BACKGROUND:Bone marrow stromal stem cels have a strong osteogenic potential, which are currently the most ideal seed cels for tissue engineering. However, there is no clinical report on the treatment of benign bone tumors and tumor-like lesions using bone marrow stromal stem cel transplantation.
OBJECTIVE: To investigate thein vivo perfusion method of inducing bone marrow stromal stem cels, and the clinical effects of bone marrow stromal stem cels on benign bone tumors and tumor-like lesions.
METHODS: Sixty-five cases of benign bone tumors and tumor-like lesions were divided into three groups according to the different treatments: bone graft group (n=30) and bone marrow stromal stem cels group (n=35). In the bone graft group, alogeneic bone was soaked in normal saline for 30 minutes, and then implanted into the bone defect site. In the bone marrow stromal stem cels group, 20-40 mL of bone marrow from each patient was extracted to isolate, purify and culture bone marrow stromal stem cels that were then perfused into the bone defect site.
RESULTS AND CONCLUSION:Under the inverted phase contrast microscope, the perfused cels appeared as a spherical shape, with different sizes. Initialy, there were more hematopoietic cels in the perfusion cel culture. With the extension of the culture time, adherent spindle cels and suspended red blood cels appeared, which were mostly round and triangular. Al the patients were folowed up for 1-12 months and healed wel after surgery. Compared with the bone graft group, infection rate and healing time were both lower in the bone marrow stromal cel group. To conclude, in vivo perfusion of bone marrow stromal stem cels used for construction of tissue-engineered bone promotes blood supply reconstruction and bone healing in patients with benign bone tumors and tumor-like lesions, which is of high clinical values.

Objective To evaluate the feasibility of ETView visual endotracheal intubation in elderly patients with a potentially difficult airway under general anesthesia.Methods A total of 80 patients scheduled for elective surgery,with at least three characteristics indicative of an increased risk for difficult tracheal intubation and aged 65-86 years with American Society of Anesthesiologists (ASA) grade [Ⅱ or Ⅲ,were selected and randomly assigned into 2 groups:the control group (Group C) and the ETView visual endotracheal intubation group (Group E) (n=40 for each).After induction with propofol 0.5-1.5 mg/kg,sufentanil 0.2 μg/kg,and rocuronium 0.6mg/kg,regular tracheal intubation and ETView visual endotracheal intubation were conducted in Group C and Group E respectively.Blood pressure and heart rate were recorded before induction (T0),before initial intubation (T1),at successful intubation (T2),and 5min after successful intubation (T3).Duration of catheterization,number of intubation attempts,rate of successful intubation at first attempt and complications within 2 days of intubation were also recorded.Results The duration of catheterization and the number of intubation attempts were lower in Group E than in Group C[(34±6) s vs.(48± 22) s,(1.0±0.0) vs.(1.4±0.4),t=2.484 and 2.373,respectively,P=0.017 and 0.023,respectively].The rate of successful intubation at first attempt was higher in Group E than in GroupC (100％ or 40 cases vs.75％ or 30 cases),x2=5.714,P=0.017).There was no significant difference in hemodynamic changes and the rate of postoperative hoarseness between the two groups (P＞0.05 for both).Conclusions ETView visual endotracheal intubation shows excellent safety in elderly patients with a difficult airway under general anesthesia,with shorter catheterization duration and a higher rate of successful intubation at first attempt than regular intubation.

This paper introduces the structure,technological process and design of the elrctrocardiomonitor system with whole course.It accomplishes the real-time collection,analysis,storage,inquiry and quotation of whole course ECG information.

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel used in patients undergoing laparoscopic gynecological surgery. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 21-64 yr, weighing 4590 kg, undergoing elective laparoscopic gynecological surgery, were randomized into 2 groups ( n = 30 each):LMA i-gel group (group Ⅰ) and LMA Supreme group (group S) . Mallampatti test was performed before operation in both groups. Anesthesia was induced with target-controlled infusion of propofol (target plasma concentration 2.5-4.0 μg/ml) and remifentanil (target plasma concentration 3-6 ng/ml) . After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA i-gel and LMA Supreme were inserted in I and S groups respectively. A gastric tube was inserted through the drain tube of the LMA. In group S the air was injected into the cuff to make intracuff pressure reach 60 cm H2O after successful LMA insertion. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of hemodynamics and ventilation, and complications (sore throat, odynopliagia,hoarseness) were recorded. The fiberoptic laryngoscopy scores were assessed after successful LMA placement. The anesthesia time and recovery time were also recorded. Results There was no significant difference in the anesthesia time, recovery time, LMA placement time, fiberoptic bronchoscopy scores and the parameters of hemodynamics and ventilation between the two group. The success rates of LMA and gastric tube placement were 100% in both groups. The airway sealing pressure was significantly higher, while the incidence of sore throat and odynopliagia was significantly lower in group I than in group S. Conclusion LMA i-gel provides adequate ventilation during operation with fewer complications and can be used effectively for gynecological laparoscopic surgery.

Objective To assess the efficacy of the laryngeal mask airway i-gel (LMA i-gel) in patients umdergoing laparoscopic cholecystectomy. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes,aged 34-62 yr, weighing 45-90 kg, undergoing elective cholecystectomy using fiberoptic laparoscope, were randomized into 2 groups (n =60 each): LMA i-gel group (group I) and LMA ProSeal group (group P). After induction of anesthesia with sufentanil 0.2 μg/kg, propofol 2.5 mg/kg and vecuronium 0.1 mg/kg, LMA i-gel and LMA ProSeal were inserted in group I and P respectively. A gastric tube was inserted through the drain tube of the LMAs. The number of attempts, success rate, success rate of gastric tube placement, airway seal pressure, SpO2 ,PETCO2, peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The fiberoptic laryngoscope scores were assessed after sccessful LMA placement. The anesthesia time, duration of surgery, extubation time and emergence time were also recorded. Results There was no significant difference in the anesthesia time, duration of surgery, extubation time and emergence time between the two groups ( P ＞ 0.05). The SpO2, PETCO2 and peak airway pressure were within the normal range during operation in both groups. The first attempt success rate of LMA placement and fiberoptic bronchoscopic scores were significantly higher, and the LMA placement time was significantly shorter in group Ⅰ than in group P (P ＜ 0.05). The success rate of LMA and gastric tube placement was 100% in both groups. The incidence of sore throat was significantly lower in group I than in group P ( P ＜ 0.05). Conclusion LMA i-gel can provide adequate ventilation during operation with less complications and can be used effectively for cholecystic laparoscopic surgery.

AIM: To investigate the effects of recombinant human interleukin-13 (rhIL-13) on the expression of proto-oncogene c-mpl in Dami cells, a human megakaryobiastic leukemia cell line. METHODS: The expression of c-mpl mRNA in Dami cells was investigated with RT-PCR. The expression of membrane-bound protein c-mpl on Dami cells was investigated with ligand combination experiment. RESULTS: In RT-PCR experiment, we found the quantitis of expression of c-mpl mRNA in 25 ?g/L rhIL-13 group increased by 24.8%. In ligand combination experiment, we found quantitis of expression of membrane-bound protein c-mpl in 100 ?g/L rhIL-13 group increased by 28.5% ( P

Objective To evaluate the clinical efficacy of the over-the-scope-clip (OTSC) for endoscopic closure of acute refractory non-variceal upper gastrointestinal bleeding. Methods This retrospective study selected 16 refractory patients, including 2 cases with Mallory-Weiss syndrome, 7 cases with gastric ulcer, 1 case with gastric carcinoma and 6 cases with duodenal ulcer, underwent OTSC treatment of acute non-variceal upper gastrointestinal bleeding from January 2015 to June 2016 as study subjects. Results All of the 16 patients with bleeding lesions were successfully controlled. The successful rate is 100.0%. The mean procedure of OTSC for endoscopic bleeding closure was between 5.0 and 6.0 min. Conclusion The Over-the-Scope-Clip system is safe and effective for closure of acute non-variceal upper gastrointestinal bleeding in refractory patients, and deserves further clinical applications.

Objective To evaluate the effect of wire-reinforced polyurethane epidural catheters on the success rate of epidural catheterization in the patients undergoing caesarean section.Methods A total of 182 pregnant patients,aged 25-43 yr,with body height of 145-178 cm,weighing 51-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were divided into 2 groups using a random number table:polyvinyl chloride epidural catheter group (group Ⅰ,n =94) and wire-reinfnrced polyurethane epidural catheter group (group 11,n=88).Spinal or epidural puncture was performed at L2,3 or L3,4 interspace,and the corresponding epidural catheter was inserted in each group aficr succcssful puncturc.Thc dcvclopment of difficult insertion,intravascular catheter insertion or paresthesia during puncture or insertion was defined as a failure of epidural catheterization.The occurrence of failed epidural catheterization was recorded.Results The failure rate of epidural catheterization was significantly lower in group 1Ⅱ than in gronp Ⅰ (P＜0.05).Conclusion Wire-reinforced polyurethane epidural catheters can raise the success rate of epidural catheterization in the patients undergoing caesarean section.

Objective To evaluate the efficacy of dexmedetomidine combined with remifentanil for drug-induced sleep endoscopy (DISE) in the patients with snoring. Methods Sixty patients of both sexes with snoring, aged 18-61 yr, with body mass index of 21. 0-33. 1 kg∕m2 , of American Society of Anesthe-siologists physical statusⅠ or Ⅱ, scheduled for elective DISE, were randomly divided into either dexme-detomidine combined with propofol group (group P) or dexmedetomidine combined with remifentanil group (group R), with 30 patients in each group. Dexmedetomidine was infused within 10 min in a loading dose of 0. 6 μg∕kg, followed by an infusion of 0. 6 μg·kg-1 ·h-1 for 10 min in both groups. Then propofol was given by target-controlled infusion with the initial target effect-site concentration (Ce) of 1. 0 μg∕ml in group P, and remifentanil was given by target-controlled infusion with the initial target Ce of 1. 5 ng∕ml in group R. At 2 min after the target effect-site and plasma concentrations were balanced, the Ces of propofol and remifentanil were adjusted by increments of 0. 2 μg∕ml and 0. 2 ng∕ml, respectively, until satisfactory snoring occurred and then the Ce was maintained at this level in P and R groups. Bispectral index value was re-corded at 5 min after admission to the operating room (T1 ), at 20 min of dexmedetomidine infusion (T2 ), at 2 min after the target effect-site and plasma concentrations were balanced (T3 ), at the beginning of DISE (T4 ), when the nasopharyngolarygnoscope reached the site of oropharynx (T5 ) and at the end of DISE (T6 ). Observer's Assessment of Alertness∕Sedation scale scores were recorded at T1-4 . The time for prepar-ing sedation, recovery time, the lowest value of SpO2 and development of adverse events were recorded. Re-sults Sixty patients completed DISE successfully. Compared with group P, the bispectral index value at T3-6 was significantly increased, the time for preparing sedation was prolonged, the recovery time was short-ened, the lowest value of SpO2 was increased, and the incidence of respiratory depression was decreased in group R (P< 0. 05). There was no significant difference in Observer's Assessment of Alertness∕Sedation scale scores at T1-4 between two groups ( P> 0. 05). Conclusion Combination of dexmedetomidine and remifentanil produces better efficacy for DISE than combination of dexmedetomidine and propofol in the pa-tients with snoring.

Objective:To evaluate the effect of astaxanthin on neuropathic pain in rats and the role of spinal heme oxygenase-1 (HO-1).Methods:Seventy-two SPF-grade healthy adult male Sprague-Dawley rats, weighing 200-250 g, in which intrathecal catheters were successfully implanted, were divided into 6 groups ( n=12 each) by a random number table method: blank control group (group C), sham operation group (Sham group), neuropathic pain (NP) group, NP plus dimethyl sulfoxide (DMSO) group (NP + DMSO group), NP plus astaxanthin group (NP + AST group) and NP plus zinc protoporphyrin plus astaxanthin group (NP+ ZnPP+ AST group). NP was induced by chronic constriction injury in anesthetized rats.In Sham group, the sciatic nerve was only isolated without ligation.At 5 days after establishing the model, 0.5% DMSO 10 μl was intrathecally injected in NP+ DMSO group, astaxanthin 1 μg (dissolved in 10 μl DMSO) was intrathecally injected in NP+ AST group, HO-1 inhibitor zinc protoporphyrin 24 μg (dissolved in 10 μl DMSO) was intrathecally injected, and 3 h later astaxanthin 1 μg (dissolved in 10 μl DMSO) was intrathecally injected in NP+ ZnPP+ AST group.Injection was given once a day for 10 consecutive days in the 3 groups mentioned above.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before establishing the model and 3, 7 and 14 days after establishing the model.The rats were sacrificed at 14 days after establishing the model, and the L 4-6 lumbar segments of the spinal cord were removed for determination of the contents of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), superoxide dismutase (SOD) and glutathione peroxidase (GHS-PX)(by enzyme-linked immunosorbent assay) and expression of HO-1 (by Western blot). Results:Compared with group C and group Sham, the MWT was significantly decreased and TWL was shortened at each time point after establishing the model, the contents of TNF-α and IL-1β were increased, and the expression of HO-1 was up-regulated in the other four groups, the SOD and GSH-PX contents were significantly decreased in NP group, NP+ DMSO group and NP+ ZnPP+ AST group, and the SOD and GSH-PX contents were significantly increased in NP+ AST group ( P<0.05). Compared with NP group, the MWT was significantly increased and TWL was prolonged at 7 and 14 days after establishing the model, the contents of TNF-α and IL-1β were decreased, and the expression of HO-1 was up-regulated in NP+ AST group, the expression of HO-1 was down-regulated in NP+ ZnPP+ AST group ( P<0.05), and no significant change was found in the parameters mentioned above in NP+ DMSO group ( P>0.05). Compared with NP+ AST group, the MWT was significantly decreased and TWL was shortened at 7 and 14 days after establishing the model, the contents of SOD and GSH-PX were decreased, the contents of TNF-α and IL-1β were increased, and the expression of HO-1 was down-regulated in NP+ ZnPP+ AST group ( P<0.05). Conclusion:Astaxanthin can reduce NP in rats, and the mechanism is related to up-regulating the expression of HO-1 in the spinal cord and inhibiting oxidative stress and inflammatory responses.