Objective To evaluate the relationship between amniotic fluid (AF) epidermalgrowth factor (EGF) concentration and fetal pulmonary maturation. Methods Lecithin － sphin-gomyelin ratio (L/S) and EGF were measured in amniotic fluid from women(n = 138,21～42 weeks'gestation) undergoing amniocentesis by TLC and RIA. ResultsThe AF L/S ratio and EGF concen-tration increased linearly with Gestational age(GA) ( r = 0.8t3 and 0.87, respectively, P < 0.01 ).There was a strong correlation between the AF L/S ratio and EGF( r = 0.76, P < 0. 001 ). Conclu-sionThere are a confirmed relationship between AF EGF levels and fetal pulmonary maturation.

Objective To investigate the application value of the XT-4000i blood cell analyzer in body fluid cell count.Methods 113 cases of body fluid specimen were collected in the hospitalized patients from September 2013 to February 2014.Then RBC and WBC counts in the collected specimens were detected whitin 1 h by XT-4000i blood cell analyzer and the manual detection method, the RBC count values were divided into 3 levels:L1 100~1 000 ×106/L,L2 1 001 ×106 ~100 000 ×106/L and L3 > 100 000 × 106/L;WBC count values were divided into 2 levels:L1 1~50×106/L and L2 >50×106/L.The correlation between the two kinds of test methods was analyzed.Results The results of RBC and WBC counts detected by the XT-4000i blood cell analyzer and the manual method had a higher correlation.The correlation coefficients were 0.931,0.996,0.865,0.942 and 0.988.Conclusion The XT-4000i blood cell analyzer can be applied in clinical fluids cell count.

Objective To evaluate the effect of mild hypothermia on the activity of hippocampal pro tein kinase R-like endoplasmic reticulum kinase (PERK) in a mouse model of cerebral ischemia-reperfusion (I/R).Methods One hundred and twenty male C56BL6 mice,weighing 20-30 g,aged 7 weeks,were randomly divided into 3 groups (n=40 each) using a random number table:sham operation group (group S),I/R group,and mild hypothermia group (group H).Cerebral I/R was induced by occlusion of bilateral common carotid arteries for 15 min followed by reperfusion in anesthetized mice.In group H,surface cooling was performed immediately after reperfusion,and the rectal temperature was maintained at 32-34 ℃ for 3 h.In I/R and S groups,the rectal temperature was maintained at 36.8-37.2 ℃.At 6,12,24 and 72 h of reperfusion,10 mice were sacrificed in each group,and the hippocampi were removed for determination of the number of apoptotic neurons in hippocampal CA1 region (by TUNEL),and phosphorylated PERK (p-PERK) expression (by Western blot).Results Compared with group S,the number of apoptotic neurons was significantly increased,and the expression of p-PERK was up-regulated at each time point in I/R and H groups (P＜0.05).Compared with group I/R,the number of apoptotic neurons was significantly decreased,and the expression of p-PERK was downregulated at each time point in group H (P＜0.05).Conclusion Mild hypothermia can reduce endoplasmic reticulum stress through inhibiting hippocampal PERK activity,thus attenuating cerebral injury in a mouse model of cerebral I/R.

Objective To investigate the anesthetic management of perventricular closure of ventricular septal defects (VSD) under transesophageal echocardiography. Methods A retrospective review of the clinical data of 52 children who underwent perventricular closure of VSD under transesophageal echocardiography were analyzed. All the children were performed tracheal intubation under general anesthesia, and the electrocardiogram, pulse blood oxygen saturation, invasive arterial pressure, central venous pressure, end tidal carbon dioxide partial pressure, temperature and urine output were continuously monitored throughout the procedure. The transesophageal echocardiography was necessary for guiding transcatheter or per-ventricular device placement. Results Perventricular closure of VSD was successfully completed in 51 children under transesophageal echocardiography, the operation time was (76.7 ± 36.4) min, the anesthesia time was (89.5 ± 27.1) min; 1 child was converted to open surgical repair. Conclusions The intraoperative transesophageal echocardiography technology is the key to the success of the surgery. At the same time of analgesia and sedation, the anesthesia doctor needs to pay attention to the changes of hemodynamics in children.

Objective To observe the safety and efficacy of ultrasound-guided radiofrequency ablation(RFA)with artificial pleural effusion for cancer of the liver located under the diaphragm.Method Fifteen lesions in 11 patients with cancer of the liver located under the diaphragm were treated by RFA with artificial pleural effusion,for which 500-1000 ml normal saline was injected into the pleural cavity.Results Artificial pleural effusion was finished successfully,the whole tumor for all of 15 lesions were visualized by ultrasound and the ideal puncture pathway were easy to find.The artificial pleural effusion was vanished within 1 week after operation.All of the lesions were treated with RFA and complete necrosis was obtained in 13(86.7%)of the 15 lesions by CT or MRI.No severe complication was observed.Conclusion RFA with artificial pleural effusion is a safe and effective treatment option for patients with liver cancer under the diaphragm.

Objective To study the effect of transcutaneous electrical acupoint stimulation(TEAS) on endtidal concentration of sevoflurane in upper abdominal operation.Methods The use of prospective,randomized,blinded principles.A total of 50 patients underwent selective epigastric operations with ASA Ⅰ - Ⅱ were randomly divided into group A(25 cases) and B(25 cases).In group A,TEAS was performed and sevoflurane was inhaled during operation.In group B,only sevoflurane was inhaled and TEAS was not performed during operation.Electrical stimulation on Nei-guan,He-gu and Zu-sanli was performed for 30min before induction of anesthesia in group A and meanwhile patients in group B were waiting for 30min in operating room.After intubation,in group A,TEAS was performed persistently and sevoflurane was inhaled,meanwhile remifentanil was infused persistently during operation.In group B,only sevoflurane was inhaled and remifentanil was infused persistently during operation.At time points:before TEAS( T0 ),skin incision( T1 ),exploratory laparotomy( T2 ),30min after exploratory laparotomy ( T3 ),60min after exploratory laparotomy( T4 ),blood glucose and angiotensin Ⅱ were measured,recorded 10min after the start of surgery,once for each end-tidal sevoflurane concentration.Results End-tidal concentration of sevoflurane of group A ( 1.4 ± 0.2 ) ％,was significantly lower than group B( 1.9 ± 0.4 ) ％ ( t =3.147,P ＜ 0.01 ).Cortisol and angiotensin Ⅱ were increased at T1 and T2 compared with T0 in both groups(F =2.256,2.432,2.132,2.334,all P＜0.05).Cortisol and angiotensin Ⅱwere decreased in group A compared with in group B at T1 ～T4(t =2.159,2.232,2.453,2.602,al1 P ＜0.05).Conclusion TEAS can decrease end-tidal concentration of sevoflurane and stress response.TEAS combined with sevoflurane has synergistic effect on general anesthesia.

Objective To investigate the relationship between C-C chemokinereceptor type 2 (CCR2) and p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the dorsal root ganglion of rats and further clarify the mechanism of inflammatory pain.Methods Sevemy-two female Sprague-Dawley rats,weighing 150-180 g,aged 3-4 months,were randomly divided into 3 groups (n =24 each) using a random number table:control group (group C),inflammatory pain group (IP group) and CCR2 inhibitor RS102895 group (group RS).Inflammatory pain was induced by subcutaneous injection of Freund's adjuvant 100μl into the plantar surface of the right hindpaw.RS102895 20 mg/kg was injected subcutaneously once a day for 7 consecutive days in addition to Freund's adjuvant in group RS.Mechanical paw withdrawal threshold (MWT) was measured before injection and at 1,3,5 and 7 days after injection.At 3,5 and 7 days after injection,8 rats in each group were sacrificed and the dorsal root ganglions were removed for determination of the expression of CCR2 and phosphor-p38MAPK (p-p38MAPK) (by immuno-histochemical staining),and CCR2 and p38MAPK mRNA (using fluorescent quantitative PCR).Immuno-histochemical staining was scored.Results Compared with group C,MWT was significantly decreased after injection,the number of p-p38MAPK positive neurons and immuno-histochemical staining score were increased,and CCR2 and p38MAPK mRNA expression was up-regulated in IP and RS groups.Compared with group IP,MWT was significantly increased after injection,the number of p-p38MAPK positive neurons and immuno-histochemical staining score were decreased,and CCR2 and p3gMAPK mRNAexpression was down-regulated in RS group.Conclusion CCR2 in the dorsal root ganglion is involved in the development of inflammato pain possibility through activating p38MAPK signaling pathway in rats.

BACKGROUND:Recent reports only concern vertebroplasty for mild to moderate vertebral compression fractures, but seldom address vertebroplasty for severe vertebral compression fractures such as vertebral colapse. OBJECTIVE:To evaluate the efficacy and imaging features of percutaneous vertebroplasty for severe vertebral compression fractures. METHODS:A total of 25 patients underwent single-level vertebroplasty for vertebral compression fractures. Imaging features were then analyzed including location, pattern of compression, extent of colapse, pre- and post kyphotic angle and adjacent disc height before and after vertebroplasty. RESULTS AND CONCLUSION:60% (16/25) patients involved the thoracolumbar junction. The height of colapsed vertebral body was 14%-30% of original vertebral body. The average height of colapse was 5.17 mm or 22% of original vertebral body. Kyphotic angle before vertebroplasty ranged from 0-33° (averagely 16°) with an average correction of 12° after vertebroplasty. Average disc height before vertebroplasty was 7.3 mm above and 7.7 mm below. Visual analogue scale score was significantly higher preoperatively than that postoperatively, showing significant difference in pain improvement (P< 0.015). These data suggest that percutaneous vertebroplasty is safe and effective in the treatment of single level severe vertebral compression fractures.

Objective To evaluate the effect of electroacupuncture (EA) preconditioning on activity of AMP-activated protein kinase (AMPK) in hippocampal neurons during cerebral ischemiareperfusion (I/R) in mice.Methods A total of 60 male C57BL6 mice,aged 7 weeks,weighing 20-22 g,were randomly divided into 5 groups (n=12 each) using a random number table:control group (C group),sham operation group (S group),I/R group,acupuncture at acupoint Baihui preconditioning group (EA + I/R group),and acupuncture at non-acupoint preconditioning group (NEA + I/R group).Baihui acupoints were stimulated with electric stimulator (frequency 2 Hz/15 Hz,intensity 1 mA) for 30 min once a day for 5 consecutive days.At 24 h after the last stimulation,the model of cerebral I/R injury was established.Bilateral common carotid arteries were occluded by clipping for 15 min followed by reperfusion.Neurological deficit score (NDS) was assessed at 3 days after operation.Then the mice were sacrificed and the brains were immediately harvested for microscopic examination and for determination of apoptosis in hippocampal neurons (using TUNEL) and expression of phosphor-AMPKα (pAMPKα) and caspase-3 (by Western blot).Results Compared with group C,NDS and the number of apoptotic neurons in hippocampal CA1 region were significantly increased,and the expression of pAMPKα and caspase-3 was up-regulated in I/R and EA+I/R groups,and no significant change was found in the parameters mentioned above in group S.Compared with group I/R,NDS and the number of apoptotic neurons in hippocampal CA1 region were significantly increased,the expression of pAMPKα was up-regulated,and the expression of caspase-3 was down-regulated in group EA +I/R,and no significant change was found in the parameters mentioned above in group NEA+I/R.The pathological changes in hippocampal CA1 region were significantly attenuated in group EA + I/R as compared with group I/R.Conclusion The mechanism by which EA preconditioning mitigates apoptosis in hippocampal neurons during cerebral I/R is related to promotion of AMPK activation in mice.

Objective To study the clinical and pathologic features,histological criteria and pathologic factors contributing to diagnosis of mixed epithelial and mesenchymal tumors(mixed m?llerian tumors,MMT)of the uterus.Methods A retrospective study of 102 cases of MMT of the uterus (74 adenofibromas including 9 recurrent cases,3 atypical polypoid adenomyomas,2 carcinofibromas,10 adenosareomas and 13 carcinosarcomas)was undertaken.Clinical records,gross features and tissue slices were reviewed.The follow-up data were analysed.Results The most common symptom was vaginal bleeding.Clinical signs included pelvic mass,uterine polyps,and enlarged uterus.Benign MMT usually presented as exophytic polypoid masses extending into the uterine cavity or protruding through the external os,often broad-based,lobulated and papillary.It was hard to distinguish low-grade malignant MMT from the benign ones by gross appearance.High-grade malignant MMT had the common gross features of carcinoma and sarcoma.Histologically,MMT showed a biphasic differentiation of mesenchymal and epithelial components.MMT were classified according to whether these elements were benign or malignant.Nine cases of adenofibroma without unique features for the diagnosis of adenosarcoma recurred at postoperative intervals of 3 to 96 months.Recurrent tumors were almost always confined to the original site.Conclusions Uterine MMT tumors according to WHO diagnostic criteria are not rare.The differential diagnosis depends on a multifactorial analysis.The recurrent adenofibromas may be a kind of borderline tumors with benign appearances and malignant behavior.