Objective To investigate the effect of isoflurane preconditioning on the nuclear factor kappa B (NF-kB)activity of leukocytes in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty ASAⅡorⅢpatients of both sexes aged 20-60 yrs undergoing cardiac valve replacement under CPB were randomly divided into 2 groups(n=10 each):control group(C)and isoflurane preconditioning group(I).Anesthesia was induced with midazolam 0.08-0.12 mg?kg~(-1),fentanyl 5-10?g?kg~(-1) and vecuronium 0.1 mg?kg~(-1).The patients were mechanically ventilated(FiO_2=100%)after tracheal intubation.Anesthesia was maintained with intermittent i.v.boluses of fentanyl and midazolam in group C or with 2 MAC isoflurane and intermittent i.v.boluses of fentanyl and midazolam in group I before CPB.Systolic BP was kept between 90-120 mm Hg,diastolic BP between 50-80 mm Hg and HR between 60-90 bpm in both groups. Isoflurane was discontinued at the initiation of CPB.Arterial blood samples were taken after tracheal intubation and before inhalation of isoflurane(T_0)at 30 min(T_1),1 h(T_2)and 2 h(T_3)after aortic unclamping for determination of NF-kB activity of leukocytes using electrophoretic mobility shift assay(EMSA).The amount of fentanyl,midazolam,dopamine and sodium nitroprusside(SNP)consumed during operation and the rate of recovery of spontaneous heart beat in both groups were recorded.Results The NF-kB activity was significantly increased after aortic unclamping in C group but there was no significant difference in NF-kB activity before CPB (T_0)and after aortic unclamping(T_(1-3))in I group.The NF-kB activity was significant lower at T_(1-3) in group I than in group C.The total amount of fentanyl consumed was 40-60?g?kg~(-1) in C group and 20-30?g?kg~(-1) in group I. Significantly less amount of dopamine was used in group I than in group C.There was no significant difference in SNP consumption between the 2 groups.The rate of recovery of spontaneous heart beat was significantly higher in group I than in group C(P＜0.01).The amount of dopamine consumed was positively correlated with the highest level of NF-kB activity in both group[r=0.962 in group C;r=0.908 in group I(P＜0.01)].Conclusion Isoflurane preconditioning can attenuate the NF-kB activity of leulocytes in patients undergoing cardiac valve replacement under CPB.

Objective To investigate the expression changes of nuclear factor-kappa B(NF-kB) and intercellular adhesion molecule-1(ICAM-1)in rats with severe acute pancreatitis(SAP)and the effect of pretreatment of pioglitazone,a specific peroxisome proliferator-activated receptor?(PPAR?),)ligand, on the development of SAP.Methods Fifty-four SD rats were divided into sham operation group(C), SAP group(A)and pioglitazone pretreatment group(Ⅰ).The SAP was induced by retrograde infusion of 5% sodium taurocholate(0.1 ml/100 g)into the biliopancreatic duct.The rats inⅠgroup were intraperi- toneally injected with pioglitazone(2 mg/100 g)two hours before operation.The rats were sacrificed at 3,6 and 12 hrs,the blood,ascites and pancreatic tissues were collected(6 rats once for each group). The expressions of NF-kB and ICAM-1 in pancreatic tissues were measured by immunochemistry,mean- while the serum amylase,the amount of ascitic,pancreatic wet/dry ratio were measured.The pathologi- cal changes of pancreatic tissues were observed by immunochemistry staining with hematoxylin and eosin and the score of the tissues were evaluated.Results Pretreatment with pioglitazone could significantly attenuated the severity of SAP,including reduction of amylase and ascites,and the mass and pathological scores of the pancreatic tissue were decreased after 6 hrs of medication.The expression of ICAM-1 and NF-kB activity were inhibited.Conclusions Above findings demonstrate that pioglitazone can attenuate the severity of SAP by inhibition of ICAM-1 expression and NF-kB activation.The beneficial effects of pioglitazone might be due to its anti-inflammatory activities.The pioglitazone can be used as a new drug in treatment of SAP.

Objective: To observe the effect of mild moxibustion on cancer-related fatigue, serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery. Methods: Seventy patients were divided into a control group and an observation group according to the random number table method, with 35 cases in each group. Patients in both groups were treated with conventional FOLFOX4 chemotherapy regimen. Patients in the control group also received routine treatments such as symptomatic treatment of complications, health education, nutritional support, and exercise intervention. Patients in the observation group received mild moxibustion on the basis of interventions used in the control group. The Piper fatigue scale-revision (PFS-R), Karnofsky performance status (KPS) and spleen and kidney yang deficiency syndrome were scored, and serum ghrelin and adiponectin levels were measured before and after treatment. Results: After treatment, total score of PFS-R in the control group did not change significantly (P>0.05), while in the observation group it was significantly reduced (P<0.05) and lower than that in the control group (P<0.05); KPS scores in both groups were increased (both P<0.05), and it was significantly higher in the observation group than in the control group (P<0.05); total score of spleen and kidney yang deficiency syndrome in the control group did not change significantly (P>0.05), while it was significantly reduced in the observation group (P<0.05) and lower than that in the control group (P<0.05); serum ghrelin and adiponectin levels in the control group had no significant changes (both P>0.05), but the levels were significantly increased in the observation group (both P<0.05) and higher than those in the control group (both P<0.05). Conclusion: Based on the routine treatments, mild moxibustion can relieve fatigue, improve quality of life, and improve the symptoms of spleen and kidney yang deficiency in patients undergoing chemotherapy after colorectal cancer surgery, which may be related to the regulation of serum ghrelin and adiponectin levels.

Objective To evaluate the safety and accuracy of CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome.Methods A total of 25 cases with hepatic lesions near the diaphragmatic dome were undertaken CT-guided cutting needle biopsy using 16 gauge or 18 gauge core biopsy needles.Results Histological examination showed malignancy in 17 cases and benign in 8 with 2 false negative results(8%),and there were no false positive results.The specificities of malignant and benign lesions were 100% and 75%,respectively.Overall accuracy was 92%.Pneumothorax,needle tract hemorrhage,and subcapsular hepatic hemorrhage occurred in 2(8%),1(4%)and 1(4%),respectively.Conclusion CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome is a reliable and relatively safe diagnostic method.(J Intervent Radiol,2007,16:838-840)

AIM:Receptor tyrosine kinase (RTK) activation is critical for growth factor-mediated cell proliferation. The present study was designed to determine the effect of the tyrphostin AG1295 and AG1296, a selective blocker of PDGF βand αRTK,on proliferative vitreoretinopathy (PVR) development.METHODS:Rabbit conjunctival fibroblasts (RCF) cells were cultured.The effects of AG1295, AG1296,PDGF-AA and PDGF-BB on RCF proliferation are evaluated by MTT assay.Homologous rabbit conjunctival fibroblasts were injected intravitreally to make animal PVR model, followed by injection of 100μmol/L of AG1295 or AG1296 respectively. The presence of tractional retinal detachment (TRD) was assessed to evaluate the effect of AG1295 and AG1296 in vivo .Electroretinography and histologic studies were performed after intravitreal injection of AG1295 into untreated eyes to evaluate toxicity. RESULTS: Both AG1295 and AG1296 (10μmol/L) significantly inhibited rabbit conjunctival fibroblast cell growth stimulated by PDGF-AA or -BB in vitro.Development of TRD was significantly reduced (P<0.05) with 100 μmol/L of AG1295 or AG1296 in vivo, but the effect of AG1295 only present till day 14. Inhibitive effect of AG1296 is longer than that of AG1295.No significant histologic or retinal functional damage was found in both drug-treated groups. CONCLUSION: PDGF αand βreceptor specific inhibitor AG1296 and AG1295 attenuated PVR without significant side effects in rabbits, and AG1296 was better than AG1295. The much longer and stronger therapeutic effect from PDGFαreceptor inhibitor indicated that PDGF α receptor is more important in the development of PVR, and inhibition of this pathway could be a useful treatment alternative to prevent PVR.

Objective To evaluate the functional outcome,predicting response and toxicity of CT- guided permanent implanted ~(125)I seed branchytherapy for metastatic cancers in vertebrae.Methods Forty three vertebrae with metastatic cancer were treated by CT-guided percutaneous permanent implanted ~(125)I seed branchytherapy in 15 patients.There were 8 male and 7 female patients with average age of 54.6 years and 2 to 5 vertebrae involved in this group.According to the size of tumor,the optimal activity and quantity of seeds were calculated by TPS and correlative formula.~(125)I seeds were implanted percutaneous puncture under CT- guidance with coaxial needles to pass the normal osseous tissue for approaching the lesions including 3 routes of pedicnlar lateral and anterior ways.The distance between seeds and posterior border of vertebral body was over 3 nun(3-10mm).Permanent ~(125)I seed implantation brachytherapy for paraspinal metastatic lesions were also taken place.Results Mean follow-up time was 12.3 months(range 3-30 months)and outcome was evaluated clinically and radiographieally in 10 of 15 procedures,with 5 only on clinical data.No new pain occurred at 11 sites with no previous complaint.The pain was completely controlled at 18/32 sites,partial control at 14/32 sites.No complications correlated to the radiotherapy damage of nerve and spinal cord were found.Conclusion The procedure of CT-guided permanent implanted ~(125)I seeds brachytherapy for vertebral metastatic cancers is a safe effective and minimal invasive method with few complications.It is beneficial not only for pretherapeutic metastasis but also for recurrent tumors after radiotherapy;bearing rather high tolerance and safety.(J Intervent Radiol,2007,16:834-837)

ObjectiveTo investigate the economic status of psychiatric patients and their families in Shaoxing area in Zhejiang Province.MethodsA self-edited questionnaire was used to survey the annual income and expenses for medical treatment among psychiatric patients and their families.ResultsThe average annual income of per person in psychiatric family was (3823.07±3354.99) Yuan while average annual income of per psychiatric patient was (1918.20±5188.42) Yuan, which were only 62.3% and 31.2% of the rural controllable annual income, 20.9% and 14.2% of urban controllable annual income in Shaoxing area. In the meantime, 30.43% psychiatric patients did not have any incomes and 47.43% were below 500 Yuan per year. Engel coefficient was (59.65±24.36). The average expense for medical treatment was 1052.54 Yuan per year, which was 54.9% of annual income of the psychiatric patients. In some illness, this rate was as high as 90% or above.ConclusionThe incomes of psychiatric family members and psychiatric patients themselves are much lower than the local average level, while they would be spent more than a half of the income on their medical treatment. Psychiatric patients as well as their family members are the extremely low income and weak social class and need help by the government and society.

Adult ; Female ; Humans ; Male ; Medial Collateral Ligament, Knee ; injuries ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods

This article focused on basic clinical skill training of Changhai Hospital,in such aspects as courses,teaching infrastructure,faculty competence,teaching pattern,evaluation system and incentives mechanism.These efforts aim at exploring the establishment of a new clinical skills teaching model,which prove satisfactory and improving the standardized residents basic clinical skill training system.

Objective To evaluate the accuracy of the fetal weight estimation system in terms of estimating the fetal weight.Methods The fetal weight estimation system developed by the Department of Electronic Engineering,Fudan University was applied to estimate the fetal weight in many hospitals,and the differences between the estimated results of the system and the actual weight of newborn fetuses,as well as the accuracy of the estimation system and the traditional estimation methods were compared.Results A total number of 610 cases were employed,with each case including the ultrasound images of fetus before birth,the corresponding measurement data and the newborn weight.The correlation coefficients between the weight of the newborn babies and the fetal parameters,which were measured by the estimation system in terms of the biparietal diameter,the head circumference,the abdomen circumference and the femur length,were higher than those obtained by manual annotations,with improvements of 0.08,0.17,0.09 and 0.05,respectively.The absolute error of the estimated weight of the system with respect to the actual weight was 44 g smaller than those estimated by traditional method,and the variance of the absolute error was 53 g smaller;while the corresponding absolute percentage error was 1.8％ lower,and the corresponding variance percentage was 1.5％ lower.Conclusions The fetal weight estimation system improves the accuracy of the prenatal ultrasound assessment and provides reliable information to clinical diagnosis.