Objective To evaluate the effect of propofol on lung cell apoptosis induced by acute pulmonary thromboembolism (APTE) .Methods Forty male SD rats weighing 280-300 g were randomly divided into 5 groups ( n = 8 each) : group Ⅰ sham operation ( group S) ; group ⅡAPTE and 3 propofol groups ( group P1-3). APTE was produced by iv injection of auto-blood clots. Venous blood 0.2 ml was obtained from rat tail vein and placed in a sterile test tube which was kept in water bath at 37 ℃ overnight. The blood clot was cut into thrombi ( diameter 1 mm, length 5 mm) the next day. Fifteen thrombi in 2 ml of normal saline were injected into immediately after iv injection of auto-bloed clots. The animals were killed at the end of 4 h propofol infusion and lung specimens were obtained for determination of lung cell apoptosis rate by flow eytometry and expression of caspase-3, Bax, Bcl-2, Fas, FasL mRNA and protein by RT-PCR and Western blot.The expression of Bcl-2/Bax mRNA and protein was calculated. Results Compared with group S,APTE significantly increased the lung cell apoptosis rate, and expression of caspase-3, Bax, Fas, FasL and decreased the expression of Bcl-2 and Bcl-2/Bax. Propofol infusion significantly attenuated these APTE-induced changes. Conclusion Propofol can inhibit APTE-induced lung cell apoptosis by down-regulating the caspase-3, Fas and FasL expression and regulating the balance between Bcl-2 and Bax expression.

Objective To evaluate clinical effect of accurate pedicle subtraction osteotomy (PSO) using osteotomes in the treatment of thoracolumbar kyphosis (TLK).Methods From June 2007 to October 2010,18 patients with TLK underwent accurate PSO using osteotomes under X-ray fluoroscopy,including 13 males and 5 females,with an average age of 48.6 years.The primary causes of TLK included old fracture (11cases),chronic tuberculosis (4 cases) and hemivertebra (3 cases).Deformity apex occurred at T12 (5 cases),L1 (9 cases),and L2 (4 cases).Radiological assessment for sagittal balance was performed by measuring Cobb angle.The Frankel grade,visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pre-and post-operative neurological status,back pain and function.Results The mean operative time,mean blood loss and mean postoperative drainage volume were 247.0±29.3 minutes,708.5±34.5 ml and 337.3±74.6 ml,respectively.All patients were followed up for 1 to 4.5 years (average,2.8 years).Solid fusion was achieved in all patients.Cobb angle was corrected from preoperative 42.3°±5.7° to 2.2°±1.9° three months postoperatively and 2.7°±2.1 ° at final follow-up.VAS and ODI scores decreased from preoperative 8.5±1.0 and 72.8％±8.3％ to 2.1±0.7 and 21.6％±9.2％ three months postoperatively,and 1.9±0.6 and 19.3％±8.6％ at final follow-up,respectively.With regard to Frankel grade,a 1-grade and 2-grade improvement was observed in 7 cases and 2 cases 3 months postoperatively,respectively.At final follow-up,a 1-grade and 2-grade improvement was observed in 5 cases and 4 cases,respectively.Two patients had transient neurological symptoms postoperatively,which recovered after drug treatment for 2 weeks.No other complications occurred.Conclusion It is safe and effective to correct TLK through accurate PSO using osteotomes,which has some advantages,such as less blood loss,higher fusion rate and fewer complications.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.

Objective To investigate the effect of ellagic acid on human epidermal melanocyte melanogenesis and melanin transfer, and the mechanism thereof. Methods The human melanocytes and and keratinocytes were co-cultured and purified. After passing the second generation, cells of 1∶10 ratio were inoculated into the small dish (3 cm × 3 cm). The changes of melanin content and tyrosinase activity in melanocytes were detected before and after intervention with ellagic acid (100, 10 and 1 mg/L) for 48 h. The melanin transfer in cultured cells was detected by flow cytometry method. The 10 nmol/L arbutin was used as the positive control. Results The tyrosinase activity was down-regulated by ellagic acid in a dose-dependent manner. The ellagic acid can reduce the melanin content except for the 1 mg/L of ellagic acid. The melanin transfer was also inhibited by ellagic acid in a dose-dependence manner. Conclusion Ellagic acid can be used for skin-whitening cosmetic and the depigmenting effect might be due to the down-regulation of melanogenesis and melanin transfer.

Objective To investigate the dilating effect of dexmedetomidine (DEX)on isolated vascular smooth muscles and to explore the mechanism.Methods Tension of isolated mesenteric arterial rings of male Sprague-Dawley rats was recorded.The effects of DEX on the rings and the effects of DEX on vascular reaction induced by various drugs were recorded. Results DEX completely relaxed the contraction induced by phenylephrine (PE)and KCl in a concentration-dependent manner in endothelium intact mesenteric arterial rings in rats.The vasodilating effect of DEX was increased by sodium nitroprusside.In phenylephrine (10-5 mol/L)based on pre-vasoconstriction,adding acetylcholine could not suppress DEX’s vasodilating effect.Vasodilation was not related to the endothelial cells.In physiological saline solution without calcium,DEX significantly inhibited the contraction induced by addition of CaCl2 .Conclusion DEX can induce vasodilation in a concentration-dependent manner,which is not dependent on the endothelial cells.

Objective To explore the effectiveness of 125I seed implantation for gastric cancer and to determine whether the therapy could increase the survival rate.Methods Seventy-six gastric cancer patients in stage Ⅱ or Ⅲ were involved and randomly divided into treatment group (n =42) and control group (n =34)by simple random sampling method.The patients in the control group underwent D2 or D3 surgery and the patients in treatment group underwent D2 or D3 surgery plus interstitial implantation of 125I seeds.All patients signed the informed consents.Treatment results were evaluated as CR,PR,NC and PD.CR and PR were considered as effective and the effective rate was calculated.All patients were followed up and the three-or five-year survival rate was calculated,the complications were examined.x2 test was used to compare the significant difference between the two groups.Results The total effective rate in control group was 50.00％ (17/34),lower than that of treatment group (73.81％,31/42; x2 =4.578,P＜0.05).In the treatment group,the three-year and five-year survival rates were 61.90％(26/42) and 42.86％(18/42) respectively,and the corresponding rates in the control group were 11.76％(4/34) and 0(0/34) respectively (x2=19.771,19.094,both P＜0.001).Both of the two groups had few severe side effects.Conclusion Radical surgery plus 1~Iseed implantation is effective and safe for the treatment of stage Ⅱ or Ⅲ gastric cancer and can further improvelong-term survival.

Objective To investigate the feasibility,safety and therapeutic effects of minimally invasive percutaneous mono-segment pedicle instrumentation in treating thoracolumbar burst fractures ( AO classification:A 3.1 and A 3.2 ).Methods Twenty-four inpatients with thoracolumbar burst fractures (AO classification:A 3.1 and A 3.2) treated with percutaneous mono-segment pedicle instrumentation from March 2010 to December 2010 were retrospectively studied.The operation time,blood loss,pre-and post-operative visual analogue scale ( VAS),ratio of anterior height between compressed vertebral body and normal vertebral body and vertebral kyphotic Cobb' s angle were evaluated.Results The operation lasted for (90 ± 25) minutes,with intraoperative blood loss of (20 ± 10) ml.The rate of anterior body height rose from pre-operative (56.5 ± 10.1 ) to (92.3 ± 12.2) one week post-operatively and to (90.2 ± 11.l)at the follow-up one year later.The vertebral kyphotic Cobb' s angle was pre-operative ( 16.5 ± 5.2) °,which was reduced to ( 7.3 ± 2.4 )° at oneweek after surgery and ( 7.9 ± 3.5 )° at the follow-up one year later respectively.The VAS scored ( 7.0 ± 1.2) points before surgery,( 1.2 ±0.7) points at one week after surgery and ( 1.1 ± 6..5) points at the follow-up one year later.The ratio of anterior body height at one week after surgery and at the follow-up one year later were both obviously higher than that before surgery (P ＜ 0.05 ),but the ratio one week postoperatively showed no significant difference in comparison with that one year postoperatively (P ＞0.05).The kyphotic Cobb' s angle had significant decrease at one week after surgery and at the follow-up one year later,as compared with that before operation (P ＜0.0 5).Also,the VAS score showed marked improvement at one week after surgery and at the follow-up one year later.Conclusions Minimally invasive percutaneous mono-segmental pedicle instrumentation is effective and safe for thoracolumbar burst fractures (AO classification:A 3.1and A 3.2),but it is not suitable for thoracolumbar burst fracture with severely compressed vertebra.

Objective To evaluate the difference of clinical short-term effect and adverse reaction between paclitaxel liposome and paclitaxel in non-small cell lung cancer patients with lymph node metastasis after pulmonary resection.Methods Sixty-eight patients after pulmonary resection were divided into two groups by random digits table method,37 patients in experimental group with paclitaxel liposome (135mg/m2) combined with carboplatin (CBP) at 300 mg/m2 in chemotherapy,and 31 patients in control group with paclitaxel (135 mg/m2) combined with CBP at 300 mg/m2 in chemotherapy.Results All patients were evaluable.In experimental group,5 patients had complete remission,10 patients had partial remission,17patients were stable,5 patients' condition aggravated,the total effective rate was 40.5％(15/37),clinical control rate was 86.5％ (32/37).In control group,2 patients had complete remission,8 patients had partial remission,15 patients were stable,6 patients' condition aggravated,the total effective rote was 32.3％(10/31),clinical control rate was 80.6％(25/31).The treatment effectiveness in experimental group was significantly higher than that in control group (P ＜ 0.05).The main adverse reaction included marrow suppression,hair loss,muscle and joint pain and gastrointestinal symptom,there was no serious hypersensitivity.The rate of hypotension,face flushing,paresthesia,muscle and joint pain,erythra in experimental group was lower than that in control group [0 vs.9.7％ (3/31),5.4％ (2/37) vs.19.4％ (6/31),10.8％ (4/37) vs.22.6％ (7/31),13.5％ (5/37) vs.38.7％ (12/31),5.4％ (2/37) vs.25.8％ (8/31)] (P ＜0.0 1 or ＜0.05).Conclusion The curative effect rate of paclitaxel liposome is better than paclitaxel in patients with lymph node metastasis after pulmonary resection and with lower incidence of side effects.

BACKGROUND:Previous studies have demonstrated that transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells can effectively promote the motor function and sensory function recovery of rhesus monkeys with spinal cord injury.
OBJECTIVE:To validate whether co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells exhibits better protective effects on spinal cord glial scar of rhesus monkeys with spinal cord injury than celltransplantation alone.
METHODS:Twelve rhesus monkeys were col ected to prepare animal models of acute severe spinal cord injury using modified Al en’s method, and then randomly divided into three groups:experimental group, co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells;control group, simple transplantation of bone marrow mesenchymal stem cells-derived neuron-like cells;blank control group, PBS. After 5 months, paraffin specimens of the spinal cord were made for detection of morphological and compositional characteristics of glial scar, regeneration of nerve fibers in the scar, glial scar area, and average absorbance of glial fibril ary acidic protein.
RESULTS AND CONCLUSION:Glial scar in the injured spinal cord was composed of astrocytes and histocytes. Less spinal cord glial scar area and lower absorbance value could be observed in the experimental and control groups as compared with the blank control group (P<0.05). In addition, in the blank control group, neurofilament negative fibers could be observed in the glial scar, and astrocytes proliferated obviously. The experimental and control groups showed less fibers passed through the scar area. The glial scar area and average absorbance in the experimental group was lower than that in the control group (P<0.05). These findings suggest that compared with simple transplantation of bone marrow mesenchymal stem cells-derived neuron-like cells, co-transplantation of control ed release glial cellline-derived neurotrophic factor and bone marrow mesenchymal stem cells-derived neuron-like cells shows better protective effects spinal tissue structure after spinal cord injury, which may be one of mechanisms by which the number of glial scars is reduced to a greater extent.

Objective To explore the feasibility of mechanical chest compression to establish a rat model of car?diopulmonary resuscitation ( CPR) . Methods 4?month old healthy male Sprague Dawley rats were randomly divided into control group ( n=6 ) and model group ( n=10 ) . After induction of anaesthesia with 10% chloraldurate ( 3 ml/kg, i. p. ) , tracheal intubation and left femoral artery cannulation were performed. Under electrocardiographic and artery blood pressure monitoring, tracheal obstruction ( TO) was performed to rats in model group. At 2 min after the cardiac arrest ( CA) occurred, CPRs were administered to the rats using a self?made animal chest compressor, which provided chest?com?pression at a rate of 200 bpm. Results Shortly after TO, rats in the model group had respiratory arrest, cyanosis and ar?rhythmia. Electrocardiography indicated that CA occurred within 4-5 min, with a decreased artery systolic blood pressure ( <40 mmHg) and a zero pulse pressure. Return of spontaneous circulation ( ROSC) after the CPR was successfully a?chieved in 8 rats (80%), with a transient reperfusion arrhythmia. Finally, 60% of the rats (n=6) recovered to con?sciousness and survived for 24 hrs. The serum biochemical analysis indicated that there were electrolyte disturbances, aci?dosis, impaired renal functions and increased myocardial enzyme spectrum. Pathological examination revealed cardiac rhab? domyolysis, no?reflow phenomenon in renal glomeruli, decrease of neurons and pulmonary congestion in the model group rats. Conclusions Mechanical chest compression can provide minimal cardiac output for the requirement of CPR incardiac arrestin rats. It is feasible to establish rat CPR model with the mechanical chest compression.