Objective: To improve the safety of anesthesia of the neonates at high risk during surgical operation. 　Methods:Before the operation, Anisodamine, Ketamine and Vecuronium bromide were injected intravenously with dosage of 0.06mg, 2mg*kg-1 and 0.08-0.1mg*kg-1, respectively. Tracheal cannula or topical anesthesia using 1% of lidocaine hydrochloride was performed. The tracheal cannulation was performed after administration of sodium hydroxybutyrate and Ketamine by injection with dosages of 50-80 mg*kg-1 and 2mg*kg-1 body weight. Anesthesia apparatus and combinative anesthesia were used. The concentrations of SpO2 were monitored during the operation. A dosage of 1-2mg*kg-1 body weight was used for resuscination of the patients after the operation. 　Results: A total of 100 cases of operation were performed using the regime of anesthetic intervention described above. A 100% of success rate was achieved and no death occurred during the operation. 　Conclusion:Significant improvement of safety in anesthesia of the neonates at high risk during surgical operation can be achieved with sufficient preoperational preparation, adequate monitoring during the operation and rational use of anesthetics as well as restrict selection of suitable anesthetical interventions.

The spinal dural arteriovenous fistula is a common vascular malformation with unclear etiology and unspecific clinical presentations.An early diagnosis is important for the treatment,therefore the authors reviewed and comprehanded the pathology,diagnosis and treatment of this AVM.

Purpose: To observe the efficacy of combined chemotherapy of navelbine( NVB) and cisplatin ( DDP) plus concurrent palliative local radiotherapy in the treatment of stage M, nasopharngeal carcinoma( NPC). Methods: 21 cases of stage M, NPC received combined chemotherapy of NVB 25 mg/m2 on dl, d8 and DDP 30 mg/m2 on day 1-3. The therapy was repeated every 28 days. All patients were concurrenly treated with palliative radiotherapy for to the distant metastases areas. The radiotherapy dose varied from 15 to 60 Gy. Results: 1.The 1-, 2- and 3- year survival rates of the patients were 71.43%, 14.29% and 9.25% respectively. The median survival time ( MST) was 17 months. 2.The Cox Regression analysis showed that the effect of treatment and the liver invasion are significant prognostic factors. The survival rate is the highest in the patients with lung metastases. Conclusions: This scheme combined chemotherapy of NVB and DDP plus concurrent palliative local radiotherapy can improve the MST of the patients with stage M1 of NPC.

Objective To discuss the effect of hyperthermia on tight junctions of the endothelial cells in the blood-brain barrier and explore the molecular mechanism. Methods An in vitro blood-brain barrier model was established by coculture of ECV304 and astrocytes. Transendothelial resistance (TER) of in vitro blood-brain barrier was determined by Millicell-ERS system. The morphological change of tight junctions of the endothelial cells in the in vitro blood-brain barrier was determined by the method of silver staining. The expression levels of zonula occluden 1 (ZO-1) and occludin were analyzed by means of semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western bloting. Results After two hours at 43℃, the mean value of TER was decreased from (321.30? 58.59) ??cm2 to (65.67?6.02) ??cm2. The integrity of tight junctions was destroyed and the expressions of ZO-1 and occludin decreased significantly. Conclusions Hyperthermia can destroy the tight junctions of the endothelial cells in the in vitro blood-brain barrier. The expression decrease of ZO-1 and occludin induced by hyperthermia is one of the most important molecular mechanisms.

Objective To investigate the deletion and mutation of Rb gene in human lung cancer.Methods Polymerace chain reaction (PCR ) and restriction enzyme analytic techniques were used to detect the exon 14-16 and 22-23 regions of Rb gene in 20 human lung cancer DNA samples and 3 normal human lung tissue DNA samples.Results Two deletions existed in the exon 14-16 regions of two lung cancer DNA samples.Conclusion Deletion of Rb gene is in existance in human lung cancer, especially in small cell lung cancer. This may be useful for studying the cause of lung cancer.

Objective To explore the value of FIB-4 and APRI index on evaluating the severity of liver fibrosis among patients with chronic hepatitis B(CHB).Methods A total of 218 CHB were enrolled in the study.Based on the staging of liver fibrosis,the patients were divided into 2 groups as S0-S2 group(n=120) and S3-S4 group(n=98).Differences in clinical data,laboratory indexes,FIB-4 and APRI index were compared between two groups.The correlation between FIB-4 index,APRI index and liver fibrosis were analyzed by Spearman correlation test.Receiver operator curve(ROC) test was used to determine the evaluating value of FIB-4 index and APRI index for the severity of liver fibrosis.Results To evaluate the staging≥S2 of liver fibrosis,the value of FIB-4 index was better than APRI index(Z=1.998,P=0.046).And to evaluate the staging≥S3 and S4 of liver fibrosis,the value of FIB-4 index for evaluating the staging≥S3(Z=1.177,P=0.239) or S4(Z=0.267,P=0.789) was the same as APRI index.Conclusion FIB-4 index and APRI index are both effective on evaluating the severity of liver fibrosis among patients with CHB,but the value of FIB-4 index is better than APRI index for evaluating early liver fibrosis.

Objective To explore the feasibility and value of preservation of left colonic artery (LCA) in dealing with inferior mesenteric artery (IMA) in laparoscopic anterior resection of rectal carcinoma.Methods The clinical data of 72 cases of laparoscopic anterior resection of rectal carcinoma from April 2010 to October 2013 were retrospectively analyzed including 32 cases with preservation of LCA (observation group) and 40 cases without preservation of LCA (control group).The blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number of lymph nodes removed around the root of IMA,the rate of lymph node metastasis around the root of IMA and prognosis were compared between two groups.Results There was no significant difference in the blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number of lymph nodes removed around the root of IMA,the rate of lymph node metastasis around the root of IMA between two groups (P ＞ 0.05).No case in observation group needed to free the splenic flexure of colon and to make the terminal ileum stoma,while 3 cases in control group needed to free splenic flexure of colon because of blood supply disorder in the proximal intestine (P =0.046),and 4 cases underwent terminal ileum stoma following anastomosis (P =0.042).No anastomotic leakage occurred in observation group,while 2 cases of anastomotic leakage occurred in control group(P =0.090).After followed up for 6-48 months,no significant difference was found in local recurrence and liver metastasis in two groups (P ＞ 0.05).Conclusion Laparoscopic anterior resection of rectal carcinoma with preservation of LCA in dealing with IMA can effectively retain the blood supply of proximal intestine.

BACKGROUND:After years of development, various in vitro loading devices for vascular tension stress have been created both at home and abroad, mainly including rectangular base stretching method, circular base deformation method and four-point bending beam load method. Although the circular base deformation method can wel reflect the real situations in vivo such as the expansion of the alveoli and vascular pulsation, the strain on the membrane is actinomorphic. The four-point bending beam load method can just bring limited strain range and load time, along with a difficult strain regulation.
OBJECTIVE: To develop anin vitro loading device for vascular tension stress using the rectangular base stretching method.
METHODS:Thisin vitro loading device for vascular tension stress developed according to mechatronics design consisted of power supply module, control module, drive module and data acquisition module. The device could achieve the tensile control on silicon diaphragm by high-precision control of the motor rotation angle and rotational speed.
RESULTS AND CONCLUSION: Through tests and experiments, the device could meet the required range of parameters and simulatein vitro human tensile stress environment, which is preliminarily considered to develop successfuly, achieving that: (1) two work patterns: stress mode and strain mode so as to solve the standardization of silicone substrate as loading device; (2) tensile stress can be adjusted in a range of 0-5×105 Pa; (3) tensile strain can be adjusted in 0-40% range; (4) stretching frequency can be in the regulation of 0-80 times/min and the stretching time can be controled.

Objective To study the clinical features of complicated upper urinary tract infection in children,aiming to provide a reference for clinical diagnosis and treatment of the disease.Methods The clinical data of 68 cases with complicated upper urinary tract infection hospitalized at the Department of Urinary Surgery NO.1,Children's Hospital of Shenzhen between January 2013 and August 2015 were retrospectively analyzed.Results A total of 68 cases,in which 44 were male,24 were female,and repeated infections were found in 15 cases.Fever was the most common clinical manifestation(48 cases,70.59％),while frequent urination and odynuria were rare(9 cases,13.24％).A total of 57 strains had been cultured form the submitted specimens which were obtained from the 68 cases,including 41 strains of gram-negative bacteria,15 strains of gram-positive bacteria and 1 strain of fungus.Two different strains were cultured in 3 children.Fourteen strains of Escherichia coli had 11 extended spectrum beta lactamases (ESBLs)-positive strains.In the 11 strains of klebsiella pneumoniae,8 trains were ESBLs-positive.The drug resistant rates of gram-negative bacteria to Ampicillin and Cefuroxime sodium were both more than 90％.The sensitive rates to Piperacillin/Tazobactam was more than 90％.Thirty-one cases of complicated upper urinary tract infection were cured by administering Piperacillin/Tazobactam,while 15 cases were cured by changing Cefuroxime sodium to Piperacillin/Tazobactam according to the drug sensitivity results.Conclusions Clinical manifestations of complicated upper urinary tract infection are untypical,and fever is the most common symptom.Repeated infection is common.The gram-negative bacteria is the dominant pathogen causing the complicated upper urinary tract infection.ESBLs-positive bacteria accounts for high proportion.The drug resistance rate to penicillin and the first,second generation of the cephalosporin is high.The drug sensitive rate of piperacillin tazobactam is high,with good prognosis.

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with rehabilitation training on motor cortex in children with motor retardation. Methods Sixty children with motor retardation were divided into treatment group and control group by random digits table method with 30 cases each. The children in control group were treated with rehabilitation training, and the children in treatment group were treated with rTMS combined with rehabilitation training. Two groups were treated for 3 courses. The Gesell pediatric neuropsychological scale and gross motor function measure (GMFM) scale before and after treatment were evaluated. Results There was no headache, dizziness and abnormal pathological reaction in the 2 groups. The motor behavior development quotient scores of Gesell pediatric neuropsychological scale after treatment in control group and treatment group were significantly higher than those before treatment: (64.37 ± 16.37) scores vs. (62.37 ± 14.21) scores and (74.50 ± 13.32) scores vs. (61.90 ± 13.76) scores, but the score in treatment was significantly higher than that in control group, and there were statistical differences (P<0.05). There was no statistical difference in language behavior development quotient score between after treatment and before treatment in control group: (79.57 ± 5.93) scores vs. (79.07 ± 5.75) scores, P>0.05. The language behavior development quotient after treatment in treatment group was significantly higher than that before treatment:(80.70 ± 5.38) scores vs. (78.57 ± 5.72) scores, and there was statistical difference (P<0.05). The A, B, C and D area scores of GMFM scale after treatment in control group and treatment group were significantly higher than before treatment, which in control group were (76.43 ± 19.18)% vs. (75.40 ± 19.38)%, (50.53 ± 27.63)%vs. (49.60 ± 28.22)%, (31.07 ± 24.93)%vs. (28.40 ± 23.70)%and (1.60 ± 1.33)%vs. (0.89 ± 0.37)%, and in treatment group were (85.80 ± 13.73)%vs. (79.13 ± 16.87)%, (65.77 ± 26.27)%vs. (49.37 ± 29.67)%, (49.60 ± 28.22)%vs. (28.83 ± 23.19)%and (2.10 ± 1.60)%vs. (1.07 ± 0.43)%, and there were statistical differences (P<0.05); the A, B and C area scores after treatment in treatment group were significantly higher than those in control group, and there were statistical differences (P<0.05); but there was no statistical difference in D area score after treatment between 2 groups (P>0.05). Conclusions The rTMS combined with rehabilitation training is better in gross movement than the single rehabilitation training for children with motor retardation. The rTMS can improve the motor function and language ability of children.