Background and purpose:Many patients may suffer from acute pain after radical mastectomy un-der general anesthesia. This article aimed to investigate the effect of intercostal nerve block coupled with general anes-thesia on analgesia after radical mastectomy for breast cancer.Methods:Ninety-six patients underwent modiifed radical mastectomy for breast cancer were randomized with random number into group C (intercostal nerve block coupled with general anesthesia) and group G (general anesthesia), with 48 patients in each group. Group C received intercostal nerve block by ultrasound before general anesthesia. Group G received only general anesthesia. The induction of general an-esthesia was the same between the two groups. During the surgery, 10 μg sufentanil was given to the patient if heart rate or blood pressure were 20% higher than baseline. After surgery, sufentanil was given if VAS score exceeded 0 point. The perioperative amount of sufentanil was recorded. VAS scores were recorded respectively on 2 (T1), 12 (T2) and 24 h (T3) after surgery. The incidence of postoperative nausea and vomiting was also observed.Results:Sufentanil amount used intra- and post- operation were signiifcantly lower in group C [(25.2±3.5) and (3.3±1.2) μg] than that in group G [(40.5±4.3) and (8.4±2.2) μg] (P<0.01). The VAS scores on 2, 12 and 24 h after surgery in group C(0.45±0.15,1.75±0.08 and 2.05±0.12), were signiifcantly lower than those in group G (4.32±0.21, 4.88±0.13 and 4.78±0.16) (P<0.01). The incidences of nausea and vomiting on 2 and 24 h after surgery in group C (6.25% and 16.66%) were signiifcantly lower than those in group G (20.8% and 41.66%). There was no adverse complication related with intercostal nerve block in group C.Conclusion:Intercostal nerve block coupled with general anesthesia plays an important role in preemptive analgesia for patients undergoing modiifed radical mastectomy for breast cancer, which may improve postoperative pain control and reduce the usage of opioids and incidence of nausea and vomiting. Intercostal nerve block under ultrasound is quite safe and effective for patients.

Background and purpose:Obvious pulmonary dysfunction may exsist preoperatively in part of the patients undergoing pulmonary lobectomy. Volume-controlled ventilation (VC) during one-lung ventilation (OLV) may lead to lung injury in lung cancer patients with preoperative pulmonary dysfunction. However, pressure-regulated volume-controlled (PRVC) ventilation mode is a new type of ventilation mode, and can alleviate ventilation-induced lung injury. This study explored the effect of PRVC on respiratory mechanics, oxygenation index, pulmonary inlfam-matory response, and clinical outcomes in patients undergoing pulmonary lobectomy during OLV compared with VC mode.Methods:Forty ASAⅡ-Ⅲ patients with moderate to severe pulmonary dysfunction undergoing pulmonary lobectomy were randomly divided into group VC and group PRVC (n=20).PRVC ventilation mode was performed for patients in group VC during the ifrst 5 minutes after OLV, and then ventilation mode was switched to VC ventilation mode till the end of surgery. In the other group, ventilation modes were performed in reverse order. Ventilation settings remained unchanged when ventilation mode was switched. Respiratory mechanics, static lung compliance, hemody-namic parameters and arterial blood gas were obtained during the surgery. Blood samples and bronchoalveolar lavage (BALF) in ventilated lung were collected to determine the level of TNF-α, IL-1β, IL-6 and IL-8 at the end of surgery.Results:Both the peak expiratory pressure and static lung compliance in group PRVC were signiifcantly lower than those in group VC (P<0.01). However, there were no statistical difference in hemodynamic parameters (heart rate and blood pressure) and arterial blood gas analysis (pH,paO2andpaCO2) between the two groups during OLV, as well as postoperative pulmonary complications and length of hospital stay. The levels of TNF-α, IL-1β and IL-6 in BALF in group PRVC were signiifcantly lower than those in group VC (P<0.05), while there was no difference in blood sample. Conclusion:PRVC mode during OLV may relieve the extravagant airway pressure and then reduce the release of inlfammatory factors in ventilation lung, which might prevent acute lung injury induced by lung barotraumas, especially for those patients with pulmonary dysfunction preoperatively. Therefore, PRVC mode is a safe and effective ventilation mode for high-risk patients undergoing pulmonary lobectomy.

Objective To observe the effect of Ginkgo Biloba Extract Injection on urinary albumin excretion rate in patients with diabetic nephropathy (DN). Methods A total of 90 patients with DN were divided into two groups: group A was micro-urinary-albumin group; group B was multiple-urinary-albumin group. Both groups were treated with routine therapy plus Ginkgo biloba extract injection (at a dose of 15ml) q.d. for 4 consecutive weeks. The urinary albumin excretion rate was compared between the two groups before and after treatment. Results As compared with the group B, urinary albumin excretion rate was significantly lowered in the group A (P＜0.01). Conclusion Ginkgo Biloba Extract Injection had effects in lowering microalbumin in urine and therapeutic effect for patients with early DN.

Objective To explore the effect of Lactobacillussalivariuson the number of CD4+CD25+Foxp3+Treg cells and expression of transform?ing growth factorβ1(TGF?β1)in asthma Balb/c mice. Methods Thirty?two female Balb/c mice were randomly divided into four groups:the nor?mal control group,the asthma group,the Lactobacillus salivarius group,and the asthma combined Lactobacillussalivariusgroup. Acute asthma mod?el was established by the ovalbumin challenge method. After extraction of primary spleen cells,flow cytometry was used to test CD4+CD25+Foxp3+Treg/CD4+T ratio in spleen lymphocytes. The levels of IL?4,IFN?γand TGF?β1 in the spleen cell culture supernatant were measured by ELISA method. Results The level of Th2 cytokine(IL?4)in the spleen cell culture supernatant of the asthma group was significantly higher than that of the control group(P<0.05),however,the level of Th1 cytokine(IFN?γ)was significantly lower than that of the control group(P<0.05). The ex?pression level of Th2 cytokine(IL?4)in the Lactobacillussalivariusintervention group was significantly decreased compared with the asthma group, and the Th1 cytokine(IFN?γ)expression level was elevated compared with the asthma group(P<0.05). The level of TGF?β1 in the Lactobacillus salivarius intervention group was higher than in the asthma group(P<0.05). The proportion of CD4+CD25+Foxp3+Treg/CD4+T in spleen lympho?cytes in the asthma group was lower than that in the control group(P<0.05),and was higher in the Lactobacillus salivarius intervention group than in the asthma group(P<0.05). Conclusion CD4+CD25+Foxp3+Treg was associated with the pathogenesis of asthma. Lactobacillus salivarius could adjust Th1/Th2 imbalance and reduce asthma inflammation through up?regulation of CD4+CD25+Foxp3+Treg and TGF?β1 expression.

Objective To study the diagnosis and management of renal artery stenosis in kidney transplants. Methods 8 cases of transplant renal artery stenosis (TRAS) were reviewed and studied . Results Color-flow Doppler has been helpful in the diagnoses for 5 of the 8 cases with a specificity of 78% and a positive predictive value of 62.5%. 7 patients underwent PTRA and have been cured of the renal stenosis in a short term. On follow up for 3～12 months, the creatinine was 186.2～121.3 ?mol/L; 1 patient underwent nephrectomy. Conclusions TRAS should be considered when ever there is hypertension of unknown cause, a sudden reduce of urine volume and on increase of creatinine after kidney transplantation. Color-flow Doppler is indicated for the screening of TRAS whereas PTRA is the procedure of first choice for the management.

Ever from FDA approved the Rituxan in 1997,an Anti-CD-20 chimeric antibody,there have been more than 20 antibodies approved and they have got into more than 56 countries.About half approvied antibodies are curing kinds of cancers and seven of them have got a excellent sale targets to be "Blockbuster Drug".As the cell culture technology improving,the large scale cell expression titer comes from 1g/L to 5g/L.At the same time,the culture scale is coming form 12,000L to 15,000L,even 20000L and it can run several bioreactors at the same time.All these are make the improvement of the antibody purification.The new edition of media,system,chromatography technology and filtration technology can product the protein to several tens kilogram antibody per cycle and tons per year,although the productivity is only several kilograms per cycle many years ago.Also the new combined technology makes a two-step chromatography production protocol come into been.This will highly improve the antibody productivity and save the investment cost.

Objective: To investigate the activity of mono-tetrahydrofuran (THF) annonaceous acetogenins (ACGs) against mitochondrial complex I of rats. Methods: The inhibitory activity of mono-THF ACGs with six different chemical structures against mitochondrial complex I of rats was investigated to clarify the carbon number and substituted hydroxyl number between THF ring and lactone ring as well as the effect of the core configuration in THF ring on mitochondrial complex I of rats. Results: The results show that mono-THF ACGs can inhibit the mitochondrial complex I of rats. With analysis of the results from the structure-activity relationship between antitumoral activity and their chemical structure of mono-THF ACGs, the less the carbon number between the two rings is, the better their inhibitory activities are; The number of substituted hydroxyl groups is not the decisive factor for influencing its activity in mono-THF ACGs. Conclusion: The inhibitory activity of compound's configurations with th/t/er is better than that of the compound's configurations with th/t/th in mono-THF ACGs.

OBJECTIVETo investigate the effects of exercise (EX), low-fat diet (LFD) and their combination intervention on the tumor necrosis factor-alpha (TNF-alpha) expression of insulin resistance in rats.

METHODSOne hundred and thirty male rats randomly assigned to 2 groups: Control (CON)-10 rats consuming a low-fat diet; HFD-120 rats consuming a high-fat diet (HFD). The dietary regimen was sustained for 8 wk, at which point the 40 HFD group rats gaining the most weight were referred to as the obese rats. Glucose tolerance was assessed by an oral glucose tolerance test (OGTT). During the procedure of OGTT, the blood was drawn for insulin assay (insulin release test). The whole body insulin resistance was assessed by glucose-insulin index. The obese HFD group rats were randomized into one of four intervention groups: HFD-sedentary (HFD-SED), HFD-exercise(HFD-EX), low fat diet-SED (LFD-SED), LFD-EX. Ex rats performed 8-wk exercise training on a motorized treadmill. The CON group had access to low-fat diet for another 8 wk. After 8 wk of exercise and low-fat diet intervention, the OGTT and insulin release test were performed again. To use ELISA technique for detecting TNF-alpha in soleus muscle and adipose tissue.

RESULTSAfter being fed high-fat diet for 8 wk, glucose-insulin index in the HFD group were significantly greater than that in CON group (P < 0.01). After 8-week exercise and low-fat diet intervention, glucose-insulin index in HFD-SED group was significantly greater than that in CON group (P < 0.01). The index in three intervention groups was significantly less than that in HFD-SED group (P < 0.01) . TNF-alpha content in adipose tissue and the soleus muscle for HFD-SED group was significantly greater than that in CON group (P < 0.01). Three intervention groups were significantly less than HFD-SED group (P < 0.01).

CONCLUSIONExercise and low-fat diet interventions can decrease the TNF-alpha expression in insulin resistance rat.

Animals ; Diet, Fat-Restricted ; Insulin Resistance ; Male ; Obesity ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

Objective:To analyze the feature of anaphylactic shock induced by alprostadil injection. Methods: Totally 1624 pa-tients treated with alprostadil injection in our hospital from January to March 2014 were undergone adverse drug reaction monitoring. Six cases of anaphylactic shock induced by alprostadil injection were statistically analyzed. Results:6 cases of anaphylactic shock induced by alprostadil injection occurred in the department of intervention and most of thd reaction happened in arterial injection. Two lot num-ber of drugs were in high frequency. Patients showed a sharp fall in blood pressure, chest discomfor, palpitation, shortness of breath, paleness, sweating and other symptoms. After anti allergy, blood pressure, oxygen the rapy and other treatment measures vital signs gradully stabilized. Conclusion:Anaphylactic shock induced by alprostadil injection is in correlation with the administration mode of artery injection. The change of the patient' s condition and vital signs should be closely observed when we inject the patient with alpros-tadil injection. We must prevent the occurrence of serious adverse reactions.

Objective To investigate the influence of pregnancy on graft after renal transplantation. Methods Clinic data from 13 female transplant recipients with pregnant duration more than 5 months from May 1978 to March 2002 were retrospectively analyzed. Results Immunosuppressive programs: 4 patients received CsA plus Pred, 5 CsA, MMF plus Pred, and 4 FK506, MMF plus Pred. Among the 13 cases, 10 had successful pregnancies with stable graft function; one died of pulmonary infection and cardiac insufficiency with functioning graft after delivery (the baby was safe); 2 experienced chronic rejection proven by biopsy, getting graft lost and pregnancy terminated: one returned to hemodialysis till now and one received successful retransplantation after 1 year hemodialysis. 11 offerings are healthy by now.Conclusion Patient/kidney survival in our study was 76.9?% . Our data and literature have demonstrated that pregnancy has no effect on graft long term survival or function. It is advisable in a woman of childbearing age with a well functioning renal graft 2 years after transplantation, but must be considered risk. Chronic rejection is a risk factor for graft loss following pregnancy. FK506,CsA and MMF have no side effect on newborns.