femoral neck fracture.Age is linked to the risk of necrosis but it is relatively insignificant.Preoperative traction in wrong positions can increase the incidence of necrosis.Garden classification is important in predicting femoral head necrosis and is associated with quality of reduction,but it is not a risk one in the combination of multiple correlation factors that lead to the necrosis.