Objective　To discuss the possibility of ultrasonic superficial spray anesthesia applied to bronchoscopy in children with intratracheal foreign bodies. Methods　50 cases with intratracheal foreign body were divided into two groups: surface anesthesia group (S group) and intravenous anesthesia group (Ⅰ group). 2% Lidocain by ultrasonic spraying inhalation for 8～10 min and r-OH 80 mg*kg-1+Ketamine 1 mg.kg-1 intravenous injection were adminstered respectively. Results　In S group perioperative the MAP and HR were stable， the complications were fewer and the SpO2 was >95%，the awaking time was shorter (70.1±15.3) min after operation；In I group the MAP and HR were descendent (P<0.05)， the complications were more and the SpO2 was <95% (P<0.05)， the awaking time was longer(P<0.01). Conclusion　The surface anesthesia is effective.The MAP and HR are stable，the complications are fewer and the awaking time is shorter.

In recent years , active vitamin D is a hot research drugs because of its renal protective effect of independent regu -lation of anti-inflammatory effects outside calcium and phosphorus metabolism , regulation of apoptosis , mediated immunity and reduc-tion of proteinuria .Podocyte is the main target of active vitamin D based on the result of clinical and animal studies .In this article, we review the current literature on mechanism of active vitamin D and its analogues on the protection of podocytes about and give the clini -cal perspectives of activity vitamin D .

ABSTRACT:Many studies show that helminth‐derived molecules can induce immunoregulatory cells to form immune net‐work‐mediated immune ,thereby inhibiting allergic and autoimmune diseases .Helminth parasites can induce immune cell activa‐tion and produce cytokine .And parasites play an inhibitory effect to affect other immune related diseases .However ,the associ‐ation between helminths infections and immune related diseases does not always have an unequivocal outcome .While some hel‐minths infections protect against allergic diseases ,other helminth can exacerbate this immunopathology .

Objective To evaluate the safety and effectively of transfusion plan guided by POTTS in gynecological patients with Hb level ranged from 60 to 100 g/L. Methods 114 gynecological patients with perioperative Hb level ranged from 60 to 100 g/L were randomly divided into POTTS group ( n=57 ) and control group ( n=57 ) . Patients in POTTS group received transfusion under the guidance of POTTS. Patients in control group received transfusion according to doctor's experience. The proportion of injecting RBCs,the amount of RBCs, the incidence of serious complications and mortality,ICU occupancy rate, postoperative Hb recovery, incision healing, hospitalization time, blood transfusion related costs and costs of hospitalization were observed and compared. Results The transfusion rate and volume in POTTS group were significantly lower than the control group ( P<0. 01 ) . Neither severe com-plications nor any mortality were found in each group. The transfusion costs in POTTS group were significantly less than the control group (P<0. 01). Two groups had no postoperative ICU admission;the postoperative Hb recovery, incision healing, hospitalization time and costs of hospitalization in two groups were not statistically significant. Conclusion POTTS could be safety and effectively used in gynecological patients with Hb level ranged from 60 to 100 g/L, also effectively save the blood, reduce the costs of blood transfusion, not increase perioperative mortality and the incidence of various complications.

Objective To evaluate in vivo tracking of swine mesenchymal stem cells (MSCs) la-beled with super paramagnetic iron oxide (SPIO) in intraportal transplantation by a clinical 1.5T MR.Methods MSCs were isolated from swine and cultured as well as expanded, which were then incuba-ted with SPIO (Feridex I. V.). Prussian blue staining was performed for showing intracelluar irons.To establish a swine model of acute liver necrosis, 0.5 g/kg of D-galactosamine was administrated to 10 pigs. MSCs(labeled cells in six, unlabeled cells in four)were injected into liver via portal veins. MR imaging was performed with a clinical 1.5T MR immediately before and at 6 h, 3 d, 7 d, 14 d after transplantation, respectively. Results Prussian blue staining of SPIO labeled MSCs could be effec-tively labeled and the labeling efficiency was almost 100%. Signal intensity loss in liver by SPIO labe-ling on FFE sequence persisted until 14 days after transplantation. Histological analysis by Prussian blue staining showed homing of labeled MSCs in liver after 14 days, primarily distributing in hepatic sinusoids and liver parenchyma. Conclusion MSCs can be labeled with SPIO in vitro successfully.MRI can monitor magnetically labeled MSCs transplanted into liver.

Objective To investigate the roles of cystatin C (CysC) and serum creatinine (Scr) in acute renal injury of patients with shock. Method A total of 71 patients with shock, 42 male and 29 female, were enrolled from February 2006 to June 2007. Patients with kidney disease or renal insufficiency were excluded. All of patients were assigned to 4 groups as per the duration of shock. The blood samples were taken from patients for measurements of CysC and Scr during the periods of 1 hr,2 hr,and 4 hr of shock and 72 hr and 7 days after correction of shock. The corrected GFR (cGFR) and decreased GFR (dGFR) were calculated. The levels of Scr and dGFR could be used to classify the acute renal injury into stages according to the Acute Kidney Injury Diagnosis Criteria. The positive detection rates of different methods were compared. The levels of CysC, Scr and cGFR were statistically analyzed. Data were studied by using Pearson's correlation analysis, Results The elevation of CysC appeared sooner than that of Scr in all shock patients. Contrarily, the high level of CysC lowered to normal level much slower than that of SCR after correction of shock. The CysC increased 1 hour after shock. The GFR was negatively correlated with CysC and Scr, especially in the early stage of shock. Conclusions The renal dysfunction appears in the early stage of shock. The CysC assayed is more sensitive in the stage 1 of renal injury than Scr.

Objective To compare the difference between crystalloids and colloids under goal-directed fluid therapy (GDFT) in elective hepatectomy.Methods Seventy patients undergoing hepatectomy, 42 males and 28 females, aged 18-65 years, ASA physical status Ⅱ or Ⅲ, were included and randomly divided into three groups base on fluid treatment: conventional fluid therapy (group C, n=24), goal-directed fluid therapy filled with colloids (group G1, n=23) and goal-directed fluid therapy filled with crystalloids (group G2, n=23).Group C received conventional fluid therapy mainly based on MAP while group G1 and group G2 received goal-directed fluid therapy based on MAP, stroke volume variation (SVV) and cardiac index (CI), and the Flotrac/Vigileo system was used to obtain SVV and CI in group G1 and group G2.250 ml colloids were administered if SVV>13% in group G1 while 250 ml crystalloids were administered in group G2.If CI<2.5 L·min-1·m-2, dobutamine 2.0-10.0 μg·kg-1·min-1 was given until CI≥2.5 L·min-1·m-2.The ScvO2, Lac and Glu were tested at 5 min before anesthesia induction (T1), 5 min before hepatectomy (T2), 5 min after hepatectomy (T3) and the end of operation (T4).The duration of operation, fluid requirement, urinary output, bleeding volume, and the use of vasoactive agent were recorded.The exhaust time, ambulation time and postoperative hospital stay were recorded.Preoperative and postoperative liver and kidney function tests and postoperative complications were followed up.Results Compared with group C, the total volume was lower, flatus time, ambulation time and postoperative hospital stay were shorter, ScvO2 at T3 and T4 were higher, Lac at T2-T4 were lower, Glu at T3 and T4 were lower, ALT and AST on the third day and the fifth day after surgery were lower in group G1 (P<0.05).Compared with group G1, the amount of crystalloids was increased, the incidences of postoperative nausea and vomiting were significantly higher in group G2 (P<0.05).There was no significant difference in flatus time, ambulation time and postoperative hospital stay between group G1 and group G2.Conclusion GDFT in hepatectomy propably improves the microcirculation and tissue oxygenation, protects liver function, promotes gastrointestinal function recovery and shortens postoperative hospital stay.GDFT using colloids bolus contribute to a much lower incidence of postoperative nausea and vomiting.There is no significant difference in tissue perfusion and postoperative recovery between colloids and crystalloids.

Objective The core mechanism of renal insterstitial fibrosis (RIF) is epithelial-mesenchymal transition.This study aimed to investigate the effect of erythropoietin on high glucose-induced epithelial-mesenchymal transition ( EMT) of normal hu-man kidney proximal tubular epithelial cells (HK-2) and its possible mechanism. Mothods HK-2 cells cultured in vitro were ran-domly divided into a blank control group , a high glucose induction group , a mannitol induction group , an EPO induction group , an EPO (5, 10, and 20U/mL) inhibition group, and an Rho kinase inhibitor group.After 24 hours of intervention, the mRNA levels of RhoA and ROCK were determined by RT-PCR, those of E-cadherin and α-smooth muscle actin (α-SMA) proteins detected by immu-nofluorescence staining , and the expression of FN proteins in the supernatant measured by ELISA . Results Compared with the blank control group , the expressions of RhoA and ROCK 1 mRNA were significantly increased in the high glucose induction group (0.945 ±0.132 vs 1.400 ±0.022, 1.007 ±0.002 vs 1.913 ±0.011, P<0.05), but markedly decreased in the 5, 10, and 20U/mL EPO inhibition groups (1.400 ±0.022 vs 1.278 ±0.006, 1.400 ±0.022 vs 0.770 ±0.005, 1.400 ±0.022 vs 0.334 ±0.009, P<0.006) in comparison with the high glucose induction group , and the effects were related to the concentration of EPO .Compared with the blank control, the expression of E-cadherin protein was increased in the high glucose induction group (0.644 ±0.006 vs 0.107 ± 0.004, P<0.05), but remarkably decreased in the 5, 10, and 20 U/mL EPO inhibition groups (0.236 ±0.006, 0.433 ±0.010, 0.521 ±0.010) in comparison with the high glucose induction group (P<0.05), and the effects were also related to the concentration of EPO.Pearson correlation analysis showed a positive correlation between the mRNA expressions of RhoA and ROCK 1 in the high glu-cose induction and EPO inhibition groups . Conclusion EPO can inhibit high glucose-induced epithelial-mesenchymal transition of normal human kidney HK-2 cells and thus delay renal fibrosis , which mignt be related to the RhoA/ROCK signaling pathway .

OBJECTIVE: To observe the clinical effect of Chinese medicine Sansheng Huatan Decoction combined with chemotherapy in treating advanced primary non-small-cell lung cancer and to evaluated the effect of Sansheng Huatan Decoction increasing clinical effect and decreasing toxicity in chemotherapy for non-small-cell lung cancer. METHODS: One hundred and sixty patients of advanced primary non-small-cell lung cancer proved by pathological examination were randomized into two groups. The treatment group was treated with Sansheng Huatan Decoction and chemotherapy, and the control group was treated only with chemotherapy. The clinic effect, life quality, natural killer (NK) activities, liver and kidney functions, and blood routine test of the 2 groups were evaluated. RESULTS: The clinical effective rates of the treatment and control groups were 56.7% and 48.2% respectively, and there was no statistic significance (P>0.10). The life quality, NK activities and blood routine test of the treatment group were better than those of the control group. CONCLUSION: Sansheng Huatan Decoction combined with chemotherapy is a better treatment for non-small-cell lung cancer as compared with chemotherapy.

Objective To understand the endemic characteristics and regularity of cystic echinococcosis by evaluating and classifying its endemic situation in Non Tibetan Plateau regions,so as to provide the evidence for formulating effective preventive and control measures. Methods The prevalence data of cystic echinococcosis in 174 counties(cities,districts,banners)in Non Tibetan Plateau regions from a national survey were collected and analyzed by the sample cluster method in 2012. Results The 174 counties(cities,districts,banners)could be classified into 4 clusters by spatial distribution. The first cluster with human high prevalence rate,low infection rate of livestock,and positive rate of dog stool antigen included 3 counties. The second cluster with high infection rate of livestock,low prevalence rate of human,and positive rate of dog stool antigen included 20 counties(cit-ies). The third cluster with high positive rate of dog stool antigen,low prevalence rate of human,and low infection rate of livestock included 39 counties(cities,districts,banners). The fourth cluster with low rates of the above 3 indices included the rest 112 counties. Conclusions The results of the cluster analysis conform to the current epidemiological status of cystic echinococcosis in the Non Tibetan Plateau regions. The epidemiological characteristics and geographical distributions of the four area types will pro-vide a basis for the classified management and guidance of cystic echinococcosis control in these areas.