Effect of oxycodone on intestinal ischemia-reperfusion injury in rats and the role of autophagy / 中华麻醉学杂志

Objective To evaluate the effect of oxycodone on intestinal ischemia-reperfusion injury in rats and the role of autophagy.Methods Twenty-four healthy adult male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were divided into 4 groups (n =6 each) using a random number table method:sham group (group S),intestinal I/R group (group I/R),oxycodone group (group O) and oxycodone plus autophagy inhibitor 3-methyladenine (3-MA) group (group O+3-MA).Intestinal I/R was induced via clamping the superior mesenteric artery for 1 h,followed by 2-h reperfusion in all the groups except for group S.Oxycodone 0.5 mg/kg was injected via caudal vein at 15 min before ischemia in group O and group O+3-MA.3-MA 30 mg/kg was intraperitoneally injected at 10 min before ischemia in group O+3-MA.Rats were gavaged with fluorescein-isothiocyanate-conjugated dextran (FITC-dextran) immediately before ischemia.Blood samples were collected from the cardiac apex at 2 h of reperfusion to detect the level of serum FITC-dextran.Blood samples were collected from the cardiac apex at 2 h of reperfusion to measure the concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) in serum by enzyme-linked immunosorbent assay.Small intestinal tissues were obtained at 2 h of reperfusion for examination of the pathological changes and for determination of the expression of occludin,Beclin-1 and microtubule-associated protein 1 light chain 3 (LC3) (by Western blot).Intestinal damage was assessed and scored according to Chiu.The ratio of LC3 Ⅱ expression to LC3 Ⅰ expression (LC3 Ⅱ / Ⅰ) was calculated.Results Compared with group S,the Chiu's score,levels of serum FITC-dextran,TNF-α and IL-1β and LC3 Ⅱ/Ⅰ ratio were significantly increased,the expression of Beclin-1 was up-regulated,and the expression of occludin was down-regulated in group I/R (P＜0.05).Compared with group I/R,the Chiu's score and levels of serum FITC-dextran,TNF-α and IL-1β were significantly decreased,LC3 Ⅱ / Ⅰ ratio was increased,and the expression of occludin and Beclin-1 was up-regulated in group O (P＜0.05),and no significant change was found in the parameters mentioned above in group O+ 3-MA (P＞0.05).Compared with group O,the Chiu's score and levels of serum FITC-dextran,TNF-α and IL-1β were significantly increased,LC3 Ⅱ / Ⅰ ratio was decreased,and the expression of occludin and Beclin-1 was down-regulated in group O + 3-MA (P＜ 0.05).Conclusion Oxycodone can ameliorate intestinal I/R injury,and the mechanism may be related to enhancing autophagy in intestinal tissues of rats.

Efficacy of preoperative transversus abdominis plane block for improving analgesia after radical resection of colorectal cancer in elderly patients / 中华麻醉学杂志

Objective To evaluate the efficacy of preoperative transversus abdominis plane (TAP) block for improving analgesia after radical resection of colorectal cancer in elderly patients.Methods Fiftysix American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 75-86 yr,weighing 52-78 kg,scheduled for elective radical resection of colorectal cancer under general anesthesia,were divided into 2 groups (n=28 each) using a random number table:TAP block group (group T) and control group (group C).After anesthesia induction,ultrasound-guided bilateral TAP block was performed,and 0.40％ ropivacaine 25 ml was injected into each side in group T.Both groups received patientcontrolled intravenous analgesia (PCIA) with fentanyl after surgery.PCIA solution contained fentanyl 600 μg and azasetron 10 mg in 100 ml of normal saline.The PCIA pump was set up with a 2 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h,and visual analogue scale score was maintained≤ 3.When the visual analogue scale score＞3,tramadol 50-100 mg was intravenously injected as rescue analgesic.The number of patients requiring rescue analgesic,consumption of fentanyl during PCIA and the number of successfully delivered doses were recorded within 24 h after surgery.The adverse reactions such as hematoma at the puncture site,nausea and vomiting,respiratory depression,chest tightness and pruritus were recorded.Results Compared with group C,the number of patients requiring rescue analgesic was significantly decreased,and the consumption of fentanyl and the number of successfully delivered doses during PCIA were decreased in group T (P＜0.05).No hematoma was found at the puncture site in group T.No respiratory depression,chest tightness or pruritus was found in the two groups,and there were no significant differences in the incidence of nausea and vomiting between the two groups (P＞0.05).Conclusion Preoperative TAP block can reduce the consumption of fentanyl and enhance the efficacy of analgesia after radical resection of colorectal cancer in elderly patients.

Wear properties of lithium disilicate glass-ceramic and bovine tooth enamel:An in vitro study / 实用口腔医学杂志

Objective:To investigate the wear characteristics of bovine enamel and lithium disilicate glass ceramic under simulated oral environment.Methods:18 cylindrical lithium disilicate glass-ceramic specimens with the length of 8 mm and diameter of 3 mm were randomly divided into 2 groups (n =9),9 lithium disilicate glass-ceramic specimens and 9 bovine enamel specimens were served as the antagonists respectively.The specimens were then loaded in a wear simulator and subjected to friction force of 10 N for 540 000 cycles in artificial saliva and room temperature(speed 100 r/min,turning radius of 2.5 mm,uniform circular motion) condition.During the testing,10 checkpoints were applied to measure the height loss of the specimens with 3D profilometer,then wear curves were plotted.Scanning electron microscopy were applied to investigate the worn surfaces at different wear stages.Results:At every checkpoints,bovine enamel wear height loss was larger than the lithium disilicate specimens (P ＜ 0.05);bovine enamel wear curve exhibits a runningin period,steady wear period and severe wear period 3 stages of wear,while wear curves of lithium disilicate glass ceramics exhibit onlyrunning-in period and steady wear period 2 wear stages.Both groups had the corresponding micro-morphological features in different periods.Conclusion:Bovine enamel and lithium disilicate glass ceramics show a phase dynamic evolution law under the simulated oral environment.Bovine enamel is more susceptible to wear than lithium disilicate,suggesting that clinical attention should be paid to prevent the excessive wear of natural teeth caused by lithium disilicate glass ceramic restorations.

Influencing factors of diabetic patients applying for specific disease health insurance and its treatment cost / 浙江大学学报·医学版

OBJECTIVE@#To compare the treatment costs on type 2 diabetes between patients with and without specific diseases health insurance, and to identify the influencing factors related to specific diseases health insurance application.@*METHODS@#A structured questionnaire was used to investigate basic information, diabetes-related pharmacy, outpatient and inpatient treatment costs. SAS9.1 software was used for statistical analysis. The enumeration data was analyzed by using Chi-square test, and variables of statistical difference were bought into Logistic regression model through stepwise method. Continuous variables were represented by median(inter-quartile range)[M(Q)], and were analyzed by using Wilcoxon test.@*RESULTS@#Compared with patients without specific disease health insurance in outpatient group, patients with specific disease health insurance had higher annual per capita total cost [2160(3081) vs 1000(2100) yuan, P5 years (OR=2.04) were more likely to succeed in specific diseases health insurance application.@*CONCLUSION@#To reduce the financial burden of patients with type 2 diabetes, government should make huge efforts to promote specific disease health insurance policies, and encourage patients to apply for it. Meanwhile, medical insurance department and medical institutions should reinforce supervision and simplify the application process. To improve the availability of specific disease health insurance, the number and coverage of designated retail pharmacies should be increased. Besides, government should pay more attention to low-income patients and those with short duration diabetes, so as to enhance their ability to resist economic risks and reflect the fairness of specific disease health insurance.

Clinical evaluation of 287 CAD/CAM zirconia ceramic restorations:A 3-year follow up / 实用口腔医学杂志

Objective:To evaluate the clinical performance of CAD/CAM zirconia all-ceramic restorations.Methods:287 all-ce-ramic Zirconia restorations in 206 patients were included in a 3-year prospectively survey with California Dental Association Standard (CDA)as a reference.The effects and the related factors such as restoration type,tooth region,fiber reinforced composite application on survival rate were analyzed.Kaplan-Meier survival analysis and Log-Rank test were used for data analysis.Results:Chipping frac-tures in 5 restorations,intense gingivitis at 4 restorations and periapical inflammation for 3 restorations were observed during the obser-vation period.The 3-year cumulative survival rate (CSR)of CAD/CAMzirconia restorations was 95.7%,The differences among the CSR of single crowns(96.3%),linked crowns (93.6%)and fixed partial dentures(95.7%)were not statistically significant(P >0.05).The difference was not statistically significant(P >0.05)between the CSR of the anterior region group(94.5%)and posterior region group(96.3%)as well as difference(P >0.05)between the CSR of fiber reinforced composite group (95.0%)and without fiber reinforced composite group(96.1%).Conclusion:The cumulative survival rate of CAD/CAM zirconia all-ceramic restorations is high.Chipping fracture is the main reason of failure.Restoration type,tooth region and fiber reinforced composite have no significant effect on the survival of zirconia restorations.

Effect of fentanyl on efficacy of low-dose ropivacaine for spinal anesthesia in patients undergoing anorectal surgery / 中华麻醉学杂志

Objective To evaluate the effect of fentanyl on the efficacy of low-dose ropivacaine for spinal anesthesia in patients undergoing anorectal surgery.Methods Forty ASA Ⅰ or Ⅱ patients,aged 20-55 yr,with body mass index 18-28 kg/m2,scheduled for anorectal surgery,were randomly divided into 2 groups (n =20 each):0.5％ ropivacaine 7.5 mg group (group R) and 0.3％ ropivacaine 6.0 mg+ fentanyl 10 μg group (group RF).A catheter was implanted into the subarachnoid space (L3.4 interspace) and advanced caudally until lumbar region.Group R received hyperbaric 0.5％ ropivacaine 1.5 ml.Group RF received 2.0 ml mixture of hyperbaric 0.3％ ropivacaine 6.0 mg and fentanyl 10μg.The onset time of sensory and motor block,upper level of sensory block,and duration of sensory and motor block were recorded.Motor block was assessed by modified Bromage scale.Results Compared with group R,the duration of sensory and motor block was significantly shortened,and modified Bromage scores were significantly decreased in group RF (P ＜ 0.05 or 0.01),and no significant change was found in the onset time of sensory and motor block and upper level of sensory block between the two groups (P ＞ 0.05).Conclusion 0.3 ％ ropivacaine 6.0 mg combined with fentanyl 10 μg provides satisfactory spinal anesthesia for anorectal surgery,with lower degree and faster recovery of motor block.

Study to determine the behavior expression system of hospitals' social responsibilities / 中华医院管理杂志

By means of literature review,the authors initiated the behavior expression system of hospitals' social responsibilities,which is further refined and revised with questionnaires and Delphi method.13 expressions of such behavior expressions were determined,namely “providing quality of care to patients”,“undertaking rescue assignment for emergencies”,and “fulfilling government-assigned tasks”.All of the 13 expressions were supported by 75％ of the experts during the second round of experts consultation.

A comparison between laparoscopic hepatectomy and open hepatectomy for the treatment of hepatocellular carcinoma / 中华普通外科杂志

Objective To investigate the efficiency and safety of laparoscopic hepatectomy (LH) and open hepatectomy (OH) in patients with hepatocellular carcinoma (HCC). Methods A total of 45 HCC cases undergoing hepatectomy from January 2008 to December 2010 in our hospital were divided into LH group ( n =21 ) and OH group ( n =24 ).Their clinical efficiency and safety were compared and analyzed. Results The amount of intraoperative blood loss and blood transfusion in LH group were significantly higher than that of OH ( respectively x2 =3.973,x2 =4.862,all P ＜ 0.05 ).LH is associated with less postoperative complications and duration of hospital stay,compared with OH ( respectively x2 =4.746,t =-2.717,all P ＜0.05).Cumulative survival rates in both groups were not statistically significant ( x2 =0.172,P ＞ 0.05 ).However tumor-free survival rate in LH was significantly higher,superior to that of OH (x2 =4.543,P ＜ 0.05). Conclusions LH and OH are all safe and effective hepatectomy for HCC.LH has the advantage of less complication and shorter hospital stay.

Diagnosis and surgical treatment of adult cavernous transformation of portal vein in 63 cases / 中华肝胆外科杂志

Objective To summarize the diagnosis and surgical treatment of the cavernous transformation of portal vein (CTPV). Methods Clinical data of 63 patients with adult CTPV trea-ted in our hospital from 1976 to 2006 were retrospectively analyzed. Results The diagnosis of CT-PV was comfirmed according to (1) The main symptoms were repeated haematemesis, hemafecia, hy-persplenotrophy, hypersplenia and normal hepatic function. (2) B uhrasonography or ultrasonic Doppler manifested that portal vein thinning or obstruction or embolism, honeycomb appearance con-duit can be seen around. Portal vein frequency spectrum can be seen in the honeycomb appearance con-duit. (3) CT and MR scan materials were exhibited that the main portal vein and its branches lost the normal shape and had the shaggy edge. (4) percutaneous splenoportography or selective arteriography of superior mesenteric artery showed that occlusion of the main branch of portal vein at the porta hepa-tis was revealed, and a masslike network of tortuose veins around the porta hepatis and many small ir-regular veins radiating from the network to the liver were demonst rated. Splenectomy and devaseu-larization was performed in 23, spleneetomy and splenorenal shunt in 32, portal systemic shunt plus porta-azygous devascularization in 8. Portal hypertension was treated first in CTPV with disease of biliary tract. No death happened. The rascult of haemogram recovered in a short period of time.Conclusion Once the patients are diagnosed to suffer from adult CTPV, they should receive explora-tory laparotomy. It is important to choose the most effective treating method for the disease.

Effect of Chinese Herb Sinitang (Monkshood,ginger and licorice) on Blood Pressure in Renovascular Hypertensive Rats / 中华高血压杂志

Objective To investigate the effect of a Chinese herbs mixture(Monkshood,ginger and licorice)on blood pressure(BP)and its possible mechanism in renovascular hypertensive rats.Methods 2K1C hypertensive rats received placebo(n=8)or Sinitung(n=8)by gavage for 2 weeks.BP was measured by tail-cuff.Plasma angiotensin Ⅱ(Ang Ⅱ)and calcium gene related peptide(CGRP)were examined by histochemical assay.Results Sinitang treatment significantly decreased BP(116.2?8.3 mm Hg vs placebo:131.6?14.2 mm Hg,P

Establishment and evaluation of renovascular hypertensive rat models / 中国组织工程研究

BACKGROUND: It is significant to establish a kind of effective, conve nient and reliable animal model of hypertension. At present, dogs, rats and rabbits are usually used to establish hypertensive models at home and abroad, and the renal artery stenosis induced hypertensive models are ex tensively used to research hypertension and its complication for human be ings because they are convenient and reliable, and there are many methods to establish them, but the effects are to be evaluated. OBJECTIVE: To establish convenient and reliable animal models of ex perimental renal artery stenosis induced hypertension. DESIGN: A randomized grouping design and animal experiment. SETTING: Institute of Cerebrovascular diseases, Medical College Hospital of Qingdao University. MATERIALS: The experiments were carried out in Shandong Key Labora tory for Prevention and treatment of Brain Disease from September 2005 to February 2006. Eighty-one healthy Wistar rats divided into 7 groups accord ing to the method of random number table: unilateral renal artery stenosis group (n=18), bilateral renal artery stenosis group (n=17), unilateral renal artery ligation group (n=15), bilateral renal artery ligation group (n=15), uni lateral renal artery stenosis sham-operated group (n=6), bilateral renal artery stenosis sham-operated group (n=4) and normal control group (n=6). METHODS: Unilateral renal artery stenosis group: Right renal artery was clamped with miniature silver clip, and left kidney was resected after 12 days. Bilateral renal artery stenosis group: Right renal artery was clamped with miniature silver clip, and the same treatment was given to the left side after 12 days. Unilateral renal artery ligation group: Right renal artery was ligated with filament, and left kidney was resected after 12 days. Bilateral renal artery ligation group: Right renal artery was ligated with filament, and the same treatment was given to the left side after 12 days. Unilateral renal artery stenosis sham-operated group: Right kidney was exposed, and returned to the original place without any treatment, and left kidney was resected af ter 12 days. Bilateral renal artery stenosis sham-operated group: Right kid ney was exposed, and returned to the original place without any treatment, and the same treatment was given to the left side after 12 days. Normal con trol group: The rats were not given any treatment. The blood pressure and heart rate were determined with RBP-2 hemomanometer for rats. MAIN OUTCOME MEASURES: The successful rate of model estab lishment, blood pressure and heart rate were observed. RESULTS: Totally 81 rats were used, and 61 of them died, all were in volved in the analysis of results without deletion. ① Blood pressures in the unilateral and bilateral renal artery stenosis groups and bilateral renal artery ligation group were obviously higher than those in the normal control group and bilateral renal artery stenosis sham-operated group [(138.0 ±36.5), (154.2±11.6), (160.5±0.7), (101.3±17.6), (108.3±5.7) mm Hg]. ② The changes of heart rate in the renal artery stenosis group were unstable, and the heart rates in the unilateral and bilateral renal artery stenosis groups, bilateral renal artery ligation group, normal control group and bilat eral renal artery stenosis sham-operated group were (367.5±47.2), (420.2 ±47.8), (386.0±4.2), (390.3±42.4), (417.3±27.5) beats per minute, respec tively. ③ The survival rates in the renal artery stenosis groups (22%, 29%) were significantly higher than those in the renal artery ligation groups (0,12%), and it was the highest in the unilateral renal artery stenosis group.CONCLUSION: The method of clamping bilateral renal arteries can establish stable rat models of hypertension induced by renal artery stenosis.

Establishment and evaluation of the model of middle cerebral artery occlusion reperfusion in mice / 中国组织工程研究

BACKGROUND: Most animal experiments of transgene are derived from mice; therefore, it is necessary to establish a focal cerebral ischemiareperfusion model and significant to prevent and cure ischemic cerebrovascular diseases.OBJECTIVE: To establish a convenient and reliable model with middle cerebral artery occlusion reperfusion (MCAO/R) in mice.DESIGN: Randomized controlled animal study.SETTING: Institute of Cerebrovascular disease, Affiliated Hospital of Medical College of Qingdao University.MATERIALS: Twenty healthy BALB/c mice, of both genders, weighing 25-30 g, of SPF grade, were divided into sham operation group (n=5), ischemia group (n=10) and 22-hour reperfusion group (n=5) on the basis of digital table. In addition, according to digital table, 130 healthy male Kunming mice were divided into sham operation group (n=10), 24-hour ischemia group (n=30), 2-hour ischemia/22-hour, 46-hour and 70-hour reperfusion groups with 30 in each group; meanwhile, 30 female mice were divided into sham operation group, 24-hour ischemia group and 2-hour ischemia/22-hour reperfusion group with 10 in each group. All Kunming mice were weighing 25-30 g and of SPF grade.METHODS: The experiment was carried out in the Institute of Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University from July 2005 to March 2006. The 6-0 suture with silica gel covered at an end was sent from the left external carotid artery (ECA) into internal carotid artery (ICA) till arriving at the initiation of middle cerebral artery (MCA) to block the blood stream in it, then drawing the suture from ICA 2 hours after occlusion to accomplish reperfusion. Mice were cut off their heads in sham operation group at 24 hours after operation, in ischemia group at 24 hours after blocking blood stream and in reperfusion group at 24, 48 and 72 hours after operation. Reliability of models was evaluated with neurology score and tetrazolium chloride stain. Longa standard scores: neurology score ≥ 1 point was regarded as successful models;coronal sections of brain tissue were stained with tetrazolium chloride, and the white region was regarded as infarcted volume.MAIN OUTCOME MEASURES: Neurology score and infarcted volume after staining of triphenyltetrazolium chloride in brain tissue.RESULTS: All mice were involved in the final analysis. ① Successful rate was 20% of BALB/c mice, 66.7%-73.3% of male Kunming mice and 40%-50% of female Kunming mice. ② Brain sections of BALB/c mice in sham operation group were orange at both sides of cortex and infarction focus was not observed. A big infarcted volume was observed on brain sections of mice in ischemia group, and infarcted volume counted for 50%-70% as homonymy hemisphere on optochiasmatic coronal sections. The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%. In addition, condition in ischemiareperfusion group was similar to that in ischemia group. A big infarcted volume was observed on brain sections, and infarcted volume counted for 50%-75% as homonymy hemisphere on optochiasmatic coronal sections.The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%.CONCLUSION: The model with MCAO/R in mice characterizes by relatively smaller trauma, and the ischemic region is stable; therefore, it can be used to accurate timing control of ischemia/reperfusion. This model is an ideal one for researching pathophysiological changes, prognosis and therapy in cerebrovascular disease.

The value of ~(99m)Tc-MIBI scintimammography and breast X-ray in the diagnosis of breast cancer / 中国普通外科杂志

Objective To evaluate the practical value of 99m Tc-MIBI scintimammography and breast X-ray in the detection of breast cancer. Methods 100 female patients with 106 suspected focuses of breast cancer on clinical examination underwent 99m Tc-MIBI scintimammography and breast molybdenum target X-ray, and the results were compared with the pathological diagnosis. Results Compared with the histopathologic diagnosis , the sensitivity of molybdenum target X-ray for detecting primary breast cancer was 44.6% and the positive predictability was 31.7%. The specificity of 99m Tc-MIBI was 87.8% and the positive predictability was 76.9%. Conclusions In comparison with breast X-ray, 99m Tc-MIBI scintimammography is of greater clinical value in the diagnosis of breast cancer.

Detection of primary breast cancer and axillary lymph node metastasis by ~(99m)Tc-MIBI prone scintimamorgaphy / 中国普通外科杂志

Objective To prospectively study the sensitivity and specificity of 99m Tc Methoxyisobutyl Isonitrile( 99m Tc MIBI) scintimammorgaphy in the detection of both primary breast cancer and axillary lymph node metastasis. Methods Eighty four consecutive women suspicious of breast cancer under clinical examination were checked by the scintimammorgaphy of planar prone imaging in three planar views(5～8?min/view). The entire breast and ipsilateral axillary region were included in the field of view. Biopsy of resectional breast and lymph node were performed within 10 days after scintimammography. Results There were 51 primary breast cancer(7 different histologic types) and 33 benign breast lesion(4 histologic types) in this series. The sensitivity of scintimammography for detecting primary breast cancer was 90.20%(46/51) and the specificity was 93.93%(31/33). Metastatic axillary lymph nodes were seen in 25 of the 51 patients. The sensitivity of scintimammography to detect metastatic lymph node was 84.0%(21/25) and the specificlty was 88.46%(23/26). Conclusions The results of this study indicate that the scintimammography has high diagnosis rate in detecting breast cancer and axillary lymph node metastasis.