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Objective To investigate the advantages and disadvantages of oxycodone combined subarachnoid block and intravenous-inhalational anesthesia in elderly patients with femoral trochanter fracturethe surgery.Methods Thirty-four patients undergoing elective surgery with closed reduction and Proximal femoral nail anti-rotation (PFNA) fixation,13 males and 21 females,aged 76-92 years,ASA physical status Ⅱ or Ⅲ,were equally randomized into two groups (n =17 each):group O and group C.Patients in group O received oxycodone combined subarachnoid block.Patients in group C received intravenous-inhalational anesthesia.Patients in group C were not premeditated beforel entering the operation room.After entering the rooms group O was given oxycodone 3-5 mg i.v first,then given ropivacaine in subarachnoid space.All patients were induced with intravenous of sulfentanil 0.2-0.3μg/kg,cisatracurium 0.15 mg/kg,etomidate 0.1-0.2 mg/kg slowly.Anesthesia was maintained by intravenous propofol 3-5 mg· kg-1 · h-1,remifentanyl 0.1-0.3 μg · kg-1 · h-1,sevofrane 0.55％-2％ infusion,intravenous bolus cisatracurium 0.05-0.10 mg/kg.The anesthesia related complications and length of hospital stay were recorded.Results Postoperative nausea and vomiting (PONV) respiratory depression of group O was significantly lower than that of group C [2(11.8％) cases vs 9 (52.9％) cases,P＜0.05],length of hospital stay of group O was significantly shorter than that of group C [(10.4±1.6) d vs (15.8±2.0) d,P＜0.05].Conclusion In the elderly patients with femoral intertrochanteric fracture closed reduction and PFNA internal fixation,oxycodone combined subarachnoid block may improve patients' recovery.
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Objective To investigate the effects of electroacupuncture (EA) of different intensities on cerebral energy metabolism in a rat model of global cerebral ischemia-reperfusion (I/R) . Methods Forty male SD rats weighing 200-230 g were randomized into 5 groups ( n = 8 each) : group A sham operation; group B global cerebral I/R and C, D, E groups cerebral I/R+ 5, 3, 1 mA EA. Global cerebral I/R was induced by 4-vessel occlusion technique. Bilateral vertebral arteries were permanently occluded by cauterization.Bilateral common carotid arteries were clamped. When the bilateral pupils were completely dilated, the arteries were unclamped. Baihui,Mingmen and Zusanli were electrically stimulated with 5,3,1 mA (30-50 Hz) for 20 min at 1 h of reperfusion in C, D, E groups. The EA was repeated at 12 h of reperfusion. The animals were sacrificed at 24 h of reperfusion.The activities of Na+ -K+ -ATPase, succinodehydrogenase (SDH) and lactic dehydrogenase(LDH) in brain tissue were measured.Results Cerebral I/R significantly increased LDH activity and decreased Na+ -K+ -ATPase activity in group B as compared with group A. EA with 5 mA significantly decreased LDH activity and increased SDH and Na+ -K+ -ATPase activities in group C compared with group B. Conclusion EA can improve the cerebral energy metabolism in a rat model of global cerebral I/R and it is related to the intensity, which may be the mechanism by which EA reduces the global cerebral I/R injury.
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CNE cells were cultured on cover glasses placed in the culture flasks, and were examined under scanning electron microscope 6,24, 48,72, and 96 hours after cultivation. The results were as following: The surface structures of tumor cells changed in different intervals of cultivation. Evenly distributed zeiotic blebs were found on the surface of tumor cell after 24 hours of cultivation and most of these blebs were seen at marginal areas of tumor cells after 2 days of cultivation, and finally disappeared after 3 days of cultivation. In addition to the blebs some microvilli which had increased since the second day of cultivation were seen over the margin of tumor cells. On the third day of cultivation a large number of microvilli were seen distributed over the entire surface of tumor cells. Besides microvilli and zeiotie blebs, lamellipodia and ruffles were also observed after 24 hours, but vanished after 48 hours of cultivation. The filopodia were seen over the whole process of cultivation. They usually divided into 2、3 branches and the expanded ends looked like suckers. All these data indicated that the surface structure of tumor cells were variable in different periods of cultivation.
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The purpose of the present experiment was to observe the morphological characteristics and invasiveness of a transplantable cancer NO 27 (U 27) after serial passages about 20 years. The results were as follows: The morphological characteristics of this tumor strain was low-differentiated carcinoma which were demonstrated by light microscopy and transmission electron microscopy. In the cytoplasm the single irregular distribution of the tensile fibrils and some semi-desmosome between adjacent cells were discovered by transmission electron microscopy. Two types of cancer cells were observed on the surface of the cancer nest by scanning electron microcopy:Ⅰ), There were many microvilli on the surface of the first type cancer cells; 2). The surface of the cancer cells of the second type were more flat sometimes with single small blebs. Many cancer cells had been released from cancer cell clump after 3 days of intramuscular implantation. Later they actively invaded into the spaces between muscle fibers in the form of amebae. Some cancer cells stretched out their filopodia directly in contact with target cells. The degenerative and atrophic changes of muscle tissue appeared in the invasive area of cancer cells. Finally these changes were leading to the disappearance of the entire structure of the muscle with the replacement by cancer tissues.
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The present experiment applied the freeze cracking technique and scanning electron microscopy for further studies of ultrastructural changes of cancer cells after they invaded into the organ. It was found that, after two days of cultivation, there were a lot of cancer ceils which adhered on to the surface of organ fragments. The cancer cells migrated on the surface of the organ and at the same time penetrated into the organ by stretching out their pseudopodia. After 3 days of cultivation, some cancer cells had already invaded into the organ. After invasion they connected target cells of the organ by different ways, but their filopodium is the important organelle for the connection and communication with those target cells.The cancer cells caught the projecting portion of surface of target cells by branches of filopodia forming a mosaic pattern with them. Sometimes the filopodia of cancer cells fused with the opposed surface of target cells by inserting into it. Some filopodia became short and thick inside the organ due probably to the limited distance between cancer cells and target cells when they were in close contact to each other. Once the tumor cell nests were formed in the organ, the tumor cells connected each other by stretching out pseudopodia from both poles, but kept a definite space between cells. It is postulated that these inter-cellular spaces were formed probably by the repelling force of the identical electric charge of the tumor cell membranes.