Objective To evaluate the abilities and thresholds of stroke volume variation (SVV) and pleth variability index (PVI) in predicting fluid responsiveness during increased intra-abdominal pressure.Methods 28 patients undergoing laparoscopy-assisted radical gastrectomy were selected.PV1 was continuously displayed by the Masimo.Radical 7.All patients were also monitored with Vigileo/FloTrac system.Haemodynamic data such as MAP,HR,SVI,SVV,PI,PVI and C VP were recorded before and after volume expansion(HES 6％,7ml/kg).Fluid responsiveness was defined as an increase in SVI≥ 15％ (△ SVI ≥ 15).Results The SVV threshold of 9.5％ before volume expansion was able to diserimihate the responders from the non-responders with a sensitivity of 100％,and a specificity of 63.6％.The threshold for PVI was 14.0％,the sensitivity of 100％ and specificity of 81.8％ were obtained.There was no significant difference between the area under the receiver operating characteristics (ROC) curves of SVV and PVI(0.981,0.939,respectively),and there was significant correlation between the baseline SVV and the baseline PVI(r =0.740,P ＜ 0.01).Conclusion SVV and PVI can predict fluid responsiveness accurately during increased intra-abdominal pressure,the baseline SVV is correlated well with baseline PVI,and the ability of SVV and PVI in predicting fluid responsiveness is similar.

Objective　To investigate the efficacy of combined use of apigenin and resveratrol in the treatment of non-alcoholic fatty liver disease (NAFLD). Methods　Fifty male C57BL/6 mice were randomly divided into a normal group (n=10) and a model group (n=40). The NAFLD model was established in the model group using carbon tetrachloride (CCl4) and a high-fat diet. After successful modeling, the model group was further divided into a model group, an apigenin group, a resveratrol group, and an apigenin and resveratrol combined group (combined administration group), with 10 mice in each group. The mice were administered once daily for four consecutive weeks. At the end of the administration, the mice in each group were weighed, the eyeballs were taken for blood samples, and the necks were dissected and sacrificed. The livers were dissected and weighed, and the liver index was calculated. The automatic biochemical analyzer was used to detect the serum biochemical indicators of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TG), and total cholesterol (TC) levels in mice. The ELISA method was used to detect the contents of superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GSH-Px) in mouse 10% liver tissue homogenate. HE staining was used to observe the pathological morphology of liver tissue in mice. Results Compared with the normal group, the liver index and serum biochemical ALT, AST, TG, TC levels in the model group were significantly increased (P<0.01), and the liver homogenate MDA was significantly increased (P<0.01), while the levels of SOD, CAT, GSH- Px were decreased significantly (P<0.01). There were a large number of fatty vacuoles and hepatic cord disorders in the liver tissue. Compared with the apigenin group and the resveratrol group, the liver index, and serum biochemical ALT, AST, TG and TC levels in the combined administration group decreased (P<0.05), and the liver homogenate MDA level decreased (P<0.05), and the levels of SOD, CAT and GSH-Px were increased (P<0.05). The number of fatty vacuoles in liver tissues were reduced, hepatic cord disorders were improved. Conclusions The combined administration of apigenin and resveratrol has a protective effect on NAFLD model mice, possibly through the reduction of hepatic enzymes and blood lipid levels, as well as enhanced antioxidant activity. The combination treatment shows better efficacy compared to the apigenin and resveratrol groups.

Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.

Objective To simulate the process of lag screw insertion on intact pelvises under guidance of conventional fluoroscopes or 2D and Iso-C3D computer-assisted navigations and evaluate the accuracy and practicability of the computer-assisted navigation. Methods Six dried intact adult pelvic specimens were selected and divided into three groups randomly. A total of 54 hollow screws were placed in bilateral pedicles of S1 and S2, anterior column of bilateral acetabulum, anterior column of bilateral acetabulum and pubic symphysis of intact adult dried pelvic specimens of three groups under guidance of conventional fluoroscopy, 2D and Iso-C3Dcomputer assisted navigations, respectively. The accuracy of the screw positions, the average operating time of each screw insertion and the average time of radiation exposure during the insertion of each screw were compared among three groups. Results There were significant differences in the accuracy of the screw positions, the average operating time and the average time of radiation exposure among three groups (P＜0.01). The navigation with Iso-C3D appeared to provide the highest accuracy and the shortest operating time of all guidance techniques. The mean operating time and the average time of radiation exposure of the conventional fluoroscope were the longest among three groups. The average time of radiation exposure of the 2D computer-assisted navigation was the shortest.Conclusions Iso-C3D computer-assisted navigation is the most accurate and expeditious means of all guidance techniques. The time of radiation exposure can be significantly reduced by both 2D and Iso-C3D computer-assisted navigations.

Objective To investigate the anti-arrhythmias mechanism of nardostachyos chinensis batal by intracardiac electrophysiologic study. Methods Intracardiac electrophysiologic study were performed in 40 supraventricular tachycardia(SVT)patients before and after oral nardostachys chinensis batal administraton,and the results were compared with 35 SVT patients or normal persons without nardostachys chineusis batal intake. Results The atrial effective,relative,functional refractory periods(AERP,ARRP,AFRP)and ventricular ERP(VERP)were significantly longer in nardostachyos chinensis batal administration group than control(AFRP(358 ± 76)ms vs.(256 ±69)ms;ARRP(365 ±74)ms vs.(287 ±55)ms;VERP(264 ± 36)ms vs.(213 ± 27)ms respectively);but the sinus and atrioventricular node function had no changes. Conclusions The anti-arrhythmia mechanism of nardostachyos chinensis batal were related to the prolonged cardiac refractory periods and the reduced cardiac excitability.

Objective To compare the efficacy of laryngeal mask airway Supreme (LMAS) and Streamlined Liner of the pharynx Airway (SLIPA) in patients undergoing general anesthesia. Methods Eighty ASA Ⅰ or Ⅱ patients aged 18-70 yr weighing 45-80 kg undergoing general anesthesia were randomly divided into 2 groups ( n = 40 each): group LMAS and group SLIPA. Pharyngeal airway was inserted after induction of anesthesia with fentanyl 3μg/kg and propofol 2.0-2.5 mg/kg. MAP, HR, number of insertion, rate of successful placement at first attempt, placement time, airway sealing pressure, peak and mean airway pressure and side effects were recorded. Results There were no significant differences in MAP, HR and rate of successful placement at first attempt between the two groups. The placement time was significantly longer, the airway sealing pressure lower and the incidence of side effects higher in SLIPA group than in LMAS group. There was no significant difference in the peak and mean airway pressure between the 2 groups. Conclusion Both LMAS and SLIPA can assure good airway sealing and adequate ventilation. The complication is rare. The efficacy of LMAS is better.

Apoptosis ; Breast Neoplasms ; metabolism ; pathology ; Cell Proliferation ; Drug Resistance, Neoplasm ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplastic Stem Cells ; metabolism ; pathology ; Prognosis ; Signal Transduction ; Twist-Related Protein 1 ; metabolism

AC133 Antigen ; Animals ; Antigens, CD ; metabolism ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; CD24 Antigen ; metabolism ; CD55 Antigens ; metabolism ; Female ; Gangliosides ; metabolism ; Glycoproteins ; metabolism ; Hedgehog Proteins ; metabolism ; Humans ; Hyaluronan Receptors ; metabolism ; Isoenzymes ; metabolism ; Neoplastic Stem Cells ; metabolism ; Octamer Transcription Factor-3 ; metabolism ; Peptides ; metabolism ; Receptors, Notch ; metabolism ; Retinal Dehydrogenase ; metabolism ; Signal Transduction ; Wnt Signaling Pathway

Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 (ALDH-1)in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma ( IMPC) of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified ( IDC-NOS) without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results ( 1 ) The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases (37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases)than in IDC-NOS group(21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases)(P<0.05).(2)Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC (P<0.05).(3)The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients(P=0.003).In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression (P<0.05).In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis ( P =0.005).Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance .

ObjectiveTo assess the feasibility of seeding adipose-derived stem cells (ADSCs) onto bladder acellular matrix grafts (BAMGs) for bladder reconstruction in a rabbit model.MethodsAutologous ADSCs were isolated,expanded and identified by flow cytometry.In the experimental group,ADSCs were seeded onto BAMGS for reconstructing bladder defects in 12 male rabbits.Unseeded BAMGs were used for bladder reconstruction in the control group of 12 rabbits.Cystography was performed at 24 weeks after grafts implantation.Following cystography,the animals were scarified and grafts were harvested； H&E and immunohistochemical staining were performed with cytokeratin AE1/AE3,smooth muscle α-actin and S-100 markers.ResultsFlow cytometry demonstrated that the ADSCs expressed CD90,CD44,CD105,CD166 and CD34,but not CD45 or CD106.The cells demonstrated good biocompatibility with BAMGs.At 24 weeks,in the experimental group,the reconstructed bladders reached a mean volume of (94.68 ± 3.31 )％ of the precystectomy bladder capacity.Complete regeneration of smooth muscle and nerve tissue was evident.Regenerated SMCs,urothelium and nerve cells stained positively for α-smooth muscle actin,AE1/AE3 and S100.In the control group,the mean bladder volume was (69.33 ± 5.05 )％ of the pre-cystectomy volume.Histologically,the control group was characterized by multi-layered urothelium without evidence for organized muscle or nerve tissue.Conclusion The tissue engineering bladder constructed by ADSCs and BAMG can be used as an ideal biomaterial to replace and repair the bladder.