Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each):the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.

The level of serum soluble interleukin-2 receptor(sIL-2R)was measured in 103 patientswith hepatitis B and 26 hepatitis B virus(HBV)carriers by enzyme-linked assay.The sIL-2Rconcentration were elevated significantly in each type of hepatitis B patients and HBV carriers,compared with control group(P

Objective To evaluate the effect of goal-directed fluid therapy on postoperative rehabili-tation in elderly patients undergoing surgery in the prone position.Methods Sixty patients of both sexes,aged 60-75 yr,of American Society of Anesthesiologists physieal status Ⅱ or Ⅲ,scheduled for elective lumbar surgery in the prone position under general anesthesia,were divided into 2 groups (n =30 each) using a random number table:conventional fluid therapy group (group C) and goal-directed fluid therapy group (group G).The CNAP system was used to monitor stroke volume variation and cardiac index continuously in group G.Mean arterial pressure was maintained at 60-110 mmHg,central venous pressure at 6-12 emH2O and urine volume more than 0.5 ml · kg-1 · h 1 using conventional fluid therapy in group C.In group G,goal-directed fluid therapy was performed under the guidance of stroke volume variation,and cardiac index was maintained at 2.5-4.0 L · min-1 · m 2.The requirement for crystalloid and colloid solution,total volume of fluid infu sed,blood loss,urine volume and requirement for vasoaetive agents were recorded during operation.After anesthesia induction,at 1 h after turning to the prone position and at the end of operation,blood samples were collected fromn the left radial artery for blood gas analysis,and the blood lactate concentration was recorded.The volume of drainage within 3 dlays after operation,perioperative blood transfusion,early postoperative cardiovascular and pulmonary complications,development of oliguria and anuria,emergence time and length of hospital stay were recorded.Results Compared with group C,the requirement for crystalloid solution,total volume of fluid infused,urine volume and requirement for vasoactive agents were significantly decreased during operation,the requirement for colloid solution was increased during operation,the blood lactate concentration was decreased at 1 h after turning to the prone position and at the end of operation,the length of hospital stay was shortened,and the incidence of postoperative cardiovascular and pulnonary eomplications was decreased in group G (P＜0.05).Conclusion Goal-directed fluid therapy can promote postoperative rehabilitation and shows a certain clinical value in elderly patients undergoing surgery in the prone position.

Objective To explore the clinical effect and application value of four-point internal fixation technique (internal fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique) for traumatic atlantoaxial instability.Methods A total of 16 patients with traumatic atlanto- axial instability,who had reducible atlantoaxial dislocation with reduction after traction and irreducible at- lantoaxial dislocation with traction reduction after anterior laxation,were treated with four-point internal fixation technique using autologous bone grafts.Results All patients' symptoms were improved to some extent,and no severe complications,such as injury of nerve blood vessels were found.All patients were followed up for 8-26 months (average 16 months).Bony fusion was obtained in all cases.The spinal cord function improvement was marked in 5 cases (31%),good in 8(50%),mild in 2(13%),but un- changed in 1 (6%).No deterioration occurred in all cases.There was no loosening or breakage of screws and clamps.Conclusion Fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique can atlain four-point internal fixation,and can provide three-dimensional stability of atlantoaxial complex and excellent biomechanics environment for bony fusion if the structure of the posterior arch of C_1-C_2 is intact.

Objective:The present study was designed to test the hypothesis that inflammation is involved in the end-organ damage(EOD) induced by sinoaortic denervation(SAD) in rats.Method:SAD was performed in male Sprague-Dawley rats at the age of 10 weeks.Under anaesthesia,aortic nerves were cut and the sinus region of the carotid artery was stripped and painted with 10% phenol.Pathological evaluation of EOD and the determination of plasma or tissue levels of the factors related to inflammation,including thromboxane B2(TXB2) interleukin-1(IL-1),tumour necrosis factor α(TNF-α) and reactive oxygen species(ROS) were performed at 16 weeks after SAD.Pathological evaluation of EOD included heart weigh ratio,myocardial and blood vessel hydroxyproline and collagen volume fraction,glomerular injury score and number of infiltrating inflammatory cells.Indomethacin(20 mg/kg per day,orally) or vitamin E(100 mg/kg per day,orally) was administered for 12 weeks,beginning from4 weeks after SAD,to observe their effects on SAD-induced EOD.Results:There were significant fibrosis and inflammatory infiltration in the myocardium and blood vessels,represented by higher hydroxyproline and collagen volume fraction,and a large amount of inflammatory cells in the tissues of SAD rats.Heart weight and kidney glomerular injury score were significantly higher in ed significantly after SAD.Indomethacin and vitamin E significantly decreased the contents of some factors related to inflammation in SAD rats.Both drugs also alleviated myocardial and vessel fibrosis,inflammatory infiltration and kidney damage.Conclusion:Inflammation is involved in the organ damage induced by SAD in rats.

Objective:The present study was designed to test the hypothesis that inflammation is involved in the end-organ damage(EOD) induced by sinoaortic denervation(SAD) in rats.Method:SAD was performed in male Sprague-Dawley rats at the age of 10 weeks.Under anaesthesia,aortic nerves were cut and the sinus region of the carotid artery was stripped and painted with 10% phenol.Pathological evaluation of EOD and the determination of plasma or tissue levels of the factors related to inflammation,including thromboxane B2(TXB2) interleukin-1(IL-1),tumour necrosis factor α(TNF-α) and reactive oxygen species(ROS) were performed at 16 weeks after SAD.Pathological evaluation of EOD included heart weigh ratio,myocardial and blood vessel hydroxyproline and collagen volume fraction,glomerular injury score and number of infiltrating inflammatory cells.Indomethacin(20 mg/kg per day,orally) or vitamin E(100 mg/kg per day,orally) was administered for 12 weeks,beginning from4 weeks after SAD,to observe their effects on SAD-induced EOD.Results:There were significant fibrosis and inflammatory infiltration in the myocardium and blood vessels,represented by higher hydroxyproline and collagen volume fraction,and a large amount of inflammatory cells in the tissues of SAD rats.Heart weight and kidney glomerular injury score were significantly higher in ed significantly after SAD.Indomethacin and vitamin E significantly decreased the contents of some factors related to inflammation in SAD rats.Both drugs also alleviated myocardial and vessel fibrosis,inflammatory infiltration and kidney damage.Conclusion:Inflammation is involved in the organ damage induced by SAD in rats.

Aged ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; immunology ; Prognosis ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo observe and measure morphological parameters of the Chinese atlanto-odontoid joint anatomically in order to provide an anatomic data for designing artificial atlanto-odontoid joint used for substituting the destroyed atlanto-odontoid joint in the orthopedic clinic.

METHODSThe relative anatomic parameters of 32 sets of fresh Chinese adults'atlanto-odontoid joint specimens were measured with a digital caliper and a goniometer, including the width of anterior arch of atlas (AW), the thickness of atlas at the junction of anterior arch and lateral mass (AD), the thickness and height of anterior tubercle of atlas (AT and AH), the middle height, length and width of the lateral mass (MHL, L and LW), the height, transverse and anteroposterior distance of odontoid process (DH, DW and DD), the retroversion angle of odontoid process (beta degree),the facial angle of odontoid process (theta degree) and so on. The data were statistically analyzed in order to ascertain the morphological parameter ranges of artificial atlanto-odontoid joint. An artificial atlanto-odontoid joint was designed according to these data. The operations of anlanto-odontoid joint arthroplasty were conducted in 3 cases of adult cadaver specimens.

RESULTSThe width of AW was (20.45+/-1.53) mm, AD (3.91+/-1.32) mm, AT and AH (9.43+/-1.93)mm and (10.23+/-1.32) mm, respectively, MHL and LW (13.68+/-1.38) mm and (12.98+/-1.52) mm, respectively, DH (15.25+/-2.11) mm, DW and DD (9.69+/-1.38) mm and (11.26+/-1.02) mm, respectively, beta degree (12.23+/-4.27) degree, theta degree (65.48+/-2.17) degree. The prosthesis was composed of atlas part, axis part and accessories. Neither the vertebral artery nor the medulla oblongata was injured.

CONCLUSIONSThe design of artificial atlanto-odontoid joint is feasible according to these parameters. The artificial joint can not only rebuild the stability of atlanto-axial joint, but also reserve the rotation function between atlas and axis. Every part of the joint has their own parameter ranges in purpose to firm fixation, convenient operation and good motion without further injury. The prosthesis can be used for patients suffering from compression of medulla oblongata and resection of dens when it is required.

Adult ; Asian Continental Ancestry Group ; Atlanto-Axial Joint ; anatomy & histology ; China ; Female ; Humans ; Joint Prosthesis ; Male ; Middle Aged ; Odontoid Process ; anatomy & histology

OBJECTIVETo investigate the reduction of chlorination by-products (CBPs) precursors using the fluidized-bed biofilm reactor (FBBR).

METHODSReduction of total organic carbon (TOC), ultraviolet absorbance (UV254), trihalomethane (THM) formation potential (THMFP), haloacetic acid (HAA) formation potential (HAAFP), and ammonia in FBBR were evaluated in detail. Results The reduction of TOC or UV254 was low, on average 12.6% and 4.7%, respectively, while the reduction of THMFP and HAAFP was significant. The reduction of ammonia was 30%-40% even below 3 degrees C, however, it could quickly rise to over 50% above 3degrees C. Conclusions The FBBR effectively reduces CBPs and ammonia in drinking water even at low temperature and seems to be a very promising and competitive drinking water reactor for polluted surface source waters, especially in China.

Biofilms ; Chlorine ; Water Purification

OBJECTIVETo investigate the feasibility of reducing THM precursors and controlling bromate taste and odor in drinking water taken from the Yellow River by an ozonation combined system.

METHODSThe appropriate ozone dosage was determined, and then the changes of TOC, UV254 and THM formation potential (THMFP) in the combined system were evaluated.

RESULTSOne mg/L ozone could effectively remove taste and odor and meet the maximum allowable bromate level in drinking water. The pre-ozonation increased THMFP, but the conventional treatment system could effectively reduce the odor. The bio-ceramic filter could partly reduce CHCl3FP, but sometimes might increase CHCl2BrFP and CHClBr2FP. The biological activated carbon (BAC) filter could effectively reduce CHCl3FP and CHCl2BrFP, but increase CHClBr2FP. Compared with other filters, the fresh activated carbon (FAC) filter performed better in reducing THMFP and even reduced CHClBr2FP.

CONCLUSIONThe combined system can effectively reduce taste, odor, CHCl3FP, and CHCl2BrFP and also bring bromate under control.

Bromates ; chemistry ; isolation & purification ; China ; Chlorine ; Humans ; Odorants ; analysis ; prevention & control ; Ozone ; chemistry ; pharmacology ; Rivers ; chemistry ; Taste ; Trihalomethanes ; chemistry ; isolation & purification ; Water Supply ; analysis ; standards