Objective: To explore the effects of Layhey’s and Lawrence’s reconstruction procedures on nutritional status and digestive symptoms following total gastrectomy for gastric cancer.Methods: To analyze retrospectively 146 patients performed total gastrectomy for gastric cancer.Among them,83 cases were operated by Lahey’s reconstruction procedures and 63 cases by Lawrence’s.It was focused on the comparision of the body weight changing,nutritional status and digestive symptoms in 6 months after operation.Results: In 6 months after operation,the weight loss of Lawrence group was less than that of Lahey group significanly.For the level of total protein and albumin at that time,they increased in Lawrence group,but decreased in Lahey’ group,and the difference was significant.The changing tedency for hemoglobin level in Lawrence group was less than that of Lahey group,but there was no significant difference between them.For the quantity and frequency of food intake,there was no significnat difference between them.In Lawrence group,the number of patients with vomiting were less than that in Lahey’group significantly.Conclusion:The Lawrence reconstruction procedure is more reasonable following total gastrectomy for gastric cancer.

Objective To explore the application effect and safety of ultrasonic location in interscalene bra-chial plexus block anesthesia.Methods 100 cases with upper extremity orthopedic surgery patients were selected, according to the brachial plexus between the different positioning methods,they were divided into control group and observation group,50 cases in each group,the control group chose the traditional anatomical localization techniques, observation group interscalene under ultrasound guidance brachial plexus block,two groups of anesthesia were com-pared,block success rates and complications were observed.Results The block operation time,anesthesia onset time,duration of analgesia and anesthesia drug dosage of the observation group were (185.5 ±24.86)s,(11.55 ± 2.89)min,(11.42 ±2.39)min,(17.25 ±2.54)mL while the control group were (228.75 ±26.20)s,(16.05 ±4.66)min,(10.95 ±2.83)min,(19.50 ±2.79)mL,there was significant difference between two groups(t =18.34, 10.28,9.72,10.68,all P <0.05).the anesthesia success rate of the observation group was 98%,significantly higher than 88% of the control group,the difference between the two groups was statistically significant(χ2 =9.12,P <0.05).The incidence rate of complications in the observation group was 0,while the control group was 8%,two groups had significant difference in complication rate(χ2 =8.34,P <0.05).Conclusion Ultrasonic location in in-terscalene brachial plexus block anesthesia has a good clinical effect,with high safety,which is worthy of populariza-tion and application.

目的观察高压氧结合针灸治疗脑外伤患者的疗效。方法对207例脑外伤患者采用高压氧、针灸配合药物进行综合治疗。同时,对78例对照组患者根据病情给予脱水及药物治疗,有手术指征者行清除血肿、减压和清创术。结果高压氧结合针灸治疗组的治愈率明显高于对照组(P<0.01)。结论高压氧结合针灸疗法综合治疗脑外伤患者,治愈率高、无痛苦、副作用少,是颅脑外伤治疗的有效方法。

Objective To investigate the effects of intrathecal (IT) ketamine on the synapsis remodeling in the spinal dorsal horn during devolopment of morphine tolerance in a rat model of neuropathic pain (NP). Methods Male SD rats weighing 200-250 g were used in this study. IT catheter was placed in the subarachnoid space according to Yaksh. Forty-eight SD rats in which IT catheter was successfully placed were randomly divided into 6groups (n=8 each): group sham operation (group S); group NP; group normal saline 20 μl IT(group NS);group morphine 20 μg IT (group M); group ketamine 50 μg IT (group K) and group morphine 20 μ g + ketamine 50 μg IT (group MK). NP was induced by compression of right L4,5 dorsal root ganglions with steel wire inserted through L4,5 intervertebral foramen in NP,M,K and MK groups. Normal saline or morphine and/or ketamine were injected IT once a day for consecutive 14 days. Paw withdrawal threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured on 0, 1, 3, 5, 7, 9, 11, 14 days during the consecutive 14 days of administration. The animals were sacrificed after the final IT administration. The lumbar segment of the spinal cord was removed for determination of the number of synapsis in the spinal dorsal horn by immuno-histochemistry in 4 animals in each group and observation of synaptic structure remodeling using electron microscope in another 4 animals in each group. Results Compared with group S, PWT was significantly decreased and PWL was shortened in the other 5 groups, and the number of synapsis was significantly increased and the synaptic structure was thickened in NP, NS, M and K groups (P ＜ 0.05). Compared with group NP,PWT was significantly increased and PWL was prolonged in M, K and MK groups, and the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05).Compared with group M, PWT was significantly increased, PWL was prolonged, the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05). Conclusion IT ketamine can inhibit the synaptic remodeling in the spinal dorsal horn during development of morphine tolerance in a rat model of NP.

2.2 in serum, the particle size of HDL shifted towards smaller sizes, which indicates that reverse cholesterol transport might be weakened and HDL maturation might be abnormal.

Objective To evaluate the effects of remifentanil on the proliferation,the cell cycle and apoptosis of human liver carcinoma cell line HepG2 in vitro.Methods Human liver carcinoma cells HepG2 were cultured in vitro.The HepG2 cells of the test group were incubated in the RPMI-1640 medium with remifentanil at different concentration(0.001,0.01,0.1,1,10,100,200 μmol/L).The HepG2 cells of the control group were incubated in the RPMI-1640 medium for 48 hours.The level of the cell proliferation was evaluated with methylthiazolyldiphenyl-tetrazolium bromide (MTT) method.The cell cycle was detected with flow cytometry (FCM).The morphological change of apoptosis cell was observed by fluorescence microscopy after staining by Hoechst33258.Results Remifentanil inhibited the proliferation of the HepG2 cells with a dose-dependent effect.Compared with control group,the cell proliferation capability was apparently decreased in the test group (P ＜ 0.05) when the concentration of remifentanil was over 1 μmol/L (P ＜0.05).However,no significant difference in cell proliferation was found when remifentanil was 100 and 200 μmol/ L.The ratio of G0/G1 phase of HepG2 cells was significantly enhanced and the ratio of S phase of HepG2 cells was significantly decreased when remifentanil was over 1 μmol/L.The fluorescent microscopy stained by the Hoechst33258 showed part of HcpG2 cells apoptosis in test group,and the apoptotic rate was significantly increased when remifentanil was over 1 μmol/L (P ＜ 0.05).Conclusions The data suggest that remifentanil would inhibit the proliferation of HepG2 cells and induce apoptosis when remifentanil was over 1 μmol/L.

AIM: To detect the change of composition and ratio of serum HDL subclasses and explore the relationship between these changes and the plasma lipid level in patients with hyperlipidemia. METHODS: The components of subclasses of serum HDL in 172 middle and old aged patients with hyperlipidemia and 115 healthy middle and old aged were determined by dimensional gel electrophoresis associated with immuno-blotting method. RESULTS: Compared to the healthy controls, the contents of pre ?_1-HDL, HDL_~3b and HDL_~3a were significantly higher (P

AIM: To Study the influence of plasma TG level on the contents of serum HDL subpopulations. METHODS: Classified by the contents of serum TG, the serum level of HDL subpopulations in 106 normal TC and 183 high TC subjects were analyzed by two-dimensional gel electrophoresis coupled with immunodection method. RESULTS: The apo-AⅠcontents of per-?_1-HDL, HDL_~3c , HDL_~3b and HDL_~3a were higher in a certain extent in TC high subjects vs corresponding TC desirable subjects. The apo-AⅠ contents of per-?_1-HDL (in borer-line high TG subgroup) and HDL_~3b (in very high TG subgroup) were significantly higher (P

Objective To compare the effects of different administration routes and dosages of tropisetron on cisplatin-induced kaolin intake in rats.Methods Ninety-six healthy adult male Wistar SPF rats were randomly divided into 8 groups(n =12 each):intrathecal (IT) control group (group TC) and 3 tropisetron groups receiving IT tropisetron 10,20 and 30 μg,the volume of each group was 30 μl (group T10,T20,T30),intravenous(Ⅳ) control group (group IC) and 3 tropisetron groups receiving Ⅳ tropisetron 0.3,0.5 and 0.7 mg/kg respectively (group I0.3,I0.5,I0.7).In group TC and IC,normal saline 30 μl and 0.5 ml were injected IT and Ⅳ,respectively.All rats received cisplatin 3mg/kg by intraperitoneal injection at the time point of thirty minutes after administration,each rat weight,the daily food and kaolin intakes were detected at the time point of 48 hours after cisplatin administration.Results Compared with group Tc,each rat weight loss,the kaolin intakes were significantly decreased (P ＜ 0.05),and food intake dose was significantly increased in group T20 (P ＜ 0.05).Compared with group IC,each rat weight loss,the kaolin intakes were significantly decreased (P ＜ 0.05),and food intake dose was significantly increased in group I0.5 and I0.7 (P ＜0.05).There was no significant difference between group I0.5,I0.7 and group T20.Conclusions The kaolin intakes and the rat weight loss can be decreased by IT tropisetron,and the food take dose was increased meanwhile,and IT tropisetron 20 μg has equivalent efficacy to IV tropisetron 0.5 or 0.7 mg/kg.IT could be the new administration route of tropisetron.

Objective To evaluate the blond-saving effect of low central venous pressure(CVP) combined with acute hypervolemic hemedilution(AHHD)in patients undergoing hepatic lobectomy.Methods sixty ASA I orⅡpatients of both sexes aged 32-48 yr weighing 47-72 kg undergoing hepatic lobectomy for primary malignant hepatonm under epidural combined with general anesthesia were randomly divided into 3 groups(n=20 each);group I control(C);group 1I AHHD and group Ⅲ low CVP+AHHD.Group C received crystalloid and coloid in a ratio of 1.5:1 during operation.In groupⅡ4% suecinylated gelatin was infused at 50 ml·kg-1·h-1 for 30 min after tracheal intubation (AHHD);while inⅢ group low CVP was induced and maintained by epidural administration of a mixture of 1.5% lidnoaine +O.2% bupivacaine 6-8 ml combined with intravenous infmion of propofol at 6 mg·kg-1·h-1 until 10 min after hepatic lobectomy was completed.then 4% succinylated gelatin was infused at 50 ml·kg-1·h-1 for 30 min.Blood glucose,Hb,Hct, WBC count,blood coagulation (PT,AVIT,Fib),shtmic-pyruvic transaminase (GPT) and renal function (BUN,Cr) were determined before operation (baseline),immediately before skin incision,immediately before and 10 min after liver lobe was removed,at the end of operation and 7 d after operation.Urine output,intraoperative blood loss and blood transfusion and complications were recorded.Results The glood glucose concentration.WBC count and GPT levd were significantly lower;the amount of fluid infused and urinary output before hepatic lobe resection and the percentage of the patients with allogeneic blood transfusion during operation were less;Hb,Hct and the amounl of fluid infused and urinary output after hepatic lobe resection were uigher in grolp Ⅲ than in group I and ⅡⅡⅡ.There were no significant differences in blood coagulation,renal function,the total amount of fluid infused and urine output among the 3 groups.No patient developed any complication.Conclusion The low CVP hefor combined with AHHD after hepatic resection can decrease intraoperative blood loss and allogeneic blood transfusior and is safe.