Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.

Objective To assess the value of magnetic source imaging (MSI) in localizing the linguistic center of auditory function of epileptic patients before operation. Methods Epileptic focus and the linguistic center of auditory function in 24 patients were localized with MSI before operation. And the relationship between epileptic focus and auditory language area was observed. Results The linguistic center of auditory function was localized in left temporal lobe in 14 patients, in right temporal lobe in 5 patients and in bilaterial temporal lobe in 5 patients. Epileptic focus was localized in left temporal lobe in 14 patients, in left temporal lobe and left parietal lobe in 1 patient, in right temporal lobe in 4 patients, in right temporal lobe and parietal lobe in 1 patient, in left frontal lobe and left temporal lobe in 1 patient, in right frontal lobe, right temporal lobe and parietal lobe in 1 patient, and in bilaterial temporal lobe in 2 patients. Epileptic focus was superimposed with the linguistic center of auditory function in 10 patients, while was not superimposed with the linguistic center of auditory function in 10 patients. The epileptic focus was localized in front of the linguistic center of auditory function in 3 patients, in behind of the linguistic center of auditory function in 1 patient. The lesion of the patient suffered from dysembryoplastic neuroepithelial tumor was not excised completely because the epileptic focus was superimposed with the linguistic center of auditory function, and the patient appeared language functional disturbance after operation in short period, remaining auditory hallucination occasionally after operation. Conclusion Epileptic focus and the linguistic center of auditory function can be localized accurately and the relationship between them can be observed clearly with MSI. MSI is useful to reduce the occurrence of language disturbance after operation.

Pancreatic cancer is characterized by high invasiveness,high malignancy and poor prognosis. Therefore,it is urgent to find biomarkers for early diagnosis and to develop targeting drugs for treatment of pancreatic cancer. MicroRNAs (miRNAs)are single-stranded,non-coding small RNA molecules with a length of 18-25 nucleotides and are highly expressed in pancreatic cancer. MiRNAs play important roles in cell proliferation,differentiation,apoptosis,invasion and metastasis,and are associated with adverse prognosis and resistance to chemotherapy in pancreatic cancer. As a new target for diagnosis and treatment of pancreatic cancer,miRNA-21 has become the hot spot of clinical research. This article reviewed the advances in studies on miRNA-21 in the pathogenesis,diagnosis and treatment of pancreatic cancer.

Objective To investigate the expression and clinicopathological significance of CXCR4 and HIF-1α protein in esophageal squamous cell carcinoma tissue and explore their correlation.Methods The expression of CXCR4 and HIF-1α protein were assessed by immunohistochemistry SP method in 56 cases with esophageal squamous cell carcinoma and in 20 cases with surrounded normal tissue.Results The expressions of CXCR4 and HIF-lα in esophageal squamous cell carcinoma were significantly higher than those in normal tissues[62.50 ％ (35/56) vs 10.00 ％ (2/20); 57.14 ％ (32/56) vs 0(0/20)](x2=16.259,19.740,P ＜0.01).The expression of CXCR4 and HIF-1α were both correlated with invasion depth (x2 =4.736,7.665,P ＜0.05) and lymph node metastasis ( x2 =7.207,6.389,P ＜0.05),and had no correlation with cancer cell differentiation.The expressions of CXCR4 and HIF-lα in esophageal squamous cell carcinoma were positively correlated (r =0.298,P ＜0.05).Conclusion CXCR4 and HIF-1α are highly expressed in esophageal squamous cell carcinoma.The two have a close relation to esophageal squamous cell carcinoma growth,invasion and metastasis.

0.05). Conclusions The primary auditory cortex could be precisely localized by MSI.

With the development of business of manned spaceflight, the body damage of astronauts on the space en-vironment has received growing concern. Weight loss is the most important cause of various diseases, and the weightlessness muscle atrophy is one of urgent problems to be solved in aerospace medicine. Although there is no concept of weightlessness or weightlessness muscle atrophy in the theory of traditional Chinese medicine (TCM), TCM can grasp the pathogenesis of complex diseases, and provide important theoretical references for the prevention and management of weightlessness diseases, especially weightlessness muscle atrophy. In this paper, TCM Cognition of weightlessness and the pathogenesis of weightlessness muscle atrophy was studied by the sight of TCM theory of qi hoisting. The discussion was made from aspects of circulation of qi and blood, zang-fu function. This work is wished to be beneficial to apply the TCM theory in aerospace medicine.

Objective To observe the changes of magnetoencephalography (MEG) during stretching and flexing forefinger in one hemiplegic patient before and after rehabilitation training.MethodsThe cerebral electromagnetic wave of one hemiplegic patient during stretching and flexing both forefingers was recorded by MEG and superposed with magnetic resonance imaging (MRI) to form magnetic source imaging (MSI). The changes of MEG before and after rehabilitation training were analyzed.ResultsThere was no movement evoking magnetic fields in right hemisphere motor cortex at two MSI detections, but detected in left hemisphere motor cortex. The latent period of the first and the second detection was -34.2 ms and -61.7 ms respectively. The exiting motor cortex was located in precentral gyrus. The exiting motor cortex at the second detection was located more front medial and low than at the first detection. The volume of the exiting motor cortex (9569.6 m3) at the second detection was more larger than the first detection (2309.7 m3). There was no movement evoking somatosensory magnetic fields in right hemisphere motor cortex at first MSI detection, but found at the second detection, the latent period was 91.1 ms, and the exiting cortex was located in postcentral gyrus.ConclusionThe cortex somatosensory function of patient with stroke recovers early than the motor function and the uninjured hemisphere function can improve obviously after rehabilitation training.

Objective:To observe the effect of intravenous anesthesia with target-controlled infusion (TCI) of remifentanil combined with propofol on hemodynamics in middle-aged and elderly patients with intracranial aneurysm clipping. Methods:Totally 40 cases of middle-aged and elderly patients undergoing intracranial aneurysm clipping were divided into combined anesthesia group and propofol group according to the random number table. The combined anesthesia group was treated with remifentanil combined with propofol target intravenous anesthesia, and propofol group was treated with propofol intravenous hypotension. The changes of mean arterial pressure(MAP),heart rate(HR),cardiac output(CO) and heart index(CI) before the induction of anesthesia (T1), tracheal intubation (T2), before aneurysm clipping(T3), after aneurysm clipping(T4) and extubation (T5) were observed. The anesthesia maintenance time, extubation time, postoperative wake-up time and adverse reactions were compared. Results:There were no significant differences in MAP and HR between the groups(P > 0.05), the levels of MAP,HR,CO and CI at T2,T3and T4were significantly lower than those at T1,and CO and CI were significantly lower in combined group than those in propofol group(P < 0.05). Conclusion:TCI remifentanil combined with propofol can maintain hemodynamic stability, shorten extubation time and wake-up time, and reduce the incidence of adverse reactions in the patients with intracranial aneurysm clipping.

Objective:To study the influence of different culture conditions on charcic and inhibition activity of nature killer cells ( NK) ,whether to join the modified K562 cells with IL-6 cytokine.Methods:According to the 5′end of the human IL-6 cDNA sequence,PCR primers designed to amplificate,express and transfect K562 cells cDNA library as a template for DNA.Genetic modified K562 cells as stimulating cells were prepared by expressing IL-6.To extract peripheral blood mononuclear cells( PBMC) from human peripheral blood.PBMC were explanted by genetic modified K562 stimulated.The expansion was initiated by CO-culture of PBMC and irradiate genetic modified K562 cell.The number of NK cell increased by directed induced generation of genetic modified K562 cell.Immunophenotypic analysis of NK cell surface markers was performed by flow cytometry (FCM).51Cr release assay was employed to measure the specific lysis skilling of NK cell target K562 cells.Results:We have constracted genetic modified K562 cells by genetic engineering.As stimulated cell added into the PBMC,an average of 760 ±18 fold expansion of CD56+CD16+CD3-cells was observed after 3 weeks of co-culture system.The NK cells population could proliferated more 91%±2% after expansion comparing with 6%± 0.4%in PBMC before expansion by FCM.The cytotoxical activity of NK cells which was induced by genetic modified K562 cell was the strongest than induced by IL-6 cytokine alone.The expanded NK cells lysed 92%±2% of K562 targets in a 5∶1 effector to target ratio.In this case,the NK cells induced by genetic modified K562 cells against tumor cells was more lethal.Conclusion:PBMC based in vitro expansion of natural killer cells was set up by genetic modified K562 cells.The cytotoxicity of NK cells was the strongest induced by genetic modified K562 cell treated.These results had important guiding significance for the the NK large number of amplification and used in clinical.

Imaging examinations such as CT,MRI and ultrasonography are of great importance for the diagnosis of digestive system neoplasms. However,some digestive system neoplasms are difficult to be detected at early stage and make qualitative diagnosis by conventional imaging techniques because of their unique clinical characteristics. Compared with conventional imaging techniques,endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA)can not only detect the early lesions,but also make accurate qualitative diagnosis. The development and improvement of EUS-FNA greatly improve the diagnostic level of digestive system neoplasms. In this paper,the diagnostic value of EUS-FNA in digestive system neoplasms was reviewed.