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Objective To compare the clinical effect of Multiloc nailing and Philos locking plate for treating proximal humerus fracture.Methods A retrospective analysis of 34 surgery treated proximal humeral fractures patients in Department of Orthopedics,Beijing Haidian Hospital and Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University from January 2015 to June 2016,in which 3 cases of high-energy injury and multiple fractures andonecase of humerus head replacement and onecase of non-surgical treatment were excluded.Finally,29 patients were included and clinical followed up to 12 months after surgery.The 29 paients were divided into the locking plate group (n =13) and intramedullary nail group (n =16),The operative time,volume of intraoperative blood loss,preoperative to postoperative 24 patients were compared between the locking plate group and intramedullary nail group underwent open reduction and internal fixation with philos locking plate hemoglobin changes,24 h postoperative visual analogue scale and 3,6,12 months postoperative Constant-Murley shoulder function score.SPSS13.0 statistical software was used to analyze the data.Measurement data were expressed as ((x) ± s).Comparison of groups used independent samples t test,repeated measurement data used repeated measures analysis of variance.Results The age of the locking plate group was (65.7 ± 9.3) years,and the age of the intramedullary nailing group was (65.6 ± 11.1) years.In the locking plate group,the operation time was (150 ± 17) minutes,the intraoperative blood volume was (300 ± 53) ml,the change of blood pigment between before surgery to 24 hours after surgery was (26 ± 8) mg/L,and the vision algetic standard of 24 hours after surgery was (3.4 ± 0.8) scores.In intramedullary nailing group,the operation time was (119 ± 13) minutes,the intraoperative blood volume was (130 ± 25) ml,and the change of blood pigment between before surgery to 24 hours after surgery was (11 ± 5) g/L,the vision algetic standard of 24 hours after surgery was (2.3 ± 0.5) scores.No serious postoperative complications occurred in either group,including infection,internal fixationfailure,and humeral head necrosis.In locking plate group,for the Constant-Murley shoulder joint function score,3 months after surgery was (76.0 ± 11.6) scores,6 months was (78.0 ± 13.4) scores,12 months was (88.0 ± 12.1) score.In intramedullary nailing group 3 months was (85.0 ± 9.7) scores,6 months was (87.0 ± 8.9) scores,12 months was (89.0 ± 10.3) scores.There were no statistical difference between the two groups at incidence of serious complications after surgery,postoperative 12 months Constant-Murley shoulder joint function score.Muhiloc intramedullary nailing group was better than Philos locking plate group in the operation time,the intraoperative blood volume,etc.Conclusion Multiloc intramedullary nail is an effective method for treating proximal humerus fracture,and it has the advantages of less surgical injury and early postoperativesatisfactory than the locking plate.
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Objective To evaluate the clinical curative effect,survival rate and adverse reactions of three-dimensional conformal radiotherapy(3D-CRT )in combination with chemotherapy on lymph nodes metastasis of esophageal carcinoma.Methods Using supraclavicular 3D-CRT combined with chemotherapy on and simple 3D-CRT supraclavicular lymph node metastasis of esophageal cancer patients,3D-CRT com-bined synchronous chemotherapy (treatment group),51 cases,only 3D-CRT 49 cases (control group).3D-CRT combined synchronous chemotherapy 51 cases (treatment group),simple 3D-CRT 49 cases (control group).These patients 3D-CRT were given the total dose of 50 ~60Gy/25 ~30F.TN chemotherapy regi-mens were applied:paclitaxel 135 mg/m2 ,d1;Nedaplatin 25 mg/m2 ,d1,1 ~3,21 days cycle in fist week and fourth week.Results Local control and treatment group survival rates in 1,2 year were significantly higher than that of control group (P <0.05).Treatment group adverse reaction rate is higher than the con-trol group,but there was no statistically significant difference.Conclusions The recent curative effect and survival rate could be significantly improved by 3D-CRT joint TN synchronous chemotherapy regimen for pa-tients with supraclavicular lymph node metastasis of esophageal cancer,but the relatively high incidence of adverse reactions,clinical application should be considered comprehensively according to actual situation.
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Objective To evaluate the effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children.Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children (aged 3 months-14 years and weighing 5-74 kg) requiring allogeneic blood transfusion during operation were randomly divided into two groups:163 children receiving normal allogeneic blood transfusion (control group,group C) and 196 children receiving leukocyte-depleted allogeneic blood transfusion (group D).Blood samples were collected from the peripheral vein before blood transfusion,and 2 and 6 days after blood transfusion for determination of the levels of CD3+,CD4+,CD8 +,and CD56+ by flow cytometry.CD4+ /CD8+ ratio was calculated.The volume of allogeneic blood transfusion during operation,the duration of operation,postoperative drainage,antibiotic administration,hospital stay and the incidence of postoperative infection were recorded.Rssults The levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio significantly increased at 6 days after blood transfusion while the duration of postoperative drainage,postoperative antibiotic administration,hospital stay and the incidence of postoperative infection significantly decreased in group D compared with group C.Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.
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Objective To evaluate the effect of hyperbaric oxygen (HBO) treatment on the expression of nerve growth factor (NGF) in the spinal cord of rats with neuropathic pain (NP).Methods Thirty healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 270-300 g,were randomly divided into 5 groups (n =6 each) using a random number table:sham operation group (group S),group NP,pure oxygen group (group O),treatment with HBO at 2.5 atmosphere absolute group (group H2.5) and treatment with HBO at 3.0 atmosphere absolute group (group H3.0).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.NP was induced by chronic constrictive injury.The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1-mm intervals with 4-0 silk thread.HBO treatment was performed with the corresponding atmosphere absolute once a day for 7 consecutive days starting from 1 day after operation in H2.5 and H3.0 groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on 3,5,7 and 14 days after operation.The animals were sacrificed after the last measurement of pain threshold,and the lumbar segments of the spinal cord were removed to detect the expression of NGF by immuno-histochemistry and Western blot analysis.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of NGF was up-regulated at each time point after operation in NP and O groups.Compared with group NP,MWT was significantly increased,TWL was prolonged,and the expression of NGF was up-regulated at each time point after operation in H2.5 and H3.0 groups,and no significant change was found in MWT,TWL and expression of NGF in group O.Compared with group H2.5,the expression of NGF was significantly down-regulated,and no significant change was found in MWT and TWL in group H3.0.Conclusion The mechanism by which HBO treatment mitigates NP is related to up-regulation of the expression of NGF in the spinal cord of rats.
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Objective To compare volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) improved by PEEP during one-lung ventilation (OLV).Methods Fifty ASA physical status Ⅰ-Ⅲ patients,aged 25-64 yr,weighing 40-80 kg,undergoing elective thoracotomy,were randomly divided into 2 groups (n =25 each) using a random number table:VCV + PEEP group (group Ⅴ) and PCV + PEEP group (group P).Those in group Ⅴ underwent OLV initially with VCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.Those in group P underwent OLV initially with PCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.At the beginning of two-lung ventilation before chest opening (T1),at 20 min of OLV before PEEP (T2),and at 20 min of ventilation with PEEP (T3),arterial blood samples were collected for blood gas analysis and the peak airway pressure (Ppeak) and development of SpO2 ＜ 95 ％ from beginning of OLV to T3 were recorded.Results Compared with group P,Ppeak at T2,3 and PaO2 at T3 were significantly increased in group Ⅴ (P ＜ 0.05).Compared with the baseline value at T1,PaO2 was significantly decreased and Ppeak was increased at T2.3 in Ⅴ and P groups (P ＜ 0.05).The incidence of SpO2 ＜ 95％ was significantly decreased and PaO2 was increased at T3 than at T2 in Ⅴ and P groups (P ＜ 0.05).Conclusion 4 cm H2O PEEP can improve VCV and PCV during OLV and the improved efficacy is better for VCV in patients undergoing thoracotomy.
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Objective To investigate the effect of different pressures of hyperbaric oxygen (HBO) treatment on neuropathic pain (NP) in rats.Methods Twenty-four healthy male Sprague-Dawley rats were randomly divided into 4 groups (n =6 each):sham operation group (group S),NP group,treatment with HBO at 2.0 atmosphere absolute group (group HBO2.0) and treatment with HBO at 2.5 atmosphere absolute group (group HBO2.5).The animals were anesthetized with intraperitoneal 5 ％ chloral hydrate 300 mg/kg.NP was induced by chronic constrictive injury.The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1-mm intervals with 4-0 silk thread.After the rats were placed in the HBO chamber,the pressure was increased at a rate of 10 kPa/min until the desired pressure was reached,and then the pressure was maintained at this level for 60 min.The pressure was then decreased at a rate of 10 kPa/min until the normal pressure was reached.HBO treatment was performed once a day for 5 consecutive days starting from 1st day after operation in groups HBO2.0 and HBO2.5.While the rats were only placed in the HBO chamber and stayed for 100 min in groups S and NP.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 0,1and 2 h after leaving the HBO chamber (T0.2).Results Compared with group S,MWT was significantly decreased and TWL was shortened in group NP (P ＜ 0.05).Compared with group NP,MWT was significantly increased and TWL prolonged at T1 during the treatment (P ＜ 0.05),while no significant change was found in MWT and TWL at T2 during the treatment in groups HBO2.0 and HBO2.5 (P ＞ 0.05).There was no significant difference in MWT and TWL at each time point during the treatment between groups HBO2.0 and HBO2.5 (P ＞ 0.05).Conclusion Treatment with different pressures of HBO can reduce NP in rats,but the change in pressure dose not affect the analgesic efficacy.
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Objective To evaluate the clinical efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with thermochemotherapy in the treatment of locally advanced pancreatic cancer (LAPC).Methods From June 2008 to June 2011,70 patients with LAPC were divided into radiotherapy group (30 patients) and combination group (40 patients).Radiotherapy used 3D-CRT with a 90％ to 95％ isodose curve,a single dose of 1.8 to 2.OGy,and total radiation dose 50 ～ 70 Gy.The combination group patients received simultaneous thermotherapy at 41.5 ～43.5 ℃ (1 h/fraction,twice a week for 6 times),and hyperthermia given simultaneously injected using arsenic trioxide 20 mg,recombinant mutant human tumor necrosis factor(rmhTNF) intravenous infusion of 10 million U,4 to 6 times,or 3D-CRT at the same time and the treatment given after gemcitabine(0.6 ～ 1.0 g/m2) on Days dl and 8 and cisplatin (DDP) (20 ～ 30 mg/m2) on Days d1-3 intravenous infusion,repeated every 28 days for 3 ～ 6 cycles.Results At 3 months after treatment,the total response (complete remission and partial remission) rate was 70.0％ (49/70),the efficiency of radiotherapy combined with chemotherapy,and radiotherapy combined with thermo-chemotherapy were 56.5％ and 88.2％,and the radiotherapy alone group was 56.7％.There were significant difference in efficiency between radiotherapy combined with thermo-chemotherapy group compared to radiotherapy-chemotherapy group and radiotherapy group (x2 =4.68,4.98,P ＜ 0.05),the last two groups showed no significant difference (P ＞ 0.05).The 1-year and 2-year survival rate was 46.8％ and 20.3％,respectively.The 1-year and 2-year survival rates were 52.4％ and 26.7％ in combination group,and 42.5％ and 16.2％ in radiotherapy group (x2 =14.17,P ＜ 0.05 ; x2 =9.74,P ＜ 0.05).No serious complications such as perforation,bleeding,and high fever were seen during treatment and follow-up.Conclusions 3D-CRT combined with thermochemotherapy is well tolerated and is relatively effective for the LAPC patients.
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Objective To investigate the efficacy and safety of oxycodone hydrochloride controlled-release tablets combined with gabapentin in the treatment of painful diabetic neuropathy.Methods Eighty patients with painful diabetic neuropathy were divided into group A and group B with 40 cases each by random digits table.Patients of group A received simple oxycodone hydrochloride controlled-release tablets,while patients of group B received oxycodone combined with gabapentin.The intensity of pain, oxycodone dosage, quality of life and adverse effect in two groups was observed and compared.Results The pain was obviously relieved in two groups, and the effective analgesic rate at 21-28 d after treatment in group B was superior to group A[95.0% (38/40) vs.62.5% (25/40)], there was significant difference between two groups (P＜0.05).Numerical rating scale NRS score at 28 d after treatment in group B and group A was 1.2 ± 0.3 and 2.8 ± 0.5 respectively,and there was significant difference between two groups (P＜ 0.01 );the oxycodone dosage at 28 d after treatment in group B was lower than that in group A[(32.2 ± 4.3 )mg vs.(40.3±5.5 ) mg], and there was significant difference between two groups (P ＜ 0.05 ); the quality of life in group B was superior to group A, and there was significant difference between two groups (P ＜ 0.05 or ＜ 0.01 );the incidence of dizzy at 7, 14 d after treatment in group B was higher than that in group A[35.0% (14/40) vs.15.0% (6/40) and 30.0% (12/40) vs.10.0% (4/40)],and there was significant difference between two groups (P ＜ 0.05 ).Conclusion Oxycodon hydrochloride controlled-release tablets combined with gabapentin is effective and safe for the management of painful diabetic neuropathy.
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ObjectiveTo determine the peripheral serum expressions and clinical value of carcinoembryonic antigen (CEA) and carbohydrate antigen CA19-9,CA242,CA72-4 and a single sialic acid ganglioside (CA50) antigen in advanced pancreatic cancer patients treated by three-dimensional conformal radiotherapy (3D-CRT) combined with endogenous field hyperthermia.Methods60 patients inoperable,advanced pancreatic cancer were treated by 3D-CRT combined with endogenous field hyperthermia.Radiation dose (DT) was 46 ～ 66 GY/23 ～ 33 F.Hyperthermia temperature was 41 ～ 43 ℃ 2 times/week,lasted 60 min each time.The expressions of CEA,CA19-9,CA242,CA72-4 and CA50 in peripheral serum were detected by Electrochemiluminescence immunoassay (ECLIA) every 2 weeks during treatment,and correlation were analyzed with tumor diameter,clinical stage,lymph node metastasis.Results From the 8th week,with 3D-CRT combined with endogenous field hyperthermia ongoing,CEA,CA19-9,CA50 andCA242 expression levels showed a gradual decline.CEA,CA19-9,CA50 and CA242 expression levels were (6.22 ± 2.71 ) μg/L,(43.44 ± 12.93 ) μg/L,(23.21 ± 7.71 )g/L and (24.26 ± 8.92) μg/L in 6 weeks,respectively.The difference was statistically significant among week 6 and week 0,week2,week 4 ( P ＜0.05),however there was no significant difference between week 6 and week 8 ( P ＞ 0.05 ).The CA724 expression did not change significantly ( P ＞ 0.05 ).There were positively correlation between CEA,CA199,CA50 and CA242 with pancreatic cancer tumor size,clinical stage and lymph node metastasis( respectively r =0.877,0.725,0.826,all P ＜ 0.01 ),however CA72-4 had no correlations ( P ＞ 0.05).ConclusionsCEA,CA19-9,CA50 and CA242 expressions in peripheral serum of pancreatic cancer patients were closely related to the treatment.Their joint detection can be served as independent objective evaluation reference information for the treatment efficacy and prognosis.
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Objective To investigate artemin and its receptors GFRα3 expression in human pancreatic ductal adenocarcinoma and its significance. Methods Expression and distribution of artemin and GFRα3 in 100 cases of human pancreatic ductal adenocarcinoma(PDAC) and 40 cases of normal pancreatic tissue were detected by immunohistochemistry and RT-PCR, quantitative RT PCR. Relations of artemin and GFRα3 with clinicopathological characteristics, especially nerve invasion were analyzed. Results Nerve invasion was detected in 64 out of 100 cases of PDAC, and the rate of nerve invasion was 64%. The ratio of expression of Artemin, GFRα3 protein in PDAC/normal pancreatic tissue was 2.697 ± 0.231 and 2.599 ± 0.588; the ratio of expression of Artemin, GFRα3 mRNA was 7.01 and 4.63. Artemin and GFRα3 expression were associated with tumor location, differentiation degree, TNM staging, nerve invasion node metastasis, but it was not associated with age, sex and tumor size. Artemin and GFRα3 expression was more positively expressed in cancer cells close to nerve tissue than cells far from nerve tissue. Conclusions Artemin and GFRα3 were involved in the development of pancreatic cancer and their high expression was closely related to perineural invasion.
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Objective To investigate the expression and the role of osteopontin(OPN)and matrix metalloproteinase-9(MMP-9)in the invasion and metastasis of pancreatic carcinoma.Methods Human pancreatic cancer cell line MIA PaCa-2 was cultured in vitro.The location of OPN protein in pancreatic tumor cell line was detected by immunofluorescence staining.100 cases of pancreatic cancer and 40 cases of adjacent normal pancreatic tissues were used to analysis.The expressions of OPN and MMP-9 were investigated by immunohistochemistry assay.Results OPN expressed in the cell membrane and cytoplasm,OPN and MMP-9 in pancreatic cancer tissues positive rates were 73.0%(73/100)and 68.0%(68/100),which were higher than that in adjacent normal pancreatic tissues(all P ＜ 0.05).OPN and MMP-9 expression were associated with pancreatic tumor grade,lymph node metastasis and perineural invasion of pancreatic cancer(P ＜ 0.05).OPN and MMP-9 in pancreatic cancer tissues were positively correlated(r,=0.39,P ＜ 0.01).Conclusions OPN and M MP-2 might play an important role in the development of invasion and metastasis of pancreatic carcinoma.OPN and MMP-2 might play synergetic roles in the progression of pancreatic carcinoma.
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ObjectiveTo investigate the effects of leukocyte-depleted allogeneic blood transfusion on perioperafive cellular immunity in children.MethodsThree hundred and fifty-nine ASA Ⅰ or Ⅱ children aged 3 month-14 yr,weighing 5-74 kg requiring allogeneic blood transfusion during operation were randomly divided into 2 groups:control group (group C,n =163) and leukocyte depletion group (group D,n =196).In group D allogeneic blood was filtered with a leukocyte filter before being transfused during operation.Blood samples were collected from peripheral vein before blood transfusion,and at 2 and 6 d after blood transfusion for determination of levels of CD3+,CD4+,CD8+,and CD56+ by flow cytometry.CD4+/CD8+ ratio was calculated.The volume of allogeneic blood transfused during operation,the duration of operation,postoperative drainage,antibiotics administration and hospital stay and incidence of postoperative infection were recorded.ResultsThe levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio were significantly increased at 6 d after blood transfusion while the duration of postoperative drainage,postoperative antibiotics administration and hospital stay and incidence of postoperative infection were significantly decreased in group D compared with group C.ConclusionLeukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.
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Objective To observe different priming techniques with intubation dose when using cisatracurium in onset time and safety. Methods Eighty ASA physical status Ⅰ and Ⅱ patients undergoing elective surgery requiring general anesthesia were enrolled. Group Ⅰ with 20 cases received cisatracurium 0.010 mg/kg, group Ⅱ with 20 cases received cisatracurium 0.015 mg/kg,group Ⅲ with 20 cases received cisatracurium 0.010 mg/kg,and group Ⅳ with 20 cases received normal saline. Four minutes after priming,group Ⅰ received cisatracurium 0.140 mg/kg ,group Ⅱ received cisatracurium 0.135 mg/kg, group Ⅲ received cisatracurium 0.190 mg/kg,and group Ⅳ received cisatracurium 0.200 mg/kg. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four (TOF) supramaximal impulses T1. The trachea was intubated when the amplitude of T1 decreased to 0. Recorded T1 and TOF in 4 minutes and onset time of muscle relaxation, then evaluated intubation condition. Results The onset time in group Ⅰ , Ⅱ, Ⅲ and Ⅳ were (151.30 ± 10.90), (138.90 ±8.37), (145.45 ± 17.12), (148.75 ± 18.70) s,respectively. The onset time in group Ⅱ was obviously shorter than that in group Ⅰ , Ⅲ and Ⅳ (P ＜ 0.01 ),thus there was no significant differences among the group Ⅰ , Ⅲ and Ⅳ. During the priming interval, the value of T1 and TOF were both showing downtrend, in group Ⅱ ,there was TOF ＜ 90%. Conclusions Priming dose 0.010 mg/kg and intubation dose 0.140 mg/kg is just the same like that in intubation dose of quadruple ED95 whether priming. There is no benefit in priming cisatracurium of intubation dose quadruple ED95. There is TOF ＜ 90% in 4 minutes priming interval when using priming dose 30% ED95 and it is proved unsafely.
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Objective To estimate the incidence,clinicopathological characteristics and therapeutic features in children with solid pseudopapillary tumors of the pancreas(SPTP).Methods Nine eases of children SPTP after diagnosis were collected in our hospital.Routine HE,PAS staining and immunohiatochemical staining of multiple indicators were analyzed,combined with literature analysis of clinical manifestations,imaging,pathological features,surgical treatment and follow-up case.Results The average age in nine cases of SPTP was 10.3 years.The SPTP patients in children in our hospital accounted for 29.0% of pancreas solid tumors.Many clinical manifestations were abdominal pain(5 cases,55.56%),abdominal mass(3 cases,33.33%),jaundice(1 cases,11.11%),and other symptoms.B-ultrasonography and CT showed pancreatic lesions,clear boundary,was solid and cystic,and some have a little calcification.Pathological features:tumor limitations,capsule integrity,and cross-section alternating solid and cystic lesions,tumors organizations sheet hemorrhage,necrosis and cystic change.Immunohistochemically,the positive rates were 100% for α1-AT,66.7% for NSE,33.3% for S-100 and 100% for PAS.The patients were followed-up for 4 months to 10 years and were alive postoperatively,but no local recurrence and distant metastasis.Histological examination showed solid with cystic areas and papillary protrusions.Conclusion SPTP should be the second most common pancreatic tumor in children.Girls were more frequently affected.The overall prognosis following surgical resection was good.
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Objective To observe the effect of single and low dose propofol administered near the end of surgery on the cardiovascular and adverse response during extnhation in patients undergoing ovarian cancer operation. Methods Fifty ASA Ⅰ - Ⅱ patients undergoing selective ovarian cancer operation were randomly allocated into group S and group P,with 25 patients in each group. In group S, inhalation of sevoflurane was discontinued at about 2 minutes before the end of operation. In group P, inhalation of sevoflurane was discontinued at about 5 minutes before the end of operation,and at the same time,0.5 mg/kg of propofol was administered intravenously. The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and recovery time of consciousness were recorded at 5 min before extubation (t_1),during extubation (t_2), 1 min after extubation (t_3), and 5 rain after extubation (t_4). The incidence of agitatian,bucking,nausea and vomiting were recorded by an observer who was blind to this study. Results There were statistical differences in HR,SBP,DBP at t_2-t_4 between two groups. The recovery time was (10.39 ± 1.26) min in group P,and(9.57 ± 1.25) min in group S,there was significant difference between group P (2 cases) and group S (9 cases)(P< 0.05). There was significant difference in the incidence of agitation between two groups (P< 0.05). Conclusion Low dose propofol before extubation can inhibit stress and cardiovascular response and decrease the incidence of agitation, bucking, nausea and vomiting.
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Objective To investigate the role of the expression of prostate stem cell antigen(PSCA)in the development of perineural invasion in pancreatic carcinoma.Methods The histopathologic and immunohis-tochemical(SABC)studies were performed on 80 patients with pancreatic carcinoma.The overall incidence of PSCA expression,perineural,lymphatic and vascular vessel invasion were counted to investigate the relationships among them.Results Perineurel invasion was positively correlated with lymphatic and vascular vessel invasion (P<0.01).A positive corelation Was found between tumor PSCA expressioa(53 cases)and the perineurel in-vasion(66 cases).A definite correlation Was also found between cancer differentiation and PSCA tyxplres-sion.Conclusion PSCA is one of the most important molecules and may play a role as a "navigating" and " docking" molecule in the developmeat of perineural invasion.
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Objective To investigate the effects of preoperative iv different doses of pantoprazole on acidity of gastric fluid in patients undergoing elective surgery. Methods Sixty ASA Ⅰ -Ⅲ patients aged 38-80 yr,weighing 44-72 kg undergoing elective surgery were randomly allocated into 3 groups (n = 20 each): group Ⅰ control (group C); group Ⅱ pantoprazole 40 mg(group P1) and group Ⅲ pantoprazole 80 mg(group P2). The patients received intravenous normal saline (NS) 100 ml, pantoprazole 40 and 80 mg in NS 100 ml respectively in group C, P1 and P2 at 30 min before surgery. Gastric content was aspirated using a gastric tube on the patients'arrival in the operating room and at 1,2 h and the end of surgery. The pH of the gastric fluid was measured. The adverse effects including dizziness, diarrhea, PONV and incidence of stress ulcer were recorded. Results The pH was significantly increased in group P1 and P2 as compared with control group but there was no significant difference in pH between group P1 and P2 . There were no significant difference in the incidence of stress ulcer and pH of the gastric fluid≤2.5 among the 3 groups. Conclusion Preoperative intravenous pantoprazole 40 mg can effectively increase pH of gastric juice and is helpful in reducing the incidence of stress ulcer and the risk of acid aspiration.
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Objective To investigate the effect of intmopemtive intravenous penehyclidine hydrochloride on pulmonary function in patients undergoning thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients aged 30-64 yr scheduled for elective radical esophagectomy for cancer were randomly divided into 2 group(n=30 each):penehyclidinc hydrochloride group and control group.Penehychdine hydrochloride 0.01 mg/kg(in nolmal saline 2 ml)was injected iv 20 min after opening the thoracic cavity in penehyclidine hydrochloride group.The equal vohlme of normal saline was injected iv in control group.Anesthesia was induced with fentanyl 2μg/kg,propofol 0.4μG/ml and rocuronium 0.6 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remlfentanyl 0.1μg·min-1,propofol 2.0-2.5 μg/ml and intermittent iv injecfion of rocuronium.The use of remifentanyl and pmpofol was stopped 5 min before operation.Dynamic lung compliance (Cd) and peak airway pressure were monitored and recorded immediately before penehychdine hydrechlofide administration (T0) and at 3 min(T1),5 min(T2),10 min(T3),30 min(T4),1 h(T5),2 h (T6)after penehyclidine hydrochloride administration.Results There was no significant difference in Cd and peak airway pressure among different time points in control group(P>0.05).Cd was significantly higher,while peak airway pressure lower at T1-6 than at T0 in penehychdine hydrochlofide group(P<0.05).Cd wag significantly higher,while peak airway pressure lower at T1-6 in penehyclidine hydrochloride group than in control group(P<0.05) .Conclusion Intraoperative intravenous penehyclidine hydrochloride can improve the pneumodynamics and is helpful for ventilation in patients undergoing thoracotomy.
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Objective To investigate the effects of artemin and its receptor GFRα - 3 on the invasion and metastasis of pancreatic cancer cells. Methods Human pancreatic cancer cell line MIA PaCa -2 was used in this study. Transwell cell culture chamber assay in vitro was used to detect the ability of invasion and metastasis of MIA PaCa -2 cells. The influence of artemin and GFRα -3 on the protein expression of MMP-2 and E-cadherin was investigated by Western blot and quantitative real time polymerase chain reaction-analyses (Q-RT-PCR). Results As the increase of artemin and GFRα -3, the invasion and metastasis of MIA PaCa- 2 was markedly increased [ 150 ng / ml concentration: Artemin group: 107.4 ± 11.4;GFRα3 group:94. 4 ± 9. 3 ;control group:34. 6 ± 7. 3, P < 0. 01 ]. With 150 ng / ml artemin and GFR-3,the synthesis of MMP-2 in MIA PaCa 2 cells was significantly increased than that in control group[ Artemin grou: (2. 17 ± 0. 05 ) × 108; GFRα3 group: (2. 02 ± 0. 03 ) × 108; control group: ( 1.02 ± 0. 02 ) × 108, t =6. 35,7. 32 ], while E-cadherin significantly decreased [ Artemin group: ( 0. 65 ± 0. 04 ) × 108; GFRα3 group: (0. 74 ± 0. 01 ) × 108; control group: ( 1. 36 ± 0. 03 ) × 108, t = 4. 27,5.61 ], the difference was statistically significant ( P <0. 01 ). Conclusions Artemin and its receptor GFRα3 could promote pancreatic cancer cell invasion and metastasis. This effect may be related to the up-regulated expression of MMP-2 and down regulated expression of E-cadherin.
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Objective To evaluate the role of μ-opioid receptor (MOR) in attenuation of bone cancer pain by anti-nerve growth factor (anti-NGF) in rats. Methods Part Ⅰ Sixty female SD rats weighing 200-220 g were randomly divided into 4 groups (n = 15 each): sham operation group (group S), sham operation + anti-NGF group (group SN), bone cancer pain group (group P) and bone cancer pain+ anti-NGF group (group PN) . Bonecancer was induced by intra-tibial inoculation of 1 × 105 Walker 256 breast cancer cells in group P and PN. Group S and SN received injection of PBS 10 μl. APE 10 catheter was inserted at L2,3 interspace into the epidural space 13 days after cancer cell inoculation. Three days after the catheter was successfully placed, group SN and PN received intrachecal (IT) injection of anti-NGF 10 μg (in normal saline (NS) 10 μl) and group S and P IT injection of NS 10 μl twice a day for 5 consecutive days. The number of spontaneous flinches (NSF), paw withdrawal latency (PWL) and paw withdrawal threshold (PWT) were measured before and 13, 16, 18, 21 day after cancer cell inoculation. The animals were sacrificed at 21 day after cancer cell inoculation and the spinal cord dorsal horn and dorsal root ganglion were removed for determination of MOR and MOR mRNA expression. Part Ⅱ Thirty female SD rats weighing 200-220 g were randomly divided into 2 groups (n = 15 each): bone cancer pain + anti-NGF group (group PN) and bone cancer pain + naloxone + anti-NGF group (group PNN). Bone cancer was induced by intratibial inoculation of 1 × 105 Walker 256 breast cancer cells. APE 10 catheter was inserted at L2-3 interspace into the epidural space 13 days after cancer cell inoculation. Three days after the catheter was successfully placed,group PN received IT injection of anti-NGF 10 μg (in NS 10 μl) and group PNN IT injection of naloxone 10μg (in NS 25 μl) and 0.5 h later IT injection of anti-NGF 10 μg (in NS 25μl) twice a day for 5 consecutive days. NSF,PWL and PWT were measured before and 13, 16, 18, 21 days after cancer cell inoculation. Results Part ⅠCompared with group S, no significant change was found in NSF, PWL and PWT in group SN, and in MOR and MOR mRNA expression in group SN and PN (P ＞ 0.05), NSF was significantly increased, PWL shortened, PWT decreased at 13-21 days after inoculation in group P and PN, and MOR and MOR mRNA expression was down-regulated in group P (P ＜ 0.05 or 0.01). Compared with group P, NSF was significantly decreased, PWL prolonged, PWT increased, MOR and MOR mRNA expression was up-regulated in group PN at 18-21 days after inoculation (P ＜ 0.05 or 0.01). Part Ⅱ Compared with group PN, NSF was significantly increased, PWL shortened, PWT decreased at 18-21 days after inoculation in group PNN (P ＜ 0.05 or 0. 01). Conclusion The mechanism by which anti-NGF attenuates bone cancer pain in rats is related to the activation of MOR.