Objective To enhance the diagnosis rate for metastasis adenocarcinoma cells in serous fluids and detect a panel of a monoclonal antibodies for distinguishing adenocarcinoma cells from reactive mesothelial cells in serous fluids. Methods Three marks of low molecular weight cytokeratin (CK LMW ), carcinoembryonic antigens (CEA) and mesothelial cells (MC) were used to immunostain the cells in serous fluids from 50 patients and in peritoneal washing from 14 patients. Results Expression rate of three groups of cells positive from CK LMW , CEA and MC in adenocarcinoma cells was 95.83%, 70.83%, 16.67%, in suspicious cancer cells 100%, 50.00%, negative, in reactive mesothelial cells 33.33%, 33.33%, 66.66%. The four suspicious cases and two reactive cases in primary cytopathological classifiecation should be reclassified as adenocarcinoma cases. The sensitivity, specificity and reliability of CK LMW , CEA and MC were 96.30%, 80.00%, 77.10%; 70.37%, 90 00%, 61 60%; 90.00%, 85.20%, 75.30%, respectively. Conclusion Immunocytochemistry, using a panel of CK LMW , CEA and MC antibodies appears to be adjunct of important value for distinguishing adenocarcinoma cells from reactive mesothelial cells in serous fluids.

BACKGROUND: Ischemic reperfusion syndrome occurs in early donor liver reperfusion after orthotopic liver transplantation. It is the most important cause for liver function failure and patient death. Ischemic reperfusion severity is closely related to blocking of inferior vena cava period. Some studies demonstrate that inferior vena retrograde perfusion can shorten the blocking time during liver transplantation. OBJECTIVE: To observe the effect of retrograde perfusion on the hemodynamics in orthotopic liver transplantation without venovenous bypass during neohepatic reperfusion phase. DESIGN, TIME AND SETTING: Case comparison was performed at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from December 2006 to June 2007. PARTICIPANTS: Thirty-nine patients underwent orthotopic liver transplantation without venovenous bypass under general anesthesia. METHODS: According to perfusion methods, the patients were divided into two groups: retrograde perfusion through inferior vena cave (n=19), and perfusion through portal vein (n=20). MAIN OUTCOME MEASURES: The systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure and other hemodynamic parameters were measured before operation, and at anhepatic phase and primary neohepatic phase. The rewarming ischemia time of grafted liver was also recorded. RESULTS: The rewarming ischemia time of grafted liver in the retrograde perfusion through inferior vena cave group was significantly less than that in the perfusion through portal vein group (P

Objective: The cytologic methods were used in the diagnosis of cancerous change of (intraductal papillomas,IP) and its significance was discussed. Methods： We studied the nipple discharge smear by using Wright-Gimsa staining. Meanwhile, infrared ray scanning B-ultrasound and X-rays were performed. Results： One hundred and twenty-eight patients were with IP， among them， 15 (11.7%)were confirmed as tumors by surgery and pathological examination. The cancerous change of cytomorphology was based on IP. The average age of patients with cancerous change was 48.1.The nipple discharge in patients with cancerous change was primarily bloody(66.7%). Conclusion： Introductal papillomas is carcerous. The possibility of canceration in persons with longer time of nipple discharge is larger than those with shorter time of nipple discharge. Women who are elder than 45 years old, with nipple discharge and post menopause, should be considered to have the possibility of cancerous change.

Objective Previous study found TGF-βpathway might be the molecular pathway influencing the prognosis of colo-rectal cancer, while it was uncertain whether Chinese population is associated with the disease.The article was to evaluate the genetic factors associated with prognosis in colorectal cancer. Methods 52 cases patients with colorectal cancer were followed-up for 36 months in our hospitals from January 2013 to August 2014.Their DNAs were extracted and stored and gene typing were carried out in 5 candidate genes to detect the association between SNPs and the prognosis in colorectal cancer. Results The results showed that within the TGF-βsignaling pathway, after adjusting for Bonferroni multiple testing, allele A of SNP rs10749971 located in gene POU2AF1 was associated with the recurrence of patients with stage III disease under additive and recessive genetic models ( HR =1.968, P=0.004;HR=2.174, P=0.010).Allele C of SNP rs961253 in the gene BMP2 could increase the recurrence risk (HR=1.992, P=0.005) and the death risk (HR=3.161, P=0.007) of patients with stage III disease under recessive genetic models.Allele A of SNP rs4464148 in SMAD7 gene could significantly decrease the death risk of patients with stage II and III colorectal cancer under dominant genetic model (HR=0.382, P=0.017;HR=0.230, P=0.006).In addition, accumulated effects of several adverse genes showed gene high risk group could increase the risk of death for patients with stage III colorectal cancer significantly ( HR=15.512, P=0.036;95%CI:1.611-149.360). Conclusion In different genetic models, SNP locus mutation within gene POU2AF1, BMP2 and SMAD7 on TGF-βpathway was associated with the prognosis of patients with colorectal cancer.With the increase of the number of unfavorable genes, the death risk increases accordingly.

Objective To investigate the sedative effect of different doses of buccal dexmedeto-midine premedication during peri-anesthesia in pediatric patients undergoing tonsillectomy and/or ade-noidectomy.Methods Eighty pediatric patients undergoing tonsillectomy and/or adenoidectomy in department of otorhinolaryngology,54 males and 26 females,aged 4-12 years,ASA Ⅰ or Ⅱ,from June,2014 through May,201 6 were enrolled,n =20 in each group.Children were randomly assigned to receive buccal dexmedetomidine 0 μg/kg (group A),1 μg/kg (group B),2 μg/kg (group C)and 4μg/kg (group D)60 min before transporting to operating room.Sedation score (OAA/S scale)was monitored before and after administering buccal dexmedetomidine.Time of post-operative first spon-taneous respiration,opening eyes,extubation,anxiety score (SAS scale),as well as OAA/S scale, pain intensity (FLACC),and adverse events 60 min after surgery were recorded.Results Compared with group A and group B,markedly superior OAA/S within 60 min after administering buccal dexmedeto-midine in group C and group D were observed (P < 0.05 ).Compared with group A and group B,the OAA/S score 5 min after extubation was lower in group D.FLACC scores within 30 and 60 min after extu-bation in group D were lower than those in group A.Group D showed obviously prolonged time of post-op-erative first spontaneous respiration,opening eyes and extubation compared with the other groups (P <0.05).All the rates of adverse events were similar.Conclusion 2 or 4 μg/kg premedecation of buccal dexmedetomidine 60 min before transporting to operating room can effectively and safely sedate pediatric pa-tients when entered operating room,improve parental separation,mask and sevoflurane acceptance,as well as decrease the stress induced by intubation and post-operative pain.

Objective: To study the effect of ?-3 polyunsaturated fatty(?-3 PUFA) on the serum lipid of ovariectomized rats.Methods: 60 virgin female Sprague-Dawley rats,3 months of age,were randomized by the stratified weight method into 6 groups: Sham group:deionized water 2 mL/d,OVX group:eionized water 2 mL/d,E2 group: OVX+17?-ethinylestradiol 0.1 mg/(kg?d),A group: OVX+?-3 PUFA 75 mg/(kg?d),B group: OVX+?-3 PUFA 150 mg/(kg?d) and C group: OVX+?-3 PUFA 300 mg/(kg?d).Each group had 10 rats.Experiment period was 90 days.Body weight were measured every week.Serum were collected to measure Cholesterol(TC),Triglyceride(TG),High-density lipoprotein-cholesterol(HDL-C),and Low-density lipoprotein-cholesterol(LDL-C).Results: There were significant difference between groups in the serum lipid.In the OVX group,TC and LDL-C increased.In the E2 group,TC increased compared with that in the Sham group,and HDL-C,LDL-C and HDL-C/TC decreased significantly compared with that in the OVX group.In the A,B and C groups HDL-C/TC increased significantly compared with those in the E2 group.Conclusion: The ovariectomized rats have lipid metabolism disorderd.The ?-3 PUFA and estrogen replacement therapy plays a role in the lipid metabolism.The ?-3 PUFA has the best efficiency in reducing the level of serum lipid.

Objective:To explore the benefit effects of ?-3 polyunsaturated fatty acids on bone biomechanics in ovariectomized(OVX) rats.Methods: 60 virgin female Sprague-Dawley rats were randomized by the stratified weight method into 6 groups: ① Sham group:deionized water 2 mL/d;②OVX group:deionized water 2 mL/d;③E2 group: OVX +17?-ethinylestradiol 0.1 mg/(kg?d);④ A group: OVX+?-3 PUFAs 75 mg/(kg?d);⑤B group: OVX+?-3 PUFAs 150 mg/(kg?d);⑥ C group: OVX+?-3 PUFAs 300 mg/(kg?d).Each group had 10 rats.After feeding for 90 days,the rats were killed and femur were separated.The maximum load,maximum deformation,elastic load,elastic deformation and energy absorption were measured from three point bending test.Bone wet weights were measured.Result: The femur biomechanics markers of OVX group decreased obviously,while that of all medicated group increased obviously(P

Objective To share the analysis results of follow -up after treatment of hyperbilirubinemia hear-ing .Methods 573 cases of neonatal hyperbilirubinemia by jaundice intervention method was divided into exchange transfusion group (67 cases ,bilirubin concentration range of 344 .2~1 107 .2 μmol/L ,457 .9 μmol/L on average) and therapy group (506 cases ,bilirubin concentration in the range of 205 .2~ 572 .6 μmol/L ,average 285 .2 μmol/L) .The auditory brainstem response ,distortion product otoacoustic emission hearing detection and immittance method were used .The two groups of hearing loss were compared with 836 cases of normal controls .Results The observation group showed that hearing disorder morbidity rate was 3 .49% (20/573) ,for the control group ,the hearing loss morbidity rate was 0 .24% (2/836) .There was a statistically significant difference between the two groups (P<0 .05) .For the exchange transfusion group ,hearing losses accounted for 25 .37% of the overall change (17/67) .For the phototherapy group ,the hearing losses accounted for 0 .59% of the overall (3/506) phototherapy , showing statistically significant difference between the two groups (P<0 .05) .There were hearing impairment with bilateral severe (80% ,16/20) and retrocochlear lesions (65% ,13/20) .Conclusion The bilirubin concentration in blood transfusion for the children tended to have hearing impairment ,more in bilateral severe and retrocochlear le-sions ,hearing loss was irreversible .

Objective To investigate the anesthetic effect and adverse events on different doses of oxyco-done combined with propofol target controlled infusion(TCI)in patients with choledocholithiasis undergoing endo-scopic retrograde cholangio pancreatography(ERCP)with endoscopic sphincterotomy(EST).Methods One hun-dred and twenty patients with choledocholithiasis underwent ERCP with EST in Department of Gastroenterology, Fuzhou General Hospital,from January,2016 to March,2017 were enrolled in this study.Patients were randomly divided into 4 groups(n=30 in each group)including the sufentanil control group(Group A),low dose of oxyco-done group(Group B),moderate dose of oxycodone group(Group C),and high dose of oxycodone group(Group D).Patients in Group A received 0.10 μg/kg intravenous sufentanil,and patients in Group B,C,and D received 0.08 mg/kg,0.10 mg/kg,and 0.12 mg/kg intravenous oxycodone,respectively,at 5 min before induction of gener-al anesthesia followed by propofol TCI. Effect of compartment concentration(Ce)of propofol,mean arterial pres-sure(MAP),and heart rate(HR)at the given time point when patients transferring to operation room(T0),after induction(T1),endoscope through throat(T2),and endoscope through major duodenal papilla(T3)were record-ed.The accumulative dose of propofol,duration of operation,and recovery time were also recorded.Intraoperative sever hypotension,bradycardia,respiratory depression,coughing and moving,and postoperative nausea and vom-iting were recorded. Results Propofol Ce at T1~T3as well as MAP and HR at T2and T3in Group B were signifi-cantly higher than those in Group A,C,and D,respectively(P < 0.05). The accumulative dose of propofol in Group B was more than that in Group A and C,while the accumulative dose of propofol in Group D was less than that in Group A,B,and C,respectively(P<0.01).Recovery time in Group D was longer than that in Group A, B,and C,respectively(P<0.05).Similar incidences of intraoperative sever hypotension,bradycardia,respiratory depression,coughing and moving,and postoperative nausea and vomiting were also observed. Conclusions 0.10 mg/kg intravenous oxycodone at 5 min before induction of general anesthesia combined with propofol TCI presents a favorable anesthetic effect in patients with choledocholithiasis undergoing ERCP with EST without a prolonged recovery time and the increased incidence of adverse events.

Objective To evaluate the effect of anti-microbia-l coated central venous catheter (CVC),compared with routine CVC,on catheter-associated deep venous thrombosis (CADVT). Methods A total of 1 359 patients,aged 26-82 years,ASA physical status Ⅰ-Ⅲ,undergoing internal jugular,axillary-subclavian,or femoral vein CVC catheterization during January to June of 2017,were retrospectively reviewed.The patients were divided into intoanti-microbial-coated CVC group (group A)and routine CVC group (group B).Gender,age,ASA class,pre-operative risk of thrombus (Caprini score),CVC site,surgical site,ultrasound-guided catheterization,and anticoagu-lation therapy,CADVT and the degree,as well as the other adverse events were recorded.Results A total of 938 patients were successfully matched.There were 323 (34.4%)articipants diagnosed with CADVT with bedside point-of-care ultrasound,in which 172 cases (36.7%)in group A and 151 (32.2%)in group B.There was no statistical significance of CADVT and the degree between the two groups.The subgroup analysis results indicated that the patients using anti-microbial-coated CVC with high risk of thrombus (Caprini score ≥ 5 points)(OR 1.34,95% C I 1.01-1.78),undergoing catheterization according to anatomical landmark (OR 1.69,95% C I 1.04-2.74),and not-receiving anticoagulation therapy (OR 1.39,95% C I 1.01-1.92)had an increased risk of CADVT compared with those using routine CVC.A significantly decreased incidence of catheter-associated infection in group A was observed compared with group B (0.9% vs 4.1%,P<0.05).Conclusion Anti-micro-bial-coated CVC does not increase the incidence of CADVT.