Objective:To investigate the impacts of two anesthesia approaches on infections of immunological parameters during splenectomy in hepatocellular carcinoma patients .Methods: Sixty hepatocellular carcinoma patients were divided into two groups randomly,each groups was thirty (liver function Child-Pugh grade was A-B).Total intravenous anesthesia with pmpofol group (group A,n=30 ) and combined intravenous inhalational anesthesia with sevoflurane group (group B,n=30 ).Before induction of anesthesia , at the end of operation ,and after operation 24 hours.blood samples were collected to determined with the level of CD 3+,CD4+,CD8+, CD4+/CD8+and TNF-α, IL-2, IL-6 of hepatocellular carcinoma patients .Results: The perioperative physiological index MAP , HR, SpO2,RR each point had no obvious difference between two groups (P>0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+had no significant difference between two groups before anesthesia (P>0.05).There was no significant changes in CD3+,CD8+with two groups in all moments.Compared with the T0,A,B two groups of CD4+,CD4+/CD8+were lower (P<0.05)in T1 point,but T2 point and T0 point had no significant difference in group B .The levels of CD4+,CD4+/CD8+in group B were higher than in group A ( P<0.05 ) . Compared with T0 moment,group A and group B patients postoperative IL-6 in T1,T2 level increased significantly (P<0.05),and there was no statistically significant difference between group A and group B in all moment .( P>0.05 ) .Compared with the T0 moment,there was no significant change in group A of TNF-αlevel (P>0.05),while group B increased significantly in postoperative day ( P<0.05 ) .The level of IL-2 in each moment interval between the two groups had no significant difference ( P>0.05 ) . Conclusion: Both total intravenous anesthesia with pmpofol and combined intravenous inhalational anesthesia with sevoflurane inhibit the immune function of the patients with hepatocellular carcinoma cell immune reaction .The inhibitory effect of sevoflurane inhalation anesthesia on cell immune function is less affected .

OBJECTIVE:To explore the prognosis effect of Shengmai injection to the rt-PA thrombolysis on broadened thera-peutic window patients of mild-to-moderate cerebral infarction under the guidance of computer tomography(CT). METHODS:168 patients with mild-to-moderate cerebral infarction were randomly divided into control group (84 cases) and observation group (84 cases). Control group received rt-PA(0.9 mg/kg),and 10% of the total rt-PA was mixed and injected into patients within 1 min, the rest 90% adding into 250 ml 0.9% Sodium chloride injection (no less than 1 h),CT was performed after 24 h thrombolytic therapy,and the patients with no intracerebral hemorrhage in re-examination received 300 mg/d aspirin for 10 d,then 100 mg/d for 90 d,and appropriate statins,calcium antagonists,β-blockers and nitrates;observation group additionally received 40 ml Sheng-mai injection,adding into 250 ml 5% Glucose injection,intravenous infusion,once a day,for 28 d. National Institutes of Health Stroke Scale (NIHSS) score,Rankin score,daily living-Barthel Index (Barthel) score,rate of symptomatic intracranial hemor-rhage,rate of secondary hemorrhage,hospitalization time,3-month postoperative mortality and incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no significant differences in the NIHSS score,Rankin score and Barthel score(P>0.05). The NIHSS score in 2 groups after 6 h,24 h and 7 d were significantly lower than before,and observa-tion group was lower than control group after 24 h and 7 d;Rankin score after 3 months was significantly lower than before,and observation group was lower than control group;Barthel score after 3 months was significantly higher than before,and observation group was higher than control group,The differences were statistically significant (P<0.05). The hospitalization time in observa-tion group was significantly shorter than in control group,and 3-month postoperative mortality was significantly lower than control group,the differences were statistically significant(P<0.05). There were no obvious adverse reactions during treatment. CONCLU-SIONS:Based on conventional treatment,Shengmai injection has improvement in the rt-PA intravenous thrombolysis on broadened therapeutic window patients of mild-to-moderate cerebral infarction under the guidance of CT,it can reduce NIHSS score and Rankin score,increase Barthel score,shorten hospitalization time and reduce the 3-month postoperative mortality,with good safety.

Objective To explore the true psychological experience of youthful patients with breast cancer in the period of diagnosis. Methods Using qualitative research based on employed phenomeno-logical methods,12 young patients of breast cancer were deep-interviewed, the literal data of interview were processed and analyzed by Colaizzid analysis method. Results 5 themes were found by analysis:change of self identification, serious uncertainty, change of self role, worry about working and social value and shortage of knowledge and ability for early diagnosis. Conclusions The clinical workers should under-stand the real psychological experience of young patients with breast cancer in diagnosis period and help them overcome the difficult period in their life.

Objective To establish a rat model of tympanosclerosis(TS) by myringotomy and inoculation of streptococcus pneummoniae, and to observe the morphological change in the tympanic membrane (TM) and middle ear mucous.Methods Forty Sprague-Dawley rats were randomly divided into two groups (n=20/group) and then ten in each group were chosen to serve as the control and the other ten were set up for the TS model.Group A (myringotomy): myringotomy was performed on the bilateral TMs of all rats except the control group.Group B (bacterial inoculation): streptococcus pneumoniae was inoculated into the bilateral middle ear cavity of all rats except the control group.The condition of the TMs and the middle ears in the two groups were respectively examined at 2 weeks after myringotomy and at the five time points (1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks) after bacterial inoculation.Then the rats were decapitated and the morphological changes were observed by hematoxylin and eosin staining.Results One rat in group B died two weeks after the inoculation.In the two experimental groups, the calcifications were observed in 70%of the TMs (14/20) in group A and in 33.33%of the TMs (6/18) at 8 weeks in group B.At the same time, the inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membrane and middle ear mucous membrane.In the two control groups, neither morphological changes nor calcifications occurred.Conclusion The current study indicated that the animal model of TS was successfully accomplished by myringotomy and inoculation of streptococcus pneummoniae, and their morphological changes were basically consistent.However, the method of myringotomy is easier to use and can obtain a higher modeling rate in a relatively short time.

Actins ; metabolism ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Immunohistochemistry ; Myofibroma ; metabolism ; pathology ; surgery ; Stomach ; chemistry ; pathology ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVE:To observe the clinical efficacy and safety of vinpocetine combined with xueshuantong in the treatment of cerebral infarction.METHODS:56 patients with acute cerebral infarction were randomly divided into control group (28 cases) and observation group (28 cases).On the basis of routine treatment,control group was given Vinpocetine for injection 20 mg,once a day.Observation group was additionally given Xueshuantong for injection (lyophilized) 150 mg,intravenously,once a day,on the basis of control group.Both groups received treatment for 2 weeks.Clinical efficacies of 2 groups were observed.The levels ofNIHSS score、VEGF,vWF,sVCAM-1,sICAM-1,CRP and IL-8,the occurrence of ADR were observed before and after treatment.RESULTS:Total response rate of observation group (96.43％) was significantly higher than that of control group (78.57％),with statistical significance (P＜0.05).After treatment,the serum levels of VEGF in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group.The serum levels of NIHSS score、vWF,sVCAM-1,sICAM-1,CRP and IL-8 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Based on routine treatmem,vinpocetine combined with xueshuantong show good therapeutic efficacy and safety for cerebral infarction.

Objective To investigate the therapeutic effects of intravenous thrombolysis,intral-arterial thrombolysis,basilar artery embolectomy combined with stent implantation on patients with posterior-circulation infarction.Methods Fifty-seven patients with acute posterior circulation infarction (onset time within 6 to 72 h),admitted to our hospital from March 2005 to February 2013,were chosen; All subjects were randomly divided into three groups:group A,accepted intravenous thrombolysis (within 6 h of onset),group B,accepted intral-arterial thrombolysis (within 6-24 h of onset),and group C,accepted basilar artery embolectomy and stent implantation (over 24 h of onset).US National Institutes of Health Stroke Scale (NIHSS) was used to observe the clinical symptom improvement,and evaluate the results before and 24 h and 7 d after treatment.Three months after treatment,modified Rankin Scale (mRS) was employed to evaluate the clinical prognosis.Results Significant differences were noted in the treatment efficacy 24 h and 7 d after treatment among the three approaches (P＜0.05):that in group B was obviously higher than that in group A; that in group C was obviously higher than that in group A and B.The mRS scores were significantly different among the three groups (P＜0.05):the clinical outcome improvement in group B was obviously higher than that in group A; that in group C was obviously higher than that in group A and B.Conclusion Different treatments should be adopted based on the specific circumstances of the patients; for those with long time window of thrombolysis,basilar artery embolectomy combined with stent implantation might be more effective in improving the prognosis of the patients.

Objective To explore the relationship between hypoxia-inducible factor-1α (HIF-1α) expression and apoptosis in early brain injury models after subarachnoid hemorrhage (SAH).Methods Fifty-five adult male Sprague-Dawley rats were randomly assigned to five groups:sham-operated group,SAH 6 h,SAH 12 h,SAH 24 h and SAH 72 h groups (n=1 1).SAH in the later four groups was induced by modified monofilament puncture method.The rats were killed by cervical dislocation.HIF-1α expression was assessed by immunofluorescence staining.TUNEL was adopted to detect brain apoptotic cells.Immunofluorescence double staining was used to identify cell types with positive HIF-1α expression.Pearson correlation analysis was employed to analyze the relationship between HIF-1 expression percentage and TUNEL positive rate.Results As compared with those in the sham-operated group,the HIF-1 expression percentage and TUNEL positive rate in the four SAH groups was significantly higher (P＜0.05).Immunofluorescence double staining showed that neuron-specific nuclear protein staining cells were coincided with most HIF-1 positive cells,while only a few HIF-1α positive cells were coincided with glial fibrillary acidic protein staining cells.A significant positive correlation was noted between HIF-1 α expression percentage and TUNEL positive rate following SAH (r=0.737,P=0.001).Conclusion HIF-1α high expression after SAH early promotes neuronal cell apoptosis,indicating HIF-1 a might participate in the pathological progression of early brain injury after SAH.

Objective To investigate the risk factors of hemorrhagic transformation(HT) in patients with acute cerebral infarction(ACI).Methods A total of 335 patients with ACI from June 2013 to September 2016 was enrolled in this study,including 47 patients in hemorrhagic transform group(HT group) and 288 patients in non-hemorrhagic transformation group(NHT group).The general clinical situation,laboratory indexes,imaging features and treatment measures of the two groups were collected and compared,and then the risk factors of HT in the patients with ACI were analyzed by Logistic regression analysis.Results Univariate analysisshowed that there were significant differences between the two groups in the history of diabetes mellitus,hìstory of atrial fibrillation,NHISS score,systolic blood pressure at admission,fasting blood glucose,glycosylated hemoglobin,low density lipoprotein cholesterol,fibrinogen,infarct location,large area infarction and thrombolytic therapy(P＜0.05).Logistic regression analysis showed that history of atrial fibrillation(OR =2.703,95 ％ CI 1.169-6.250),high fasting blood glucose(OR =2.098,95 ％ CI 1.532-2.875),large area infarction(OR=9.999,95％CI 4.648-21.510) and thrombolytic therapy(OR=6.557,95％CI 1.954-22.003) were independent risk factors for HT.Conclusion The history of atrial fibrillation,high fasting blood glucose,large area infarction and thrombolytic therapy are the risk factors for HT in patients with ACI.Corresponding nursing measures should be arranged to facilitate the disease treatment.

OBJECTIVES: To investigate the expression of prostaglandin E2 receptor subtypes, E-prostanoid (EP) 1–4 receptors, in acquired cholesteatoma and its possible role in the pathologic process of this disorder. METHODS: Specimens of human acquired cholesteatoma were obtained from 29 patients and 19 skin biopsies of normal external auditory canal were as controls. The mRNA and protein expression of EP receptors was assessed by quantitative real-time polymerase chain reaction, immunohistochemistry and Western blot. RESULTS: In acquired cholesteatoma, EP1–EP4 receptors were mainly expressed on squamous epithelium and subepithelial infiltrated inflammatory cells. In external auditory canal skin, EP1–EP4 receptors were mainly expressed on squamous epithelium and glandular epithelium. The expression of EP4 receptor on mRNA and protein levels were significant lower in acquired cholesteatoma compared with controls. EP1–EP3 receptors had no significant difference between the experimental and control group. CONCLUSION: Low expression of EP4 may play a crucial role in the pathologic process of inflammation reaction and bone destruction in acquired cholesteatoma, but not EP1, EP2, or EP3 receptors.
Biopsy ; Blotting, Western ; Cholesteatoma ; Cholesteatoma, Middle Ear* ; Dinoprostone* ; Ear Canal ; Ear, Middle* ; Epithelium ; Humans ; Immunohistochemistry ; Inflammation ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Skin