Objective To compare the effectiveness of supraclavicular brachial plexus block guided by ultrasound with that guided by nerve stimulator or anatomical landmarks. Methods One hundred and twenty ASA Ⅰ-Ⅲ patients (81 male, 39 female) aged 16-62 yrs weighing 40-75 kg scheduled for upper extremity operation under brachial plexus block via supraclavicular approach were randomized into 3 groups ( n = 40 each) : In group U block was guided by ultrasound; in group N nerve stimulator was used to locate the brachial plexus and in group T block was performed in the traditional way based on anatomical landmarks. A mixture of equal volumes of 0.75% ropivacaine and 2% lidocaine (0.4 ml?kg-1) was injected in the 3 groups. The onset and intensity of sensory block of musculocutaneous, median, radial and ulnar nerves were measured and analgesia was rated as excellent, effective and failure.Results The rate of satisfactory block of ulnar nerve was significantly lower than that of musculocutaneous and radial nerves in group N and T ( P

Objective To investigate the effect of ovarian cycle on the sedative effect of propofol in patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 20-40 yr, with body mass index 20-25 kg/m2 , scheduled for elective gynecologic laparoscopic surgery, were divided into 2 groups according to the progesterone level ( n = 20 each): follicular phase group (group F, serum progesterone concentration 0.31-1.52 ng/ml) and luteal phase group (group L, serum progesterone concentration 5.16-18.56 ng/ml). Anesthesia was induced with target-controlled infusion (TCI) of propofol and iv injection of fentanyl and cisatracurium. The initial target plasma concentration (Cp) of propofol was set at 2 μg/ml, after the Cp reached the predetermined level, the Cp increased by 0.5 μg/ml every 30 s until the patients lost consciousness and BIS value was decreased to 50. The BIS value and Cp of propofol was recorded when the patients lost consciousness. The Cp of propofol was also recorded when BIS value was decreased to 50. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol combined with remifentanil. BIS value was maintained at 45-55 by adjusting the Cp of propofol. Results The Cps of propofol were significantly higher when the patients lost consciousness and when BIS value was decreased to 50 in group F than in group L ( P ＜ 0.05 or 0.01) . There was no significant difference in BIS value when the patients lost consciousness between the two groups (P ＞ 0.05). Conclusion Ovarian cycle can affect the sedative effect of propofol in patients, which shows that the sedative effect during the follicular phase is lower than that during the luteal phase.

Objective:To observe the effects of hyperthermia on the sensitivity of gastric cancer cell lines to paclitaxel (TAX) . Methods :To establish TAX-resistant gastric cancer cell line through a method of increasing concertration gradient and named it MKN-45/TAX .Immunocytohistochemistry staining method was used to detect the expression of multi-drug resistance gene (MDR1) in MKN-45/TAX and MKN-45 .CCK-8 test was used to detect the proliferation inhibition rates in two kinds of cell lines under different temperatures and different TAX concentration .Real-time polymerase chain reaction (RT-PCR) and West-ern blotting were used to detect the expression of MDR1 mRNA and P-glycoprotein (P-gp) before and after target siRNA treat-ment .Results:Establishment of MKN-45/TAX cell line was successful .The expression level of MDR1 was high in MKN-45/TAX whereas it was low in MKN-45 .As TAX concentration increased ,the proliferation inhibition rates of both cell lines in-creased .At 42 ℃ the proliferation inhibition rate of MKN-45/TAX to TAX chemotherapy decreased ,while that of MKN-45 was the opposite .Both the expression of MDR1 mRNA and P-gp decreased after the siRNA transfection .Conclusions :Hyper-thermia combined with chemotherapy may enhance the resistance of TAX-resistant gastric cancer cell line to TAX ,while it may enhance the sensitivity of TAX-sensitive gastric cancer cell line to TAX .The mechanism may be related to the expression of MDR1 .

Objective:To compare the clinical efficacy of laparoscopy-assisted choledochoelectroscopy and endoscopic retrograde cholangiopancreatography on treatment of acute cholangitis with bile duct stones .Methods :The clinical datum of 103 cases of a-cute cholangitis with bile duct stones treated by laparoscopy-assisted choledochoelectroscopy (Group L ,n=64) or endoscopic retrograde cholangiopancreatography (Group E ,n=39) from October 2008 to September 2013 were analyzed retrospectively . In hospital days ,costs ,the rates of residual stones ,the rates of complications and the stone recurrence rates were compared between the two groups .Results:The operation success rates were 96 .25% and 89 .74% ,and hospital days were (9 .6 ± 0 .9) and (8 .3 ± 0 .7) days in Group L and Group E ,respectively ,but had no stastically significant differences (P> 0 .05) .The cost ,the rate of residual stones ,the rates of complications and the stone recurrence rate in Group L were significantly lower than those in Group E (P<0 .05) .Conclusions :Acute cholangitis with bile duct stones can be treated by laparoscopy-assisted choledochoelectroscopy or endoscopic retrograde cholangiopancreatography .However ,the former presents more clinical advan-tages .

OBJECTIVETo investigate the effects of antisense glutamic acid decarboxylase (GAD(67)) oligodeoxynucleo-tide (ODN) on behavior, seizure threshold and EEG of hippocampus in the epileptic rats induced by pentylenetetrazol (PTZ).

METHODSA model of chronic epilepsy in rats was established by PTZ. The inhibition of GAD(67) mRNA expression in hippocampus was selectively induced by antisense oligodeoxynucleotide of GAD(67). The effect of antisense GAD(67) ODN on behavior, seizure threshold and EEG recording of kindled rats was examined.

RESULTSAntisense GAD(67) ODN could inhibit the expression of GAD(67) mRNA and the concentration of GABA. It also could significantly shorten the latencies of seizure and increase the level of seizure and the frequency of epileptiform discharges.

CONCLUSIONThe gene of GAD(67) may be an anti-seizure gene, which might inhibit epileptiform discharge. The treatment of epilepsy by GAD(67) gene will have a bright future.

Animals ; Electroencephalography ; Epilepsy ; chemically induced ; physiopathology ; Glutamate Decarboxylase ; genetics ; pharmacology ; Hippocampus ; physiopathology ; Isoenzymes ; genetics ; pharmacology ; Kindling, Neurologic ; Male ; Oligonucleotides, Antisense ; pharmacology ; Pentylenetetrazole ; Rats ; gamma-Aminobutyric Acid ; analysis

BACKGROUNDTo investigate the role of curative and palliative surgical treatment of lung cancer with video-assisted thoracoscopic surgery (VATS).

METHODSForty-three patients with lung cancer were prescribed operations with VATS, which included 5 cases of stage IA, 14 cases of IB, 1 case of IIA, 4 cases of IIB, 7 cases of IIIA, 6 cases of T4-IIIB and 6 cases of IV. The 7 patients of stage IIIA were previously staged as N0 before operation, but reevaluated as N2-IIIA after operation. There were 3 cases of malignant pleural effusion and 3 cases of pleural implantation in stage IIIB cases. There were 2 cases of cardiac tamponade, 1 case of solitary brain metastasis, and 3 cases of ipsilateral or contralateral solitary lung metastasis in cases of stage IV. The main methods of operation performed included lobectomy in 36 cases, wedge resection in 5 cases, and pericardial opening in 2 cases. Systemly mediastinal lymph node dissections were performed in 36 cases. Concurrent contralateral pulmonary wedge resections were performed in 2 cases of contralateral solitary lung metastasis. Malignant pleural effusions were prescribed resection of implantation nodules, electrocautery and pleurodesis.

RESULTSThere was no perioperative death or bronchial leak. Five cases suffered lung infection, and 2 cases occurred with incision infection. Malignant pleural effusion in the 3 cases was controlled satisfactorily. Two cases of pericardial opening died in 4 months and 8 months after operation respectively. The other patients were alive till present. Postoperative hospital stay was 5-15 days with average of 7.4 days, except of two cases of pericardial opening.

CONCLUSIONSVATS is an alternative way for complete resection of early stage lung cancer. It is technically feasible to dissect mediastinal lymph node for accidental N2 lung cancer. VATS has significant advantage in concurrent bilateral pulmonary resection. The palliative operation of malignant pleural effusion and cardiac tamponade by VATS can markedly improve the quality of life of patients.

OBJECTIVETo study whether recombinant adeno-associated virus (rAAV) mediated foreign gene, LacZ, could pass the blood brain barrier by intra-carotid artery delivery and express in vivo in ischemic brain of the focal embolic stroke rats to investigate a possibility of delivering foreign gene through carotid artery to treat acute ischemic stroke.

METHODSThe carotid artery territory in 41 rats was embolized with or without arterial-like fibrin rich clots to make a model of focal embolic stroke rat. rAAV containing LacZ gene (rAAV-LacZ) was constructed in 293 cells by calcium phosphate cotransfection. The rats were assigned to one of the following treatments: 1 control (without embolism) groups, including PBS treated (n = 6), pLacZ treated (n = 6 ) and rAAV-LacZ treated (n = 6): 2 embolic groups, including embolism + PBS (n =7),embolism + pLacZ (n = 8) and embolism + rAAV-LacZ (n = 8). Brains were cryosectioned and kappa-Gal stain was performed at 2, 4, and 8 weeks, respectively, after transfection, and then infarct volume was measured and the percentage of LacZ staining-positive cells was calculated.

RESULTSIn all the control groups and embolism + PBS treated animal, no kappa-Gal staining-positive cells were found, but in embolism + pLacZ (n = 8) and embolism+rAAV-LacZ groups a lot of kappa-Gal staining-positive cells were found. The expression cells were in the tissues around the infarction. The gene expression persisted only nearly four weeks in embolic group with pLacZ. In the embolic group with rAAV-LacZ the expression was very stable during the experiment course (eight weeks) and the percentage of the expressed cells was significantly higher than that of its contralateral areas at the same time points, respectively.

CONCLUSIONSThe plasmid vector and rAAV could enter the brain through the ischemia-damaged blood barrier and foreign gene can be expressed in brain. The positive gene expression is mainly in the peripheral areas of the infarction. rAAV as a permanent expression vector may ultimately be used for gene therapy of human ischemia cerebravascular diseases.

Animals ; Blood-Brain Barrier ; Brain ; virology ; Carotid Arteries ; Dependovirus ; genetics ; Genetic Therapy ; Genetic Vectors ; Intracranial Embolism ; therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Stroke ; therapy

BACKGROUND: Meshes play a crucial role in hernia repair. However, the displacement of mesh inevitably leads to various associated complications. This process is difficult to be traced by conventional imaging means. The purpose of this study is to create a contrast-enhanced material with high-density property that can be detected by computed tomography (CT). METHODS: The contrast-enhanced monofilament was manufactured from barium sulfate nanoparticles and medical polypropylene (PP/Ba). To characterize the composite, stress tensile tests and scanning electron microscopy (SEM) was performed. Toxicity and biocompatibility of PP/Ba materials was verified by in vitro cellular assays. Meanwhile, the inflammatory response was tested by protein adsorption assay. In addition, an animal model was established to demonstrate the long-term radiographic effect of the composite material in vivo. Subsequent pathological tests confirmed its in vivo compatibility. RESULTS: The SEM revealed that the main component of the monofilament is carbon. In vitro cell experiments demonstrated that novel material does not affect cell activity and proliferation. Protein adsorption assays indicated that the contrast-enhanced material does not cause additional inflammatory responses. In addition, in vivo experiments illustrated that PP/Ba mesh can be detected by CT and has good in vivo compatibility. CONCLUSION These results highlight the excellent biocompatibility of the contrast-enhanced material, which is suitable for human abdominal wall tissue engineering.

Evoked Potentials ; Humans ; Magnetic Resonance Imaging ; methods ; Optic Neuritis ; diagnosis ; Retrospective Studies