Objective To compare the effects of different methods of anesthesia on immune function during renal transplantation. Methods Thirty-nine uremic patients of both sexes (20 male, 19 female) aged 19-65 yr, undergoing renal transplantation were studied. Patients who had infection, fever, immune system disease or had received immunoregulatory drugs were excluded. The patients were randomly divided into 3 equal groups: Ⅰ continuous epidural anesthesia group (CEA , n = 13); Ⅱ combined spinal-epidural anesthesia group (CSEA, n = 13) and Ⅲ general anesthesia group (GA , n = 13). In group I an epidural catheter was inserted at T12-L1 or L1-2 into epidural space and advanced in cephalad direction and a mixture of 2% lidocaine and 0.7% dicaine (1: 1) 11-12 ml was given. The height of block was T8 In group II CSEA was performed at L2-3 and a mixture of 1% dicaine, 10% glucose and 3% ephedrine (1 : 1 : 1) 3 ml was injected intrathecally. An epidural catheter was threaded in a cephalad direction. The block height was T8. 2 % lidocaine was given epidurally when the operation lasted more than 2 hours. In both group I and II pathidine 50 mg and droperidol 5 mg were given iv. In group III anesthesia was induced with fentanyl 5 ?g kg-1 , etomidate 0.3 mg ? kg-1 and vecuronium 0.08 mg ? kg-1 and maintained with isoflurane supplemented with intermittent iv boluses of vecuronium. Blood samples were obtained from peripheral vein for determination of CD+3 , CD+4 , CD+8 , CD+4 /CD+8 ratio and IgG, IgA, IgM, C3 , C4 before anesthesia (T0 ) , after anesthesia (T1), before blood transfusion (T2), 30 min and 1 h after blood transfusion (T3,4) ,when renal circulation was restored (T5), at the end of operation (T6 ) and 1 and 3 days after operation (T7.8) .Results There were no significant changes in T lymphocyte subgroups, immunoglobulins and complements measured after anesthesia (T1 ) as compared with the baseline values(T0) in the 3 groups. In group Ⅰ and Ⅱ CD+3 , CD+4 , IgG, IgA, IgM, C3 , C4 and CD+8 unchanged significantly as compared with the baseline values (T0 ) ; CD+4 /CD+8 ratio decreased after anesthesia ( P

Objective To study the effect of the magnetic field-treated water on metabolism of monoaminergic nerve transmitters in mice. Methods Twenty healthy aged Kunming mice were divided into a control group and an experimental group randomly. The mice in the control group were given tap-water and those in the experimental group magnetic field-treated water for 30 days. The content of monoaminergic nerve transmitters in brain of mice in the two groups were determined. Results A significant difference was found in the content of monoaminergic nerve transmitters between the control and the experimental groups. The contents of NE, DA, 5-HT and 5-HIAA increased significantly(P

Objective To study the significance of No12 lymphadenectomy in patients of advanced distal gastric cancer undergoing D2 distal or total gastrectomy.Methods Clinical and pathological data of 193 distal gastric cancer cases undergoing D2 gastrectomy and No12 lymphadenectomy during Jan 2012 and Jan 2013 were analyzed retrospectively.Results In Borrmann Ⅲ,Ⅳ No.12a LN metastasis was significantly higher than that in Borrmann Ⅰ,Ⅱ (x2 =4.841,P =0.028).In cases of multiple cancer 12a LN metastasis was significantly higher than that in gastric angle,gastric antrum (11.1％ 、9.7％ 、30.4％).High-differentiated cancer was lower in LN metastasis than that of low differentiated both in No.12a group (x2 =4.292,P =0.038),and in No.12b group (x2 =4.079,P =0.043).In cases with serosal invasion LN metastasis was higher than that without infiltration both in No.12a group (x2 =8.107,P =0.004),and in 12b group (x2 =3.836,P =0.050).In cases of N 0 ～ 1 the LN metastasis was lower than that in N 2 ～ 3 in 12a group (x2 =10.960,P=0.001),12b group (x2 =4.989,P =0.026),and in 12p group (x2 =4.433,P =0.035 respectively).In cases of tumor diameter ＜3 cm,3 ～5 cm and ＞5 cm,the 12a lymph node metastasis rate was 4.2％,10.0％,and 29.2％,respectively.Tumor size ＞ 5 cm has higher metastasis rate in No.12a group (x2 =6.464,P =0.011).Conclusions No.12 lymphadenectomy should be included routinely in D2 gastrectomy in patients of distal gastric carcinoma.

Objective:To compare the efficacy and safety of a new type of plastic biliary stent modified based on the pigtail nasobiliary duct and the common plastic biliary stent for hilar cholangiocarcinoma.Methods:Data of a total of 38 patients with obstructive jaundice caused by hilar cholangiocarcinoma who received endoscopic retrograde cholangiopancreatography (ERCP) palliative treatment at the Endoscopy Center, General Hospital of Northern Theater Command from June 2018 to December 2020 were collected, including 20 cases using the new type of plastic biliary stent (the new stent group), and 18 cases using the common plastic stent (the common stent group). Patients were followed up to May 30, 2021. The procedure time, hospital stay, postoperative biliary infection incidence, the bilirubin decrease, and the patency time of the stents in the two groups were compared.Results:The procedure time was 19.85±1.07 minutes in the new stent group and 22.00±3.38 minutes in the common stent group, respectively, showing no significant difference between them ( t=1.26, P=0.607). The lengths of hospital stay of the two groups were 11.45±2.39 days and 11.33±3.51 days, respectively, showing no significant difference between them ( t=-0.52, P=0.938). The median margins of total bilirubin reduction in the two groups were 122.85 μmol/L and 96.25 μmol/L, respectively, with significant difference ( Z=-2.03, P=0.042). The incidence of long-term cholangitis of the new stent group was significantly lower than that of the common stent group [10.0% (2/20) VS 44.4% (8/18), P=0.027]. The patency time of the new stent group was significantly longer than that of the common stent group (109.45±32.67 days VS 82.11±20.95 days) with significant difference ( t=2.23, P=0.032). Conclusion:In the palliative treatment of hilar bile duct obstruction, the new plastic bile duct stent modified based on pigtail type can reduce the incidence of long-term cholangitis and prolong the patency of bile duct stent compared with the common stent group.

AIM: To investigate the effect and mechanism of hypoxia inducible factor-1α on intestinal mucosal barrier in sepsis. METHODS: SD rats were randomly divided into 4 groups: sham group, sepsis group, sepsis+HIF-1α stimulant (sepsis+DMOG group), sepsis+HIF-1α inhibitor (sepsis+Bay87-2243 group), 6 rats in each group. Sepsis model was established by cecal ligation and perforation (CLP). The levels of inflammatory markers IL-1β, IL-6, TNF-α, oxidative stress markers MDA and antioxidant factors SOD and CAT were detected by ELISA and the expression of HIF-1α in intestinal mucosa was detected by Western blot. The pathological damage of intestinal mucosa was detected by HE staining. RESULTS: Inflammatory factors, oxidative stress factors and HIF-1α were significantly up-regulated in septic rats (P<0.05). The contents of IL-1β, IL-6, TNF-α and MDA in plasma were significantly decreased by intraperitoneal injection of DMOG (P<0.05); the levels of SOD and CAT in plasma were increased (P<0.05), HIF-1α was up-regulated (P<0.05), and the pathological damage of intestinal mucosa was alleviated, with decreased Chiu's score (P<0.05). Oral administration of Bay87-2243 gave the opposite result. CONCLUSION: HIF-1α has a protective effect on intestinal mucosal injury in sepsis. The mechanism may be related to the alleviation of inflammatory response and inhibition of oxidative stress.