Objective To explore the changes of index of heart function and major cardiovascular events (nonfatal myocardial infarction, stroke, and cardiovascular death) to H-type hypertension patients with left ventricular hypertrophy caused by Tianma Gouteng Decoction.Methods 126 H-type hypertension patients with left ventricular hypertrophy from January 2014 to May 2014 in our hospital were divided into observation group and control group,63 cases in each group.Control group was treated with conventional western medicine, observation group was treated with Tianma Gouteng Decoction on the basis of control group.The levels of plasma homocysteine (Hcy), left ventricular ejection fraction (LVEF),the E/A, and the incidence of major cardiovascular events were recorded and compared between the two groups.Results Compared with pre-treatment, the levels of Hcy in the two groups were significantly decreased(P<0.05), and the effect of observation group was better (P<0.05).After the treatment, the E/A and LVEF of the two groups were significantly improved (P<0.05); the E/A ratio and LVEF in observation group were significantly higher than those in control group (P<0.05).The incidence of major cardiovascular events in observation group was significantly lower than that in control group (6.35%VS 19.05%,P<0.05).Conclusion Tianma Gouteng Decoction can significantly reduce the Hcy of patients who get H-type hypertension, improve diastolic and systolic function and lower the occurrence of major cardiovascular events.

Objective To observe the cell apoptosis, oxidative stress reaction and expressions of Bcl-2 and Bax in kid?ney of dietary zinc deficiency mice during growth period, and discuss the mechanism of renal cell apoptosis induced by zinc deficiency. Methods Thirty weaning male mice were randomly divided into zinc-deficient group and zinc-adequate group, and 15 mice for each group. Zinc-deficient group was fed with zinc deficiency diet (0.85 mg/kg), while zinc-adequate group was fed with enough zinc diet (30 mg/kg). The TUNEL method was applied to observe the cell apoptosis, and the apoptotic in?dex was measured. The content of SOD and MDA were detected to observe the oxidative stress reaction in kidney. The ex?pression levels of Bcl-2 and Bax protein were detected by Western blot assay. Results Compared with zinc-adequate group, the cell apoptosis and oxidative stress reaction were increased in zinc-deficient group. The expression of Bcl-2 de?creased, and the expression of Bax increased. The ratio of Bcl-2 and Bax declined in kidney of zinc deficiency mice. Conclu?sion Diet zinc deficiency in growth period may result in the decreased antioxidase, the increased oxidative stress reaction, and the changed Bcl-2 and Bax expression, which promote the occurrence of cell apoptosis in kidney.

Objective To evaluate the patient-controlled paravertebral block (PCPB) in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in patients.Methods Forty-one ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-64 yr,with body mass index of 20-25 kg/m2,of TNM staging Ⅰ or Ⅱ,undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope,were randomly divided into 2 groups using a random number table:PCIA group (n =21) and PCPB group (n =20).PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In PCPB group,the patients received paravertebral injection of 0.2％ ropivocaine 5 ml at T5 level on the affected side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0.75％ ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose,with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤ 3,and analgesia lasted until 50 h after operation.Before induction of anesthesia (baseline),at end of operation,and at 1,3 and 5 days after operation,peripheral venous blood samples were collected to determine the levels of regulatory T cells,natural killer cells and natural killer T cells (by flow cytometry) and plasma concentrations of interleukin-10 and transforming growth factor-β (by ELISA).Results Compared with group PCIA,the level of regulatory T cells was significantly decreased,the levels of natural killer cells and natural killer T cells were increased,and the plasma concentrations of interleukin-10 and transforming growth factor-β were decreased at 1 and 3 days after operation,and no significant change was found in the rate of cellular immune function decline after operation in group PCPB.Conclusion PCPB provides no significant difference clinically in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in the patients.

Objective:To explore the diagnostic value of the serial position effect combined with delayed recall of auditory verbal learning test in diagnosing the elderly patients with different levels of cognitive impairment.Methods:A total of 310 subjects were enrolled and divided into three groups: the normal control group(NC group, n=128), the mild cognitive impairment group(MCI group, n=133)and the mild Alzheimer's disease group(mild AD group, n=149)matched for gender, age and education level.Comprehensive neuro-psychological tests were performed on all subjects, and the Auditory Verbal Learning Test-Huashan version(AVLT-H)was used to analyze the serial position effect.Results:There were significant differences in the primacy effect of the second and third time of immediate recall, short-term and long-term delayed recall among the three groups( P<0.05), but no difference was found in the recency effect between the MCI and mild AD groups( P>0.05). The long-term delayed primacy effect combined with the short-term delayed recall showed a better validity to distinguish those elderly subjects with different levels of cognitive impairment than other memorial indexes, and the correlative sensitivity and specificity were 83.21% and 71.43%(NC group vs.MCI group), 85.71% and 92.86%(NC group vs.mild AD group), 66.67% and 75.57%(MCI group vs.mild AD group), respectively. Conclusions:The long-term delayed primacy effect combined with the short-term delayed recall can assist in distinguishing elderly patients with different levels of cognitive impairment.

Objective To find out the incidence tendency and characteristics of bladder tumors during the past 28 yesrs in our institution. Methods The data from 1980 to 2007 were divided into three stages:1980-1989,1990-1999和2000-2007.Microsoft excel and SPSSl3.O were used to analyze the sex,age and histological types. Results There were 2350 cases of bladder tumors in 28 years.There were 92(66 males,26 females)cases of benign tumors and 2258(1788 males,470 females)malignant tumors,the incidence in male was 3.8 times higher than that in female.The cases of bladder malignant tumors increased,and the female increased faster than male.The peak age of incidence changed from 50-69 in 1980-1989 to 60-79 in 2000-2007.The average age of squamous cell carcinomas was 68 years,which was the oldest;and the average of paraganglioma was 35,which was the youngest.The age of urinary bladder carcinoma in 1980-1989,1990-1999 and 2000-2007 were significantly different(male:57.5±11. 7,62.6±12.3,65.9±11.3;female:58.7±13.6,60.75±12.1,65.85±12.0,respectively,P<0.05).In male,the age of squamous cell carcinomas was significantly different from the age of urothelial cell carcinomas and adenocarnomas(68.0±9.7 vs 59.85±14.1 and 63.4±9.9,respectively,P<0.05).Inverted papillomas were the most common bladder benign tumors;urothelial cell carcinomas were the most common bladder malignant tumors,and adenocarcinomas were the second,squamous cell carcinomas were the third. Conclusion The incidence of bladder malignant carcinomas in our institution increased and the female increased more quickly than male.

Objective To observe the safety and efficacy of different concentration of remifen-tanil TCI combined with dexmedetomidine for awake nasal intubation in cervical spine surgery patients and explore the clinical suitable concentrations for remifentanil TCI.Methods Sixty cervical spine surgery patients undergoing selective surgery under general anaesthesia (male 40 cases,female 20 ca-ses,aged 18-68 years,ASA Ⅰ or Ⅱ)were randomly divided into three groups according to TCI con-centration of remifentanil.The plasma concentration of remifentanil TCI of group A,B,C were 1.5 ng/ml,2.0 ng/ml,2.5 ng/ml respectively,which combined with dexmedetomidine 1 μg/kg.The value of MAP,HR,SpO2 ,RR were recorded when patients entering the operating room(T1 ), before intubation(T2 ),immediately after tracheal tube passing through nasopharynx(T3 ),immedi-ately after tracheal intubation(T4 ),immediately after tracheal tube cuff inflated(T5 )and 1min after intubation(T6 ).The success rate of first intubation were recorded.The incidence of cough,limb movement,respiratory depression,awareness and other adverse reactions during intubation were re-corded.Results In group A,MAP and HR at T3-T5 were significantly higher than those at T1 (P <0.05);SpO2 at T4-T6 and RR at T3-T6 were significantly lower than those at T1 (P <0.05)in group C.In group A,the incidence of cough and limb movements were significantly higher than those in group B,C(P <0.05).In group C,the incidence of respiratory depression was significantly higher than that in group A,B(P <0.05).Conclusion TCI concentration 2.0 ng/ml for remifentanil com-bined with dexmedetomidine can effectively inhibit the stress response to intubation with little respira-tory depression and can be widely used for awake nasal intubation in cervical spine surgery patients.

Objective To compare the efficacy of laryngeal mask of Supreme and i-gel for the airway management in patients undergoing elective lumbar vertebral surgery in prone position. Methods A total of 264 patients,ASA physical status Ⅰ or Ⅱ,scheduled for elective lumbar verte-bral surgery in prone position under general anesthesia were divided into two groups (n =132)using a random number table:laryngeal mask of Supreme group (group S)and laryngeal mask of i-gel group (group I).The laryngeal mask of Supreme or i-gel were respectively placed in group S and group I im-mediately after anesthesia induction according to manufacturers’specification.Volume-controlled ven-tilation was used to observe the ventilation quality.The number of laryngeal mask insertion,laryngeal mask insertion time and the ventilation quality in supine and prone position were recorded,as well as the airway seal pressure.The position of laryngeal mask was evaluated by fibero ptic examination in both supine and prone positions.The blood on the laryngeal mask was noted.Finally,the occurrence of laryngeal mask related complications was observed.Results One patient in group I was excluded due to the failure of laryngeal mask insertion after three attempts.No significant difference in type of laryngeal mask,insertion time,adjusted cases,peak airway pressure,and fiber optic examination in both supine and prone positions between two groups.Compared with group S,group I required signif-icantly more attempts of insertion (P < 0.01 ).Nevertherless,ventilation quality in prone position was improved and airway seal pressure in supine and prone position increased (P <0.01 or P <0.05) in group I.No significant difference was found in the occurrence of laryngeal mask related complica-tions.Conclusion In the airway management of patient undergoing elective lumbar vertebral surgery in prone position,laryngeal mask of i-gel is more difficult to be inserted but can maintain higher air-way seal pressure compared with laryngeal mask of Supreme.

AIM:To observe the influence of adenovirus latent infection on the oxidant/antioxidant balance in rat alveolar epithelial cells.METHODS:The rat alveolar epithelial cells were stably transfected with the plasmid pE1Aneo and control plasmid pneo.GSH and MDA contents,the activities of major anti-oxidative enzymes including SOD,CAT,GPx,GST and ?-GCS were detected in oxidant stress.RESULTS:Adenovirus E1A expression repressed the activity of ?-GCS,and decreased GSH contents in oxidant stress.As a result,the activity of GPx and GST was decreased.The contents of MDA maintained high in oxidant stress.CONCLUSION:Adenovirus latent infection amplifies the oxidant/antioxidant imbalance in rat alveolar epithelial cells in oxidants stress,and adenovirus E1A protein decreases the activity of ?-GCS,which plays an important role in this process.

Objective To determine the median effective target plasma concentration (EC50) of remifentanil inhibiting responses to skull-pin placement when combined with propofol in the female patients undergoing neurosurgery.Methods Sixteen female patients,aged 20-60 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective neurosurgery under general anesthesia,were enrolled in this study.Anesthesia was induced with propofol and remifentanil given by target-controlled infusion and iv rocuronium 0.6 mg/kg.The target plasma concentration (Cp) of remifentanil and propofol was set at 5 ng/ml and 3 μg/ml,respectively.At 3 min after tracheal intubation,the target Cp of remifentanil was adjusted and set at 5 ng/ml in the first patient.The skull-pin was placed after the target effect-site and plasma concentrations were balanced.The Cp increased/decreased by 20％ each time in the next patient depending on whether or not the response to skull-pin placement was positive.The ratio between the two successive concentrations was 1.2.The response to skull-pin placement was defined as positive when heart rate and/or mean arterial pressure increased by 20％ of the baseline value within 1 min after placement.The EC50 and 95％ confidence interval of remifentanil required to inhibit responses to skull-pin placement were calculated when combined with propofol.Results The EC50 (95％ confidence interval) of remifentanil required to inhibit responses to skull-pin placement was 3.74 (3.43-4.09) ng/ml when combined with propofol.Conclusion When combined with propofol,the EC50 of remifentanil inhibiting responses to skull-pin placement is 3.74 ng/ml in the female patients undergoing neurosurgery.

Objective To investigate the effect of dexmedetomidine on the cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Forty ASA Ⅱ or Ⅲ patients of both sexes,aged 43-64 yr,scheduled for elective cardiac valve replacement,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.6 μg/kg was injected intravenously over 15 min before induction of anesthesia,followed by infusion at 0.2μg· kg-1 · h-1 until the end of operation in group D.While the equal volume of normal saline was given in group C.Blood samples were obtained from the radial artery and jugular bulb for blood gas analysis before CPB,immediatelv after declamping of the ascending aorta,at the end of CPB and at 6 h after operation (T1-4).The arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The plasma concentrations of S-100β and neuron-specific enolase (NSE) in the blood samples obtained from the jugular bulb were measured at T1-4 and 24 h after operation.Results Compared with group C,the jugular venous oxygen saturation was significantly increased and Da-jvO2 and CERO were decreased at T2,3,and the plasma concentrations of S100β and NSE were decreased at T2-4 in group D (P ＜ 0.05).Conclusion Dexmedetomidine can decrease the cerebral O2 metabolic rate and reduce the cerebral injury in patients undergoing cardiac valve replacement under CPB.