Objective: To investigate the efficacies of heart rate (HR), mean artery pressure (MAP), central venous pressure (CVP), pulmonary artery wedge pressure (PAWP) and stroke volume variation (SVV) in assessing low stroke volume index (SVI) caused by volume deficiency in major non-cardiac surgeries. Methods: Twelve patients undergoing sacral or retroperitoneal tumor resection were enrolled in this study. After induction and onset of mechanical ventilation, radial artery was cannulated and connected to FloTrac for BP and SVV monitoring. Swan-Ganz catheter was placed via internal jugular vein into the pulmonary artery for CVP, PAWP, and SVI monitoring. HR, MAP, CVP, PAWP, SVV, and SVI were recorded every 30 min. If phenylephrine was injected within 5 min before the time point for data-record, the record should be postponed to 5 min after the injection. If vasoconstrictor or cardiotonic was injected intravenously and continuously to keep the normal blood pressure, the data-record in this patient should be stopped then, otherwise it should be stopped when the concentration of sevoflurane was turned lower at the end stage of the operation. The receiver operating characteristic (ROC) curves of HR, MAP, CVP, PAWP, and SVV were made according to a low stroke volume which was less than 25 ml/m2 and AUC (area under curve) were counted. Results: The AUC of SVV for assessment of a low SVI was 0.837, while AUC of HR, MAP, CVP and PAWP were 0.615, 0.647, 0.623, and 0.658, respectively. The highest Youden's index was at the point when SVV was 9.5% in its ROC curve, with a sensitivity of 82.4% and specificity of 74.6%. Conclusion: SVV is a middle-level effective variable to assess the abnormally low SVI caused by volume deficiency, while HR, MAP, CVP and PAWP have a low efficacy for the same assessment.

The implantation of the foldable multifocal intraocular lens,a new pseudophakia intraocular substitute,needs only a small incision and the post-operative complications are rare.The incoming light can be refracted into several fo-cuses.Improved visual acuities both for far and near distance are obtained,which downregulated the glasses-wearing rate.This article summarizes the theories and designs,implantation,clinical application,theropeutic outcomes,and complications of this type of multifocal intraocular lens.

The theory of ascending and descending activities of qi is one basic theory that guides diagnosis and treatment of disease clinically. It has been esteemed by ancient physicians throughout their academic thinking and clinical diagnosis. As a kind of unbalanced disease in the whole body, the basic internal mechanism of tumor formation may be caused by unbalanced ascending and descending activities of qi. Better clinical efficacy is liable to get by applying the theory of ascending and descending activities of qi in cancer treatment. Therefore, we hope to provide a reference for clinicians from the following aspects: historical status and academic value of the theory of ascending and descending activities of qi, case examples and classical prescriptions.
Humans ; Neoplasms ; diagnosis ; therapy ; Qi

As a characteristic tumor therapy in China, Chinese medicine (CM) plays an important position in comprehensive treatment of tumor. It's a critical issue of objective realization, analysis and evaluation of CM safety for scientific decision-making in tumor safe medication and it also is a pivotal issue which affects the international communication. The safety evaluation of CM includes three phases: pre-clinical safety evaluation, clinical trials (micro-dose studies and traditional clinical trials) and post-marketing CM safety assessment. The key point of evaluation should be distinguished among different stages and various types of CM (such as classic formulas, Chinese herbal extracts, etc). Emphasis should be given to chronic toxicity when evaluating oral Chinese herbal , microdose studies and quality control must be underlined while injection is evaluated and more attention should be pay to the dose-effect relationship and time-effect relationship when turned to toxic Chinese medicine , and so as for the toxicity grading study. Moreover, we should constantly improve CM safety assessment method in various stages of tumor treatment, such as introducing the concept of syndrome classification theory, bringing in metabonomics and real-world research method which are similar to the CM therapeutic concept. Most importantly, we must keep its own feature of CM theory when we learn the concept of safety evaluation from abroad. Actively exploring the anti-tumor medicine safety evaluation methods and strategies is of great significance for clinical and experimental research, and it can provide supportability platform to CM's international communication.
Animals ; Combined Modality Therapy ; Humans ; Medicine, Chinese Traditional ; adverse effects ; methods ; Neoplasms ; therapy ; Safety

Adolescent ; Child ; Child, Preschool ; Female ; Hepatocyte Growth Factor ; metabolism ; Humans ; Kidney ; metabolism ; pathology ; Male ; Nephrotic Syndrome ; metabolism ; pathology ; Proto-Oncogene Proteins c-met ; metabolism

Objective To assess and compare the affects upon renal function after endovascular exclusion (EVE) or conventional surgery (CS) for infrarenal abdominal aortic aneurysms(IAAA). Methods The records of 157 consecutive patients with IAAA from 1997 to 2002 were retrospectively reviewed. There were a group of 115 patients undergoing EVE and a group of 42 patients undergoing CS. The postoperative changes of plasma Cr and BUN with EVE and CS were analyzed respectively and compared. Results The plasma Cr and BUN were significantly increased in the group of CS postoperatively, but no significant difference were shown before and after endovascular repair was discovered in the group of EVE. Moreover, there was a case with acute renal failure in CS group. Conclusion The affects upon renal function with EVE are much less than CS for IAAA patients.

Objective To assess the value and safety of stent placement in treating proximal endoleak after endovascular exclusion for abdominal aortic aneurysms.Methods Three patients with primary endoleak and one patient with secondary endoleak underwent implantation of stent. Stents were deployed below renal artery in 1 case and cross bilateral renal arteries in 3 cases. Results In all 4 patients, the stents were successfully implanted and the endoleaks were completely occluded. No complications such as renal function damage, stent shift or endoleak reappearance were observed. Conclusion Stent placement appears to be a feasible, effective and safe treatment option for endoleak after endovascular exclusion for abdominal aortic aneurysms.

Objective To assess the prophylactic measures of paraplegia and paralysis after endovascular graft exclusion(EVE) for Stanford B thoracic aortic dissections(TAD). Methods The records of 116 consecutive patients undergoing endovascular TAD repair from 1998 to 2001 were retrospectively reviewed. Steroids were administrated postoperatively in high risk patients likely to be candidates for paraplegia or paralysis. Results No paraplegia or paralysis occurred postoperatively in all cases, including the patient undengone selective spinal artery angiography (SSAA). Conclusions Transluminal repair can avoid spinal cord ischemia due to aortic cross-clamping, there is still a risk of spinal cord injury caused by occlusion of intercostal arteries under the cover of endograft. A combination of the prophylactic measures, including SSAA and steroids, have been able to reduce the risk of paraplegia and paralysis. A graft-stent of appropriate length is the key point fo this procedure.

By means of a comprehensive coverage of the numbers,distribution,makeup and efficiency of health human resources in China,a comparative study was made as to the deployment for the present stage.It reveals the following findings:sufficient human resources in general,with its growth lagging behind economic development; out-of-balance deployment; irrational makeup as shown in the inverse ratio between doctors and nurses; good efficiency of the health professionals.Based on these findings,the researchers put forward the feasible policy suggestions as to optimizing the mechanisms of the introduction,training,evaluation and incentives for these professionals.

Angiopoietins ; metabolism ; physiology ; Animals ; Cell Proliferation ; Endothelial Cells ; cytology ; physiology ; Humans ; Neoplasms ; blood supply ; Neovascularization, Pathologic ; physiopathology ; Neovascularization, Physiologic ; physiology ; Pericytes ; cytology ; metabolism ; physiology ; Proto-Oncogene Proteins c-sis ; metabolism ; physiology ; Receptor, Platelet-Derived Growth Factor beta ; metabolism ; physiology ; Receptor, TIE-2 ; metabolism ; physiology ; Signal Transduction