Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; pathology ; Retrospective Studies

Objective To discuss the epidural cavity surgical anatomical physiology under fiber optic epidural catheter, and to analyze the technological advantages compared to the the agent under blind. Methods 60 cases who need to epidural abdominal surgery from Jan. to Nov. 2013 were collected. Common duct (30 cases) and fiber optical epidural catheter (30 cases) were respectively used at anesthesia, and the epidural cavity surgical anatomy physiology were observed. Results Compared with indexs before anesthesia, before induction and before intubation, the HR, SPB, and MAP in 5 min after intubation and at the moment of skin incision were of statistically significant differ-ences (P<0. 05). There is a cavity between epidural space and vertebral canal periosteum which is not linked to cranial cavity, but there were a certain amount of connective tissue and venous plexus. The volume of the cavity was about 100 mL, the front and side were narrow and the back was wide, and it began to gradually expand from the neck, and reached its peak at the waist, and then gradually narrowed, un-til the sacral hiatus. Conclusion Fiber optic epidural catheter could make the patient’ s anatomy physiology structure more clear, and it also make it possible to cathetering visually for the anesthesiologist.

Objective To analyze tumor-free survival rate and recurrence rate of radiofrequency ablation (RFA) versus surgical resection(SR) for small hepatocellular carcinoma. Methods Clinical data of 64 patients (hospitalized from October 2008 to October 2010) with small hepatocellular carcinoma(≤ 5 cm) in our hospital were retrospectively analyzed. 29 cases among them underwent RFA, and the 35 cases underwent SR, then they were further divided into two groups according to the tumor diameter (≤ 3 cm vs. ≤ 3 ~ 5 cm). The rate of complete elimination of tumor , complications , recurrence and metastasis , and survival rate out of tumor-free at year 1, 3, and 5 were compared. Accumulated survival rate of the two groups at year 1, 3, and 5 were compared. Results The rate of complete elimination of tumor, and complications in the RFA group were 89.66% and 6.9% respectively, and no statistically significant difference was found compared with the SR group (100% and 14.29%, respectively) . The rate of recurrence and metastasis and 1, 3, 5- year tumor-free rate in RFA and SR group with tumor diameter < 3 cm were 60.00%, 80.00%, 40.00%, 30.00% and 38.46%, 84.62%, 61.54%, 38.46% (P > 0.05) respectively, and for the cases with tumor diameter in 3 ~ 5 cm, these data showed no significant difference between groups (P > 0.05). No significant difference were found in tumor-free survival rate within groups, while rate of recurrence and metastasis was significantly lower in the < 3 cm group (P < 0.05). The accumulated survival rate in RFA at year 1, 3 and 5 were 100%, 62.07%, 37.93% and 100%, 62.86%, 48.57% in SR group (P > 0.05). Conclusions RFA and SR had similar medium and long term clinical effect for small hepatocellular carcinoma with tumor diameter≤ 5 cm. The larger in size of the tumor, the higher rate of recurrence and metastasis. RFA is less invasive and can avoid complications and should be considered an eligible treatment for small hepatocellular carcinoma with tumor diameter ≤ 5 cm.

Gene chip is a research tool on molecular biology which can detect generous gene expression rapidly.The studies on gene chip of leiomyoma have revealed the changes of gene expression related to cell growth,proliferation,apoptosis,metabolism,angiogenesis,formation of extracellular matrix,cell differentiation and immunity.The article reviews the advance on gene chip of leiomyoma and approaches the pathogenesis of leiomyoma on molecular level.

Objective To genotype Yersinia pestis and explore intrinsic relationship among different ecotypes of Yersinia pestis in Yunnan foci.Methods A total of 171 strains from three types of Yersinia pestis,house mouse,wild-type mouse and Yulong Yersinia pestis,were tested.Twenty-three different regions (DFR) were used to genotype and cluster analysis was performed using BioNumerics 5.0.Results A total of 171 Yersinia pestis were divided into 7 genotypes by 23 DFRs,which were Genomovar5,Genomovar7,Genomovar9 and 4 newly discovered genotypes.The genotypes of all Yulong plague were Genomovar5.The genotypes of the 16 strains of wild-type mouse plague (the highland of northwestern Yunnan Province type) were divided to 3 genotypes,13 of them were Genomovar 7,2 of them were Genomovar9,and 1 of them was newly discovered genotype Genomovaryn1.The genotypes of the 148 strains of house mouse plague(the residential area of Yunnan and Fujian Provinces type) were divided into 4 genotypes,145 of them were Genomovar9,and 3 of them were newly discovered including Genomovar-yn2,-yn3 and-yn4.The ecological typing results of clustering showed genotype of Yulong plague was similar to the highland of northwestern Yunnan Province type(wild-type mouse plague),and the percentage of similarity was up to 87.20％,but only up to 73.75％ to the residential area of Yunnan and Fujian Provinces type (house mouse plague).The genotypes of 2 wild-type strains of the highland of northwestern Yunnan Province type(wild-type mouse) and main genotypes of the residential area of Yunnan and Fujian Provinces type(house mouse)were Genomovar 9.The genotype of Genomovar-yn 1 of the highland of northwestern Yunnan Province type was similar to Genomovar 7,but lack of DFR 11.The genotypes of Genomovar-yn2,-yn3 and-yn4 of the residential area of Yunnan and Fujian Provinces type were similar to Genomovar 9,but lack of DFR 10,DFR 9 and DFR 11,respectively.Conclusions One newly genotype strain is found in wild-type mouse plague and 3 newly genotype strains are founded in house mouse plague.Wild-type mouse strains are founded in the house mouse strains.The similarity of genotype between Yulong plague and the highland of northwestern Yunnan Province type (wild-type mouse plague) is high while the similarity between Yulong plague and the residential area of Yunnan and Fujian Provinces type(house mouse plague) is low.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

OBJECTIVETo deposit silver nanoparticles on a titanium surface to obtain antibacterial properties. To reduce the incidence of peri-implantitis, and improve the success rate of implantation.

METHODSA silver nanoparticle-modified titanium (Ti-nAg) surface was prepared using silanization method, and its surface was characterized by using X-ray photoelectron spectroscopy (XPS) and energy dispersive X-ray spectrometer (EDX). Two species of bacteria, namely, Staphylococcus aureus and Escherichia coli, were used to test the antibacterial effect of Ti-nAg surface.

RESULTSScanning electron microscope (SEM) revealed that a small quantity of silver nanoparticles were deposited on the titanium surface. XPS analyses revealed that 6.8% of silver was present on the titanium surface. After 24 h of incubation, 94.23% of Staphylococcus aureus and 95.34% of Escherichia coli were killed on the Ti-nAg surface.

CONCLUSIONResults suggest that silver nanoparticle-modified titanium is a promising material with an antibacterial property that may be used as an implantable biomaterial.

Objective To study the effect of nursing intervention on postural hypotension of aged with heart disease.Methods Nursing intervention were gived to the 68 aged patients with heart disease and postural hypotension.The effect of nursing intervention on postural hyporension and hypotension associated symptoms were observed.Results The postural hypotension was improved and the incidence of hypotension associated symptoms were reduced after nursing intervention.Differences were statistically significant(P＜0.01).Conclusion Nursing intervention was effective on the improvement of postural hypotension.

In the field of artificial muscle(AM) research,it is very difficult for humans to make the biological muscles,but there are experiments trying to put the function of muscles into practice of technology.With the development of materials and models of mathematics theories,people have made the AM of different materials and models true,however,as far as the characteristics of them and the widely used are concerned,they need deeply scientific research.And,in the near future,AM will play an important role in medical equipments,rehabilitation medicine,bionics,intelligent robots,military weapons,aerospace,etc.The authors review the types,characteristics,application in rehabilitation,as well as the function evaluation of AM.

Objective To evaluate the effects of locking calcaneal plate in the treatment of SandersⅢ～Ⅳcalcaneal fractures.Methods 15 feet of 12 patients of SandersⅢ～Ⅳcalcaneal fractures received the treatment of internal fixation reduction with locking calcaneal plate and hone graft.Results All the patients were followed up for 4 to 21 months(average 11 months) with the results that according to Maryland foot score,4 feet were reported ex- cellent,6 good,1 average and 1 poor,with total excellent and good rate of 83.3 %.Conclusion Using locking cal- caneat plate in the treatment of complicated calcaneal fractures was proved to be a good method and had satisfactory effects.