Objective To assess the efficacy of recoil of inflating syringe plunger in limiting laryngeal mask airway (LMA) cuff pressure.Methods Sixty ASA Ⅰ or Ⅱ patients aged 22-64 yr with body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were enrolled in this study.LMA Supreme (Laryngeal Mask Co.Singapore) size # 3 (for patients with body weight ≤50 kg) or # 4 (for patients with body weight ＞ 50 kg) was placed after induction of anesthesia.Correct position of LMA was confirmed by fiberoptic bronchoscopy.The LMA cuff was inflated to 60,80,100 and 120 cm H2O step by step using a 20 ml-syringe.The cuff pressure was measured with a monometer through a 3-way stopcock and maintained at each level for 10 seconds.The plunger was then allowed to recoil.The cuff pressure at the end of recoil (residual cuff pressure) was recorded.The patients were mechanically ventilated.The inspiratory pressure was limited to 30 cm H2 O.The airway pressure at which the air started to leak between LMA and larynx (leak pressure-Pleak) was recorded.Results The residual cuff pressure following the 4 inflating pressures was all ＜ 60 cm H2 O.The Pleak was ＞20 cm H2O.There was no significant difference in residual cuff pressure and Pleak between size # 3 and # 4.Conclusion Recoil of inflating syringe plunger can limit LMA pressure to safe level.

AIM: To study the chemical constituents of Isodon.excia(Maxin.) Hara in Changbai Mountain. METHODS: Chromatograms column was used to separate and purify the chemical constituents.The structures were elucidated on the basis of physic-chemical properties and spectrum data. RESULTS: Two diterpenoids compounds exciain(Ⅰ) and exciain(Ⅱ),were separated and identified. CONCLUSION: The compound(Ⅰ) is obtained from this plant for the first time.

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

OBJECTIVETo investigate the postoperative analgesic effect of parecoxib sodium in patients with posterior spinal surgery.

METHODSEighty patients undergoing posterior spinal surgery under general anesthesia were randomly divided into parecoxib sodium group and placebo group (n=40). All the patients received a single dose of m ml morphine (1.0 mg/ml) as the background analgesia immediately after the operation. The patients in parecoxib sodium group were given 40 mg parecoxib sodium intravenously, and those in the placebo group received an equivalent volume of saline instead, and at 24 and 48 h after the operation, the same dose was repeated. The visual analog pain score, patient satisfaction and adverse reactions were recorded after the administrations.

RESULTSCompared with the placebo group, the patients in parecoxib sodium group had significantly lowered VAS score at 6, 12, 24, and 48 h after the operation (P<0.05). No significant differences were noted in the patient satisfaction and adverse reactions between the two groups.

CONCLUSIONPostoperative short-term use of parecoxib sodium can can provide good postoperative analgesic effect in patients undergoing posterior spinal surgery.

Analgesics, Non-Narcotic ; therapeutic use ; Anesthesia, General ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; Isoxazoles ; administration & dosage ; therapeutic use ; Male ; Pain, Postoperative ; drug therapy ; Spinal Diseases ; surgery

OBJECTIVETo evaluate the effects of mechanical stress on the formation and expression of core binding factor alpha1 (Cbfalpha1) in MG-63 cells cultured on titanium in vitro.

METHODSMG-63 cells cultured on the titanium were subjected to a centrifugal force (2.205 N) 15 min per 4 hours and collected after 4, 8 and 12 hours. The formation and expression of Cbfalpha1 were examined by immunofluorescence staining and reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSBoth the cells with or without centrifugal force created the fluorescence in the nucleus and the immunofluorescence intensity of Cbfalpha1 in MG-63 cells with centrifugal force were higher than those without centrifugal force (P<0.05). Meanwhile, both the cells with or without centrifugal force expressed the mRNA of Cbfalpha1 and the relative mRNA level of Cbfalpha1 in MG-63 cells with centrifugal force were higher than those without centrifugal force, and the differences were great significant (P<0.05).

CONCLUSIONMechanical stress are beneficial to the formation and expression of Cbfalpha1.

Core Binding Factor Alpha 1 Subunit ; In Vitro Techniques ; RNA, Messenger ; Stress, Mechanical

OBJECTIVETo examine the relationship between the dissected lymph-node number and the prognosis in D(2) gastrectomy for gastric cancer.

METHODSFrom January 1996 to January 2005, 457 patients with primary gastric cancer undergone gastrectomy with different extent of lymphadenectomy in our hospital were followed-up in term of prognostic benefit.

RESULTSIn lymph-node metastasis group, the 1-, 3-, 5-year survival rates were 82.4%, 49.0%, 33.4% with dissection of >20 nodes and 71.5%, 49.7%, 40.1% with dissection of 16-20 nodes. In the group without lymph-node metastasis, the 1-, 3-, 5-year survival rates were 98.2%, 92.7%, 84.7% with dissection of >20 nodes and 94.0%, 89.7%, 81.4% with dissection of 16-20 nodes. Whether or not it had lymph-node metastasis, the survival curve failed to show any significant difference with regard to the extent of lymph node dissection.

CONCLUSIONSAs to lymphadenectomy for gastric cancer, it is enough to excise the lymph node between 16 and 20. The number of excised lymph node should not be overemphasized unless it is metastasized.

Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Neoplasm Staging ; Prognosis ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVESTo explore the relationship between the expression of IL-10 and liver regeneration following reduced-size orthotopic liver transplantation in rats.

METHODSRats models with reduced-size orthotopic liver transplantation were established. The rats were divided in three groups: partial liver resection (I), orthotopic liver transplantations (II), and reduced-size orthotopic liver transplantation (III). The expression of IL-10 and regenerative response of liver in rats were evaluated by immunohistochemistry and flow cytometry on the 1st, 2nd, 4th and 7th days after the operations, respectively.

RESULTSThe liver grafts were capable of regeneration, the proliferation activity peaked on the fourth day with 26.3+/-0.9, 35.8+/-2.2, and 32.4+/-1.8 in I, II, and III groups, respectively. The expression of IL-10 was negative correlation to liver regeneration (r=-0.58, P<0.01).

CONCLUSIONSWhole and reduced-size transplanted livers show the same regenerative activity. The maximal regenerative response delayes slightly, compared with that after partial hepatectomy. IL-10 plays an important immunomodulatory role in liver regeneration,and the effect is affected by general immune system and other cytokines.

Animals ; Flow Cytometry ; Immunohistochemistry ; Interleukin-10 ; analysis ; Liver ; chemistry ; Liver Regeneration ; Liver Transplantation ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the impact of microwave radiation on GC-2spd cells.

METHODSWe exposed cultured GC-2spd cells to microwave radiation at the average power densities of 0, 10 and 30 mW/cm2 for 15 minutes and, from I to 24 hours after the exposure, we observed the changes in cell proliferation, histology and ultrastructure, cell apoptosis, and cAMP content by MTIT, light microscopy, electron microscopy, flow cytometry and ELISA.

RESULTSCompared with the control group, the GC-2spd cells showed a significant decrease in proliferation ability at 1 -24 hours after 10 and 30 mW/cm2 microwave radiation, except at 12 hours after 30 mW/cm2 radiation (P <0.05 or P <0.01), with reduced length and number of cell enation and increased intra cytoplasm vacuoles. The rate of cell apoptosis (%) was significantly increased in the 10 and 30 mW/cm2 groups at 6 hours (4.56 +/- 2.09 vs 14.59 +/- 1.09 and 8.48 +/- 1.73, P <0.05 or P <0.01) , with agglutination and margin translocation of chromatins and obvious dilation of endo cytoplasmic reticula. The cAMP content (nmol/g) in the GC-2spd cells was remarkably reduced in the 10 and 30 mW/cm2 groups at 6 and 24 hours (2.77 +/-0.24 vs 1.65+/- 0. 17 and 1.96+/-0.10, 3.02 +/-0.47 vs 2.13 +/-0.33 and 1.69 +/-0.27, P <0.05 or P <0.01).

CONCLUSIONMicrowave radiation at 10 and 30 mW/cm2 may cause injury to GC-2spd cells, which is manifested by decreased content of intracellular cAMP, reduced activity of cell proliferation, and increased rate of cell apoptosis.

Animals ; Apoptosis ; radiation effects ; Cell Line ; radiation effects ; Cell Proliferation ; radiation effects ; Male ; Mice ; Microwaves ; adverse effects ; Spermatocytes ; radiation effects

OBJECTIVETo assess the effect of Qingfei Quyu Decoction (QQD) in preventing radiation pneumonitis in esophageal carcinoma patients by concurrent using it with chemoradiotherapy.

METHODSA total of 120 patients with mid-late stage esophageal carcinoma were randomly assigned to the treatment group (60 cases) and the control group (60 cases). All patients received concurrent radiochemotherapy. Patients in the treatment group additionally took QQD, one dose per day for 8 successive weeks. The incidence of radiation pneunonitis was compared between the two groups. The improvement rates of short-term benefit rate, Karnofsky performance scale (KPS), and body weight (BW) improvement rate were calculated between the two groups. The 1-and 2-year overall survival rates were compared between the two groups.

RESULTSThe incidence of radiation pneunonitis was 8.93% (15/56) in the treatment group and 18.64% (11/59) in the control group (P < 0.05). The short-term benefit rate was 92.86% (52/56) in the treatment group and 69.49% (41/59) in the control group (P < 0.05). Besides, the KPS and BW improvement rate were higher in the treatment group [89.29% (50/56) and 83.05% (49/59) ] than in the control group [80.36% (45/56) and 66.10% (39/59)] (P < 0.05). The 1-and 2-year overall survival rate were 66.07% and 35.71% in the treatment group, higher than those of the control group (61.02% and 30.51%; P > 0.05).

CONCLUSIONConcurrent using QQD with chemoradiotherapy for treating esophageal carcinoma patients could lower the incidence of radiation pneumonitis, attenuate the degree of radiation induced lung injury, improve clinical benefit rate, and elevate their QOL.

Carcinoma, Squamous Cell ; Chemoradiotherapy ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Humans ; Radiation Pneumonitis ; prevention & control ; Survival Rate

OBJECTIVETo investigate the association between catecholamine-beta-adrenoceptor (beta-AR)-adenosine 3', 5'-monophosphate (cAMP) system and long-term prognosis in patients with chronic heart failure (CHF).

METHODSThe study population comprised 73 patients with CHF (EF: 23% +/- 10%) with a mean follow-up of 3.8 +/- 1.9 years. Plasma levels of norepinephrine (NE) were measured using high performance lipid chromatography, beta-adrenergic receptor density (Bmax) and the content of cAMP in peripheral lymphocytes were calculated using 3H-dihydroalpneolo as ligand and competitive immunoassay, respectively. Deaths due to cardiovascular events within the follow-up period were registered.

RESULTSThe total mortality was 64.7%, 57.4% of which was for cardiogenic (worsening heart failure: 32.4%; sudden death: 25.0%). In the cardiogenic death group, plasma levels of NE and epinephrine (E) (3.74 nmol/L +/- 0.09 nmol/L and 3.17 nmol/L +/- 1.0 nmol/L) and the contents of peripheral lymphocyte cAMP (3.64 pmol/mg protein +/- 1.4 pmol/mg protein) were significantly increased as compared with the survival group (2.68 nmol/L +/- 0.07 nmol/L, 2.41 nmol/L +/- 0.24 nmol/L and 2.73 pmol/mg protein +/- 0.9 pmol/mg protein, respectively, all P < 0.01). In the sudden death group, plasma levels of NE and E (5.01 nmol/L +/- 0.06 nmol/L and 4.13 nmol/L +/- 0.08 nmol/L) were significantly increased as compared with the worsening heart failure group (2.49 nmol/L +/- 0.07 nmol/L and 2.33 nmol/L +/- 0.8 nmol/L, all P < 0.001) and to the survival group (2.68 nmol/L +/- 0.07 nmol/L and 2.41 nmol/L +/- 0.14 nmol/L, all P < 0.01). The incidences of sudden death were 0%, 75%, and 100% (chi(2) = 16.018, P < 0.01) in patients with plasma NE < 2.5 nmol/L, NE 2.5 nmol/L - 4.5 nmol/L, and NE > 4.5 nmol/L, respectively. In the worsening heart failure group, the content of peripheral lymphocyte cAMP (4.46 pmol/mg protein +/- 0.18 pmol/mg protein) was significantly increased compared with the sudden death group (2.39 pmol/mg protein +/- 0.9 pmol/mg protein, P < 0.001) and to the survival group (2.73 pmol/mg protein +/- 1.1 pmol/mg protein, P < 0.001). The worsening heart failure death occurences were 5.0%, 72.2%, and 100% (chi(2) = 14.26, P < 0.01) in patients with a content of peripheral lymphocyte cAMP < 2.5 nmol/L, cAMP 2.5 nmol/L - 4.5 nmol/L, and cAMP > 4.5 nmol/L, respectively. Bmax in peripheral lymphocyte was not significantly different (P > 0.05) among the sudden death, worsening heart failure, and survival groups in CHF patients.

CONCLUSIONSPlasma levels of catecholamine increase significantly, and Bmax and the contents of cAMP in peripheral lymphocytes decrease significantly in patients with CHF. High plasma catecholamine levels may be associated with sudden death, and high intralymphocyte cAMP content may be associated with worsening heart failure in CHF patients.

Adult ; Aged ; Catecholamines ; blood ; Cyclic AMP ; blood ; Death, Sudden, Cardiac ; Female ; Heart Failure ; blood ; mortality ; Humans ; Lymphocytes ; chemistry ; Male ; Middle Aged ; Receptors, Adrenergic, beta ; blood