Objective To investigate the effects of ulinastatin on cerebral injury during cardiac valve replacement and the possible mechanisms involved. Methods Twenty-four NYHA Ⅱ or Ⅲ patients of both sexes (13 male, 11 female) aged 23-45 yr undergoing cardiac valve replacement with hypothermic cardiopulmonary bypass (CPB) were randomly divided into two groups: control group (group C, n = 12) and ulinastatin group (group U, n = 12) . In group U ulinastatin 12 000 U?kg-1 was given i.v. after induction of anesthesia, 6 000 U? kg-1 was added to the priming solution and another 6 000 U?kg-1 was given at 5 min before aortic unclamping. In group C normal saline was given instead of ulinastatin. Internal jugular vein was cannulated and the catheter was advanced in a cephalad direction till jugular bulb. Blood samples were taken from jugular bulb after induction of anesthesia(T1) , when rewarming to 36℃(T2), 30 min (T3 ) and 6 h (T4 ) after discontinuation of CPB for determination of plasma S100? protein, neuron specific evolase (NSE) , MDA concentrations and SOD activity. Plasma TNF-?, IL-6, IL-8 and IL-10 levels were also determined at T1, T3 and T4.Results Plasma levels of S100? protein, NSE and MDA were significantly increased during and after CPB (T2-4) compared to the baseline values before CPB (T1), but were significantly lower in group U than in group C (P

Objective To compare the protective effects of midazolam and propofol at equivalent dose on myocardial ischemia reperfusion injury during open heart surgery Methods Thirty six patients,scheduled for elective open heart surgery, were divided into midazolam (M), propofol (P) and no occluding (N) groups Before induction, a bolus of midazolam 0 2mg?kg -1 was given in group M or N , and a bolus of propofol 2 0mg?kg -1 in group P; after induction, midazolam was infused at 0 4mg?kg -1 ?h -1 in group M or N , and propofol at 4 0mg?kg -1 ?h -1 in group P The arterial blood samples were taken to measured the activities of serum enzymes ,at the beginning of CPB, 30min, 4, 12 and 24h after release of the aortic cross clamp Results As compared with those at at the beginning of CPB, the activities of serum enzymes increased significantly in three groups following declamping (P

Objective To investigate the relationship between the activity of Na +/K +pump on RBC membrane and abnormal potassium transportation through cellular membrane in hypokalemic patients Methods Activity of RBC ATPase in 17 cases of hypokalemic paralysis patients and 16 cases of healthy controls was tested Results Activity of RBC ATPase was statistically higher in hypokalemic periodic paralysis (HOPP)group[( 25 6?3 5) ?mol?(10 7RBC) 1 ?h 1 ], and lower in nephridium oxidosis group [(1 9?0 8) ?mol?(10 7RBC) 1 ?h 1 ]than in control group[(6 2?0 9) ?mol?(10 7 RBC) 1 ?h 1 , P

Objective To describe the diagnostic approach and clinical outcomes of fetal intraabdominal extralobar pulmonary sequestration (IEPS).Methods Three cases of IEPS were diagnosed prenatally by ultrasound in our center.The data of these 3 cases and 43 cases in prior studies from 1986 to 2016 were retrospectively reviewed.The prenatal sonographic features,treatment,and outcomes were collected.Results The gestational age of diagnosis IEPS was (24.5±5.9)weeks,the male-to-female ratio was 3-4∶1,78.3% (36/46) of IEPS masses located on the left side,47.8% (22/46) of lesions were homogenous and hyperechoic,8.7% (4/46) of cases associated anomalies,78.3% (36/46) of patients were preformed resection and postoperative recovery and subsequent course were uncomplicated.Feeding arteries were detected in 15.2% (7/46) cases and confirmed by surgery or autopsy.Conclusions Prenatal ultrasound has the diagnostic accuracy of IEPS.Feeding arteries noted on color Doppler are strongly indicators of IEPS.Postsurgical outcomes are favorable.

ObjectiveTo explore the effects of insomnia on heart rate variety(HRV) in aged hypertension patients. Methods259 subjects were divided into healthy group (74 cases),simple hypertension group (71 cases),coexisting hypertension and insomnia group (114 cases) which was sub-grouped to ＜5 years,5-9 years and ≥-10 years according to the duration of insomnia.All subjects had 24 h recordings of ECG.The data of HRV time domain (SDNN,SDANN and ASDNN) were collected and compared.ResultsHRV time domain was lower in healthy group than in the other two groups (F=12.02,10.54 and 4.27,P＜0.01),and decreased more significantly in coexisting hypertension and insomnia group compared with simple hypertension group(P＜0.01).The values of SDNN and SDANN in 5-9 years and ≥ 10 years subgroups decreased as compared with ＜ 5 years subgroup (F=8.63 and 4.54,P＜0.01),and these values further lower in ≥10 years subgroup than in 5-9 years subgroup (P＜ 0.01 ). ConclusionsInsomnia may lead to more serious disorder of automatic nervous system and further aggravated disorders appear in the elderly with hypertension along with increasing years of insomnia.

Objective To evaluate the model of end-stage liver disease (MELD) and Child-Tur-cotte-Pugh (CTP) in prognosis for cirrhotic patients with massive hemorrhage from esophageal varieosis, who underwent emergency endoscopic sclerotherapy (EIS). Methods The clinical and follow-up data of a co-hort of 65 liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS were ana-lyzed retrospectively. Correlation between MELD values and CTP score and classification was analyzed. The area under the receiver operating characteristic (ROC) curve was used to compare MELD with CTP score and classification in predicting mortality risk. The optimal threshold of MELD to determine the prognostic death risk was calculated by ROC curves. Results MELD, CTP score and classification correlated signifi-cantly with each other. Seven patients died within six months and 9 died within the first year of follow-up.There was no significant difference in gender, age and serum bilirubin between the survival and death groups, while the serum creatinine, international normalized ratio (INR), CTP score, and MELD score were significantly different. The areas under the ROC curve of MELD were both greater than 0.8 to predict 6-month and 1 -year survival, and also were greater than those of CTP score and classification. Areas under the ROC curve of MELD is superior to, but not significantly different though, CTP score or classification. The optimal threshold values of MELD and CTP score both showed satisfactory predicting accuracy of mortality risk. Conclusion MELD is an accurate predictive system for 6 months and 1 year in liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS. The MELD value is very important in the selection of patients for E1S. But it is not more efficient than CTP score and classification.

Objective: To observe the effects of propofol on lipid peroxides(LPO)and superoxide diomutase(SOD) during open heart surgery. Method: Twenty patients undergoing cardiac valve replacement, were diviced into two groups: propofol group and etomidate group. The serum samples were taken to measure LPO and SOD lerels before and after ischemic reperfusion,and recorded ECG and MAP. Result: The serum LPO level decreased sign ficantly during aortic cannulation,and increased after aortic cross-release in propofol group(P

Objective To investigate the effects of high temperature preconditioning on hydrogen peroxide (H2 O2)-induced expression of mitochondrial metallothionein (MT) in rat cardiomyocytes.Methods The rat cardiomyocytes H9C2 cultured in vitro were randomly divided into 3 groups (n =6 each):control group (group C) ;H2O2 group (group H2O2); high temperature preconditioning group (group HTP).The cells were continuously cultured for 3 h in group C.The cells were cultured for 3 h in serum-free DMEM liquid culture medium containing H2O2 0.5 mmol/L in an incubator filled with 5％ CO2 at 37 ℃ in group H2O2.In group HTP,the cells were cultured in serum-containing DMEM liquid culture medium,then placed in a warm bath of 42 ℃ for 1 h,cultured for 12 h in an incubator filled with 5％ CO2 at 37 ℃,DMEM liquid culture medium was then removed,and the other procedures were similar to those previously described in group H2 O2.Myocardial cell apoptosis was observed by flow cytometry.The apoptotic rate was calculated.The ultrastructure of myocardial mitochondria was examined with electron microscope.The expression of mitochondrial MT in cardiomyocytes was determined using Western blot.Results Compared with group C,the apoptotic rate was significantly increased,and the expression of mitochondrial MT was up-regulated in groups H2O2 and HTP (P ＜ 0.01).The apoptotic rate was significantly lower,and the expression of mitochondrial MT was higher in group HTP than in group H2O2 (P ＜ 0.01).The mitochondrial injury was attenuated in group HTP as compared with group H2 O2.Conclusion The mechanism by which high temperature preconditioning reduces H2 O2-induced myocardial damage may be related to up-regulation of expression of mitochondrial MT in cardiomyocytes and endogenous myocardium-protective mechanism in rats.

OBJECTIVE To discuss the function of sustaining quality improvement in preventing perineum wound infection.METHODS The perineum wound infection situation in 2003 was retrospectively analyzed,and since then the measures for sustaining quality improvement were implemented.RESULTS In 2004 and in 2005 the perineum wound infection percentage and the stitch inflammation rate were obviously reduced than in 2003.The difference was statisticaly significant.CONCLUSIONS Sustaining quality improvement is an unceasing,gradually advancing and long-term process.The prevention of perineum wound infection is a long time work for obstetrics workers.To carry out strictly the aseptic technical operation,grasp skilled suture technology,choose easily absorbable suture,maintain suitable cleanliness and nursing and use the antibiotic could be effectively to prevent the perineum wound infection and the stitch inflammation occurrence.

Objective To explore the effect of collaborative nursing on the quality of life and nursing of stroke patients. Methods Toally 84 care-givers for 84 stroke patients hospitalized during February 2014 to March 2016 were chosen. In the control group(hospitalized from Feburary 2013 to Feburary 2014), traditional nursing was carried out, while in the research group(hospitalized from March 2014 to March 2016), the collaborative care intervention was done. The comparisons were done between the two groups in terms of quality of life and care ability by the GHQ-28 quality of life scale assessment, family caregiver task inventory (FCTI) before the intervention and 4 weeks after the intervention. Results Before the intervention, the two groups had no significant differences in life quality and care ability (all P > 0.05). After the intervention, the scores on symptoms, anxiety, depression, insomnia and social dysfunction were all significantly higher than those of the control group (all P<0.05). The scores on the care role, strain, assistance, personal emotion control, family assessment and community resources, and adjustment of life to meet the care needs were all significantly lower than those of the control group (all P<0.05). Conclusions The collaborative care is effective in improving the quality of life of stroke patients. It can improve the care ability of the caregiver.