Glutathione S-transferase genetic polymorphisms and fluoride-induced reproductive toxicity in men with idiopathic infertility / 亚洲男科学杂志(英文版)

Male infertility caused by idiopathic oligoasthenospermia (OAT) is known as idiopathic male infertility. Glutathione S-transferase (GST) and fluoride may play important roles in idiopathic male infertility, but their effects are still unknown. Our study examined the relationship between GST polymorphisms and fluoride-induced toxicity in idiopathic male infertility and determined the underlying mechanism. Sperm, blood, and urine samples were collected from 560 males. Fluoride levels were measured by a highly selective electrode method, and GST genotypes were identified using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP). Semen parameters, DNA fragmentation index (DFI), mitochondrial membrane potential (MMP), and oxidative stress (OS) biomarkers were statistically assessed at the P < 0.05 level. Compared with healthy fertile group, semen parameters, fluoride levels, OS biomarkers, sex hormone levels, and MMP and DFI levels were lower in the idiopathic male infertility group. For glutathione S-transferase M1 (GSTM1[-]) and glutathione S-transferase T1 (GSTT1[-]) or glutathione S-transferase P1 (GSTP1) mutant genotypes, levels of semen fluoride, OS, MMP, and DFI were considerably higher, and the mean levels of sperm parameters and testosterone were statistically significant in GSTM1(+), GSTT1(+), and GSTP1 wild-type genotypes. Both semen and blood fluoride levels were associated with oxidative stress in idiopathic male infertility patients. Elevated fluoride in semen with the genotypes listed above was linked to reproductive quality in idiopathic male infertility patients. In conclusion, GST polymorphisms and fluorine may have an indicative relationship between reproductive quality and sex hormone levels, and OS participates in the development of idiopathic male infertility.

Effects of mild/asymptomatic COVID-19 on semen parameters and sex-related hormone levels in men: a systematic review and meta-analysis / 亚洲男科学杂志(英文版)

Coronavirus disease 2019 (COVID-19) has yet to be proven to alter male reproductive function, particularly in the majority of mild/asymptomatic patients. The purpose of this study was to explore whether mild/asymptomatic COVID-19 affects semen quality and sex-related hormone levels. To find suitable comparative studies, a systematic review and meta-analysis was done up to January 22, 2022, by using multiple databases (Web of Science, PubMed, and Embase). Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify and choose the studies. Meta-analysis was used to examine the semen parameters and sex-related hormones of mild/asymptomatic COVID-19 patients before and after infection. The effects of semen collection time, fever, and intensity of verification on semen following infection were also investigated. A total of 13 studies (n = 770) were included in the analysis, including three case-control studies, six pre-post studies, and four single-arm studies. A meta-analysis of five pre-post studies showed that after infection with COVID-19, sperm concentration (I2 = 0; P = 0.003), total sperm count (I2 = 46.3%; P = 0.043), progressive motility (I2 = 50.0%; P < 0.001), total sperm motility (I2 = 76.1%; P = 0.047), and normal sperm morphology (I2 = 0; P = 0.001) decreased. Simultaneously, a systematic review of 13 studies found a significant relationship between semen collection time after infection, inflammation severity, and semen parameter values, with fever having only bearing on semen concentration. Furthermore, there was no significant difference in sex-related hormone levels before and after infection in mild/asymptomatic patients. Mild/asymptomatic COVID-19 infection had a significant effect on semen quality in the short term. It is recommended to avoid initiating a pregnancy during this period of time.

Predicting the surgical reparability of large-to-massive rotator cuff tears by B-mode ultrasonography: a cross-sectional study

Purpose@#This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs). @*Methods@#This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively. @*Results@#Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found. @*Conclusion@#B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs.

Potential Mechanism of Houttuyniae Herba Against Prostate Cancer： A Review / 中国实验方剂学杂志

According to the 2020 world cancer data report， the prevalence of prostate cancer ranks second in male malignant tumors and the mortality fifth. In China， due to the poor living and eating habits， the prevalence of prostate cancer is still rising， and advanced prostate cancer can adapt to and tolerate androgen castration related drugs through a variety of mechanisms， which often indicates poor therapeutic outcomes in the late stage. Houttuyniae Herba， a medicinal plant of family Saururaceae， has been officially identified both as food and medicine by the National Health Commission. The existing studies have shown that Houttuyniae Herba inhibits the proliferation， migration， and invasion of prostate cancer and induces its apoptosis and cell cycle arrest via multiple targets， links， and pathways. These anti-tumor activities can also be observed in breast cancer， leukemia， gastric cancer， colorectal cancer， and other tumor cells. Such activities are mainly related to the inhibited expression of cyclin and cyclin-dependent kinase， regulation of apoptosis-related proteins， activation of apoptosis-related pathways， reduced secretion of matrix metalloproteinase， inhibition of activator of transcription 3 （STAT3）/Zinc finger protein （Snail） / transcription factor twist signaling pathway， and antagonization of growth factor receptor， androgen， inflammation， and oxidative stress in promoting the occurrence and development of prostate cancer. In addition， Houttuyniae Herba is able to alleviate diabetes， regulate blood glucose-lowering pathways， and boost immunity by inhibiting the protein kinase B （Akt）/mammalian target of rapamycin （mTOR） and mitogen-activated protein kinase （MAPK） signaling pathways， thus suppressing the occurrence and progression of prostatic cancer. In conclusion，Houttuyniae Herba can be used as a potential drug against prostate cancer.

Radiofrequency ablation of benign thyroid nodules: recommendations from the Asian Conference on Tumor Ablation Task Force

Radiofrequency ablation (RFA) is a thermal ablation technique widely used for the management of benign thyroid nodules. To date, five academic societies in various countries have reported clinical practice guidelines, opinion statements, or recommendations regarding the use of thyroid RFA. However, despite some similarities, there are also differences among the guidelines, and a consensus is required regarding safe and effective treatment in Asian countries. Therefore, a task force was organized by the guideline committee of the Asian Conference on Tumor Ablation with the goal of devising recommendations for the clinical use of thyroid RFA. The recommendations in this article are based on a comprehensive analysis of the current literature and the consensus opinion of the task force members.

Mental Disorders and Interferon Nontreatment in Hepatitis C Virus Infection-a Population Based Cohort Study

Objective@#This study investigates the association between mental disorders and interferon nontreatment in patients with chronic hepatitis C virus (HCV) infection in a large national sample. @*Methods@#Using the National Health Insurance Research Database of Taiwan, we conducted a nationwide population-based study. Each case was matched to five controls by age, sex, urbanization, and income. Conditional logistic regression was used to assess odds of HCV nontreatment in different mental disorders. @*Results@#From 1999 to 2013, we identified 92,970 subjects with HCV infection and 15,495 HCV cases (16.7%) had received IFN therapy. Other than chronic obstructive pulmonary disease, the medical diseases and mental disorders were significantly different between IFN and non-IFN treated HCV patients. After adjusting for medical diseases, depressive disorder and anxiety disorder was positively associated with receiving IFN therapy. Patients with schizophrenia, bipolar disorders and alcohol use disorders were significantly less likely to receive interferon. Antidepressant exposure (cumulative daily exposure or cumulative daily dose) was associated with lower odds of IFN treatment. @*Conclusion@#Our nationwide cohort study demonstrated that INF nontreatment rate was lower in certain mental disorders. Antidepressant exposure might lower the chance of receiving IFN treatment. Our results may help to identify and to overcome the obstacles for HCV treatment and further apply to DAAs regimen.

RE: 2017 Thyroid Radiofrequency Ablation Guideline: The Korean Society of Thyroid Radiology

No abstract available.

Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy.</p><p><b>METHODS</b>The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis.</p><p><b>RESULTS</b>The operative blood loss in the VATS group was significantly less than that in the open group ((62.14 ± 55.43) ml vs. (137.87 ± 165.25) ml, P < 0.05). The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase. Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases, 89 cases from the VATS group and 62 cases from the open group, with a mean follow-up period of 59.3 months, range from 12 to 117 months. Complete stable remission (CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P = 0.035) and non-thymomatous MG (P = 0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%.</p><p><b>CONCLUSIONS</b>Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.</p>

Periprosthetic femur fractures after hip replacement:a report of 13 cases / 中国基层医药

Objective To investigate the effective methods for the treatment of periprosthetic fracture after hip replacement.Methods The clinical data of 13 cases underwent the artificial total hip replacement (THR) with postoperative periprosthetic femur fractures were analyzed.Results The happening time was 12 days to 2 years after primary THR.According to Vancouver classification,there were 2 cases of type A,two cases of type B1,7 cases of type B3,and 2 cases of type C.The treatment included nonoperative treatment in 2 cases,3 cases received open reduction with memory alloy encircling fixer fixation,one case received wire binding with autologous iliac bone grafting,7 cases received revisions with modular revision implant combined with wire binding and autologous iliac bone grafting.The stem was loosened in one type B1 patient at 3 months after surgery.X-ray examination showed that the fractures were united and no infection occurred after operation in 12 patients.No migration or breaking of the instruments was observed.The average Harris hip score was 81 (70 ～ 86points).Conclusion The effective treatment method of periprosthetic fracture after THR should determined by Vancouver classification,degree of bone defect and economic situation of the patients.

Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF.</p><p><b>METHODS</b>Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version.</p><p><b>RESULTS</b>Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured.</p><p><b>CONCLUSION</b>Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.</p>

Review of management ways of rescue drugs / 中华医院管理杂志

A review of the drug supply for international rescue teams in their earthquake rescue in recent years. Based on the characteristics of drug supply assurance and requirements, experiences and setbacks were summarized in an effort to build practical rescue drug management ways. Such drug management ways, when built, will maximize rescue drug use efficiency.

The advancement of predictive diagnosis and molecular mechanism in multiple primary lung cancer / 癌症

Due to the advanced diagnostic technique and better understanding for multiple primary lung cancers (MPLC), the increasing incidence of MPLC has been reported. Very often, MPLC are misdiagnosed as metastasis because of lacking efficient molecular biomarkers for prediction and diagnosis. Studies on the molecular mechanism for tumorgenesis and progression of MPLC may therefore facilitate the discovery of biomarkers for disease diagnosis and prognosis, so that an individual and rational treatment can be achieved. We tried to further our understanding and improve the diagnostic skill for MPLC by reviewing the current status and the latest advancement of molecular markers related to MPLC.

Carbachol improve oxygen dynamic parameters during orally fluid resuscitation of a 50% TBSA full-thickness burn in dogs / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effect of carbachol(CAR) on oxygen dynamic parameters and hyperlactacidemia during oral fluid resuscitation of burn shock.</p><p><b>METHODS</b>Twelve male Beagle dogs were surgically prepared for cannulation of carotid and jugular vein, and enterostomy, 24 hours later they were subjected to a 50% (total body surface area, TBSA) full-thickness flame injury under a 10-15 minute anesthesia by IV injection of propofol. The dogs were randomized to gastric fluid infusion group (GI group)and gastric fluid infusion plus CAR group (GI + CAR). Either a glucose-electrolyte solution(GES) or GES containing CAR (20 microg/kg) were intragastricly given to animals in GI group or GI+ CAR groups. The delivery rate and volume of GES was in accordance with that of Parkland formula. Mean arterial pressure (MAP), intestinal mucosal blood flow (IMBF) and blood lactic acid were determined, and blood gas analysis evaluated for oxygen delivery (DO2), oxygen consumption (VO2) and oxygen uptake (O2ext) at 0, 2, 4, 8, 24, 48 and 72 hours after injury.</p><p><b>RESULTS</b>The levels of MAP and IMBF markedly reduced, and LAC obviously increased in both groups after burn. MAP returned to 0 h level at 72 h post burn, while IMBF, and LAC were still higher or lower than 0 h levels. The level of MAP of GI + CAR group was significantly higher than that of GI group at 2 h, and those showed no significant differences between two groups after then. Carbochol administration led to a markedly higher levels of IMBF, and significant lower levels of LAC from 8 h after burn compared with those of GI group (P < 0.05 or P < 0.01). The levels of DO2 VO2 and Oext were reduced markedly after burn in both groups. At 72 h after burn, DOQ returned to 0 h level; while VO2 and Oext though still much lower than 0 h levels. The level of DO2. VO2 and Oext of GI + CAR group were significantly higher than those of GI group from 8 h after burn (P < 0.05 or P < 0.01). Three of six animals died in GI+ CAR group, which was lower than two of six in GI group.</p><p><b>CONCLUSION</b>The results indicates that carbachol promotes intragastric fluid resuscitative effect of burn shock by increasing oxygen delivery and decreasing hyperlactacidemia.</p>

Efficacy of laryngeal mask airway Supreme in patients undergoing gynecological laparoscopic surgery / 中华麻醉学杂志

Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing gynecological laparoscopic surgery. Methods Eighty ASA Ⅰ or Ⅱ patients, aged 40-64 yr,weighing 50-70 kg, undergoing elective gynecological laparoscopic surgery, were randomized into 2 groups ( n = 40 each): LMA Supreme group (group S) and LMA ProSeal group (group P). Mallampati test was performed before operation in both groups. The patients were classified as Ⅰ or Ⅱ . LMA Supreme and LMA ProSeal were inserted in group S and P respectively after induction of anesthesia with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 3 μg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA. The number of attempt, success rate, LMA placement time, success rate of gastric tube placement, cuff volume, peak airway pressure, and airway seal pressure, BP, HR, ECG, SpO2, PET CO2 and complications were recorded. The duration of surgery and pneumoperitoneum, and emergence time were also recorded. The fiberoptic bronchoscope scores were assessed after successful LMA placement. Results There were no significant differences in the duration of operation and pneumoperitoneum, emergence time between the two groups (P ＞ 0.05). The BP, HR,SpO2, PET CO2 and peak pressure were within the normal range during operation in both groups. The first attempt success rates of LMA placement and gastric tube placement were significantly higher, the LMA placement time was significantly shorter, and the fiberoptic bronchoscopic scores were significantly higher in group S than in group P ( P ＜ 0.05). Conclusion LMA Supreme is helpful for ventilation during operation with less complications and can be used effectively for gynecological laparoscopic surgery.

Effect of ultrasound-guided transverses abdominis plane block on efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy / 中华麻醉学杂志

Objective To investigate the effect of ultrasound-guided transverses abdominis plane (TAP)block on the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy. Methods Sixty ASA Ⅰ - Ⅱ patients scheduled for abdominal hysterectomy under general anesthesia were randomly divided into 2groups (n = 30 each): ropivacaine group (group R) and normal saline (group NS). After induction of anesthesia,ultrasound-guided bilateral TAP block was performed, and 0.375% ropivacaine 40 ml was injected in group R,while the equal volume of normal saline was used instead in group NS. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation. The VAS score was maintained ≤ 3, the level of sedation was evaluated with Ramsay sedation score, and the comfort level was evaluated with Bruggrmann comfort scale (BCS) score at 2, 6, 8, 12 and 24 h after operation. The hemodynamic parameters were recorded. The consumption of sufentanil during operation and within 24 h after operation, the number of successfully delivered doses ( D1 )and the number of attempts ( D2 ) within 24 h after operation were recorded. D1/D2 was calculated. The adverse reactions were also recorded. Results SP, DP, HR, SpO2 and RR were in the normal range and there was no significant differences between the two groups ( P ＞ 0.05). The consumption of sufentanil were significantly lower,while the BCS score and D1/D2 higher in group R than in group NS (P ＜ 0.05). There were no adverse reactions in both groups. Conclusion Ultrasound-guided TAP block reduces the perioperative sufentanil consumption and enhances the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy.

The learning curve of single-direction complete video-assisted thoracoscopic surgery for lung cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the learning curve of single-direction complete video-assisted thoracoscopic surgery (cVATS) for lung cancer.</p><p><b>METHODS</b>From May 2006 to April 2009, 125 cases of cVATS for lung cancer were performed by two dedicated surgeons. Clinical data were collected prospectively and analyzed retrospectively. The patients operated by different surgeon were divided into 2 groups (group A, n = 24; group B, n = 101), and group B was further divided sequentially into 4 subgroups (B1, B2, B3 and B4) by the number of patients. The patients in group A and B were operated by the surgeons with 2-year and 5-year experience of VATS respectively. The operating time, blood loss, number of resected lymph nodes (NLN), rate of thoracotomy conversion (RTC) and postoperative complications (POC) were compared.</p><p><b>RESULTS</b>Compared with group B, the operating time of group A was significantly prolonged [(237 ± 85) min vs. (187 ± 43) min, P = 0.013], but there were no significant differences in blood loss, NLN, RTC and POC. Comparing group A with B1, the same results were got. From group B1 to B4, the operating time was gradually reduced and blood loss decreased, but the difference was not statistically significant. And in group B, there was a significant reduction of blood loss for the last 51 cases compared to the first 50 cases [(122 ± 141) ml vs. (87 ± 81) ml, P = 0.009].</p><p><b>CONCLUSIONS</b>At the early stage of cVATS resection of lung cancer, the duration of operation was longer, which it was more significant for the surgeons with short carrier of thoracoscopic experience. But the morbidity of operation related complications did not increase. The indicator of proficiency in this operation is achievement of 50 cases of complete thoracoscopic resection of lung cancer.</p>

Influence of enteral administration of hypertonic electrolyte glucose solution on the intestinal barrier and organ functions in dogs with severe burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the change in intestinal barrier and organ functions of burned dog after enteral administration of hypertonic electrolyte glucose solution (HEGS) in shock stage.</p><p><b>METHODS</b>Twenty-four Beagle dogs inflicted with 35% TBSA full-thickness burn were divided into no-fluid group (NF), intravenous infusion with isotonic electrolyte glucose solution (IEGS) group (II group), enteral infusion with IEGS group (EI), and enteral infusion with HEGS group (EH) according to the random number table, with 6 dogs in each group. Saline, containing 50 g/L glucose, was intravenously or enterally infused into dogs in II group and EI group respectively 0.5 hour post injury (PIH) for resuscitation. Total infusion volume within PIH 24 was 4 mL x kg(-1) x %TBSA(-1) (half of the total volume was infused in the first 8 hours in a constant speed, the other half volume was infused in the rest 16 hours in a constant speed). HEGS, containing 18 g/L NaCl and 50 g/L glucose, was enterally infused into dogs in EH group. Total infusion volume within PIH 24 was 2 mL x kg(-1) x %TBSA(-1), with the same infusion speed as that in II and EI groups. Liver and kidney function indexes [activity of ALT and CK-MB, expression levels of creatinine and blood urea nitrogen (BUN) in serum], activity of diamine oxidase (DAO), and activity of Na(+)-K(+)-ATPase in intestinal mucosa at PIH 24 were determined.</p><p><b>RESULTS</b>ALT activity in each group was close to one another. Serum levels of creatinine and BUN in II, EI, and EH groups were significantly lower than those in NF group. CK-MB activity obviously increased at PIH 2 in every group. CK-MB activity in EH group at PIH 2 to 8 was respectively lower than that in NF and II groups. DAO activity in serum in II, EI, and EH groups decreased since PIH 4 or PIH 6, respectively from (3.9 + or - 0.6) U/L to (3.6 + or - 0.5) U/L, (4.8 + or - 0.4) U/L to (2.8 + or - 0.8) U/L, (6.4 + or - 1.8) U/L to (3.5 + or - 0.8) U/L, all were significantly lower than those in NF group [from (12.5 + or - 0.4) U/L to (9.7 + or - 1.1) U/L, comparison between EH group and NF group, t value at PIH 4, 6, 8, 24 was respectively 10.25, 12.44, 17.99, 16.21, P values all below 0.05]. The order of Na(+)-k(+)-ATPase activity in intestinal mucosa at PIH 24 in each group from high to low was II group, EH group, EI group, and NF group (comparison between former 3 groups and NF group, t value was respectively 10.09, 4.96, 8.32, F value was 26.79, P values all below 0.05).</p><p><b>CONCLUSIONS</b>HEGS does not cause significant harm to the barrier function of intestinal mucosa of shock dog after burn. Compared with NF, HEGS can significantly improve functions of heart, liver, and kidney, and it can achieve the same resuscitation effect as enteral or intravenous infusion of IEGS with only half of the solution volume.</p>

Effect of exchange of tracheal tube for laryngeal mask airway(LMA) on intratracheal extubation stress response under deep anesthesia level after surgery in elderly patients with hypertension / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of exchange of tracheal tube for a laryngeal mask airway (LMA) on intratracheal extubation stress response under deep anesthesia level after surgery in elderly patients with hypertension.</p><p><b>METHODS</b>From October 2008 to June 2009, 40 hypertension patients aged from 65 to 78 years scheduled for upper abdominal surgery were randomly divided into 2 groups, one was extubated intratracheal tube when being awake (group TT, n = 20) and the other was extubated and exchanged for LMA under deep anesthesia (group LM, n = 20). The American Society of Anesthesiologists (ASA) of the patients were I o rII. The data of mean arterial pressure (MAP), heart rate(HR), pulse oxygen saturation (SPO(2)), end-tidal carbon dioxide tension (P(ET)CO(2)) and rate pressure product(RPP) were recorded before induction of anesthesia (T(0)), suction (T(1)) and at 0 (T(2)), 5(T(3)), and 10 (T(4)) and 15 min (T(5)) after extubation tracheal tube or LMA in two groups. The indices mentioned above also were recorded before and after extubation in group LM. Blood samples were taken at T(0), skin incision, T(2), T(3), for determination of serum concentrations of blood glucose and cortisol. The airway adverse events in the recovery period were recorded.</p><p><b>RESULTS</b>Compared with group LM, MAP, HR and RPP were significantly higher at T(1), T(2), T(3) than T(0) in group TT (P < 0.05). There was no significant difference in the indices mentioned above during extubated intratracheal tube and exchanged for LMA under deep anesthesia in group LM (P > 0.05). The incidence rate of glossoptosis in group TT was significantly higher than those in group LM (P < 0.01), while complications, such as cough, bucking, breath holding during the recovery stage in group TT were more than those in group LM (P < 0.05). Compared with the baseline value, blood glucose and cortisol concentration level were significantly increased in group TT than in group LM (P < 0.01).</p><p><b>CONCLUSIONS</b>Exchange of tracheal tube for LMA under deep anesthesia during recovery stage can decrease the stress response during the recovery stage and attenuate the harmful response of respiratory tract. It is suitable for the elderly patients with hypertension.</p>

Surgical treatment of invasive thymoma: a prognostic retrospective study / 中华外科杂志

<p><b>OBJECTIVES</b>To observe the clinical outcome of invasive thymoma, and analyze how the surgical methods, Masaoka staging, adjuvant radiotherapy and/or chemotherapy affect the prognosis.</p><p><b>METHODS</b>The clinical data of 59 surgical patients with invasive thymoma and conducted follow-up from January 2000 to December 2009 was analyzed retrospectively. There were 34 male and 25 female, aged from 18 to 72 years with a mean age of 49 years. Forty-four cases underwent radical resection while the other 15 cases underwent palliative resection or biopsy. Masaoka staging: 18 cases with stage II, 30 cases with stage III, 11 cases with stage IV. Patients with stage II didn't undergo further adjuvant radiotherapy or chemotherapy after surgery. Among the patients with stage III and stage IV, 26 patients received adjuvant radiotherapy and/or chemotherapy after surgery, while the other 15 patients did not receive any further therapy. The relationship between the prognosis and the different surgical methods, Masaoka staging, adjuvant radiotherapy and or chemotherapy was evaluated.</p><p><b>RESULTS</b>Fifty-nine patients had been followed up for 1 to 111 months with an average of 54 months. Three cases were lost with the rate of 6.1%. Nineteen patients suffered local recurrence or systemic metastasis, and 14 of them died. The 3-year and 5-year survival rates were 86.8% and 70.8% respectively. Univariate analysis indicated that patients with early Masaoka staging and who received radical resection, adjuvant radiotherapy and/or chemotherapy after surgery had better survival (P < 0.05). Multivariate analysis indicated that radical resection, adjuvant radiotherapy and or chemotherapy were the most significant prognostic factors which could remarkably improve the survival of patients (P < 0.05). For patients with resectable recurrence, reoperation could also improve survival.</p><p><b>CONCLUSIONS</b>The Masaoka staging is related to the prognosis of patients with invasive thymoma. Radical resection, adjuvant radiotherapy, chemotherapy can significantly improve the survival of patients with invasive thymoma. Reoperation can improve the survival of some patients with recurrence.</p>

Observation on the effect of vitamin C in alleviating peroxidative damage in gut of dogs during enteral fluid resuscitation of severe burn shock / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of vitamin C (VC) on alleviating peroxidative damage in gut of dogs during enteral fluid resuscitation of severe burn shock.</p><p><b>METHODS</b>Eighteen male Beagle dogs were subjected to 50% total body surface area (TBSA) full-thickness burn 24 hours after duodenostomy and cannulation of cervical artery and vein. The dogs were divided into no resuscitation (NR) group (no treatment after burn), enteral resuscitation (ER) group, and ER+VC group according to the random number table, with 6 dogs in each group. Dogs in ER and ER+VC groups were respectively infused with glucose-electrolyte solution (GES) and GES containing 250 mg/kg VC through duodenostomy tube 30 minutes after burn. The infusion rate and volume of GES were in accordance with Parkland formula. Venous blood of dogs was drawn before (0) and at 2, 4, 6, and 8 post burn hours (PBH) to determine the activity of diamine oxidase (DAO) in plasma. Dogs were sacrificed at PBH 8 to collect specimens of jejunum tissue for determining the content of malondialdehyde (MDA), and activity of myeloperoxidase (MPO), xanthine oxidase (XOD) and superoxide dismutase (SOD), and assessment of the water ratio of intestinal tissue by dry-wet weight method.</p><p><b>RESULTS</b>50% TBSA burn injury resulted in significant elevation of DAO in every group. The activity of DAO in ER group was obviously higher than that in NR group at PBH 6 and 8 (P < 0.05), but DAO activity in ER+VC group was significantly lower than those in the other two groups after PBH 2 (P < 0.05 or P < 0.01). MDA content, MPO and XOD activity and the water ratio of intestinal tissue [(5.74 +/- 0.51) nmol/mg, (2.08 +/- 0.46) U/g, (58.4 +/- 3.8) U/mg, (81.5 +/- 1.8)%] in ER group at PBH 8 was respectively significantly higher than that in NR group [(5.43 +/- 0.25) nmol/mg, (1.55 +/- 0.21) U/g, (50.1 +/- 2.8) U/mg, (78.3 +/- 1.5)%, P < 0.05 or P < 0.01]. While the activity of SOD in ER group (72 +/- 12) U/mg was lower than that in NR group (97 +/- 20) U/mg. MDA content, MPO and XOD activity and water ratio of intestinal tissue in ER+VC group was respectively lower than that in ER group, with activity of SOD in the former group higher than that in the latter group (P < 0.01).</p><p><b>CONCLUSIONS</b>Vitamin C can alleviate peroxidative damage and tissue edema in gut induced by ischemia and reperfusion, and intestinal complications during oral rehydration during burn shock can be reduced.</p>