Objective To investigate the changes in cerebral oxygen metabolism during liver transplantation in patients with liver cirrhoses.Methods Sixteen ASAⅢorⅣpatients with liver cirrhoses(14 male,2 female)aged 25-67 yrs,weighing 45-80 kg undergoing liver transplantation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Swan-Ganz catheter was placed in pulmonary artery (PA)via right internal jugular vein(IJV)for cardiac output(CO)monitoring and sampling mixed venous blood. Left IJV was cannulated and the catheter was advanced cephalad until jugular bulb for blood sampling.Anesthesia was induced with midazolam,fentanyl,propefol and vecuronium and maintained with isoflurane inhalation and intermittentⅣboluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.PaCO_2 was maintained between 30-45 mm Hg.Blood samples were taken from radial artery,pulmonary artery and jugular bulb simultaneously for blood gas analysis before operation(T_0,baseline),10 min before anhepatic phase(T_1)20 min after onset of anhepatic phase(T_2),30 min after graft reperfusion(T_3)and at the end of operation(T_4).Oxygen delivery(DO_2),oxygen consumption(VO_2),oxygen content of jugular bulb blood (CjvO_2),cerebral arterial-venous oxygen content differences(Ca-jvO_2)cerebral oxygen extraction ratio(CERO_2) and CBF/CMRO_2 were calculated.Results The mean duration of operation was(364?51)min and the mean intraoperative blood loss was(1340?430)ml.CO was significantly increased before anhepatic phase(T_1), during neohepatic phase(T_3)and at the end of operation(T_4)but decreased during anhepatc phase(T_2)as compared with the baseline value at T_0.Hb,CaO_2,Ca-jvO_2 and CERO_2 were all decreased while SjvO_2 and CBF/ CMRO_2 were increased during operation;DO_2,VO_2 and CjvO_2 were decreased during anhepatic phase;DO_2 was increased during other phases;VO_2 was increased at the end of operation as compared with the baseline(T_0)(P＜0.05 or 0.01).Conclusion There is no cerebral oxygen deficiency during liver transplantation in patients with liver cirrhoses.

Objective: To revise Frost's Multidimensional Perfectionism Scale (FMPS) within a sample of Chinese college students based on clinical knowledge and Hewitt & Flett's perfectionism questionnaire.Methods:Three hundred and fifty college students responded to the inventory with additional 15 items to the FMPS. Exploratory factor analysis was applied to the data. Results: The revised Perfectionism Scale consisted of 50 items, four subscales (Concerns with Mistakes and Doubts, Personal Standards, Organization, Parents' Expectation and Control). Factor analysis indicated that, the four factors explain 42.31% of the variance with loading between 0.37~0.79. The five subscales had internal consistencies with split-half reliabilities 0.73~0.88, Cronbach's alphas 0.80~ 0.91, and test-retest reliabilities of 0.68~0.80 (P

Objective:To investigate the relationship between college students' perfectionism and their mental health,and parental rearing styles.Methods:The present study was a cross-sectional design.Three hundred and thirty seven Chinese college students(152 males and 185 females;aged 16～24) were recruited through cluster sampling.Participants were from three major universities,and responded to the revised Perfectionism Scale for Chinese College Students,Egna Minnen av Barndoms Uppfostran(EMBU),and SCL-90.Results:The group with high score in perfectionism also got higher scores in their perception of fathers' over-protection,over-intervention,and refusal/denial than the low score group [(2.4?0.5) vs.(2.0?0.4),(2.2?0.4) vs.(2.0?0.3),(1.5?0.5) vs.(1.4?0.5);P

Dextroscope workstation is an advanced equipment developed in recent years and isused to make virtual reality model.We not only used it in surgical planning of thyroid disease,but also applied it in clinic teaching.Application of Dextroscope virtual reality system can help to improve students'capabilities of clinical thoughts and clinical techniques,stimulate their learning interest,enlarge the knowledge,shorten learning curve and release the conflict in practice.Dextroscope system will push forward the progress of education reform,so it is worth spreading.

Objective To investigate the changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension(PPH)during liver transplantation.Methods Eight patients with liver cirrhosis and PPH(5 male,3 female)aged 50-63 yr weighing 45-80 kg were included in PPH group. Another 8 liver-cirrhotic patients without PPH served as control group.The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg.Anesthesia was induced with midazolam 3-5 mg,fentanyl 0.15-0.2 mg,propefol 1 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 0.5%-3% isoflurane inhalation and intermittent Ⅳ boluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.P_(ET)CO_2 was maintained at 30-45 mm Hg.Right subclavian vein was cannulated for fluid and drug administration and blood transfusion.Radial artery was cannulated for BP monitoring.Swan-Ganz catheter was placed via right internal jugular vein.BP,CVP,MPAP,PAWP,CI,PVRI and SVRI were monitored and recorded before operation(baseline),during preanhepatic phase,at 3 and 30 min of anhepatic phase and 3,7, 15,60 min of neohepatic phase and at the end of operation.Results(1)The two groups were comparable with respect to fluid balance,the amount of vasoactive drugs used during anhepatic and neohepatic phase,duration of anhepatic phase and operation.(2)MPAP and PVRI were significantly higher before operation in PPH group than in control group.(3)CI,MPAP, PAWP and CVP were siguificanfly decreased during anhepatic phase as compared to the baseline values(before operation)in both groups and then gradually returned to and even exceeded the baseline values during neohepatic phase.(4)During neohepatic phase PVRI in PPH group was significantly increased as compared to the baseline value and was significantly higher than that in control group.Conclusion MPAP and PVRI are significantly increased during neohepatic phase in patients with PPH and need to be treated.

OBJECTIVETo explore the operative skills and effect of unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation in treating degenerative low lumbar disease.

METHODSFrom January 2009 to December 2011,22 patients with degenerative low lumbar disease were treated with transforaminal lumbar interbody fusion, during the operations, unilateral pedicle screw and contralateral percutaneous transfacet screw fixation were performed. There were 16 males and 6 females, aged from 32 to 71 years old with an average of (51.1 ± 10.6) years, including single segment in 20 cases and two segments in 2 cases. Clinical effects were evaluated according to visual analogue score (VAS) and Oswestry Disability Index (ODI).

RESULTSAll patients were followed up from 1 to 2.5 years with an average of 18 months. One case complicated with leakage of cerebrospinal fluid after operation and 1 case with lower limb pain of decompression-side on the 3rd day after operation. Twenty-two patients got bony fusion. There were no instability and evidence of instrument failure during follow-up. The VAS and ODI score decreased from preoperative 8.24 ± 0.72, 36.72 ± 6.84 respectively to 3.18 ± 0.66, 4.36 ± 1.12 at the final follow-up (P < 0.05).

CONCLUSIONUnilateral pedicle screw combined with contralateral percutaneous transfacet screw fixation is safe and feasible surgical technique in treating low lumbar degenerative disease. It has advantages of little trauma, rigid fixation, high fusion rate, and less complication. etc.

Adult ; Aged ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fusion ; methods

Aged ; Aged, 80 and over ; China ; epidemiology ; Dengue ; epidemiology ; Female ; Humans ; Male ; Middle Aged

Objective To investigate the 5-and 10-year survival and complications of patients with stage Ⅱb cervical carcinoma treated by pre-operative photon radiotherapy (POPRT) plus brachytherapy (192Ir) and selective lymphadenectomy hysterectomy (SLH) plus intra-operative electron radiotherapy (IOERT). Methods From February 1997 to May 2007, 160 patients with stage Ⅱb cervical carcinoma were treated by POPRT of 20 Gy in 10 fractions to the whole pelvis, 192Ir brachytherapy of 14 Gy in 2fractions, followed by IOERT of 18 -20 Gy to the whole pelvis during SLH one week after. Results The follow-up rate was 98.1%. The number of patients followed-up for 5 and 10 years was 143 and 135,respectively. The 5-year overall survival rate, disease-free survival rate and local control rate of all patients were 89.4%, 86. 3% and 96. 3%, with the corresponding 10-year rates of 84.4%, 81.0% and 95.0%,respectively. The radiation-induced rectitis and cystitis were 5.0% and 0. 6%, respectivly. The rate of hydronephrosis and lower extremity edema was 6. 3% and 1.3%, respectively. Conclusions Combination of EBRT plus 192Ir brachytherapy and SLH plus IOERT could improve the survival and local control of patiens with cervical carcinoma, with only a few side effects.

Objective To characterize the molecular characteristics of hemagglutinin (HA) and neuraminidase (NA) of influenza B viruses isolated in Jiangsu province,2011.Methods Thirteen strains of influenza B virus in different areas and epidemic period in Jiangsu province,2011 were selected for whole-genome sequencing,and analysis of molecule epidemic characteristics for HA and NA was carried out by bioinformatics method.Results Of the 13 randomly selected influeuza B strains,10 strains were assorted to Victoria lineage strains with NA genes from Yamagata lineage,and 3 strains belong to Yamagata lineage.Compared nucleotide and amino acid sequences of HA and NA genes with their vaccine strains respectiuely,196/197 glycosylation site appeared on HA1 gene in Yamagata/Victoria isolates virus.Conclusion Both B/Victoria and B/Yamagata lineage viruses co-circulated in Jiangsu province,and reassortant virus of Victoria lineage were predominant virus.

Objective:To analyze the activities of human NKG2D ligand MICA/B promoter induced by 5-Fu.Methods:The 5'-end flanking regions of MICA /B promoter and their different truncated fragments were amplified from A549 genome by PCR. The resulting amplicons were cloned into pGL3-Basic vector to generate the MICA/B luciferase reporter plasmids. All the constructs were transiently transfected A549 cells. The promoter region activities were determined by dual-luciferase reporter assays. The effect of 5-Fu on the promoter activities of MICA/B was also tested.Results and Conclusion:The 5'-end flanking regions of MICA /B promoter and five of their different truncated fragments were successfully obtained. The normalized luciferase reporter gene activities driven by the above promoters and fragments were 3.61,2.26,1.63,0.313,0.711 and 0.663 for MICA and 17.49,10.11,7.398,0.822,0.997 and 0.49 for MICB,respectively. Promoter activities in transiently transfected A549 cells treated by 20,40,80,160 and 320 μg/m of 5-Fu increased 1.69,1.48,1.62,1.55 and 1.78 fold for MICA and 1.44,1.87,1.38,1.19 and 1.25 fold for MICB. Our results suggest that 5-FU can significantly up-regulate the promoter activity of both MICA and MICB.