Animals ; Arthritis, Rheumatoid ; Disease Models, Animal

Objective To evaluate the effects of parecoxib on cellular immune function during patientcontrolled intravenous analgesia (PCIA) with butorphanol after modified radical mastectomy in patients.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 36-60 yr,weighing 48-82 kg,scheduled for elective modified radical mastectomy,were randomly divided into 2 groupe (n =30 each):control group (group C) and parecoxib group (group P).PCIA with butorphanol 10μg/kg was used at the end of operation.The PCIA pump was set up to deliver a 0.5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In group P,parecoxib 40 mg was injected intravenously at the end of operation and 12,24 and 36 h after surgery,while in group C,the equal volume of normal saline was injected.VAS score was maintained at ≤4.When VAS score≥5,butorphanol was injected intravenously as a rescue analgesic.Blood samples were obtained from the right internal jugular vein at 5 min before induction of anesthesia,2 h after skin incision,and 6 h and 1,3,7 days after surgery for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) and natural killer (NK) cells (by flow cytometry).CD4+/CD8+ was calculated.The number of attempts,the number of successfully delivered doses and requirement for rescue analgesics were recorded at 2,6,12,24 and 48 h after surgery.Adverse effects were also recorded after surgery.Results Compared with group C,the number of attempts and requirement for rescue analgesics were significantly decreased,the number of successfully delivered doses was increased,and the levels of CD3+,CD4+,CD4+/CD8+ and NK cells were decreased at 1 day after surgery (P ＜ 0.05).There was no significant difference in adverse effects between the two groups (P ＞ 0.05).Conclusion Parecoxib can enhance the efficacy of postoperative PCIA with butorphanol and reduce the consumption of butorphanol thus improving cellular immune function after modified radical mastectomy in the patients.

Objective This study is to investigate the expressions of MACC1 and c-Met genes in prostate cancer tis?sues and to explore the relationship between these gene expressions with the development, invasion and metastasis of pros?tate cancer. Methods The expressions of MACC1 and c-Met genes were examined in 30 cases of benign prostatic hyperpla?sia and 67 cases of prostate cancer using citron acid-microwave-SP immunohistochemical method and analysed with their clinical pathological features. Results Expressions of MACC1 and c-Met in prostate tissues show statistical difference ac?cording to Gleason score, PSA level, pathological stages and whether bone metastasis occurs after radical surgery ( P<0.05 or P < 0.01), but their expressions in prostate tissue show no significant difference among different sex, age and whether smoking or not. Expression of MACC1 in prostate tissue of stageⅢandⅣcancer is significantly higher than that in benign prostatic hyperplasia (BPH) tissues (P<0.05) while the expression of c-Met only shows statistical difference in prostate tis?sue of stage Ⅳcancer compared with that in BPH (P < 0.05). There is a positive correlation between the expression of MACC1 with expression of c-Met in prostate cancer tissues (P<0.01). Kaplan-Meier curves revealed that the survival rates was lower and survival time of bone-free metastasis were shorter in patients with high MACC1 and c-Met expressions in prostate tissue than those with low expressions of MACC1 and c-Met in prostate tissue. Conclusion Expression of MACC1 and c-Met is closely related to the development, invasion and metastasis of prostate cancer, so MACC 1 and c-Met may be used as promising diagnostic and prognostic markers for prostate tumor, and as new therapeutic targets for prostate cancer.

Objeetive To follow up the patients with Parkinson's disease (PD) who underwent subthalamic nucleus (STN) deep brain stimulation (DBS) therapy,and to compare the changes of cognitive function before and after this functional surgery.Methods The authors set up a series of clinical tests including unified Parkinson's disease rating scale (UPDRS) Ⅱ & Ⅲ,Hoehn & Yahr stage (H-Y stage),mini mental state examination (MMSE),Wechsler memory scale (WMS),serial reaction time task (SRTT),degraded picture naming (DPN),verbal fluency (VF),clock drawing test (CDT) to measure the performance of both clinical characteristics and cognitions 1 week before and 12 months after STN-DBS operation in 20 PD patients,matched with 20 healthy adults who just assessed by the neuropsychological tests.Results Activity of daily life (UPDRS Ⅱ),motor manifestations (UPDRS Ⅲ) and disease condition (H-Y stage) were all significantly improved whether they were on period or off period (P ＜ 0.01).In the test of WMS,the memory quotient (MQ) scores of PD patients (88.10 ± 16.70) were significantly lower (t =-3.187,P ＜0.01) than the control group (100.90 ± 6.45).By SRTT test,the mean average response time (Tavg) of the control group,pre-operation and post-operation groups was (1.09 ± 0.32) s,(1.58 ± 0.83) s and (1.62 ± 0.83) s,respectively.As to the comparison of the blocks,no changes were found within each group of PD (pro-F =0.329,P =0.964 ; post-F =0.377,P =0.945),by contrast,it had been proved to be statistically significant in the control group (F =2.316,P ＜0.05).The mean error rates of the control group,pre-operation and post-operation groups were 4.84％ ± 4.27％,9.76％ ± 1.52％ and 13.41％ ± 1.11％ respectively,and the control group was not different from pre-operation group (t =1.388,P =0.173) while significantly different compared with post-operation group (t =3.225,P ＜0.01).As for MMSE and DPN results,no significant benefits were obtained in the control,pre-operation and post-operation groups.In regard to VF,there was a statistically significant difference between control group and pre-operation group (Z =-2.927,P ＜ 0.01),and it was significantly worse after surgery (Z =-2.469,P =0.014).As for CDT,significant benefits were obtained in both preoperation (Z =-2.762,P ＜ 0.01) and post-operation groups (Z =-2.165,P =0.03) compared with control group.Conelusions To some extent,STN-DBS can affect the cognition of PD patients,such as lowing VF,improving visual-spatial function and attention,a decreasing trend of implicit memory and executive function.Explicit memory is partly dissociated with implicit memory.文章序号>=10.3760/cma.j.issn.1006-7876.2014.09.005

Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.

The solvent sublation technique was applied for the separation and enrichment of L-Arg using dodecylbenzene sulfonic (DBSA) as the surfactant, di (2-ethylhexyl) phosphoric acid (P204) as the extractant and n-heptane as the organic solution. The solvent sublation was compared with the floatation complexation extraction, foam floatation and solvent extraction. The experimental results showed that enrichment ratio of 16.2 and removal rate of 97.2% to L-Arg were obtained by the solvent sublation under the conditions of room temperature, 0.09 g/L L-Arg aqueous solution 250 mL, DBSA concentration 0.15 g/L, the initial pH 7.0, volume of n-heptane 10 mL, volume of P204 4.5 mL, gas flow rate of 200 mL/min. The study of the kinetics indicated that the solvent sublation process could be divided into three stages distinctly. The processes of the first stage and the second stage followed the first order kinetics equation; the process of the third stage followed the zero order kinetics equation. The separation mechanism of solvent sublation was also discussed.

The O152 antigens of Escherichia coli contains a Glc-β-1,3-GlcNAc linkage within the repeating unit. The wfgD gene in E. coli O152 O antigen gene cluster had been demonstrated utilizing NMR technique to encode a glucosyltransferase which is responsible for the synthesis of Glc-β-1,3-GlcNAc linkage. In this study, a synthetic substrate analog of the natural acceptor substrate undecaprenol-pyrophosphate-lipid [GlcNAc-α-PO_3-PO_3-(CH_2)_(11))-O-phenyl]) was used as an acceptor and UDP-Glc as a donor substrate, and electrospray ionization tandem mass spectrometry(ESI-MS-MS) was used for the detailed structural characte-)rization) of the enzyme product. A systematic study was conducted on product to allow rationalization of the fragmentation) processes. The major fragments observed in the ESI-MS-MS spectra result from cleavage of glycosidic) bond and diphosphate moiety. The fragment originating from the nonreducing end of the product yields information on sequence). Cross-ring cleavages, which are very informative of the linkages of the monosaccharide residues constituting) the product, and "internal" cleavage ions which are derived from elimination of substituents from around) the pyranose ring, were also observed. This extensive fragmentation was shown that the expected Glc-β-1,3-GlcNAc linkage in the product, confirming that wfgD is in the form of UDP-Glc: GlcNAc-pyrophosphate-lipid β-1,3-glucosyltransferase.)

Objective To evaluate the safety,biocompatibility and efficacy of transcatheter closure of atrial septal defect(ASD)with no stainless-steel-screw occluder in canine model.Methods The device was constructed from superelastic Nitinol wires tightly woven into two flat disks and sewed with polyester fibers inside,with a pliable loop on the right-atrial-disk of the device,connecting to the delivery cable.ASD was created by transcatheter puncture and balloon dilatation and then closed by occluder under fluoroscopy in the catheterization laboratory.The location and the influence of the implanted device on function of tricuspid valve and mitral valve were evaluated by echocardiography.At 1,2,3 and 6 months after the operation,the animals were killed and autopsy was conducted.Results Eight dogs with puncture-produced ASD underwent ASD closing procedure successfully.The occluder showed no influence on the function of MV and AV demonstrated by echocardiogram.The two disks of the implanted device were covered with a smooth intact neogenesis layer in all dogs.Endocardial cells fully covered the surface of the two disk without inflammating reaction 3 months later. There was no evidence of corrosion on the surface of the nitinol wire removed from the dog after 6 months.Light microscopic examination of the liver,kidney,lung and spleen showed no evidence of embolization and inflammation.Conclusion Transcatheter ASD occlusion with new-type occluder is safe,feasible,effective and good biocompatibility with a good prospective clinical application.

Objective The purpose of this study was to assess the incidence,treatment and prognosis of silent pulmonary embolism (PE) after off-pump coronary artery bypass graft (CABG).Methods From December 2009 to September 2012,582 consecutive patients underwent off-pump CABG by a same surgeon.Their age ranged from 16 to 86 years with a mean age of (61.4 ± 9.3) years.Left internal mammary artery and saphenous vein were harvested routinely.A dose of 20 mg unfractionated heparin was given intravenously every 6 hours on the operative day after postoperative pleural fluid less than 50 ml per hour.All patients received aspirin 100 mg daily starting on postoperative day 1.The 64-slice coronary MDCT was performed to assess the graft patency on postoperative day 5 ～ 7.Results There were no in-hospital death.PE,which involved the lobar or more proximal arteries,was detected on the CT images of 10 patients (1.7％).In these 10 patients,there were no significant dyspnea or hypoxemia postoperatively ; echocardiography and ECG showed no specific signs of PE ; all bypass grafts were patent in CT images except a LIMA to LAD graft with LAD endarterectomy.PE involved both lungs in 6 patients,and only the right lung in 4 patients.All patients received anticoagulation with warfarin for 3 to 6 months except one.All patients were with good quality of life during 6 to 18 months of follow-up.Three to six months after discharge,8 patients received repeated MDCT,which showed diminish of PE.Conclusion Acute PE after off-pump CABG was an uncommon complication and was difficult to diagnose.MDCT played an important role in examining the patency of graft vessels and helped detect silent PE in CABG patients.The prognosis of acute PE after off-pump CABG was acceptable.PE diminished after 3 months of anticoagulation with warfarin.

Objective To investigate the application effect of stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi. Methods The clinical data of 96 patients with upper ureteral calculi were retrospectively analyzed, all patients underwent ureteroscopic holmium laser lithotripsy. Forty-eight cases used the stone basket in the operation process (observation group), and 48 cases did not use the stone basket in the operation process (control group). The operation time, length of stay, success rate of lithotripsy, stone residual rate and incidence of postoperative complication were compared between 2 groups. Results The patients of 2 groups successfully completed surgery. There were no statistical differences in operation time, length of stay and incidence of postoperative complication between 2 groups (P>0.05). The success rate of lithotripsy in observation group was significantly higher than that in control group: 97.92% (47/48) vs. 75.00% (36/48), and the stone residual rate was significantly lower than that in control group:4.17%(2/48) vs. 18.75%(9/48), and there were statistical differences (P<0.05). Conclusions The stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi can thoroughly remove stones. It reduces the incidence of residual stones, does not affect the safety of the operation, and has good clinical value.