Objective To investigate effect of dexmedetomidine sedation anesthesia on perioperative hemo-dynamics and heart rate variability in patients with hypertension .Methods 50 cases with selective laparoscopic chol-ecystectomy were randomly divided into Group A ( dexmedetomidine sedation ) and Group B ( saline control ) ,25 cases each group .Low-frequency ( LFnu ) , high-frequency ( HFnu ) , LF/HF, LFnu ( LF/TP ×100%) , HFnu ( HF/TP × 100%)and total-power(TP)were recorded at the time points of baseline (T0),immediately after administration(T1), immediately after anesthesia induction (T2),1 min after anesthesia induction (T3),5 min after anesthesia induction (T4)and 10 min after anesthesia induction (T5).NIBP and HR were recorded at the points of T0 ~T5.Results Compared with T0 or Group A,there was an increase in SBP and HR at T2~T4(P<0.05)in Group B.Heart rate variability changes showed that Lfnu [(66.3 ±7.8),(64.5 ±6.0),(65.3 ±6.5)],LF/HF[(1.9 ±0.7),(1.7 ± 0.5),(1.7 ±0.8)],TP[(2 283 ±472),(2 197 ±310),(2 108 ±256)]decreased significantly at T2-T4(tLFnu=5.16,4.15,4.40,tLF/HF=4.55,4.24,3.49,tTP=3.27,1.71,0.96,P<0.05) in Group A,while there was no significant change in Group A .Conclusion Dexmedetomidine sedation may have less influence on hemodynamics and automomic nerve ,which be an useful analgesic adjuvanct for the patients undergoing selective laparoscopic chole -cystectom.

Objective:To evaluate the psychosomatic effects of relaxation and the correlation between the effects and the personality and behavior pattern of the subject.Methods:68 medical students were involved in the study. All the subjects received relaxation training for 2 months. They were tested with Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) before and at the end of the study. They were also tested electroencephalogram (EEG), electromyography (EMG) and skin temperature at the above two time-points. The correlation between the personality and the extents of alteration in index of EEG were also studied.Results:After training, the scores of SAS and PSQI in the subjects were significantly lower than those before training. The indexes of EEG, EMG and skin temperature were improved. The extents of alteration in index of EEG were correlated positively with the N-scores of Eysenck Personality Questionnaire (EPQ), the total scores and TH-scores of Type A Behavior Pattern (TABP).Conclusion:Relaxation can improve psychosomatic states of undergraduates. The extents of alteration in index of EEG were correlated with the personality and behavior pattern of the subject.

[Objective]To explore the therapeutic effect of three surgical procedures(anterior approach,posterior approach and posterior-anterior approach) for cervical spondylotic myelopathy(CSM). [Methods]A total of 111 patients with cervical spondylotic myelopathy treated with three surgical procedures from June 2002 to December 2007 were retrospectively analyzed.Group A(anterior approach) comprised 54 patients with a mean age of 57.1 years(ranged,44~75 years).Group B(posterior approach,Laminoplasty) comprised 33 patients with a mean age of 61 years(ranged,41~73 years).Group C(posterior-anterior approach) comprised 24 patients with a mean age of 62 years(ranged,48-78 years).All patients were followed-up,neural function and cervical sagittal alignment were recorded.According to JOA score,preoperative and postoperative follow-up scores were compared,improvement rates were calculated,respectively.[Results]Patients were followed up for 3 months to 5 years with an average of 2 years.JOA scores of the three groups at 3,6,12 months and at the last follow-up after operation were compared with those of preoperation(P0.05).Cervical sagittal alignment(D numerical value) had no statistical difference at the postoperative and the final follow-up between group A and group C(P=0.434,P=0.492,P=0.569).There was significant difference between group B and group A/C(P

ObjectiveTo investigate the effect of intrathecal (IT) Ro25-6981 (a selective NR2B receptor antagonist) on focal cerebral ischemia-reperfusion (I/R) injury in rats.MethodsSixty healthy male SD rats weighing 280-320 g in which IT catheter was successfully implanted without complication were randomly divided into 4 groups ( n ＝ 15 each):group sham operation (group S) ; group focal cerebral I/R(group I/R) ; group I/R + Ro25-6981 (group Ro) and group I/R+ normal saline (group NS).The right middle cerebral artery was occluded for 2 h with a nylon thread with rounded tip which was inserted into right internal carotid artery and advanced cranially until resistance was met in groups I/R,Ro and NS.In group Ro Ro25-6981 100 μg/10 μl was injected IT at 0,2,23 h of reperfusion,while in group NS NS was injected IT instead of Ro25-6981.Neurological dificit was assessed and scored (0 ＝ no deficit,3 ＝ severe deficit) at 24 h of reperfusion.The infarct size was determined by 2,3,5-triphenyl tetrazolium chloride staining.ResultsIT administration of Ro25-6981 significantly reduced cerebral I/R-induced infarct sized and neurological deficit score in group Ro as compared with groups I/R and NS.ConclusionRo25-6981 injected IT can protect the brain against local cerebral I/R injury.

Objective To summarize the clinicopathological characteristics and effects of surgical treatment on gastric stump cancer.Methods With meta- analysis, clinical data of 902 gastric stump cancer patients who were treated in our hospital or were reported in literatures were included for analysis.Age, gender, pathological types, TNM stages, surgical treatment, prognosis were evaluated.Results Gastric stump cancer developed mostly in male patients (4.1∶1) , and the median age was 61 years.Incidence of gastric stump cancer after digestive tract reconstruction with Billroth- Ⅱ operative modality was higher than that with Billroth- Ⅰ (81.6% vs.17.1%).50.5% of the cancers were present at the anastomotic site, 21.7% at the gastric lesser curvature, 18.5% at the gastric cardia, and less than 10% at other places.Resection and radical resection rates were 81.3% and 62.7% , while operation combined organ resection was carried out (36.5% ).The 1-, 3-, 5- year survival rate of the patients with radical resection were significantly better than those with palliative resection, which was 77.8% vs.36.4% , 58.2% vs.9.8% and 28.9% vs.3.9% (P＜0.01) respectively.Conclusions Distal gastrectomy and Billroth Ⅱ GI tract reconstruction was the most common type of previous operation.Gastric stump cancer occurs more frequently at anastomotic site and the majority of histological types was well-differentiated adenocarcinoma.Most cases were at the advanced TNM-stage when diagnosed.Radical resection is an effective way to prolong the postoperative survival time in gastric stump cancer patients, especially in early stage.

Objective:To investigate the effect and mechanism of donor-Ag specific T cell vaccination on inducing specific immune tolerance of allogenic liver transplantation and the mechanism of immune privilege of liver transplantation .Methods:CBA mice were recipients,B6 mice were donors,T cell vaccination (TCV) were made from the attenuated spleen cells of CBA mice ,which were stimulated by Con A and were challenged with the spleen cells of B 6 mice.There are 3 groups in this experiment:Transplant control group:Orthotopic liver transplantation ( OLT) were performed with the recipients of CBA mice and donors of B 6 mice;Flt3-L treating group:OLT were performed with the recipients of CBA mice and donors of B 6 mice treated with Flt3-L;TCV group:OLT were performed with the recipients of CBA mice inoculated with TCV and donors of B 6 mice treated with Flt3-L.Median survival time (MST) of liver grafts was recorded, IL-4, IL-10 and IFN-γin peripheral blood were tested after transplantation in each group .One-way mixed lymphocyte reaction ( MLR) were carried out with effectors of spleen cells from CBA mice and stimulator of spleen cells from B 6 mice at the 5th day after transplantation.The apoptosis of liver graft infiltrating cells (GICs) were analyzed by flow cytometric analysis at the 5th day after transplantation.Results: Flt3-L treating donor activated allogenic acute rejecting reaction , TCV vaccinating recipient before and after transplantation significantly depressed the acute immune rejecting reaction mediated by Flt 3-L.The liver grafts were accepted by recipient without the presence of Flt 3-L.The cytokines test show that the serum value of IL-4 and IL-10 were increased in Transplant control group and TCV group ,but decreased in Flt3-L treating group.The value of IFN-γwas increased in Flt3-L treating.

AIM:To put forward three-level design(Box-Behnken design)for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of binomial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was-4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.

AIM:To put forward three-level design(Box-Behnken design) for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of bino-mial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was -4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.

Objective To obtain a clear and qualified compound glycyrrhiza oral solution by using NaSO3 and EDTA as stabi-lizers and Tween80 as solubilizer so as to solve the problem of morphine content instability. Methods NaSO34g and EDTA 0.6 g as stabilizers,and Tween803 g as solubilizer were added in the traditional method. The pH of the solution was adjusted to 8.0. Then the solution was obtained and filled in the brown polyester bottle. Results The preparation was clear,qualified and the content of mor-phine was steady. Conclusion The improved method is feasible,simple,stabilized and suitable for manufacturing.

Objective To study the relationship between circumferential resection margin status and prognosis of patients with middle and lower rectal cancer.Methods Specimens from 49 patients with middle and lower rectal cancer undergoing total mesorectal excision were studied by the large slice pathologic technique.The local recurrence,metastasis and five-year survival rate were evaluated by Kaplan-Meier Survival analysis.The related clinicopathologic factors were also analyzed.Results The cancer involvement rate of the circumferential resection margins was 24%(12/49).The overall local recurrence rate was 12%(6/49),the distant metastasis and recurrence rate was 27%(13/49),and the five-year survival rate was 67%(33/49).For the 12 patients in which the eircumferential resection margin was tumor positive.the local recurrence rate was 33%compared with 5%in those with negative circumferential resection margin(X2=6.577,P=0.010),distant recurrence was 50%compared with 19%in those with tumor negative margin(X2=4.491,P=0.034).Kaplan-Meier survival analysis showed that patient's survival time was statistically correlative with the circumferential resection margin status(log-rank.P=0.009).Five-year survival rate was 33%in patients with positive circumferential resection margin,compared with 78%in those with negative margins.Tumor diameter(X2=4.451,P=0.035),T staging (X2=20.283,P=0.000),N staging(X2=7.773,P=0.018),the distance away from the anocutaneous line(X2=6.502,P=0.04),tumor location(X2=4.421,P=0.035)and operation type(X2=5.754,P=0.016)were significantly correlated with the circumferential resection margin status of the middle and lower rectal cancer.Conclusions The circumferential resection margin status was an important predictor of local and distant recurrence as well as survival of patients with middle and lower rectal carcinoma.and the status is significantly correlated with tumor diameter,T staging,N staging,the distance away from the anocutaneous line,tumor location and operation type.