Application of nanotechnology in local anesthetic drug sustained release and light-responsive controlled release / 药学学报

Local anesthetic drugs are commonly used to block the conduction function of patient's nerves temporarily for anesthesia during surgery or to provide targeted analgesia after trauma. Compared with general anesthetics, local anesthetics makes less impact on the physiological status and alleviates pain complications in the presence of clear consciousness. However, its clinical application is still limited by its systemic toxicity, as well as toxicity to nerves and muscles, duration of action and lack of penetration. Nanotechnology can help it penetrate the physiological barrier, prolong the time of nerve block, and reduce toxic side effects. In addition, by building a light-responsive release system, local anesthetics can be released on demand, enhancing drug effectiveness and safety. However, in addition to the problems of poor consistency and high production costs, the system of light response release is still limited in application due to the limitation of the depth of penetration of the tissue. According to the current research progress, this paper briefly introduces and analyzes the main dosage forms, hoping to provide new ideas for the responsive release of local anesthetic drugs.

Study on modeling, simulation, and sensorless feedback control algorithm of the cavopulmonary assist device based on the subpulmonary ventricular exclusion / 生物医学工程学杂志

The subpulmonary ventricular exclusion (Fontan) could effectively improve the living quality for the children patients with a functional single ventricle in clinical. However, postoperative Fontan circulation failure can easily occur, causing obvious limitations while clinically implementing Fontan. The cavopulmonary assist devices (CPAD) is currently an effective means to solve such limitations. Therefore, in this paper the

Application of lung protective ventilation strategy in radiofrequency ablation of atrial fibrillation / 实用医学杂志

Objective To observe the clinical significance of lung protective ventilation strategy in pa-tients with radiofrequency ablation of atrial fibrillation under general anesthesia through clinical controlled study. Methods Sixty patients undergoing radiofrequency catheter ablation were randomly divided into group L (n=30) and group C(n=30).Breathing parameters were set after tracheal intubation of general anesthesia.Arterial blood gas was collected.PETCO2and airway pressure were recorded during the operation.The operative time,ablation time,flu-oroscopy time and operation-related complications were recorded together with the surgeon satisfaction. Patients were followed up postoperatively for pulmonary complications. The length of patient′s hospital-stay was recorded. Results There was no significant difference in operation time, fluoroscopy time, ablation time and hospitalization days between the two groups (P>0.05). There was no significant difference in the occurrence and grade of PPCs between the two groups (P>0.05). There was significant difference in surgeon satisfaction between the two groups (P<0.01).Conclusion LPVS is suitable for ventilation management in radiofrequency ablation of atrial fibrillation.

The Effect of Gabapentin on TRPV1 in Rat DRG after CCI / 中国医科大学学报

Objective To study the effect of Gabapentin(GBP)on the transient receptor potential vanilloid l(TRPV1)in dorsal root ganglion (DRG)of rats with chronic constriction injury(CCI). Methods SD male rats were used to establish CCI model and randomly divided into 3 groups,the control group,the CCI group,and the CCI+GBP group. Mechanical allodynia and thermal hyperalgesia were measured to evaluate the es?tablishment of CCI model and the analgesic effect of GBP. At the postoperative 8 days,all rats were sacrificed and dorsal root ganglions were collect?ed for further RT?PCR and Western?blotting analysis to detect expression of TRVP1 in DRG. Results The mRNA and protein expression of TRPV1 were both significantly increased in DRG after CCI operation and GBP could decrease mRNA expression of TRPV1 gene in DRG after CCI. Conclusion The expression of TRPV1 was increased in DRG after CCI operation which was decreased after administration of GBP.

Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy.</p><p><b>METHODS</b>Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods.</p><p><b>RESULTS</b>Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115).</p><p><b>CONCLUSION</b>For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.</p>

Association between lymphangiogenesis and clinicopathological features and prognosis in laryngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect lymphangiogenesis by labeling the lymphatic endothelial marker, lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), and study the prognostic relevance of lymphangiogenesis in laryngeal squamous carcinoma.</p><p><b>METHODS</b>Clinical files and specimens of 78 patients with histologically diagnosed laryngeal carcinoma were stained with LYVE-1 as a specific lymphatic endothelial marker. The lymphatic vessel density (LVD) was measured, and the correlation between LVD and clinicopathological features of the tumor cases was analyzed.</p><p><b>RESULTS</b>The mean LVD in laryngeal carcinoma (13.24 ± 5.09) was significantly higher than that in adult laryngeal papilloma (5.54 ± 3.15) and squamous dysplasia (6.76 ± 4.45, P < 0.05). The LVD of poorly differentiated tumors (15.74 ± 5.24) was significantly higher than that in the moderately differentiated tumors (13.84 ± 6.20), and the LVD in the moderately differentiated tumors was significantly higher than that in the well-differentiated tumors (11.68 ± 6.34). The LVD in stage 0 to stage II group (10.66 ± 5.70) was significantly lower than that in the stage III to IV group (17.01 ± 6.35). The lymph node metastasis group (17.25 ± 7.37) was significantly higher than non-lymph node metastasis group (8.60 ± 5.23, P < 0.05). There was no significant association between LVD and age, sex, primary site and distant metastasis. The overall survival in the patients with a LVD higher than the mean value was 33.5 month, and that of cases with a LVD lower than the mean value was 81.6 month (P < 0.05). The multivariate survival analysis showed that the clinical stage and LVD were independent prognostic factors of laryngeal cancer.</p><p><b>CONCLUSIONS</b>The LYVE-1 staining histochemistry demonstrates that the lymphangiogenesis occurrs mainly at the edge of the tumors, and lymphangiogenesis plays an important role in the carcinogenesis, cancer progression and lymph node metastasis in laryngeal cancer. LVD may be an independent indicator of poor prognosis of laryngeal cancer.</p>

Comprehensive treatment of 352 cases with hypopharyngeal cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review the experience of different surgical construction methods and comprehensive treatments for hypopharyngeal cancer.</p><p><b>METHODS</b>Three hundred and fifty-two cases (According to UICC 2002 criteria, stage I, 3; II, 31; III, 134; IV, 184) with hypopharyngeal cancer were retrospectively reviewed from 1999 to 2005 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University, including 321 males and 31 females. The median age was 58 years old, ranged from 26 to 82 years old. All the tumors originated from the pyriform sinus (272), posterior pharyngeal wall (61), postcricoid area (19). There were no distant metastasis. Two hundred and fourty-one cases were surgically treated with laryngeal functions preserved and 111 cases without laryngeal functions preserved. All the patients received modified neck dissection, including both unilateral (247 patients) and bilateral (105 patients). Pharyngoesophageal defect reconstruction methods in cases with laryngeal functions preserved were: direct suture in 137, pectoralis major musculocutaneous flap in 62, split graft in 2, pectoralis major musculocutaneous flap combined with the split graft in 5, stomach pulling-up in 12, colon interposition in 23 patients. While in cases without laryngeal functions preserved the methods includes: direct suture in 54, laryngotracheal flap in 54 patients, pectoralis major musculocutaneous flap in 7, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 8, stomach pulling-up in 22, colon interposition in 3 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy).</p><p><b>RESULTS</b>The overall 3 and 5 year survival rates were 65.1% (229/352) and 53.6% (142/265), respectively. For stage I, the 5 year survival rate was 3/3, stage II, 80.6%(25/31), stage III, 65.0% (67/103), stage IV, 36.7% (47/128). The 3 and 5 year survival rates in functionally preserved group were 68.0% (164/241) and 59.7% (114/191), respectively, while in non-functionally preserved group were 58.6% (65/111) and 37.8% (28/74), respectively. The cervical lymph node metastasis was found in 239 sides. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 84, 163, 105 cases, respectively. Laryngeal functions (voice, respiration and deglutition) were completely restored in 169 patients and partially restored (voice and deglutition) in 72 patients.</p><p><b>CONCLUSIONS</b>Combined surgery and radiotherapy are the best choice for hypopharyngeal cancer. The continuity of the pharyngoesophagus is restored and the laryngeal function is preserved as far as possible. The preservation of laryngeal function and the laryngeal and pharyngeal reconstruction are based on the premise that the tumor was excised completely.</p>

Surgical management and preservation of laryngeal function for senile patients with advanced laryngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the methods of surgical treatment and preservation of laryngeal function in senile patients with advanced laryngeal carcinoma.</p><p><b>METHODS</b>A retrospective data review of 87 advanced laryngeal carcinoma patients aged over 65 years was carried out. Of these 87 patients treated by different modes of surgery, 48 had supraglottic cancer, 35 glottic cancer and 4 subglottic cancer. The surgery modes consisted of major partial laryngectomy in 36 patients, subtotal partial laryngectomy with laryngoplasty in 21 and total laryngectomy in 30. All patients received postoperative radiotherapy to a dose of 50-60 Gy. Kaplan-Meier method was used to analyze the survival.</p><p><b>RESULTS</b>The overall 3- and 5-year survival rate was 73.2% and 67.4%, respectively. The ultimate rate of larynx preservation was 65.5%. Of 57 patients with partial laryngectomy, 46 were decannulated with a decannulation rate of 80.7%. Yet, in all patients, the nasal feeding tube was removed and food intake per os was resumed. All patients who underwent partial laryngectomy regained their phonation function.</p><p><b>CONCLUSION</b>It is safe and effective to treat and preserve laryngeal function surgically in the senile patients with advanced laryngeal carcinoma. The key points to achieve this are selection of proper patient, renovation of surgical procedure and improvement of surgical skill.</p>

Value of color Doppler flow imaging in the diagnosis of subclinical varicocele / 中华男科学杂志

<p><b>OBJECTIVE</b>To identify the value of color Doppler flow imaging (CDFI) in the diagnosis of sterility caused by subclinical varicocele (SVC).</p><p><b>METHODS</b>The spermatic veins of 56 sterile patients with seminal abnormality were examined with CDFI and the internal diameters and the time of blood reflux of pampiniform plexus of the veins were observed. In addition, selective X-ray examination of internal spermatic veins was performed for contrast analysis.</p><p><b>RESULTS</b>The diameter of the pampiniform plexus was (2.24 +/- 0.16) mm under the static condition and (2.67 +/- 0. 26) mm during the Valsalva test. The time of blood reflux was (1 487 +/- 203.66) ms. The accuracy of CDFI for diagnosing SVC was 92.8%.</p><p><b>CONCLUSION</b>CDFI has been proved of more value in the diagnosis of SVC than that of clinical varicocele in the etiological screening of male sterility.</p>

Surgical treatment of hypopharyngeal cancer with cervical esophageal invasion / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review the experience of different surgical construction methods for hypopharyngeal cancer with cervical esophageal invasion.</p><p><b>METHODS</b>From 1989 to 2000,forty-eight patients with advanced hypopharyngeal cancer and cervical esophageal invasion were retrospectively reviewed, including 38 males and 10 females. The median age was 54. 3 years old, ranged from 26 to 71 years old. According to UICC 1997 criteria, all the tumors were T4 stage and originated from the pyriform sinus (33), posterior pharyngeal wall (14), postcricoid area (1), there were 28 patients in cN0, 15 in cN1, 5 in cN2 and no distant metastasis. Precise preoperative evaluation was performed with computed tomography scan, barium swallow perspective and biopsy. All the patients received modified neck dissection, including both unilateral (38 patients) and bilateral (10 patients). Pharyngoesophageal defect reconstruction methods were: laryngotracheal flap in 11 patients, pectoralis major musculocutaneous flap in 13, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 6, pectoralis major musculocutaneous flap combined with the split graft in 10, stomach pulling-up in 3, colon interposition in 5 patients. Total laryngectomy was carried out in 8 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy).</p><p><b>RESULTS</b>The cervical lymph node metastasis was found in 20 patients. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 18, 24, 6 cases, respectively. The overall 3 and 5 year survival rates were 52.1% (25/48) and 27.3% (12/44), respectively. The 3 and 5 year survival rates in functionally preserved group were 65.2% (15/23) and 33.3% (7/21), while in non functionally preserved group were 40.0% (10/25) and 21.7% (5/23), respectively. Fifteen patients laryngeal functions (voice, respiration and deglutition) were completely restored and 8 patients partially restored (voice and deglutition). The decannulation rate was 65% (15/23). The complication included pharyngeal fistulas in 10 cases and splitting of chest wall in 1 cases.</p><p><b>CONCLUSIONS</b>Combined therapy was the best choice for hypopharyngeal cancer with cervical esophageal invasion. The laryngeal function is preserved as far as possible. The continuity of the pharyngoesophagus was restored by pectoralis major musculocutaneous flap, laryngotracheal flap, or combined with the split graft. Stomach transposition or colon interposition was used while the defect of the esophagus was greater.</p>

Preservation of laryngeal function in surgical treatment of pyriform sinus carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and the related surgical techniques of laryngeal function preservation in surgical treatment of pyriform sinus cancer.</p><p><b>METHODS</b>Two hundred and thirty cases (stage I, 6; stage II, 10; stage III, 91; stage IV, 123) with pyriform sinus cancer were treated surgically from 1978 to 1996 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University. The methods of removing tumor and repairing surgical defects were depended on the extension of lesions. The laryngeal and pharyngeal functions were rebuilt by normal tissue preserved with lesions entirely removed. One hundred and fifty-eight cases were surgically treated with laryngeal functions preserved and 72 cases total laryngectomy. The most of the cases received postoperative radiotherapy.</p><p><b>RESULTS</b>The overall 3 and 5 year survival rates were 67.4% (155/230) and 48.3% (111/230) respectively. For stage I, the survival rate was 5/6; stage 11, 70.0% (7/10); stage III, 57.1% (52/91) and stage IV, 38.2% (47/123); the 3 and 5 year survival rates in functionally preserved group were 67.7% (107/158) and 50.0% (79/158), while in none functional group were 66.7% (48/72) and 43.1% (31/72), respectively. 75.3% (119/158) patients have laryngeal functions (voice,respiration and deglutition) completely restored and 24.7% (39/ 158) partially restored(voice and deglutition).</p><p><b>CONCLUSIONS</b>The preservative surgery is feasible for the selected pyriform sinus cancer cases. Choosing and following optimum surgical methods is a prerequisite for improving the quality of life of the cases.</p>

Surgical treatment of postcricoid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the surgical techniques in surgical treatment of postcricoid carcinoma.</p><p><b>METHODS</b>Twenty-one cases with postcricoid carcinoma were treated surgically. The TNM stage were as follows: T3NOM0 5 cases, T3N1M0 1 case, T3N2M0 2 cases, T4NOM0 7 cases, T4N1M0 4 cases, T4N2M0 1 case, T4N3M0 1 case. The laryngeal and pharyngeal functions were rebuilt by the remaining tissue when the lesions entirely removed. Ten cases were surgically treated with laryngeal functions preserved and 11 cases with total laryngectomy. Eight cases were received unilateral neck dissection, and 3 cases were received bilateral neck dissection. All the cases received postoperative radiotherapy.</p><p><b>RESULTS</b>The follow-up interval varied from 60 to 276 months with average interval 96 months. Four cases died of cervical metastasis,3 died of local recurrence, 1 died of cardiopulmonary failure, 2 died of unknown reasons. The overall 3 and 5 year survival rates were 61.9% (13/21) and 52.4% (11/21), respectively. Among 10 cases having laryngeal functions partially restored (voice and deglutition), the postoperative complications included 5 cases of pharyngeal fistula, 3 hypopharyngeal stenosis and 1 severe aspiration.</p><p><b>CONCLUSIONS</b>The preservative surgery is feasible for the selected cases with postcricoid carcinoma. The laryngeal function can be partially restored with lesions entirely removed. The patients can gain satisfied survival rate and quality of life.</p>

Substitution of esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved.</p><p><b>METHODS</b>Twenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy).</p><p><b>RESULTS</b>Twenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%.</p><p><b>CONCLUSION</b>Surgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.</p>

Surgical treatment of tonsillar cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the surgical treatment of tonsillar cancer.</p><p><b>METHODS</b>Twenty-four patients with tonsillar cancer were treated with surgery and postoperative radiotherapy. The choice of surgical procedure was decided on the condition of the lesion. The tumor was resected through the transoral approach, mandibular swing approach, mandibular resection approach or hyoid approach. Surgical defect was repaired by pectoralis major myocutaneous flap, sternohyoid myofascial flap, tongue flap or soft palate flap.</p><p><b>RESULTS</b>The 3- and 5-year survival rates were 76.0% and 60.8%. Function of chewing, deglutition, respiration and speech was restored well.</p><p><b>CONCLUSION</b>Method of total resection of the tonsillar carcinoma through the optimum approach is best chosen according to the condition of the lesion, while preserving the oropharyngeal function. When combined with postoperative radiotherapy, the survival rate and quality of life of patients can be improved.</p>

Experimental study on protective role of propofol in hepatic ischemia-reperfusion injury / 中华麻醉学杂志

ve To assess the effect of propofol on hepatic ischemia-reperfusion (I/R) injury and the mechanism. Methods Sixty healthy rabbits of either sex, weighing 2.0-3.4 kg were randomly divided into three groups of twenty animals each: control group (C), propofol group (P) and etomidate group (E) . The rabbits were anesthetized with 3.0% pentobarbital 1.0 ml?kg-1 iv. Internal jugular artery was cannulated for continuous MAP monitoring and internal jugular vein was cannulated for intravenous fluid and drug administration. In group C normal saline was infused at a rate of 2 ml?kg? h-1; in group E etomidate 0.1 mg ? kg-1? h-1 and in group P propofol 20 mg? kg-1? h-1 was infused during the experiment until the end of surgery. Hepatic ischemia was produced by clamping hepatic hilum for 20 min and reperfusion was allowed for 30 min after release of the clamp before the animals were sacrificed. Blood samples were taken from internal jugular artery before hepatic ischemia immediately, 15 and 30 min after I/ R for determination of AST, ALT and SOD concentration. Liver tissue 0.5g was taken from right lobe and kept in liquid nitrogen for determination of MDA content and left lobe of the liver was taken for electron microscopic examination. Results The serum levels of AST and ALT increased after reperfusion in all three groups, but were significantly lower in group P than in group C and E. The serum SOD level decreased in all three groups after reperfusion, but the decrease in SOD was significantly less in group P than in group C and E. The MDA content of liver increased in all three groups after reperfusion but the increase in MDA was significantly less in group P than in group C and E. Electron microscopic examination revealed that mitochondria swelled obviously, the ridge disappeared, ribosome was disarranged and endoplasmic reticulum was expanded and vacuolated in group C and E; while in group P mitochondria only slightly swelled, the ridge was seen clearly, the arrangement of endoplasmic reticulum was trim and there was no exfoliated ribosome. Conclusions Propofol has protective effect in liver I/R.