Objective To compare the effects of target-controlled infusion(TCI) of remifentanil in three different doses in thoracic patients undergoing total intravenous anesthesia.Methods Forty-five ASA Ⅰ～Ⅱ patients aged 40～60yr undergoing thoracic surgery were randomly divided into three groups.The patients were given midazolam 0.05mg/kg and artropine 0.5 mg/kg i.m.before anesthesia.Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously.The target concentration of propofol was set at 3?g/ml and remifentanil at 4,6,8ng/ml(groupⅠ,Ⅱ,Ⅲ).When the patients lost conscionsness,rocuronium 0.6mg/kg was given i.v.to facilitate intubation.Anesthesia was maintained with TCI of propofol-remifentanil and intermittent i.v.boluses of rocuronium.Remifentanil target concentration maintained unchanged during anesthesia.BIS index was controlled at 45～55 by modify propofol target concentration.SBP,DBP,MAP,HR and BIS index was recorded in baseline(T0),before intubation(T1),intubation(T2),skin incision(T3),the opening of the chest(T4),skin closuer(T5),extubation(T6).Vein blood samples were taken for determination of plasma concentration of epinephrine(E) and norepinephrine(NE) by ELASA.Results SBP,DBP,MAP,HR and plasma NE concentration at T2,T3,T4,T5 were higher than T0 in group Ⅰ(P

Objective · To evaluate the clinical characteristics of endometrial pathology in postmenopausal women with asymptomatic thickened endometrium. Methods · A retrospective review was conducted of the patients between October 2013 and October 2015 in the International Peace Maternity & Child Health Hospital. The postmenopausal women with asymptomatic thickened endometrium of 5 mm or more found by transvaginal ultrasonography were recruited. They underwent hysteroscopy and endometrial sampling to analyze the relationship between endometrial pathology and endometrial thickness. Results · A total of 257 patients were recruited. The average age was 61.3 years old, the average menopause period was 122 months, and the average endometrium thickness was 8.6 mm. The endometrial pathology included normal atrophic endometrium, endometrial polyp, submucous myoma, intrauterine adhesion, uterine septum, endometrial hyperplasia and endometrial cancer. The most common pathological type was endometrial polyp, accounting for 66.9% of the all patients and 83.9% (172/205) of all pathological types. Three cases of adenocarcinoma (1.2%) were diagnosed. There was significant difference in endometrial thickness among normal endometrium, endometrial polyp and endometrial cancer (P<0.05). The endometrium in endometrial cancer was the thickest, which was (13.20±5.38) mm averagely. There was significant difference in ages among the pathological types (P=0.004). Conclusion · There are few patients of malignancy among asymptomatic postmenopausal women with thickened endometrium. Follow-up visits were recommended to these women.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Fracture Fixation ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Humans ; Intraoperative Period ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Recovery of Function ; Smell ; Young Adult

Objective To investigate the effects of robot-assisted walking training after total knee replacement (TKR).Methods Forty TKR patients at 1 week post-operation were randomized into a control group (n =20) and a treated group (n =20).For 2 weeks the control group accepted routine rehabilitation therapy.The treated group received the same treatment as the control group,but also walking training using a robot-assisted walking training system.The results were evaluated using the Hospital for Special Surgery knee rating scale (HSS),knee proprioception grading,Berg scores,and 6 minute walking distance in both groups.All the analyses were administered before the operation and 2 weeks,l month,3 months and 12 months after the operation.Results The treated group had significantly better HSS scores,Berg scores,and 6 minute walking distances than the control group on average.However,there was no significant difference in average knee proprioception between the two groups.Conclusion Robot-assisted walking training was significantly more effective than conventional rehabilitation alone in improving knee joint function,balance ability and walking after TKR.

Objective Detecting the level of IDO and KYN in ulcerative colitis (UC) patients; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of dis-ease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent (ELISA) methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression (P<0.05). There was a positive correlation between KYN level and IDO expression (P<0.05). ②The levels of IDO and KYN in UC group were higher than those of disease control group and health control group (P<0.05). ③The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC (P<0.01), and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels (P<0.05). ⑤The IDO,KYN and CRP area under ROC curve were 0.976, 0.856 and 0.864;best cut-off point were 53.66 U/L, 2.34 nmol/L and 1.75 mg/ml;sensitiv-ity were 90.5%, 78.65% and 100.0%; specifity were 94.4%, 83.3% and 61.1%; Youden index were 0.839 2, 0.619 0 and 0.611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

ObjectiveTo investigate the cell toxicity of a novel macropores calcium phosphate cement (CPC) scaffold and its influence on cell adhesion,growth and proliferation.MethodsA novel CPC material was synthesized by means of adding mannitol porogens and applying sodium solution as the cement liquid.The cell growth and proliferation in the novel CPC material extraction was observed by CCK8 assay.Scanning electron microscopy was used to observe hole diameter of the material,cell adhesion and growth in the material.The experiment of three point bending was used to test the biomechanic performance of the CPC material.ResultsThe novel CPC material reached hole diameter value of (267.43±118.01)μm,microporosity of (66.15±6.91)％.Maximum load,flexural strength and toughness of the novel CPC material was increased about one time compared to the traditional CPC(P＜0.05).CCK8 assay showed there were no significant difference of the light absorption value of cells in the CPC extraction in the 4th,6th,8th day compare to the control group (P＞0.05).ConclusionThe novel CPC material has the strong biomechanics performance,macropores,high microporosity and excellent biocompatibility,which is promising for ideal bone tissue engineering scaffold.

Objective To analyze the clinical value of chemotherapy combined with endocine therapy after standard treatment failure for advanced metastatic breast cancer.Methods 30 metastatic breast cancer patients after standard treatment failure were analyzed.Etoposide (75-100 mg/d) wasused on days 1-10,followed by 11 days of rest combined with medroxyprogesterone 0.5 g,twice per day,or megestrol 160 mg/d for 21 days.Clinical effects and life quility were analysed.Results The median treatment line of this therapy was 6 (range 3-9).The clinical benefit rate is 16.7 ％ (5/30),and the median progression free survival (PFS) was 4.0 months (range 1.0-13.0 months).Conclusion The combination of chemotherapy (etoposide) and endocrine therapy (progesterone) is a choice of treatment after standard drug failure for advanced mastatic breast cancer patients.

Objective To screen the mimic epitopes of Rh(D)blood group antigens and identify their immunity from phage display peptide library.Methods A twelve mer phage peptide library was biopanned with anti-Rh(D)monoclonal antibody immobilized on plastic surface.After three round panning,thirty-five clones were randomly selected and positive clones were identified by ELISA and cross-reaction,followed by antibody competition inhibition assay and DNA sequencing to obtain the mimic epitopes of Rh (D)blood type antigens.The target phage clones were characterized and the antigenicity was analyzed by Western blot.Results After the third round screening,phages were enriched,and eleven positive clones were obtained.According to sequencing and competition inhibition analysis,the same"-WP-Q-"structure existed in seven of the eleven clones,and they had more than 40%inhibition ratio.The other clones had no same characteristics with low inhibition ratio possibly due to non-specific binding.Western blot analysis indicated that these phage clones could be specifically recognized by the anti-Rh(D)serum and they shared the same antigenicity of Rh(D)protein.Conclusions Rh(D)mimotope of"-WP-Q-"structure is successfully obtained by phage peptide library screening with anti-Rh(D)monoelonal antibody.The results lay the foundation for further exploration of pathogenesis and vaccine development of Rh(D)hemolytic diseases of newborn.