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 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.

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.

Recently,increasing cancer researches focus on antibody-drug conjugates(ADCs) which can improve the anti-tumor potency with less adverse effect while benefiting patients in the future. However,safety evaluation of ADCs is a big challenge because of complex components as well as in experience in preclinical studies. In this review,the authors reviewed the mode of action,hazard risks,and toxicity observed in preclinical/clinical studies of ADCs,summarized the preclinical studies of Adcetris(brentuximab vedotin)and Kadcyla(ado-trastuzumab emtansine),and suggested a better strategy of ADCs in preclinical safety evaluation.

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 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

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.

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

Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.

Diaphragm is the principal respiratory muscle.Diaphragm dysfunction resulting from mechanical ventilation,chronic cardiopulmonary disease,medicine,cardio-thoracic surgery,septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay.Traditionally,the method of assessment of diaphragm structure and function was invasive,lacking specific,and was difficult to be used bedside.A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate,safe and noninvasive method of quantification of diaphragm structure and function.This article reviews the related researches of technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic structure and function,which may possibly result in timely identification of patients with diaphragm dysfunction and improve the assessment of recovery from diaphragm weakness.