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.

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.

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.

Objective To investigate the effect of drug dependence severity on the relationship between impulsivity and craving.Methods 36 abstiuent drug-dependent individuals were recruited in the study.The participants were divided into the heavy depeudence group (HDG) or the low dependence group (LDG) according to the scores of Addiction Severity Index (ASI).The Barratt Impulsiveness Scale (BIS-11) and classical Stroop task were used to measure the trait impulsivity and state impulsivity.Block designed cue-induced craving paradigm was presented to measure cue-elicited craving.Results For the HDG,a significant positive correlation was found between trait impulsivity (the mean value of BIS-11-CI scale was (39.03± 16.50)) or state impulsivity (the difference of reaction time between congruent and incongruent situation was (87.77±36.95)ms)and cue-elicited craving (0.83± 1.91)(r=0.487,0.500,P＜0.05).However,for the LDG subjects,the impulsivity was not found significantly correlated with the cue-elicited craving(r=-0.261,0.081,P＞0.05).Conclusion The addiction severity influences the relationship between impulsivity and craving,and impulsivity can only be used as a predictor of relapse in HDG.The findings suggest that the drug may influence the shared brain mechanism between impulsivity and craving.

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.

Objective To explore the relationship between red blood cell volume distribution width (RDW) and degree of liver fibrosis in patients with chronic hepatitis B (CHB). Methods One hundred and sixty-four patients with CHB were consecutively selected. According to the fibrosis index based on the 4 factors (FIB-4) index, the patients were divided into 3 groups: low-FIB group (FIB-4 <1.45, 116 cases), mid-FIB group (FIB-4 1.45-3.25, 31 cases) and high-FIB group (FIB-4 > 3.25, 17 cases), and the clinical data and laboratory indexes (including RDW) were compared. The patients were divided into Ⅰ group (RDW<0.113, 43 cases), Ⅱ groups (RDW 0.113-0.119, 40 cases), Ⅲ group (RDW 0.120-0.127, 43 cases) andⅣgroup (RDW>0.127, 38 cases) according to the RDW, and the FIB-4 were compared. The correlation between RDW and FIB-4 was analyzed by Spearman correlation test. Results The RDW and aspartate aminotransferase (AST) in low-FIB group, mid-FIB group and high- FIB group were gradually increased: 0.117 ± 0.011, 0.122 ± 0.010, 0.134 ± 0.018 and (18.9 ± 7.3), (28.2 ± 10.4), (44.1 ± 13.3) U/L, but the platelet was gradually decreased:(211.3 ± 48.8), (159.3 ± 40.0) and (150.4 ± 31.2) ×109/L, and there were statistical differences (P<0.05). The FIB-4 inⅠgroup,Ⅱgroup,Ⅲgroup andⅣgroup was gradually increased:1.07 ± 0.74, 1.11 ± 0.56, 1.35 ± 0.70 and 2.03 ± 1.06, and there was statistical difference (P<0.05). Spearman correlation test result showed that FIB-4 and RDW was positively correlated (r=0.447, P<0.01). Conclusions The level of RDW is closely related with the degree of liver fibrosis in patients with CHB. RDW has a potential value in assessing the progress of liver fibrosis.

AIM: To study signal transduction pathway of nitric oxide-induced PC12 cell death. METHODS: After PC12 cells were incubated with sodium nitroprusside(SNP), caspase-3 inhibitor Ⅱ plus SNP or p38 inhibitor-SB203580 plus SNP, cell survival rate was quantified by MTT assay and caspase-3 activity was measured with caspase-3 assay kits. RESULTS: SNP induced PC12 cell death in a dose- and time-dependent manner, and increased caspase-3 activity gradually. Both caspase-3 inhibitorⅡand SB203580 reduced cell death significantly, but SB203580 reduced caspase-3 activity significantly. CONCLUSION: NO might induce PC12 cell death through the activation of p38 and caspase-3.