Application value of new liver function scoring models in radiofrequency ablation for hepatocellular carcinoma / 临床肝胆病杂志

Comprehensive scoring models are one of the main methods for liver function evaluation and an important part of the treatment strategy for hepatocellular carcinoma. This article summarizes the value and limitations of traditional scoring models (Child-Turcotte-Pugh score and Model for End-Stage Liver Disease score) and new scoring models (albumin-bilirubin score, platelet-albumin-bilirubin score, and albumin-indocyanine green score) in radiofrequency ablation for hepatocellular carcinoma and points out that the new scoring models, especially platelet-albumin-bilirubin score, are advantageous.

Effect of dexmedetomidine on postoperative pulmonary function in patients undergoing laparoscopic operation / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on the postoperative pulmonary function in patients undergoing laparoscopic operation.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-70 kg,undergoing laparoscopic radical resection of rectal cancer,were divided into 2 groups (n =40 each) using a random number table:control group (group C) and dexmedetomidine group (group Dex).General anesthesia combined with epidural anesthesia was used.In group Dex,dexmedetonidine was intravenously infused as a bolus of 0.3 μg/kg over 10 min after epidural catheterization and before induction of general anesthesia,followed by an infusion of O.4 μg · kg-1 · h-1 starting from the end of tracheal intubation until 30 min before the end of operation.The equal volume of normal saline was given instead in group C.After epidural catheterization and before infusion of dexmedetomidine (T0),immediately before termination of pneumoperitoneum (T1) and at 1,6 and 24 h after operation (T2-4),blood samples were taken from the peripheral vein for determination of concentrations of serum interleukin-6 (IL-6),IL-10,tumor necrosis factor-alpha and malondialdehyde,and arterial blood gas analysis was performed simultaneously.Respiratory index and oxygenation index (OI) were calculated,and the occurrence of OI ≤ 300 mmHg was recorded.Results Compared with group C,the serum IL-6 and tumor necrosis factor-alpha concentrations and respiratory index were significantly decreased,and IL-1O concentrations and OI were increased at T1-4,and malondialdehyde concentrations were decreased at T1-3,and the incidence of OI ≤ 300 mmHg was decreased in group Dex (P＜0.05).Conclusion Dexmedetomidine can inhibit inflammatory responses and improve the postoperative pulmonary function in patients undergoing laparoscopic operation.

Effects of positive end-expiratory pressure after recruitment maneuvers on respiratory mechanics and gas exchange during laparoscopy in obese patients / 中华麻醉学杂志

Objective To investigate the effects of positive end-expiratory pressure (PEEP) after recruitment maneuvers (RM) on respiratory mechanics and gas exchange during laparoscopy in obese patients.Methods Sixty-three ASA physical status Ⅱ or Ⅲ patients,aged 42-64 yr,with body mass index 30-40kg/m2,were randomly allocated into 3 groups (n=21 each):PEEP0 group,PEEP5 group and PEEP10 group.PEEP was not given after RM in PEEP0 group.In PEEP5 and PEEP10 groups,a recruiting maneuver was followed by PEEP 5 and 10 cm H2 O,respectively,until the end of pneumoperitoneum.The intraabdominal pressure was set at 12mmHg in the three groups.Parameters of respiratory mechanics including peak airway pressure (Ppeak),airway plateau pressure (Peat),chest wall plateau pressure (PplatCW),airway resistance (Raw),elastance of respiratory system (ERS),elastanc of chest wall (ECW) and elastance of lung (EL) and parameters of gas exchange including oxygenation index (PaO2/FiO2),arterial to end-tidal difference in carbon dioxide (Da-ETCO2),alveolar-arterial oxygen tension difference (DA-aO2),and dead space/tidal volume ratio (VD/VT) were measured before pneumoperitoneum (T0),at 20 min of pneumoperitoneum (T1),at 10 min after the end of recruitment (T2),and at the end of pneumoperitoneum (T3).Results Da-ETCO2,ERS and Raw were decreased at T2,ECW and EL were decreased at T3 in PEEP5 group,and Da-ETCO2,VD/VT,DA-aO2,Pplatcw Raw and EL were decreased at T2.3,and PaO2/FiO2 was increased at T2,ECW was decreased at T3 in group PEEP10 as compared with that in group PEEP0 (P ＜ 0.05).Da-ETCO2 and VD/VT were decreased and PaO2/FiO2 was increased at T2,3,Raw was increased and EL was decreased at T2 in group PEEP10 as compared with that in group PEEP5 (P ＜ 0.01).Conclusion PEEP after RM can improve respiratory mechanics and gas exchange during laparoscopy in obese patients and PEEP maintained at 10 cm H2O after RM provides better efficacy than PEEP at 5 cm H2 O.

Effect of dexmedetomidine on postoperative intracranial pressure in patients with severe brain injury / 中华麻醉学杂志

ObjectiveTo investigate the effect of dexmedetomidine on postoperative intracranial pressure (ICP) in patients with severe brain injury.MethodsNinety ASA Ⅱ or Ⅲ patients with severe brain injury,aged 19-64 yr,with Glasgow coma scale 3-7,undergoing emergency craniotomy,were randomly divided into 3 groups (n =30 each):control group (group C) and 2 different doses of dexmedetomidine groups (groups D1,D2 ).Anesthesia was induced with propofol 1.5-2.0 mg/kg,fentanyl 4 μg/kg and vecuronium 0.1 mg/kg and maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of vecuronium.The patients were mechanically ventilated after tracheal intubation.Dexmedetomidine 0.3 and 0.7 μg· kg- 1· h- 1 were infused after tracheal intubation in groups D1 and D2 respectively and the infusion was maintained for 48 h.ICP was monitored after operation and maintained ＜ 30 mm Hg by iv injection of hexadecadrol,mannitol and glycerol fructose within 2 d after operation.Venous blood samples were obtained from peripheral vein after anesthesia induction and at 6,12 and 24 h after operation (T0-3) for determination of sertum IL-1β and TNF-α concentrations by ELISA.The clinical results were evaluated using Glasgow prognosis score at 3 months after operation.The amount of hexadecadrol,mannitol and glycerol fructose consumed during 2 d after operation was recorded.ResultsCompared with T0,serum IL-1βand TNF-α concentrations were significantly higher at T1-3 in the three groups ( P ＜ 0.05).The serum IL-1β and TNF-α concentrations at T1-3 and the amount of hexadecadrol,mannitol and glycerol fructose consumed were significantly lower,and the clinical results were significant better in groups D1 and D2 than in group C,and in group D2 than in group D1 ( P ＜ 0.05).ConclusionDexmedetomidine can reduce postoperative ICP in patients with severe brain injury in a dose-dependent manner which is helpful for improving prognosis.The decrease in IL-1β and TNF-α levels and inhibition of inflammatory response may be involved in the mechanism.

Incidence of postanesthetic shivering in patients undergoing radical operation for lung cancer under dexmedetomidine- assisted anesthesia / 中华麻醉学杂志

Objective To evaluate the incidence of postanesthetic shivering in patients undergoing radical operation for lung cancer under dexmedetomidine-assisted anesthesia.Methods Eighty ASA Ⅰ or Ⅱ patients,aged 50-75 yr,height 158-180 cm,weighing 48-79 kg,scheduled for radical operation for lung cancer under general anesthesia combined with epidural anesthesia,were randomly divided into 2 groups ( n =40 each): normal saline control group (group C) and dexmedetomidine group(group D).Anesthesia was induced with midazolam,fentanyl,propofol and rocuronium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with sevoflurane inhalation and intermittent epidural ropivacaine.BIS was maintained at 40-55.Group D received dexmedetomidine intravenous infusion at 0.5 μg · kg- 1· h- 1 from immediately after tracheal intubation until 1 h before the end of operation,and group C received the equal volume of normal saline.The shivering within 1 h after operation was scored and recorded.Results The incidence rate of postanesthetic shivering was 50％ in group C and 10％ in group D.Compared with group C,the incidence rate and degree of shivering were decreased in group D( P ＜ 0.05).Conclusion Dexmedetomidine-assisted anesthesia can reduce the incidence of postanesthetic shivering in patients undergoing radical operation for lung cancer.

Effect of preemptive analgesia with parecoxib sodium on postoperative cognitive function in the elderly patients / 中华麻醉学杂志

Objective To investigate the effect of preemptive analgesia with parecoxib sodium on postoperative cognitive junction in the elderly patients.Methods Sixty ASA ⅠorⅡ patients aged 69-83 yr weighing 47-73 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 2 groups (n=30 each):control group (group C) and parecoxib group (group P).Their preoperative mini-mental state examination scores were more than 23.Parecoxib sodium 40 mg in 5 ml normal saline was injected iv before induction of anesthesia in group P. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients. VAS score was maintained ≤3. If VAS score was more than 3, a bolus of fentanyl 0.2 μg/kg was given iv.Venous blood samples were taken at 1 day before and 1, 4, 24 and 72 h after operation for determination of plasma concentrations of cortisol.Cognitive function was assessed by mini-mental state examination. The total amount of fentanyl and tramadol consumed was recorded. Results Plasma cortisol concentrations and incidence of postoperative cognitive dysfunction were significantly lower and the total amount of fentanyl and tramadol consumed was smaller in group P than in group C.Conclusion Preemptive analgesia with parecoxib sodium 40 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.

Effect of Shenfu injection on intestinal mucosal barrier of Rats with hepatic ischemia-reperfusion / 中国基层医药

Objective To observe the effects of Shenfu injection on intestinal mucosal barrier of rats with hepatic ischemia-reperfusion.Method Ninety SD male rats and weight from 230 to 270g were randomly divided into three groups( 30 rats in each),and 30 rats in each group divided again into 6h and 12h group( 15 rats in each):(1)SO group received sham operation(SO);(2) IR + NS group received so and 0.9 normal saline intravenously imediately before the ischemia reperfusion injury;(3) IR + SF group received Shenfu injection intravenously imediately before the ischemia reperfusion injury,IR + NS group and IR + SF group occlusion of the hepatoduodenal ligament,and endotoxin,ALT and MDA were detected.Results The levels of ALT,MDA in IR + NS group were higher than those in IR + SF group,and the rate of bacterial translocation( BT)group.

Study on the orient differentiation from embryo hepatic Sca-1+ cell to hepatic cell under the induction of HGF and aFGF in vitro / 中国基层医药

Objective To investigate the feasbility of the orient differentiation from embryo hepatic Sca-1+ cell to hepatic cell or hepatic cell precursor under the induction of hepatocyte growth factor(HGF) and acor fibroblast growth factor(aFGF) in vitro. Methods Sea-1+ cells were isolated by immunomagnetic beads and their morphous were observed by contrast phase microscope. The expression of mRNA of albumin(ALB) and meta-thyroprotein were detected by RT-PCR; ALB, AFP, CK8/18 protein were detected by immunohistochemical method, and cell staining for glycogen and urea synthesis function were tested. Results The activity, purity, recovery rate of Sca-1+ cells were (94. 24±1.04) %, (85.57±1.66) %, (62. 31±1.85 ) % respectively. After the induction of HGF and aFGF, Sca1+ cells became anomalism and transformed to heptic cell in morphous,disappeared in expression of AFP protein and upregulated in expression of ALB and CK8/18 protein,upregulated in expression of ALB and transthyroprotein mRNA,cell staining of glycogen and urea synthesis function were strengthened,the cell differentiated to mature hepatic cell. Conclusion Embryo hepatic Sca-1+ cell could differentiate to hepatic cell or hepatic cell precursor under the induction of HGF and aFGF in vitro.

Expressions and relationship of suppressor of cytokine signaling1 and c-myc in human hepatocellular carcinoma tissue / 中国现代普通外科进展

Objective:To study the expression of suppressor of cytokine signaling 1(SOCS1) and cellular myelocytomatosis oncogene(c-myc)in hepatocellular carcinoma(HCC),and to inves-tigate the relation between the expression of SOCS1 and c-myc in HCC.Methods:The expressions of SOCS1 and c-myc protein of 41 HCC tissues and surrounding tissues,as well as the tissues of 11 normal cases,were detected by immunohistochemical(IHC)staining using SP method.The expression of SOCS1 mRNA was detected by RT-PCR.And the clinical and pathological data were analysed.Results:Compared with the para-carcinoma and normal liver tissue,the levels of SOCS1 and SOCS1 mRNA in HCC tissues were significantly lower(P

Modified intraperitoneal onlay mesh laparoscopic herniorrhaphy for adult indirect inguinal hernia / 中国微创外科杂志

Objective To summarize the experience of laparoscopic purse-string transfixion of the internal ring combined with intraperitoneal onlay mesh(IPOM) laparoscopic herniorrhaphy in the treatment of adult indirect inguinal hernia.Methods The modified IPOM laparoscopic herniorrhaphy(laparoscopic purse-string transfixion of the internal ring combined with IPOM laparoscopic herniorrhaphy) was performed in 15 adult patients with indirect inguinal hernia in this hospital from September 2004 to February 2005.Results The time of operation was 30~60 min(mean,35 min). The patients were discharged from hospital 2~3 days after operation.Two patients complained of tractive discomfort after operation and were cured with postoperative physical therapy for 2 weeks.Follow-up observations in 15 patients for 2~6 months(mean,4.8 months) revealed no recurrence.Conclusions The modified IPOM laparoscopic herniorrhaphy is a safe and feasible option for adult indirect inguinal hernia,with advantages of simplicity of performance, few complications,mild postoperative pain,quick recovery,low recurrence,and good cosmetic results.

Detection of genetic instability in gastric cancer tissues by RAPD PCR / 中国普通外科杂志

ObjectiveTo detect the instabilities of DNA and chromosome in gastric carcinoma. Methods A total of 33 gastric cancer specimens were analyzed by RAPD(random amplified polymorphic DNA) PCR with nine 10-base arbitrary primers for detecting instabilities of DNA and chromosome. ResultsSample 5 and 3 showed the highest genomic changes and that there were significant differences in the ability of each primer to detect genomic instability ranging from 21% to 85%.ConclusionsThe genetic instabilities often concentrated on some special loci of chromosome e.g. repetitive sequences. It is difficult to influence the result of cancer treatment in gene therapy targeting at only one oncogene or tumor suppressor gene because of the extensive DNA variations occurred during the progression of tumor.

Expression of Glypican-3 gene and its regulating mechanism in hepatocellular carcinoma / 中国病理生理杂志

0.05).CONCLUSION: The high expression of GPC3 mRNA in hepatocellular carcinoma is independent to the gene mutation,and to the expression of P53 and PCNA protein.