Objective To investigate the effect of malignant tumor on neuromuscular block of cisatracurium. Methods Sixty ASA Ⅰ or Ⅱ patients with head and neck neoplasms (15 cases with benign tumor, 45 with malignant tumor), aged 18-64 yr, were randomly divided into 4 groups ( n = 15 each): Ⅰ benign tumor group (group B,3 × ED95 ); Ⅱ -Ⅳ different dose cisatracurium group (group C1 (2 × ED95 ), C2 (3 × ED95 ) and C3 (4 ×ED95)). Neuromuscular block was assessed with accelerograph F (TOF-watch SX). Single stimulation of ulnar nerve was used. Anesthesia was induced with TCI of propofol (target plasma concentration 3 μg/ml) and remifentanil (target effect-site concentration 3 ng/ml). Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg in group B, and with cisatracurium 0.10, 0.15 and 0.20 mg/kg in group C1, C2 and C3 respectively. The onset time, clinical duration, time for recovery of T/Tc to 75 % and recovery index were recorded. Results The clinical duration, time for recovery of T/Tc to 75 % and recovery index were significantly longer in group C2 than in group B (P ＜ 0.05). The onset time was significantly shorter, while the clinical duration and time for recovery of T/Tc to 75% were significantly longer in group C2 and C3 than in group C1 , and in group C3 than in group C2 ( P ＜0.05) .Conclusion The duration of action and recovery times of cisatracurium were prolonged in patients with malignant tumor.

BACKGROUND:Selection of resin core materials may affect the overal strength of the fiber posts.
OBJECTIVE:To compare the overal flexural strength of five kinds of resin core materials combined with glass fiber posts.
METHODS:Fifty viva glass fiber posts were randomly divided into five groups respectively binding to five different resin materials for repair:group A, MEDENTAL dual curing resin cement+glass fiber post;Group B, Tina dual curing resin cement+glass fiber post;group C, Bisco BisCem+glass fiber post;group D, 3M nano composite resin curing light P60+glass fiber post;group E, PULPDENT dual curing resin cement+glass fiber post. The root canals were embedded with self-curing plastic, and fixed in the universal testing machine. The load in tooth length axis was added onto the core at a 135° angle with a loading speed of 1.0 mm/min, until the fracture. Then, the stress at fracture and the fracture mode were measured.
RESULTS AND CONCLUSION:The flexural strength was (83.248±7.857) N in group, (89.230±4.326) N in group B, (95.188±5.147) N in group C, (76.646±6.463) N in group D, and (83.064±3.964) N in group E. Except groups A and E, there were significant differences between every two groups (P<0.05). These findings indicate that Bisco BisCem resin cement binding to the fiber post can obtain a higher flexural strength.

Objective:To introduce the method and clinical effect of inferior pedicle flap used in reduction mammoplasty.Methods:From January 2010 to December 2019, 19 patients with moderate to severe macromastia who underwent reduction mammoplasty with inferior pedicle flap were enrolled in this study. The method of inferior pedicle flap was based on Robbins vertical inferior pedicle flap. New position of nipple areola and inferior pedicle flap were designed in terms of the breast anatomy.Results:A total of 19 patients (38 breasts) were included in this study. The average tissue reduction of one side breast was 570 g (385 g to 1 525 g). After operation, all patients were satisfied with natural appearance and nipple erection effect. There were no operation-related complications including nipple-areola necrosis. After 6 months to 8 years following-up, No inverted T hypertrophic scar occurred. Hyperpigmentation occurred on two patients with dark-skinned. The position of bilateral nipples and areola was higher in 1 patient after operation. The other 18 patients were satisfied with the position and shape of nipples and areola.Conclusions:It is a good choice for patients with moderate to severe macromastia to receive reduction mammoplasty with inferior pedicle flap. Through the method, large amount of breast tissue reduction and stable blood supply of nipple and areola complex could be obtained.

Objective To discuss the effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma. Methods A total of 42 cases of severe craniocerebral trauma were randomized divided into two groups, ie, control group and treatment group, to observe the changes of brain tissue oxygen pressure ( PbtO2 ) , hematocrit (HCT) and 6-month Glasgow outcome scale (COS) after injury. Then, PbtO2, HCT and GOS were compared between two groups. Restilts ( 1 ) There was a positive correlation between PbtO2 and HCT when HCT was lower than 0.25( r =0. 732 ,P ＜0. 001 ) in the treatment group; while a negative correlation was found between PbtO2 and HCT when HCT was higher than 0.25(r = - 0. 698 ,P＜0. 001 ). (2) Compared with control group, the index of brain tissue oxygen in treatment group was obviously higher ( t = 2.27, P = 0. 029 ) , with better prognosis (X2= 5.09, P ＜ 0.05 ). Conclusion Hemodilution can significantly increase brain tissue oxygen supply and improve the prognosis of cases of severe craniocerebral trauma.

Objective To investigate the feasibility of centerline measurement method in estimating aortic diameter at the proximal landing zone in Stanford B type aortic dissection. Methods CT angiography materials of 30 patients with type B aortic dissection were randomly selected from the hospital database (24 males with a median age of 49.5 years), which were retrospectively analyzed with multiplanar reformation (MPR) and centerline technique by two experts in vascular radiology. Difference between two measurement techniques was analyzed by using mixed linear model, and the agreement of measurements between two readers as well as between two techniques were evaluated by Bland-Altman plots. Results The diameters measured with MPR method by two experts were (29.73±2.99) mm and (29.86±2.95) mm respectively, while the diameters measured with centerline measurement method by two experts were (29.66 ±2.81) mm and (29.71 ±2.91) mm respectively. No statistically significant differences in the diameter value existed between the two measurement methods, although the results determined by centerline measurement method were more stable. Conclusion In determining aortic diameter at the proximal landing zone in Stanford B type aortic dissection, the centerline analysis provides a checking method for MPR measurement.

Objective To investigate the difference of short-term clinical efficacy between decompressive laminectomy into In-Space and simple decompressive laminectomy for treatment of lumbar spinal stenosis with vertebral instability.Methods Thirty-three patients with lumbar spinal stenosis with vertebral instability admired from May 2009 to July 2010,were divided into two groups by random number table.Group A of 16 cases was treated with laminectomy decompression and placement In-Space,group B of 17 cases was treated with laminectomy decompression.Lumbar anteroposterior,lateral and flexion-extension X-ray films,preoperatively,and the follow-up were used to measure anterior and posterior disc height,foraminal height,segmental lordotic angle at surgical level.Using Oswestry disability index (ODI) and the visual analogue scale (VAS) to evaluate the clinical efficacy.Results All patients were followed up for (13.20 ± 2.91 ) months (range 6 to 21 months).The anterior disc height after operation of group A was slightly decreased compared with the preoperative(P＞ 0.05 ),the posterior disc height at 1 day after operation and foraminal height after operation of group A were significantly increased compared with the preoperative (P＜ 0.05).The anterior and posterior disc height,foraminal height of group B at 1 day,1 month,3 months after operation were no significantly different compared with the preoperative (P ＞ 0.05 ),at 6 months after operation and the end of follow-up were significantly decreased compared with the preoperative or 1 day after operation (P ＜ 0.05 ).Activity of lumbar vertebra by preoperative 9.86° ± 1.90° decreased to the end of followup 5.60° ± 2.02°in group A,while activity of lumbar vertebra by preoperative 9.89° ± 2.00°increased to the end of follow-up 10.76° ± 3.14° in group B.At the end of follow-up,lumbar back pain VAS,ODI score [ (2.02 ± 1.98 ),( 20.18 ± 18.80) scores ] of group A were significantly lower than those of group B [ (4.15 ±2.36),(30.39 ± 16.62 ) scores ],the differences were statistically significant (P ＜ 0.05 ).No patient suffered In-Space loosening,fracture and emerge.Conclusion The operation of In-Space can maintain spinal mobility and stability as well as avoiding lumbar vertebral instability,and its short-term efficacy is satisfactory.

Objective To explore the application value of carpal shoot through view in the palmar plating of distal radius fractures.Methods From March 2015 to May 2016,there were 62 acute distal radius fractures received various operation in our department,in which 48 patients were only performed volar locked plating.Among these 48 cases,there were 21 males and 27 females,with ages ranging from 17 to 75 years (mean 43.6±10.6 years).There were 15 cases of type A,11 cases of type B and 22 cases of type C distal radial fractures according to AO/OTA classification.All the operations were performed through modified Henry's approach between the radial artery and flexor carpi radialis.Once achieved satisfactory reduction,we performed rigid fixation of distal radius using anatomical locking plates.In all cases,bicortical drilling was performed.Screw lengths selected measured 1 to 2 mm less than the depth gauge number avoiding dorsal cortex penetration.After plate fixation of these 48 cases,standard posteroanterior and lateral radiographs were taken followed by the carpal shoot through view.To obtain carpal shoot through view,the patient's forearm was maximally supinated,the elbow flexed about 60°-70°and the wrist maximally dorsiflexed.The image intensifier beam is directed over the base of the thenar eminence.Compare the ratio of dorsal protrusion between standard view and carpal shoot through view,then statistical analysis was performed.After operation,CT scan was routinely taken to further test the effectiveness of carpal shoot through view.Results Five cases were detected dorsal cortex screw protrusion using standard posteroanterior and lateral views (10.4％,5/48).There were totally 16 cases (including the former 5 cases) of dorsal screw penetration uncovered by the carpal shoot through view(33.3％,16/48.Statistically significant difference was existed between the two fluoroscopy methods.Additionally,in 2 cases,a screw had penetrated the distal radioulnar joint (DRUJ),which was only apparent on the shoot through view.All the improper screws were exchanged and again were verified by the carpal shoot through view.The overall screw exchange rate was 37.5％ (18/48).Conclusion Compared with standard AP and lateral fluoroscopy,the carpal shoot through view can reliably reveals dorsal screw penetration.Meanwhile,it provides excellent visualization of DRUJ.

Objective To measure the level of interleukin-15(IL-15) in serum and its expression in lung tissues,and analyze the correlations between IL-15 and IL-4,IFN-?,eosinophil(Eos),and explore the effect of IL-15 on bronchial asthma.Methods Thirty femal BALB/C mice were randomly divided into three group(n=10),group A(asthma model),group B(corticosteroid treatment) and group C(normal control).All mice were killed 24 h after final OVA challenge.Blood were obtained for measurement of serum IgE,IL-4,IFN-? and IL-15 levels by enzyme-linked immunoabsorbent assay(ELISA).Bronchoalveolar lavage fluid(BLAF) was collected for Eos count.The left lungs were isolated for pathological examination.The lung sections were stained with hematoxylin and eosin(HE).The expressions of IL-15 in lung tissues were measured by immunohistochemical SP method.Results ①The mouse asthma model appeared ethological changes specific to asthma,the Eos count in BALF was increased,and IgE and IL-4 levels in serum were also increased compared with control group(P

Objective To evaluate the effect of the percutaneous transluminal septal myocardial ablation(PTSMA)on the left ventricular function in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods All HOCM patients underwent echocardiogram measurements before and after the PTSMA procedure.The peak velocity of mitral annulus was measured at Doppler tissue pulsed wave mode.Doppler tissue imaging(DTI)was obtained at the 4- and 2-chamber apical view,and the peak systolic(Sa),early diastolic(Ea),and late diastolic(Aa)myocardial velocities of mitral annulus was measured at the long apical view.Results Compared with the velocity parameters before the PTSMA procedure,the peak Sa and Ea after the PTSMA were significantly lower while Aa was un-significantly lower.Conclusions In patients with HOCM,the diastolic and systolic function of the left ventricle decreased after the PTSMA procedure.

Objective To evaluate the potential differences in serum proteomic profiles between patients with esophageal squamous cell carcinoma(ESCC)and precancerous lesions in order to establish proteomic pattern model for diagnosis of ESCC and precancerous lesions in high risk area,and to investigate its value in screening ESCC.Methods The serum and endoscopic biopsy samples were obtained from 38 normal controls,63 patients with atypical hyperplasia(class Ⅰ 26 cases,class Ⅱ 26 cases,class Ⅲ 11 cases)and 36 patients with advanced esophageal carcinoma.The serum proteomic patterns were examined using surface enhanced laser desorption/ionization time of flight mass spectrometry(SELDI-TOF-MS)and CM10 protein chip.The data was analyzed and disease diagnostic models were established using support vector machine(SVM).The diagnostic model was evaluated and validated by leave one cross validation.Results ①The diagnostic model could differentiate advanced esophageal carcinoma from normal controls with a specificity of 89.47%and a sensitivity of 83.33%.②The results delivered 92.31%,80.77% and 90.91%specificity,and 80.56%,83.33%and 94.44%sensitivity for discrimination of atypical hyperplasia Ⅰ,Ⅱand Ⅲ,respectively,using diagnostic models.③Four(4291,5644,5664,8775)m/z peaks observed repeatedly using diagnostic models.Conclusions The SELDI-TOF-MS and SVM provide a new approach for discrimination of ESCC and precancerous lesions in high risk area.Four(4291,5644,5664,8775)m/z peaks may considered as potential biomarkers which related to the ESCC and esophageal precancerous lesions.