ObjectiveTo analyze the influencing factors of the blood pressure fluctuation during the perioperative period of pheochromocytoma,and discuss the ways to improve the hemodynamics.Methods The clinical data of patients with pheochromocytoma who had received operation from 2000 to 2010 werestudied retrospectively.The influencing factors of perioperative blood pressure fluctuation were analyzed by statistical methods including Pearson correlation analysis and Logistic regression.ResultsAccording to Pearson correlation analysis,the influencing factors of the highest fluctuation value of the systolic blood pressure ( △ SBP) during the operation included the preoperative highest systolic blood pressure (r =0.196,P =0.013 ),the content of preoperative 24-hour urine epinephrine ( r =0.207,P =0.008 ) and the lost blood volume during the operation (r =0.253,P=0.003).Logistic regression analysis showed that the postoperative persisting hypotension was influenced by the content of preoperative 24-hour urine norepinephrine(OR =1.273,P =0.002) and preoperative preparation duration(OR =0.921,P =0.034);the risk factors of postoperative hypertension were residual tumor (OR =16.920,P =0.001 ) and the preoperative hematocritchange(OR =1.467,P =0.018).ConclusionsIn spite of the adequate preoperative preparation,great changes of blood pressure would still occur during the perioperative period of pheochromocytoma,and it is influenced by many factors.Corresponding measures aiming to these factors should be taken to decrease the perioperative blood pressure fluctuation and surgical risks.

OBJECTIVE: To explore the materials and design of intraocular lens for traumatic cataract caused by sports injuries.METHODS: The databases of Medline and CNKI were retrieved by computer with key words of "sports injury, cataract, and intraocular lens". The languages were restricted as Chinese and English. By searching, 12 literatures concerning intraocular lens for traumatic cataract caused by sports injuries were selected, including 3 written in English and 9 in Chinese.RESULTS: One of the causes for cataract is sports injury. Every year, thousands of cases suffered eye damages in China due to sports. Here, first, a brief introduction of the causes of cataract was presented, and then the suitable intraocular lens implantation for athletes was prepared, finally, the materials and design of intraocular lens was discussed.CONCLUSION: The intraocular lens is developed fast both in basic theory and clinic, which exhibit good features in biocompatibility, visual function, regulatory ability, as well as photoprotection following transplantation. The widening of intraocular lens can provide more choices for physicians, and the life quality of patient was obviously improved.

Medical tourism has grown into a booming market worldwide,which however remains at a startup stage in China given its fast development in recent years.This paper probed into the present status of medical tourism at home and abroad,discussed key roadblocks to tackle for medical tourism,including government regulations,medical resources,international certification,promotions and marketing,language barriers,and visa.On such basis,the authors come up with the following recommendations:enhance policy support and complete the governance of medical tourism; tap resources of public hospitals and encourage private involvement; encourage international certification of medical institutions to explore overseas medical tourism; encourage tourist firms to develop medical tourim products and promoting medical tourism; build brands and complete product lines.

ole on the development of septic AKI. It's useful to decrease the incidence of AKI by elevating the blood pressure and C1, but super-normal goal won't work better.

Objective To investigate the expression of presenilin-2(PS2) and glutathione S transferase ?(GST?) and their role in the prognosis and therapy of infiltrating ductal breast carcinoma. Methods The expression of PS2 and GST? in tumor tissues from 210 patients with infiltrating ductal breast carcinoma confirmed by pathologic examination and treated with modified radical mastectomy was examined by using LSAB immunohistochemical method. Results The expression rate of PS2 was 49.5%(104/210) and the expression rate of GST? was 48.1%(101/210). The grade of the postoperative 5-year survival rate and 10-year survival rate in four groups of 210 patients, from high to low, was the group 1 (PS2 positive expression/GST? negative expression), the group 2 (PS2 positive expression/GST? positive expression), the group 3 (PS2 negative expression/GST? negative expression) and the group 4 (PS2 negative expression/GST? positive expression). Conclusion The prognosis of the group 1 is the best, the group 2 better, the group 3 good and the group 4 the worst. The results suggest that reasonable use of endocrinotherapy and chemotherapy in infiltrating ductal breast carcinoma is necessary.

Objective To investigate the relationship between galectin-3 and tumour metastasis, and the future prospect of galectin-3 in clinic.Methods Related articles were reviewed. Results Galectin-3, a member of the ?-galactoside-binding proteins, is expressed widely in epithelial and immune cells, and interacts with intracellular glycoproteins, cell surface molecules and extracellular matrix proteins. Galectin-3 is involved in various biological phenomena including cell growth, adhesion, differentiation, angiogenesis and apoptosis, and is associated with invasion and metastasis of tumour. Conclusion Because of the correlation between galectin-3 and tumour invasion and metastasis, galectin-3 may act as the diagnostic marker for tumour metastasis and one of the target proteins for cancer treatment.

Objective To investigate the molecular mechanism of peritoneal dissemination of gastric cancer. Methods Literatures in recent years about mechanisms of peritoneal metastasis in gastric cancer were reviewed and summarized.Results Peritoneal metastasis related to viability of cancer cells and peritoneal characteristics. Moreover, it is necessary that many adhesive moleculars, protein hydrolase, cell factors and vascular factors involved in peritoneal metastasis.Conclusion Peritoneal metastasis of gastric cancer was induced by multiple factors together.

Objective To investigate the effects of the low-dose ketamine on the minimum alveolar concentration (MAC) of sevoflurane in patients undergoing gynecological abdominal surgery.Methods Fifty-one ASA Ⅰ or Ⅱ patients aged 36-49 yr with body mass index ≤ 30 kg/m2 scheduled for gynecological abdominal surgery were randomly divided into control group (group C, n = 29) and ketamine group (group K, n = 22) . The paitents were unpremedicated. In group K, a loading dose of ketamine 0.2 mg/kg was injected intravenously followed by infusion at a rate of 14 μg·kg-1 ·min-1 , while equal volume of normal saline was given in group C. Anesthesia was induced with inhalation of sevoflurane (end-tidal concentration 4%-5%, maintaining for 5 min) in both groups. Endotracheal intubation was performed. The patients breathed sevoflurane until the predetermined target end-tidal sevoflurane concentration was reached for at least 15 min before skin incision. Occurrence of body movement was determined by any visible contraction of the muscle bundle of trunk, limbs, head and neck during skin incision and/or within 60 s after skin incision. The initial end-tidal concentration of sevoflurane was set at 1.8 % .If body movement occurred, the end-tidal concentration of sevoflurane was increased by 0.2% , while if not, decreased by 0.2% . MACs of sevoflurane were calculated. Results The MAC of sevoflurane was 1.51% (95% confidence interval 1.45%-1.58%) in group K, and 2.49% (95% confidence interval 2.40%-2.57%) in group C, and there was significant difference between the two groups ( P < 0.05) . Conclusion Intravenous infusion of the low-dose ketamine can enhance the anesthetic effect of sevoflurane in patients undergoing gynecological abdominal surgery.

Objective To study the clinical efficiency and possible side effects of lower tidal volume combined with sustained inflation(SI) on acute respiratory distress syndrome (ARDS) for post operative carcinoma surgery patients.Methods Fifty one hypoxemia post operative carcinoma surgery patients from Jan.2007 to Dec.2009 in Cancer Hospital and Institute,Chinese Academy of Medical Sciences and Peking Union Medical College were included.Their cirrculation was stable.Mechanical ventilation could not be removed due to ARDS.Noninvasive continuous artery blood pressure ( NBP),pulse oximetric saturation ( SPO2 ),arterial blood gas ( ABG ) analysis,static compliance of respiratory system (Cst) were monitored and recorded.Patients were ventilated on volume control mode.Tidal volumes (VT) was set to 6 ml/kg.SI were conducted by continuous positive airway pressure of 35 cm H2O,sustaining for 40 seconds.Positive end-expiratory pressure (PEEP),FiO2,respiratory rate (F),Pplateau inspiratory pressures (Pplat),the peak inspiratory pressures (Ppeak),VT,Cst and ABG before SI applying and at 10 min,24 h,48 h after SI applying were measured.Results The level of PaO2 and FiO2 were significantly lowered,VT and Crs increased significantly,Ppeak,Pplat,and F were improved significantly at 10 min,24 h and 48 h after SI in all cases.No complication occurred.All patients were discharged without adverse event.Conclusions Hypoxemia of ARDS following carcinoma surgery could be improved by lower tidal volume combined with SI.

BACKGROUND: It has been proved that the rare earth compounds can obviously restrain the growth of tumor in vitro and in vivo.OBJECTIVE: To check the effect of chlorinated lanthanum (LaCl3) on the expressions of cyclin D1 and cyclin dependent kinase 4 (CDK4) of hepatocellular carcinoma cells.DESIGN: Controlled observation.SETTING: Department of Nephropathy, First Clinical Hospital, Jilin University. MATERIALS: The experiment was carried out in the cell culture laboratory (province-level) of Department of Histology and Embryology, Jilin University from July 2002 to June 2003. Wells of the microwell plate seeded with CBRH-7919 cells were randomly divided into 4 groups according to the dose of LaCl3: control, 0.01, 0.1, 1.0 mmol/L LaCl3. And each group was further divided into three subgroups according to the culture time: 1, 3, 5 days, with 6 wells for each.METHODS: The growth of CBRH-7919 cells was monitored following treated with 0.01, 0.1, 1.0 mmol/L LaCl3 for 1, 3, 5 days in vitro, respectively. ① Absorbance(A) of each well was measured by MTT assay.② The changes of distribution of cells into different phases of cell cycle were detected by flow cytometry. ③ Cyclin D1 and CDK4 expression was detected by immunocytochemical analysis.MAIN OUTCOME MEASURES: The expression of cyclin D1 and CDK4 in CBRH-7919 cells of different doses of LaCl3 at different time.RESULTS: Effect of LaCl3 on the growth of CBRH-7919: On days 3 and 5, the A value of each well in the 0.1 and 1.0 mmol/L LaCl3 groups was respectively significantly lower than that in the control group (day 3: 1.140±0:070, 0.706±0.092,1.461±0.087; day 5: 1.888±0.020,0.625±0.037,2.544±0.032, respectively) (P ＜ 0.05,0.001 ). ②Effect of LaCl3 on the percentage of CBRH-7919 cells at G0/G1 stage: On days 1, 3, and 5, the percentage of CBRH-7919 cells at G0/G1 stage in the 1.0 mol/L LaCl3 group was respectively significantly higher than that in the blank control group [(60.70±0.20)%, (39.49±0.67)%; (61.66±0.97)%, (45.56±1.00)%; (69.92±0.18)%, (49.24±0.27)%, (P ＜ 0.01,0.001 )]; On day 5, the percentage of CBRH-7919 cells at G0/G1 stage in the 0.1 mol/L LaCl3 group was respectively significantly higher than that in the blank control group[(58.88±0.73)%, (49.24±0.27)%, P ＜ 0.05]. ③ Effect of LaCl3 on the expressions of cyclin D1 and CDK4 of CBRH-7919 cells: On day 1, the expressions of cyclin D1 and CDK4 of CBRH-7919 cells in the 0.1 and 1.0 mmol/L LaCl3 groups were respectively lower than those in the blank control group (expression of cyclin D1: 562±35,453±22,860±82;expression of CDK4: 705±84,680±28,762±16, P ＜ 0.05, 0.01 and 0.001).CONCLUSION: LaCl3 inhibited the growth of CBRH-7919 cells correlating down-regulating cyclin D1 and CDK4 as reflected on the cell cycle arrest of CBRH-7919 cells from G1 stage to S stage.