Objective To compare the influence between target controlled infusion propofol vein anesthesia and midazolam vein anesthesia toward serum amylase and triglyceride in children with cleft lip and palate.To make a definitude that the feasibility of target controlled infusion propofol used in children′s anesthesia.Methods Sixty children with cleft lip and palate aged from 4 months to 3 years,weighting 6.5-15.9 kg,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were randomly allocated to group P and group M(n=30,each).Group P received target controlled infusion propofol.Anesthesia was induced with target controlled infusion propofol at the target effect-site concentration 3.0 mg/L,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and target controlled infusion propofol at the effect-site concentration 3.0 mg/L.Group M received intermittent boluses of midazolam 0.1 mg/kg.Anesthesia was induced with midazolam 0.2 mg/kg,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and intermittent boluses of midazolam 0.1 mg/kg every hour.The venous blood samples were taken before anesthesia induction(T1),4 hours(T2) and 24 hours(T3) after surgery to measure the serum concentration of serum amylase and triglycride.Results The duration of anesthesia induction,extubation and emergence were shorter in group P compared with group M(Pa0.05).Conclusions The serum concentration of triglyceride may increase because of the stress of anesthasion and operation,and can be higher during target controlled infusion propofol,but does not exceed the normal value.The serum amylase concentration does not increase during target controlled infusion propofol in children.

Objective To compare vacuum-assisted excision with periareola incision surgery for benign breast cancer.Methods One hundred and twenty one patients with benign breast nodules treated in our hospital from October 2014 to October 2015 were enrolled in the study,including 58 cases received vacuum-assisted excision (study group) and 63 cases received periareola incision surgery (control group).There were no differences in age[(30.2 ±5.4) vs.(32.1 ±6.2) years] and tumor diameter[(1.3 ±0.4) vs.(1.5 ± 0.3) cm] between two groups.Results There were no severe complications in both groups.Compared with the control group,the operation time was shorter] (20.4 ±4.7) vs.(48.2 ± 15.4)min,t =3.165,P =0.006],intraoperative blood loss was less [(18.4 ± 5.7) vs.(17.2 ± 3.7) ml,t =-0.297,P =0.672],malformation rate was lower [5.2％ (3/58)vs.22.2％ (14/63),x2 =7.27,P =0.007],incidence of postoperative hematoma was higher [20.7％ (10/58) vs.6.3％ (4/63),x2 =3.502,P =0.041],and the cost of surgery was more expensive(5 100 ± 300) vs.(3 400 ± 1 200) Yuan,t =2.181,P =0.023].Conclusion Comparing with conventional periareolar incision surgery,the vacuum-assisted excision has its advantages and disadvantages for treatment benign breast tumors,and two surgical modalities can be chosen accordingly.

Objective To explore a novel operative management for irreducible atlantoaxial dislocation. Methods Fifty-four patients, which as 32 males and 22 females aged from 7 to 63 years old with a mean of 32 years, were diagnosed with irreducible atlantoaxial dislocation, including 18 patients with os odontoideum, 22 occipitalization, 5 malunion of odontoid fracture and 9 relaxation of transverse ligament of atlas. Forty patients presented signs and symptoms of myelopathy or spinal cord injury. All of the patients underwent the operation of open reduction and release by transoral approach. The longus collies muscles, longus capitis muscles, anterior longitudinal ligament, atlantoaxial articular capsules, the apical odontoid ligament and alar odontoid ligaments may be included, were transected, followed by arthrodesis via posterior approach in one stage. Different methods of posterior arthrodesis were conducted as followed: C1,2 transarticular screw fixation in 5 cases, occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 37 cases, and C1,2 joint fixation with plates and screws in the lateral masses of the atlas and axis in 12 cases. Results A complete reduction was achieved in 41 cases, and the other 13 patients obtained partial reduction. Forty-eight patients were followed up from 4 to 40 months, 15.7 months at the average. All of them achieved solid arthrodesis. According to Odom's scoring system, among the 38 patients with preoperative upper cervical myelopathy, 15 patients were assessed as excellent, 14 good, 8 fair and 1 poor. During the operation, cerebral spinal fluid leakage occurred in 1 case, and pedicle screwing failed in 1 case. After the operation, respiratory failure was found in 1 case, nasal sound in 3 cases, dysphagia in 1 case. One patient became quadriplegia due to myelitis caused by septicemia at two weeks after the operation. The internal fixation loosened in 1 case at 2 months postoperatively. Conclusion Transorally surgical release for reduction and posterior arthrodeses could achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.

Understanding of the classification of intracerebral hemorrhage may help to better manage the patients with intracerebral hemorrhage.Selecting the appropriate diagnosis and treatment measures as well as preventive strategies for different subtypes in order to improve the prognosis of intracerebral hemorrhage and prevent the recurrence.This article reviews the present common classification methods of intracerebral hemorrhage studied and reported in the world.

Humans ; Liver Neoplasms ; metabolism ; pathology

Objective To assess the value of serum N terminal pro-brain natriuretic peptide(NT-Pro-BNP) in the diagnosis of congestive heart failure(CHF) and evaluation of cardiac function in children with ventricular septal defect (VSD).Methods Fifty one children were enrolled from March 2004 to March 2005.NT-Pro-BNP was measured by enzyme immunoassay technique.At the same time,left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS) were detected with echocardiography.Results The data of NT-Pro-BNP were showed but the logarithms of which were normal distribution.The values of NT-Pro-BNP were developed successively along with the severity of cardiac function.But there was no difference between the group of no heart failure and mild heart failure.But the values of LVEF and LVFS had no differences in the control,the mild and the moderate heart failure and the same time all of which beyond the standard of diagnosing heart failure.NT-Pro-BNP could reflect the degree of heart failure or cardiac function (r=0.826).But LVEF and LVFS can not reflect the degree of the cardiac function.Conclusions NT-Pro-BNP can reflect the degree of the cardiac function in VSD,and the degree of the heart failure can be classed by the levels of serum NT-Pro-BNP.But the value of LVEF and LVFS can not reflect the degree of the heart failure in the same disease.

Corynebacterium glutamicum SA001 is a mutant with lactate dehydrogenase (ldhA) deletion. In order to increase metabolic flux from isocitrate to succinate, and to improve the production of succinate under anaerobic conditions,we transducted the gene aceA coding isocitrate lyase (ICL) from Escherichia coli K12 into Corynebacterium glutamicum SA001 (SA001/pXMJ19-aceA). After 12 h aerobic induction by adding 0.8 mmol/L of IPTG, the recombinant strain was transferred to anaerobic fermentation for 16 h. Succinate reached 14.84 g/L, with a productivity of 0.83 g/(L x h). Compared to C. glutamicum SA001, the activity of ICL of the recombinant strain was increased 5.8-fold, and the succinate productivity was increased 48%. Overexpression of isocitrate lyase will increase the metabolic flux of glyoxylate bypass flowing to succinate.
Corynebacterium glutamicum ; genetics ; metabolism ; Escherichia coli ; enzymology ; genetics ; Gene Deletion ; Industrial Microbiology ; Isocitrate Lyase ; biosynthesis ; genetics ; L-Lactate Dehydrogenase ; genetics ; Succinic Acid ; metabolism ; Transduction, Genetic

Objective: To investigate the effect of microcatheter in chemoembolization of HCC. Methods Using 4 - F - 5 - F Yashiro/Kouno and 5 - F Hook catheters as guiding catheter,3 - F microcatheter was put into segmental hepatic artery or tumor feeding artery and chemoembolization was carried out. Results All 35 cases had 50 times chemoembolizations totally, of them, 16 cases with small HCC had segmental TAE and 19 cases with large but localized HCC had right/left hepatic artery or anterio/posterio brtanch of right hepatic artery embolization, 1-2 year survial rates were 100%, 87. 5% and 52. 6%,42. l% respectively after TAE. Liver function damage after TAE was slight and no complications occurred. Conclusion Improving embolization precision by using microcatheter is valuable in the cases with small HCC or large but localized HCC with tortuous hepatic artery,hepatic artery stenosis after injury and variations.

Objective To evaluate the various patterns of hepatic perfusion disorders with multi-slice spiral CT and to emphasize the significance of recognition for them . Methods In a period of 1 year, the all CT images of 1568 patients received multi-slice spiral CT examination of upper abdomen were analyzed retrospectively. The CT findings, etiologies and mechanisms of different pattens of hepatic perfusion disorders were investigated. Results 103 cases were demonstrated to have hepatic perfusion disorders. 69 cases were associated with tumors and the other 34 cases were non-tumor associated. The etiologies of various hepatic perfusion disorders were classified as (1)arterioportal fistulae(41.7%), (2) portal venous inflow obstruction(23.3%), (3) inflammartory hyperemic changes(17.5%), (4) steal phenomenon by hypervascular tumors(6.8%), (5) hepatic venous outflow obstruction(4.9%), (6) aberrant hepatic blood supply (3.9%) and (7) uncertain causes(1.9%). There was significant correlation between the CT images of perfusion disorders in shape and distribution and the causes of them. Conclusion Multi-slice spiral CT provides a new effective technique for demonstrating and understanding various hepatic perfusion disorders. Familiarity with the spiral CT appearances of these perfusion disorders will result in more accurate evaluation for various pathologic or physiologic states reflected by them.

Objective To study the technique of modified multi-slice spiral CT aniography(MSCTA) for displaying the whole length of the carotid arteries and the origin of the vertebral arteries,and to evaluate its clinical value.Methods A total of 152 patients underwent modified MSCTA of extracranial carotid artery which scanned from skull base to aortic arch with contrast medium injected from the femoral vein, the image quality and the detection of lesions were assessed in comparison with that of DSA in a few of cases. Results (1) The jugular vein was displayed in 4 cases, only accounting for 2.63%. (2) The carotid segments including the proximal common carotid artery(CCA), the middle CCA, the carotid bifurcation, the internal carotid artery(ICA) bulb and the distal ICA could be visualized adequately by MSCTA,the showing rates were 97.69%,97.69%,97.69%,95.62% and 97.64%,respectively. Furthermore, moderate or severe stenosis detected by MSCTA in 17 cases was closely corresponding with the results of DSA. Conclusion Modified MSCTA of extracranial carotid artery can display the whole length of extracranial carotid artery and the origin of the vertebral arteries satisfactorily without the interference of the jugular, subclavian and innominate veins, and can improve its clinical application.