Objective To determine the sites of action of propofol and isoflurane on somatosensory pathway using median nerve somatosensory evoked potential(MnSSEP) .Methods Twenty-six ASA I - II patients aged 20-50 yrs were randomly divided into two groups: I propofol group( n = 13) and H isoflurane group( n = 13) .In propofol group patients received propofol infusion at a rate of 10 mg?kg-1?h-1 .Oxygen was administered via mask and respiration was assisted or controlled to maintain SpO2 at 96%-100% and PETCO2 at 35-45 mm Hg. The propofol infusion was continued until the patient failed to respond to verbal command. Six minutes later if the patient was still breathing spontaneously, the rate of propofol infusion was increased to 20-40 mg?kg-1?h-1 . In isoflurane group anesthesia was induced with propofol 2 mg ? kg-1 and intubation was facilitated by succinylcholine and anesthesia was maintained with isoflurane inhalation and intermittent iv boluses of vecuronium. The end-tidal isoflurane concentration was maintained at 0.5,1.0 and 1.5 MAC. Each concentration was maintained for 15 minutes. MAP, HR, SpO2,PCTCO2, T0(naso-pharyngeal) and BIS were continuously monitored. MnSSEP( Viking IV D type) was measured and recorded before induction of anesthesia(baseline) and in propofol group when patients became unconscious and apneic; in isoflurane group when end-tidal isoflurane reached 0.5,1.0 and 1.5 MAC.Results In group I there was no change in both latencies and amplitudes of N9 and N13'.With increasing infusion rate, propofol gradually prolonged the latencies and decreased the amplitudes of N60, P45, N35, N20 and P25 waves. In isoflurane group there was no change in the latencies and amplitudes of N9. There was no change in the latencies of N13', but the amplitudes decreased at 1.0 and 1.5 MAC. With increasing concentration, isoflurane gradually prolonged the latencies and decreased the amplitudes of P45, N60, N35, N20 and P25 waves. At 1.5 MAC the inter-peak latencies between N13'-N20 and N13'-P25 were prolonged. Conclusions The sites of action of different infusion rates of propofol and different concentrations of isoflurane are different on somatosensory pathway. The higher the doses, more widespread are the sites of action.

Autoimmune diseases (AID) are a group of diseases,in which the tolerance of immune system to self component is broken.However,the etiology and pathogenesis of AID has not yet been clear so far.For better understanding the pathogenesis of AIDs and providing new idea on the diagnosis and treatment of AID,this review will focus on the latest development on pathogenesis of AID,including genetic background,environment factors,abnormal immune regulation,and the role of target cells.

Objective To study the expression of hMLH1, hMSH2 and their association with clinico-pathological characteristics in hepatocellular carcinoma(HCC). Methods The expression of hMLH1 and hMSH2 in 37 HCC tissues was detected by SABC immunohistochemistry. Results The positive rate (score) of hMLH1 and hMSH2 expression in HCC was 48.7%(1.65?1.70) and 59.5%(2.30?1.96), respectively, which was obviously lower than that in the adjancent tumor tissues with 83.8%(3.30?1.37), and 86.5%(4.30?2.01), and in the normal liver tissues with 88.2%(3.88?1.98) and 82.3%(4.29?1.83), respectively(P

Objective The purpose of this study is to explore the expression of 12 tumor Markerss in the serum of colon cancer patients by C 12 tumor marker protein chip ,screening most valuable Markers for diagnosis . Methods C12 tumor Marker of protein chips were used for 12 sorts of tumor marker detection among 60 CRC patients and 40 healthy controls ,address the most valuable tumor marker relative to colon cancer and contribution of combinations effect on diagnosis .Result CEA+CA199+CA242+Bete-HCG combination diagnosis has the highest effectivity and diagnosis sensitivity was greatly improved by combination detection .The optimized diagno-sis showed no significant tendency to be correlated with age ,sex,differentiation stage,pathology,Lymph node me-tastasis,clinical stage.Conclusion It is of importance to use sera CEA +CA199+CA242+Bete-HCG detec-tion as markers for colon cancer diagnosis ,which may improve diagnosis efficiency .

Exosome is a self-secreted phospholipid bilayer nanovesicles, and has shown great potential in drug delivery field due to the important advantages of low immunogenicity and homologous targeting. Phototherapy, mainly includes photodynamic therapy (PDT) and photothermal therapy (PTT), utilize light to activate photoactive drug for tumor cell killing. The advanced therapeutic strategy shows low toxic side-effect and non-invasion precise advantages, and thus has made great progress in tumor treatment over the past few years. Therefore, using exosomes as a drug delivery system to deliver phototherapeutic agents can improve therapeutic performances with a reduced side-effect, and further enhance their application potential for clinical tumor therapy. This review focus on the rising cross-subjects field involving exosomes and phototherapy, and mainly introduce the research progress and relative case of exosomes-based delivery system for cancer phototherapy. Additionally, the advantages and challenges of exosome-based phototherapy are also discussed and proposed.

Objective To evaluate the role of fetal brainstem-vermis (BV) and brainstem-tentorium (BT) angles in differential diagnosis of fetal cereballar vermis anomalies by three-dimensional ultrasonography. Methods A total of 335 normally developed fetuses at 18-34 gestational weeks were examined prospectively in Prenatal Ultrasound Center of Suzhou Municipal Hospital from July 2013 to July 2014 by three-dimensional ultrasonography scanning. The BV angles and BT angles were measured at the mid-sagittal sections of fetal heads which were obtained by three-dimensional ultrasonography. Sixteen fetuses with abnormal cerebellar vermis were selected. The BV angles and BT angles were measured and compared with the measurements of normal group. Results In normal fetuses, the mean of BV angles was (3.3±1.7)° , ranging from1.0 to 10.0°;the mean BT angle was (31.5±6.9)° , and ranging from 16.6 to 57.8° . In 16 cases of abnormal cerebellar vermis, 4 cases of Dandy-Walker Malformation (DWM) showed significantly upward rotated cerebellar vermises, the BV angles increased significantly (88.9±18.1)° , the cerebellar tentoriums were superior displaced, the BT angles increased remarkably (89.0±12.8) ° ;6 cases of Dandy-Walker variant (DWV) showed upward rotated cerebellar vermises, with increased BV angles (23.7±5.2) ° , and slightly increased BT angles (54.5±12.0)°;6 cases of Blake′s pouch cyst (BPC) showed upward rotated cerebellar vermises were, mildly increased BV angles (16.7±1.8)° , and slightly increased BT angles (50.3±8.2)° . The comparison results showed:BV angles increased with increasing severity of the condition in BPC, DWV and DWM;BT angles increased significantly in DWM. Conclusions The measurements of BV angles and BT angles are valuable in the differential diagnosis of fetal cereballar vermis anomalies. From 19 gestational weeks, a BV angle>60° is strongly suggestive of a Dandy-Walker malformation, while a measurement>10.0° and<20° favors the diagnosis of Blake′s pouch cyst.

Sudden sensorineural hearing loss (SSHL),which is a common and frequently encountered disease,is considered to be a medical emergency in otolaryngology.The prevalence of SSHL is increasing in China.The pathogenesis of SSHL is not clear yet.Microcirculatory disorder of inner ear is considered as one of the most important causes of SSHL.In recent years,several reports have found the levels of serum lipids were changed in patients affected by SSHL.The relationship between SSHL and serum lipids was reviewed to provide new ideas for the diagnosis and treatment of SSHL.

Aged ; Biopsy ; Bone Marrow Examination ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, B-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To compare the clinical effect between CO2-1aser assisted and cold instrument assisted suspension laryngoscopic surgery for vocal fold cyst.Methods From January, 2011 to December, 2014, 72 patients with vocal fold cyst, which diagnosed by strobolaryngoscopy, were randomly divided into CO2-1aser assisted group and cold instrument group.Strobolaryngoscopy, acoustic analysis and perceptual voice analyses were performed on each patient before surgery, 1 month, and 3 months after surgery, respectively.Results All operations were successfully completed.The complete vocal fold cyst resection rate of CO2-1aser assisted group was significantly higher than cold instrument group (29/36, 80.5％ vs 21/36, 58.3％, P ＜ 0.05), especially the left vocal fold cyst (13/16, 81.3％ vs 9/19, 47.4％, P ＜ 0.05).The complete right vocal fold epidermoid cyst resection rate was significantly higher than retention cyst (17/19, 89.4％ vs 11/18, 61.1％, P ＜ 0.05).Two recurrent cases were found in cold instrument group but no recurrent cases in CO2-laser assisted group (0/36, 0％ vs 2/36, 5.6％, P ＞ 0.05).Correlation analysis showed that vocal fold cyst recurrence was related to complete resection rate and has no relation with surgical methods, histopathological types and position.Subjective and objective assessment of voice quality in preoperative, 1-month postoperative and 3-month postoperative were similer between CO2-1aser assisted group and cold instrument group (P ＞ 0.05).Conclusion The CO2-laser assisted suspension laryngoscopic surgery for vocal fold cyst, can increase the surgical precision, reduce the left hand impact, improve the complete resection rate and reduce the recurrence rate.

Objective To evaluate the role of interleukin-4 receptor (IL-4R) in renal fibrosis following renal ischemia-reperfusion (I/R) injury in mice.Methods Twelve male wild type BALB/C mice and 12 IL-4Rα gene-knockout mice,aged 8-10 weeks,weighing 20-30 g,were used in the study.The mice of either type were divided into 2 groups (n =6 each) using a random number table:sham operation group (group S) and group I/R.In group I/R,renal I/R was induced by occlusion of the right renal artery for 1 h with atraumatic microclips followed by 2 weeks of reperfusion.The right renal artery was only isolated in group S.At 2 weeks of reperfusion,blood samples were taken from the orbital vein for determination of the concentrations of serum blood urea nitrogen (BUN) and creatinine (Cr).The renal tissues were obtained,and the renal fibrosis area was measured by Sirius Red staining.The expression of fibronectin (FN),collagen Ⅰ (COL-Ⅰ) and α-smooth muscle actin (α-SMA) in renal tissues was detected by immunofluorescence.The expression of signal transducer and activator of transcription 6 (STAT6) and phospho-STAT6 in renal tissues was determined by Western blot.The ratio of phoshop-STAT6 to STAT6 was calculated to reflect the phosphorylation of STAT6.Results Compared with group S of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly increased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly up-regulated,and the phosphorylation of STAT6 in renal tissues was significantly increased in group I/R of wild type and IL-4Rα KO mice (P＜0.05).Compared with group I/R of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly decreased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly down-regulated,and the phosphorylation of STAT6 in renal tissues was significantly decreased in group I/R of IL-4RαKO mice (P＜0.05).Conclusion The mechanism of renal fibrosis following renal I/R injury is partially related to IL-4R,and IL-4R results in renal fibrosis through promoting activation of STAT6 signaling pathway in mice.