Objective:To compare the efficacy and safety between propofol and sevoflurane in free flap breast reconstruction.Methods:The data of patients,who underwent free flap breast reconstruction with propofol(P group,n=16)or sevoflurane(S group,n=19),were collected.Postoperative complications of flap,postoperative nausea and vomiting(PONV)and intraoperative mean arterial blood pressure were retrospectively analyzed.Objective:No statistical significance of the baseline patient characteristics,duration of surgery and anesthesia was found between the two groups.The incidence of flap compromise was 6.3％in the P group while it was 10.5％in the S group.No statistical significance of the history of PONV,motion sickness and smoking was found between two groups.Also no statistical significance of intraoperative sufentanil and remifentanil administered,postoperative PCIA consumption was found between the two groups.The incidence of nausea(from 0 to 2 h)was significantly decreased in the P group(18.8％vs 68.4％,P=0.003).The incidences of vomiting(from 2 to 6 h,0 to 24 h)were significantly reduced in the P group(18.8％vs 52.6％,P=0.039;18.8％vs 57.9％,P=0.019).No statistical significance of preoperative mean arterial blood pressures was found between two groups([88.06±6.86] mmHg vs [88.10±8.13] mmHg,P=0.987).Significant decreases in intraoperative mean arterial blood pressures compared with preoperative mean arterial blood pressures were observed in both groups(P<0.05).Intraoperative mean arterial blood pressure was lower in the S group compared with the P group(P<0.05).More ephedrine was used in the S group(P<0.05).There was no intraoperative awareness in both groups.There were no significant differences in extubation time and 24 h quality of recovery score between the two groups.Conclusions:There was no difference in the outcome of flap between propofol and sevoflurane.Compared with sevoflurane,propofol improves postoperative nausea and vomiting with less intervention in mean arterial blood pressure.

A GeXP based multiplex RT-PCR assay was developed to simultaneously detect twelve different respiratory viruses types/subtypes including influenza A virus, influenza B virus, influenza A virus sH1N1, parainfluenza virus type 1, parainfluenza virus type 2, parainfluenza virus type 3, human rhinovirus, human metapneumovirus, adenovirus, respiratory syncytial virus A, respiratory syncytial virus B and human bocavirus. Twelve sets of specific primers were designed based on the conserved sequences of available respiratory-virus sequence database. The specificity of the multiplex system was examined by positive specimens confirmed previously. The sensitivity to detect twelve respiratory viruses simultaneously was 10(3) copies/microL. Twenty four clinical specimens were further detected by this novel assay and the results were compared with that of the real-time RT-PCR. These results showed that this novel assay based on GeXP is a fast, sensitive, and high throughput test for the detection of respiratory virus infections.
Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; isolation & purification ; Orthomyxoviridae ; genetics ; isolation & purification ; Orthomyxoviridae Infections ; virology ; RNA Viruses ; genetics ; isolation & purification ; Real-Time Polymerase Chain Reaction ; instrumentation ; methods ; Respiratory Syncytial Viruses ; genetics ; isolation & purification ; Respiratory Tract Infections ; virology ; Reverse Transcriptase Polymerase Chain Reaction ; instrumentation ; methods ; Rhinovirus ; genetics ; isolation & purification ; Sensitivity and Specificity

Endoplasmic reticulum (ER) stress is involved in the process of kidney fibrosis. Spliced X-box binding protein 1 (XBP1S) is the key mediator of ER stress while its role in fibrosis is still poorly understood. This study was aimed to investigate the role of XBP1S in renal fibrosis and evaluate whether valsartan could alleviate fibrosis through XBP1S. Renal interstitial fibrosis was induced by unilateral ureteral obstruction (UUO) in C57BL/6 mice, and UUO mice were daily administered with valsartan (20 mg/kg) through oral gavage. After 7 days of UUO, at euthanasia, left kidney was collected to examine the histological alteration by using haematoxylin-eosin staining, Masson's trichrome staining, Sirius red staining and immunohistochemistry. Western blot was used to assess XBP1S, targets of XBP1S, fibronectin, α-SMA, BAX and BCL2 protein levels. Real-time polymerase chain reaction was performed to assess NADPH oxidase subunits p47-phox and p67-phox mRNA levels. The results showed that XBP1S expression was decreased by about 70% in the UUO mice compared with that in sham mice (P < 0.01), which was reversed by valsartan administration (P < 0.05). Meanwhile, UUO-induced renal interstitial fibrosis was attenuated by valsartan treatment. In addition, the protein levels of fibronectin and α-SMA were upregulated by UUO induction (P < 0.01), and valsartan administration inhibited the protein levels of fibronectin and α-SMA in UUO mice (P < 0.05). Western blot analysis showed that the ratio of BAX to BCL2 protein level was increased in UUO model compared with that in sham mice, and the increment also was diminished by valsartan treatment (P < 0.05). Finally, UUO-induced mRNA levels of p47-phox and p67-phox were significantly attenuated by valsartan administration (P < 0.05). These results showed that valsartan at least partly restores renal interstitial fibrosis by enhancing XBP1S activation through inhibiting oxidative stress and apoptosis in the UUO mice. These results suggest that XBP1S could be a potential therapeutic target for kidney fibrosis.
Animals ; Apoptosis ; Fibronectins ; Fibrosis ; Kidney ; Kidney Diseases ; Mice ; Mice, Inbred C57BL ; NADPH Oxidases ; Oxidative Stress ; Phosphoproteins ; Real-Time Polymerase Chain Reaction ; Ureteral Obstruction ; X-Box Binding Protein 1

OBJECTIVETo retrospectively analyze the results of a consecutive series of 100 ALL patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in our center.

METHODSOf the 100 ALL patients, 69 were male and 31 female, with a median age of 29.5 (4 - 47) years. Sixty-nine cases were in the first complete remission (CR(1)), 13 in more than CR(1) and 18 in relapse before transplant. Allo-HSCT from HLA identical siblings was performed for 86 patients, of whom 64 received bone marrow transplantation (BMT) and 22 peripheral blood stem cell transplantation (PBSCT). HLA matched unrelated BMT was performed for 8 patients, cord-blood transplantation from unrelated donor for 6 patients. Forty-five patients underwent allo-HSCT with conditioning regimen of Cy/TBI, 55 with BUCY. Prophylaxis of graft-versus-host disease (GVHD) included long-term MTX regimen (4 cases) and CsA + MTX regimen (96 cases). The average follow-up was 38.1 months.

RESULTSThe 5-year overall survival (OS) and disease-free survival (DFS) of the 100 cases of ALL was 53.4% and 50.5%. The 5-year OS and DFS were significantly longer for patients in CR(1) than in >CR(1) and relapse patients before allo-HSCT (P < 0.001). The outcome of PBSCT seemed superior to that of BMT, but there was no difference between them. Multivariate analysis showed the most significant factor associated with long post allo-HSCT survival was that the patient underwent transplantation in CR(1). There was no significant difference in 5-year OS, DFS, cumulative incidences of relapse rate and treatment related mortality between the two cohorts prepared with TBI or BUCY.

CONCLUSIONSAllo-HSCT can cure a significant proportion of ALL patients, especially for those in CR(1). There was no significant difference in OS, DFS between the two different conditioning regimens and the different transplant choices.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; mortality ; therapy ; Recurrence ; Transplantation, Homologous