Three-way laryngeal mask reduces anesthesia-related stress responses in bronchoalveolar lavage: an experimental canine study

Objective: to compare the ventilatory effects of the three-way laryngeal mask airway [TLMA] and tracheal tube [TT] on hemodynamics, respiratory function, and stress responses in a canine model during bronchoalveolar lavage [BAL]

Study Design: experimental study

Place and Duration of Study: the 303rd Hospital of the Chinese People's Liberation Army in May 2013

Methodology: sixteen dogs were divided into two groups. MAP, SpO[2] and HR were recorded before anesthesia [T[0]], immediately before intubation [T[1]], during intubation [T[2]], at 3 [T[3]] and 10 [T4] minutes after mechanical ventilation, at 10 [T[5]], 20 [T[6]], and 30 [T[7]] minutes during the course of BAL, during extubation [T[8]], and 3 minutes after extubation [T[9]]. Tidal volume, peak inspiratory airway pressure, and expiratory CO[2] pressure were recorded at time points T[2], T[5], T[6], T[7], and T[8]. Stress responses variables, including epinephrine and norepinephrine levels, were examined at time points T[0], T[2], T[3], T[5], T[8], and T[9]

Results: BAL was successfully completed in all animals. In comparison to the TT, the TLMA was capable of maintaining hemodynamic stability and ventilation [p < 0.05], and producing less stress responses [p < 0.05]

Conclusion: in a canine model, ventilation with the TLMA was better than the TT during BAL in terms of maintaining effective ventilation and stable hemodynamics, and producing less stress responses

Retrospective observation of dynamic levels of serum Golgi protein 73 in patients prior to the onset of liver cancer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the dynamic levels of serum Golgi protein 73(GP73) in patients prior to and after the onset of liver cancer, and to explore the related factors.</p><p><b>METHODS</b>From 2007 to 2012, a periodical screening program was carried out in a group of high risk population with positive Hepatitis B surface antigens (HBsAg) , twice a year. Their serum specimens from every screening time point were kept in Qidong Biobank until liver cancer was diagnosed. Thirty-nine patients with liver cancer were recruited for the study, each of them at least had three times of specimens collected as well as B ultrasound scan (BUS) exam results at onset of disease and within 30 months before diagnosed, amongst 6 time points. In total, there were 162 specimens collected to test GP73 by double-antibody sandwich enzyme-linked immuno-sorbent assay (ELISA). Statistical analyses of time series and differences among groups were performed by stata software 10.</p><p><b>RESULTS</b>The average value of 39 patient's GP73 at the time point of liver cancer onset was (126.77 ± 73.73) µg/L, while the values at the other five time points prior to the onset were (128.32 ± 81.18) , (129.97 ± 83.62) , (127.38 ± 80.10) , (135.52 ± 97.88) and (138.24 ± 93.58) µg/L, respectively, with no significant difference (F = 0.07, P = 0.997). No obvious changing trends of GP73 were observed among the 39 liver cancer cases at the 6 time points. All 162 samples were divided into two groups: without hepatic cirrhosis (63 samples) and with cirrhosis (99 samples) according to findings of B-ultrasonic wave; whose average GP73 values were separately (97.16 ± 51.39) and (151.20 ± 91.68) µg/L. The difference showed statistical significance (F = 18.22, P < 0.01). Furthermore, if we grouped the samples by the average value of GP73 at 130.19 µg/L, then there were only 1/14 of the subjects without hepatic cirrhosis having higher GP73 values, but 12 of the 25 subjects with hepatic cirrhosis having higher GP73 values. The difference showed statistical significance (P = 0.013). The results of Linear regression model also showed that there was no correlation between GP73 and time series (t = 0.75, P = 0.455), but significant correlation between GP73 and hepatic cirrhosis (t = 4.30, P < 0.01).</p><p><b>CONCLUSION</b>No significant changes of the dynamic levels of GP73 could be found among the liver cancer patients within 30 months prior to the onset of disease. GP73 values of the patients with liver cancer may depend on their background of hepatic diseases; and hepatic cirrhosis might be one of the main influencing factors or confounding factors.</p>

Survey of the serum hepatocellular carcinoma marker Golgi glycoprotein (GP73) among Qidong residents and correlation analysis to outcome at two-year follow-up / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To survey the levels of Golgi glycoprotein (GP73), a hepatocellular carcinoma (HCC) marker, in residents of Qidong and determine the correlation of detected GP73 concentration ranges with outcome at two-year follow-up.</p><p><b>METHODS</b>A total of 12,378 individuals (age range: 35-69 years old) from Qidong were enrolled in the study. All participants were tested for hepatitis B virus (HBV) by detecting hepatitis B surface antigen (HBsAg) in serum. One-tenth of the participants were assigned to a stratified-random sample group (those with identification numbers ending with "0") to represent a "subgroup of the natural population" (HBsAgPop, n = 1227). All HBsAg carriers were stratified as a "subgroup of positivity" (HBsAgPve, n = 1025). One-tenth of all HBsAg-negative individuals were assigned to a stratified-random sample group to represent a "subgroup of negativity" (HBsAgNve, n = 1132). Enzyme-linked immunoassay was used to measure the serum GP73 and alpha-fetoprotein (AFP) levels; the distribution, medians (50th percentile), and 95th percentiles of GP73 were determined for the three subgroups. A two-year follow-up was carried out to observe the differential incidence of HCC between the HBsAgPve and HBsAgNve subgroups.</p><p><b>RESULTS</b>A positively skewed distribution of the GP73 values was observed for all three subgroups. The medians for HBsAgPve, HBsAgNve, and HBsAgPop were 67 mug/L, 54 mug/L, and 55 mug/L; the 95th percentiles were 174 mug/L, 108 mug/L, and 114 mug/L, respectively. The AFP positivity rates were 7.23% (37/512) for carriers whose GP73 values were above the median level and 0.78% (4/513) for carriers with GP73 values below the median level, with a highly significant difference between the two (P less than 0.01). A the two-year follow-up, 23 (4.49%) of the 512 carriers with GP73 more than or equal to 67 mug/L had developed HCC, while only one patient (0.19%) of the 513 carriers with GP73 less than 67 mug/L developed HCC, which yielded a relative risk value of 23.6. In the non-carriers, no HCC cases had occurred, regardless of serum GP73 level.</p><p><b>CONCLUSION</b>Serum GP73 has a higher potential as a diagnostic/prognostic marker of HCC in individuals with HBsAg positivity. In follow-up of HBsAg carriers, GP73 may help in the early detection of liver cancer.</p>