Objective To investigate the effect of propofol and fentanyl on inflammatory response to tissue injury in children undergoing open heart surgery with CPB and the possible mechanism. Methods Twenty HYHA class Ⅱ - Ⅲ children with congenital heart disease, aged 10 month-12yr, undergoing elective open heart surgery were randomly divided into two groups: group F in which anesthesia was maintained with high dose fentanyl (50-80?g? kg-1 ) and group FP in which anesthesia was maintained with propofol infusion (20mg?kg-1?h-1 ) and intermittent iv boluses of fentanyl (

Objective To assess the benefit of intraoperatively placed nasointestinal feeding tubes for early postoperative enteral nutrition.Methods The retrospective study was carried out on 19 cases of in-fants with long gap esophageal atresia who underwent one-stage operation in Xinhua Hospital from January 2006 to December 2013.Patients were divided into two groups according to whether the transanastomotic na-sointestinal feeding tubes(TNFT)were placed.Demographics,associated anomalies,operative findings,com-plications,duration of enteral nutrition(EN),length of stay were analyzed.Results Thirty-seven patients had long gap esophageal atresia and nineteen underwent one-stage operation.Eight patients were identified as TNFT group while eleven patients were identified as nonfeeding tube(NFT)group.There was no significant differences between the two groups in gestational age,birth weight,associated anomalies,anastomotic leak, weight gain,ICU-free days and length of stay(P>0.05).But the ventilator-free days(23.5 d vs.19.3 d), first EN time(0.8 d vs.9.1 d)and total EN feeding time(15.9 d vs.21.4 d)between the two groups were significantly different(P<0.05 ).Conclusion Intraoperatively placed TNFT may lead to earlier EN feeding and shorter parenteral nutrition duration,but a larger prospective study would be required to prove the benefits and ensure the safety.

Objective To evaluate the effect of intratumor injection of Pingyangmycin for the treatment of superficial hemangioma and venous malformation.Methods From May 2005 to March 2008,42 patients with superficial hemangioma or venous malformation,including 17 men and 25 women(aged 3 months to 51 years)were treated in our hospital by injecting pingyangmycin intratumorally.Among the patients,18 had hemangioma,20 had venous malformation,and 4 had the both.The injection consisted of a mixture of Pingyangmycin(8 mg),2% lidocaine(2 ml),normal saline(2 ml),and dexamethasone(2.5 mg).The volume of the tumor was evaluated before the injection.And then the mixture was injected intratumorally at a density of 0.5 mg/cm2(0.3 mg/cm2 for the patients with ulcers in the skin or mouth).For the patients who had residual tumor after the first injection,a second treatment was performed in 10 days to 3 weeks or longer.The maximum dosage of Pingyangmycin for a single injection was 8 mg,and the maximum total dosage was 70 mg.Results One year after the treatment,85.5%(47/55)of the patients were cured,and 12.7%(7/55)were improved.The total effective rate was 98.2%(54/55).Conclusions Injection of Pingyangmycin is an effective and safe method for superficial hemangioma and venous malformation with low blood flow.The maximum injection density is 0.5mg/cm2.

Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

Objective To investigate the effects of levator ani muscle exposure in abdominal periueal resection for rectal cancer.Methods The clinical data of 109 patients with rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2001 to January 2008 were retrospectively analyzed.There were 55 patients received traditional procedure (conventional method group) and 54 patients received modified procedure with levator ani muscle exposure (levator ani muscle exposure group).The mesorectum was sharply dissected according to the total mesorectal excision principle.It is essential to remove the rectum along with the mesorectum up to the level of the levators.Preoperative bowel preparation,anesthesia,body position,abdominal incision,perineal incision and suture of the 2 groups were the same as Miles procedure.In the conventional method group,the superficial dissection was carried out with electrocautery or ultracision harmonic scalpel.The presacral space was entered by dividing the rectococcygeus muscle,commencing at the level of the tip of the coccygeus.The levators were then divided near the pelvic wall attachments and next procedures were performed without levator ani muscle exposure.In levator ani muscle exposure group,once the ischiorectal fat was cleared by electrocautery,the planes of levator ani muscle were identified and exposed after dividing the rectococcygeus muscle and next procedures were performed.The patients in stage Ⅰ only needed to follow-up; the patients in stage Ⅱ had to receive chemotherapy with following situation:poor differentiation,T4 stage,blood vessel or lymphatic invasion,number of lymph nodcs detected ＜ 12.Patients in stage Ⅲ or Ⅳ needed adjuvant chemotherapy.The follow-up evaluation included blood routine examination,hepatic and renal function examination,chest radiography,hepatobiliary ultrasonographic evaluation and determination of CEA levels (once every 3 months in the first year after operation,and once every 6 months after one year).Abdominal CT scan and colonoscopy should be employed every year.All the patients were followed up till December of 2012.All data were analyzed using the chi-square test or t test.The survival curve was drawn using the Kaplan-Meier method,and the prognosis was analyzed using the Log-rank test.Results The operation time were (60 ± 15)minutes and (30 ± 10) minutes in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =3.936,P ＜ 0.05).The intraoperative blood loss were (300 ± 60) mL and (30±20) mL in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =5.687,P ＜ 0.05).Three patients were with rectal injury,1 with urethral injury,1 with vaginal injury,and 10 with incision infection in the conventional method group.There were 9 patients with incision infection in the levator ani muscle exposure group.The course of chemotherapy was under 12 in 30 patients,and above 6 in 41 patients.The median time of follow-up of the patients was 56 months (range,15-95 months).Of the 109 patients,10 missed the follow-up,15 patients had local recurrence,30 had distal metastasis,and 35 patients died.The 1-,3-,5-year cumulative survival rates were 93.4％,76.0％ and 65.6％.The 5-year survival rates were 65.2％ and 66.3％ for patients in the conventional method group and the levator ani muscle exposure group,with no significant difference between the 2 groups (x2=4.210,P ＞0.05).Conclusion Levator ani muscle exposure method provides clearer vision of operational field,shorter operation time,less blood loss and less injury to the rectum or urinary tract (vagina).

Objective:To evaluate the efficacy and safety of raltitrexed plus oxaliplatin combined with concurrent radiotherapy for advanced esophageal carcinoma. Methods:A total of 54 patients with stageⅡ/Ⅲadvanced esophageal carcinoma according to the clinical staging of esophageal carcinoma nonsurgical methods were treated with raltitrexed plus oxaliplatin combined with concurrent radiotherapy. The patients were irradiated with a dose of 60 Gy in 30 fractions. Two cycles of concurrent chemotherapy were adminis-tered during radiotherapy, with 100 mg/m2 oxaliplatin and 2.6 mg/m2 raltitrexed on d1 and d22. Results:The complete response rate was 16.7%(9/54), and the partial response rate was 68.5%(37/54). The total response rate was 85.2%. The no response and progression rate was 14.8%(8/54). The one-and two-year local control rates and overall survival rates were 75.4%, 57.3%and 70.4%(95%CI, 0.6-0.8), 46.6%(95%CI, 0.3-0.6), respectively. The incidence rates of radiation-induced esophagitis, leucopenia, acute diarrhea, neuro-toxicity were 100%, 72.2%, 16.7%, and 44.4%, of which 7.4%, 7.4%, 1.9%, and 0%were≥grade 3, respectively. Conclusion:Ralti-trexed plus oxaliplatin combined with concurrent radiotherapy can enhance the response rate and prolong the survival of patients with advanced esophageal carcinoma. The regime has mild toxicity and is worthy of further study in PhaseⅢ.

AIM: To investigate the expression of soluble guanylate cyclase protein and its mRNA in rat pulmonary artery after exposure to hypoxia and hypercapnia. METHODS: Male Sprague-Dawley rats were randomly split into 4 group, which were hypoxic hypercapnic (HH 1 week, HH 2 weeks, HH 4 weeks) group and control group, to copy pulmonary hypertensive animal model. The expression of sGC? 1 and ? 1 subunits protein of medial and small pulmonary artery was performed by immunohistochemistry with a polycolonal antibody. In situ hybridization was performed on the rat lung tissue using sGC oligonuclear probe to assay the expression of sGC? 1 subunit mRNA. RESULTS: The sGC? 1 and ? 1 subunits protein and sGC? 1 subunit mRNA were faint staining in the pulmonary small and medium artery in HH1 week, HH 2 weeks and HH 4 weeks groups compared with control group (all P

AIM: To investigate the effect of roxithromycin on the NF-?B activity,the airway inflammation and bronchial hyperresponsiveness of asthma rats.METHODS: Thirty male adult Sprague-Dawley rats were randomly divided into the control group(Group C,n=10),asthma group(Group A,n=10) and roxithromycin group(Group R,n=10).The asthma model was induced by ovalbumin and Al(OH)3.The airway reactivity was detected and then rats in each group were sacrificed after 24 hours for the last provocation.The concentrations of IL-4,IL-5 and IFN-? in bronchoalveolar lavage fluid(BALF) were measured by ELISA,and the activity of NF-?B protein in bronchial epithelium was detected by immunohistochemistry.RESULTS: Compared with Group C,the airway reactivity in Group A was increased(P

Purpose To observe the effect of Xiange Granule on osteoporosis in ovariectomized rat model and explore the mechanism of prevention and treatment of osteoporosis.Methods 60 female rats were randomly divided into blank control group, model group, Xiange Granule low, middle and high-dose group, CEE3 group of 6 groups. The method used ovariectomy made animal model of postmenopausal osteoporosis. Gavage after 3 months measured femur bone mineral density, calcitonin, bone gla protein and estradiol concentration, observed cancellous bone of femur with electron microscope.Results Xiange Granule could significantly increase the bone mineral density, calcitonin, bone gla protein and estradiol levels of the ovariectomized rat model and improve the microstructure of cancellous bone.Conclusion Xiange Granule is effective for prevention and treatment on osteoporosis.

OBJECTIVE To investigate the etiology of acute respiratory tract infection(ARI)in Hefei area and risk factors that may influence the distribution of common pathogens.METHODS Direct immunofluorescence assay was applied to detect the respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(FluA),influenza virus B(FluB),parainfluenza virus PIV(1,2,3)and real time fluorescent quantitation polymerase chain reaction (FQ-PCR)was applied to measuring Mycoplasma pneumoniae(MP)and Chlamydia pneumoniae(CP)in nasopharyngeal secretions and sputum specimens.RESULTS Among 530 cases included in this study,421 cases (79.43%)showed positive viral etiology.ADV accounted for 73(13.77%),FluA-68(12.83%),FluB-56 (10.56%),RSV-48(9.05%),PIVl-47(8.86%),PIV3-42(7.92%),PIV2-33(6.22%),MP-32(6.03%)and CP-22(4.15%).The detected positive rate of pathogens isolated in winter was the highest(85.07%).CONCLUSIONS Acute upper respiratory tract infection(AURTI)is common and more than 75%pathogens in Hefei area are virus in which the most commonly virus is ADV.Meanwhile atypical pathogens of infection should not be ignored.