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Objective To compare the effects between propofol and sevoflurane on NK cells and B lymphocytes in patients undergoing radical operation for tongue cancer.Methods Forty patients (male 25 cases,femal 1 5 cases,aged 44-67 years,ASA Ⅰ or Ⅱ)undergoing elective radical operation for tongue cancer were randomized into 2 groups:group P received 2.0-2.5 mg/kg propo-fol,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for induction and 4-6 mg · kg- 1 · h- 1 propofol, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance; group S received 8 %sevoflurane with 5 L/min fresh gas flow,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for in-duction and 2 %-3 % sevoflurane, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance. Peripheral venous blood samples were taken at 3 0 min before (T0 )and 1 h (T1 ),3 h (T2 )and 5 h (T3 )after induction of anesthesia,the end of operation (T4 )and at 2 4 h (T5 ),4 8 h (T6 )and 7 2 h (T7 )after operation for determination of the percentages of NK cells (CD3 - CD1 6 + 5 6 + )and B lymphocytes(CD3 - CD1 9 + )by the flow cytometer.Results Compared with T0 ,the percentages of CD3 - CD1 6 + 5 6 + and CD3 - CD1 9 + in two groups were significantly decreased at T1-T5 (P <0.0 5 ),and the percentage of CD3 - CD1 6 + 5 6 + in group S was significantly decreased at T6 (P <0.0 5 ).The percentage of CD3 - CD1 6 + 5 6 + in group S were significantly lower than that in group P at T2-T6 (P < 0.0 5 ).There were no significant difference in the percentages of CD3 - CD1 9 +between two groups at the same time points.Conclusion Compared with sevoflurane,propofol can maintain a higher percentage of NK cells,and was helpful to maintain the immune function in patients undergoing radical operation for tongue cancer.
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objective To introduce the design concept and structure of a new type of lumbar intervertebral fusion cage ,and to e-valuate its biomechanical properties .Method A partially bioasorbable interbody fusion cage(PBIFC) made of nano hydroxyapatite and poly amino acid /calcium sulfate copolymer materials was developed .Range of motion(ROM ) ,compressive load ,and pull-out test on flexion ,extension ,lateral bending ,and torsion moment on fresh calf L3/L4 specimens of functional spinal union were carried out of iliac bone group ,PBIFC group ,and nano hydroxyapatite/polyamide 66(nHA/PA66) group .Result Of each movement ,the ROM value of iliac bone group are higher than the other two groups ,the difference was statistically significant (P0 .05) .The pull-out strength of PB-IFC group are higher than iliac bone group ,and the difference was statistically significant (P0 .05) .The compressive load of iliac bone group was lower than that of two cage group ,the difference was statistically significant (P0 .05) .Conclusion With good implant stability ,pull-out resistance ,and compression resistance performance ,PBIFC can meet the biomechanics requirements of clinical implant .
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BACKGROUND:K-wire and steel wire tension band wiring is the most commonly method for the treatment of patel ar fracture. However, there have been many reports of complications related to the mental implants. Based on the reasons above, some scholars begin to replace the steel wire with braided polyester sutures for the treatment of patel ar fracture. OBJECTIVE:To observe the effect of patel ar ring pins and FiberWire braided polyblend sutures tension band fixation for treatment of patel ar fracture. METHODS:We performed a retrospective analysis involving 26 patients with patel ar fracture (16 males, 10 females, at the age of 36-54 years with a mean age of 44.6 years) who were treated with patel ar ring pins and FiberWire braided polyblend sutures tension band fixation. RESULTS AND CONCLUSION:Al the patients were fol owed-up for 6-18 months, average of 12 months. Al patients were primary healing and achieved bone union in 8-16 weeks, averaged in 12 weeks from surgery. There was no fracture fragment displacement, internal fixation loosening and break. No pins protruding from the subcutaneous and irritate the skin. According to the Lysholm&Gil quist scales, 18 cases were excellent, four cases were good, and four cases were fair, with the excellent and good rate of 85%. Tension band fixation using patel ar ring pins and FiberWire braided polyblend sutures resulted in good outcomes with few complications.
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Objective To investigate the effects of different general anesthesia protocols on immune function in patients with oral malignant tumor. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective radical operation for oral malignant tumor were randomly divided into 3 groups ( n = 20 each): group Ⅰ total intravenous anesthesia (TIVA); group Ⅱ combined intravenous-inhalational anesthesia (IV-INH) and group Ⅱ inhalational anesthesia (INN). Anesthesia was induced and maintained with propofol and remifentanll in group Ⅰ; with sevoflurane,propofol and remifentanil in group Ⅱ and with sevoflurane and remifentanil in group Ⅲ. Peripheral venous blood samples were taken at 30 min before (To) and 1 h (T1), 3 h (T2 ) and 5 h (T3) after induction of anesthesia, the end of operation (T4 ) and at 24 h (T5 ), 48 h (T6 ) and 72 h (T7) after operation for determination of the percentages of T lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+/CD8+ ratio). Natural killer (NK) cells (CD16+ ,CD56+ ) and B lymphocyte (CD19+ ) with flow cytometer. Results The percentages of CD3+ , CD4+ , NK cells, B lymphocyte and CD4+/CD8+ ratio were significantly decreased during and after operation at T1-5 in all groups and the percentges of CD3+ ,CD4+ ,NK cells and CD4+/CD3+ ratio were decreased at T6 in groups Ⅱ and Ⅲ as compared with the baseline values before anesthesia at To. The percentage of CD4+ cells and CD4+/CD8+ratio were significantly lower during anesthesia at T2,3,6 in group Ⅱ than in group Ⅰ . The percentages of CD4 +and NK cells and CD4+/CD8+ ratio were significantly higher after operation at T4,5 in group Ⅱ than in group Ⅲ.The percentages of CD3 + , CD4 + , NK cells and CD4 +/CD8 + ratio were significantly lower at T2-6 in group Ⅲthan in group Ⅰ . Conclusion TIVA with midazolam, propofol and remifentanil has less impact on immune function than inhalational and combined intravenous-inhalational anesthesia in patients with oral malignant tumor under-going elective radical operation.