Baekground:Obstetric hemorrhage is a major cause of maternal death during cesarean delivery.The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section.Methods:We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018.In this study,196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group).Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group.Patients in the IOCS group were matched 1:1 to patients in the ABT group.Results:After propensity score matching,137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group.Patients in the IOCS group were associated with significantly shorter length of hospital stay,compared with ABT group (8.9 ±4.1 days vs.10.3 ± 5.2 days,t=-2.506,P =0.013).The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t =-4.056,P ＜ 0.001).The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6g/L,respectively,which were significantly different (t=2.615,P=0.009).Allogeneic red blood cell transfusion was significantly lower at 0 unit (range:0-11.5 units) in the IOCS group when compared with 2 units (range:1-20 units) in the ABT group (P ＜ 0.001).Condusions:This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.

OBJECTIVETo study the effects of two specific cyclooxygenase inhibitors (SCI), rofecoxib and celecoxib, combined with chemotherapeutic drugs 5-Fu, DDP and VP-16 on gastric cancer cell line BGC-823, and to evaluate whether specific cyclooxygenase inhibitors can be used as a synergetic agent in chemotherapy.

METHODSThe gastric cancer cell line BGC-823 cells were incubated for 48 hours with rofecoxib and celecoxib, 5-Fu, DDP and VP-16 (concentration gradient of 5-Fu, DDP and VP-16:1 microg/ml, 10 microg/ml and 100 microg/ml), or in combination, respectively. MTT working solution was added to each culture and calculated the survival rates of gastric cancer cells. Median-effect principle and Professor Jin's evaluation methods were applied to detect the interaction between the specific cyclooxygenase inhibitors and chemotherapeutic agents.

RESULTSThe inhibition rates of gastric cancer cells were 42.63% +/- 1.26% and 50.67% +/- 2.35% by treatment with 0.1 micromol/L rofecoxib and 50 micromol/L celecoxib, respectively. The inhibition rates of gastric cancer cells by treatment with 5-Fu, DDP and VP-16 at different concentrations (1 microg/ml, 10 microg/ml and 100 microg/ml) were 39.75% +/- 3.14%, 49.96% +/- 2.08%, 87.93% +/- 3.66%; 48.28% +/- 2.08%, 59.46% +/- 1.69%, 88.23% +/- 4.81%; and 29.23% +/- 3.27%, 49.34% +/- 3.75%, 79.24% +/- 2.44%, respectively. However, the inhibition rates showed a synergetic role while combined the two SCI (0.1 micromol/L rofecoxib and 50 micromol/L celecoxib) with chemotherapeutic agent at different concentrations (P <0.05).

CONCLUSIONBoth rofecoxib and celecoxib have an ability to suppress gastric cancer cells in vitro, and the synergetic role becomes evident when rofecoxib and celecoxib are combined with chemotherapeutic agents at different concentrations, which indicate that the two specific cyclooxygenase inhibitors may be used as a chemotherapeutic sensitizer.

Adenocarcinoma ; pathology ; Antimetabolites, Antineoplastic ; pharmacology ; Antineoplastic Agents ; pharmacology ; Celecoxib ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cisplatin ; pharmacology ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Cyclooxygenase Inhibitors ; pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Etoposide ; pharmacology ; Fluorouracil ; pharmacology ; Humans ; Lactones ; pharmacology ; Pyrazoles ; pharmacology ; Stomach Neoplasms ; pathology ; Sulfonamides ; pharmacology ; Sulfones ; pharmacology

OBJECTIVETo observe the effects of Tongguan Capsule (TGC) on post-myocardial infarction ventricular remodeling and heart function in rats.

METHODSA rat model of acute myocardial infarction (AMI) was established by coronary ligation. Experimental rats were randomized to 4 groups including three model groups (Group A: captopril 5 mg/kg * day, n=7; Group B: TGC 10 g/kg * day, n=7; and Group C: placebo, n=8), and a sham-control group (Group D: blank control, n=6). Animals were treated for 4 weeks. The cardiac function of rats was assessed at the end of the experiment based on left ventricular ejection fraction (LVEF) and left ventricular short axis fractional shortening (LVFS) detected by colored echocardiography; meanwhile, the condition of ventricular remodeling was observed through the levels of left ventricular mass (LVM), plasma aldosterone (ALD), myocardial angiotensin II (Ang II) and myocardial collagen measurements.

RESULTSAt the end of the experiment, LVEF and LVFS in Group A and B were improved significantly, while those in Group C were unchanged, the LVEF in Group A, B, C, and D was 0.57+/-0.46, 0.61+/-0.08, 0.36+/-0.55 and 0.76+/-0.02, respectively; and their LVFS was 0.31+/-0.52, 0.34+/-0.04, 0.23+/-0.57 and 0.45+/-0.03, respectively. The difference was statistically significant when comparing the two indexes in Group A and B with those in Group C and D (P<0.05). LVM, levels of plasma ALD and myocardial Ang II were lower in Group A and B than in Group C, but a comparison between Group A and B showed an insignificant difference in lowering LVM and ALD, while the lowering of Ang II was more significant in Group B than in Group A (754.7 +/- 18.7 pg/mL vs 952.6+/-17.6 pg/mL, P<0.05). Morphological examination showed that in Group A and B the swollen myocardial cells had shrunk, with regularly arranged myocardial fibers and decreased collagen proliferation, but the improvements in Group B were more significant.

CONCLUSIONTGC could markedly improve the post-infarction ventricular remodeling and cardiac function in rats, showing that the efficacy was better than or equal to that of captopril.

Angiotensin II ; blood ; Animals ; Antihypertensive Agents ; pharmacology ; Capsules ; Captopril ; pharmacology ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Echocardiography, Doppler ; Heart ; drug effects ; physiopathology ; Male ; Myocardial Infarction ; diagnostic imaging ; drug therapy ; physiopathology ; rehabilitation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Ventricular Function, Left ; drug effects ; Ventricular Remodeling ; drug effects

Objective To observe the effects of dexmedetomidine combined with esketamine on early postoperative pain and cognitive function in elderly patients undergoing spinal surgery.Methods The aged spinal surgery patients were divided into control group and treatment group by random number table method.Both groups were anesthetically induced by intramuscular injection of esketamine 3 mg·kg-1,while the control group was anesthetically induced by intravenous injection of propofol 4 mg·kg-1 with constant velocity pump.The treatment group was given 1 μg·kg-1 dexmedetomidine by intravenous pump for 10 min,and then continued pumping at 0.5 μg·kg-1 rate.The changes of vital signs 5 min before surgery(T1),5 min after surgery(T2),at the end of surgery(T3),at the time of recovery(T4),early postoperative pain,cognitive function,the time of the first patient control analgesia(PC A),the cumulative dosage of sufentanil in different time periods within 48 h and the occurrence of adverse drug reactions were observed in the 2 groups.Results 44 patients were included in the control group and 45 patients in the treatment group,respectively.At T2,T3 and T4,the heart rate of treatment group were(82.51±3.05),(80.15±3.21)and(81.51±3.04)beat·min-1,and that of control group were(92.54±3.10),(93.52±3.05)and(88.45±3.51)beat·min-1,respectively.The mean arterial pressure(MAP)of the treatment group were(54.51±3.58),(55.25±3.21)and(60.25±3.24)mmHg;and that of the control group were(73.25±3.54),(70.52±3.20)and(68.51±3.05)mmHg,respectively.The blood oxygen saturation(SPO2)of treatment groups were(98.56±0.38)％,(98.25±0.35)％and(99.02±0.14)％;and the SPO2 of control group were(94.52±0.35)％,(95.25±0.25)％and(96.25±0.32)％,respectively.Visual analogue pain(VAS)scores were(5.69±1.12),(5.02±0.89),(4.52±0.65)and(4.01±0.45)scores at 2,4,6 and 8 h after operation,respectively;the control group were(6.25±1.35),(5.46±1.12),(4.98±0.84)and(4.25±0.52)scores,respectively.24,36 and 72 h after operation,the scores of MMSE in treatment group were 24.25±1.15,26.25±1.14,27.25±0.89 and 28.86±0.62,respectively;the control group were 22.52±1.02,24.25±1.12,26.58±0.87 and 28.78±0.52,respectively.Compared with the control group,there were statistically significant differences in the above indexes of treatment groups(all P＜0.05).The adverse drug reactions in the control group were mainly lethargy,respiratory depression,nausea and vomiting,and the adverse drug reactions in the treatment group were mainly lethargy,nausea and vomiting,and the incidence of total adverse drug reactions in the treatment group and the control group was 6.67％and 22.73％,respectively,with statistical significance(P＜0.05).Conclusion Dexmedetomidine combined with esketamine is safe and effective in elderly patients undergoing spinal surgery.It can effectively reduce early postoperative pain and quickly restore cognitive function.

Objective:To investigate which indicator is more advantageous when using arterial oxygen saturation(SaO2)and fingertip pulse oxygen saturation(SpO2)for blood oxygen detection in patients with hyperleukocytic acute leukemia(HAL).Methods:In this prospective research,the difference between SaO2 and SpO2 of 18 HAL patients(observation group)and 14 patients(control group),as well as the relationship between the difference and white blood cell(WBC)counts were analyzed.Results:SaO2 was lower than SpO2 in the observation group(P＜0.05),and SpO2-SaO2 difference was positively correlated with WBC counts(r=0.47).However,there was no statistical difference between SaO2 and SpO2 in the control group.SaO2 and PO2 showed a downward trend with the prolongation of detection time after arterial blood was collected in the observation group,but there was no statistical difference.There was no downward trend of SaO2 and PO2 in the control group.Conclusion:HAL patients have a phenomenon where SaO2 is lower than SpO2,that is pseudohypoxemia,and this phenomenon may be caused by excessive consumption of oxygen by the leukemia cells in vitro.SpO2 can be monitored bedside in real time and is non-invasive,it is a better way to detect the blood oxygen status of HAL patients.

The central nervous system is one of the most sensitive targets of microwave radiation. Microwave radiation can affect spatial learning and memory and neural information transmission. The effects of microwave radiation on neurotransmitters in the hippocampus and the underlying mechanisms are still unclear. This paper reviews the effects of microwave radiation on learning/memory and neurotransmitters as well as the mechanisms of action on neurotransmitters. This paper aims to provide a scientific basis for future research in this area.

OBJECTIVE: To compare the perioperative and oncologic outcomes of female patients receiving laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC). METHODS: Retrospective review of 91 consecutive female patients with urothelial carcinoma of bladder undergoing radical cystectomy at a single academic institution from 2006 to 2017. Those female patients received open radical cystectomy were matched to the patients who underwent laparoscopic radical cystectomy by using propensity score matching in 1 ∶1 ratio. The matching factors included age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, pathologic stage and pathologic nodal stage. The perioperation and oncology characteristics were compared, and Kaplan-Meier method was used to analyze the overall survival (OS), cancer specific survival (CSS) and progression-free survival (PFS) estimates. Finally, we did a sensitive analysis by using multivariable COX regression of all the patients, adjusting for the matching factors. RESULTS: There were 65 ORC and 26 LRC patients identified in this cohort with urothelial carcinoma of bladder, the median follow-up time was 38 months (interquartile range 18-69). The age (P<0.001) and ASA scores (P=0.018) were less for LRC before being matched. There were 22 LRC and 22 ORC patients matching successfully. Before being matched, the estimate blood loss (P=0.005), transfusion rate (P<0.001) and total complications rate (P=0.015) were less for LRC, and the lymph nodes yield was greater for LRC, but there were no differences in OS (P=0.698), CSS (P=0.942) and PFS (P=0.837) between the two groups. After being matched, the estimate blood loss (P=0.009), transfusion rate (P=0.001) and total complications rate (P=0.040) were less for LRC, but there was no difference in the lymph nodes yield. Besides, there were no statistic differences in OS (P=0.432), CSS (P=0.429) and PFS (P=0.284) between the two groups. In addition, in multivariable COX regression analysis, surgical approaches (LRC/ORC) were not found to be a predictor of OS (HR 1.134, 95%CI 0.335-3.835, P=0.839), CSS (HR 1.051, 95%CI 0.234-4.719, P=0.949) and PFS (HR 0.538, 95%CI 0.138-2.095, P=0.371) of the female patients with urothelial carcinoma of bladder. CONCLUSION It is advantageous for laparoscopic radical cystectomy in terms of estimating blood loss, transfusion rate and complication rate. But there was no evidence that laparoscopic radical cystectomy for female patients with bladder cancer had a better oncologic prognosis than open radical cystectomy from this study.
Cystectomy ; Female ; Humans ; Laparoscopy ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder Neoplasms/surgery*

OBJECTIVE: To investigate the clinical features of acute myeloid leukemia patients aged over 80 years. METHODS: The clinical data from 24 cases of acute myeloid leukemia (non-M3) aged over 80 years were analyzed retrospectively. Clinical characteristics, therapeutic efficacy and overall survival rate of the patients received low dose chemotherapy and/or decitabine were compared with that received only supportive care. RESULTS: According to FAB classification, the 10 patients were M2 subtypes (41.7%), the 7 patients were M4 subtypes (29.2%), the 4 patiens were M5 (16.7%), the 3 patients were unclassifed (16.5%). 22 patients (91.0%) were complicated with underling diseases. Among 13 patients received low dose chemotherapy or decitabine, 8 cases (61.5%) achived partial remission or higher remission. The median survival time of patients who reseived chemotherapy was 30 weeks, and signicantly longer than that of patients received supportive care (median survival time was 9 weeks (P<0.05)). The univariated analysis showed that WBC≥50×10/L, ECOG≥2 and received supportive care were unfavonrable prognostic factors for overall survival. CONCLUSION More than half of patients aged over 80 years who received individudized treatment can achieve partial remission or higher remission, and can have more longer survival time..
Aged, 80 and over ; Decitabine ; Humans ; Leukemia, Myeloid, Acute ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.