Objective To explore the effects of Xuan Yun Ning on the plasma endothelin in pafients with vertebrobasilar ischemia.Methods 60 cases of vertebrobasila ischemia were randomly recruited into a treatment group and a control group,with 30 cases in each group.The control group was treated with Nimodipin,and the treatment group was treated with Xuan Yun Ning plus Nimodipin.Another 30 healthy persons whose age is more than 40 years were recruited for a healthy control group without any treatment The alterations of plasma endothelin were measured by radiation immunological test in the treatment group,the control group,and the healthy control group.Results The elevated plasma endothelin was significantly decreased in treatment group than the control group and the healthy control group(P＜0.05).Conclusion Xuan Yun Ning improves the blood volume by lowering the level of plasma endothelin and thus treats patients with vertebrobasilar ischemia.

BACKGROUND:The pathogenesis of avascular necrosis of the femoral head is still uncertain,so the treatment is not favorable.OBJECTIVE:To study the feasibility and mechanism of intramedullary injection with salvia miltiorrhiza for preventing of steroid-induced necrosis of the femoral head.DESIGN,TIME AND SETTING:Randomized controlled animal trial was performed at Zunyi Medical College between April 2005 and May 2007.MATERIALS:Thirty 6-month-old healthy rabbits,half amount of male and female,weighing(2.5?0.25) g,were randomly divided into three groups(n=10):control,model,and prevention groups.METHODS:Normal saline was injected into the control group.Prednisolone was injected into model group,7.5 mg/kg,two times per week for 8 weeks.Glucocorticoid-induced animal model in the prevention group was intramedullary injected with salvia miltiorrhiza,0.3-0.5 cm below the third trochanter of the femur,0.4 mL/kg,twice a week for 8 weeks.MAIN OUTCOME MEASURES:Blood lipids level,serum calcium and phosphorus were measured;X-ray,emission computerized tomographic(ECT) and histopathology were performed.RESULTS:The serum calcium and phosphorus in model group were remarkably reduced.X-ray showed inhomogeneous density of the femoral head,with irregular radiolucent area,obscure structures of bone-trabecula,but intact femoral head and normal joint space.The blood flow and blood pool showed decreasing radioactive distribution of the femoral head,and local concentration of nuclide in the delayed phase in the model group.Histopatholgical observation suggested that the cortical bone was thinned,with thin bone-trabecula and irregular arrangement,necrosed bone marrow and pimelosis and increased bone lacuna.The calcium-phosphorus product of prevent group was increased;X-ray showed normal femoral head appearance and normal bone density except unclear bone-trabecula.ECT showed the dynamic and static images of the prevention group were similar as normal imaging of rabbits.In addition,histopatholgical observation suggested the rate of empty lacuna was decreased,and bone trabecula minimally thinned with ordered arrangement.CONCLUSION:Salvia miltiorrhiza injection plays a good effective role in the prevention of steroid-induced avascular necrosis of femoral head through improving hemorheology and reducing rate of empty lacuna.

Objective To explore changes in glycogen synthase kinase-3 (GSK-3) levels in the lymphocytes of patients with mild cognition impairment (MCI) and Alzheimer's disease (AD). Methods GSK-3 activity was measured by 32P liquid scintillography in a control group, an MCI group and an AD group. The expressions of GSK-3βat Ser9 and total GSK-3β were determined by western blotting. Results GSK-3 levels were significantly higher in the AD and MCI groups than in the control group. The phosphorylation of GSK-3βat Ser9 was significantly lower in the AD and MCI groups compared with the control group, but there was no difference in the phosphorylation of total GSK-3β among the three groups. Conclusions Higher GSK-3 activity in the lymphocytes might have value in the diagnosis of MCI and early AD.

AIM:To explore the safety of anesthesia for neonates by studying the effects of general anesthesia (GA) and spinal-epidural anesthesia (SA) on the levels of lactic acid, S100B, superoxide dismutase (SOD) and malond-ialdehyde ( MDA) in the umbilical cord blood and placental stereological changes .METHODS:The singleton , term preg-nancy of 50 patients for elective cesarean section were assigned to 2 groups:GA group and SA group , with 25 patients in each group.Blood pressure (BP) and heart rate (HR) of the parturient women were monitored and recorded at 6 time points.The Apgar score was calculated at 1 min and 5 min after birth.The gas analysis of the umbilical artery blood , S100B protein concentration, blood lactic acid, SOD and MDA were also measured .Stereological evaluation of the vascular adaptations in the human placental villous capillary was performed .RESULTS:BP, HR, Apgar scores, gas analysis, the pH value of the umbilical artery blood , the serum concentrations of S 100B protein and the length density of villous capillar-ies had no significant change between the 2 groups (P>0.05).The levels of blood lactic acid and SOD in GA group were significantly lower than those in SA group (P<0.01).MDA content and volume density of villous capillaries in GA group were significantly higher than those in SA group ( P<0.01 ) .CONCLUSION: General anesthesia for cesarean section was safety for neonates .However, as indicated by the oxidation index , general anesthesia may have some harmful effect on the neonates by oxygen free radicals .

Objective To evaluate the protective effect of perfluorocarbon emulsions (FCE) on donor lung of rats during storage.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 350-400 g,were equally and randomly divided into 2 groups using a random number table:University of Wisconsin (UW) solution group (UW group) and FCE group (FCE group).After the model of lung perfusion was established according to the method described by Fischer et al,the lung and heart were removed and perfused with 4 ℃ UW or FCE preservation solutions.The lung was taken out when stored for 6 h for determination of SOD activity (by WST assay),malondialdehyde (MDA) content (by TBA assay),and activity of myeloperoxidase (MPO) and content of interleukin1 β (IL-1β),IL-6,tumor necrosis factor-apha (TNF-α) (using ELISA) in lung tissues and for microscopic examination of pathologic changes.Results MPO activity was significantly lower in UW group than in FCE group (P ＜0.05).There were no significant differences in the SOD activity and content of MDA,IL-1β,IL-6,TNF-α between the two groups (P ＞ 0.05).Conclusion FCE can reduce the neutrophil infiltration in lung tissues,indicating that FCE is more superior to UW solution in reduction of injury to the donor lung of rats.

ObjectiveTo evaluate the safety of breast-conserving surgery for ductal carcrnoma in situ (DCIS).MethodsOne hundred and nineteen patients with pathologically confirmed DCIS were analyzed retrospectively. The relationship among local recurrence and distant metastasis with relevant factors including surgical procedure, age, tumor size, estrogen/progesterone status and human epithelial receptor 2 (HER-2) status were analyzed by univariate and multivariate methods.ResultsIn this study 48 patients received breast conserving surgery,71 patients received mastectomy. All patients were followed up for 7-132 months (median 35 months). Chest wall recurrence was found in mastectomy group in one case and none in ipsilateral breast tumor recurrence (IBTR) in breast conservation group (P =0. 384). Two patients had distant metastasis in mastectomy group, and one patient in breast conserving group ( P =0. 383 ). The three year disease-free survival (DFS) were 100％ and 94. 4％ in breast conserving and mastectomy groups respectively(P =0. 225). Univariate analysis showed that age( ＜40 years)was the risk factor for distant metastasis(P =0. 035) ,a factor not confirmed by multivariate analysis (P =0. 086).ConclusionsThere is no significant difference on local recurrence and distant metastasis between breast conserving surgery and mastectomy for DCIS of the breast.

Objective To study the effects of MF59 in combination with heat-killed BCG ( hBCG) as adjuvant on the immunogenicity of Mycobacterium tuberculosis fusion protein PstS1-LEP.Methods BALB/c mice were divided into six groups from group 1 through group 6.They were immunized with PstS1-LEP+MF59 ( group 1 ) , PstS1-LEP+MF59/hBCG ( group 2 ) , PstS1-LEP+hBCG ( group 3 ) , MF59 ( group 4 ) , PstS1-LEP (group 5) and hBCG (group 6) for three times at intervals of two weeks , respectively.The mice were sac-rificed two weeks after the last immunization .The serum samples were collected for antibodies detection .The splenic lymphocytes and peritoneal macrophages were isolated and cultured with PstS 1-LEP.Indirect ELISA and sandwich ELISA were used to detect PstS 1-LEP-specific antibodies and cytokines in the supernatants of culture , respectively.Results The level of IFN-γ, IL-1β, IgG, IgG1 and IgG2a in group 1 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 and IL-4 in group 1 were higher than those in groups 4 and 6 (P<0.05).The level of IFN-γ, IL-1β, IL-12, IgG, IgG1 and IgG2a in group 2 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 was higher in group 2 than that in groups 4 and 6 (P<0.05). The level of IL-4 in group 3 was higher than that in group 4 ( P=0.05 ) .The level of IL-1βin group 3 were higher than that in groups 4 and 5 ( P<0.05 ) .The level of IgG was higher in group 3 than that in groups 4 and 6 (P<0.05).IgG1 level in group C was up-regulated in comparison with that in groups 4, 5 and 6 (P<0.05 ) .Conclusion hBCG as PstS1-LEP adjuvant induces a shift towards Th 2-type immune response , while MF59 induces Th1/Th2-type immune response.The combination of MF59 and hBCG inhibits the secretion of IL-4 by spleen lymphocytes , but enhances the secretion of IL-12 by macrophage .

AIM: To evaluate the effects of hyperthermic peritoneal chemiotherapy (HPC) on cardiovascular system. METHODS: Twenty-six patients whose age was 31 to 75 receiving gastric cancer radical resection followed by HPC were involved in this trial. All hemodynamic parameters were recorded during whole procedures. RESULTS: The blood temperature(T) increased significantly during HPC; cardiac index increased immediately when HPC began( P

BACKGROUND:The cervical pedicle screws provide ideal three-column stability for cervical vertebra, but there is stil no a standard with the choice of pedicle screw place methods in cervical vertebra. Here, we try to seek a simpler, safer and accurate pedicle screw place method.OBJECTIVE:To evaluate the accuracy and security of transpedicular screw placement assisted by rapid prototyping individual navigation template. METHODS:Eight cadaver cervical specimens (C3-6) were selected to take CT-scan and data were saved in DICOM format. Three-dimensional (3D) software MIMICS was used to establish the C3~6 3D model, and designed the best pedicle screw channel. According to the morphological feature of the posterior cervical spine elements, the reverse template was designed. Then, the best pedicle screw channels were fused into bilateral navigation template. The navigation template was manufactured by rapid prototyping, and saved in STL format. Rapid prototyping technology was used to print out the navigation template. Cervical pedicle screws were inserted with the assistance of navigation templates fitted with the posterior structure of the vertebral body. Postoperative X-ray and CT scan were used to evaluate the accuracy of screw placement. RESULTS AND CONCLUSION:(1) Total y 64 screws were inserted with the assistance of individual navigation templates. Of them, 62 screws were completely in the pedicle;1 screw perforated the medial cortex of pedicle;1 screw perforated the lateral cortex of pedicle. Accuracy of screw placement was 97%. (2) The individual navigation template with a high accuracy rate is a feasible and safe method for cervical pedicle screw placement, which has great prospects for clinical application.

OBJECTIVETo observe the anesthetic efficacy and safety of bilateral ultrasound-guided supraclavicular brachial plexus block in patients undergoing arthrolysis for shoulder periarthritis.

METHODSTwenty-seven patients (ASA class I-II) undergoing bilateral shoulder joint release surgery and 24 ml received bilateral ultrasound-guided supraclavicular brachial plexus block anesthesia with 0.4% ropivacaine and 0.8% lidocaine. The visual analogue scale (VAS) scores for shoulder joint pain were recorded before and after anesthesia. The efficacy of axillary nerve, dorsal scapular nerve and suprascapular nerve block was evaluated, and the anesthetic effect and complications was assessed during surgery. Before and after anesthesia, the range of left and right diaphragmatic muscle movement was measured when the patient took a quiet breath and a deep breath.

RESULTSThe patients showed no significant variations in MAP, HR, or SpO₂after anesthesia. The VAS scores of shoulder joint pain during anteflexion, abduction, posterior extension, rotation, posterior extension and medial rotation were significantly lowered after anesthesia (P<0.05), but the left and the right diaphragm movement range showed no significant difference between quiet breath and deep breath (P>0.05). The rates of complete block of the axillary nerve and dorsal scapular nerve was 100%, and that of suprascapular nerve was 92.6%. Partial phrenic nerve block occurred in 1 case with mild local anesthetic toxicity in another.

CONCLUSIONSBilateral ultrasound-guided supraclavicular brachial plexus block in patients has excellent analgesic effect in should joint release surgery with good safely.

Amides ; Anesthetics, Local ; Brachial Plexus Block ; Diaphragm ; Humans ; Lidocaine ; Orthopedic Procedures ; Pain Measurement ; Periarthritis ; diagnostic imaging ; surgery ; Shoulder Joint ; diagnostic imaging ; physiopathology ; Ultrasonography