Objectives　To study of the method for isolation and transplantation of mouse islets. Methods　The method for isolation of mouse islets described by Gotoh G was modified. The solution of digestion was injected not through the common bile duct but through gallbladder. Soybean trypsin inhibitor and BSA were added into the digestive and Ficoll separation solutions. Results　The yield of islets was increased from 41.7±13.2 to 266.5±32.1(P<0.01). Islet viability was more than 95!%. Among the purified islets, there was no exocrine tissue but few ductal fragments. Conclusions　By the improved method, digestive solution could be injected into pancreas without inverted microscope, which made manipulation easier and more successful. Having avoided the digestive effect of trypsin on islets, the yield of islets was increased and good repetitiousness was obtained.

Objective To investigate the clinical efficacy of target fire red-hot needling in treating articular deformity due to rheumatoid arthritis.Methods Ninety-six rheumatoid arthritis patients with articular swelling and deformity were randomly allocated to treatment and control groups, 48 cases each. The treatment group received target scattered fire red-hot needling and the control group, conventional acupuncture. After two courses of treatment, pre-/post-treatment changes in the self-reported pain score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immunoglobulins (IgA, IgG and IgM) were observed in the two groups and the clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 89.6% in the treatment group and 50.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment groups (P<0.05). There were statistically significant pre-/post-treatment differences in ESR, CRP, and IgG in the treatment groups (P<0.05). There were statistically significant post-treatment differences in ESR, CRP, IgA, IgG and IgM in the treatment and control groups (P<0.05).Conclusion Target fire red-hot needling is an effective way to treat articular deformity due to rheumatoid arthritis.

Objective To evaluate the effects of lateral position on fiberoptic bronchoscope (FOB)-guided orotracheal intubation under general anesthesia in the patients with ankylosing spondylitis.Methods Forty-five patients with ankylosing spondylitis, aged 19-63 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were divided into 2 groups using the random number table: group supine position (group S, n=22) and group lateral position (group L, n=23).After induction of general anesthesia, orotracheal intubation was performed under the guidance of FOB.Intubation time, catheterization time, intubation condition and intubation-related complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) were also recorded before anesthesia induction, immediately before intubation, immediately after onset of intubation, and at 2 and 4 min after intubation.Results The success rates of intubation were both 100％ in the two groups.Compared with group S, the intubation time and catheterization time were significantly shortened, the success rates of intubation and catheterization at first attempt were increased, MAP and HR were decreased immediately after onset of intubation, and no significant change was found in intubation-related complications in group L.Conclusion Lateral position can raise the success rate of FOB-guided orotracheal intubation under general anesthesia with shorter operation time, it is helpful in stabilizing hemodynamics during intubation, and intubation-related complications are fewer in the patients with ankylosing spondylitis.

Objective To evaluate the effects of total intravenous anesthesia without muscle relaxants on motor evoked potential (MEP) monitoring during scoliosis surgery.Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-25 yr,scheduled for posterior spinal fusion surgery,were randomly divided into 2 groups with 25 patients in each group: muscle relaxants combined with total intravenous anesthesia group (group Ⅰ) and total intravenous anesthesia without muscle relaxant group (group Ⅱ).In both groups,a loading dose of dexmedetomidine 1 μg/kg was infused over 20 min,followed by infusion at 0.2 μg· kg-1 · h-1.After the loading dose of dexmedetomidine was given,anesthesia was induced,the patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil 0.2μg· kg-1 · min-1 and propofol 80-120 μg· kg-1 · min-1.The bispectral index value was maintained at 40-60.Train of four stimulation of ulnar nerve was used to monitor the neuro-muscu-lar block.Cisatracurium was infused at 0.5-1.5 μg·kg-1 ·min-1,T1 was maintained at 45％-55％,and the infusion was stopped 30 min before the isolation of paraspinal muscles was completed in group Ⅱ.MEP were monitored and recorded during the period when the administration of the muscle relaxation was stopped,and the degree of muscle relaxation was assessed by the surgeon.The successful wake-up test was recorded.Results The incidence of successful MEP monitoring was significantly higher in group Ⅱ than in group Ⅰ (P ＜ 0.05).There was no significant difference in the degree of muscle relaxation between the two groups (P ＞ 0.05).All the patients were successfully woken up.Conclusion Total intravenous anesthesia without muscle relaxants can provide satisfactory muscle relaxation for scoliosis surgery and increase the probability of successful MEP monitoring simultaneously.

Objective To investigate the analgesic effects of intrathecal dexamethasone injection on pain induced by chronic compression of dorsal root ganglion in mouse.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion ( CCD), 40 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 5 groups:Sham-operation group ( Sham group, n = 8 ), Control group ( CCD group, n = 8), Dexamethasone group ( D group, n = 8), Akt inhibitor V group (A group, n = 8 ) and Dexamethasone plus Akt inhibitor Ⅳ group (DA group, n = 8 ).Rats in D group, A group or DA group were intrathecally treated with dexamethasone (100μg/kg) ,Akt inhibitor Ⅳ (0.6μg/10μl) or dexamethasone ( 100 μg/kg) plus Akt inhibitor Ⅳ (0.6 μg/10 μl) on Day 3,13 after CCD respectively, while rats in C and Sham group received Vehicle (10% DMSO).Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on 3 d before and 3 d,4 d,7 d,10 d,13 d,14 d and 15 d after operation.Results Compared with Sham group,both PWMT (P＜0.01) and PWTL (P＜0.01) were significantly decreased after CCD surgery on the ipsilateral side.After dexamethasone and Akt inhibitor were respectively intrathecally injected at 3 postoperative day,PWMT (7.33 ± 1.03 ) g, (5.67 ± 1.03 ) g, (2.67 ± 1.03 ) g (P ＜0.01 ) ,PWTL( 16.47 ±0.46)s, ( 14.48 ±0.84) s, ( 10.82 ±2.21 ) s(P＜0.01 ) ,then decreased gradually,and intrathecally injected again at 13 postoperative day, PWMT ( 7.33 ± 1.03 ) g, ( 5.67 ± 1.03 ) g, (2.33 ± 0.81 ) g (P ＜0.01 ), PWTL( 16.44 ±0.90) s, ( 14.01 ±0.82)s, ( 10.22 ± 1.28)s (P＜0.01).Coadministration dexamethasone and Akt inhibitor exhibit significant synergies, postoperative 4 d PWMT( 10.83 ± 2.04)g, (2.67 ± 1.03 )g (P ＜0.01),PWTL(19.11 ±2.01)s,(10.82 ±2.21)s (P＜0.01);14 d PWMT (7 ±0.82)g,(2.33 ±0.81)g (P ＜ 0.01 ), PWTL( 17.16 ± 1.14)s, ( 10.22 ± 1.28 ) s (P ＜ 0.01 ).Conclusion Intrathecal high-dose dexamethas one or PKB / Akt inhibitors can effectively improve pain behavior response induced by chronic compression of dorsal root ganglia,combination of these two drugs could generate significant synergies, and the effection is more obvious, more durable.

256?g/ml.Oxacillin-resistance rate in adults was significantly higher than that in children(?2=54.15,P

Objective To study the methods and effects of endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Methods The study included 15 patients with unilateral thyroid benign nodules.A transversal subclavicular incision 2~3 cm in length was made.Endoscope-assisted partial thyroidectomy was performed through the subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Results The operation was accomplished successfully in all the 15 patients.The operation time was 40~80 min(mean,50 min) and the intraoperative blood loss was 10~50 ml(mean,20 ml).No surgical complications occurred.The patients were discharged from hospital on 3~4 postoperative days.Follow-up observations in the 15 patients for 1~12 months(mean,7 months) revealed no recurrence.Conclusions Endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle has the advantages of minimal invasion,little blood loss, low complication rate,quick recovery,and good cosmetic results.

Objective To compare the effects of sevoflurane and isoflurane on ventilation function during laparoscopic cholecystectomy by monitoring side stream spirometry(SSS).Methods Totally 40 adult patients(ASA grade Ⅰ-Ⅱ),who were to undergo laparoscopic cholecystectomy,were randomly divided into sevoflurane group(group Ⅰ) and isoflurane group(group Ⅱ),with 20 cases in each.The two groups were given same preoperative medication and induction of anesthesia.Anesthesia maintenance was performed with inhaling of 1% sevoflurane or 1% isoflurane,combined with continuous intravenous infusion of propofol [3 to 5 mg/(kg?h)] and atracurium [0.3 to 0.5 mg/(kg?h)].The changes of the lung compliance and Airway resistance of the two groups,as well as dead space ratio,were observed in the two groups.Results ① Compared with the patients received intubation at the supine position,the two groups showed reduced pulmonary compliance(Cdyn) and significantly increased airway pressure(Paw,P

Secondary hyperparathyroidism (SHPT) is a common complication in patients with chronic renal failure (CRF).Medical treatment may be the first choice for most SHPT patients,but parathyroidectomy (PTX) is neededwhen medical treatment doesn't work in patients with refractory SHPT.However,there is no strong evidence to support which surgical procedure is the most effective one for patients with SHPT.An interdisciplinary discussion between nephrologists and surgeons is needed when choosing a preferred surgical method for refractory SHPT patients.The factors must be discussed including:the patient's age,the underlying kidney disease,clinical symptoms,the level of intact parathyroid hormones (iPTH) and blood calcium,the patient's ability to obtain and comply with medication treatment and the estimated duration of dialysis before kidney transplantation.Refractory SHPT patients will benefit from the surgical operation treatment and reoperation of recurrent SHPT is still an ideal treatment method.

Objective To discuss the relationship between BMP-2 protein and possible mechanism and to compare the postive rate of two different imaging examinations in evaluating the epiphyseal plate involved by osteosarcoma.Methods Radiographic and MRI features of epiphyseal plate extension by osteosarcoma confirmed by pathology in 36 cases were analysed retrospectively.The expression of BMP-2 was detected with immunohistochemical SABC method in different part of specimen.Results The diagnostic accurate rate in evaluating the epiphyaeal plate extension from osteosarcoma by X-ray and MRI was 44.44% and 100% respectively.The positive reactive rate of BMP-2 in tumor body,epiphyseal plate soak district,normal epiphyseal plate and normal tissue nearby the tumor was 88.89%(32/36),99.44%(34/36),10.00%(1/10) and 20.00%(2/10) respectively.Conclusion MRI is more sensitive to radiography in evaluating the epiphyseal plate involved by osteosarcoma,the higher positive reactive rate of BMP-2 protein is correlated to the epiphyseal plate extension of osteosarcoma.