Objective To evaluate the efficacy and safety of China-made remifentanil in a randomized, controlled and double-blinded multi-center clinical study. Methods Two hundred and one patients were randomly divided into two groups: control group received intravenous fentanyl and study group received intravenous remifentanil. In both groups anesthesia was induced with propofol 1-2 mg ?kg-1 and fentanyl 2.5?g/kg or remifentanil 2 ?g/kg. Intubation was facilitated with succinylcholine 1.0-1.5 mg?kg-1. The patients were mechanically ventilated(VT 8-10 ml?kg-1 , RR 10 bpm) . Anesthesia was maintained with fentanyl at 0.03 ?g?kg-1?min-1 or 0.2?g?kg-1?min-1 supplemented with 66% N2O and intermittent iv boluses of vecuronium. The efficacy variables recorded were the changes in blood pressure(BP) and heart rate(HR) during surgical stimulation and the quality of anesthesia. The safety variables included BP and HR, the doses of ephedrine, atropine, urapidil and naloxone required during surgery, the volume of intraoperative blood loss, changes in EGG, and the pre- and post-operative liver and kidney function, extubation time, emergence time (opening eyes when the patient's name is being called), end-tidal CO2 before extubation, admission to PACU or ICU, and the unexpected events in postoperative period. Results The anesthetic efficacy of remifentanil was similar to that of fentanyl with better analgesic effect . Remifentanil wore off faster in comparable doses. Conclusion China-made remifentanil is a good and safe anesthetic with better analgesic effect.

Objective To evaluate the recent curative efficacy and security of High Intersity Focused Ultrasound(HIFU)in treating patients with advanced pancretic carcinoma.Methods 17patients with cancer of pancreas were treated by FEP-BY02,received 135(average 8)times.Results The overall response rate was 70%(CR+PR),including11.76%(2/17)complete response(CR)and 58.82%(10/17)partial response(PR).The clinical benefit response(CBR)was 82.36%.The inefficiency was 17.64%(3/17).The cancer pain was relieved in 80% patients(8/10).Nocomplications occurred.such as pancreatic juice leakage,bleeding,perforation of gastrointestinal tracts,scalding of skin in the group.Conclusions The preliminary results show that HIFU has a high efficacy and quite safety for advanced pancreatic carcinoma,it is worthy of futher clinical trail.

Objective To explore the expression of matrix metalloproteinase-11 (MMP-11) gene in gastric cancer cells and its correlation with transcription factor Sp1.Methods T In the present study,the expression of the MMP-11 was studied and the importance of Sp1 in the expression of the MMP-11 was proved with reverse transcription polymerase chain reaction (RT-PCR),differential PCR,Western-Blot,and DNA sequencing analysis in 10 kinds of the gastric cancer cell lines.Results MMP-11 cDNA was amplified with RT-PCR and differential PCR.In 34 cycle,the MMP-11/β-actin of SNU16,BGC823,MKN45,SGC7901,MGC803,SNU5 and PAMC82 were 3.32 ±0.12,2.22 ±0.11,1.41 ±0.12,1.35 ± 0.05,1.19 ± 0.05,0.97 ± 0.05,and 0.79 ± 0.05 (F =371.54,P ＜ 0.001).DNA sequencing analysis and BLAST showed the MMP11/β-actin of SNU16 DNA was 2 ～2.5 times as much as that of others.This result indicated that MMP-11 gene was amplified on the SNU16 DNA.Differential PCR and DNA sequencing analysis were carried out to amplify the MMP-11 gene in the SNU16 cell.Toward a better understanding of transcription of the MMP-1 1 gene,bioinformics technology was used to demonstrate the existence of two GC-boxes of the 5'-flanking region of MMP-11 DNA.Sp1 protein and MMP-11 protein were over-expressed in tumor cells and tended to have correlation with them (r =0.951,P ＜ 0.05).Conclusions The present results described the expressions of MMP-11 and Sp1 in gastric cancer cells.Moreover and clarified the correlation between MMP-11 and Sp1.It will establish the basic theory in order to confirm further whether Sp1 is a significant promoter of the 5'-flanking region of MMP-11 DNA.

Objective To investigate the efficacy of super selective intra-arterial infusion of verapamil for the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods From January 2013 to February 2016,the clinical data of 15 patients with subarachnoid hemorrhage (SAH) who had CVS after intracranial aneurysm clipping (n=8) or endovascular treatment (n=7) were analyzed retrospectively.All patients received whole brain digital subtraction angiography (DSA).Microcatheter super selection to spastic arteries was used and verapamil (11.1±3.4 mg) was infused.The findings of whole brain DSA before and after treatments were compared.The blood pressure and heart rate were collected during the treatment and the findings of transcranial Doppler ultrasonography were recorded.The patients were followed up for 6 months and the Glasgow outcome scale (GCS) scores were obtained.Results (1) A total of 20 intra-arterial infusion treatments were performed in 15 cases.They were compared before and after perfusion.CVS was improved on DSA in 14 cases,there was no significant change in on cases.(2) Transcranial Doppler ultrasonography showed that the mean blood flow velocity (mBFV) of the middle cerebral artery was decreased from 181±4 cm/s before the super selective intra-arterial infusion to 126±4 cm/s within 1 hour after treatment.There was significant difference (t=42.46,P<0.01).No complications associated with the use of microcatheters were observed.(3) The right upper arm blood pressure of the patients was monitored in the process of perfusion.The systolic pressure was 138±8 mmHg at the beginning of the perfusion,it was 135±10 mmHg at the end of the perfusion,and it was 137±7 mmHg at 1 h after the perfusion.The heart rate was 83±6/min at the beginning of the operation,it was 79±8/min at the end of the operation,and it was 80±5/min at 1 h after the operation.There were no significant differences (P>0.05).(4) All patients were followed up for 6 months.The GOS score at 6 months:good recovery in 9 cases,moderate disability but could take care of themselves in 3 cases,severe disability and could not take care of themselves in 3 cases,no persistent vegetative state or death.Conclusion Super selective intra-arterial infusion of verapamil can effectively improve the treatment of aneurysmal SAH caused CVS.At the same time,it has no obvious effect on blood pressure and heart rate.

Immediate patency assessment of a completed microvascular anastomosis is considered an essential step in a microsurgical procedure. The most frequently used patency test is the milking patency test, which is too traumatic for use in clinical microsurgery. An atraumatic patency test remains to be devised. According to the principle of mechanics that rolling friction is smaller than sliding friction, we designed the so-called rolling patency test. The femoral arteries of Wistar rats were used in the experimental study to make a comparison between the two patency tests. The result showed that intact endothelial cells covered more than 90% of the inner wall of the artery in the rolling patency test, but less than 25% in the milking patency test. The study suggests that the rolling patency test is a reliable and atraumatic immediate patency test for use in clinical microsurgery.

Objective To investigate the outcome of microsurgical treatment and its influencing factors in patients with aneurysmal subarachnoid hemorrhage.Methods The consecutive patients with aneurysmal subarachnoid hemorrhage treated with the early or ultra-early microsurgery were enrolled retrospectively.The Glasgow outcome scale (GOS) was used to assess the outcomes of patients at discharge.GOS 4-5 was defined as good outcome,and GOS 1-3 was defined as poor outcome.Results A total of 147 patients with aneurysmal subaraclnoid hemorrhage were enrolled.One hundred and twelve patients (76.2％) had good outcomes.There were significant differences in the proportions of preoperative Glasgow Coma Scale (GCS) scores (12.8 ± 2.8 vs.7.5 ± 3.8;t =7.525,P ＜0.001),low Hunt-Hess grade (83.0％ vs.31.4％;x2 =34.318,P ＜ 0.001),size of aneurysm (x2 =9.531,P =0.009),preoperative rebleeding (6.3％ vs.25.7％;x2 =8.506,P =0.003),preoperative brain herniation (4.5％ vs.40.0％;x2 =26.846,P ＜ 0.001),initial CT scan showing intracerebral hemorrhage (19.6％ vs.48.6％;x2 =11.449,P =0.002),and intraventricular hemorrhage (8.9％ vs.40.0％;x2 =18.846,P ＜0.001) between the good outcome group and the poor outcome group.Multivariate logistic regression analysis showed that the larger aneurysm (odds ratio [OR] 3.194,95％ confidence interval [CI] 1.458-6.999;P =0.004),older age (OR 1.054,95％ CI 1.013-1.097;P=0.010),lower preoperative GCS score (OR 0.539,95％ CI 0.410-0.724;P ＜ 0.001),and preoperative brain herniation (OR 3.633,95％ CI 1.039-12.700;P =0.043) were the independent risk factors for poor outcomes.Conclusions After active surgical treatment,most of the patients with aneurysmal subarachnoid hemorrhage have good outcomes,however,patients with older age,larger aneurysms,lower preoperative GCS scores,and preoperative brain herniation usually have poor outcomes.

Objective To explore the expression of matrix metalloproteinase-11 (MMP-11) gene in gastric cancer and its correlation with transcription factor Sp1.Methods The expressions of the MMP-11 and Sp1 in level of RNA and protein in 11 specimens from the gastric cancer patients s were detected by RT-PCR,differential PCR and Western-blot,respectively.Results Electrophoresis illustration showed MMP-11 mRNA expression had significant differences in eight pairs of gastric cancer tissues and normal tissues,including 7 pairs of over expressed in gastric cancer tissues and low or no expression in normal tissues,and 1 pair of low expression in cancer tissues but high in normal tissues.The relative molecular weight of Sp1 protein was mainly 95×103 in cancer tissue and 106×103 in normal tissues.Activated MMP-11 protein mainly was over expressed in gastric cancer tissues,and low or no expression in normal tissues,but degradable MMP-1 1 protein was not observed.The enzyme prototype of and activated type of MMP-11 protein were also associated with Sp1 protein.Conclusions The MMP-11 mRNA expression in gastric tissue is higher than that in the adjacent tissues.Sp1 protein and MMP-11 protein are expressed in gastric cancer,but are low or no expression in normal tissue.There is relationship between Spl and MMP-11.

Objective To study the effect of bile reinfusion on immunologic function of erythrocyte in patients with obstructive jaundice after external drainage of biliary tract.Methods Patients with obstructive jaundice who had received biliary tract external drainage were randomly divided into bile reinfusion group ( n =24) and simple external drainage group ( n =27). Patients without jaundice,who received cholecystectomy in the same period with the above ones,were selected randomly as control group( n =25). In external drainage groups patients’ bile was collected daily, and was filtered through gauze, and then, pumped back into the patients’ duodenum or jejunum after being heated to 38 ℃-40 ℃. The bile reinfusion could be started after the intestinal function recovered postoperatively. The changes of C 3bRRT, ICRT, RFER and RFIR were observed before and after operation. The data were analysed through SPSS8.0.Results Preoperative C 3bRRT and RFER levels in patients with obstructive jaundice were lower than those without jaundice significantly, and Preoperative ICRT and RFIR levels in patients with obstructive jaundice were higher than those without jaundice significantly. C 3bRRT levels in bile reifusion group was higher obviously than those in simple drainage group ( P

Objective To investigate the extent of pancreatic and liver function damage of acute necrotizing pancreatitis (ANP) rats under altitude hypoxia environment,and to provide a reference for better diagnosis and treatment of severe acute pancreatitis (SAP) in the plateau region.Methods Ninety-six specific pathogen free (SPF) Wistar male rats were involved in 1 500 meters,3 300 meters and 4 300 meters altitude.The model of ANP was established by using pancreatic capsule injection of sodium taurocholate (NaTc).In the sham operation group,the rats' belly was opened and closed after only flipping its pancreas several times.Rats in sham group were sacrificed at 6 h,and ANP group were sacrificed at 6,12,24 h after modeling.Serum amylase activity was measured,and pancreas and liver tissue were harvested for pathological examination and score.Results Serum amylase activity in sham operation group rats was not remarkably changed,and pathological changes of pancreas and liver were not obvious.At same altitude,serum amylase activity,pancreas and liver pathology score of ANP rats at each time point were significantly higher than those in the sham operation group;and serum amylase activity,pancreas and liver pathology scores of ANP 12,24 h group rats were significantly higher than those of ANP 6h group;and the difference was statistically significant (P ＜ 0.05).At 3 300 meters,4 300 meters altitude,the pancreas and liver pathology scores of ANP rats at each time point were significantly higher than those at 1 500 meters altitude,and the differences were statistically significant (P ＜ 0.05),but the difference in serum amylase activity was not statistically significant.Conclusions With the increase of altitude,pancreatic and liver pathological damage of ANP rats shows continuing aggravation.

Objective Toinvestigatetheimpactofthedifferentrupturepoints(sac,neck,andtop) of intraoperative aneurysm rupture (IAR)on the prognosis of patients in anterior circulation aneurysm clipping.Methods Theclinicaldataof135consecutivepatients(148aneurysms)acceptedmicrosurgical aneurysm clipping from May 2009 to March 2012 were analyzed retrospectively. The prognostic evaluation of the patients after procedure was assessed by using the Glasgow outcome scale (GOS). The different aneurysm rupture points of IAR were used as influencing factors,and the relationship between the different rupture pointsandtheprognosisofpatientswasanalyzed.Results Duringclippingof148aneurysmsin 135 patients,31 aneurysms in 30 patients had intraoperative rupture (20. 9% of the aneurysms, 22.2% of the patients). Nine rupture points occurred on the top of aneurysms,17 occurred on the sac,and 5 occurred on neck. The Glasgow outcome scale (GOS)scores 5,4,3,2 and 1 were in 17,8,2,1 and 2 patients,respectively. A total of 25 patients had good prognosis and 5 cases had poor prognosis. There were no significant differences in the impact of different rupture points of IAR on the prognosis in patients of IAR (OR,100. 00,95% confidence interval 6. 764-18. 344,P=0. 006). Of the 25 patients with aneurysm sac or top rupture,1 case had poor prognosis. Of the 5 patients with aneurysm neck rupture, 4caseshadpoorprognosis.Conclusion Inanteriorcirculationaneurysmclipping,thedifferent aneurysm rupture points may have significant impact on the prognosis of patients,the aneurysm neck rupture is a main factor for resulting in the poor prognosis of patients.