Effects of oxycodone early analgesia on stress response in patients undergoing uvulopalatopharyngoplasty / 临床麻醉学杂志

Objective To study effects of oxycodone post-operative early analgesia on stress re-sponse with in diabetics undergoing uvulopalatopharyngoplasty (UPPP).Methods Eighty patients undergoing UPPP,53 males,27 females,aged 28-65 years,ASA Ⅰ or Ⅱ were randomly divided in-to two groups(n =40).1 5 minutes before the end of the operation,group O was intravenously given oxycodone 0.07 mg/kg;Group F fentanyl 0.7 μg/kg.The patients of the two groups were sampled venous blood 3 ml in the morning of operation (T1 ),postoperative 1 hour (T2 ),postoperative 3 hours (T3 )for determination of serum cortisol (Cor),serum insulin(Ins),serum C-peptide(C-P)u-sing electrochemical luminescence method.Results Cor at T2 ,T3 was lower than that at T1 , C-P was higher than that at T1 (P <0.05)in group O,respectively;Cor at T2 ,T3 was higher than that at T1 , respectively,C-P was lower than that at T1 (P <0.05);Cor in group F was higher than that in group O,C-P in group F was lower than that in group O(P <0.05).Ins at T2 ,T3 was lower than that at T1 and was lower than that in group O(P <0.05).Conclusion Oxycodone 0.07 mg/kg early analgesia for UPPP significantly inhibits the occurrence of stress response.

Neoadjuvant chemotherapy for locally advanced gastric cancer: A Meta analysis / 肿瘤

Objective: To evaluate the efficacy of neoadjuvant chemotherapy (NC) for locally advanced gastric cancer by Meta-analysis. Methods: A computer-based online search of PubMed, Embase, Cochrane Library, China Biology Medicine disc (CBMdisc), National Knowledge Infrastructure (CNKI), China Academic Journals Full-text Database (CJFD), Wanfang Data, China Conference Paper Database (CCPD) and China Cancer Database was performed. In accordance with the inclusion and exclusion criteria, the randomized controlled trials (RCTs) were selected. After evaluating the quality of the included studies and extracting the data, a Meta-analysis was perfomed by using RevMan 5.0 software. Results: A total of 8 RCTs including 1 260 patients were included in this Meta-analysis. The resection rate [odds ratio (OR): 1.04, 95% confidence interval (CI): 0.76-1.43; P = 0.79], radical resection rate (OR: 1.02, 95% CI: 0.57-1.83; P = 0.94) and perioperative mortality (OR: 1.06, 95% CI: 0.56-2.00; P = 0.86) beween the neoadjuvant chemotherapy combined with surgical operation group and surgical operation alone group were not statistically different. The difference in one-year survival rate was not statistically significant (OR: 1.05, 95% CI: 0.79-1.41; P = 0.72) between the two groups, but the 2-year (OR: 1.33, 95% CI: 1.03-1.72; P = 0.03) and 3-year (OR: 1.61, 95% CI: 1.23-2.09; P = 0.000 5) survival rates of the neoadjuvant chemotherapy combined with surgical operation group were higher than those of the surgical operation alone group. Conclusion: Neoadjuvant chemotherapy for locally advanced gastric cancer may not increase the resection rate and the operation risk, and it can improve the long-term survival rate. Copyright © 2014 by TUMOR.

Subjective sleepiness in heart failure patients with sleep-related breathing disorder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies show that sleep-related breathing disorder (SRBD) is common in patients with heart failure (HF) and is associated with increased mortality. This study aimed to determine whether there was significant difference of subjective daytime sleepiness between HF patients with and without SRBD.</p><p><b>METHODS</b>We enrolled, prospectively, 195 consecutive HF patients with left ventricular ejection fractions (LVEF) < or = 45% and all subjects underwent polysomnography to measure the sleep structure between 2005 and 2008. Patients were then assigned to those with SRBD including obstructive and central sleep apnea (apnea-hypopnea index (AHI) > or = 5/hour of sleep) and those without SRBD (AHI < 5/hour) according to the sleep study. The subjective sleepiness was assessed with Epworth sleepiness scale (ESS).</p><p><b>RESULTS</b>Among 195 HF patients, the prevalence of obstructive sleep apnea (OSA) was 53% and of central sleep apnea (CSA) was 27%. There was no significant difference of ESS scores between patients without SRBD (NSA) and with SRBD (NSA vs OSA: 6.7 +/- 0.6 vs 7.6 +/- 0.4, P = 0.105 and NSA vs CSA: 6.7 +/- 0.6 vs 7.4 +/- 0.5, P = 0.235, respectively), indicating that SRBD patients had no more subjective daytime sleepiness. Compared with NSA, patients with SRBD had increased arousal index (ArI) (NSA vs OSA: 14.1 +/- 1.4 vs 26.3 +/- 1.5, P < 0.001 and NSA vs CSA: 14.1 +/- 1.4 vs 31.3 +/- 3.5, P < 0.001, respectively), more awake number after sleep onset (NSA vs OSA: 19.2 +/- 1.5 vs 26.2 +/- 1.4, P = 0.01 and NSA vs CSA: 19.2 +/- 1.5 vs 36.9 +/- 4.4, P < 0.001, respectively), and reduced proportion of slow-wave sleep (SWS) (NSA vs OSA: 13.8 +/- 1.7 vs 9.3 +/- 0.7, P = 0.024 and NSA vs CSA: 13.8 +/- 1.7 vs 8.9 +/- 0.9, P = 0.024, respectively).</p><p><b>CONCLUSIONS</b>OSA and CSA remain common in patients with HF on optimal contemporary therapy. Patients with both HF and SRBD have no significant subjective daytime sleepiness compared with patients without SRBD, despite of significantly increased awake number, arousal and decreased proportion of deep sleep stages. It is not a credible way and means to exclude SRBD in patients with HF according to the absence of subjective daytime sleepiness.</p>

Construction of tissue engineered gingiva with gingival epithelia and acellular dermal matrix / 中南大学学报(医学版)

OBJECTIVE@#To culture human gingival epithelia in vitro, and to construct the tissue engineered gingiva with the acellular dermal matrix (ADM).@*METHODS@#Human gingival epithelia were isolated from the gingival tissue, and the cells were cultured and seeded onto the surface of ADM. After 7 days of submerged incubation, an air-liquid interface culture was performed for 7, 14, and 21 days. The complex constructed above was taken for histological examination.@*RESULTS@#Human gingival epithelia could proliferate well on the surface of ADM, and form multilayer structure. But the superficial epithelium was partially keratinized.@*CONCLUSION@#Tissue engineered gingiva may be constructed with human gingival epithelia and ADM in vitro.