Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

Based on the study of four diagnostic methods in Treatise on Exogenous Febrile Diseases,this dissertation analysed the cause of differentiation of syndrome unavailable,and indicated that:differentiation of syndrome unavailable resulted from multi-reasons.The patients who had symptoms and signs but all the modern physics and chemistry index were normal,the data get from traditional four diagnostic methods were useful to discriminate and estimate diseases.Modern physics and chemistry index can help in improving exactitude,but we cannot ignore traditional diagnostic methods.

Objective To investigate the significance of PI3K/AKT signal transduetion pathway in gastrointestinal stromal tumors(GIST).Methods The expression of PI3K、Akt、PTEN were detected with RT-PCR and Westem-blot of tumor specimens from 124 GIST cases and the corresponding normal gastric mucosa.Results In gastrointestinal stromal tumors,the tumor suppressor gene-PTEN was on low expression as with the inereased expression of PI3K and Akt.The positive expression rate of PTEN,PI3K and Akt was not statistically correlated with patients'demographics and tumor histological type,but they are significantly correlated with lymphatic metastasis and mucosal invasion.The expression of PI3 K and Akt are of significantly positive correlation(r=0.292,P=0.031).The expression of PI3K and PTEN are of significantly negetive correlation(r=-0.412,P=0.036).The expression of PTEN and Akt are of significantly negetive correlation(r=-0.386,P=0.024).Conclusion PI3 K/Akt and P,PTEN may have bean on reciprocally suppressive effect during the development of GIST.

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Male ; Mucin-1 ; metabolism ; Palatal Neoplasms ; metabolism ; pathology ; surgery ; Palate, Hard ; surgery ; Tongue Neoplasms ; metabolism ; pathology ; surgery

Objective To investigate the clinical value of MRI in evaluating the cardiac structures and function of congenital heart diseases.Methods Fifteen cases with surgically proved different types of CHD were examined by the techniques of magnetic resonance imaging ( MRI) and echocardiography (ECG).The results were compared to determine their values in showing the abnormalities of cardiac structures and function.Results In 15 cases,20 malformations were diagnosed correctly by MRI within 24 abnormalities confirmed by operation(20/24),21 by ECG (21/24).MRI was better than ECG in displaying great vascular diseases, while ECG was better in valvular diseases.There was no significant difference between MRI and ECG in examining cardiac function.Conclusion MRI can clearly show the abnormalities of cardiac anatomy and function.

Objective:To evaluate the expression of vascular endothelial growth factor C(VEGF-C),Epstein-Barr virus(EBV) latent membrane protein 1(LMP1),cyclooxygenase-2 (COX-2) in nasopharyngeal carcinoma(NPC).Method:LMP1, COX-2 and VEGF-C were detects by immunohistochemical staining for 57 case NPC tissue.Result:The positives rates of LMP1,COX-2 and VEGF-C detected by immunohistochemical staining were 49.1%(28/57), 75.4%(43/57)and 59.6%(34/57), respectively. The expression of LMP1, COX-2 and VEGF-C were correlated to each1 other in NPC(P<0.05).Conclusion:LMP1 and COX-2 may induce expression of VEGF-C directly or LMP1 induce expression of VEGF-C by induce COX-2 expression, may contribute to lymph metastasis and develop NPC.

Deproteinized calf blood injection is composed of small protein-free molecules extracted from fresh calf blood. The pre-vious studies showed that it can improve metabolic balance by increasing glucose and oxygen uptake to enhance energy metabolism. In recent years, due to the expanding clinical applications of deproteinized calf blood injection, new observation results and ideas contin-ued to emerge. However, the reports of adverse reactions and excessive applications were also gradually increased. In order to provide reference for the promotion of reasonable clinical application, the paper reviewed the latest development in the studies on the clinical application of deproteinized calf blood injection.

Objective To explore the value of interventional therapy in unruptured intracranial aneurysms combined with brain arteriovenous malformations (BAVM).Methods Data of 23 patients with unruptured aneurysms combined with BAVM were retrospectively analyzed.All patients were treated with interventional embolization,and the embolization methods were choosen according to the Redekop classification.The proximal or distal hemodynamic aneurysms were embolized with coils,and the intranidal aneurysms were embolized with Onyx.The outcome was assessed by the Glasgow outcome score (GOS) one week after treatment.DSA scan was used to observe whether there was recurrence during 3-6 months after embolization.Results Totally there were 36 aneurysms in 23 patients,including 8 intranidal aneurysms,16 proximal flow-related aneurysms,11 distal flow-related aneurysms and 1 unrelated aneurysm.Embolizations of 16 proximal hemodynamic aneurysms and l0 distal hemodynamic aneurysms were done with coils.And embolization of 8 intranidal aneurysms were done with Onyx.One distal hemodynamic aneurysm was not embolized due to the difficulty of embolization and the regular shap of aneurysm;and the patient died of cerebral hernia caused by intracranial hemorrhage on the sixth day after embolization.Because it was more suitable for surgical clipping,1 unrelated hemodynamic aneurysm was not embolized.In 23 cases,BAVM were completely embolized in 7 cases and incompletely embolized in 16 cases.A week after operation,the GOS score were 5 in 19 cases and 4 in 3 cases.The GOS score was not evaluated in the dead case.Except for 1 cases of death,the other 22 cases were followed up after embolization.No recurrence and intracranial hemorrhage occurred.Conclusion Interventional treatment of unruptured intracranial aneurysms combined with BAVM is safe and effective.Making treatment plan according to the hemodynamic characteristics of lesions and completely embolizing all lesions to prevent postoperative bleeding is helpful to improve the prognosis of patients.

Objective To approach a way to induce MSCs to dopaminergic neuron by mesencephalic conditional media and cytokines in vitro,and supply an ideal cells source for the treatment of Parkinson's disease.Methods The rat MSCs were isolated primarily from the femurs and tibias of the Wistar rats.MSCs were cultured,proliferated and purified by passage culture.Cultuered MSCs were divided into the control and the experimental group.In control group,MSCs were cultured without any induction medium.MSCs of experimental group were first cultured at medium containing bFGF for 24 hours.Then media were replaced with induction media which contained the agents as follows,respectively:GM_1,GDNF, GDNF+GM_1,GDNF+GM_1+mesencephalic conditional media.The surface markers of the differentiated neuron,such as NSE and TH were detected by immunocytoehemistry after MSCs were cultured in induction media for 3 and 7 days.Results In control groups,the NSE expression of MSCs was very lower than experimental groups.The percentage of NSE-positive cells of GDNF+GM_1+mesencephalic conditional media group in 7 day((45.257?5.999)/HP)was significantly more than other groups(control group is 2.214?0.779,GM_1 group is 22.014?3.624,GDNF group is 31.345?2.850,GDNF?GM_1 group is 40.314?4.203,P

ObjectiveTo observe the retinal function and nerve fiber layer (RNFL) thickness after laser in situ keratomileusis (LASIK). MethodsLASIK was performed in 15 cases (30 eyes) with myopia after strict preoperative examination. All examinations such as vision, correction vision, diopter, intraocular pressure, corneal thickness, ocular axis, topography scan and fundus of eye examination were performed before and 1 day, 1 week, 1 month,3 months and 6 months after operation, as well as electroretinography (ERG), visual evoked potential (VEP), optical coherece tomography at same time. ResultsThere was not significant difference in the intraocular pressure, ERG and VEP 1 day after LASIK. The thickness of RNFL decreased 1 week after LASIK (P<0.05) and recovered 1～6 months later. ConclusionLASIK does not disturb the retinal function and RNFL thickness irreversiblely.