Objective To compare the effects of sevoflurane versus propofol on a tourniquet-induced lower extremity ischemia-reperfusion (I/R) injury in patients undergoing orthopedic operation.Methods Fifty-four ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 44-85 kg,scheduled for elective orthopedic operation,were randomly assigned into 3 groups (n =18 each)∶ control group (group C),propofol group (group P) and sevoflurane group (group S).After lumbar plexus-sciatic nerve block,the laryngeal mask airway insertion was facilitated with propofol 2-4 mg/kg and anesthesia was maintained with infusion of propofol at 2-4 mg· kg-1 · h-1 during operation in group P.In group S,8 ％ sevoflurane was inhaled,the laryngeal mask airway was inserted and anesthesia was maintained with inhalation of 2％ sevoflurane during operation.A tourniquet was applied and inflated (300 mm Hg)during 15-20 min after administration of propofol or sevoflurane in groups P and S,and a tourniquet was also applied at the same time point in group C.The tourniquet was released at the end of operation.Postoperative analgesia was performed with oral meloxicam or intramuscular pethidine and VAS score was maintained ＜ 3.Blood samples were taken after admission to the operating room (T1) and 30 min after tourniquet release (T2) to determine the plasma concentrations of MDA and TNF-α.The changing rate of MDA and TNF-α concentrations was calculated.The tourniquet-related adverse events and amount of analgesics consumed within 24 h after operation were recorded.Results No tourniquet-related adverse events occurred in all the patients.Compared with group C,the plasma concentrations of MDA and TNF-α and changing rate were significantly decreased at T2 in groups P and S (P ＜ 0.05).There were no significant differences in the plasma concentrations of MDA and TNF-α and changing rate between group S and group P (P ＞ 0.05).Compared with the baseline value at T1,no significant change was found in the plasma concentrations of MDA and TNF-α at T2 in groups P and S (P ＞ 0.05),and the plasma concentrations of MDA and TNF-α were significantly increased at T2 in group C (P ＜ 0.05).There was no significant difference in the amount of analgesics consumed within 24 h after operation between the three groups (P ＞ 0.05).Conclusion Both sevoflurane and propofol can reduce a tourniquet-induced lower extremity I/R injury in patients undergoing orthopedic operation and the efficacy is comparable.

Objective To explore protective effect of heparin on renal of children with Henoch-Schonlein purpura(HSP).Methods Two hundred and fifteen cases with HSP were divided into heparin-treated group(110 cases,male 64,female 46) and control group (105 cases,male 61,female 44).Serum IL-6 and IL-8 levels were examined by using radioimmunoassay respectively.These patients were followed up for more than 6 months.Results 1.The level of IL-6,IL-8 did not show significant difference between heparin-treated group and control group before treatment.The serum concentrations of IL-6,IL-8 in heparin-treated group were obviously lower than those in control group,after treatment,there was significantly different[IL-6(116.50?19.45)vs(123.88?22.55)ng /L,t=2.573 P=0.011;IL-8(0.161?0.043)vs(0.173?0.048)?g/L,t=2.024 P=0.044].2.During more than 6 months follow-up there were 26 cases suffering from purpura nephritis in heparin-treated group, the morbidity was 25%; the morbidity in control group was 39.8%,the morbidity in treatment group was significant lower than that in control group(?2=5.061 P=0.024).The time of renal injury was significantly delay in treatment group(35.0?13.2)d compared with that of control group (26.0?12.1)d(t=2.659 P=0.010).Conclusions The serum IL-6 and IL-8 concentrations in HSP obviously decrease after heparin treatment.Heparin therapy can decrease the morbidity of renal injury in children with HSP and delay the time of renal injury effectively.

Breast Neoplasms ; diagnostic imaging ; radiotherapy ; Female ; Humans ; Imaging, Three-Dimensional ; Mastectomy, Segmental ; Postoperative Period ; Radiotherapy Planning, Computer-Assisted ; methods ; Respiration ; Surgical Instruments ; Tomography, X-Ray Computed ; methods ; Tumor Burden

Adult ; Breast Neoplasms ; diagnostic imaging ; radiotherapy ; surgery ; Cone-Beam Computed Tomography ; Female ; Humans ; Mastectomy, Segmental ; Postoperative Period ; Radiotherapy Planning, Computer-Assisted ; methods ; Respiration

Animals ; Gene Expression Regulation ; drug effects ; Gene Targeting ; methods ; Humans ; Oligonucleotides, Antisense ; genetics ; pharmacology ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To establish a experimental autoimmune thyroiditis(EAT) rat model and to observe pathological change levels of CD4 + T lymphocyte infiltration in thyroid tissues under different iodine nutrient conditions.Methods One hundred and thirty-five four weeks old female Lewis rats(body weight about 80 g) were divided into control(NC),model(TG),high iodine-Ⅰ (HⅠ),high iodine and model-Ⅰ (HⅠ + TG),high iodine-Ⅱ (H Ⅱ),high iodine and model-Ⅱ (H Ⅱ + TG) groups according to body weight by random number table.There were 20 rats in NC,HⅠ and H Ⅱ groups,and 25 rats in TG,H Ⅰ + TG and H Ⅱ + TG groups.The rats of HⅠ and HⅠ + TG groups drank deionized water containing iodine 25.7 mg/L; rats of HⅡl and H Ⅱ + TG groups drank deionized water containing iodine 423.3 mg/L; rats of NC and TG groups drank distilled water.Rats of TG,HⅠ + TG and H Ⅱ + TG groups were immunized with 0.1 ml thyroglobulin(Tg,8.0 g/L) in incomplete Freunds adjuvant (IFA),once two weeks for three times.Urine samples were collected after immunization for 8 weeks; after immunization for 15 weeks,rats were killed,blood samples and thyroid tissues were taken.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry; pathological changes in thyroid tissue were observed by Hematoxylin-Eosin (HE) method ; immunohistochemical method was used to identify the infiltration of inflammatory cells in thyroid tissue.Results The difference of rat thyroid relative quality between groups was statistically significant (F =44.428,P ＜ 0.05).Compared with NC group (0.085 25 mg/g),thyroid relative qualities were increased in experimental groups (TG,HⅠ,HⅠ + TG,H Ⅱ,H Ⅱ + TG groups:0.095 22,0.092 85,0.097 48,0.096 55,0.095 33 mg/g,all P ＜ 0.05).The difference of urinary iodine between groups was statistically significant(x2 =106.4,P＜ 0.05).Compared with NC group(456.45 μg/L),urinary iodine levels in TG,HⅠ,HⅠ +TG,HⅡ,HⅡ + TG groups(800.08,18 633.20,13 869.00,87 889.97,61 661.51 μg/L) were increased(all P ＜ 0.05).The pathological changes of rats in each group were increased with increasing of iodine intake.Rats in NC group had normal thyroid structure; in TG,HⅠ groups,a small amount of lyrnphocytes were found between thyroid follicular; the lymphocytes infiltrated into the follicular in HⅠ + TG group; rats in H Ⅱ,H Ⅱ + TG groups had follicular fusion,and diffused inflammatory cell infiltration.There was a tendency of increased CD4+ T lymphocyte infiltration in rat thyroid with increasing of iodine intake.There was no CD4+ T lymphocyte positive staining in NC group; TG group had a small amount of positive cells; HⅠ group had scattered yellowish-brown positive cells.HⅠ + TG group had a focal lymphocyte infiltration; HⅡ group had follicular expansion obviously; follicular structure damage in HⅡ + TG group was serious,and showed a diffused yellow dye.Conclusion Excessive iodine intake and Tg immunization can induce and aggravate the incidence of autoimmune thyroiditis in rats,and pathological change situation has exacerbated with increasing of iodine intake; excessive iodine intake may also lead to an increased tendency of CD4+ T lymphocytes infiltration in thyroid tissue of EAT rat.

Objective To understand and evaluate the early breastfeeding behaviors in preterm infants,and to analyze the evolution process of early breastfeeding behaviors in preterm infants,and therefore to provide a theoretical basis for preterm infant breastfeeding.Methods A continuous evaluation of early breastfeeding behaviors in 38 preterm infants was performed commencing on the beginning of breastfeeding and finishing on the attainment of breastfeeding.Results The earliest breastfeeding was initiated from a postmenstrual age (PMA) of 30 weeks.Obvious rooting,efficient areolar grasp,repeated short sucking bursts and irregular swallowing were noted from 31 weeks; The maximum number of consecutive sucks was limited to between 6 and 24 sucks,with a median of 18 sucks.Full breastfeeding was attained at a median of 36 weeks,between 33 and 38 weeks.Conclusions The early breastfeeding capacity in preterm infants is enhanced and becomes perfect gradually with the implementation of breastfeeding,and that is sufficient and practical for establishment of full breastfeeding at a low postmenstrual age of preterm infants.

Totally 11 subjects with diabetic foot have been treated by umbilical cord blood mesenchymal stem cell (UCB-MSC) transplantation from November 2006 to October 2008 at the Chengyang People’s Hospital of Qingdao City. The course of disease was 6-18 years. Following over 6-months drug treatment and/or scaffold implantation, vascular bypass outcomes were bad. Of these patients, there were foot and/or lower limb cooling, pain, intermittent claudication and rest pain in 7 cases, abnormal color in foot skin in 7 cases, foot ulcer in 6 cases, gangrene in 4 cases, and concurrent infection in 2 cases. UCB-MSCs were obtained from healthy pregnant women, and supplied by Beike, Shenzhen, China. Following epidural or lumbar anesthesia, UCB-MSC suspension [cell number (1-6)?1011/L, 0.3-0.5 mL per point] was injected into affected lower extremity through multipoint muscles, with a distance among each point was about 3 cm ? 3 cm. Demixing injection could be performed in regions with plenty of muscles. At 1-4 weeks following transplantation, foot pain in 9 cases got amelioration or easement and cold sensation in 10 cases improved markedly. At 4-16 weeks after transplantation, foot ulcers were better and ulceration area reduced in 4 cases, gangrene area in 2 patients reduced and avoided amputation. 1 limb was amputated but with lowered level of amputation. After 12-24 weeks, 6 patients with intermittent claudication improved obviously, ankle-brachial index (ABI) increased in 3 cases, angiography showed an increase in visible collateral vessels in 3 patients. Transplantation of UCB-MSCs might be a simple, safe and effective method for patients with lower limb ischemia. It can effectively increase blood flow of lower limbs, promote ulcer healing and decrease amputation rate and amputation level.

Objective Pulmonary artery atresia (PAA) with intact ventricular septum (IVS) is an anatomically heterogeneous entity. A variety of surgical strategies is possible. We sought to evaluate the clinical results of various surgical corrections of PAA with IVS. Methods A retrospective review of our surgical database revealed 17 patients with PAA and IVS operation between January 1992 to August 2004. There were 9 males and 8 females. The age ranged from 15 days to 12 years [(25.5?7.9) months]. The body weight was 3.5 to 28.0 kg [(7.8?5.4) kg]. Radical operation was performed in 10 cases with the Z score -2.3～1.2 (-0.78?0.34), the pulmonary artery index (PAI) 149.53～297.89 mm~2/m~2 (206.35?82.15 mm~2/m~2). Two infants received BT shunt operation for the severe hypoxia at first postoperative day. Palliative operation was performed in 6 cases with the Z score -6.1～0.2 (-2.7?0.92), the PAI 39.88～218.29 mm~2/m~2 (131.85?72.93 mm~2/m~2), including bi-directional Glenn bypass (2 cases), systemic-to-pulmonary arterial (BT) shunt (1 case), right ventricular outflow tract (RVOT) reconstruction and BT shunt (3 cases). One patient accepted one and a half ventricular repair, first underwent bi-directional Glenn bypass operation, two years later ,underwent ASD occulsion、PDA occlusion and RVOT reconstruction. Results 3 patients(16.7%) died at perioperative time [two patients who had the radical operation, but next day, had the BT shunt operation, one patient had the right ventricular outflow tract (RVOT) reconstruction and BT shunt]. The rest recovered smoothly. The main complications included low cardiac output in 3 patients, hypoxemia in 3 patients, hydrothorax in 1 patients and right heart failure in 3 patients. Conclusion Surgical outcome for patients with the PAA with IVS maybe satisfactory, strategries are to be chosen according to the anatomic subtypes such as the tricuspid valve diameter, right ventricular size, pulmonary artery index and coronary anatomy.

OBJECTIVE:To establish a method for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin, palmatine hydrochloride and berberine hydrochloride in Baipuhuang tablets. METHODS:HPLC method was adopted. The determi-nation of Agela Technologies Venusil XBP C18(L)with mobile phase consisted of acetonitrile-0.05 mol/L monopotassium phosphate (gradient elution)at the flow rate of 0.8 mL/min. The detection wavelengths were set at 203 nm(pulchinenoside B4)and 323 nm (caffeic acid,baicalin,palmatine hydrochloride,berberine hydrochloride). The column temperature was set at 30 ℃,and the sam-ple size was 10 μL. RESULTS:The linear ranges were 0.08141-8.141μg for pulchinenoside B4(r=0.9998),0.01871-1.871 μg for caffeic acid (r=0.9994),0.03733-3.733 μg for baicalin (r=0.9992),0.02885-2.885 μg for palmatine hydrochloride (r=0.9996) and 0.02758-2.758 μg for berberine hydrochloride (r=0.9997). The limits of quantitation were 0.009,0.006,0.008, 0.011,0.013 ng,respectively. The limits of detection were 0.030,0.020,0.025,0.034,0.036 ng,respectively. RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%. The average recoveries were 97.39%-102.34%(RSD=1.81%,n=6),96.77%-98.92%(RSD=0.85%,n=6),97.38%-103.72%(RSD=2.46%,n=6),96.73%-102.01%(RSD=2.22%,n=6)and 96.47%-101.07%(RSD=1.61%,n=6),respectively. CONCLUSIONS:The method is simple,accurate and reproducibility,and can be used for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin,palmatine hydrochloride and berberine hy-drochloride in Baipuhuang tablet.