Objective To compare the analgesia and side-effects of different concentrations of sufentanil combined with 0.125% ropivacaine for postoperative epidural analgesia after general thoracic surgery.Methods Thirty-six ASA Ⅰ-Ⅲ patients (25 males, 11 females) ages 21-64 yrs weighing 42-79 kg undergoing elective general thoracic surgery under general anesthesia were randomly assigned to receive patient-controlled epidural analgesia (PCEA) with 0.125% ropivacaine combined with sufentanil 0.4 (group A, n = 12) , 0.5 (group B, n = 12) or 0.6 ?g?ml-1 (group C, n = 12) . Epidural catheter was placed at T7,8 or T8,9 interspace. The PCEA pump was set up with back ground infusion of 2 ml?h-1 , a3ml bolus dose and a 30-min lock-out period. VAS scores was used to assess analgesia at rest and during movement. The total bolus doses, PCEA button pressing times (effective/actual), vital signs including MAP, HR, respiratory rate, SpO2 and side effects (nausea, vomiting, pruritus and dyspnea) were recorded. Results During the 48 hours after operation the VAS scores in group C were significantly lower than those in group A and B ( P

Objective To construct canine bifurcation aneurysms suitable for evaluating the exploration of endovascular devices for interventional therapy by endovascular technique.Methods The right common carotid artery of six dogs was expanded with a pliable balloon by means of endovascular technique, then embolization with detached balloon was taken at their originations DAS examination were performed on 1,2,3 d after the procedurse. Results 6 aneurysm models were created in six dogs successfully with the mean width and height of the aneurysms decreasing in 3 days.Conclusions This canine aneurysm model presents the virture in the size and shape of human cerebral bifurcation saccular aneurysms on DSA image, suitable for developing the exploration of endovascular devices for aneurismal therapy. The procedure is quick, reliable and reproducible.

Objectives: Early postoperative inflammatory ileus(EPII) is a special type of ileus. For its special pathophysiological and clinical characters, EPII is hard to be treated.The combination therapy including total parenteral nutrition(TPN), enteral nutrition(EN), somatostatin and cortin has been used to treat EPII. Methods: From May 2001 to December 2001, 10 EPII patients were treated and the changes of clinical symptoms, serum total protein, albumin, prealbumin and the curative effect were observed. Results: All patients were cured without operation. Two days after treatment, the gastric juice was reduced from (1 377.5?856.8)ml to (484.0?396.3)ml ( P = 0.037 ) but the serum total protein, albumin and prealbumin had no changes. The clinical symptoms subsided quickly. Average TPN time was 21 days and EN time was 9 days. The average time in hospital was 32 days. Conclusions:The combination therapy can obviously alleviate the clinical symptoms, maintain the nutritional status and promote the recovery of intestinal function in EPII patient.

Objective:To observe the applications of damage control surgery(DCS) theory in selective abdominal operations.Methods:Two patients suffered from abdominal huge tumour were included in this clinical observation.DCS method was used in the first case when uncontrollable haemorrhage happened in the operation.In the second case,the DCS method was planed before operation.Results:Both the two patients were healed.The second one had no dangerous states after operation.Conclusion:In selective abdominal operation,perioperative DCS method should be considered if some life-threatening risks may happen in the operative procedure.

Objective Inquire into the relationship between diabetic peripheral neuropathy(DPN)pathogenic factor and Antigangliosides antibody(Anti-GS-Ab)in type 2 diabetes mellitus. Methods It was examined by enzyme-linked immunosorbent assays(ELISA)to the levels of serum Anti-gangliosides(Anti-GS)in 2 DM and DPN as well as healthy.Results The positive rate of Anti-GS-IgM,IgG in DPN group were 46.7% and 20.0%.repectivily it was obviously higher than normal group and 2 DM group.Conclusion The relationship between the DPN and Anti-GS-Ab is a close.It show that Anti-GS-Ab play an important role in DPN pathological process.

Objective To explore the application of cancer pain standardized treatment in patients with lung cancer pain and clinical results.Methods 120 cases of lung cancer pain patients as the research object in Our hospital from April 2015 to June 2016,The patients were randomly divided into study group and control group,60 cases in each group,the patients in the control group were treated with routine therapy and nursing,and the patients in the study group were treated with normalized treatment and care of cancer pain,and then compared the two groups after treatment Pain status changes and adverse events and patient satisfaction statistics.Results There was no significant difference in pain status and VAS score between the two groups before treatment,but the pain status was relieved after treatment.The pain status of patients in the study group after standardized treatment of cancer pain changed significantly,the VAS score was lower than the control,the difference between the two groups was statistically significant(P<0.05).After treatment,the adverse events of the study group including non-on-time medication,syncope pressure sores and the incidence of self-mutilation or suicide were statistically significant And the difference was statistically significant(P<0.05).The satisfaction of the patients in the two groups showed that the satisfaction of the patients in the study group was significantly higher than that of the control group,The difference between groups was statistically significant(P<0.05).Conclusion The standardized treatment of cancer pain is effective in the treatment of patients with lung cancer pain.It can effectively relieve the pain and improve the quality of life and satisfaction of patients with lung cancer pain.It has broad clinical application and popularization value.

Objective To investigate the clinical efficacy of laparoscopic surgery for pelvic radiation induced enteritis (PRIE).Methods The retrospective cross-sectional study was conducted The clinical data of 66 patients with PRIE who were admitted to the Nanjing General Hospital of Nanjing Military Command from January 2012 to December 2015 were collected.Laparoscopic surgery will be applied to patients based on patients' clinical manifestations after completing relative examinations.Observation indicators:(1) surgical situations:surgical method,conversion to open surgery,reoperation,surgical incision length,grade of abdominal adhesions,surgical time,volume of intraoperative blood loss,duration of postoperative hospital stay;(2) occurrence of surgical complications;(3) follow-up situations.Follow-up using telephone interview was performed to detect patients' survival and recurrence of PRIE up to April 2016.Measurement data with normal distribution were represented as x±s.Results (1) Surgical situations:① of 59 patients with small intestinal obstruction,11underwent laparoscopic small intestinal resection or enterostomy,including 2 with conversion to open surgery due to dense adhesions,1 due to uncertainty of tumor recurrence and 1 due to intestinal canal dilatation affected vision;48 underwent laparoscopic resection of ileocecum,including 1 1 with conversion to open surgery due to dense adhesions,2 due to iliac vessels injury and 4 due to injuries of sigmoid colon,rectum and bladder.Four patients with colonic obstruction and proctitis underwent laparoscopic colostomy,without conversion to open surgery.One patient received conversional open surgery and underwent intestinal resection of internal fistula + exclusion of rectal stump due to intestine-rectum fistula induced dense adhesions.One patient with anal atresia underwent laparoscope-assisted resection of pelvic tissues and rectal stump.One patient with localized peritonitis underwent laparoscope-assisted ileostomy.② Among 66 patients,4 received reoperations,including 2 with cervical cancer and 2 with rectal cancer,reoperations of 4 patients were respectively caused by intestine-rectum fistula,rectovaginal fistula,anastomotic fistula and ostomy + stoma reversion.Of 4 patients with reoperations,1 received conversion to open surgery due to dense adhesions and then underwent intestinal resection of internal fistula+exclusion of rectal stump,1 with rectovaginal fistula underwent laparoscopic colostomy,1 with anastomotic fistula underwent resection and anastomosis of small intestine due to dense adhesions and 1 underwent laparoscopic ileostomy and stoma reversion.③ Sixty-six patients received 70 operations,including 46 laparoscopic surgeries and 24 conversion to open surgeries.Surgical incision length and average length were respectively 3.0-6.0 cm,4.0 cm in 46 laparoscopic surgeries and 8.0-25.0 cm,15.5 cm in 24 conversion to open surgeries.Grade 0,1,2 and 3 of abdominal adhesions were detected respectively in 7,13,13,13 laparoscopic surgeries and in 1,1,12,10 conversion to open surgeries.Operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were respectively (128±50) minutes,(108±56) mL,(30± 15)days in 46 laparoscopic surgeries and (173±44) minutes,(222± 105) mL,(38± 19) days in 24 conversion to open surgeries.(2) Occurrence of surgical complications:1 patient was complicated with bladder injury in 46 laparoscopic surgeries,and 2,4 and 2 patients in 24 conversion to open surgeries were respectively complicated with bladder injury,colorectal injury and injury of right iliac vessels,they received intraoperative symptomatic treatment.Two,3,3,6 and 1 patients were respectively complicated with pleural effusion,wound infection or dehiscence,venous catheter infection,anastomotic fistula and cholestatic cholecystitis after 46 laparoscopic surgeries.One,5,1,4,2 and 1 were respectively complicated with pleural effusion,wound infection or dehiscence,venous catheter infection,anastomotic fistula,cholestatic cholecystitis and abdominal wall hemorrhage after 24 conversion to open surgeries.They were improved by symptomatic treatment.(3) Follow-up situations:all the 66 patients were followed up for 4-50 months,with a median time of 26 months.During the follow-up,3 patients died of intraperitoneal infection,short bowel syndrome and pulmonary infection,and 3 patients had PRIE.Conclusion The appropriate surgical method is selected based on clinical manifestations of patients,and laparoscopic surgery is safe and feasible for PRIE.

Objective To detect the expression of SALL4 in patients with acute myeloid leukemia (AML) and analyze its potential clinical significance. Methods Reverse transcription polymerase chain reaction and Real-time fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) was used to examine SALLA expression in peripheral blood mononuclear cells (PBMCs) of 68 cases of AML including 36 cases in acute phase and 32 cases in remission phase, 30 healthy controls, Kasumi-1 cells and THP-1 cells. Then, flow cytometry, bone marrow smear and automated hematology analyzer were used to analyze the relationship between the SALL4 expression and blast cell counts in the bone marrow, peripheral white blood cell (WBC) counts, peripheral large unstained cell (LUC), CD34 in blast cells. Further, the change of SALL4 level during pre-chemotherapy, chemotherapy (2nd w to 3rd w) and remission were investigated in 5 AML cases. Results The level of SALL4 expression in patients with AML in acute phase [69.01 (17.20-120.28)] was 26-fold and 61-fold high compared with that in remission phase [2.64(1.35-5.41)] and in healthy control [1.14(0.50-1.62)] (Z=-6.48,-6.83,P<0.01). The level of SALL4 expression in remission phase was 2.3-fold high compared with that in healthy control (Z=-3.61 ,P<0.01). The expression level of SALL4 was decreased along with efficient chemotherapy in 5 AML cases in which SALL4 expression level was 79.74 (33.76-89.09), 7.19 (5.97-20.21) and 3.40 (1.44-15.53) during pre-chemotherapy, chemotherapy (2nd w to 3rd w) and remission, respectively. In groups of abnormal increased counts of blast cell, peripheral LUC% and CD34%, expression of SALL4 [33.82 (16.00-144.01), 30.70(23.75-72.50) and 56.25(23.79-153.81), respectively] were higher than that in groups of normal counts [2.74 (1.59-5.13), 5.71 (2.52-22.40) and 20.82 (14.03-55.12), respectively ] (Z=-4.64,-2.18,-3.66,P<0.01 or P<0.05). The expression of SALL4 in the group of increased WBC counts [89.26(23.75-154.34)] was higher than that in the group of normal WBC counts [3.86(2.03-6.01)] and the group of decreased WBC counts [6.66(2.51-17.06)] (Z=-4.91,-4.21,P<0.01). The level of SALL4 expression was positively correlated with blast cell counts in bone marrow and peripheral WBC counts (r=0.45,0.40,P<0.01). Conclusions FQ-RT-PCR method can be used successfully to detect the expression of SALL4,and the expression of SALLA may be useful to predict disease progression of AML.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective To study the effects of liver graft on the immune tolerance of intestinal allograft in auxiliary en-bloc liver-small bowel transplantation in pigs.Methods Seventy outbreed Landrace pigs were divided into 4 groups.Ten auxiliary liver-small bowel allotransplantations were performed in group A,B,C,respectively,and 5 segmental small bowel allotransplantatiom were performed in group D.Pigs were administered with routine and lower dose of cyclosporine and methylprednisolone in group B and C,respectively. No immunosuppressive agent was administered to pigs in group A and D.Results The initial time of acute rejection was obviously prolonged in group A than group D.and the acute rejection was milder in group A than group D(P＜0.05).There was no significant difference upon postoperative survival time,initial time of acute rejection and degree of acute rejection between group B and C(P＞0.05).Conclusions The immune tolerance of intestinal allograft Can be induced by liver graft in auxiliary en-bloc liver-small howel transplantation.