Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling.Near infrared spectroscopy probe was placed on the forehead.Anesthesia was induced with propofol TCI (Cp =5 μg/ml),fentanyl 3 μg/kg and rocuronium 0.6 mg/kg.The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml/kg,RR 10-12 bpm,I∶ E 1∶2,FiO2 =1.0).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with sevoflurane (end-tidal concentration 1.0％-1.7 ％) or propofol TCI (Cp =3-4 μg/ml) in combination with remifentanil TCI (Cp =3.5 ng/ml) and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS was maintained at 40-60 during operation.rSO2 was recorded before induction of anesthesia (T0),10 min before and 10 min after blood vessel was clamped (T1,T2) and 10 min after anastomosis was completed (T3).Results rSO2 was significantly increased on the operated side at T3 in PR group while in SR group bilateral rSO2 was significantly increased at T1-3 as compared with the baseline values at T0 (P ＜ 0.05 or 0.01).rSO2 on the operated side was significantly higher at T1 in group SR than in PR group (P ＜ 0.05).Conclusion The efficacy of sevoflurane-remifentanil anesthesia is similar to that of propofol-remifentanil anesthesia for revascularization for moyamoya disease in terms of maintence of the balance between cerebral oxygen supply and demand.

Objective To understand the cognition，attitude and awareness on the prevention and control of COVID-19 among recent international travellers back to China（hereinafter referred to as the inbound group）and local residents（domestic group），and to provide scientific evidence for further prevention and control of the epidemic. Methods Using a questionnaire website，a questionnaire entitled “Investigation and analysis of residents’ knowledge，attitude，and practice on COVID-19”was prepared，with the targeted population of the survey being international travelers back to China and local residents who had been quarantined at home for 14 days in Jinqiao Town. Cluster sampling was used to conduct the survey through WeChat. The two groups were then compared using chi-square test by using SPSS 23.0. Results Between the two groups，the awareness on the respiratory droplet transmission and inactivation effectiveness by alcohol，peracetic acid and ultraviolet ray on the SARS-CoV-2 were statistically different（P < 0.05）. In the attitude towards prevention and control measures，there was significant difference between the two groups in selecting prevention and control plans for the whole population during the outbreak（P < 0.05）. In the comparison of behavior，there was a statistical difference between the two groups（P < 0.05）whether to maintain a distance of more than 1 meter in social communication. Regarding the choice of quarantine methods（stay-at-home，intensive quarantine and no quarantine），the difference between two groups was statistically significant（P < 0.05）. Conclusion In terms of the knowledge of COVID-19，attitude towards prevention and control measures，and their own behavior，there are some differences between the inbound group and domestic group.

Objective To investigate the regulating effect and mechanism of microRNA-21 (miR-21) on extracellular matrix (ECM) of vascular smooth muscle cells (VSMCs) by vascular remodeling of hypertension. Methods By narrowing the abdominal aorta in rats, the hypertension models were established and divided into 2-week hypertension group and 4-week hypertension group, and sham-operated group was also established as control. VSMCs from the rat aorta were subjected to 0% (static), 5% (normal) and 15%（hypertensive）elongation strain at a constant frequency of 1.25 Hz and duration of 12 hours, respectively. The expressions of Smad 7 and ECM were detected by Western blotting, and the expression of miR-21 was examined by Real-time RT-PCR. Finally, miR-21 siRNA was used to study the role of miR-21 in the mechanical strain-induced expression of ECM, miR-21 and Smad 7. Results Compared with the sham-operated group, ECM and miR-21 in thoracic aorta of 2-week hypertension group were significantly elevated. Collagen I, collagen III and miR-21 in thoracic aorta of 4-week hypertension group were significantly elevated. Compared with the static and 5% strain groups, the protein expression of collagen I in VSMCs did not show significant change, but the protein expression of collagen III was significantly elevated and Smad 7 expression was significantly decreased in 15% strain group. The cyclic strain also enhanced miR-21 expression in VSMCs. miR-21 inhibitor effectively decreased the expression of miR-21 in VSMCs and protein level of collagen III, while enhanced Smad 7 expression under the static and 15% strain. Conclusions The vascular remodeling of hypertension causes the high expressions of ECM and miR-21. The cyclic strain induces the high expression of miR-21, which via Smad 7 results in enhancing the expression of ECM, collagen III especially, in VSMCs under vascular remodeling of hypertension.

OBJECTIVETo observe the expression of angiopoietins in oral squamous cell carcinoma and relationship between the expression of angiopoietins and pathologic classification.

METHODSThe expression of Ang-1 and Ang-2 protein in samples from 42 oral squamous cell carcinoma and 16 oral normal mucosa were detected by immunohistochemical technique.

RESULTSThe expression of Ang-1 and Ang-2 was found in both oral squamous cell carcinoma and normal control. It was found Ang-1 expression alike in oral squamous cell carcinoma and control (P > 0.05). Ang-2 expressed at low level in control while strongly positive in oral squamous cell caroinoma and the level of Ang-2 expression in oral squamous cell caroinoma was related to pathologic classification (P < 0.05).

CONCLUSIONAng-2 expression in oral squamous cell carcinoma is related to angiogenesis and pathological classification, which is probably involved in angiogenesis regulation, promotes the development and metastasis of oral squamous cell carcinoma.

Angiopoietin-1 ; Angiopoietin-2 ; Angiopoietins ; Carcinoma, Squamous Cell ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; Mouth Neoplasms ; Neoplasms ; Neovascularization, Pathologic

Sciatic nerve injury is a common disease of peripheral nerve in clinic. After nerve injury, there are many dysfunctions in motoneurons and muscles following regeneration. Previous studies mostly investigated the aspects related to the injured nerve, and the effect on the recurrent inhibition (RI) pathway of spine following regeneration was not fully understood. Following reinnervation after temporary sciatic nerve crush, the functional alteration of RI was studied. In adult rats, RI between lateral gastrocnemius-soleus (LG-S) and medial gastrocnemius (MG) motor pools was assessed by conditioning monosynaptic reflexes (MSRs) elicited from the cut dorsal roots and recorded from either the LG-S or MG nerves by antidromic stimulation of the synergist muscle nerve. The following results were obtained. (1) The RI of MSRs in rats was almost lost (<5 weeks) after sciatic nerve crush. Although the RI partially recovered following reinnervation (6 weeks), it remained permanently depressed (up to 14 weeks). (2) Sciatic nerve crush on one side did not affect the contralateral RI. (3) Sciatic nerve crush did not induce any motoneuron loss revealed by immunohistochemistry. Peripheral nerve temporary disconnection causes long term alterations in RI pathway which make up motoneuron's function enhance for the alteration of muscle power and suggests that peripheral nerve injury induces long term plastic changes in the spinal motoneuron circuitry.
Animals ; Long-Term Synaptic Depression ; physiology ; Male ; Motor Neurons ; physiology ; Nerve Crush ; Nerve Regeneration ; physiology ; Neuronal Plasticity ; physiology ; Neurons, Afferent ; physiology ; Rats ; Rats, Wistar ; Reflex, Monosynaptic ; physiology ; Sciatic Nerve ; injuries ; physiopathology ; Spinal Cord ; physiopathology ; Spinal Nerve Roots ; physiopathology

OBJECTIVETo investigate the efficacy of continuous blood purification(CBP) in the treatment of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children.

METHODSOne hundred and forty seven cases of ALI/ARDS were hospitalized to our pediatric intensive care unit, and 32 cases were treated with continuous blood purification (CBP) from June, 2006 to May, 2011. The model for CBP was continuous veno-venous hemofiltration dialysis (CVVHDF). CBP treatment persisted for at least 8 hours and replacement + dialysis fluid dose was 35 - 100 ml/(kg·h). The clinical outcome measures included the mortality rate at 28th day, respiratory index (FiO2/PO2), dynamic lung compliance (Cdyn), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), mechanical ventilation parameters, vasoactive drug dose and lung X-ray changes.

RESULTSIn totally 147 cases of ALI/ARDS, 89 cases (60.5%) were male and 58 (39.5%) were female, mean age was (43.4 ± 36.7) months. Death occurred in 54 cases, the total mortality was 36.7%. The cause of ALI/ARDS was mainly severe pneumonia, severe sepsis, and leukemia or tumor diseases. There were significant differences in severity of illness between the CBP treatment group and non-CBP treatment group on Pediatric risk of score mortality (PRISM) III score (15.3 vs. 12.7, P < 0.05) and pediatric critical illness score (66.8 ± 19.3 vs. 74.6 ± 17.7, P < 0.05). The average duration of CBP treatment was 52 hours (12 hours to 232 hours). PaO2/FiO2 and Cdyn were improved after 2 hours CBP treatment compared with those before CBP treatment (P < 0.05), mechanical ventilation parameters including fraction of inspired oxygen (FiO2), peak inspiratory pressure (PiP) and positive end expiratory pressure (PEEP) were reduced. The use of vasoactive drugs in patients with MODS and shock gradually declined. The average ventilator-free days of the two groups did not show significant difference (P > 0.05). The mortality on CBP treatment group and non-treatment group were 37.5% and 36.5%, respectively, the difference was not significant (P > 0.05).

CONCLUSIONCBP adjuvant treatment for ALI/ ARDS could reduce pulmonary edema, improve PaO2/FiO2 and Cdyn, and improve mechanical ventilation parameters. CBP may be a very promising treatment for ALI/ARDS in children.

Acute Lung Injury ; physiopathology ; therapy ; Adolescent ; Child ; Child, Preschool ; Female ; Hemofiltration ; methods ; Humans ; Infant ; Intensive Care Units, Pediatric ; Lung Compliance ; Male ; Respiratory Distress Syndrome, Adult ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo form a wound information management scheme with objectivity, standardization, and convenience by means of wound information management system.

METHODSA wound information management system was set up with the acquisition terminal, the defined wound description, the data bank, and related softwares. The efficacy of this system was evaluated in clinical practice.

RESULTSThe acquisition terminal was composed of the third generation mobile phone and the software. It was feasible to get access to the wound information, including description, image, and therapeutic plan from the data bank by mobile phone. During 4 months, a collection of a total of 232 wound treatment information was entered, and accordingly standardized data of 38 patients were formed automatically.

CONCLUSIONSThis system can provide standardized wound information management by standardized techniques of acquisition, transmission, and storage of wound information. It can be used widely in hospitals, especially primary medical institutions. Data resource of the system makes it possible for epidemiological study with large sample size in future.

Burns ; Cell Phone ; Databases as Topic ; Humans ; Management Information Systems ; Software

OBJECTIVETo explore the effects of percutaneous transhepatic radiofrequency ablation (PRFA) combined with tumor edge of percutaneous absolute ethanol injection (PEI) on liver cancer adjacent to major blood vessels.

METHODSSeventy five patients with liver cancer adjacent to major blood vessels were randomly divided into two groups: PRFA+PEI therapy group (38 cases) and PRFA control group (37 cases). Tumor necrosis rate, AFP levels, local recurrence rate, median for survival time and cum survival were used as the evaluation index to evaluate the efficacies of the two methods.

RESULTSTumor necrosis rates of the therapy group and the control group were 84.2% and 54.1% (P < 0.01), respectively; AFP levels of therapy group and control group at 1, 3, 6 and 12 months after treatment were (105.0 ± 35.5) μg/L, (28.4 ± 4.3) μg/L, (58.6 ± 6.7) μg/L, (89.5 ± 12.5) μg/L and (137.2 ± 34.6) μg/L, (84.2 ± 18.4) μg/L, (106.6 ± 20.3) μg/L, (173.7 ± 32.0) μg/L, respectively. The rates of therapy group was significantly lower than of control group. Local recurrence rates of the therapy group and control group were 2.6%, 7.9%, 13.2% and 31.6% vs 10.8%, 21.6% , 40.5% and 62.1% (P < 0.05) at 3, 6, 12 and 24 months after treatment, respectively. Median for survival time of the therapy group and control group were 28.0 ± 2.8 months and 19.0 ± 3.6 months, respectively. Cum survival of the therapy group and control group were 84.2%, 78.9%, 60.5% and 31.6% vs 78.4%, 67.6%, 37.8% and 8.1% (P < 0.05) at 6, 12, 24 and 36 months after treatment, respectively.

CONCLUSIONPEI as a supplementary treatment of PRFA can effectively improve the treatment of liver cancer adjacent to major blood vessels and significantly reduce the local recurrence rate and improve long-term survival rates.

Adult ; Aged ; Bile Duct Neoplasms ; Carcinoma, Hepatocellular ; pathology ; therapy ; Catheter Ablation ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

BACKGROUNDUnheralded sudden death and acute myocardial infarction are common manifestations of coronary atherosclerosis. Such events are related to thrombotic occlusion at the site of non-flow limiting atherosclerotic plaques in epicardial coronary arteries. This study aimed to assess plaque characterization of nonculprit lesions in patients with acute coronary syndrome (ACS) compared with those with stable angina pectoris (SAP) determined by analysis of intravascular ultrasound (IVUS) radiofrequency (RF) data.

METHODSIn 81 patients, nonculprit vessels with < 50% diameter stenosis and nontarget segment of culprit vessels with < 50% diameter stenosis were studied with IVUS. Tissue maps were reconstructed from RF data using IVUS-Virtual Histology software.

RESULTSMean lipid core percentage was significantly higher in patients with ACS than in those with SAP ((25.78 +/- 6.30)% vs (9.11 +/- 4.90)%, P < 0.001). In addition, patients with SAP showed more fibrotic vessels ((59.66 +/- 16.87)% vs (49.07 +/- 10.20)%, P < 0.001). There was no significant difference in either mean calcium ((4.37 +/- 2.40)% vs (5.12 +/- 3.00)%, P = 0.225) or fibrolipid ((24.94 +/- 9.40)% vs (25.82 +/- 13.60)%, P = 0.731) percentages in nonculprit vessels, but the mean calcium percentage was significantly higher in nontarget lesions of culprit vessels ((5.51 +/- 3.29)% vs (3.57 +/- 2.10)%, P = 0.003). In addition, there was a positive correlation between lipid core and remodeling index (RI) (r = 0.847, P < 0.001) and a negative correlation between fibrous tissue and RI (r = -0.946, P < 0.001).

CONCLUSIONSIn this study, in both nonculprit vessels and nontarget lesion of culprit vessels, plaque characterization of nonculprit lesions determined by spectral analysis of IVUS RF data was significantly different in patients with ACS. The percentage of lipid core was significantly higher in patients with ACS than in those with SAP. Conversely, SAP patients showed more fibrotic content. In vivo plaque composition and morphological changes were related to remodeling of the coronary artery tree.

Acute Coronary Syndrome ; diagnostic imaging ; pathology ; Adult ; Aged ; Aged, 80 and over ; Angina Pectoris ; diagnostic imaging ; pathology ; Atherosclerosis ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; methods ; Young Adult

OBJECTIVETo elevate the immunological effect of subunit influenza vaccine in infants and aged people (over 60) using liposomal adjuvant in the context of its relatively low immunity and to investigate the relation between vaccine antigens and liposomal characteristics.

METHODSSeveral formulations of liposomal subunit influenza vaccine were prepared. Their relevant characteristics were investigated to optimize the preparation method. Antisera obtained from immunizinged mice were used to evaluate the antibody titers of various samples by HI and ELISA.

RESULTSLiposomal trivalent influenza vaccine prepared by film evaporation in combinedation with freeze-drying significantly increased its immunological effect in SPF Balb/c mice. Liposomal vaccine stimulated the antibody titer of H3N2, H1N1, and B much stronger than conventional influenza vaccine. As a result, liposomal vaccine (mean size: 4.5-5.5 microm, entrapment efficiency: 30%-40%) significantly increased the immunological effect of subunit influenza vaccine.

CONCLUSIONThe immune effect of liposomal vaccine depends on different antigens, and enhanced immunity is not positively correlated with the mean size of liposome or its entrapped efficiency.

Animals ; Influenza A Virus, H1N1 Subtype ; immunology ; Influenza A Virus, H3N2 Subtype ; immunology ; Influenza B virus ; immunology ; Influenza Vaccines ; administration & dosage ; immunology ; Liposomes ; Mice ; Mice, Inbred BALB C ; Orthomyxoviridae Infections ; prevention & control ; Specific Pathogen-Free Organisms ; Vaccines, Subunit ; administration & dosage ; immunology