Objective To compare the clinical effects of remifentanil combined with sevoflurane or with isoflurane in elderly patients undergoing radical gastrectomy for cancer and their recovery.Methods Sixty-two patients,who scheduled for radical gastrectomy for cancer was randomly divided into remifentanil combined with sevoflurane group ( SR group,n =31 ) and remifentanil combined with isoflurane group ( IR group,n =31 ).They were classified into American Society of Anesthesiology(ASA) physical status Ⅱ and ,The procedure of two Anesthesia was same,in which remifentanil was continually pumped into at the same velocity using micro pump immediately after intubation,tili the target density in plasma increased to 6 μg/L.Sevoflurane at 1.5％ to 2.0％ was inhaled in the SR group,whereas isoflurane at 1％ to 2％ in the IR group.The inhalation was ended at 5 mins before the surgery was completed,Remifentanil was stopped while stuturing,and 0.1 mg of Remifentanil was injected at 20 mins before the surgery was completed.The heart rate(HR) and blood pressure were recorded at before induction of anesthesia (T0),after induction of anesthesia ( T1 ),immediate intubation ( T2 ),surgery after the start of 5 min ( T3 ),30 min (T4) and the time of surgery ( T5 ),respectively.The recovery time and extubation time,and quality score for awakening after extubation (OAAS) were also recorded.Results There were no significant differences in HR,SBP and DBP at every time points observed between the two groups.The recovery time( 10.4 ± 3.9)mins and extubation time(5.9 ± 3.1 )min in SR group was significantly shorter than that of(16.3 ± 5.8) min and (9.7 ±2.5) min in the IR group(t =6.25 and 4.19,P =0.02 and 0.01,respectively ).The OAAS after extubation in the two groups gradually increased,and immediately after extubation and extubation after 10 min,OAAS in the SR group was(4.1 ± 1.2),which was significantly higher than that of (2.9±1.0)in the IR group(t =3.27,P =0.03).Conclusion Either stevoflurane-remifentanil or isoflurane remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Anesthesia with Sevoflurane-remifentanil provides better faster recovery than isoflurane- remifentanil in elderly patients.

Introduction to the specific practice and policies of the hospital for academic promotions. The emphasis is placed on "quality priority" and "work performance", making an overall assessment of the applicants on their professional virtue, academic skills, research outcome and social services. Among all these indicators, appraisal of the clinical skills and teaching skills is prioritized,encouraging the creativity and incentives of clinicians for clinical and teaching work.

Transforming growth factor ?1 (TGF ?1) promotes the formation of extracellular medium(ECM).This study was designed to investigate the effects of angiotensinⅡ(AngⅡ) and Interferon ?(IFN ?) on expression of TGF ? Receptor type I(T?R I) in rat vascular smooth muscle cell(VSMC). We observed the changes of T?R I expression after 24h stimulation with AngⅡ(10 -7 M) and IFN ?(500U/ml) by Western blotting, and found that AngⅡ markedly stimulated expression of T?R I from 62 24?4 39 in control group to 103 06?9 34 in AngⅡ group (expressed in OD, P

Objective:To observe the role of enteral nutritional support in treating superior mesenteric artery syndrome. Methods: Enteral nutritional support was used in two patients with superior mesenteric syndrome after percutanous endoscopic jejunostomy.Enteral nutrition was used for 69 days and 180 days.The symptoms were observed.Body weight and index of nutrition were measured.Results: After enteral nutritional support,symptoms of two patients disappeared.Body weight and fibronectin and prealnumin increased.Conclution: Enteral nutritional support is one of effective methods of treating superior mesenteric artery syndrome.

Objective To evaluate percutaneous endoscopic gastrostomy (PEG) for long-term enteral nutrition in patients with cancers of head and neck. Methods PEGs were performed for 12 patients with head and neck cancers, the indication for which included serious buccal mucositis, difficulty in swallowing, anorexia, and obstruction of the digestive tract. Before PEG and 8 weeks after PEG, serum concentrations of total protein and albumin of the patients were measured, body composition including body weight, free fat mass, and fat mass were measured by bioelectric impedance analysis (BIA), and Karnofsky performance score ( KPS) was evaluated. Results After enteral nutrition for 8 weeks through PEG, the serum concentrations of total protein and albumin of the patients increased significantly (63.8?0.3g/L vs 57.4?0.2g/L, P

An introduction to the practice of introducing the“ surgeon qualification admittance system”in the hospital and a description of its management framework,basic principles,rules of classification for surgical operations,application and approval procedure,and supportive management regulations.The authors hold that this system has normalized behavior of medical activities,clarified operation authorities of medical doctors at various levels,and intensified the awareness of risk exposure.Therefore this system can safeguard the quality and safety of surgical operations and its efficiency to a great extent,in addition to better building the team and backup forces.

Objective　To evaluate the role of transfected angiotensinⅡ(Ang Ⅱ) receptor AT1 anti-sense nucleotide (AT1A) in the expression of subtypes of AngⅡ receptor mRNA, synthesis of protein and nucleic acid in cardiomyocytes. Methods　AT1 cDNA sequence (476 bp) was cloned with RT-PCR and reversely inserted into PcDNA3.1 (5.4 kb) to construct an intact plasmid containing AT1A (PAT1A). The plasmid was then transfected into the cultured cardiomyocytes and identified with RT-PCR and Western blot. The synthesis of protein and nucleic acid identified by 3H-Leu and 3H-TdR incorporation, and expressions of AT1 and AT2 mRNA by RT-PCR, were compared between transfected and nontransfected cardiomyocytes after being stimulated with 10-7 mol/L AngⅡ for 24 h. Results　The plasmid PAT1A were successfully constructed. The AT1 mRNA and its protein were expressed significantly less in the transfected cardiomyocytes than in the control (P<0.01). In the transfected cardiomyocytes, AT1 mRNA expression was markedly decreased, but that of AT2 mRNA obviously increased (P<0.01) when compared with the nontransfected cardiomyocytes after stimulation for 24 h with AngⅡ 10-7 mol/L; no significant difference was found in 3H-Leu and 3H-TdR incorporation between them. Conclusion　After the cardiomyocytes was tranfected with AT1A, the expression of AT1 mRNA was markedly suppressed，while AT2 mRNA up-regulated at the same time. Our results indicate that AT1A blocking can not effectively interrupt the Ang Ⅱ-induced synthesis of the protein and nucleic acid in cardiomyocytes.

This paper dealt with the influences of different media, temperature, light and pH to the amount of oospore formation. The results showed that millet agar, bai yun beau agar and soybean agar provided the favorable condition for oospore formation, the number of oospores was 131.6~149.6 /cm2, but a few oospores was formation on frozen pea agar. The results also suggested that the optimal conditions for oospore formation were 18℃, pH7 and darkness. The oospores failed to be formed tinder fluorescent or black light.

Objective To investigate the therapeutic effect of argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) for primary hepatocellular carcinoma (HCC) and its influence on vascular endothelial growth factor (VEGF) level, and to compare it with simple TACE treatment. Methods During the period from Aug. 2013 to Aug. 2014 a total of 50 patients with primary HCC were admitted to Hunan Provincial People’s Hospital. The patients were randomly and equally divided into group A (TACE group, n=25) and group B (argon-helium cryoablation+TACE group, n=25). VEGF levels in the peripheral blood were determined before and after the treatment, and the results were statistically compared between the two groups. Results After the treatment the VEGF level in group A was significantly increased when compared with preoperative VEGF level (P<0.05). In group B, the VEGF level was decreased after the treatment, which was statistically significant lower than the preoperative VEGF level (P<0.05). The differences in VEGF level between the two groups were statistically significant (P<0.05). Conclusion The statistic analysis of VEGF levels indicates that argon-helium cryoablation combined with TACE is probably superior to simple TACE in the inhibition of tumor angiogenesis.

AIM: To explore the relationship between proliferation, hypertrophy of vascular smooth muscle cells(VSMC) and platelet-derived growth factor-AA(PDGF-AA) and PDGFR-? expression in spontaneously hypertension rats(SHRs) and the role of tyrosine protein kinase (PTK) in it. METHODS: 1. The difference of PDGF-AA, PDGFR-? and PDGFR-? expressions in SHR/Wistar-kyoto rat(WKY)-VSMC was examined by Western blot. 2.The effect of PTK inhibitor (genistein) on proliferation and hypertrophy of SHR-VSMC induced by PDGF-AA was observed by Western blot and incorporation. RESULTS: 1.PDGF-AA and PDGFR-? expression markedly increased in SHR-VSMC compared with WKY-VSMC. There was no difference in PDGFR-? expression levels between SHR and WKY-VSMC. 2.Dose-dependent PDGF-AA-stimulated PCNA expression and incorporation were observed in SHR-VSMC. 3. Genistein inhibited PCNA expression and incorporation induced by PDGF-AA in a dose-dependent manner in SHR-VSMC. CONCLUSIONS: Spontaneous increasing expression of PDGF-AA and PDGFR-? in spontaneously hypertension rats(SHRs) may be one of the important factors in vascular reactivity and vascular modeling mediated through proliferation and hypertrophy in SHR-VSMC. Tyrosine protein kinase plays an important role in this process.