Objective: To systematically review the cardioprotective of sevoflurane in patients undergoing heart surgery under cardiopulmonary bypass,so as to provide evidence for anesthesia decision of cardiac surgery. Methods: Trials about the cardioprotective effect of sevoflurane under CPB were collected through electronic search of Medline, CNKI, and CMBdisk (from the date of database establishment to October 2008); manual search was also conducted. Based on the inclusion and exclusion criteria, fourteen randomized-controlled trials were finally included in the present analysis. The details of the trial design, the characters of the subjects, and the results of the studies were reviewed and analyzed using RevMan 4.2 software. Results: The 14 trials involved 1226 patients, including 616 receiving sevoflurane and 610 receiving total intravenous anesthesia (TIVA). Compared with TIVA, our analysis showed the following results. (1) Cardiac function: sevoflurane significantly increased the postoperative cardio index (CI, P < 0.01) and cardiac output (CO, P < 0.01). (2) Serum cTnI concentration at 24 h postoperation: sevoflurane group was significantly lower than that of TIVA group (P < 0.01). (3) Sevoflurane significantly decreased the period of mechanical ventilation (P < 0.01) and the length of intensive care unit stay (P < 0.01), but the postoperative hospital stay was similar between the two groups. (4) The postoperative usage of inotropic agent was lower in sevoflurane group (P < 0.01). There were no significant differences in the mortality (P = 0.59), the incidence of atrial fibrillation (P = 0.11), and the myocardial infarction rate (P = 0.11) between the two groups. Conclusion: Sevoflurane has cardioprotective effect in patients undergoing heart surgery under CPB.

Liver transplantation is the most effective treatment for patients with advanced liver diseases. Patients undergoing liver transplantation are likely to have severely impaired liver function and poor general condition. Meanwhile, the operation is complicated and needs long time; the hemodynamics fluctuates greatly during operation and many drugs are needed after operation. All the above factors are likely to induce injuries to the heart, brain, lung, etc, and resulting in severe complications and finally leading to the death of patients. Therefore the protection of organs during perioperative period is an important step for liver transplantaion of advanced liver diseases, and it is also a focus of study in the area. This article summarizes the injury mechanism and protection strategy of organs in patients during perioperative period of liver transplantation.

ObjectiveTo investigate the effect of propofol on IL-1β and TNF-α release from BV-2 microglia cells induced by lipopolysaccharide (LPS) and the role of Toll-like receptor 4 (TLR4).MethodsBV-2 microglia cells were seeded in 96-well plates and randomly divided into 4 groups ( n =12 each):control group,LPS group,propofol group (group P) and LPS + propofol group.In group LPS,the cells were incubated with LPS 1 μg/ml for 24 h.In group P,the cells were incubated with propofol 30 μmol/L for 24 h.In group LPS + propofol,the cells were incubated with LPS 1 μg/ml and propofol 30 μmol/L for 24 h.The concentrations of TNF-α ( at 6 h of incubation) and IL-1β (at 24 h of incubation) in the supernatant were detected by ELISA.TLR4 mRNA expression was detectedat at 6 h of incubation by RT-PCR.TLR4 protein expression was detected at 24 h of incubation by Western blot.ResultsCompared with control group,IL-1β and TNF-α release was significantly increased,and the expression of TLR4 mRNA and protein up-regulated in groups LPS and LPS + propofol ( P ＜ 0.05).Compared with group LPS,IL-1β and TNF-α release was significantly decreased,and the expression of TLR4 mRNA and protein down-regulated in group LPS + propofol (P ＜ 0.05 ).Conclusion Propofol can inhibit IL-1β and TNF-α release from BV-2 microglia cells induced by LPS and inhibition of TLR4 expression may be involved in the mechanism.

Objective To compare the osseo-induction and biodegradation performances of three types of injectable and degradable calcium phosphate cement (CPC) so as to find out a better bone substitute. Methods Three types of injectable and degradable CPC were respectively implanted into the bilateral tibias of 24 New Zealand rabbits: pure CPC (Group A), CPC added with Zinc and Strontiumions (Group B), and CPC with composite rhBMP-2 (Group C) . Their systematic and local reactions in implanted region were closely observed. The degra- dation and osseo-induction performances were compared macroscopically, microscopically and by CT scan to find out the one that could best meet clinical needs. Tissue slices were sampled and photographed four, eight and 16 weeks after operation. Five photographs were selected in each group and at each time points for computer software (Image Pro Plus 5.1) processing to calculate the percentages of bone in the images of postoperative slices. Results In Groups A and B, new bone was found to form slowly and little by little, and the ossification was not synchronous with the material degradation. In Group C, however, new bone was observed to form early and massively, and the os- sification was almost synchronous with the material degradation. In Groups A, B and C, the percentage of bone in the images of postoperative slices was (41.7?16.6)%, (31. 2?12.2)% and (71.7?21.0)% respectively. The bone percentage in CPC with composite rhBMP-2 was significantly higher than that in the other two types of CPC (P＜0.01 ). Conclusion The injectable and degradable CPC with composite rhBMP-2 is more suitable for clinical use, because it can induce early new bone formation and synchronous biodegradation.

Objective To understand the actual psychological conditions of pregnant patients with gynecologic malignancies during chemotherapy so as to instruct the nurses to provide individualized psychological care to the patients and their relatives. Method The in-depth interviews were conducted to 7 patients by implementing the phenomenological approach of qualitative study. The acquired data were analyzed. Result The patients experienced four psychological conditions: pessimism about prognosis, anxiety to know more about the chemotherapy and guilty to their family and hope for treatment effect. Conclusion Nurses should pay attention to the psychological conditions of pregnant patients with gynecologic malignancies and help them successfully live through the treatment.

Atomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit presynaptic noradrenaline transport protein,strengthen noradrenaline's resupination effect,and increases noradrenaline's activity released by synaptic cleft to improve the symptoms of the attention deficit hyperactivity disorder(ADHD)patients.ADHD patients often accompany with other psychological diseases like oppositional defiant disorder,anxiety disorder,which may hinder the diagnosis of ADHD.There is still no accepted effective medicine nowadays.Currently,research on the treatment of the ADHD is more and more popular.Good therapeutic effect of atomoxetine to treat ADHD has been found in resent studies.This article summarized the current management of using atomoxetine to treat ADHD.

Objective To explore the selection and clinical effects of internal or external drainage for upper urinary tract obstruction complicated with acute renal failure.Methods A total of 25 cases of upper urinary tract obstruction complicated with acute renal failure were treated with double J(DJ) tube internal drainage(12 cases,15 times) or percutaneous nephrectomy(PCN) external drainage(19 cases,23 times).15 cases of obstruction were induced by tumor and 10 cases of obstruction induced by benign disease.Results The drainage treatments were performed successfully in 23 cases,with the success rate of PCN and DJ drainage being 86.9%(20/23) and 60.0%(9/15),respectively.Postoperative bleeding occurred in 1 patient with PCN.Conclusions PCN is superior to DJ in the treatment of malignant obstruction,but DJ internal drainage may be the first choice for non-malignant obstruction.

Objective: To study the relationship among shame, persona li ty and mental health, and to establish a structural model of them Meth o d: Structural equation modeling was used for the data from 178 college s tudents (including 86 male and 92 female, mean age 21), who were tested with SCL -90, EPQ-R Short Scale (EPQ-RS)and shame scale Result: A theor etical model was established for the relationship of personality, shame and ment al health It wa s also confirmed through model comparison that shame has a part-mediating role b etween personality and mental health

Objective: To study social anxiety proneness in college students and factors having influence on it Method: 200 college students were assessed with Social Anxiety Inventory, Shame-Proneness Scale, EQQ-short form, Coping Style Questionnaire, Beck Depression Scale, and Trait Anxiety Scale Result: Social anxiety of college students was influenced by shame-proneness, psychoticism and extroversion of personality Students with high social anxiety proneness were also more easily ashamed by their own behaviors Lack of negative coping styles also contributed to their proneness Low social anxiety proneness could be explained partially by three factors: psychoticism and extroversion personality, self-appraised trait anxiety Conclusion: Shame-proneness, psychoticism and extroversion personality are main factors having influence on social anxiety proneness Positive self-evaluation and coping style are helpful in reducing social anxiety

Objective To investigate the effects of different doses of ketamine on spatial cognitive function and the expression of mRNA and protein of N-methyl-D-uspartate (NMDA) receptor subunits NR1 and NR2B in the hippocampus of aged rats.Methods Forty SD rats of both sexes aged 15 months weighing 470-570 g were randomly divided into 4 groups (n=10 each) : one control group (C) and three ketomine groups (K1 ,K2 ,K3).The animals in group K1 ,K2 and K3 received intraperiteneal(IP) ketaminc 10,20 and 100 mg/kg respectively once a day for 3 days,whereas the animals in control group received IP normal saline instead of ketamine.One day after the last drug administration,the animals underwent Morris water maze test 4 times a day for 3 consecutive days.The animals were killed within 1 h after the last test for determination of the expression of NR1 mRNA and NR2B mRNA (using RT-PCR) and protein (using immuno-histochemistry) in the hippocampus.Results The latency period and swimming distance of water maze test were significantly longer on the 2nd and 3rd days in group K3 than in control group.The NR2B mRNA and protein expression was significantly lower in group K3 than in control group.Conclusion Anesthetic dose of ketamine decreases spatial cognitive function and the expression of NR2B mRNA and protein in aged rats whereas subanesthetic doses of ketamine do not.