ObjectiveTo investigate the effect of sevoflurane preconditioning on heme oxygenase-1 (HO-1) expression in lung tissues during one lung ventilation (OLV) in rats.MethodsTwenty-four male SD rats weighing 220-250 g were randomly divided into 4 groups ( n =6 each):control group (group C) ; two lung ventilation group (group T); OLV group (group O) and sevoflurane preconditioning+ OLV group (group SO).The animals were anesthetized with intraperitoneal pentobarbital sodium 40 mg/kg.In group T,the animals were tracheal intubated and bilateral lungs were ventilated for 1 h (VT 10 ml/kg,RR 60 bpt/min,I∶E 1∶2) and PETCO2 was maintained at 35-50 mm Hg.In groups O and SO,the animals were tracheal intubated and OLV was performed for 1 h (VT 5 ml/kg,RR 80 bpt/min,I:E 1:2) and PETCO2 was maintained at 35-50 mm Hg.In group SO,2.4％sevoflurane was inhaled for 30 min before OLV and then washed out by inhalation of oxygen for 15 min.The left lung tissues were removed in groups C and T,and the bilateral lung tissues were removed in groups.O and SO for microscopic examination and determination of wet/dry lung weight ratio (W/D ratio) and expression of HO-1 (by Western blot).Results Compared with group C,W/D ratio was significantly increased and the expression of HO-1 was up-regulated in left lung tissues in group T and in bilateral lung tissues in groups O and SO ( P ＜0.05).Compared with group T,W/D ratio was significantly increased and the expression of HO-1 was up-regulated in bilateral lung tissues in group O and in right lung tissues in group SO ( P ＜ 0.05).Compared with group O,W/D ratio was significantly decreased,the expression of HO-1 was up-regulated (P ＜ 0.05) and the pathological changes were reduced in bilateral lung tissues in group SO.ConclusionThe mechanism by which sevoflurane preconditioning reduces OLV-induced lung injury is related to up-regulation of HO-1 expression.

Objective High-density porous polyethylene(Medpor)has been widely used in chin augmentation in recent years.The study aimed to observe the outcomes of clinical use of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face.Methods From 2005 to 2008,149 cases of chin augmentations intraorally with Medpor implants combined with were collected.121 of them received bilateral mandibular angle osteotomy and 28 cases received bilateral mandibular angle osteotomy and bilateral malar reduction simultaneously.They wre all females aged from 17 to 46 years.The patients were followed up for 6 to 36 months(average 24 months)and photographs were taken before and after operations.Clinical outcomes were observed and analysed.Resuits 145 patients(97.3%)were satisfied with their chin and contour of low face.2 patients (1.3%)were not satisfied with the projection of their chin,and 1 of them were admitted to take out the implant and received sliding advancement genioplasty.1 patient(0.7 0A)felt the implants was too large to some extent and was admitted to modify the implant.1 patient(0.7%)received genioplasty 6months after operation because of the deviation of the implant.20 patients(13.4%)felt numbness of the lower lip which gradually disappeared 1 to 3 months postoperatively.Complications such as infection,edema and extrusion,break of the implant were not found during the following period.Conclusions Medpor is an excellent biomaterial with good biocompatibility.Simultaneously chin augmentation with Medpor combined with bilateral mandibular angle osteotomy intraorally shows a good result in contour plastic surgery of low face.

Objective To investigate the effect of fructose-1,6-diphosphate (FDP) pretreatment on myocardial connexin43 (Cx43) in a rat model of acute myocardial ischemia.Methods Thirty-six male 8-12 week old SD rata weighing 220-280 g were randomly divided into 3 groups (n=12 each):group Ⅰ sham operation (group S);group Ⅱ ischemia(group Ⅰ)and group Ⅲ FDP+ischemia(group F).The animals were anesthetized with intraperitoneal 10%chloral hydrate 40 mg/100 g,tracheostomized and mechanically ventilated.Acute myocardial ischemia was induced by occlusion of left anterior descending coronary artery for 30 min.Myocardial ischemia was;verified by elevation of S-T segment on ECG.In group F FDP 100 mg/kg was injected iv at 10 min before ischemia.Arrhythmia was recorded within 30 min after occlusion and the severity of arrbythmia was aggesged.The hearts were removed after 30 min myocardial ischemia.The Left ventricle area (LVA),myocardial infarct area (IA) and area at risk (AAR) were measured and AAR/LVA and IA/AAR ratios were calculated.The expression of myocardial Cx43 protein was determined by immuno-histochemestry and analysis of mean optical density.Results The severity of arrhythmia was significantly higher in group F and I than in gropu S.while lower in group F than in group I(P<0.05).The IA,IA/AAR ratio was significantly lower in group F than in group I.The myocardial Cx43 protein expression was down-regulated in group I and F as compared with group S.and was significantly lower in group I than in group F.Conclusion FDP pretreatment can protect myocardium against acute ischemia by up-regulation of myocardial Cx43 expression.

Objective To evaluate short-term and long-term prognosis of revascularization in patients with acute coronary syndrome. Methods A total of 6005 patients who received coronary revascularization in our institution between July 2003 and September 2005 were enrolled. The patients were followed up in clinic or by telephone after discharge between September 2006 and November 2006. The clinical and prognosis data of all-cause mortality, neo-myocardial infarction, nonfatal stroke, and rerevascularization of ST-segment elevation myocardial infarction ( STEMI ) , non ST-segment elevation myocardial infarction ( NSTEMI) and major adverse cardiovascular and cerebrovascular events ( MACCE) were analyzed. Results Among 4865 acute coronary syndrome patients, 955 cases were STEMI; 263 cases were NSTEMI; and 3647 cases were unstable angina ( UA) pectoris. There were no significant difference for in-hospital mortality and late mortality ( 18 month survival 96% , 98% and 98% ) between patients with STEMI, NSTEMI and UA. Patients with UA had lower MACCE rate (18 month non-MACCE survival of STEMI, NSTEMI and UA group were 86% , 86% , and 89% respectively). Conclusions Despite different clinical characteristics, patients with STEMI, NSTEMI and UA undergoing revascularization had similar short-term and long-term mortality. Patients with UA had lower MACCE rate.

Objective To assess whether anemia is an independent predictor of poor long-term outcome after percutaneous coronary intervention(PCI).Methods The second drug-eluting stent impact on revascularization registry(DESIRE-2)is a single-center registry of 6005 patients undergoing coronary revascularization from July 2003 to September.2005.We examined the clinical data and outcome of 3809 PCI patients based on hemoglobin(Hb)value before the interventional procedure.Patients were classified as anemia using the World Health Organization deftnition(＜120 g/L in women and＜130g/L in men). 744 of the 3809 patients were anemic.We compared the clinical features and prognosis of the patients with or without anemia.Results Anemic patients were older and had a higher percentage of comorbidities as compared with the nonanemic ones.When compared with nonanemic patients,anemic patients had higher mortality(4.7%VS 1.5%,P＜0.001)and higher major adverse event end points,including nonfatal myocardial infarction,stroke and revascularization(14.0%vs10.8%,P=0.014).After adjustment for comorbidities,anemia was associated with a higher risk of mortality after percutaneous coronary intervention(RR 2.216,95%CI 1.019-4.428;P=0.024).Conclusions Anemia is an independent predictor of mortality after PCI.Since PCI iS a common procedure and anemia is a frequent condition in the general population,strategies for the management of anemic PCI patients should be developed.

This study determined the profile of renal insufficiency in patients without chronic kidney disease(CKD)undergoing coronary revascularization and elucidated the effect of renal insufficiency of different degrees on clinical outcomes after revascularization and examined whether the reasonable choice of the mode of revasoularization could favourably influence prognosis.Methods Patients undergoing coronary revascularization were grouped by estimated creatinine clearance(CrCl)(Group Ⅰ,CrCl≥90 ml/min;Group Ⅱ,60 CrCl<90 ml/min;Group Ⅲ,30≤CrCl<60 ml/min;Group Ⅳ,CrCl<30 ml/min).We evaluated the relationship between the CrCl and the clinical outcomes of all of the patients.Results The mean Scr level of 2896 patients was(80.0±35.4)μmol/L There were 1035 patients(35.7%)in Group Ⅰ,1337 patients(46.2%)in Group Ⅱ,524 patients(18.1%)in Group Ⅲ and no patient in Group Ⅳ.During hospitalization,significant difference was found among Group Ⅰ-Ⅲ on mortality (1.0%.2.5% and 2.9%,P=0.009)and major adverse cardiar cerebra tvents(MACCE)(1.4%,3.5% and 4.6%.P=0.001).Compared with the normal renal function group,there were significantly higher rate of mortality(2.5% vs.1.0%,P=0.007).new-onset myocardial infarction(1.0% vs.0.2%,P=0.018)and MACCE(3.5% vs.1.4%,P=0.002)in miid renal insufficiency(Group Ⅱ).During follow-up,there were significant difference among Group Ⅰ-Ⅲ on mortality(2.0%,3.0% and 5.7%,P=0.002),stroke(1.0%,1.8% and 3.1%,P=0.023)and MACCE(9.9%,10.3% and 16.6%,P=0.001).The independent risk factors for all-cause death in patients after revascularization were the mode of revascularization(OR 8.332,95% CI 2.386-22.869,P=0.001).age(OR 1.184,95% CI 1.020-1.246,P=0.001).and the level of CrCl(OR 0.503,95% CI 0.186-0.988,P=0.045).In patients with normal renal function and mild renal insufficiency.the all-cause mortality after PCI was significantly lower that than after CABG(both P<0.01).Conclusions Renal insufficiency is common in patients without CKD undergoing coronary revascularization,even mild renal insufficiency is correlated with adverse clinical outcomes after revascularization.In patients with normal renal function or mild renal insufficiency,the mode of revascularization might lead to a prognostic difference.

Objective To investigate the effect of sevoflurane anesthesia on the cognitive function and phosphorylation of tau in hippocampal neurons in amyloid precursor protein (APP) transgenic mice.Methods Male APP gene mutation mice,weighing 18-22 g,aged 8-12 weeks,were used in the study.Forty-four APP positive mice were randomly divided into 2 groups (n =10 each):sevoflurane group (group AS,n =28) and control group (group AC,n =16).Forty-four APP negative mice were randomly divided into 2 groups:sevoflurane group (group S,n =28) and control group (group C,n =16).Animals in groups S and AS inhaled 3％ sevoflurane for 4 h.While in groups C and AC,animals inhaled pure oxygen for 4 h.Morris water maze was performed 24 h after sevoflurane or pure oxygen inhalation.The phosphorylation of tau at Ser262 and Ser396 was detected by Western blot on 1 day after pure oxygen inhalation (T1) in groups AC and C,and on 1,3 and 7 days after sevoflurane inhalation in groups AS and S.Results Compared with group C,the escape latency was significantly prolonged and the duration of staying at the original platform quadrant was shortened in groups S and AC,and the phosphorylation of tau at Ser262 in group S and phosphorylation of tau at Ser262 and Ser396 in group AS were increased (P ＜0.05).Compared with group S,the escape latency was significantly prolonged,the duration of staying at the original platform quadrant was shortened and the phosphorylation of tau at Ser262 and Ser396 was increased in group AS (P ＜ 0.05).Compared with group AC,the escape latency was significantly prolonged,the duration of staying at the original platform quadrant was shortened and the phosphorylation of tau at Ser262 and Ser396 was increased in group AS (P ＜ 0.05).Conclusion Sevoflurane anesthesia can aggravate the impairment of cognitive function in APP positive mice and the increase in the phosphorylation of tau at Ser262 and Ser396 is involved in the mechanism.

ObjectiveAnalyzing the left atrium and pulmonary vein morphologicallv by 64 multislice spiral CT(MSCT)scan to guide the catheter ablation of Atrial fibrillation.MethodsTwo hundred and thirty-two patients(146 cases in atrial fibrillation group and 86 cases in control group)received 64 MSCT examination of the left atrium and pulmonary vein.The incidence of anatomical variation of pulmonary vein was compared between atrial fibrillation group and control group. For each group,the anatomical morphology ot every pulmonary vein and the auricle of left atrium was analyzed, the diameter of the orifice of each pulmonary vein and the size of left atrium were measured.ResultsSixty-four MSCT of left atrium and pulmonary vein could demonstrate detailed connecting type between left atrium and pulmonary Veins and the possible anatomieal variation. Anatomical variation of pulmonary vein in this study accounted for 16.8% (39/232)of total sample. For both groups,orifices of pulmonary veins appeared oval and their superoinferior diameters were larger than their anteroposterior diameters. There was significant difference in the inner diameter of left atrium between atrial fibrillation group and control group[atrial fibrillation group:(39.47±8.98)mm,control group:(36.94 ±5.49)mm,P=0.02],while there was no difference in the diameters of orifices ot puhnonary veins between two groups [ superoinferior diameters of pulmonary veins in atrial fibrillation group:left-up(18.15±1.35)mm,left-down(16.96 ±1.18)mm,right-up(17.50±