Objective To evaluate the accuracy of stoke volume variation (SVV) determined using FloTrac/Vigileo and Picco-plus technologies in prone position for assessment of the blood volume in the patients undergoing spine surgery,Methods Forty-three ASA physical status Ⅰ-Ⅲ patients of both sexes,aged ＞ 18 yr,weighing 40-100 kg,scheduled for elective posterior approach to lumbar spinal fusion or scoliosis surgery were studied.After induction of anesthesia,a volume expansion was performed in supine and prone positions.Hydroxyethyl starch 130/0.4 sodium chloride injection 5 ml/kg was rapidly infused intravenously over 10 min to carry out the test for fluid responsiveness.Picco-plus and FloTrac/Vigileo systems were simultaneously applied in every subject to measure SVV (SVVP and SVVF).Positive fluid responsiveness was defined as the changing rate of stroke volume index ≥ 10％ as measured by using Piccoplus system.The patients were divided into response group (Rs group) and non-response group (NRs group) according to the changing rate of stroke volume index ≥ 10％ and ＜ 10％.The receiver operating characteristic (ROC) curve for SVV was plotted,and the diagnostic threshold,area under the ROC curve and 95％ confidence interval (CI) were calculated.Results Forty-one patients were included for analysis in this study.In supine position,the area under the ROC curve for SVV in predicting the fluid responsiveness was 0.740 (95％ CI:0.568-0.913),the diagnostic threshold was 12％,and the sensitivity and specificity in determining fluid responsiveness were 86％ and 54％,respectively,for SVVF,and the area under the ROC curve was 0.637 for SVVP.In prone position,the area under the ROC curve was 0.451 for SVVF,and 0.634 for SVVP.Compared with Rs group,the baseline value of SVVFwas significantly lower,and no significant change was found in the other hemodynamic parameters before volume expansion in supine position in NRs group.There was no significant difference in the hemodynamic parameters before volume expansion in prone position between the two groups.Conclusion SVV determined by using FloTrac/Vigileo and Picco-plus systems in prone position can not accurately assess the blood volume in the patients undergoing spine surgery.

Objective To explore the feasibility of off-pump coronary artery bypass grafting (OPCAB) in the treatment of severe coronary atherosclerotic heart disease. Methods Clinical data of 37 cases of severe coronary heart disease from January to December, 2002, were retrospectively reviewed. All operations were conducted under general anesthesia by midline sternotomy. The left internal mammary artery (LIMA) and the great saphenous vein (SV) were divided for grafting. Then we stabilified the local myocardium and exposed the diseased coronary arteries. Following the insertion of an intracoronary shunt, the LIMA was anastomosed to the left anterior descending artery (LAD). Afterwards, the SV was proximally anastomosed to the aorta, and then, to the coronary artery. Results All the operations were completed by beating heart revascularization. The number of bypass grafting was 3 2?0 5 (range, 1～6). Except 1 patient died on the 10th postoperative day, no severe complications, such as peri-operative myocardial infarction, respiratory failure, renal insufficiency or cerebrovascular accident, took place in the remaining 36 patients. Conclusions In the context of skillful procedure techniques and strict peri-operative management, OPCAB in the treatment of severe coronary atherosclerotic heart disease is feasible.

Observed index is a very important element in a research design, because it is a specific reflection of the effects of research factors on the research subjects and is indispensable in any research. Generally, there are two types of observed indexes: the indexes that reflect natural attributes, habits or states of the research subjects and the indexes that reflect the effects of different drugs or treatments on research subjects. This article mainly introduces the definition, characteristics, selection and observation of research indexes and the major and minor indexes.

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Styrenes ; analysis ; Workplace

Objective To compare the humoral immunity features of acute glomerulonephritis and nephritic syndrome(NS) in children for earlier differential diagnosis and rational administration.Methods Nephelometry was used to determinate the serum level of immunoglobulin(Ig)G,IgA,IgM,C3,C4 in children by England MININEPH machine and correlated reagent. The serum level of IgE was determined by IgE enzyme linked immunosorbent assay(ELISA),assay ELISA kit of America E&ELABSINC company. Immunoturbidimetry and westergren method were used to detect anti-streptolysin O(ASO) and erythrocyte sedimentation rate(ESR),respectively.Results There were significant diffe-rence features of humoral immunity between acute glomerulonephritis and NS in children.IgG,IgA,IgE,C3,C4 had significant difference between acute glomerulonephritis children and healthy children(Pa

Objective To compare the perioperative safety and curative effects oflaparoscopic adrenal sparing surgery (ASS) with laparoscopic total adrenalectomy (TA) for aldosterone producing adenoma (APA).Methods An online systematical retrieval was performed with Pubmed,ScienceDirect,Springerlink,the Cochrane library,CNKI and China Biology Medicine disc for clinical comparative studies published before May 2016,these studies reported the treatment of ASS/partial adrenalectomy (PA) versus TA for APA.The selected studies were applied to Revman 5.3 software for meta-analysis.The main contents were perioperative outcomes (operative time,intra-operative blood loss,and length of hospital stay) and postoperative efficacy (cure rate,partial response rate,inefficiency rate).Results A total of 9 clinical studies (3 English documents and 6 Chinese documents) with 1036 patients were included into the final analysis,among which 544 patients were assigned to ASS group and 492 in TA group.The analyzed results demonstrated no statistical significance between ASS group and TA group on operative time (WMD:-2.09min,95％CI:-9.86-5.67,P=0.60),length of hospital stay (WMD:-0.10d,95％CI:-0.32-0.12,P=0.36),intra-operative blood loss (WMD:1.13ml,95％CI:-8.86-11.12,P=0.82),cure rate (OR=l.07,95％CI:0.73-1.58,P=0.72),partial response rate (OR=0.85,95％CI:0.57-1.27,P=0.43) and inefficiency rate (OR=2.15,95％CI:0.32-14.34,P=0.43).Conclusion For surgical treatment of APA,ASS is technically safe,can achieve reliable postoperative efficacy and a similar therapeutic effect compared with TA,so deserves further application in clinical practice.

Because of the population aging,the increase of the stroke patients and the need for rehabilitation,the treatment only in the rehabilitation department of the hospital is far from the satisfaction of people's demands of the service of rehabilitation.It is important to extend the community-based rehabilitation.Compared with the rehabilitation in hospitals,it is more economy,efficiency and convenience for stroke patients in community-based rehabilitation services,and further improve the rehabilitation effect of stroke patients.

Background Elevated intraocular pressure leads to the loss of retinal ganglion cells and vigorous reaction of retinal glial cells.The expression of nestin in retinal glial cells secondary to hypertention and its significance are unclear.ObjectiveThis study aim to investigate the expression of nestin in retinal glial cells (RGCs) in ocular hypertention rats.Methods The ocular hypertention models were established by cauterizing the limbus-draining veins in the right eyes of 42 SD rats,and a conjunctival incision in the left eyes of the rats served as the sham group.The intraocular pressure (IOP) was measured with the Tono-Pen XL tonometer.The number of RGCs in the rats with ocular hypertention was counted.The expression of the nestin protein in RGCs was semi-quantitatively analyzed using Western by immunochemistry.Double immunofluorescence was carried out to evaluate the the confocal laser scaning microscope.Results Significant differences were found in the IOP between the model group and the sham group at various time points (P＜0.05).In 1 week to 3 weeks after operation,the number of RGCs significantly declined in the model group compared with the sham group (P＜0.05).Immunochemistry showed that from 2 hours through 1 week after operation,the expression of nestin was gradually enhanced in the model group in comparison with the sham group.Western blot revealed that the expression of the nestin protein reflected a similar tendency to that of immunofluorescence.The increased introcular pressure as manifested by the induced expression of nestin.Immunoelectron microscopy also confirmed the induced expression of nestin especially at their end-feet suggests a potential neuroprotective mechanism in neuronal degeneration.Nestin may be a useful biomarker for retinal injury study.

Alzheimer's Disease (AD) is a chronic neurodegenerative disease that usually takes many years from preclinical phase to prodromal phase characterized by mild symptoms before the onset of dementia. Once diagnosed with AD, the brain is already severely damaged and the disease will process quickly to the most severe stages since there is no medications that reverse the neuronal injuries in the brain. Thus, simple, inexpensive, and widely available methods for detecting potential AD patients during their preclinical phases are urgently needed. In such case, olfactory testing may offer a chance for early diagnosis of AD. However, there are limitations in these olfactory tests due to the complexity of the brain areas it extends to and the frequently olfactory fatigue occurred in the behavioral olfactory tests. Great efforts have been done epidemiologically to investigate the correlation between olfactory functions and possibility of developing AD. Different patterns of olfactory dysfunction have been found in AD at early stages and even mild cognitive impairment (MIC), but the cause of the dysfunction remained unclear. Various kinds of AD animal models have been used in the field to clarify the existence of olfactory dysfunctions and thus study the underling mechanism of the dysfunction. In this review we discuss (1) the function of Tau physiologically and pathologically; (2) the genetic background and biological characteristics of the most commonly used Tau transgenic mice; (3) the structural and molecule basis of olfaction; (4) the possible relationship between Tau pathology and olfactory dysfunction. Finally, we suggest that the tau transgenic mouse models may be helpful in studying the possible mechanisms of the dysfunction.
Alzheimer Disease ; physiopathology ; Animals ; Disease Models, Animal ; Mice ; Mice, Transgenic ; Olfaction Disorders ; physiopathology ; tau Proteins

Objective To study the expression and the mechanism of miR-155in the villi of patients with unexplained recurrent spontaneous abortion (URSA).Methods The expression of miR-155 in the villi of 36 cases with URSA (URSA group) and 25 women with normal early pregnancy (control group) were detected by stem-loop real-time reverse transcription (RT) qPCR.Expression of hypoxia inducible factor-1 (HIF-1α),vascular endothelial cell growth factor(VEGF) and micro lymphatic vessel density (MVD) in the villi of were measured by immnohistochemical staining among two groups.Results (1) miR-155 expression:the mean miR-155 expression were 1.456 (0.489,2.459) in URSA group and 2.833 (1.740,3.794) in control group,which reached statistical difference (P ＜0.05).The mean expression of miR-155 of 1.683 (0.902,2.459) in URSA group with abortion times (≤ 3) was significantly higher than 1.229 (0.489,1.719) in URSA group with more than 4 times abortion (P ＜ 0.05).(2) Indexes:the expression of HIF-1α,VEGF and MVD value were 121 ± 12,134 ± 12,36 ± 6 in URSA group and 99 ± 10,109 ± 10,28 ±4 in control group,which reached statistical difference(P ＜ 0.01).The expression of HIF-1α,VEGF and MVD value of 119 ± 12,134 ± 12,35 ± 5 in URSA group with less than 3 times abortion was significantly lower than 128 ± 12,138 ± 12,43 ± 6 in URSA group with more than 4 times abortion (P ＜ 0.01).Conclusions The expression of miR-155 and HIF-1α is topically stimulated by oxygen signal.HIF-1α adjusts the transcription and translation of VEGF,which together involved in placental trophoblast invasion and placental angiogenesis.The low expression of miR-155 could interfere with expression of HIF-1α and VEGF,which might be involved in villous vascular dysplasia in URSA.