Objective To investigate the effects of controlled hypotension induced with sodium nitroprusside (SNP) or nicardipine on hemodynamics during hip operation and postoperative hepatic and renal function.Methods Twenty ASA Ⅰ or Ⅱ patients aged 20-70 yrs weighing 50-80 kg scheduled for total hip replacement or open reduction and internal fixation of fracture of acetabulum were randomized to receive either SNP (group Ⅰ ) or nicardipine (group Ⅱ ) for induced hypotension during operation. Each group included 10 patients. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. The probe of Hemo-Sonic ?100 esophageal supersonic hemodynamic monitor (Arrow U.S.A) was placed in the esophagus and fixed when best signal was obtained. ECG, hemodynamics including MAP, HR, CVP, CO and other parameters, SpO2 and PetCO2 were continuously monitored. Anesthesia was induced with propofol 2 mg?kg-1 , fentanyl 2-3 ?g? kg-1 and vecuronium 0.1 mg?kg-1 and maintained with 1.5% isoflurane and continuous infusion of propofol ( at 4-6 mg?kg-1 ?h-1 ) and intermittent i.v. boluses of vecuronium after tracheal intubation. MAP was reduced to 55-65 mm Hg with SNP (at a rate of 0.5-8.0 ?g?kg-1?min-1 ) or nicardipine (at 1.0-8.0 ?g?kg-1 ?min-1 ) . Intraoperative blood loss and blood transfusion and postoperative drainage from the wound were measured and recorded.Hemodynamic parameters were recorded before hypotension and 15, 30 and 60 min after start of induced hypotension and 15 and 30 min after recovery from hypotension. Hepatic and renal functions were measured before and after operation using total bilirubin, AST, ALT, BUN and creatinine. Results The two groups were comparable with respect to sex ratio (M/F) , age, height, body weight, duration of induced hypotension and operation. MAP and systemic vascular resistance (SVR) were significantly reduced and tachycardia developed during hypotension in both groups. The left ventricular ejection time was significantly prolonged and aortic blood flow (ABF) and cardiac output (CO) were significantly increased and CVP was lowered during hypotension as compared to the baseline values in SNP group. BUN was significantly reduced after operation ( P

Ear Canal ; surgery ; Ear Neoplasms ; surgery ; Humans ; Microscopy

AlM:To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.
METHODS: This was cross sectional study, multifocal retina electroretinogram ( mf-ERG ) , contrast sensitivity ( CS) and central retinal artery color Doppler examination were recorded from 30 cases ( 30 eyes ) matched control subjects, 35 cases (35 eyes) with type 2 diabetes mellitus (DM) without diabetic retinopathy ( NDR) and 38 cases ( 38 eyes ) with non-prolifera tive diabetic retinopathy ( NPDR) . One-way ANOVA and SNK-q test were used for data analysis.
RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy (P<0. 05);CS of NDR patients were found significant in middle and high frequency ( P < 0. 05 ), NPDR patients were found significant in full frequency ( P<0. 05 ); Central retinal artery (CRA) blood flow in the control groups and NDR groups were not found statistically significant (P>0. 05), The differences between normal group, NDR group and NPDR group were found statistically significant (P<0. 05).
CONCLUSlON: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

Objective To investigate the causes of acute renal failure(ARF)after orthtopic liver transplantation(OLT)in patients of acute liver failure(ALF)and the effects of systemic therapy based on continuous renal replacement(CRRT).Methods Clinical data of 412 patients who underwent liver transplantations between January 2001 and June 2006 were analyzed retrospectively (all the cases were followed up to June 2007).According to UNOS grading scale,54 patients were of acute liver failure(UNOS 1 and 2A).Posttransplant ARF developing in 17 cases underwent a systemic therapy based on CRRT as well as anti-rejection,anti-infection and nutrition support.The perioperative courses,complications,causes of death and follow up results were analyzed.Results There were no severe complications during CRRT.Perioperative mortality was 5.4%and 58.8%in patients without ARF and those with ARF respectively.the rate of complications was 35.1%vs 100%.1 year survival rate Was 89.2% vs 41.2%.3 year survival rate was 81.1% vs 41.2%.Condusions The effect of surgery mainly depends on the function of liver and other vital organs.The ALF recipients suffered from a high perioperative mortality,especially those with posttransplant ARL.The systemic therapy based on CRRT benefits patients with postoperative ARF.

AIM: To study the changes of a member of Ca~ 2+ -activated Cl~- channel, gob-5 and mucin gene Muc5ac expression in lungs of asthmatic mice. METHODS: Twenty-two pathogen-free BALB/c mice were randomly divided into asthma group and control group. Expression of gob-5 mRNA and Muc5ac protein in lungs were detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical assay, respectively. RESULTS: The expression of gob-5 mRNA in asthma group was positive (0.2297?0.0186,A), whereas in control group was absent (P

To study the expression of cyclooxygenase 2 (COX-2) gene and its relationship with clinicopathological characteristics of lung cancer, expression of the COX-2 mRNA was evaluated by reverse transcription polymerase chain reaction (RT-PCR) in cancerous tissues and paired adjacent non-cancerous tissues from 56 patients and benign lesions from 12 patients. Our results showed that expression of COX-2 gene was detected in a significantly greater proportion of cancerous tissues (60.7%) than adjacent noncancerous tissues (10.7%, P<0.01) and benign lesions (3/12, P<0.05). Expression of COX-2 gene was higher in adenocarcinoma than in squamous carcinoma (P<0.01). There was no significant relationship between COX-2 gene expression and patients' age, sex, histological type of tumors, differentiation degree and TNM stages (P>0.05). The up-regulation of COX-2 gene in lung cancer tissues especially in adenocarcinoma suggested that COX-2 may play a role in the lung carcinogenesis and COX-2 gene may serve as a potential therapeutic target in lung cancer.
Adenocarcinoma/*enzymology ; Cyclooxygenase 2 ; Lung Neoplasms/*enzymology ; Membrane Proteins ; Prostaglandin-Endoperoxide Synthases/*biosynthesis ; Prostaglandin-Endoperoxide Synthases/genetics ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Reverse Transcriptase Polymerase Chain Reaction

To study the effects of glucocorticoid on the IL-13-induced Muc5ac expression in airways of mice, and investigate its role in mucus secretion of airways, 24 pathogen-free BALB/c mice were randomly divided into 3 groups. IL-13 group received an nasal instillation of 100 microg of recombinant murine IL-13 solution on days 1, 3 and 5. In dexamethasone group, dexamethasone (0.5 mg/kg) was administered intraperitoneally 24 h before and 1 h before the first instillation of IL-13 and on 4 consecutive days (day 0 to day 5, 6 consecutive days in total), while control group was not treated with IL-13 or dexamethasone. Bronchoalveolar lavage fluid (BALF) was collected and eosinophils were counted, and expression of Muc5ac mRNA and protein in lungs were detected by reverse transcription-polymerase chain reaction (RT-PCR) technology and immunohistochemical assay respectively. Our results showed that the number of mice, with positve Muc5ac protein expression, expression of Muc5ac mRNA and eosinophils in BALF after IL-13 treatment were all significantly higher than that of control group (all P<0.01). Despite eosinophils reduced (P<0.01), the number of mice with positive Muc5ac protein expression, expression of Muc5ac mRNA afterdexamethasone treatment didn't decreas significantly as compared with that of IL-13 group. It is concluded that IL-13 can up-regulate the expression of Muc5ac mRNA and protein, which may play a pivotal role in the mucus overproduction of airways. Dexamethasone can suppress IL-13-induced eosinophilic infiltration in lung but can't inhibit the mucus overproduction.
Bronchoalveolar Lavage Fluid/cytology ; Dexamethasone/*pharmacology ; Interleukin-13/*pharmacology ; Mice, Inbred BALB C ; Mucins/*biosynthesis ; Mucins/genetics ; Mucus/secretion ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Respiratory System/*metabolism

OBJECTIVETo investigate the method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus.

METHODSFrom January 2010 to December 2013,31 patients with medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus, including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification, 7 fractures were type A1, 3 fractures were type A2, 6 fractures were type A3, 2 fractures were type B1, 4 fractures were type B2, 2 fractures were type B3, 4 fractures were type C, 3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS) which 0 indicated normal upper extremity function, and 1 to 100 indicated varying degrees of damage to the function of the upper extremties.

RESULTSThere was no neurologic complication or postoperative wound infection in this series. The followed-up period ranged form 8 to 15 months (means 11 months) postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, the score before operation was 76.2±11.8, the final follow-up score was 8.2±7.4, the final follow-up score was significant higher than before operation (P<0.01). The function of the upper extremities recovered satisfactorily.

CONSLUSIONThe method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Humerus ; innervation ; surgery ; Male ; Middle Aged ; Radial Nerve ; injuries ; surgery

OBJECTIVE:To systematically review the efficacy and safety of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CBM, CJFD,VIP Database,Wanfang Database,Medline,EMBase,Cochrane Library and American Medical Association Database,ran-domized clinical trials(RCT)about Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were col-lected,Meta-analysis was performed by using Rev Man 5.3 software after data extracting and quality evaluating by Cochrane 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 434 patients. Results of Meta-analysis showed recent efficacy [RR=1.38,95%CI(1.14,1.67),P=0.001] and improvement rate of life quality [RR=1.36,95% CI(1.15,1.60),P<0.001] of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were significantly higher than only chemotherapy. The incidence of Ⅲ-Ⅳ leukemia inhibition [RR=0.58,95%CI(0.37,0.91),P=0.02],incidence of Ⅰ-Ⅳ hemoglobin inhibition [RR=0.76,95%CI(0.60,0.95),P=0.02],incidence of Ⅰ-Ⅳ platelet inhibition [RR=0.69,95%CI(0.52,0.91),P<0.001] and Ⅲ-Ⅳ[RR=0.53, 95%CI(0.30,0.93),P=0.03] and incidence of Ⅰ-Ⅳ neurotoxicity[RR=0.69,95%CI(0.52,0.93),P=0.01] in test group were sig-nificantly lower than control group,the differences were statistically significant. CONCLUSIONS:Both efficacy and safety of El-emene injection combined with chemotherapy in the treatment of gastric carcinoma are good.