Application of image guided technique in rhino-orbital related endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

To review retrospectively six cases of rhino-orbital related endoscopic surgeries aided by Fusion electromagnetic system,to explore the indications and clinical value of image guided technique in endonasal endoscopic surgery.Retrospective research methods were used.In this study,six cases of nasal endoscopic sinus surgery using Fusion electromagnetic system were analyzed,including 1 nasal penetrating foreign body,2 optic nerve decompressions,1 orbital apex hemangioma,1 sieve frontal sinus cyst,1 intraorbital mass biopsy.The preparation time of navigation system,the accuracy of intraoperative positioning and surgical coherence,intraoperative and postoperative complications of surgery were recorded.The average preparation time was(8.13 ± 1.858)min.In the navigation,the sinus ostium,orbital cardboard,skull base,optic nerve,internal carotid artery and other important structures can be accurately located in all patients,while registrations had been accurate within 1 mm.Six patients were successfully operated by image guided technique.There was no intracranial or intraorbital complications due to intraoperation error.Image guided technique allows for a truely microinvasive and accurate rhino-orbital related endoscopic surgeries.It requires less preoperative preparation time,has high surgical navigation accuracy,improves the surgical coherence and safety,and reduces the surgical complicationgs.However,as an auxiliary tool,it can not replace the surgeon's anatomical knowledge,surgical training and clinical experience.

Effect of magnesium-calcium alloy extract on matrix metalloproteinase-9 and matrix metalloproteinase inhibitor-3 in human colonic epithelial cells / 新乡医学院学报

Objective To investigate the effect of different concentrations of magnesium-calcium alloy extract on the expression of matrix metalloproteinase-9 (MMP9) and tissue inhibitor of metalloproteinase-3 (TIMP3) in human colonic epithelial NCM460 cells.Methods The different concentrations of extracts (the volume fraction was 10％,50％ and 100％ respectively) were made with magnesium-calcium alloy.The 5 × 106 L-1 NCM460 suspension was randomly divided into control group,experimental group 1,experimental group 2 and experimental group 3.The cells in the control group were cultured by 2 000 μL high glucose Dulbecco's modified Eagle's medium (containing 10％ volume fraction of fetal bovine serum).The cells in the experimental group 1,2 and 3 were cultured by 2 000 μL magnesium-calcium alloy extract with volume fraction of 10％,50％ and 100％ respectively.The expressions of MMP9 and TIMP3 mRNA in NCM460 cells was detected by real-time fluorescence quantitative polymerase chain reaction,and the expression of MMP9 and TIMP3 protein in NCM460 cells was detected by Western blot at after one,three and five days of cultivation respectively.Results The expression of MMP9 mRNA and TIMP3 mRNA in NCM460 cells of the experimental group 1,2 and 3 was significantly lower than that in the control group after one day of cultivation (P ＜ 0.05).After three and five days of cultivation,the expression of MMP9 mRNA in NCM460 cells of the experimental group 1 was significantly lower than that in the control group (P ＜ 0.05),but the expression of MMP9 mRNA in the NCM460 cells of the experimental group 2 and 3 was significantly higher than that in the control group and the experimental group 1 (P ＜ 0.05).The expression of MMP9 mRNA in NCM460 cells of the experimental group 3 was significantly higher than that in the experimental group 2 after five days of cultivation (P ＜ 0.05).The expression of MMP9 mRNA in NCM460 cells of the experimental group 1,2 and 3 after three and five days of cultivation was significantly higher than that after one day of cultivation(P ＜ 0.05).There was no significant difference in the expression of MMP9 mRNA in NCM460 cells of the experimental group 1 between three and five days of cultivation (P ＞ 0.05).The expression of MMP9 mRNA in NCM460 cells of the experimental group 2 and 3 after five days of cultivation was significantly higher than that after three days of cultivation(P ＜ 0.05).The expression of TIMP3 mRNA in NCM460 cells of the experimental group 2 and 3 was significantly higher than that in the experimental group 1 after one day of euhivation (P ＜ 0.05).After three days of cultivation,the expression of TIMP3 mRNA in NCM460 cells of the experimental group 1,2 and 3 was significantly lower than that in the control group (P ＜ 0.05);the expression of TIMP3 mRNA in NCM460 cells of the experimental group 2 was significantly lower than that in the experimental group 1 and 3 (P ＜ 0.05).After five days of cultivation,the expression of TIMP3 mRNA in NCM460 cells of the experimental group 1,2 and 3 was significantly higher than that in the control group (P ＜ 0.05).The expression of TIMP3 mRNA in NCM460 cells after three and five days of cultivation was significantly higher than that after one day of cultivation (P ＜ 0.05),and the expression of TIMP3 after five days of cultivation was significantly higher than that after three days of cultivation in the experimental group 1 (P ＜ 0.05).The expression of TIMP3 mRNA in NCM460 cells after three days of cultivation was significantly lower than that after one day of cultivation (P ＜ 0.05),and the expression of TIMP3 after five days of cultivation was significantly higher than that after one and three days of cultivation in the experimental group 2 (P ＜ 0.05).The expression of TIMP3 mRNA in NCM460 cells after five days of cultivation was significantly higher than that after one and three days of cultivation in the experimental group 3 (P ＜ 0.05).After five days of cultivation,there was no significant difference in the expression of MMP9 protein in NCM460 cells between the experimental group 1 and control group (P ＞ 0.05),the expression of MMP9 protein in NCM460 cells of the experimental group 2 and 3 was significantly higher than that in the control group and the experimental group 1 (P ＜ 0.05),but there was no significant difference in the expression of MMP9 protein in NCM460 cells between the experimental group 2 and 3 (P ＞ 0.05).After five days of cultivation,the expression of TIMP3 protein in NCM460 cells of the experimental group 1,2 and 3 was significantly higher than that in the control group (P ＜0.05);but there was no significant difference in the expression of TIMP3 protein in NCM460 cells among the experimental group 1,2and 3 (P ＞ 0.05).Conclusions The high concentration of magnesium-calcium alloy extract has certain influence on the expression of MMP9 and TIMP3 gene in NCM460 cells,which may lead to the early inflammatory reaction,and the mechanism may be related to the calcium ion concentration in the extract.

Primary drug resistance among newly reported human immunodeficiency virus infected individuals in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province in 2015 / 中华传染病杂志

Objective To determine the prevalence of human immunodeficiency virus (HIV) primary drug resistance (HIV-PDR) in newly reported HIV-infected individuals in Dehong Prefecture,Yunnan Province in 2015.Methods Newly reported HIV-positive patients who had viral load ≥ 1 000 copies/mL from January to November in 2015 were tested for HIV-PDR by reverse transcriptionpolymerase chain reaction (RT-PCR) and HIV pol gene sequencing.HIV-PDR was determined according to the Surveillance Drug Resistance Mutations (SDRM) list of Stanford University,which was recommended by World Health Organization (WHO) in 2009.Results A total of 322 newly reported HIV-infected cases whose pol gene was successfully amplified were included in the final analysis.Of them,211 (65.5％) were male,and 229 (71.1％) were sexually transmitted.A total of 152 (47.2％) were Chinese.A total of 29 HIV subtypes were found,including type B (12.1％),type C (28.0％),type CRF01_AE (24.5％),type CRF07_BC (5.9％),type CRF08_BC (5.6％),type 62_BC (7.5％),type BC-new breakpoint (3.4％) and other subtypes (13％).Six patients (1.9％) were defined as primary resistance to HIV according to the WHO standard.Conclusions The prevalence of HIV-PDR is 1.9％ among newly reported HIV-infected individuals,which is relatively low in the studied area.But HIV-PDR surveillance should be strengthened in this area with the scaling up of antiretroviral therapy.

Effect of intraoperative using cell saver on blood sparing and its impact on coagulation function / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effectiveness of using cell saver (CS) during surgery on blood sparing and its impact on patient's hematology and coagulation function.</p><p><b>METHODS</b>One-hundred and thirty-eight patients undergoing elective surgery were recruited for intraoperative blood salvage using CS. Blood routine, blood chemistry and coagulation function were measured before surgery, after infusion of salvaged blood and postoperative day 1, respectively.</p><p><b>RESULTS</b>In total, 112,056 ml of packed red blood cells were collected, with a mean value of 812 ml per patient. The percentage of autologous blood transfusion volume to the total blood transfusion volume was from 48% to 89%. Allogenic blood transfusion rate was from 5% to 100%. Compared with the values before surgery, the hemoglobin concentration, platelet count, plasma total protein and fibrinogen concentration decreased significantly after the transfusion of salvaged blood and the first postoperative day (P < 0.05 or P < 0.01), while the prothrombin time was significantly prolonged (P < 0.05).</p><p><b>CONCLUSIONS</b>The use of CS during surgery can, to a certain extent, reduce the requirement of allogenic blood. However, reinfusion of large amount of salvaged blood may affect coagulation function.</p>

Influence of obesity on pharmacokinetics and pharmacodynamics of isoflurane / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effect of obesity on pharmacokinetics and pharmacodynamics of isoflurane.</p><p><b>METHODS</b>Twenty-six patients undergoing cholecystectomy were divided into obese group (Group A, BMI > or = 27, n = 13) and normal body weight group (Group N, BMI < or = 24, n = 13) according to body mass index (BMI). All patients were given to the same isoflurane anesthesia. Inspired and end-expired concentrations of isoflurane were monitored and uptake fraction of isoflurane were calculated.</p><p><b>RESULTS</b>Isoflurane concentrations of vaporizer in Group A [(1.8 +/- 0.3)%] were evidently higher than those in Group N [(1.5 +/- 0.1)%] at all observed points (P < 0.05 or P < 0.01). Uptake fraction of isoflurane in Group A were higher than those in Group N at observed points (P < 0.05, P < 0.01 or P < 0.001), but there were no differences in the time when isoflurane concentration was lowered to 50% and awake time between the two groups after discontinuing inhaling isoflurane.</p><p><b>CONCLUSIONS</b>Obese patients demand higher inspired concentration and uptake of isoflurane than those in normal weight patients but discharge of isoflurane was influenced by obesity within the observed period of (66 +/- 33) min.</p>