Efficacy of recombinant human interferon α2b in the adjuvant treatment of neonatal pneumonia / 中国基层医药

Objective:To investigate the efficacy of recombinant human interferon α2b in the adjuvant treatment of neonatal pneumonia.Methods:A total of 60 children with neonatal pneumonia who received treatment in Lingbi County People's Hospital from January 2020 to January 2022 were included in this study. They were randomly divided into study and control groups ( n = 30/group). The control group was treated with conventional therapy and the study group was treated with recombinant human interferon α2b and conventional therapy. All children were treated for 7 days. The time to clinical symptom remission, total response rate, and inflammatory factor levels were compared between the two groups. Results:Before treatment, there were no significant differences in general data between the study and control groups (all P > 0.05). After treatment, the time to body temperature recovery, rale disappearance, cough disappearance, and shortness of breath disappearance in the study group were (4.03 ± 1.27) days, (5.13 ± 1.72) days, (4.96 ± 1.64) days, and (5.45 ± 1.52) days, respectively, which were significantly shorter than (5.13 ± 1.52) days, (6.73 ± 1.85) days, (6.73 ± 1.82) days, and (6.82 ± 1.74) days, respectively in the control group ( t = 3.04, 3.46, 3.95, 3.24, all P < 0.05). The total response rate in the study group was 93.3% (28/30), which was significantly higher than 80.0% (24/30) in the control group, and clinical efficacy was better in the study group than that in the control group ( Z = 2.40, P = 0.016). High-sensitivity C-reactive protein, procalcitonin, interleukin-6, and serum amyloid A in the study group were (2.96 ± 0.84) mg/L, (0.72 ± 0.33) μg/L, (6.25 ± 2.18) mg/L, and (3.48 ± 1.13) mg/L, respectively, which were significantly lower than (4.02 ± 1.53) mg/L, (1.16 ± 0.47) μg/L, (8.04 ± 2.06) ng/L, and (6.42 ± 2.03) mg/L, respectively in the control group ( t = 3.32, 4.19, 3.26, 6.93, all P < 0.05). Conclusion:Recombinant human interferon α2b for the adjuvant treatment of neonatal pneumonia can shorten the time to clinical symptom remission, decrease inflammatory factor levels, and improve clinical efficacy.

Analysis of influencing factors for poor effect of short-term electrical spinal cord stimulation in treatment of postherpetic neuralgia / 中华麻醉学杂志

Objective:To analyze the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of postherpetic neuralgia (PHN).Methods:The medical records of PHN patients of either sex, aged 40-85 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who received short-term electrical spinal cord stimulation from July 2017 to July 2022, were retrospectively collected. The therapeutic effect was evaluated using the modified MacNab criteria at 3 months after operation, and the patients were divided into good efficacy group (excellent and good efficacy) and poor efficacy group (fair and poor efficacy). General information, disease course, lesion site, complicated diseases, ossification of the yellow ligament in the diseased spinal segment, severity of pain in the herpetic stage, standard antiviral therapy in the herpetic stage (for more than 7 days) and use of neurotrophic drugs in the herpetic stage (for more than 7 days) were collected. Multivariate logistic regression analysis was used to screen the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN.Results:A total of 168 patients were eventually enrolled, among which 69 had poor curative effect, and the rate of poor curative effect was 41.1%. The results of multivariate logistic regression analysis showed that the patient′s age ( OR=2.230, P=0.015), course of disease ( OR=2.191, P=0.027), complication with diabetes mellitus( OR=8.859, P=0.010), ossification of ligamentum flavum at the same segment ( OR=6.602, P=0.019), severity of pain in the herpetic stage ( OR=5.788, P=0.038) and non-standard antiviral therapy in the herpetic stage ( OR=6.765, P=0.021) were the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN. Conclusions:Age, course of disease, complication with diabetes mellitus, ossification of ligamentum flandum at the same segment, severity of pain in the herpetic stage and non-standard antiviral therapy in the herpetic stage are the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of PHN.

Analysis of failure patterns and survival after SBRT for 147 cases of T 1-2N 0M 0 stage non-small cell lung cancer / 中华放射肿瘤学杂志

Objective:To analyze the failure patterns and survival after stereotactic body radiotherapy (SBRT) in patients with T 1-2N 0M 0 non-small cell lung carcinoma (NSCLC). Methods:Clinical data of early-stage NSCLC patients who received SBRT at Zhejiang Cancer Hospital from January 2012 to September 2018 were retrospectively analyzed. The primary observed endpoint was the pattern of disease progression, which was divided into intra-field recurrence, regional lymph node recurrence and distant metastasis. Overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan-Meier method. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox's model.Results:A total of 147 patients with 156 lesions were included. The median follow-up time was 44.0 months (16.5-95.5 months). A total of 57 patients (38.8%) progressed: 14 patients (24.5%) had recurrence with the 1-, 3-, and 5-year local recurrence rates of 2.0%, 10.9%, and 14.3%, respectively; 36 patients (63.2%) had Distant metastasis with the 1-, 3- and 5-year distant metastasis rates of 12.2%, 22.4% and 28.6%, respectively; and 7 patients (12.3%) had recurrence complicated with distant metastasis. The 3-, 5- and 7-year OS rates were 80.5%, 64.2% and 49.9% for all patients, respectively. The median OS was 78.4 months. The 3-, 5- and 7-year PFS rates were 64.8%,49.5% and 41.5%, with a median PFS of 57.9 months (95% CI: 42.3-73.5 months). Univariate and multivariate analyses showed that biologically equivalent dose and age were the factors affecting the efficacy of SBRT (both P<0.05). Conclusion:Distant metastasis is the main failure pattern in patients with T 1-2N 0M 0 NSCLC after SBRT. High-risk population should be selected for further systematic treatment to improve the efficacy.

Failure mode and long-term survival after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

Diagnosis and treatment of dwarfism with prostate cancer without prostate biopsy: a case report / 中华泌尿外科杂志

Prostate cancer in patients with dwarfism is rarely reported. One case was reported in this article. The patient was admitted to the hospital due to the PSA elevation for more than 4 years. Due to the dwarf disease, the patient could not accommodate the transrectal ultrasound probe, and was highly suspected of prostate cancer.The prostate needle biopsy was not performed. Combined with the medical history, PSA level, preoperative MRI and PSMA-PET/CT examination, the patient was clinically diagnosed with localized prostate cancer, and radical surgical treatment was performed.

A survey of pre-anesthesia anxiety and analysis of risk factors / 中华麻醉学杂志

Objective To investigate the occurrence of anxiety before anesthesia and identify the risk factors for anxiety. Methods A total of 500 patients of both sexes, aged 18-80 yr, of American So-ciety of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective surgery, were selected. The patients were investigated using the Generalized Anxiety Disorder 7-item scale and anxiety factor questionnaires. It was evaluated whether the patient had anxiety before anesthesia according to the scale score, and then the patients were divided into anxiety group and non-anxiety group. The possible risk factors for anxiety were compared, and the statistically significant variables were further analyzed by Logistic regression to stratify the risk factors. Results The incidence of pre-anesthesia anxiety was 46. 80％. Logistic regression analysis showed that gender, lack of understanding of the next treatment, fear of death, fear of surgical failure, fear of intraoperative and postoperative pain were independent risk factors for anxiety before anesthesia. Conclusion The incidence of pre-anesthesia anxiety is 46. 80％, and gender, lack of understanding of the next treatment, fear of death, fear of surgical failure, fear of intraoperative and postoperative pain are in-dependent risk factors for pre-anesthesia anxiety in the patients undergoing surgery.

Role of mammalian target of rapamycin in synaptic plasticity of entorhinal area-hippocampal formation in rats with inflammatory pain / 中华麻醉学杂志

Objective To evaluate the role of mammalian target of rapamycin (mTOR) in the synaptic plasticity of entorhinal area-hippocampal formation in rats with inflammatory pain.Methods Twenty-four healthy adult male Sprague-Dawley rats,weighing 180-240 g,were divided into 4 groups (n =6 each) by using a random number table method:control group (group C),inflammatory pain group (group IP),dimethyl sulfoxide (DMSO) group and mTOR inhibitor rapamycin group (group R).Inflammatory pain model was established by subcutaneous injection of 50 μl bee venom into the plantar surface of the left hindpaw.The equal volume of normal saline was subcutaneously injected into the plantar surface of the left hindpaw in group C.In group DMSO,2％ DMSO was administered by intragastric gavage for 3 days,1 ml per day,and the inflammatory pain model was established at 1 h after administration on 3rd day.In group R,rapamycin was administered by intragastric gavage for 3 days,1 ml per day,and the inflammatory pain model was established at 1 h after administration on 3rd day.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 2 h after establishing the model.The rats were sacrificed after measurement of the pain threshold,and hippocampi were removed to prepare hippocampal slices.Hippocampal CA1 region and dentate gyrus (DG region) were located with an inverted microscope.Planar microelectrode array technique was used to record the number of channels and the standardized amplitude of evoked effective field excitatory postsynaptic potentials (fEPSPs) (fEPSPs amplitude＞20％ of the baseline value) at different stimulus intensities.Results Compared with group C,MWT was significantly decreased,TWL was shortened,the number of effective fEPSP channels at different stimulus intensities was increased,and the amplitude of standardized fEPSPs in hippocampal DG and CA1 regions was increased in group IP (P＜0.05 or 0.01),and no significant change was found in the parameters mentioned above in group R (P＞0.05).Compared with group IP,MWT was significantly increased,TWL was prolonged,the number of effective fEPSP channels at different stimulus intensities was decreased,and the amplitude of standardized fEPSPs in hippocampal DG and CA1 regions was decreased in group R (P＜0.05 or 0.01),and no significant change was found in the parameters mentioned above in group DMSO (P＞0.05).Conclusion mTOR is involved in the changes in the synaptic plasticity of entorhinal areahippocampal formation in rats with inflammatory pain.

Efficacy of transforaminal endoscopic spine system technique in treating lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis / 中华麻醉学杂志

Objective To evaluate the efficacy of transforanminal endoscopic spine system (TESSYS) technique in treating lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.Methods Thirty-two patients with lumbar disc herniation,aged 51-82 yr,weighing 52-93 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n=16 each) according to whether patients had lumbar spondylolisthesis:lumbar disc herniation group (Y group) and lumbar disc herniation combined with Ⅰ degree stability of lumbar spondylolisthesis group (Y+Z group).Extirpated protrusion,plasty ligamenum flavum and posterior longitudinal ligament and nerve root decompression were carried out using TESSYS technique in two groups,and in addition excision of osseous neoplasias and retro-positioned posterior margin of lumbar vertebral body was done in group Y+Z.Pain was assessed using Visual Analogue Scale (VAS) score at 1 day before surgery and 3 days and 1,3,6 and 12 months after surgery.Patient's function was assessed by using the Oswestry Disability Index (ODI) at 1 day before surgery and 12 months after surgery.The therapeutic effect was evaluated using modified Macnab criteria at 12 months after surgery.Results Compared with the baseline at 1 day before surgery,VAS scores were significantly decreased at each time point after surgery,and ODI was decreased at 12 months after surgery in two groups (P＜0.05).Compared with group Y,VAS scores were significantly decreased at 3 and 6 months after surgery (P＜0.05),and no significant change was found in ODI at each time point or VAS scores and Macnab outcome grade at 12 months after surgery in group Y+Z (P＞ 0.05).Conclusion TESSYS technique can be used to treat lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.

Efficacy of three liver-protecting drugs commonly used in treatment of drug-induced liver injury: a comparative analysis / 临床肝胆病杂志

ObjectiveTo compare the efficacy of three liver-protecting drugs commonly used in the treatment of drug-induced liver injury. MethodsThe clinical data of 90 patients with drug-induced liver injury who were treated in Yingcheng People′s Hospital from November 2012 to April 2015 were analyzed retrospectively, and according to the drugs administered, they were divided into groups A, B, and C, with 30 patients in each group. The patients in groups A, B, and C were treated with reduced glutathione, polyene phosphatidylcholine injection, and tiopronin injection, respectively. The efficacy, drug cost, and incidence of adverse events were compared between the three groups. An analysis of variance was used for comparison of continuous data between multiple groups, and the LSD t-test was used for comparison of continuous data between any two groups; the chi-square test was used for comparison of categorical data between multiple groups. ResultsGroup A had a significantly higher overall response rate than groups B and C (90.0% vs 73.3%/76.7%, χ2=2.78 and 3.75, both P＜0.05). Group B had a significantly higher drug cost than groups A and C (316.12±4.05 RMB vs 235.13±2.90 and 135.21±7.62 RMB, both P＜0.01). The incidence of adverse events showed no significant differences between the three groups (P＞0.05). ConclusionIn the clinical treatment of drug-induced liver injury, reduced glutathione has better efficacy compared with polyene phosphatidylcholine and tiopronin, as well as a reasonable cost. Therefore, this drug is preferred in the treatment of this disease.

Role of autophagy in development of inflammatory pain in rats / 中华麻醉学杂志

Objective To evaluate the role of autophagy in the development of inflammatory pain in the rats.Methods Twenty-four healthy adult male Sprague-Dawley rats,weighing 180-240 g,were randomly divided into 4 groups (n=6 each) by using a random number table:control group (group C),inflammatory pain group (group IP),dimethyl sulfoxide (DMSO) group (group D),and rapamycin (autophagy inducer) group (group R).Inflammatory pain was produced by injecting 50 μl bee venom into the plantar surface of the left hindpaw.In group C,0.9％ normal saline was injected into the plantar surface of the left hindpaw.In group D,2％ DMSO was injected through a gastric tube into the stomach 1 ml per day for 3 consecutive days,and the model was established at 1 h after injection on 3rd day.In group R,rapamycin l0 mg/kg (in 2％ DMSO) was injected through a gastric tube into stomach 1 ml per day for 3 consecutive days,and the model was established at 1 h after injection on 3rd day.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 2 h after the model was established.After measurement of the pain threshold,the dorsal horn of the spinal cord was removed for determination of the expression of microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p62 by Western blot.Results Compared with group C,the MWT was significantly decreased,the TWL was significantly shortened in IP and D groups,and the expression of LC3 Ⅱ,Beclin-1 and p62 in the dorsal horn of the spinal cord was significantly up-regulated in IP,D and R groups (P＜0.05 or 0.01).Compared with group IP,the MWT was significantly increased,the TWL was significantly prolonged,the expression of LC3 Ⅱ and Beclin-1 in the dorsal horn of the spinal cord was significantly up-regulated,and the expression of p62 was significantly down-regulated in group R (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Conclusion Autophagy disorders are involved in the development of inflammatory pain in the rats.

Role of hippocampal mammalian target of rapamycin signaling pathway in inflammatory pain in rats / 中华麻醉学杂志

Objective To evaluate the role of hippocampal mammalian target of rapamycin (mTOR) signaling pathway in inflammatory pain in rats.Methods Sixty adult male Sprague-Dawley rats,weighing 180-240 g,were randomly divided into 4 groups (n=6 each) by using a random number table:control group (group C),inflammatory pain group (group IP),dimethyl sulfoxide (DMSO) group and rapamycin (inhibitor of mTOR) group (group R).Inflammatory pain was produced by injection of honey bee venom 50 μl into the plantar surface of the left hindpaw.While the equal volume of normal saline was given instead in group C.In group D,2％ DMSO was injected through a gastric tube into stomach 1 ml per day lasting for 3 days,and inflammatory pain was produced at 1 h after the last injection on 3rd day.In group R,rapamycin 10 mg/kg (in 2％ DMSO) was injected through a gastric tube into stomach 1 ml per day lasting for 3 days,and inflammatory pain was produced at 1 h after the last injection on 3rd day.At 2 h after the model was established,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.Rats were sacrificed after measurement of pain threshold,and hippocampal tissues were obtained for detection of the expression of mTOR,phosphorylated mTOR (p-mTOR),ribosomal S6 kinase (S6K) and phosphorylated S6K (p-S6K).Results Compared to group C,the MWT was significantly decreased,TWL was shortened,the expression of p-mTOR and p-S6K was up-regulated,and no significant change was found in the expression of mTOR and S6K in IP and DMSO groups,and no significant change was found in group R in the MWT,TWL and expression of p-mTOR,mTOR,p-S6K and S6K.Compared to group IP,no significant change was found in group DMSO in the MWT,TWL and expression of p-mTOR,mTOR,p-S6K and S6K,and the MWT was significantly increased,TWL was prolonged,the expression of p-mTOR and p-S6K was down-regulated,and no significant change was found in the expression of mTOR and S6K in group R.Conclusion Hippocampal mTOR signaling pathways are involved in the development of inflammatory pain in rats.

Features of lymph node metastasis in resectable non-small cell lung cancer and their clinical significance / 中国肿瘤临床

Objective:To analyze the characteristics of regional lymph node metastasis in patients with resectable non-small cell lung cancer (NSCLC) and assess its clinical significance in surgical mediastinal lymph dissection and the target volume definition of postoperative radiotherapy. Methods:We retrospectively reviewed 810 patients with NSCLC, and analyzed the metastatic frequency of each regional lymph node station as well as the correlation between tumor location and regional lymph node metastases. Results:Re-gional lymph node metastases were significantly associated with the age of patients, histology, tumor size, and tumor location (P=0.013, 0.000, 0.009 and 0.000, respectively). Conclusion:The younger patients with left lung adenocarcinomas and large tumor size tended to regional lymph node metastases. The trend of regional lymphatic drainage in the lobes of lung occurred differently. The prior location of involved regional lymph nodes in different lobes of the NSCLC patients was as follows:The station 2-4 for right upper lobe tumors, the station 2-4 and 7 for right middle lobe tumors and right lower lobe tumors, the station 5-6 for left upper lobe tumors, and the station 5-6 and 7 for left lower lobe tumors. We should pay more attention to the regions regarding the higher frequencies of lymph node metastases, when determining the extent of lymph node dissection or delineating the target volume of postoperative radiotherapy for NSCLC patients.

Clinicopathologic analysis of urothelial carcinoma of bladder with squamous differentiation / 中华泌尿外科杂志

Objective To investigate the clinical feature , pathologic characteristics and prognosis of urothelial carcinoma of bladder with squamous differentiation . Methods From Jan.2010 to Jun.2013, the pathological and clinical data of 96 cases of urothelial carcinoma of bladder with or without squamous dif-ferentiation were compared .Of the group with squamous differentiation , there were 39 males and 9 females with a median age of 70 (29 to 87) years.44 cases presented with painless gross hematuria .4 cases presen-ted with finding of bladder tumors in annual physical examination .TURBT, partial cystectomy and radical cystectomy were performed in 25, 8 and 13 cases, respectively.In addition, one case was only underwent bi-lateral ureteral skin gastrostomy .The last one only performed cystoscopy .In accordance with sex , age, path-ological stage and classification and surgical approach , 48 controls were selected .For the other group , there were 40 males and 8 females with a median age of 68 (39 to 86) years.45 cases presented with painless gross hematuria.3 cases presented with finding bladder tumors by annual physical examination .TURBT, par-tial cystectomy and radical cystectomy were performed in 28, 7 and 13 cases, respectively.All patients with retaining bladder had postoperative intravesical instillation for one year .Some patients with or without bladder performed 3-6 cycles chemotherapy with the GC protocol . Results In squamous differentiation group , there were 1 (2.1%) pTa, 25 (52.1%) pT1, 17 (35.4%) pT2, 4 (8.3%) pT3 and 1 (2.1%) pT4 tumors. Whereas, 1 (2.1%) pTa, 28 (58.3%) pT1, 16 (33.3%) pT2, 2 (4.2%) pT3 and 1 (2.1%)pT4 tumors were selected in the control group .There were 2 (4.2%) cases with low grade and 46 (95.8%) cases with high grade carcinomain in both groups .Patients were followed up with a mean duration of 16 and 12 months in squamous differentiation and control group , respectively .In squamous differentiation group , eight recur-rences were recorded with a mean follow-up of 12 months.Of the 3 died patients, only one died from bladder cancer.In control group, seven recurrences were recorded with a mean follow-up of 22 months, and no pa-tient died.For patients with TURBT, 3 year recurrence rate of patients with squamous differentiation was 49.5%, while the control was 34.8%.The difference was statistically significant (P<0.05). Conclusions Urothelial carcinoma of bladder with squamous differentiation is at a high level of malignant and recurrence . The rate of myometrial invasion with squamous differentiation is higher than pure urothelial bladder cancer . Patients with squamous differentiation should be closely followed up .

Application of stereotactic body radiotherapy in extracranial metastases / 国际肿瘤学杂志

Stereotactic body radiation therapy (SBRT) has been applied in extracranial metastases effectively,with the characteristics of concentrated dose distribution in target region,great dose gradient change in surrounding region and low dose in normal tissue beside target region.The radiation biology characteristics of SBRT,therapeutic mechanism,integration of SBRT into standard systemic therapy regimens have been studied further.

Efficacy of prostaglandin E1 administered via pulmonary artery for treatment of pulmonary hypertension / 中华麻醉学杂志

Objective To investigate the efficacy of prostaglandin E1 administered via the pulmonary artery for treatment of pulmonary hypertension in patients.Methods Thirty ASA Ⅱ or Ⅲ patients undergoing offpump coronary artery bypass grafting complicated with pulmonary hypertension,with pulmonary arterial systolic pressure (PASP) ＞ 40 mm Hg,were randomly divided into 2 groups (n =15 each):administration via the central vein group (group C) and administration via the pulmonary artery group (group P).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufentanil.The patients were tracheal intubated and mechanically ventilated.Swan-Ganz catheter was placed via the right internal jugular vein for monitoring of hemodynamic parameters after induction of anesthesia.The central vein and pulmonary artery were cannulated for infusion of prostaglandin E1.Prostaglandin E1 was infused at a rate of 20-50 ng· kg-1 · min-1 starting from the end of skin incision until PASP was decreased to 20-30 mm Hg.Heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),PASP,pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) were recorded at 5 rain before administration (To) and 5 min after administration (T1).The pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) were calculated.The amount of prostaglandin E1 consumed was recorded.Results Compared with group C,the amount of prostaglandin E1 consumed was significantly reduced,PASP and PVR were decreased at T1,while MAP and SVR were increased at T1 in group P(P ＜ 0.05).Conclusion Administration via the pulmonary artery can increase the potency of prostaglandin E1 for treatment of pulmonary hypertension and exerts no influence on the systemic hemodynamics.

Effects of dexmedetomidine on cerebral oxygen and glucose metabolism in patients undergoing mitral valve replacement under cardiopulmonary bypass / 中华麻醉学杂志

ObjectiveTo investigate the effects of dexmedetomidine on cerebral oxygen and glucose metabolism in patients undergoing mitral valve replacement under cardiopulmonary bypass (CPB).Methods Fiftyeight ASA Ⅱ or Ⅲ patients of both sexes aged 32-64 yr weighing 52-90 kg undergoing mitral valve replacement were randomly divided into 2 groups (n =29 each): control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was infused iv at 0.5 μg· kg- 1 · h- 1 starting after tracheal intubation until the end of operation in group D,while in group C equal volume of normal saline was infused instead of dexmedetomidine.Blood samples were collected from radial artery and jugular venous bulb for blood gas analysis and determination of glucose and lactate concentrations before CPB (T1,nasopharyngeal temperature =36 ℃ ),during CPB (T2,nasopharyngeal temperature =30 ℃ ),immediately and 30 min after restoration of spontaneous heart beat ( T3,T4 ).Arterial O2 content ( CaO2 ),arteriovenous O2 content difference ( Da-jvO2 ),cerebral extraction of O2 ( CEO2 ),arteriovenous glucose and lactate content differences (Da-jvGlu and Da-jvLac) were calculated.ResultsThe Da-jvO2 and CEO2 were significantly decreased at T2 in group D as compared with group C.There was no significant difference in CaO2,Da-jvGlu and Da-jvLac between the 2 groups.ConclusionDexmedetomidine can reduce cerebral O2 metabolism and help maintain the balance between cerebral O2 supply and demand but has no effect on cerebral glucose metabolism in patients undergoing mitral valve replacement under CPB.

Cardioprotective effect of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective To evaluate the cardioprotective effect of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting. Methods Forty-six ASA Ⅱ or Ⅲ patients aged 37-64 yr weighing 54-81 kg undergoing off-pump coronary artery bypass grafting were randomized into 2 groups ( n = 23 each): control group (group C) and dexmedetomidine group (group D) . Dexmedetomidine was infused at 0.5 μg·kg-1·h-1 starting after induction of anesthesia until the end of operation in group D. Radial artery was cannulated and Swan-Ganz catheter placed via right internal jugular vein. HR, MAP, mean pulmonary arterial pressure, pulmonary capilary wedge pressure, central venous pressure, and cardiac output were recorded and stroke volume index, left and right ventricular stroke work index, systemic vascular resistance and pulmonary vascular resistance were calculated at the beginning of operation (T1 ), immediately (T2 ) and at 30 min after reestablishment of coronary blood flow (T3 ) and the end of operation (T4 ) . Venous blood samples were taken before induction of anesthesia (T0 , baseline) , at T4 and 4 h (T5 ) and 24 h (T6 ) after operation for determination of plasma concentration of cardiac troponin I by ELISA. Results Stroke volume index and left ventricular stroke work index were significantly higher at T4 while systemic vascular resistance was lower at T34 in group D than in group C. Plasma cardiac troponin Ⅰ concentration was significantly lower at T6 in group D than in group C. Conclusion Dexmedetomidine infusion at 0.5 μg ·kg-1·h-1 during operation can protect myocardium in patients undergoing off-pump coronary artery bypass grafting.

Effect of γ-rays combined with blocking VEGF expression on esophageal cancer xenografts / 中华放射医学与防护杂志

Objective To investigate the effect of blocking VEGF expression on the radiation sensitivity of esophageal cancer cell line TE-1 in vivo. Methods 32 male Balb/c/nu nude mice were randomly divided into four groups, including control group, radiation group, anti-VEGF group, and anti-VEGF + radiation group. The anti-VEGFcDNA cells were subcutaneously injected into the paw pats of mice (2 × 106/100 μl). The subcutaneous tumors were irradiated with 18 Gy of 60Co y-rays when the diameter of tumors varied from 0. 8 to 1.0 cm. The volume of the tumors was measured before and after irradiation, respectively. The expression level of VEGF mRNA and protein were examined by RT-PCR and Western blotting, respectively. Apoptotic cells were detected by electron micrographs. Results Latent period of the tumor formation of anti-VEGF group was lengthened compared with other groups(t = 13. 898,P ＜0.01 ). The volumes of tumor in anti-VEGF group [ ( 1207. 50 ± 97.07 ) mm3 ] and anti-VEGF +radiation group [ ( 1057. 5 ± 91.50 ) mm3 ] were not statistically different post-irradiation ( t = 1. 124, P ＞0.05 ) , but smaller than those in control group [ ( 5442. 50 ± 185.08 ) mm3 ] and radiation group [ (2922. 50 ± 152. 773)mm3 ] with statistical differences( t = 9. 475-21. 238, P ＜ 0. 01 ). The expression level of endogenous VEGFmRNA and protein in anti-VEGF group and anti-VEGF + radiation group were statistically different from control group and radiation group (F = 387.394, 13.519, P ＜ 0.01 ).Conclusions Antisense VEGF could inhibit the proliferation of esophageal cancer cell in the nude mice.Effect of blocking VEGF expression before irradiation on esophageal cancer xenografts might be limited.

A clinical study in undifferentiated small cell carcinoma of the esophagus / 中国癌症杂志

Background and purpose:Esophageal cancer(EC) is one of the most common cancers that account for cancer-related deaths and over 400,000 new cases has been diagnosed per year.The morbility of small cell carcinoma of the esophagus(SCEC) is very low.This paper was to study was the clinical characteristics,treatment and prognosis of undifferentiated small cell carcinoma of the esophagus(SCEC).Methods:From 1961 to 2003,743 patients with SCEC were treated in different hospitals.The number of small cell carcinoma of the esophagus seen accounted for 1.38% of esophageal cancer treated in those hospitals in the same period.the average age was 56.8(range,51 to 66).511 of patients were male and 232 female.2 of them had primary tumor in the cervical proportion of the esophagus,68 in the upper thoracic proportion,420 in the mid thoracic proportion,252 in the lower proportion and 1 in the whole esophagus.88 patients were treated by surgery alone,23 by radiotherapy alone,24 patients by chemotherapy alone and all other of patients were treated by combined modality.Results:The median survival was 12.4 months for all patients,with 10.8 months for surgery,6.2 months for radiotherapy,6.6 months for chemotherapy,14.7 months for surgery combined with radiotherapy,16.1 months for surgery combined with chemotherapy,12.3 months for chemoradiotherapy and 16.2 months for surgery combined with chemoradiotherapy,respectively.The survival rates at 1,2,3,4,and 5 years were 56.4%、27%、19.3%、11.1%、(9.7%) for the whole group,respectively.Conclusions:We recommend that combined modality should be used for SCEC.The combination of surgery and multi-drug chemotherapy may improve the treatment outcomes for the patients with early stage SCEC.

Clinical Observation on Yangyin Shengxue Mixture in Prevention and Treatment of Radiation Injury of Oral Mucosa in Nasopharyngeal Carcinoma Patients:A Report of 30 Cases / 中医杂志

Objective To observe the preventive and therapeutic effect of Yangyin Shengxue Mixture (Herbal decoction for nourishing yin and blood) on radiation-induced oral mucosal injury.Methods Sixty nasopharyngeal carcinoma patients were randomized into two groups: treatment group (30 cases) receiving Yangyin Shengxue Mixture three days before till one week after radiotherapy, and control group (30 patients) using conventional Tinidazole Gargle for prevention of oral-mucositis. Before and after treatment, the body weight, hemoglobin and state of infection of patients were examined. The time of occurrence of symptoms, degree of acute radiation mucositis and degree of pain were observed to evaluate the damage of oral mucosa according to RTOG standard for radiation injury of oral mucosa and Numeric Rating Scales (NRS). Results There were different degrees of radiation mucositis in both groups during radiotherapy, but the time of occurrence in the treatment group was significantly later than that of the control group (P