It was developed that a new method for measuring the ratio of pulmonary blood flow tosystemic biood flow by two-dimensional Doppler echocardiography.Qp and Qs blood flow were consid-ered to be propotional to the mitral and tricuspid Doppler flow velocity time integral multipled respectively by mitral or tricuspid valve ring diameters(MVID or TVID),I.e.MVID/TVID was equal to Qp/Qs.With the method,we calculated the Qp/Qs ratio close to 1:1(0.939+/-0.083)in 18 normal Per-sons,0-656+/-0.167 in 15 patients with Tetralogy of Fallot.Qp/Qs in TOF corrected negativly With hemoglobin.Our results demonstrated that conventional Doppler mdthod to calculate the Qp/Os ratio can be simplified.

Liver hanging maneuver(LHM)was first performed to assist right hepateetomy by Jacques Belghiti in 2001.During the procedure of hepatectomy,the liver is lifted by a tape which passes between the anterior Surface of the inferior vena cava and the liver.LHM provides effective vascular control and makes the anterior approach safer and easier.As one of the most important innovations in the field of liver resection,LHM has some definite advantages over the classical approach,including less hemorrhage,less tumoral manipulation and rupture,better hemodynamic stability,reduced ischemic damage of the liver remnant and better survival for patients with hepatocellular carcinoma.Moreover,LHM can serve as a guide to the correct analomical transection plane,and help to improve the exposure of the deep parenchymal plane.LHM developed rapidly in the past few years and it has been widely adopted not only in the treatment of liver cancer,but also in living donor liver transplanration,orthotopic liver transplantation and the treatment of benign liver diseases.Furthermore,many surgeons utilize LHM to facilitate various anatomical liver resections.Although the concept of LHM is widely accepted,its limits and contraindications still need to be investigated in the future.

ObjectiveTo investigate the effects of isoflurane anesthesia on the expression of brain-derived neurotrophic factor (BDNF) and phosphorylated extracellular signal-regulated kinase (p-ERK) in neonatal rat hippocampus.MethodsForty-eight SD rats of both sexes,aged 7 days,weighing 12-17 g,were randomly divided into 2 groups ( n =24 each):control group (group C) and isoflurane anesthesia group (group Ⅰ).In group Ⅰ,the rats were exposed to2.5％ isotlurane for 3 min and then 1.5％ isoflurane was inhaled for 4 h,while in group C the rats were exposed to air for4 h.Arterial blood samples were collected immediately after anesthesia for blood gas analysis and for determination of the blood glucose concentration.Five rats in each group were sacrificed at 0,6,24 and 48 h after anesthesia (T1-4) and hippocanpi were removed for determination of the expression of potassiumchloride cotransporter 2 (KCC2),potassium-chloride cotrmsporter 1 (NKCC1),BDNF and p-ERK by Western blot.NKCC1/KCC2 ratio was calculated.ResultsAcid-base imbalance,hypoxemia and glycopenia were not found immediately after anesthesia in both groups.Compared with group C,KCC2 expression was significantly down-regulated and NKCC1/KCC2 ratio was increased at T3 and T4,and the expression of BDNF and p-ERK was dewn-regnlated at T1 and T2 in group Ⅰ (P＜0.05).There was no significant difference in NKCCI expression at each time point between groups Ⅰ and C ( P ＞ 0.05 )、ConclusionIsoflurane anesthesia delays the neuronal development in neonatal rat hippocampus through down-regulating the expression of BDNF and p-ERK.

Objective To discuss the predictable factors for the occurrence of intraoperative aneurysm rupture(IAR) of anterior circulation aneurysm treated by clipping.Methods The clinical data of 96 patients with 115 aneurysms treated by clipping were retrospectively analyzed.The univariate analysis and Logistic regression analysis was performed for the risk factors of IAR such as history of hypertension,pre-operative Hunt-Hess scale,aneurysm location,aneurysm sac,aneurysm dome/neck ratio,aneurysm direction,and operation time.Results Twenty-one patients occurred IAR [18.3 ％ (21/115) of aneurysms,21.9％ (21/96) of patients] during the operation,2 patients died and 94 patients were estimated by Rank scale:0 score was for 66 patients,2 scores was for 10 patients,3 scores was for 6 patients,4 scores was for 4 patients,5 scores was for 6 patients and 6 scores was for 2 patients at 6 months after surgery.Statistic analysis revealed that history of hypertension (P =0.037),pre-operative Hunt-Hess scale (P =0.040),aneurysm direction (P =0.009),aneurysm sac (P =0.010),operation time (P =0.001) and aneurysm dome/neck ratio (P =0.029) were the predictable factors for the occurrence of IAR,while aneurysm location was not included (P =0.198).Conclusion The history of hypertension,pre-operative Hunt-Hess scale,aneurysm direction,aneurysm sac,operation time and aneurysm dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors lead to the occurrence of IAR.

Objective: To evaluate the feasibility of hypofractionated intensity-modulated radiation therapy (IMRT) combined with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the hypopharynx. Methods:Patients with stageⅢ-ⅣA carcinoma of the hypopharynx were treated with IMRT and cisplatin-based concurrent chemotherapy. Two groups were di-vided according to the prescription dose to the primary gross tumor volume, as follows:Cohort-1 comprised patients who were recruit-ed before February 2013 (70 Gy/33 F and 2.12 Gy/F);and Cohort-2 comprised patients who were recruited since February 2013 (69 Gy/30 F and 2.30 Gy/F). Acute toxicities were evaluated. This study was registered with the number ChiCTR-ONRC-14004240. Results:Between August 2008 and December 2014, a total of 76 patients (35 in Cohort-1 and 41 in Cohort-2) were recruited. No xerostomia of grade 3 and higher was observed in all patients, who showed low incidences of grade 3 skin reaction, oral mucositis, and dysphagia. All patients did not show acute toxicities of higher than grade 4. No statistical differences in acute toxicities were observed between the two cohorts. No statistical difference was observed in acute toxicities between the IMRT techniques. Induction chemotherapy was the inde-pendent prognostic factor for grade 2 xerostomia (P=0.002). Conclusion:The 69 Gy/30 F hypofractionated IMRT was safe and effec-tive in the treatment of locally advanced squamous cell carcinoma of the hypopharynx. Late toxicities and long-term outcome need to be investigated further.

Objective To evaluate the effects of isoflurane anesthesia on inflammatory responses and long-term cognitive function in the hippocampi of neonatal rats .Methods Forty-six Sprague-Dawley rats of both sexes , aged 7 days ,weighing 12-17 g ,were randomly divided into 2 groups (n=23 each):control group (group C) and isoflurane anesthesia group (group I ) .In group I ,the rats were exposed to 2.5% isoflurane for 3 min to induce anesthesia and then exposed to 1.5% isoflurane for 4 h to maintain anesthesia ,while in group C the rats were only exposed to air for 4 h .Eight rats in each group were sacrificed and hippocampi were removed for determination of the levels of interleukin-6 ,interleukin-1βand tumor necrosis factor-α.Open field and Morris water maze tests were carried out three weeks later in the left rats .Results Compared with group C ,the escape latency was significantly prolonged ,the time of staying at the central region was shortened ,the time of staying at the border region was prolonged ,the total distance was reduced , and the contents of interleukin-1β and tumor necrosis factor-αwere increased in group I ( P<0.05) .Conclusion Isoflurane anesthesia results in decreased cognitive function ,which may be related to promotion of inflammatory responses in the hippocampi of neonatal rats .

Objective To evaluate the effects of ulinastatin pretreatment on cognitive dysfunction induced by chronic exposure to ketamine in immature mice.Methods Thirty-six healthy male C57BL/6 mice,aged 21 days,weighing 20-30 g,were randomly divided into 3 groups (n =12 each) using a random number table:control group (group C),ketamine group (group K),and ulinastatin pretreatment group (group U).In K and U groups,ketamine 30 mg/kg was injected intraperitoneally three times a day at 30-minute intervals for 21 consecutive days,while in group U,ulinastatin 50 000 U/kg was injected intraperitoneally at 30 min before the first injection of ketamine everyday.Cognitive function was assessed using Morris water maze and open field tests at 24 h after the last administration of ketamine.Mice in each group were sacrificed immediately after the end of the tests and hippocampi were harvested to determine the contents of interleukin-6 (IL-6),IL-1 and tumor necrosis factor-α (TNF-α) using ELISA.Results Compared with group C,the escape latency was significantly prolonged,the time spent in the original platform and in the central area for the open field was shortened,the frequency of crossing the original platform was decreased,and the contents of IL-1,IL-6,and TNF-α were increased in group K (P ＜ 0.05),while there were no significant differences in the indexes mentioned above in group U (P ＞ 0.05).Compared with group K,the escape latency was significantly shortened,the time spent in the original platform and in the central area for the open field was prolonged,the frequency of crossing the original platform was increased,and the contents of IL-1,IL-6,and TNF-α were decreased in group U (P ＜ 0.05).Conclusion Ulinastatin pretreatment can improve cognitive dysfunction induced by chronic exposure to ketamine in immature mice,and inhibition of inflammatory responses in hippocampi may be involved in the mechanism.

Objective To study the differential diagnosis o n cerebral concussion and mild cerebral contusion value of the brain type creati n e kinase isoenzyme(CK-BB),and evaluate the seriousness of brain damage and prog nosis of the patients with acute head injury.Methods Chromatographic separating and fluorometric quant ifying technique was used to detect the CK-BB activity in the cerebrospinal flu id(CSF) of 117 patients with acute head injury and 12 patients with increased in tracranial pressure and 20 normal people.Results The CSF-CK-BB activity of the patients with acu te head injury was remarkably higher than that of the normal people and the CSF -CK-BB activity increased with the seriousness of brain damage.There was a clo se relationship between CSF-CK-BB activity and prognosis,and higher activity o f CSF-CK-BB indicated poor prognosis.Conclusion CSF-CK -BB activity could be used as a new index to diagnose brain damage and evaluate the seriousness of brain damage and prognosis.

Objectives:To establish hybridomas secreting monoclonal antibodies(McAbs) against O6-methylguanine-DNA methyltransferase(MGMT) and to observe the relationship between MGMT expression and clinical responses to ACNU and BCNU in human brain tumors.Methods:The hybridomas were established by cell fusion.MGMT expression in 60 glioma specimens was detected by means of immunohistochemical assay.Results: Seven hybridomas secreting McAbs against MGMT were obtained.Thirty tumor specimens had no detectable or low level of MGMT expression(Mer-), while 30 specimens had high level of MGMT expression(Mer+). The Mer- patients showed more sensitive to ACNU and BCNU than the Mer+ patients.Conclusions: The high specific hybridomas secreting monoclonal antibodies(McAbs) against MGMT were established.The preliminary study indicated that MGMT negative tumors were sensitive to ACNU and BCNU, whereas MGMT positive ones were more resistant to nitrosourea drugs.

INTRODUCTIONThe proteins found in tears play an important role in maintaining the ocular surface and changes in tear protein components may reflect changes in the health of the ocular surface. Proteomics provides a comprehensive approach for cataloguing all the proteins of the tear proteome, which will help to elucidate disease pathogenesis, make clinical diagnoses and evaluate the influence of medications on the structure, composition and secretion of tear proteins. In this study, an alternative proteomic strategy was investigated to explore the human tear proteome.

MATERIALS AND METHODSTear samples were obtained from patients who had pterygium and were collected on the first day and third day after pterygium surgery. Tears pooled from 6 patients were used in the analysis. Reverse-phase high-pressure liquid chromatograph (RPHPLC) was used as the first step to separate intact proteins into 21 peaks. Each fraction was then tryptic-digested and analysed by nanoLC-nano-ESI-MS/MS to characterise the protein components in each fraction.

RESULTSIn total, 60 tear proteins were identified with high confidence, including well-known abundant tear proteins, and tear-specific proteins such as lacritin and proline-rich proteins. Among them, proline-rich protein 5 was found for the first time in tear fluid. A large number of plasma proteins were also observed in tear fluid.

CONCLUSIONSThe results showed that the proteomic strategy used in this study was successfully applied to analyse tear proteome.