Objective To investigate the effect of hydroxyl starch (HES 200/0 5) infusion on blood rheology during operation Methods Forty adult ASA Ⅰ Ⅱ patients (male 28, female 12) scheduled for elective operation on spine (26 patients) and lower extremities (14 patients) were enrolled in this study The age ranged from 18 56 yr and weight from 40 85kg Preoperative heart, lung, liver and kidney function tests, blood routine exam, bleeding and coagulation time were all normal No patients had any history of abnormal bleeding The patients were randomly divided into two equal groups: control group(C) receiving lactated Ringer solution 1 000ml during operation and HES group receiving 6% HES 1 000ml No patient received any plasma or whole blood during operation The patients were premedicated with intramuscular atropine 0 5mg and sodium luminal 0 1g The operations were all performed under continuous epidural block (1 6% lidocaine with adrenaline 1:200 000) BP,ECG,and SpO 2 were continuously monitored during operation Blood pressure was maintained with range and SpO 2 above 97% Venuos blood samples were taken before anesthesia , 30min and 4h after the fluid had been infused and 24h after operation for determination of blood viscosity, plasma viscosity, hematocrit(HCT) index of red blood cell (RBC) aggregation and deformation and index of fibrinogen Results Blood viscosity, Hct, index of RBC aggregation and fibrinogen decreased significantly (P

Objective To investigate the effects of different tidal volume mechanical ventilation on pulmonary function and inflammatory factors in gynecologic laparoscopic surgery.Methods 45 patients undergoing gynecological laparoscopic surgery without lung disease,ASA Ⅰ-Ⅱ,aged 20-45 years old,weight 45-65 kg,operation time 2-3 hours,were randomly divided into A,B,C three groups,15 cases in each group.Mechanical ventilation with different tidal volume of the three groups,A group,B group and C group were 8mL/kg,9mL/kg,10mL/kg.Blood gas analysis was performed before anesthesia (T0),30 minutes (T1),(T2),PA-aDO2 (60 minutes) (T3),and 120 min (T4),respectively,and the peak airway pressure and mean pressure were recorded.IL-6,TNF-α and IL-10 levels in plasma by radial artery blood sampling were simnultaneously determined.Results Comnpared with A group,the concentrations of Ppeak and Pmean were increased in B group at T1-T4 (t =5.13,4.78,6.54,5.32 and t =7.54,4.88,5.37,4.95;all P ＜ 0.05),the concentration of Ppeak and Pmean in C group at T1-T4 increased (t =7.76,8.87,7.23,8.99 and t =6.42,7.38,7.62,9.86;all P ＜ 0.05).Compared with B group,the concentrations of Ppeak and Pmean were increased in C group at T1-T4 (t =4.76,5.87,4.23,3.99 and t =4.76,3.99,6.06,4.52;all P ＜ 0.05).Compared with A group,the A-aDO2 values of B group and C group were increased at T1,T2,T3 and T4 (t =5.32,5.48,4.88,5.69 and t =7.85,7.32,8.45,6.67;all P ＜ 0.05).Compared with B group at the same time point,the A-aDO2 value of C group increased at four times of T1-T4 (t =5.62,4.38,6.94,4.22,P ＜0.05).Compared with group A,the concentration of A-aDO2 in C group was higher than that in B group at the same time point (t =4.45,4.87,5.32,4.79 and t =7.68,7.59,7.44,8.38;all P ＜ 0.05).The levels of IL-6 and TNF-α in C group were significantly higher than those in the control group (t =4.78,5.56,7.62,8.03 and t =3.98,4.52,5.46,6.23;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations AT T2-T4 in A group had no statistically significant differences (all P ＞ 0.05).Compared with B group,the levels of IL-6 and TNF-α in C group were significantly higher (t =4.58,4.99,6.53,4.77 and t =5.62,7.89,6.43,4.52;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations at T2-T4 in A group had no statistically significant differences (all P ＞0.05).There was no significant difference in IL-10 concentration among the thrce groups.Conclusion Laparoscopic surgery according to the end tidal carbon dioxide partial pressure (PetCO2) ventilation frequency,8 mL/kg tidal volume mechanical ventilation has no effect on the IL-6,TNF-alpha,IL-10 and other inflammatory factors,mechanical ventilation tidal volume is more appropriate.

Objective To reveal the incidence and types of acid-base disorder (ABD) of critically ill patients in emergency.Methods The clinical data of critically ill patients in the resuscitation room were collected prospectively from December 1,2008 to March 31,2009.Both arterial and venous blood samples were collected to detect arterial blood gas analysis and serum electrolytes simultaneously and their ABD were analyzed.Results Of totally 766 cases,the incidence of ABD was 97.3％ (745 cases).Among ABD the simple acid-base disorder ( SA BD) was 149 cases ( 20.0％ ),dual acid-base disorder (DABD) 525 (70.5％ ) and triple acid-base disorder (TABD) 71 (9.5％ ).After calculating anion gap (AG),the incidence of TABD increased from 12 to 71 cases and the missed diagnosis rate were 83.1％ (59 cases) and after calculating potential HCO3-,the incidence of TABD increased from 8 to 71 cases and the missed diagnosis rate were 88.7％ (63 cases).The age of patients with TABD (77.9 ± 10.7 years old) was older ( P ＜ 0.01 ) than that of other two groups of SABD and DABD as well as APACHEⅡ score (25.9 ± 7.1 ) and incidence (22.5％ ) of MODS in TABD were higher (P ＜0.01 ).The mortality of patients with TABD on the first,second,third and seven day were 14.1％,23.9％,26.8％ and 38.0％ respectively and significantly higher than those in SABD and DABD (P ＜0.05 or P ＜0.01 ).Conclusions The incidence of ABD was 97.3％.Calculation of AG and potential HCO3- would help find metabolic acidosis and TABD.The age and APACHEⅡ score were key factors to poor prognosis of patients with TABD.

Objective To evaluate the possible correlation between anxiety state and serum angiontensin Ⅱ levels in patients with vitiligo.Methods Sixty patients with progressive vitiligo and 30 normal human controls were included in this study.Self-rating anxiety scale (SAS) was used to evaluate the anxiety state,and enzyme linked immunosorbent assay was performed to determine the serum level of angiontensin Ⅱ,in these subjects.Results SAS score was significantly increased in patients compared with the controls (46.13 ±11.72 vs.36.73 ± 12.59,t =3.50,P ＜ 0.01),and 48.3％ of the patients were affected by anxiety.The SAS score and prevalence of anxiety were statistically higher in female than in male patients (t =2.47,x2 =4.58,both P ＜ 0.05),in unmarried than in married patients (t =2.59,P ＜ 0.01; x2 =6.17,P ＜ 0.05),in patients with lesions on exposed areas than in those with lesions on unexposed areas (t =3.60,P ＜ 0.01; x2 =5.84,P ＜0.05).In patients affected by anxiety,the level of serum angiontensin Ⅱ was significantly elevated compared with patients without anxiety (63.83 ± 10.92 vs.40.74 ± 8.70 ng/L,t =9.09,P ＜ 0.01 ).Conclusions Patients with vitiligo are usually affected by anxiety.The serum level of angiontensin Ⅱ is closely correlated with anxiety state in patients with vitiligo as well as with the development of vitiligo,and may have an impact on the initiation and progression of vitiligo.

Objective: To study the nursing of patients with morbid obesity treated with laparoscopic vertical banded gastroplasty (LVBG). Methods: Before operation, obese degree, obesity-related conditions and mental states were examined routinely. Monitoring of respiratory tract, observing operative complications and instructing of diets were done after operation. Results: Among 6 patients, 5 were at the third degree of obese, one was at second. In obesity-related conditions, 4 patients had hypertension and acantha derma, 1 had arthritis, and all had respiratory sleeping syndrome. The operations were all successful. The food amount food and body weight both decreased significantly 1 month after operation. The common operative complications were mild bleeding (1 case), shoulder-back pain (1 case), nausea and vomiting (5 cases). Diet principle was high protein, low energy, liquid food was the first choice. Conclusion: Observing and preventing respiratory sleeping syndrome are the main points of postoperative cares. Instructing patients to establish correct diet habit is the key to reach the best efficacy of LVBG.

Objective To investigate the operative technique and treatment effect for the cerebellum he-mangioblastoma. Methods The clinical data of 18 patients with cerebellum hemangioblastoma who underwent sur-gery were analyzed retrospectively. The clinical data included imaging data,the operative approach and microsurgery method. Results In the 18 cases, 15 undertook complete remove of tumor,and the other 3 cases experienced partial remove. 16 patients were followed up for 1 to 3 years,and 2 cases experienced recurrence. No death occurred. Con-clusion The measures including sufficient preoperative imaging and gentle manipulation during the operation can significantly increase the rate of total removal of the tumors, while radioneurosurgery or γ treatment is applicable after operation.

Objective To study the effect of thermo-radiotherapy on multidrug resistance (MDR) and levels of intracellular adriamycin (ADM) in tongue squamous cell carcinoma cell line Tca 8113 and its MDR cell line Tca 8113/CBDEA. Methods Samples of the two cell lines were treated with thermo-radiotherapy (42℃ for 0.5 h and 2 Gy of radiation). Four and 24 hours later, the expression of the MDR relative proteins P-glycoprotein (P-gp),multidrug resistance associate protein 1 (MRP1) and glutathione s-tranferase-π (GST-π) were detected using immu-nohistochemistry. Intracellular ADM concentrations were measured using an HTS 7000 Plus bioassay reader. Re-sults No change in the expression of P-gp was observed in the Tca 8113/CBDEA and Tca 8113 cell lines after 4 or 24 hours. Expression of MRP1 was not significantly altered in the Tca 8113/CBDEA cell line, but there was a signifi-cant drop in the Tca 8113 cell line 24 hours post-thermo-radiotherapy. Expression of GST-π was not altered in either the Tca 8113/CBDEA or the Tca 8113 cell line at 4 hours post-thermo-radiotherapy, but there was a significant de-crease at 24 hours. At both 4 and 24 hours, drug tolerance had decreased and intracellular drug concentration had in-creased significantly in both cell lines. Conclusions Thermo-radiotherapy can enhance the effects of chemotherapy and suppress the expression of MDR factors induced by radiation. The combination of hyperthermia and radiotherapy does not induce MDR.

Objective To evaluate the function of MRE11 in inflammasome activation.Methods Different stimuli,in-cluding Poly(I∶C), Poly(dA∶dT),E.coli gDNA,293T gDNA,CPPD and HSV,were used to identify the effective inflamma-some activator using ELISA.Then, MRE11 siRNA oligos were sythesized and transfected into THP-1 cells while Western blotting was used to analyze the efficacy of MRE 11 knockdown .Finally ELISA and Western blotting were used to analyze the involvement of MRE11 in inflammasome activation induced by Poly (I∶C), Poly(dA∶dT), E.coli gDNA and 293T gDNA. Results The IL-1βsecretion and pro-caspase-1 activation which induced by Poly ( I∶C) , Poly( dA∶dT) , E.coli gDNA and 293T gDNA were reduced with different degrees in MRE 11-knockdown THP-1 cells.Conclusion These results indicate that MRE11 is required for inflammasome activation induced by genetic materials .

Objective To study the contrast enhanced magnetic resonance imaging (MRI)features of surgical margin and its path-ologic basis of the experimental rat model by resecting partial brain tissue.Methods Forty-two rats were randomly divided into six experimental groups (postoperative 1d,3d,7d,14d,21d,28d groups)and one contrast group.A partial resection of the parietooc-cipital region was performed.MRI procedures consisted of T1 WI and T2 WI and contrast enhanced T1 WI,pre-and postcontrast scan-ning were enforced in different postoperative days.Brain tissue samples were obtained after MRI examination.Pathological study was made and the results were compared with MRI findings.Results (1 )The earliest enhancement was observed around surgical margin on the first day after surgery,which enhancement was lasted until 28 days;(2)The enhancement of the surgical margin was significantly increased after 7d,the signal intensity ratio in this period reached the peak,but this ratio between 7d and 14d had no ob-vious disparation.The degree of enhancement gradually weakened in the next few days;(3)The number of neovessels reached the peak at 7d,which was higher than that at other experimental groups and contrast group (P <0.05);The amount of neovessels in 14d,21d and 28d had no obvious disparation (P >0.05).Conclusion The contrast enhanced MRI features of the surgical margins after resected partial brain tissue is related to the time of the postoperation,and the neovascularization plays an importent role in this process.

Objective To investigate the accuracy of CTVision image-guided stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC).Methods 10 lung SBRT patients were imaged with CTVision before and after irradiation for acquiring and analyzing the three-dimensional set-up error data sets in our department from October 2010 to May 2012.Gross tumor volumes (GTVs) were contoured on pre-and post-SBRT CT sets and combined for generating internal gross tumor volumes (IGTVs).Planning target volume (PTV) margin was calculated,and IGTVs and PTVs were compared for off-line verification of accuracy of SBRT.A paired t-test statistical analysis was conducted with the datasets using SPSS 17.0.Results 80 CT image sets were totally obtained.Setup errors was significant difference before and after radiotherapy in the left-right,superior-inferior and anterior-posterior directions,that were (-0.10±1.30) mmand (-0.15±1.31) mm (P=0.720),(0.18±1.32) mm and (0.18±1.43) mm (P =1.000) and (-0.08 ± 1.19) mm and (-0.13 ± 1.18) mm (P =0.750),respectively.IGTVs of ten patients were smaller than corresponding PTVs (13.53 cm3 and 37.84 cm3,P =0.000).Conclusion Accuracy and safety of SBRT could be verified by imaging with CTVision before and after delivery for non-small cell lung cancer.