Objective To evaluate the effect of positive end-expiratory pressure (PEEP) on intraoperative pulmonary function in the patients undergoing urological retroperitoneal laparoscopic surgery in the mode of protective ventilation.Methods Forty patients of both sexes,aged 30-64 yr,with body mass index of 16-29 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective retroperitoneal laparoscopic ureterolithotorny,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and PEEP group (group P).After induction of general anesthesia,the patients were endotracheally intubated.Intermittent positive pressure ventilation (tidal volume [Vr] 6 ml/kg,respiratory rate [RR] 12 breaths/min,inspiratory/expiratory ratio [I:E] 1:2,fraction of inspired oxygen 50％) was performed from the end of intubation until the onset of pneumoperitoneum.After the onset of pneumoperitoneum,the patients were ventilated (VT 6 ml/kg,RR 22 breaths/min,I:E 1.0:1.5),and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg in group C.After the onset of pneumoperitoneum,the patients were ventilated (VT 6 ml/kg,RR 22 breaths/min,I:E1.0:1.5,PEEP 5 cmH2O),and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg in group P.At 5 min before pneumoperitoneum (T1),at 10,30 and 60 min of pneumoperitoneum (T2-4),immediately after the end of pneumoperitoneum (T5),and at 5 min before extubation (T6),arterial blood samples were collected for blood gas analysis.Peak airway pressure and mean airway pressure were also recorded.Dynamic lung compliance,oxygenation index,respiratory index,dead space fraction and alveolararterial oxygen gradient were calculated.Results Compared with group C,mean airway pressure was significantly higher at T2-4,oxygenation index was significantly higher at T3,alveolar-arterial oxygen gradient difference was significantly lower at T3 and T6,and respiratory index was significantly lower at T6 (P＜0.05),and no significant change was found in the peak airway pressure,dynamic lung compliance and dead space fraction at each time point in group P (P＞0.05).Conclusion PEEP (5 cmH2O) can improve the intraoperative pulmonary function in the patients undergoing urological retroperitoneal laparoscopic surgery in the mode of protective ventilation.

Guinea pigs were given orally with a daily dose of 0.5 mg ascorbic acid per 100 g body weight 20 days before and 4 days after a whole-body r-irradiation and then injected subcutaneously with 10 mg ascorbic acid at 24 hours intervals. During the injection period, the daily urinary output of total ascorbic acid in the animals irradiated with 500 or 1000 r was significantly higher than that in controls, but the difference of 24 hours excretions of total ascorbic acid between the group irradiated with 150 or 250 r and the control group was not statistically significant.As shown in the urinary output of dehydroascorbic acid and diketo- gulonic acid estimated by our modified Roe's method, r-irradiation has no effect on its excretion in guinea pigs and rats.The levels of ascorbic acid in plasma, spleen and adrenals were significantly lower in the irradiated group than in the control group, but might increase with the increase of the injected dose of ascorbic acid.

By reverse transcription-polymerase chain reaction (RT-PCR), an open reading frame of pathogenesis-related protein 1 (PR1) was isolated from Panax notoginseng and named as PnPR1. Molecular and bioinformatic analyses of PnPR1 revealed that an open reading frame of 501 bp was predicted to encode a 166-amino acid protein with a deduced molecular mass of 18.1 kD. Homology analysis showed that the deduced amino acid sequence of PR1 protein of Panax notoginseng had a high similarity with other higher plants had the same conservative structure domain of cysteine-rich secretory protein (CAP). The recombinant expressed plasmid pET28a(+)-PnPR1 was expressed in Escherichia coli BL21. The expression conditions were optimized by induction at different times, different temperatures, different IPTG concentrations and different giving times. The optimum expression condition was 0.4 mmol.L-1 IPTG at 28 degrees C for 20 h. The successful expression of PnPR1 provides some basis for protein purification and preparation of the monoclonal antibody.
Amino Acid Sequence ; Cloning, Molecular ; Escherichia coli ; metabolism ; Molecular Weight ; Open Reading Frames ; genetics ; Panax notoginseng ; chemistry ; Phylogeny ; Plant Proteins ; genetics ; metabolism ; Plants, Medicinal ; chemistry ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Alignment

Objective To evaluate the diagnostic value of MRI in brachial plexus injury.Methods Total 98 patients with brachial plexus injury were examined by MRI before operation.Fifty-four of 98 patients MR imaging were obtained by 0.5 Tesla scanner and other 44 patients were obtained by 1.5 Tesla scanner.The scanning sequences include: SE T_1WI,T_2WI,FFE T_2WI and T_2WI SPIR. Exploration of the supraclavicular plexus was carried out and the MR imaging were compared with the operative finding in 63 patients.Thirty-five patients who had not surgery were followed-up.Results MR imaging found pre-ganglionic injuries in 45 patients and post-ganglionic injuries in 56 patients.Pre-and post-ganglionic injuries simultaneously in 16 patients among them.MR imaging can not find injury sings in 13 patients.The positive rate was 86.73%.MR imaging finding of pre-ganglionic injuries include:(1) Spinal cord edema and hemorrhage,2 patients (4.44% ).(2)Displacement of spinal cord,17 patients (37.78%).(3)Traumatic meningoceles,37 patients (82.22%).(4)Absence of roots in spinal canal, 25 patients(55.56% ).(5)Scarring in the spinal cnanl,24 patients (53.33%).(6)Denervation of erector spine,13 patients (28.89%).MR imaging finding of post-ganglionic injuries include:(1)Trunk thickening with hypointensities in T_2WI,23 patients (41.07%).(2)Nerve trunk complete loss of continuity with disappeared of nerve structure,16 patients (28.57%).(3)Continuity of nerve trunk was well with disappearance of nerve structure,14 patients(25.00%).(4)Traumatic neurofibroma,3 patients (5.36%).Conclusion MR imaging can reveal Pre-and post-ganglionic injuries of brachial plexus simultaneously.MR imaging is able to determine the location (pre-or post-ganglionic)and extent of brachial plexus injury,provided important information for treatment method selection.

Objective To improve recognition and imaging diagnosis of aneurysmal bone cyst secondary to a giant cell tumor.Methods To collect the dates of 12 patients with aneurysmal bone cyst secondary to a giant cell tumor were proved by operation and pathology from January 2003 to October 2006. Analyzed and summarized their imaging manifestations and correlation with pathohistology.Results Six lesions were located in epiphysis and metaphysic regions of long bone.Six lesions were located in pelvis.All cases showed a cystic lesion with expanded and osteolytic,eccentric 10 cases and centric 2 cases.Four cases display trabeculate,the margin is well define with a rim of bone sclerosis in 2 cases.Magnetic resonance imaging(MRI)scans were available in 10 patients.All case showed cystic,dilated lesions with solid areas. Eight cases manifested single or multitude solid nodules in big cystic wall.Two cases appeared solid masses with multitude cysts.The sign of multitude fluid-fluid level,best seen on T_2-weighted images,was present in all patients.Seven cases emerged soft-tissue masses.MR found indicative of large amounts of hemosiderin in one cases.Eight cases were examined by spiral CT with plain scanning and enhancement scanning. Reconstructed image were CTA and 3D-MPR(three dimensions multiplanar reconstruction)imaging.All cases showed cystic,dilated lesions with solid areas.The sign of multitude fluid-fluid level was present in 6 patients.The solid areas and cystic-wall of lesions showed contrast enhancement in 8 patients.3D-MPR imaging showed supply blood vessel of tumors in 3 cases.Arteriovenous malformation did not found in all patients.The surgeons'operative findings and the gross specimens were studied in all patients.All lesions were composed of solid areas and cystic areas.The diagnosis of pathology were ABC with GCT(grade Ⅱ)in 10 cases and ABC with GCT(grade Ⅲ).Conclusion Aneurysmai bone cyst secondary to a giant cell tumor is not rare.Adequately recognizing the pathologic basis of ABC,and selecting imaging techniques correctly (X-ray and MRI,or X-ray and CT)is especially important to diagnose a giant-cell tumor with secondary aneurysmai bone cyst.When an eccentric,expanded,lytic tumor with a cystic-solid lesion in epiphysis of long bone or pelvis shows multiple fluid levels,a giant-cell tumor with secondary aneurysmai bone cyst components should be sufficiently considered.

WRKY transcription factor is one of the Zinc finger proteins which contains a highly conserved WRKY domain and is a family of the plant-specific transcription factor. The plasmid pET28a-SmWRKY1 harboring Salvia miltiorrhiza WRKY1 (SmWRKY1) gene was successfully transformed and expressed in Escherichia coli BL21 (DE3). The conditions on protein expression of SmWRKY1 in E. coli, including induction duration, temperature, IPTG concentration and the E. coli concentration were optimized. The results showed that the highest protein expression of SmWRKY1 was obtained at 24 hours after the E. coli was cultured in the presence of 0.2 mol x L(-1) IPTG at 20 degrees C with A600 values of 1.0-1.5. This recombinant histidine-tagged protein was expressed at 2.454 g x L(-1) as inclusion body, which was first extracted using urea, and then purified by Ni2+ affinity chromatography and identified by SDS-PAGE. The expression of SmWRKY1 in E. coli was further confirmed by western blotting analysis.
Blotting, Western ; Cloning, Molecular ; DNA-Binding Proteins ; chemistry ; genetics ; isolation & purification ; metabolism ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; chemistry ; genetics ; metabolism ; Molecular Weight ; Plant Proteins ; chemistry ; genetics ; isolation & purification ; metabolism ; Recombinant Proteins ; chemistry ; genetics ; isolation & purification ; metabolism ; Salvia miltiorrhiza ; genetics

OBJECTIVESTo investigate the influence of combined thoracoscopic and laparoscopic esophagectomy for early postoperative pulmonary function, and to study the relative factors for postoperative pulmonary complications.

METHODSFrom September 2009 to December 2010, 61 patients with esophageal cancer had undergone esophagectomy surgery, of which 32 patients had undergone combined thoracoscopic and laparoscopic esophagectomy (CTLE group), and 29 patients had undergone open three-field esophagectomy (open group). Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) were measured on the 1(th) preoperative day, 5(th) and 10(th) postoperative day, and arterial blood gas analyses were performed during the same period. Meanwhile, pain scores and other potentially relevant factors were recorded as well.

RESULTSPreoperative pulmonary function and arterial blood gas analysis, including FEV(1)%, FVC%, PaO2 in two groups had no significant difference (t = -1.608 to 0.709, P = 0.113 to 0.481). On the 10(th) postoperative day, FEV(1)%, FVC%, PaO2, and SaO2 of two groups were significantly different (FEV(1)%: 77% ± 17% vs. 53% ± 13%, t = 6.241, P = 0.000; FVC%: 78% ± 13% vs. 57% ± 16%, t = 5.549, P = 0.000; PaO2: (87 ± 9) mmHg vs. (79 ± 14) mmHg, t = 2.477, P = 0.017; SaO2: 96% ± 3% vs. 94% ± 2%, t = 2.313, P = 0.024; 1 mmHg = 0.133 kPa). Pain score of CTLE group was lower than open group, and the scores of two groups had significant difference before the 5(th) day after surgery (t = -4.398 to -1.815, P = 0.000 to 0.049). Postoperative pulmonary complications of CTLE group was lower than open group (6/32 vs. 12/29, χ(2) = 3.745, P = 0.049).

CONCLUSIONSCombined thoracoscopic and laparoscopic esophagectomy has advantages on early postoperative pulmonary function. It can relatively reduce the incidence of pulmonary complications after surgery.

Aged ; Esophageal Neoplasms ; physiopathology ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Laparoscopy ; Lung ; physiopathology ; Male ; Middle Aged ; Postoperative Complications ; Postoperative Period ; Respiratory Function Tests ; Thoracoscopy

A new and a known anthraquinone glycosides were isolated from the ethanol extract of the roots of Rheum officinale Baill. The extract was purified by various chromatographies, such as silica gel, Sephadex LH-20, RP-C18 column chromatography and HPLC. Two compounds were identified by the spectroscopic techniques of NMR, MS, and chemical method. In addition, they were tested for their cytotoxic effects against HepG2 cell. Unfortunately, they showed no or weak activity.
Anthraquinones ; chemistry ; isolation & purification ; pharmacology ; Glycosides ; chemistry ; isolation & purification ; pharmacology ; Hep G2 Cells ; Humans ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rheum ; chemistry

OBJECTIVETo evaluate the feasibility and efficacy of a new MRI imaging method--diffusion weighted imaging (DWI) with short TI version recovery-echo planar imaging (STIR-EPI) sequence in differentiating benign cervical lymph nodes from malignant ones. METHODS Twenty nasopharyngeal carcinoma patients and fourteen volunteers received both conventional MRI and DWI with STIR-EPI. Ability of detecting lymph nodes between conventional MRI and STIR-EPI-DWI was compared, and the difference of apparent diffusion coefficient (ADC) value between metastatic lymph node and normal lymph node was analyzed.

RESULTSDWI was more sensitive in detecting lymph node than conventional MRI. ADC value of metastatic lymph node (0. 766 +/- 0. 119) x 10 (-3) mm(2)/s was significantly lower than that of normal lymph node (0. 975 +/- 0. 179) x 10 - mm2/s (P < 0. 01).

CONCLUSIONAs a new MRI imaging technique in detecting cervical lymph nodes, diffusion weighted imaging ( DWI) with short TI version recovery-echo planar imaging ( STIR-EPI) sequence is more reliable and sensitive than conventional MRI imaging, providing an alternative way to differentiate benign lymph nodes from malignant ones.

Adult ; Aged ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Echo-Planar Imaging ; methods ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; Neck ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVETo observe the efficacy and safety of PEG-interferon alpha-2a (PEG-IFNalpha-2a) treatment on lamivudine (LAM)-resistant chronic hepatitis B (CHB) patients.

METHODSEighty-one patients with lamivudine-resistant HBeAg (+) chronic hepatitis B patients were enrolled and divided into PEG-IFNalpha-2a treatment group (40 cases) and adefovir dipivoxil (ADV) control group (41 cases). Two groups were combined with LAM in the first 12 weeks(w). The ALT normalization rate, the HBV DNA and HBeAg negative rate, and the HBeAg seroconversion rate were observed in 12 W, 24 W, 48 W.

RESULTSThe ALT normalization rate in 12 W, 24 W of PEG-IFNalpha-2a group was 62.5% and 80.0%. And it was higher than that of ADV group. The HBeAg negative rate and HBeAg seroconversion rate in 48 W of PEG-IFNalpha-2a group were 60% and 57.5% , which were higher than that of ADV group. The difference was statistically significant (P < 0.05).

CONCLUSIONPEG-IFNalpha-2a treatment of lamivudine-resistant HBeAg (+) chronic hepatitis B is superior to ADV, and its security is well.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; analysis ; drug effects ; Drug Resistance, Viral ; drug effects ; genetics ; Female ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Interferons ; immunology ; pharmacology ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Mutation ; Organophosphonates ; therapeutic use ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; Treatment Outcome ; Watchful Waiting