Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.

Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.

Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.

Sleep status is an important indicator to evaluate the health status of human beings. In this paper, we proposed a novel type of unperturbed sleep monitoring system under pillow to identify the pattern change of heart rate variability (HRV) through obtained RR interval signal, and to calculate the corresponding sleep stages combined with hidden Markov model (HMM) under the no-perception condition. In order to solve the existing problems of sleep staging based on HMM, ensemble empirical mode decomposition (EEMD) was proposed to eliminate the error caused by the individual differences in HRV and then to calculate the corresponding sleep stages. Ten normal subjects of different age and gender without sleep disorders were selected from Guangzhou Institute of Respirator Diseases for heart rate monitoring. Comparing sleep stage results based on HMM to that of polysomnography (PSG), the experimental results validate that the proposed noninvasive monitoring system can capture the sleep stages S1-S4 with an accuracy more than 60%, and performs superior to that of the existing sleep staging scheme based on HMM.

Objective To observe the influence of Shenmai injection for the postoperative infection and related serum indexes of patients with breast cancer,in order to provide evidence for the prevention of patients'postoperative infection.Methods 90 patients with breast cancerwere selected as the study object,and all the patients were randomly divided into control group(conventional postoperative treatment group)45 cases and observation group (conventional treatment and Shenmai injection group)45 cases,then the postoperative infection rates,inflammatory indexes and immune indexes before the treatment and after the treatment at different time were compared .Results The total postoperative infection rate of observation group was one case (2.22%),and it had no obviously difference compared with four cases (8.89%) of control group,the inflammatory indexes including PCT, TNF-α, IL-6 and hs-CRP at first,third and seventh day after the treatment were all lower than those of control group ,the immune indexes including CD3 +、CD4 +、CD8 +及 CD3 +CD4 +were all better than those of control group ( all P<0.05 ) .Conclusion The Shenmai injection can effectively control the postoperative infection rate of patients with breast cancer,and it also plays active improvement role for the infection related indexes.

BACKGROUND: Focal cerebral ischemia model in rats should be established under drugged state by surgery operation, but anaesthetic drug may influence the outcome of focal cerebral ischemia.OBJECTIVE: To observe the effects of ketamine anesthesia on the pathological outcome of focal cerebral ischemia model in rats, and perform control with pentobarbital.DESIGN: Randomized controlled animal experiment.SETTING: Center of Experimental Animal and Department of Pathology of Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University.MATERIALS: The experiment was performed in the Center of Experimental Animal and Department of Pathology of Second Affiliated Hospital,School of Medicine, Xi'an Jiaotong University from May 2004 to March 2005. Thirty male SD rats were randomly assigned into pentobarbital group and ketamine group with 15 rats in each group.METHODS: The rats in the pentobarbital group and ketamine group were subjected to 40 mg/kg pentobarbital and 60 mg/kg ketamine by abdominal anaesthesia, respectively. The permanent middle cerebral artery occlusion (MCAO) was performed in rats by thread embolism in cavity in order to induce cerebral ischemia after abolition of righting reflex.MAIN OUTCOME MEASURES: ①A modified Bederson's scoring system was adopted to determine the neurological functional deficit at hour 4 after the MCAO. ②Five rats from each group were selected at hour 24 after MCAO. They were killed and their brain was stained with 20 g/L 2,-3,-5-triphenyltetrazolium hydrochloride (TTC). The infarct volume was determined. ③ MCAO was performed for 72 hours and mortality rate of two groups were recorded. Four rats in each group were re-anesthetized. They were killed and their brain was gained. Survival neurons were detected with toluidine blue staining.RESULTS: Totally 30 rats were involved in the result analysis. ①There was no significant difference in neurological score 4 hours after MCAO between pentobarbital group and ketamine group (1.46±0.98,1.38±0.68 ,P＞0.05). ②The infarct volume in the ketamine group was less than that in the pentobarbital group at hour 24 after MCAO [(28.1±4.11)%,37.8±4.95]%, P＜0.05]. ③The mortality rate 72 hours after ischemia was not significantly different between pentobarbital group and ketamine group (42% vs 33%,P＞0.05). But neuron density in penumbra in the ketamine group was higher than that in the pentobarbital group [(836±15),(740±24) numbers/mm2, P＜0.05].CONCLUSION: ①The ketamine anesthesia induces minor brain injury in setting of the focal cerebral ischemia model in rats. ②When neuroprotective effects of procedures or drugs being studied are evaluated in this focal cerebral ischemia model, they might provide no additional advantage to cerebral ischemia.

Objective To evaluate the value of electronic video endoscopy for adults in upper gastrointestinal disease in children. Methods Results of video endoscopy for adults performed on 128 children with abdominal pain, upper gastrointestinal hemorrhage, accidental foreign bodies, and esophageal stenosis were analyzed retrospectively. Results The total positive detection rate was 100%. The incidence rates of chronic superficial gastritis and/or duodenitis, peptic ulcer, and foreign bodies were 64.84%, 25.78%, and 8.59%, respectively. Only 1 case of esophageal stenosis was found. Conclusion Video endoscopy for adults, also safe for children, is of significant value in the etiological diagnosis of upper gastrointestinal disease in children.

0.05). The costs of Group A, B and C were 20.0 yuan, 39.3 yuan and 46.0 yuan, respectively(P