Objective To investigate the effects of forced-air prewarming combined with fluid warming on body temperature and thermal comfort in patients undergoing lobectomy.Methods Forty six patients scheduled for video-assisted thoracoscopic surgery (VATS) of lobectomy were randomized into two groups (n=23 each):warming group (group T) and the control group (group C).Forced-air prewarming combined with infusion heating was applied in the warming group,while only conventional passive warming was used in control group.The tympanic membrane temperatures were recorded before prewarming,after prewarming, during the anesthesia, the end of operation, the moment in and out of the postanesthesia care unit (PACU).Incidence of postoperative shivering, thermal comfort and the time in the PACU were recorded.Results The warming group had a slower temperature decrease at 1,2, 3 hours after operation and end of operation(P< 0.01), warming group had significantly lower incidence of hypothermia and shivering than control group(8.7% vs 56.5%, 4.3% vs 34.8%,P<0.05),and the thermalcomfort score was higher in warming group than in control group(8.52±0.94 vs 7.65±0.83,P<0.05).Conclusions Forced-air prewarming combined with fluid warming has significant clinical effects to stabilize patients` body temperature during operations,to reduce the incidence of hypothermia and shivering and to improve the thermal comfort, which provides a simple and effective temperature protection strategy for patients undergoing lobectomy.

Objective To compare the GlideScope video-laryngoscope and Macintosh laryngoscope for double-lumen tube (DLT) intubation.Methods Seventy ASA Ⅰ-Ⅲ patients,aged 18-75 yr,scheduled for thoracic surgery and requiring one-lung ventilation,were randomly divided into 2 groups (n =35 each):Macintosh laryngoscope group (group M) and GlideScope video-laryngoscope group (group G).Anesthesia was induced with propofol,fentanyl and rocuronium.The exposure of glottis obtained with Macintosh laryngoscope and GlideScope video-laryngoscope was assessed using Cormack-Lehane grade.DLT intubation was assisted with Macintosh laryngoscope or GlideScope video-laryngoscope.The Cormack-Lehane grade,difficulty of DLT placement,and reverse DLT placement were recorded.The success rate of DLT placement at first attempt and intubation time were also recorded.Blood pressure and heart rate were recorded before intubation and at 0 and 3 min after intubation.The postoperative side effects were recorded.Results Compared with M group,the intubation time was significantly prolonged,the difficulty of DLT placement and blood pressure at 0 and 3 min after intubation were increased in G group (P ＜ 0.05).There was no significant difference in the success rate of DLT placement at first attempt,rate of reverse DLT placement,Comark-Lehene grade and heart rate at each time point between the two groups (P ＞0.05).The Comark-Lehene grade obtained with GlideScope video-laryngoscope was superior to that obtained with Macintosh laryngoscope in G group (P ＜ 0.05).Conclusion GlideScope video-laryngoscope can provide a better exposure of glottis and improvement in the intubating conditions,but the method is more complex and the response to intubation is stronger than Macintosh laryngoscope for DLT intubation.

Objective To investigate the safety and feasibility of anesthesia for patients with myasthenia gravis using target controlled infusion without muscle relaxant.Methods Thirty-one patients with myasthenia gravis were recruited into study.A target controlled infusion was started with targeting effect-site concentration of propofol 3 μg/mL and remifentanil 4 ng/mL.Intubation was performed when patients were unconsciousness and target concentrations of both drugs were reached.No muscle relaxant was used during anesthesia.Blood pressure,heart rate,performance of intubation and respiratory recovery including extubation and wake time were observed.Results All patients were intubated successfully in one attempt.38.7% patients had mild cough when the endotracheal tube past through the vocal cord during intubation.Blood pressure and heart rate at post-intubation increased significantly as compared with pre-intubation (P＜0.01).After cease of drugs,time of spontaneous breathing recovery was (6.5±2.9) min.Extubation and wakeup time were (9.8±3.6) and (7.4±3.1) min respectively.No adverse event was noted.Conclusion Target controlled infusion without muscle relaxant was safe and effective anesthesia for myasthenia gravis patients undergoing thymectomy.

Objective To identify the risk factors for the development of intraoperative hypothermia in the patients undergoing thoracic surgery.Methods One hundred twenty patients of both sexes,aged 23-83 yr,weighing 43-92 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective thoracic surgery,who had an expected surgical duration of more than 2 h,with the core body temperature of 36.0-37.5 ℃,were included.After admission to the operating room,the core body temperature was measured.Intraoperative nasopharyngeal temperature of lower than 36 ℃ was defined as hypothermia.The patients were randomly divided into hypothermia group or non-hypothermia group according to whether or not intraoperative hypothermia occurred.Factors including the patient characteristics,the total amount of fluid infused (including the volume of blood transfused),duration and way of anesthesia and duration and type of surgery were recorded.The risk factors associated with intraoperative hypothermia were identified by logistic regression analysis.Results A total of 94 patients developed hypothermia during surgery,and the incidence of hypothermia was 78.3％.The lowest body temperature was 33.6 ℃.There was significant difference between the two groups in age,duration of surgery,the total amount of fluid infused,and the body temperature when patients were admitted to the operating room.Logistic regression analysis revealed that the total amount of fluid infused＞2 000 ml (OR =3.499) and low body temperature when patients were admitted to the operating room (OR =0.074) were independent risk factors for intraoperative hypothermia in the patients undergoing thoracic surgery.Conclusion The total amount of intravenous fluid infused＞2 000 ml and low body temperature when patients were admitted to the operating room are independent risk factors in the patients undergoing thoracic surgery.

Objective The double-blinded, randomly study was designed to determine the clinical efficacy and safety of ropivacaine for combined spinal-epidural anesthesia (CSE). Methods Sixty patients, ASA class Ⅰ-Ⅱ , 18 to 75 years, undergoing elective lower limb or perineum surgery, were randomly allocated to receiving spinally hyperbaric mixture 1.5-2ml of 1% ropivacaine (group R, n=20), 0.75% bupivacaine(group B,n=20), or 1% tetracaine (group T,n=20), combined with 10% glucose 1ml and 3% ephidrine 1ml respectively,and the anesthesia was maintained with epidural administration with 2% lidocaine if necessary during the operation ,after the B-D DurasafeTM combined spinal epidural anesthesia kit was applied at the L 3-4 interspace.Results The time to maximum spread of anesthesia in group R was longer, but the recovery time was shorter than those in group T(P0.05). Additionally, as compared with ones in group B and T, the onset of motor block and the time to peak motor block were prolonged significantly (P

BACKGROUND:Injection of isoproterenol is known to induce proliferation and hypertrophy of acinar cells in rodent salivary glands. However, the clonal proliferation ability of stem/progenitor cells of salivary glands by isoproterenol remains unclear.
OBJECTIVE:To study the proliferation and activation ability of stem/progenitor cells of submandibular gland with colony assay by intraperitoneal injection of isoproterenol.
METHODS:Sprague-Dawley rats were randomly divided into two groups, isoproterenol and control groups, respectively intraperitonal y injected with isoproterenol and normal saline for 5 consecutive days. The gland tissues were harvested, and the stem/progenitor cells of submandibular gland were obtained by enzyme digestion in vitro. The number of clonal colonies of each group was analyzed. The larger colony cells were col ected for immunohistochemistry staining with CD90.1, laminin andα6β1.
RESULTS AND CONCLUSION:The number of middle and low proliferative potential colony-forming cells was less but high proliferative potential colony forming cells were significantly more in isoproterenol group compared with control group (P<0.05). However, there was no significant difference in the total number of the colonies between two groups (P>0.05). The high proliferative potential colony forming cells were positive for CD90.1, laminin andα6β1. Results showed that isoproterenol treatment model cannot increase the cellnumber, but enhance the proliferation ability of stem/progenitor cells from the submandibular gland.

Objective:To prepare and purify siRNA targeting a proliferation-inducing ligand targeted(APRIL-siRNA),so as to provxde a basis for studying the role of APRIL in human pancreatic cancer.Methods:pET-22b-APRIL was constructed to express APRIL dsRNA of human pancreatic cancer cell line CFPAC-1 in E.coli and the product was purified by chromatography using CF-11 column.APRIL dsRNA was digested by RNaseⅢto prepare APRIL siRNA,then the reaction mixture was loaded onto a DEAE ion exchange chromatography to remove RNaseⅢfrom oligonucleotides,and size exclusion chromatography was used to purify 21 bp siRNA.The purified APRIL siRNA was used to transfect Chinese hamster ovary(CHO)cells and the expression of APRIL in CHO cells was observed under fluorescence microscope Results:APRIL dsRNA was successfully expressed in E.coli after IPTG induction and was purified by CF-11 column.dsRNA was hydrolyzed with RNaseⅢand was purified by DEAE ion exchange chromatography and size exclusion chromatography.15% nondenaturing PAGE and 12% SDS- PAGE confirmed that RNaseⅢwas removed from oligonucleotides and 21 bp siRNA was purified with size exclusion chromatography.It was also found that APRIL siRNA obviously depressed APRIL expression in CHO cells.Conclusion:We have successfully constructed APRIL siRNA targeting APRIL gene of CFPAC-1 cells with in vitro transcription,which provides a basis for knock-down of APRIL gene in CFPAC-1 cells.

Aim To investigate the molecular mechanisms of differentiation in human leukemia HL-60 cells induced by diallyl disulfide(DADS)using suppression subtractive hybridization(SSH).Methods In our privious study,the subtractive cDNA library was constructed successfully and efficiently. 30 clones were randomly analyed with restriction enzyme.The inserts of cDNAs were analyzed by restrictive enzyme EcoR I.Positive clones were sequenced and the homology of resulting cDNA sequences were analyzed through bioinformatics software Blastn.Results 18 clones contained 100～600 bp cDNA inserts.10 differantiation genes were obtained and involved in cell cycle,signal transduction,metabolism and RNA binding.And 3 of 10 genes,p21,STAT1 and CAMTA1 were up-regulated and detected by RT-PCR,the results matched with SSH.Conclusion sThere are tight correlation between the differentiation induced by DADS and three-upregulated gene:p21,STAT1 and CAMTA1.

Image processing research group applied immersive experience into “medical image processing”. A scheme named “introduction by game, case driven, lecture on specific theme, grouping experiment, and seminar”was designed and practiced. We designed a game for each subject and made students immersed in the game to feel the pleasure of learning. We changed the traditional teaching method which focused on every point of knowledge, presented and then decomposed the case before teaching each knowledge point which was related to the case. By grouping experiment and seminar, students can learn actively. We also developed a virtual experiment platform with .NET and Matlab for students to develop learning.