Objective: To study the influence of recombinant human erythropoietin (rhEPO) preconditioning on the liver function and expression of nuclear factor-κB (NF-κB) during early stage following liver transplantation, and to investigate the possible mechanism of rhEPO preconditioning on ischemia-reperfusion injury after liver transplantation. Methods: Twenty-six patients with advanced hepatic cirrhosis were randomly divided into two groups(n= 13) : the rhEPo pre-treatment group received subcutaneous injection of rhEPO 100 U/kg at 1, 3 and 5 d before liver transplantation, and the control group received 2 ml normal saline in the same manner. The peripheral blood samples were harvested at 1, 2, 4 and 6 h after blood supply recovery in the donator liver to examine the hepatic functions. The NF-κB p65 expression in the peripheral blood samples were examined by Western blotting analysis, the TNF-α level in the blood was detected by ABC enzyme linked immunosorbent assay. Serum ALT and AST were also determined. Results: The liver function indices and the levels of serum NF-κB p65, TNF-α in the rhEPO pretreatment group were significantly lower than those in the control group (P<0.05). Conclusion: Pre-treatment with rhEPO can inhibit hepatic inflammation early after liver transplantation, protecting hepatic function and reducing ischemia-reperfusion injury after liver transplantation.

Objective To deter mine the effect-site concentration of sufentanil blunting responses to tracheal intubation with video laryngoscope during propofol target controlled infusion (TCI). Methods Twenty-three patients undergoing selective surgery under general anesthesia were enrolled in this study. Induction of anesthesia was initiated by TCI sufentanil at the target effect-site concentration 3 min later , TCI of propofol began at the target plasma concentration of 3 μg/mL. Cisatracurium 0.15 mg/kg was ad ministrated for video laryngoscope tracheal intubation after loss of consciousness. The target concentration of sufentanil for consecutive patients was deter mined using the modified Dixon′s up-and-down method by the intubation response of the previous patient , in an increment or decrement of 0.05 ng/mL. The initial concentration was set at 0.4 ng/mL. Results The EC50 of Sufentanil was 0.32 ng/mL with 95%confidence interval of 0.29~0.35 ng/mL; the EC95 was 0.38 ng/mL with 95%confidence interval 0.35-0.55 ng/mL during video laryngoscope tracheal intubation. Conclusion The EC50 and EC95of sufentanil blunting responses to tracheal intubation with video laryngoscope are 0.32 ng/mL and 0.38 ng/mL during propofol TCI.

Carcinoma, Papillary ; classification ; pathology ; surgery ; Humans ; Neoplasm Recurrence, Local ; Urinary Bladder Neoplasms ; classification ; pathology ; surgery ; Urothelium ; pathology ; surgery ; World Health Organization

Objective To explore the correlation of patient-controlled sedation of dexmedetomidine and Narcotrend values. Methods Forty patients with lower limb surgery were enrolled. Until CSEA block fixed , the electronic pump ran the patient-controlled sedation of dexmedetomidine. The parameter of electronic pump was set as follows: load dose 2 mL + background dose 1.5 mL/h + single dose 0.5 mL + locktime 20 s. The heart rate , mean arterial pressure, pressing times, effective times, OAA/S sedation scores and NI values were determined. Results At T4 point, the patients reached appropriate sedation. At T4 ~ T9 OAA/S scores kept 3 to 4. From T5 point, NI values showed significant decrease. After the T7 point. OAA/S scores and NI values reached the plateau time of (7.5 ± 1.8) min and (13.1 ± 3.4) min, OAA/S scores of 1, 2, 3, 4, respectively, corresponding roughly with NI values 95 to 100, 90 to 94, 65 to 89, 40 to 64. The correlation coefficient was 0.58. The time of NI values significant decreased in the younger group and in the elderly group, with (10.2 ± 1.6) min and (14.4 ± 2.2) min. In T5~ T9 point, NI values of the younger group were significantly lower than those in the elderly group. Conclusion Relevant relationships are observed between dexmedetomidine patient-controlled sedation depth and the narcotrend values under CSEA.

Adenoma, Oxyphilic ; classification ; pathology ; Carcinoma, Renal Cell ; classification ; metabolism ; pathology ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; classification ; genetics ; pathology ; therapy ; Molecular Biology ; methods ; trends

OBJECTIVE:To study the accuracy of infusion of Midazoloam with plasma concentration as target. METHODS:The parameters of Midazoloam obtained from our researches were inputted into target-controlled infusion(TCI) system with C language. The clinical anesthesia of 12 patients undergoing selective operations was completed with plasma concentration as target-controlled infusion. Predicted value of plasma concentration of Midazoloam was compared with measured value. Parameters of Midazoloam sample were calculated such as performance error(PE),absolute performance error(absPE),median performance error(MDPE),median absolute performance error(MDAPE),constancy error(CE),absolute constancy error(absCE),median constancy error(MDCE) and median absolute constancy error(MDACE). RESULTS:PE,absPE,MDPE and MDAPE of plasma concentration were -2.57%,14.16%,-3.28% and 15.34%,respectively. CE,absCE,MDCE and MDACE were 0.06%,1.42%,0.03% and 1.21%,respectively. The measured values were in indirect relationship with predicated values(r=0.986,P

Objective To investigate the expression of 5-LOX in pancreatic cancer tissue and the relationship between 5-LOX expression and expression of VEGF.Methods The expression of 5-LOXmRNA,(VEGFmRNA) in 35 pancreatic cancer fresh tissue samples were detected by semi-quantitive reverse(transcriptase)-polymerase chain reaction method.Results Expression of 5-LOXmRNA,VEGFmRNA in(pancreatic) cancer tissue were 74.3%,60% respectively,and the expression was correlated to the with(clinical) stages of the tumor;also expression of VEGFmRNA was correlated to the differentiation of the tumor.Expression of 5-LOXmRNA and VEGFmRNA were synergetic in pancreatic cancer(P

Objective To improve the clinic,CT and pathologic knowledge of pleomorphic hyanilizing angiectatic tumor of soft parts(PHAT).Methods Clinical,CT and pathologic characters of PHAT in one case at the right nuchal region were detailedly analysed with literature review.Results The clinical symptoms of PHAT were slight and unspecified.The lesion appeared as a orbicular-ovate tumour with sublobe and clear edge,the density of tumor was uneven on plain scan and uneven enhanced after injected contrast agent,and a part of the tumour was enhanced close to the CT value of blood vessel.The characters of pathology were the presence of clusters of dilated thin-walled vessels,with prominent hyalinization of vessel wall,perivascular and intercellular hyalinization,and pantomorphia neoplastic cell distributed between these dilated vessels.Conclusion PHAT is a low potential malignant soft tissue tumor,it has some specific CT and pathologic characters.

Objective To evaluate the efficacy of closed-loop coadministration of propofol and remifentanil guided by Narcotrend index (NI) in laparoscopic cholecystectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 20-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective laparoscopic cholecystectomy,were randomized into 2 groups (n =30 each):program regulation group (group P) and artificial regulation group (group A).After the initial target effect-site concentration of propofol was selected,the target effect-site concentration of remifentanil was determined according to the formula.In group A,the target effect-site concentrations of propofol (2-4 μg/ml) and remifentanil (3-4 ng/ml) were adjusted artificially according to anesthesiologists' experience every 5 min to maintain NI value at 26-46.Induction time,anesthesia induction and mean maintenance doses and the initial,highest and lowest target concentrations of propofol and remifentanil,mean NI value,percentage of time with NI between 26 and 46,emergence time,and development of fluctuation in heart rate or mean arterial pressure ＞ 20％ of the baseline value and intraoperative awareness were recorded.Results No intraoperative awareness was found in the two groups.Compared with group A,the induction time was significantly shortened,the induction dose and initial target concentration of remifentanil were increased,the mean maintenance dose and lowest target concentration of propofol and remifentanil were decreased,the percentage of time with NI between 26 and 46 was increased,and the emergence time was shortened (P＜0.05 or 0.01),and no significant change was found in the induction dose and initial target concentration of propofol,the highest target concentrations of propofol and remifentanil,mean NI value,or incidence of fluctuation in heart rate or mean arterial pressure ＞ 20％ of the baseline value in group P (P＞ 0.05).Conclusion For laparoscopic cholecystectomy,NI-guided closed-loop coadministration of propofol and remifentanil produces safe and effective anesthesia,and the efficacy of precise administration is superior to that of artificially regulated target-controlled infusion.

Objective:To investigate the expression of TIP30 and its relationship with clinico-pathological characteristics in patients with extrahepatic cholangiocarcinoma (ECC).Methods:The expression of TIP30 in 78 cases of ECC tissues and 78 cases of para-cancerous tissues were detected by immunohistochemistry.Results:The positive expression rate of TIP30 was 43.59％ and 75.64％ in ECC tissues and para-cancerous tissues,respectively.Differences were statistically significant (P＜ 0.05).The expression levels of TIP30 were not correlated with age,gender,degree of differentiation and tumor size(P＞0.05),but correlated with lymph node metastasis,distant metastasis and TNM staging(P＜ 0.05).The median overall survival of 78 ECC cases was 14.8 months,and it of TIP30 positive expression cases was 20.3 months,statistically higher than 11.5 months in TIP30 negative expression cases(P＜ 0.01).Conclusion:The downregulation of TIP30 is closely correlated with the development,metastasis and prognosis of ECC.TIP30 may be used as a molecular marker to identify and predict the progression,metastasis and prognosis of ECC.