Objective:To explore the protective effect of sodium channels antagonists HOE642 on lung ischemia reperfusion and the role of the p38 mitogen activated protein kinase (p38MAPK) signaling pathway in this process.Methods:A total of 36 mice were randomly divided into a sham operation group (SHAM group),a lung ischemia reperfusion group (I/R group) and a lung ischemia reperfusion+HOE642 group (HOE group).The water content was detected by electronic scales,and the lung tissue pathological changes were observed under optical microscope.The inflammatory cytokines including IL-6 and TNF-α were examined by ELISA.The intracellular calcium fluorescence intensity was examined and observed under fluorescence microscope,and the protein expression of p38MAPK was detected by Western blot.Results:Lung water content in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Lung interstitial edema,hemorrhage,lung tissue inflammatory cells infiltration were significantly alleviated in the HOE group than those in the I/R group,while the injury in the HOE group was aggravated than those in the SHAM group (both P＜0.05).T he IL-6 and TNF-α in lung tissues in the HOE group were lower than those in the I/R group,but higher than those in the SHAM group (both P＜0.05).Intracellular calcium fluorescence intensity in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).The protein expression of p38MAPK in lung tissues in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Conclusion:HOE642 may exert protective effect on pulmonary I/R injury through regulation of the p38MAPK signaling pathway,resulting in reduction of intracellular calcium ion concentration and calcium overload,and decrease of inflammatory response.

Objective: To investigate the clinical efficacy of two different anterior cervical surgeries in treatment of multi-segmental cervical spondylosis. Methods: A total of 86 patients with multi-segmental cervical spondylosis were treated by anterior cervical surgery procedure. Among them, 62 and 24 cases were involved in three and four gap, respectively. Each patient underwent the surgery of long or segmented anterior cervical decompression and fixation. Preoperative and postoperative cervical curvature change, internal if xation stability, fusion rate and nerve function were evaluated. Results: All patients were successfully completed the operation, segmented surgery showed better cervical lordosis recovery, but there were no significant difference between long and segmented anterior cervical surgery in blood loss and recovery of neurological function (P>0.05). Conclusion: The segmented anterior cervical surgery has advantages in the treatment of multi-segmental cervical spondylosis.

Objective To explore the curative effect of prealbumin (PA) in the hand-foot-and-mouth dis-ease and analysis its value in monitoring and prognosing this disease. Method Detect levels of serum PA of 390 ca-ses of children before, after and during the treatment and compare the changes during the treatment. Then observe the prognosis. Results There are significant difference of PV levels between cases of different prognosis (P < 0.05). Conclusion The PV levels of children of hand-foot-and-mouth disease will change significantly after effective treat- ment. There are clinical significance in observing and prognosing the hand-foot-and-mouth disease by detecting the se-rum PV levels.

Objective To investigate the effect of lidocaine pretreatment on renal HMGB1 expression during renal ischemia-reperfusion (I/R) in rats.Methods Thirty-six male Wistar rats weighing 300-350 g were randomly divided into 3 groups ( n=12 each):sham operation group (group S),I/R group and lidocaine pretreatment group (group L).Renal I/R was induced by occlusion of bilateral renal arteries for 60 min followed by 4 or 24 h reperfusion.Lidocaine 5 mg/kg was injected iv at 60 min prior to ischemia followed by 2 mg· kg- 1· h- 1 infusion iv for 60 min in group L.Equal volume of normal saline was given in group I/R.Six rats in each group were sacrificed at 4 or 24 h of reperfusionand their kidneys were removed for microscopic examination and for determination of SOD activity,MDA content and the expression of HMGB1 mRNA and protein.Results Compared with group S,renal HMGB1 mRNA and protein expression,MDA content were significantly increased,while SOD activity were significantly decreased in groups I/R and L( P ＜ 0.05).Compared with group I/R,renal HMGB1 mRNA and protein expression,and MDA content were significantly decreased,while SOD activity were significantly increased in group L ( P ＜ 0.05 ).Conclusion Lidocaine pretreatment can attenuate renal I/R injury in rats by down-regulating HMGB1 expression

Objective To evaluate the role of mitochondrial ATP-sensitive potassium (mito-KATP) channels in attenuation of renal ischemia-reperfusion (I/R) injury by lidocaine pretreatment in rats.Methods Sixty healthy male Wistar rats,weighing 300-350 g,were randomly assigned into 5 groups (n =12 each) using a random number table:sham operation group (group S); renal I/R group (group I/R); lidocaine pretreatment group (group L) ; 5-HD (a specific blocker of the mito-KATP channel) group and 5-HD + lidocaine pretreatment group (group 5-HD + L).Renal ischemia was induced by occlusion of bilateral renal arteries for 60 min with atraumatic microclips followed by 4 h reperfusion.At 60 min before renal ischemia,lidocaine 5 mg/kg was intravenously injected followed by continuous infusion at 2 mg· kg-1 · h-1 in group L.5-HD 10 mg/kg was injected intraperitoneally at 65 min before ischemia in group 5-HD.In 5-HD + L groups,5-HD 10 mg/kg was injected intraperitoneally at 65 min before ischemia and the other procedures were similar to those previously described in group L.In S and I/R groups,the animals received equal volumes of normal saline instead of lidocaine.Blood samples were obtained at 6 h of reperfusion for determination of serum creatinine (Cr) and urea mitrogen (BUN) concentrations.Bilateral kidneys were removed for determination of mitochondrial membrane potential in the renal tubular epidural cells,malondialdehyde (MDA) content,and superoxide dismutase (SOD) activity and for microscopic examination.Results Compared with group S,the serum Cr and BUN concentrations and MDA content were significantly increased,and SOD activity and mitochondrial membrane potential were decreased in I/R,L,5-HD and 5-HD + L groups (P ＜ 0.05).Compared with group I/R,the serum Cr and BUN concentrations and MDA content were significantly decreased,and SOD activity and mitochondrial membrane potential were increased in L and 5-HD + L groups (P ＜ 0.05),and no significant changes were found in the serum Cr and BUN concentrations,MDA content,SOD activity and mitochondrial membrane potential in group 5-HD (P ＞ 0.05).Compared with group L,the serum Cr and BUN concentrations and MDA content were significantly increased,and SOD activity and mitochondrial membrane potential were decreased in 5-HD + L group (P ＜ 0.05).The pathological changes were significantly reduced in group L as compared with I/R and 5-HD + L groups.Conclusion Mito-KATp channels are involved in reduction of I/R-induced renal injury by lidocaine pretreatment in rats.

Objective To compare the minimum 5?year follow?up outcomes of surgical management by posterior only, anterior only and combined posterior and anterior approaches for lumbar tuberculosis in adults, evaluate the mid?term follow?up results of the surgery for the treatment of lumbar tuberculosis and explore its advantages and indications. Methods From Jun 2004 to Jan 2010, 311 adult patients with lumbar tuberculosis were treated surgically. The clinical data of 137 cases that met the enrolled criteria and had integrity following?up data was analyzed retrospectively. It included the patients who had the surgical indication of the posterior only surgery but underwent the anterior only or the combined posterior and anterior ap?proaches before 2008. There were 83 cases of male and 54 cases of female. The age ranged from 20 to 75 years, with a mean of 65.6 years. Among these patients, 63 cases were treated with single?stage posterior debridement, interbody fusion and instru?mentation (the posterior group); 42 cases were treated with posterior instrumentation, and anterior debridement and bone graft in a single or two?stage procedures (the combined group) and 32 cases were treated with anterior debridement and strut graft?ing with instrumentation (the anterior group). Trauma index (the operation time, blood loss, the length of hospital stay, compli?cations);imaging parameters (Segment kyphotic angle, corrective rate, loss angle, bone fusion time) and the quality?of?life indi?cators (Oswestry Disability Index、Frankle grade、visual analogue scale、Macnab score) were compared among three groups. Re?sults The mean operation time, mean blood loss and the complications rate were (207.9 ± 30.9) min, (409.5 ± 107.9) ml and 12.95%in the posterior group;(270.7±32.0) min, (649.0±120.0) ml and 30.95%in the anterior group;(349.7±38.9) min, (840.0± 168.7) ml and 25%in the combined group. The operation time, blood loss and the complications rate of the posterior group were less than the anterior group and the combined group, and the difference was significant;The combined group consumed the longest operation time, associated with the most intraoperative blood loss, the highest complication rate and the longest hospital stay among the three groups, and the difference was significant. The correction rate of kyphosis achieved of the anterior group ( 52%± 5.45%) was significantly inferior to the posterior group (74%±5.04%) and the combined group (69%±7.95%), while the loss of cor?rection in the anterior group (2.5°) was higher than both the posterior group (0.8°) and the combined group (1.1°), and the differ?ence was significant. The average follow?up was(6.5±1.96)years (range, 5-11). The mean bone fusion time of the posterior group, the anterior group and the combined group were (6.0±1.5) months, (6.2±1.3) months and (6.5±1.6) months respectively, and there was no statistic difference. After the surgery, the quality of life was improved obviously in all patients. At the time of the latest fol?low?up, the improvement rate of the ODI,VAS and the excellent and good rate according to the Macnab score were 80.6%±2.1%, 81.7%± 1.6%and 95.24%in the posterior group;79.8%± 1.5%, 79.7%± 2.0%and 92.95%in the anterior group;81.3%± 1.1%, 79.9%±0.8%and 90.63%in the combined group. There was no significant difference among the groups in the improvement rates of the ODI, VAS, Frankel grade and the excellent and good rate of the Macnab score. Conclusion The Mid?term follow?up of the different surgical procedures for the treatment of the lumbar tuberculosis in adults were basically satisfactory. Compared with the traditional surgery, the posterior?only surgery is a safe, minimally invasive and effective method in the management of monoseg?ment lumbar tuberculosis in adults.

Objective To explore the prognostic factors of primary mediastinal large B-cell lymphoma (PMBCL) and the effects of chemoradiotherapy versus chemotherapy alone on patients' prognosis before and after rituximab era. Methods We extracted the data of PMBCL patients diagnosed from 2001 to 2015 from SEER database. SEER Stat software was used to calculate the incidence rate. Kaplan-Meier method and Cox regression model were used to analyze the impact of various clinical variables on prognosis. Results We included 635 patients with PMBCL. Multivariate Cox regression analysis showed that age, stage and chemotherapy were independent prognostic factors. Kaplan-Meier survival analysis showed that OS of the patients receiving chemotherapy only in 2006-2015 was significantly better than that in 2001-2005 (χ²=10.002, P=0.002). The patients who received chemoradiotherapy had better OS than those who received chemotherapy alone from 2001 to 2005. The OS and DSS of patients receiving chemoradiotherapy were not significantly different from those of chemotherapy alone from 2006 to 2015. Conclusion The application of rituximab improves the long-term survival of PMBCL patients. The prognosis of patients who received chemoradiotherapy is comparable to that of chemotherapy alone from 2006 to 2015.

ObjectiveTo find out the risk factors causing iatrogenic spinal cord injury (ISCI) so as to provide theoretical support for reducing the spinal cord injury during spinal operation. Methods A retrospective study was done on 120 patients undergone cervical or thoracic spinal( C1-T12 ) surgery at Xiangya Hospital of Central South University from January 2002 to January 2009. The patients were randomly divided into injury group (n = 34) and control group (n = 86) and the univariate analysis was used to analyze 30 factors including clinical factors, iconography factors, operation and pathology factors as well as possible protective factors. Then, the factors with statistical difference were analyzed by using the multi-factor unconditioned Logistic analysis.Results The univariate comparison between the two groups showed statistical difference ( P ＜ 0. 05 ) in nine factors including combined hypertension, combined diabetes mellitus, preoperative ASIA grade, spinal canal stenosis rate, ratio of spinal cord area/efficient area of vertebral canal, spinal cord MRI T2WI high signal, bleeding amount during operation, intraspinal prominence adhesion to dura mate of spinal cord as well as intraoperative use of methylprednisolone. The multi-factor Logistic regression analysis revealed that ASIA grade, value of spinal cord area/efficient area of vertebral canal, spinal cord MRI T2W1 high signal and bleeding amount in operation had positive correlation with ISCI. Use of methylprednisolone during operation had negative correlation with ISCI. ConclusionsCombined diabetes mellitus, ASIA grade, spinal cord MRI T2W1 high signal, ratio of spinal cord/vertebral canal area and bleeding amount in operation are the risk factors for ISCI. Use of large dose methylprednisolone exerts preventive effect on ISCI.

Objective To evaluate the effect of dexmedetomidine pretreatment on the expression of mitochondrial transcription factor A ( TFAM) and succinate dehydrogenase ( SDHA) during lung ischemia-reperfusion ( I∕R) in mice. Methods Twenty-four clean-grade healthy male C57BL∕6J mice, aged 8-10 weeks, weighing 18-22 g, were divided into 3 groups ( n=8 each) using a random number table method:sham operation group ( group S ) , lung I∕R group ( group I∕R ) and dexmedetomidine pretreatment group ( group D) . In I∕R and D groups, lung I∕R was induced by clamping the left pulmonary hilum for 60 min followed by 120-min reperfusion in anesthetized mice. The chest was only opened, but the left pulmonary hilum was not occluded in group S. Dexmedetomidine 25μg∕kg was intraperitoneally injected at 30 min be-fore ischemia in group D, while the equal volume of normal saline was given instead of dexmedetomidine in I∕R and S groups. The mice were sacrificed at 120 min of reperfusion, and lungs were removed for determi-nation of wet∕dry weight ratio ( W∕D ratio) , cell apoptosis ( by TUNEL) and expression of TFAM and SDHA mRNA in lung tissues ( by real-time polymerase chain reaction ) and for examination of the pathological changes of lung tissues. The apoptosis index was calculated. Results Compared with group S, the W∕D ratio, apoptosis index and lung injury scores were significantly increased, and the expression of TFAM and SDHA mRNA was down-regulated in I∕R and D groups ( P<0. 05) . Compared with group I∕R, the W∕D ra-tio, apoptosis index and lung injury scores were significantly decreased, and the expression of TFAM and SDHA mRNA was up-regulated in group D ( P<0. 05) . Conclusion The mechanism by which dexmedeto-midine pretreatment attenuates lung I∕R injury is related to up-regulating the expression of TFAM and SDHA in mice.

Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoper-ative analgesia in patients undergoing thoracoscopic lobectomy. Methods Sixty patients undergoing thoracoscopic lobectomy were randomly divided into the dexmedetomidine group(DS group)and the control group(S group). The two groups were treated with PCIA.The Group DS:dexmedetomidine 2 μg/kg+sufentanil 1.5 μg/kg+ondan-setron 8 mg;and the group S:sufentanil 2 μg/kg+ondansetron 8 mg,in which all drugs were dissolved in 100 mL 0.9 normal saline. Parameters:loading dose 2 mL;infusion speed 2 mL/h;PCA dosage 2 mL each time;lock time:15 min. The mean arterial pressure(MAP),heart rate(HR),resting(VASR)and cough(VASC)VAS score,and Ramsay sedation score were recorded at 2,6,12,24,36 and 48 h after surgery.The number of press analgesic pump,the amount of sufentanil used,the incidence of adverse reactions such as,the nausea and vomit-ing,respiratory depression,bradycardia and so on were recorded within 48 h after operation. Results Compared with the group S,the MAP and HR of patients in the group DS decreased significantly at each time(P < 0.05), the scores of VASR and VASC decreased obviously at 6,12,24 h after surgery(P<0.05),the number of press analgesic pump,the amount of sufentanil used,the incidence of nausea and vomiting decreased obviously within 48 h after operation(P<0.05).Conclusions Dexmedetomidine combined sufentanil administration in PCIA after thoracoscopic lobectomy can obtain satisfactory analgesic effect and more stable hemodynamics,and reduce the dosage of sufentanil,the incidence of nausea and vomiting.