BACKGROUND:When hip replacement patients treated with general anesthesia, intubation can cause physical stimulus of receptors of throat and trachea, which can increase stress response of patients, especial y in patients with hypertension. LMA Supreme laryngeal mask can lessen cardiovascular stress response of perioperative patients and reduce airway complications.
OBJECTIVE:To investigate the effects of Supreme laryngeal mask and endotracheal intubation on stress response of hypertensive patients with hip arthroplasty.
METHODS:A total of 45 patients treated with hip arthroplasty in the Shuyang Renci Hospital from January 2010 to September 2014 were enrol ed in this study. They were divided into laryngeal mask group (23 cases) and endotracheal intubation group (22 cases). The same protocol for induction and maintenance of general anesthesia was used in the two groups. During arthroplasty, systolic blood pressure, diastolic blood pressure, heart rate and blood oxygen saturation were monitored in patients. Systolic blood pressure, diastolic blood pressure, blood oxygen saturation, heart rate, blood glucose, plasma epinephrine, norepinephrine, serum cortisol, angiotensin II and atrial natriuretic factor levels were recorded before induction (T0), immediately (T1), 5 minutes (T2) and 15 minutes (T3) after intubation in the two groups.
RESULTS AND CONCLUSION:Systolic blood pressure and diastolic blood pressure were significantly reduced in the T1-T3 compared with T0 in the laryngeal mask group (P<0.05);blood oxygen saturation and heart rate were stable in T0-T3 (P>0.05). Systolic blood pressure and diastolic blood pressure were significantly increased at T1 compared with T0, systolic blood pressure was significantly reduced at T2 and T3 compared with T0, and diastolic blood pressure was significantly diminished at T 3 compared with T 0 in the endotracheal intubation group (P<0.05). Blood oxygen saturation and heart rate were significantly higher at T1 (P<0.05). Compared with endotracheal intubation group, systolic blood pressure and diastolic blood pressure were significantly lower at T 1-T 3 (P<0.05), and heart rate was significantly slower at T1 and T2 (P<0.05) in the laryngeal mask group. Blood oxygen saturation was significantly higher at T1 in the laryngeal mask group than in the endotracheal intubation group (P<0.05). Compared with T0, blood glucose, plasma epinephrine, norepinephrine and cortisol contents were significantly higher at T 1-T 3 in the endotracheal intubation group, and above indexes were higher in the endotracheal intubation group than in the laryngeal mask group (P<0.05). Angiotensin II levels were significantly higher at T1-T3 compared with T0 in the endotracheal intubation group, and it was significantly higher in the endotracheal intubation group than in the laryngeal mask group (P<0.05). Atrial natriuretic factor levels were increased at T 1-T 3 in the two groups, and it was significantly higher in the endotracheal intubation group than in the laryngeal mask group (P<0.05). These results confirm that laryngeal mask slightly impacted stress-related biochemical indicators, which is a physiological basis for slight effect of laryngeal mask on hemodynamics. Compared with endotracheal intubation, laryngeal mask obviously lessened stress reaction of hypertensive patients under general anesthesia treated with hip arthroplasty.

Objective Hyperperfusion syndrome is a rare and devastating complication of carotid artery angioplasty and stenting(CAS).We report the clinical character of this complication in a patient undergoing CAS.Methods This report is a retrospective review of one case with severe extracranial carotid stenosis of carotid angioplasty and stenting performed on March,2004.We analysesed the clinical and imagining character of this hyperperfusion syndrome related to CAS. Results The patient with subtotal occlusion of the right internal carotid artery had a 10-mm lesion treated percutaneously with implantation of 2 stents (Precise 6?30mm、10?40mm) under general anesthesia.The stenosis was postdilated with a 5?20mm balloon. Postprocedural angiography showed no significant stenosis, the blood pressure varied between 230～300/100～130mmHg,the heart rate decreased to 55/min. An urgent brain CT revealed extensive hemorrhage with 80ml in the right basal ganglia. Surgical evacuation was performed urgently under general anesthesia.After operation the patient presented with vegetative status.Conclusions Intracerebral hemorrhage is related to cerebral hyperperfusion after CAS.One of risk factors for hyperperfusion syndrome is of severe ipsilateral stenosis of 90% severity or greater with collateral carotid stenosis. Peri-and postintervention TCD monitoring is mandantory, TCD can be identified patients at risk of cerebral hyperperfusion,to decrease postintervention hemorrhage.

Objective To analyse the expression of alpha-fetoprotein variant-L3(AFP-L3)and glypican-3(GPC-3)in primary he-patic carcinoma(PHC)with different concentration of alpha-fetoprotein (AFP),so as to provide references for the diagnosis of PHC.Methods 240 cases of outpatients,inpatients and individuals on physical examination were selected as subjects and serum levels of AFP-L3 and GPC-3 were detected.All of the subjects were divided into negative group(0≤AFP<20 ng/mL),low concen-tration group(20≤AFP<400 ng/mL)and high concentration group(AFP≥400 ng/mL)according to the serum levels of AFP.Ser-um levels of AFP-L3 and GPC-3 were compared among the three groups.And the sensitivity,specificity and accuracy of single de-tection of AFP-L3 or GPC-3 and those of combined detection of AFP-L3 and GPC-3 were compared as well.Results The serum levels of AFP-L3 and GPC-3 in the low concentration group and high concentration group were both higher than those in the nega-tive group,and those in the high concentration group were also higher than those in the low concentration group,had statistically significant differences(P < 0.05 ).The sensitivity,specificity and accuracy of combined detection of AFP-L3 and GPC-3 were 84.4%,95.9% and 93.8% respectively,which were higher than those of single detection of AFP-L3 or GPC-3.Conclusion Com-bined detection of AFP-L3 and GPC-3 could improve the sensitivity,specificity and accuracy for diagnosis of PHC,which has clinical significance for the diagnosis of PHC.

Objective To study CT features of liver abscesses caused by the fasciola hepatica infection , and discuss its pathologic basis.Methods CT images of 15 Patients were collected. All patients underwent both unenhanced and biphasic enhanced CT scanning, then its CT performances were analyzed. Results round and nodular lesions were observed in 15 cases, branching and stripping lesions like dilated bile duct in 9 cases. The density of lesions was inhomogeneous, and the lesions were multifocal and multiform. The liver abscesses caused by the fasciola hepatica infection had no “rim sign” or “target” sign, Liver abscesses were less than 3.0 cm in diameter, and the dilation of the bile duct were not observed. Conclusion Liver absessed caused by the fasciola hepatica infection have characteristic CT features. Combined with clinical examination and laboratory test, the reliability of diagnosis will be considerably increased.

Objective To investigate the change characteristics of serum ferritin(SF)and parathormone (PTH)levels in differ-ent stages of chronic kidney disease(CKD)and their correlation with serum beta 2-microglobulin(β2-MG).Methods The levels of serum PTH,SF andβ2-MG in different stages of CKD were detected and the detection results were compared with those in the con-trol group.The correlation between serum SF and PTH withβ2-MG in each stage of CKD was analyzed.Results The level of ser-um PTH,SF andβ2-MG in the compensation group had no statistical difference compared with the control group (P >0.05),while which had statistical differences among the decompensation group,renal failure group and uremia group (P <0.05)The correlation analysis showed that serum PTH was positively correlated with serumβ2-MG in 145 cases(r=0.92,P <0.05),and the serum SF level was also positively correlated with serumβ2-MG level(r=0.92,P <0.05).Conclusion Detecting serum PTH,SF andβ2-MG levels possesses the important clinical significance for understanding CKD condition and prognosis.

Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI)in diagnosis of extramural vascular invasion (EMVI)of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings (k=0.324,P=0.039).The accuracy rate of MRI in diagnosis of EMVI was 66.7% (22/33).The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both (r=0.546).The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both (r=0.469). ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI (AUC=0.757).Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.

Objective To discuss the feasibility and accuracy of dual-source CT ( DSCT) in the evaluation of aortic stenosis ( AS) with transthoracic echocardiography ( TTE) as reference.Methods A total of 53 patients who underwent both DSCT and TTE were prospectively evaluated.All of them were assessed by TTE for aortic stenosis.Maximum aortic valve area ( AVA) in systolic phase was measured with DSCT , and was compared to that index obtained from the continuity equation on TTE.The severity of AS was graded as mild , moderate , or severe according to the AVA.Linear regression analysis and Bland-Altman plots were used to compare the AVA measured by using CT and TTE.Agreement on semi-quantitative grades of AS severity between the two methods was tested by using Kappa statistics.Results The mean AVA using DSCT was (1.45 ±0.35 ) cm2 compared to the mean AVA of ( 1.33 ±0.36 ) cm2 using TTE, with a significant correlation between them (r=0.92,P<0.01).Bland-Altman analysis demonstrated good inter-modality consistency between DSCT and TTE.However , DSCT demonstrated a slight overestimation of the AVA compared to TTE.As identified by TTE, there were 53 patients with AS, 13 with mild AS, 21 with moderate AS , and 19 with severe AS.In 3 patients DSCT showed no AS , TTE detected mild AS.In 6 cases, TTE had graded the stenosis as moderate , but the stenosis degree was graded as mild using DSCT.Kappa analysis showed a good agreement between the two methods on semi -quantitative grades of aortic stenosis severity (Kappa=0.75,P<0.01).Conclusion AVA measurements using DSCT is feasible and reasonably accurate for those patients with moderate to severe aortic stenosis.

Objective To explore the feasibility and accuracy of dual-source computed tomography(DSCT)coronary angiography for evaluation the morphology and motion of aortic valve.Methods A total of 125 cases with suspected coronary artery disease un-derwent computed tomography coronary angiography and transthoracic echocardiography examination.Twenty CT data sets were re-constructed in 5% steps from 0% to 95% of R-R interval.The morphologic features,changes of motion and image quality of the aortic valve in cardiac cycle were observed and recorded with CT dynamic cine-mode technique.The differences of aortic opening area in the various phases of the systole were analyzed by using ANOVA.Results 92.3% of aortic valve images among the total 2500 phases were good enough for evaluated in the 125 patients examined.DSCT visualized 123 patients with tricuspid aortic valve while 2 patients with bicuspid aortic valve.27 patients with degenerative aortic valve disease were identified.CT correctly identified 26 patients with aor-tic insufficiency during diastole.Compared with TTE,3 patients were false positives and two patients were false negatives on DSCT. Aortic valve opening was seen in phase 0% to 35% in 92% of patients,and it was closed during phase 40% to 95% of R-R interval in 75.2% of patients.There were significant difference between the AVA in the various phases of the systole(F =2.97,P <0.05). Conclusion DSCT allows accurate and dynamic visualization of morphology and motion of aortic valve throughout the cardiac cycle. The area of the aortic opening is widest and image quality is best during midsystole.

Glucose-6-phosphate dehydrogenase is main regulatory enzyme for pentose phosphate pathway. To amplify the core sequence of G6PDH gene from Chimonanthus praecox, the primers were synthesized, based on the conserved nucleotide sequence of other reported plant G6PDH genes. The specific primers were designed according to the major fragment. The full length cDNA of the G6PDH1 gene was isolated by the 3' and 5' rapid amplification of cDNA ends approach. Transcript levels of G6PDH1 isoform was measured by real-time quantitative RT-PCR in different tissues and in responds to cold treatment. The G6PDH1 subcellular localization, transmembrane domain, three-dimensional structure, and phylogenetic analysis were predicted by different software to analysis the bioinformatics of G6PDH1 protein. The G6PDH1 cDNA sequence was 2 011 bp in length and consisted of 1 551 bp Open Reading Frame (ORF) , encoding a protein of 516 amino acids. Expression analysis results in different tissues showed that G6PDH1 was primarily observed in flowers and roots, as opposed to the leaves and stems. Cold treatment experiments indicated that cold treatment caused a rapid increase in G6PDH1 expression in flowers within 12 h. The full-length cDNA of G6PDH1 and its expression analysis will play an important role for further study on cold stress responses in Ch. praecox.
Calycanthaceae ; chemistry ; classification ; enzymology ; genetics ; Cloning, Molecular ; Enzyme Stability ; Glucosephosphate Dehydrogenase ; chemistry ; genetics ; metabolism ; Models, Molecular ; Open Reading Frames ; Phylogeny ; Plant Proteins ; chemistry ; genetics ; metabolism

Objective To determine the distribution and influencing factors(dehydration method, storage time and chili varieties) of arsenic contents in chilies from southwest China, and the relationship between arsenic content and selenium content in chilies. Methods There were 272 dried chili samples, 76 groups of fresh chili samples and its corresponding soil samples, which were collected from the markets and peasant households in 76 counties of 9 regions in southwest China, and 36 dried chilies from other regions in China and abroad as a comparison. Their dehydration methods and storage time were investigated. The chilies were classified by Bailey Criteria. Arsenic content and selenium content in chilies were determined with hydride generation atomic fluorescence spectrometry. Arsenic content in soils were determined with water bath hydride generation atomic fluorescence spectrum. Results Their ranges of arsenic content in dried chili and fresh chili were 0.2 - 16 637.3,0.2 - 295.8 μg/kg, respectively. The median of arsenic content in the dried chili was 106.9 μg/kg while it was 0.2 μg/kg (dry weight) in the fresh chili. The chilies median arsenic of different drying methods and storage time, in order were: the furnace-dried stored for more 1 than year( 197.3 μg/kg), the sun-dried stored for more than 1 year (130.7 μg/kg), the furnace-dried stored for less than 1 year(94.1 μg/kg), the sun-dried stored for less than 1 year (55.5 μg/kg). The arsenic content of different kinds of solar-dried chilies and roast chilies were different. In solar-dried chilies, the median of arsenic contents from a order of high to low sequences were cluster chili (101.5 μg/kg), cherry chili (95.6 μg/kg), corn chili (86.8 μg/kg), and long chili (47. 1 μg/kg); in roast chilies, the median of arsenic contents from a order of high to low sequences were cherry chili(275.5 μg/kg), cluster chili (173.0 μg/kg), corn chili( 164.3 μg/kg), and long chili( 136.8 μg/kg). The medians of chilies from other regions of China and Turkey were higher than that of southwest China, their median were 125.8,112.3 μg/kg, respectively;the medians of chilies from America, France, and other countries were lower than that of southwest China, their median were 29.4,54.1,85.3 μg/kg, respectively. There was no significant correlation between fresh chilies and its corresponding soil arsenic(r = 0.010, P ＞ 0.05). There was a significant positive correlation between the amount of arsenic and selenium in chilies(r = 0.616, P ＜ 0.05). Conclusions The arsenic of dried chilies from southwest China was higher than that of fresh chilies. The arsenic of chili was different with different dehydration methods and storage time. There was a significant positive correlation between the amount of arsenic and selenium in chilies.