005), but NO level declined remarkably 90 min and 120 min following inhalation(P

Objective To evaluate the effects of applying XF-9801 type of anesthetics waste gas absorber, an activated carbon filter,to removing nitrogen oxides (NOx) and fluoride. Methods Thirty patients, undergoing general anesthesia with enflurane or isoflurane/nitrous oxide, were enrolled in this study.The gas samples were taken at the waste gas outlet of anesthetic machine,to identify the concentrations of nitrogen oxides and fluoride before and after the application of anesthetics waste gas absorber. Results Compared with those before the absorber application, nitrogen oxides and fluroide concentrations in anesthetic waste gas decreased significantly following the absorber application (P

Objective Desflurane is now well accepted by anesthesiologists because of its rapid induction and recovery but carboxyhemoglobin(CUHb) formation from interaction of desflurane with soda lime is a major concern. The purpose of this study was to investigate the effects of different fresh gas flow(FGF) rates on COHb formation during desflurane anesthesia. Methods Forty ASA Ⅰ-Ⅱ nonsmoking patients undergoing elective surgery were randomly divided into four groups with ten patients in each group according to FGF rate: group Ⅰ 0.5L/min; groupⅡ 1.0L/min; group Ⅲ 2.0L/min; group Ⅳ4.0L/min. The patients were premedicated with pethidine 1mg/kg and atropine 0.01mg/kg. Anesthesia was induced with midazolam 0.05mg/kg, propofol 2mg/kg and fentanyl 7pg/kg. Intubation was facilitated with succinylcholine. Anesthesia was maintained with desflurane( 1 .5 MAC), nitrous oxide( 50%) and intermittent vecuronim and fentanyl. PET CO2 was maintained between 35-40 mmHg. Venous blood samples were taken before and 2h, 4h and 6h after induction of anesthesia and at the end of operation for determination of COHb level. Results There was no significant difference among the four groups in age, gender and weight. COHb concentration was not significantly different before and 2h after induction of anesthesia among the four groups, but increased significantly at 4h and 6h after induction of anesthesia and at the end of surgery in groupⅣ, and tended to increase as the operation was prolonged. It was found that patients who developed postoperative headaehe and PONV were mostly from group IV, but no patients developed delayed neuropsychologic sequelae. Conclusions COHb level increases with high FGF rate but not with low FGF rate because of dryness and higher temperature of soda lime. Fresh soda lime should not be left in Canister too long and should be replaced shortly before anesthesia.

Objective To investigate the protective effect and possible mechanism of Decorin on pulmonary fibrosis.Methods A total of 90 healthy Wistar rats were randomly divided into three groups:group A served as control group,group B was injected BLMA5 through trachea,group C was injected BLMA5 and received treatment of Decorin.Ten rats in each group were killed 7、14、28 days after intratrachael instillation.TGF-?_1 expression was measured by immunohistochemical technique.The degree of alveolitis and fibrosis were measured by HE staining.The contents of hydroxideproline were measured in the homodenate of the rat lung.Results The expressions of TGF-?_1 were increased gradually in group B;in group C the expressions were decreased significantly than group B(P

Objective To identify the value of multiparametric MR imaging features including diffusion weighted (DW) and dynamic contrast-enhanced (DCE) MR imaging features in differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.Methods Seventy-seven patients were included in this study,including 12 malignant transformation of inverted papilloma and 65 inverted papillomas.Conventional MRI including nonenhanced and static contrast-enhanced imaging,DCE-and the DW-MRI were analyzed.Differences in conventional MRI features,ADCs and DCE-MRI parameters between the two entities were determined by Fisher exact test,independent samples t-test and Mann-Whitney U test,respectively.Results There were significant differences in convoluted cerebriform pattern (P=0.045),necrosis (P=0.003) and orbit involvement (P＜ 0.01) between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.The ADCs of inverted papilloma were significantly lower than those of malignant transformation of inverted papilloma (P＜0.01).There were significant differences in time to peak enhancement (P＜0.01),maximum contrast index (P=0.004) and time intensity curve types (P＜0.01) between the two entities.Conclusions A multiparametric approach using conventional MR imaging with added ADCs and DCE-MRI parameters had the potential to improve the differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.

Objective To establish the analytical method for the fingerprint of the volatile components in the root tuber of Pseudostellaria heterophylla by GC-MS and provide the basis for quality assessment of the crude drug.Methods The volatile components in the root tuber of P.heterophylla from different habitats were analyzed and the chromatographic fingerprints were established by GC-MS.The common peaks were determined and the fuzzy cluster was selected to compare the results.Results There were 12 main characteristic components in the volatile components in the root tuber of P.heterophylla.GC-MS Fingerprint of 12 common peaks was established preliminarily.Conclusion The method is reliable and accurate,and can be used for quality control of the root tuber of P.heterophylla.with favourable reproducibility.

Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.

BACKGROUND: Hyperuricemia (HUA), serving as a component of metabolic syndromes (MS), has a major regulatory role in inflammatory responses. However, the correlation between G-308A tumor necrosis factor-α (TNF-α) and MS is still controversial.OBJECTIVE: To study the correlation among G-308A TNF-α genotype distribution, TNF-α mRNA expression and C-reactive protein (CRP) in patients with HUA.DESrGN: Patients with HUA were selected as the subjects, while normal peoplewere taken as the controls.SETTING: Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: Subjects were selected from 5 003 people, including 188 patients with HUA and 51 healthy people.Patients with HUA included 40 patients with simple HUA, 42 patients with HUA and dyslipidemia, 80 patients with HUA and dyslipidemia and hypertension, and 26 patients with gout (administration of allopurinol was stopped at one week before the experiment).METHODS: TNF-α gene promoter G-308A genotype was determined by using PCR application followed by Nco/digestion.TNF-α mRNA expression was studied by RT-PCR with semi-quantitative analysis. Antibody sandwich method and enzyme linked immunosorbent assay (ELISA) were adopted to determine the CRP concentration. And the serum uric acid was measured by uricase method, while the insulin resistance index (IRI) was evaluated with homeostasis model.MArN OUTCOME MEASURES: ① Hardy-Weinberg equilibrium test of genotypic frequency. ② Changes in distribution of G-308A TNF-α genotypes and TNF-α mRNA expression in patients with HUA. ③ Changes in TNF-α mRNA expression and other parameters in G-308A TNF-α AA+GA and GG groups. ④ Multiple stepwise regression analysis.RESULTS: A total of 188 patients and 51 normal people were involved in the analysis of results. ① G-308A TNF-α genotypes distribution in 239 enrolled subjects accorded with Hardy-Weinberg equilibrium. ② AA+GA was compared with GG due to lower frequency of AA in population. The results revealed the HUA with dyslipidemia and hypertension group displayed a greater prevalence in G-308A TNF-α AA+GA genotype (30%) than that in the control group (12%) (P ＜ 0.05),while there were no significant differences among other groups. ③ TNF-α mRNA expression and CRP concentration were the highest in the gout group, and HUA accompanied by dyslipidemia and hypertension group listed the second,and then was the HUA and dyslipidemia group, while simple HUA group listed the last, all of which were higher than those in the normal control group (P ＜ 0.05-0.01). TNF-α mRNA expression in HUA accompanied by dyslipidemia and hypertension group, gout group was higher than that in the normal control group (P ＜ 0.05-0.01). The WHR, SBP, DBP,serum uric acid, triglycerides, TNF-α mRNA expression and CRP concentration in AA+GA group were remarkably higher than those in the GG group (P ＜ 0.05-0.01). ④ After adjustment of age, gender, systolic pressure, diastolic pressure,fasting blood glucose, and multiple variable linear stepwise regression showed that triglycerides, uric acid, TNF-α 308 A carrier were related with quantityof TNF-α mRNA expression. Meanwhile, the uric acid concentration, WHR and the quantity expression of TNF-α were significantly in positive association with CRP concentration.CONCLUSTON:The genotype of TNF-α 308 A carriers is associated with TNF-α expression and plasma CRP levels in HUA patients.

Objective To investigate the methods and techniques of simplified binding pancreaticojejunostomy for patients with periampullary malignant tumor after radical pancreatoduodenectomy (RPD). Methods From March 2005 to May 2010, 323 patients with periampullary malignant tumor received RPD at the Tongji Hospital of Huazhong University of Science and Technology, and their clinical data were retrospectively analyzed.Simplified binding pancreaticojejunostomy was applied after RPD: the distal end of pancreas was freed for 3-4 cm;a No. 6 or No. 8 silicone urinary catheter was inserted into the pancreatic duct for 4-5 cm, and the remaining urinary catheter (6-8 cm) out of the pancreatic duct was sutured to the pancreatic stump with absorbable sutures.The cutting end of the jejunum (2-3 cm) was everted, and the everted mucosa of the jejunum ( 1 cm) was injured by electrocautery, then the everted jejunum was reverted to its normal position. The cutting end of the mesentery of jejunum and its opposite side, as well as the mid-point of these two parts were sutured symmetrically with the lower and upper edges of the pancreas, and with the capsule of pancreas between them. The everted jejunum was wrapped over the pancreatic stump and sutured it to the pancreas for fixation. The cutting end of the jejunum was bound to the pancreatic stump with 1-0 absorbable suture after confirming the jejunum was completely invaginated into the pancreas. The alimentary tract was reconstructed by using Child's method. Results Simplified binding pancreaticojejunostomy was successfully completed in all patients, Pancreatic fistula was detected in one patient who was complicated with anastomotic bleeding on the third day after secondary laparotomy. The patient was discharged with catheter and spontaneously recovered one month later. Pancreatic fistula was also detected in two patients with distal bile duct carcinoma and two patients with carcinoma in the uncinate process of pancreas at postoperative day 3, 6, 8 and 11, and they were cured by expectant treatment. The incidence of pancreatic fistula was 1.5% (5/323). Conclusion Simplified binding pancreaticojejunostomy is simple, safe and feasible, and it can significantly reduce the incidence of pancreatic fistula.

Objective To investigate the effect of adrenomedullin on rat renal tubular epithelial cell line (NRK-52E) apoptosis induced by hypoxia-reoxygenation (HR) injury and its mechanism.Methods NRK-52E cells were cultured and randomly allotted to the following 4 groups:control group,HR group,empty plasmid + HR group,ADM + HR group.NRK-52E cells were transfected with pcDNA3.1-myc-his B empty vector or pcDNA3.1-ADM by transfection complex comprising optimal proportion of plasmid and Fugene HD reagents.Cells were counted by trypanblau and cell survival rate was computed.The concentration of lactate dehydrogenase (LDH) was detected by spectrophotometric method to evaluate cell vitality.The apoptotic rate of NRK-52E cells was measured by flow cytometry.The transfer efficiency was detected by immunocytochemistry.The mRNA expressions of ADM,Bax,Bcl-2 and Fas were determined by Semi-quantitative RT-PCR,and active caspase-3,8,9 protein expression were examined by Western blotting.Results Compared with control group,the expression of ADM significantly increased in HR group (P ＜ 0.05).The expression of ADM significantly increased in ADM + HR group than that in empty plasmid + HR group.Compared with control group,in HR group,the living cell counts and cell survival rate significantly decreased; the LDH concentration in media,apoptotic rate and the levels of Bax,Bcl-2,Bax/Bcl-2,Fas,active Caspase -3,8,9 significantly increased (all P ＜ 0.05).Compared with HR group,in ADM + HR group,the living cell counts and cell survival rate significantly increased; the LDH concentration in media,the cell apoptotic rate and the levels of Bax,Bax/Bcl-2,Fas,active Caspase-3,8,9 significantly decreased,while Bcl-2 was promoted (all P ＜ 0.05).The above indexes had no differences between empty plasmid + HR group and HR group (all P ＞ 0.05).Conclusion The increased expression of ADM can inhibit NRK-52E apoptosis induced by HR,and the mechanism might be achieved by inhibiting mitochondrial and death receptor-mediated apoptotic pathways.