Objective To study the efficacy of tourniquet to block the distal of radial styloid on success rate of radial artery catheterization.Methods One hundred and forty ASA Ⅰ-Ⅲ patients, aged 22-88 years,undergoing general anesthesia and requiring radial artery catheterization were in-cluded in this study and were randomly allocated into touch positioning group (group A)or tourni-quet-assisted group (group B).Radial artery catheterization was conducted after induction of general anesthesia in two groups.The invasive systolic blood pressure (ISBP ), invasive diastolic blood pressure(IDBP)and HR of patients were recorded in group B at 1 min before ischemia (T1 ),using pressure pulse blocking after 1 min (T2 ),2 min (T3 ),5 min (T4 )and the complete release of tour-niquet after 1 min (T5 ),5 min (T6 )and 10 min (T7 ).The first and total success rate of radial artery puncture,puncture times,puncture duration and complications were recorded.Results The radial ar-tery diameter was not statistically significant in group B between before and after blocking radial artery .ISBP at T2-T4 in group B was significantly higher than that at T1 (P <0.05).The first time puncture success rate and overall success rate in group B was significantly higher than that of group A,The number of puncture in group B was significantly less than that of group A,and puncture time was significantly shorter in group A (P <0.05).Conclusion Tourniquet-assisted radial artery cathe-terization could improve success rate,decrease puncture times and shorten puncture duration.

Objective To evaluate the efficacy of preoperative aspects and dimensions used for an anatomical (PADUA) scores in determining the surgical approach for T1 stage renal masses.Methods From Jan 2010 to Dec 2012,clinical data of 122 cases (76 males and 46 females),who underwent surgery for T1 stage renal masses,were collected retrospectively.The mean age was 51 years(range 21-81) and mean body mass index was (22.8±3.9) kg/m2.Sixty-three tumors were found in left kidney and 59 in right kidney.Among them,78 patients were diagnosed as T1a stage and 44 patients were T1b stage.In patients with T1a stage,56 received nephron sparing surgery (NSS) and 22 received radical nephrectomy (RN).In patients with T1b stage,21 received NSS and 23 received RN.The PADUA nephrometry score was analyzed to evaluate their relationships to surgical type and the approach of NSS.Results According to the PADUA nephrometry score,the number of low risk,middle risk and high risk patients were 24,62,26,respectively.Inlow risk group,middle risk group and high risk group,the proportion of RN and NSS was 8.3％/ 91.7％,30.6％/69.4％,66.7％/33.3％.In 77 patients received NSS,the unmber of laparoscopic NSS and open NSS was 18 ∶ 4,25 ∶ 18,2 ∶ 10,respectively.The PADUA nephrometry score was significantly associated with the type of surgery (x2 =23.16,P＜0.01),and the NSS approach (x2 =13.57,P＜0.01).Tumor size (HR =2.79 ; 95％ CI,1.29-6.02 ; P＜ 0.01),percentage of tumor deepening into the kidney (HR =3.82; 95％CI,1.77-8.09; P＜0.01),longitudinal (HR=4.00;95％CI,1.83-8.72; P＜0.01),tumor relationships with renal sinus(HR=103.13; 95％CI,21.85-486.81 ; P＜0.01),tumor relationships with urinary collecting system (HR =15.11 ; 95％ CI,5.95-38.35 ; P＜ 0.01),rim tumor location (HR =3.50 ; 95％ CI,1.61-7.59; P＜0.01) were closely related with surgery approach.The correlation coefficients of relationship with renal sinus was highest (r=0.70).Conclusions The PADUA nephrometry score provides a simple,useful and stable system to character the salient renal anatomy and guide the surgery.Low risk group should consider the NSS as the first line therapy.NSS could also be chosen in the middle risk group.However,the renal anatomy in those patients should be referred.RN should be chosen in high risk group.

Animals ; Fatty Liver, Alcoholic ; drug therapy ; Female ; Male ; Phytotherapy ; Rats ; Rats, Wistar ; Saponins ; therapeutic use ; Trigonella

Objective To investigate the optimal scheme about the external loading of resetting tensile stress for clavicular fracture,so as to provide some mechanical references for optimal design of external fixators for clavicular fracture.Methods The shoulder CT scanning data from a volunteer were used to establish the three-dimensional model of human left shoulder by Mimics software.In order to better simulate the actual human shoulder,the ligament tissues were added in the model and the constraints of muscles were considered,and the experimental model for simulation analysis on resetting tensile stress was established.By 3 simulation experiments,the impacts from directions of resetting tensile stress,positions of action points and value ranges were simulated and analyzed,respectively.The resetting tensile stresses obtained from clavicle of the shoulder model under various external loading cases were simulated by orthogonal test methods.Results When the θ (angle between the horizontal plane projection of shoulder force which was loaded by external fixator and the coronal axis) was greater than 45°,clavicle could obtain the resetting tensile stress,which became greater with the angle θ increasing.When η (angle between the sagittal plane projection of shoulder force which was loaded by external fixator and the sagittal axis) was 30°-45°,the resetting tensile stress of clavicle was the maximum.The farther the position on which the loads from external fixator was exerted from the horizontal position of clavicle,the larger the resetting tensile stress of clavicle was.Conclusions The results of orthogonal test show that the optimal resetting tensile stress is produced with parameter combination of θ =65°,η =50°,acting on the center of humerus head of the shoulder.

Infestation, moldy and other phenomenon in the processing and storage of Chinese herbal medicines is a problem that faced in the production of Chinese traditional medicine. The low productivity of traditional processing methods can not guarantee the quality of Chinese herbal medicines. Sulfur fumigation is the first choice of grassroots to process the Chinese herbal medicine with its low cost and easy operation. Sulfur fumigation can solve some problems in the processing and storage of Chinese herbal medicines, but modern pharmacological studies show that long-term use of Chinese traditional medicine which is fumigated by sulfur can cause some serious harm to human liver, kidney and other organs. This paper conducts a review about the application history of sulfur fumigation, its influence to the quality of Chinese herbal medicines as well as domestic and foreign limits to sulfur quantity, and a brief introduction of the status of modern processing technologies in the processing of food and some Chinese herbal medicines, the problems ex- isting in the Chinese herbal medicines processing, which can provide a reference basis for the further research, development and application of investigating alternative technologies of sulfur fumigation.
Fumigation ; adverse effects ; methods ; Medicine, Chinese Traditional ; methods ; Quality Control ; Social Control, Formal ; Sulfur ; chemistry ; Technology, Pharmaceutical ; methods

Expression of HLA class Ⅱ antigens(HLA-DR, DQ and DP), interleukin2 receptors(IL-2R) and transferrin receptors(TfR) of blood monocytes from 10 patients with insulin-dependent diabetes meIlitus (IDDM) were assayed with the indirect immune fluorescence technique using corresponding monoclonal antibodies and the FITC-labelled second antibody. The results showed that the number of HLA-DQ~+ monocytes was much more in diabetics than in normal controls. The percentages of HLA-DR~+ and HLA-DP~+ monocytes in diabetics were not different significantly from those in normal controls. Besides, IL-2R~+ and TfR~+ monocytes were also found to be very much increased in diabetics as compared with controls. It was possible that increased expression of HLA-DQ antigen, IL-2R and TfR of monocytes in patients with IDDM might play a role in the pathogenesis of the autoimmune reaction.

Objective To investigate the effects of hypoxia on the features and chemoresistance of cancer stem cells in Hep-2 cells and underlying mechanism. Methods The shRNA interference recombinant plasmid targeting HIF-1α was synthesized and transfected into Hep-2 cells. The HIF-1αknockdown Hep-2 cells were established after clonal selection and the expression of HIF-1α was measured.The cellular features including proliferation,clonal formation,cell cycle,apoptosis and CD133 phenotype were measured in Hep-2 cells cultured under hypoxic condition in vitro. CD133 + cells were sorted from Hep-2 cells with flow cytometry. Clonal formation test and cisplatin treatment were carried out,and theexpressions of related genes( Oct-4,suvivin and p53 ) in CD133 + cells were measured.Results HIF-1αknockdown Hep-2 cells was successfully established,as evidenced by the reduced mRNA and proteinexpressions of HIF-lα. The Hep-2 cells cultured under hypoxic microenvironment showed higher proliferation and clonal formation activity,cell cycle arrest in G0/G1,lower apoptosis,up-regulated CD133,however the effects of hypoxia reduced in HIF-1α knockdown Hep-2 cells.CD133 + cells were successfullysorted from Hep-2 cells,and the CD133+ cells showed increased clonal formation activity and cisplatintreatment resistance in hypoxia. Also the effects of hypoxia on CD133 + cells decreased with HIF-1αknockdown,showing down-regulated Oct-4 and survivin and up-regulated p53.Conclusions Hypoixa caninduce the features of cancer stem cells in Hep-2 cells and increase proliferation,differentiation and chemoresistant ability of CD133 + cells,which might be correlated with the changes in expressions of HIF-1 αand related genes regulated by HIF-1 α.

OBJECTIVETo study the diagnosis and treatment of pheochromocytoma in urinary bladder.

METHODSSix cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine (CA) was increased in a case, and vanillymandelic acid (VMA) was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5), computerized tomography (CT) in 3 cases (3/3), cystoscopy in 5 cases (5/6). Four cases took alpha-receptor blocker for 2 weeks, 1 case took beta-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations.

RESULTSThree cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma postoperatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy.

CONCLUSIONSTypical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, (131)I-MIBG (methyliodobenzylguanidine) and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.

Adult ; Blood Pressure ; Female ; Humans ; Male ; Middle Aged ; Pheochromocytoma ; diagnosis ; physiopathology ; surgery ; Urinary Bladder Neoplasms ; diagnosis ; physiopathology ; surgery

OBJECTIVETo study the response of specific antibodies against severe acute respiratory syndrome (SARS)-CoV in patients infected with SARS.

METHODSIgM-capture, indirect and antigen-sandwiched enzyme linked immunosorbent assay (ELISA) were used to detect the SARS-CoV specific IgM, IgG and total antibodies in sera of clinical SARS patients or non-SARS individuals.

RESULTSThe positive rates of IgM, IgG and total antibodies to SARS-CoV in 146 sera of SARS patients collected in different phases of the disease were 61.64%, 53.43% and 69.86%, respectively. The earliest detectable days after onset of the disease for IgM and IgG to SRAS-CoV were 7 and 12 days, respectively. The specific IgM disappeared as early as 42 days after the onset of SARS. Of 70 sera from hepatitis A patients, 2 showed false positive results, while 127 sera from other patients were all negative, detected by the 3 methods. Serum from one medical worker who had been close contact to SARS patients was positive for anti-SARS-CoV IgG and total antibodies. These 3 methods used for detection were all not influenced by rheumatoid factor (RF).

CONCLUSIONAll of the three methods were specific and sensitive for the detection of specific antibodies to SARS-CoV, and useful for epidemiological research and clinical diagnosis, but not for early diagnosis of SARS.

Antibodies, Viral ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Male ; SARS Virus ; immunology ; Sensitivity and Specificity ; Severe Acute Respiratory Syndrome ; immunology ; virology

BACKGROUNDVascular endothelial growth factor (VEGF) is well known as a hypoxia-induced protein. That it markedly increased expression of VEGF and improvement of rat motor function after spinal cord injury suggested that VEGF could play a neuroprotective role in ischaemic tolerance. This study investigated whether vascular endothelial growth factor has direct neuroprotective effects on rat spinal cord neurons.

METHODSWe employed primary cultures of embryonic rat spinal cord neurons, then administrated different concentrations of VEGF164 in the culture medium before hypoxia when the number of neurons was counted and the cell viability was detected by MTT. The neuronal apoptosis and expression of VEGF and its receptor genes were evaluated by terminal deoxynucleotidyl transferase mediated dUTP nick-end labelling (TUNEL) and immunohistochemistry. The VEGFR2/FLK-1 inhibitor, SU1498, was used to confirm whether the neuroprotective effect of VEGF was mediated through VEGFR2/Flk-1 receptors.

RESULTIn hypoxic conditions, the number and viability of neurons decreased progressively, while the number of TUNEL-positive cells increased along with the prolongation of hypoxic exposure. When the concentration of VEGF in cell culture medium reached 25 ng/ml, the cell viability increased 11% and neuronal apoptosis reduced to half, this effect was dose dependent and led to an approximately 25% increase in cell viability and about threefold decrease in TUNEL-positive cells at a maximally effective concentration of 100 ng/ml. In normal conditions, VEGF/Flk-1 but not VEGF/Flt-1 gene expressed at a low level: after hypoxia, the expression of VEGF/Flk-1, but not VEGF/Flt-1 was significantly increased. The protective effect of VEGF was blocked by the VEGFR2/Flk-1 receptor tyrosine kinase inhibitor, SU1498.

CONCLUSIONSVEGF has direct neuroprotective effects on rat spinal cord neurons, which may be mediated in vitro through VEGFR2/Flk-1 receptors.

Animals ; Cell Hypoxia ; Cells, Cultured ; Cinnamates ; pharmacology ; Female ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; drug effects ; Vascular Endothelial Growth Factor A ; pharmacology ; Vascular Endothelial Growth Factor Receptor-2 ; physiology