Objective To determine if propofol-remifentanil and isoflurane have any different effects on intrapulmonary shunt during one-lung ventilation (OLV). Methods Twenty-four ASA Ⅰ or Ⅱ patients (18 male, 6 female) aged 42-69 yr undergoing radical esophagus cancer resection via left thoracotomy were randomly divided into 2 equal groups ( n = 8 each) : propofol group (Pro) and isoflurane group (Iso) . The preoperative lung function was normal in both groups. The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Radial artery was cannulated and S-G catheter was placed via right internal jugular vein in pulmonary artery. Anesthesia was induced with propofol 1.5-2.0 mg?kg-1, fentanyl 4 ?g?kg-1 and succinylcholine 1.5 mg?kg-1 and maintained with TCI of propofol and remifentanil (target plasma concentration was set at 3.2 ?g?ml-1 and 4.5 ng?ml-1 ) or isoflurane inhalation ( end- tidal isoflurane concentration = 1.5% -2.5 % ) and intermittent i. v. boluses of fentanyl. The patients were mechanically ventilated after endobronchial intubation with double-lumen tube (VT = 8-10 ml, RR= 10-12 bpm, I:E = 1:2) . During OLV VT was reduced to 6-8 ml and RR increased to 14-16 bpm.PaCO2 was maintained at 35-45 mm Hg. ECG, HR, MAP, SpO2, auditory-evoked potential index (AAI), cardiac index (CI), airway pressure and end-tidal isoflurane concentration were continuously monitored during operation. Blood samples were taken from radial artery and pulmonary artery at 10 min after S-G catheter placement (T0, baseline) at 10 min bilateral ventilation (in right lateral position) (T1) at 15, 30, 60, 90 min of OLV (T2-5) for measurement of blood gases and calculation of Qs/Qt.Results The two groups were comparable with respect to age, M/F ratio, body weight and preoperative lung function. AAI was below 30 during operation and PaCO2 and pH were within normal range in both groups. Qs/Qt was significantly increased while PaO2 was significantly decreased during operation (from T1 to T5 ) as compared to baseline values (T0) but Qs/Qt was gradually decreasing while PaO2 was gradually increasing from T2-5 in both groups. Qs/Qt was significantly lower in Pro group than in Iso group at each interval (T2-5) but there was no significant difference in PaO2 at T2-5 between the two groups. Conclusion There is less intrapulmonary shunt during OLV under general anesthesia with propofol-remifentanil than with isoflurane but the difference is not significant enough to affect PaO2.

The PIWI family members are defined as conserved PAZ and PIWI domains and play important roles in stem-cell self-renewal,spermatogenesis,RNA interference and translational regulation.Recent researches have showen that some PIWI are specifically expressed in tumors and associated with tumor development and growth.PIWI is likely to be a new significante index for tumor diagnose and prognosis,the feasibility of PIWI acting in tumor gene theropy could be in vestigated by studying the mechanism of PIWI expression and regulation.

Endothelial progenitor cells(EPC),which have the capacity to differentiate into mature endothelial cells,have been found to home to and incorporate into the angiogenic vasculature of growing tumors with high specificity once mobilized into the circulation.Yet the mechanism still remains unclear.EPC have potential as spatial-specific delivery vehicles.Thus,further studies on the mechanisms of tumor neovascularization and tumor therapy in glioma using genetically engineered EPC as angiogenesis-selective vectors will be of help to explore the potential in the basic and clinical application of EPC in(glioma.)

Objective To investigate the effect of Fillet flap and postoperative pressure combined with magnet pieces and triamcinolone acetonide injection therapy for keloid in aural region.Methods From January 2009 to January 2011,87 patients (102 side ears) with keloid at the aural region were treated.Fillet flap repaired for keloid in aural region,pressure treating by magnet pieces began at 14 days after operation,and continued for more than one year.Triamcinolone acetonide injection therapy began 1 months after operation if keloid recurrence tendency.Results After operation,80 patients (94 lateral ears) healed by first intention.Hematoma under flap appeared in 7 patients (8lateral ears),and healed by changing dressings.And 87 cases (102 lateral ears) were followed up for 1 year.The effect of operation and pressure therapy group and operation,pressure and injection therapy group was significantly higher than operation group,with statistically significant differences.Effect of operation,pressure and injection therapy group was higher than that of operation and pressure therapy group,but there was no significant difference.Conclusions Fillet flap and postoperative pressure combined with magnet pieces and triamcinolone acetonide injection therapy can effectively treat aural region keloids.

Humans ; Postural Orthostatic Tachycardia Syndrome

Objective To investigate the expression pattern of microRNA (miRNA) in the kidneys of unilateral ureteral obstruction (UUO) rats and to identify specific miRNA related to renal interstitial fibrosis (RIF).Methods Forty-eight male SD rats were divided into two groups:UUO group and sham-operated (Sham) group.Rats were sacrificed at 3,7 and 14 days after operation.Histologic changes were examined by Masson staining.Forty-eight selected miRNAs were examined by stem-loop real-time qPCR.Results At the 3rd day after operation,obstructed kidneys from operation rats showed mild edema in the interstitium and mononuclear cell infiltration.At the 7th day after operation,focal interstitial fibrosis was observed.At the 14th day after operation,fibrosis became more severe.The Sham kidneys showed no pathological changes.At the 3th day after operation,25 miRNAs were differentially expressed.At the 7th day after operation,24 miRNAs were aberrantly expressed,whereas 21 miRNAs were differentially expressed at the 14th day after operation (P＜0.05).Among these miRNAs,miR-132,miR-192,miR-194,miR-29c and miR-203 were consistently up-regulated or down-regulated in a time-dependent manner after operation.There were significantly correlations between the expression of five miRNAs and severity of tubulointerstitial injury (P＜0.05).Conclusions There are at least 20 miRNAs differentially expressed in the process of RIF induced by UUO.There are significantly correlations between the expression of miR-132,miR-192,miR-194,miR-29c and miR-203 and the severity of tubulointerstitial injury.They may be closely related to RIF.A further study is needed.

Objective To evaluate three internal fixation methods in treatment of type C3 fractures of distal humerus.Methods From February 2002 to January 2005,73 cases of humeral intercondylar fractures were treated with single plating (Group A,21 cases),Y-shape plating (Group B,33 eases) and dual plating (Group C,19 cases).According to the AO/ASIF classification,73 cases belonged to type C3.The posterior midline incision and the approach of liguliform flap of musculus triceps brachii were used for all the cases.The recorded clinical data were reviewed to analyze effects of internal fixation methods,functions of the elbow and the complications.Results All the cases were followed up.The follow-ups ranged from 12 to 36 months,with an average of 22.3 months.By the end of the twelfth month,according to the Jupiter scoring system,the elhow function was excellent and good in 57.1% of cases in Group A,81.8% in Group B and 89.5% in Group C,the difference between Gronp A and Groups B and C being statistically significant(P＜0.05).Meanwhile,according to Sodergard's criteria for failure of internal fixation system for intercondylar fracture of humerus,the failure rate was 33.3% in Group A,15,2% in Group B and 5.3% in Group C.The loosening or breakage rate in Group C was significantly lower than in Groups A and B (P＜0.05),and that in Group B was obviously lower than in Group A (P＜0.05).No incision necrosis or deep infection occurred.Conclusions The type C3 fractures of distal humerus should not he treated with single plating,because the functional outcome of elbow joint is poor,and the rate of loosening or breakage of internal fixation is higher than other fixation methods.Y-shape plating and dual plating are good for them,but Y-shape plating is not good for severe intercondytar comminnted fractures of the humerus,because its peculiar shape tends to lead to a higher rate of loosening.

Biodiesel, a nontoxic,cleaning, renewable and biodegradable fuel, is expected as a substitute for conventional fossil diesel. There are three main approaches to produce biodiesel, alkali-catalysis processing, enzymatic-catalysis processing and supercritical processing. With the unique property of energy-saving and environment-friendly, enzymatic-catalysis appears a great potential for industrial application. The main bottleneck of this technology is high cost and low stability of the lipase, as well as the inactivation of lipase by methanol and so on. To settle the problem, several methods have been used including the fixed-bed bioreactor, enzyme immobilized processing, whole-cell biocatalyst, changing addition method of methanol, developing of novel acyl acceptor, enhancing methanol resistance of lipase. The main problems and the relative strategy research of the enzymatic-catalysis technology were sum up.

Angioplasty, Balloon ; methods ; Aortic Valve Stenosis ; therapy ; Cardiac Pacing, Artificial ; methods ; Child, Preschool ; Heart Ventricles ; Humans ; Infant ; Male

Angioplasty, Balloon ; methods ; Aortic Coarctation ; diagnostic imaging ; pathology ; therapy ; Aortography ; Cardiac Catheterization ; methods ; Child ; Humans ; Male ; Platinum ; Prosthesis Design ; Stents ; Tomography, X-Ray Computed ; Treatment Outcome