Objective To observe the influence of sodium phosphocreatine on the hemodynamics,human heart fatty acid binding protein (hFABP),cardiac troponin Ⅰ (cTnI) during perioperative period.Methods Forty patients (ASA grade Ⅱ to Ⅲ ) with extensive myocardial ischemia diagnosed by preoperative electrocardiogram were divided into two groups:sodium phosphocreatine group (group A) and control group (group B) with 20 cases each by random digits table. Both groups underwent routine preoperative preparation and group A were given sodium phosphocreatine 2 g/d till anesthesia induction immediately in the operation day. Hemodynamic parameters including mean artery pressure (MAP),heart rate (HR),cardiac output (CO), stroke index (SI) and pulmonary vascular resistance (PVR) were recorded respectively at 3 d before treatment (T0), anesthesia induction immediately before ( T1 ), tracheal intubation immediately after (T2),tracheal extubation immediately after (T3). And blood hFABP and cTnl levels were detected. Results Compared with group B, there was no significant difference in HR of group A at To to T3 (P ＞ 0.05 ). MAP,CO, SI at T1 to T3 of group A were significantly higher than those of group B(P＜ 0.05 ) ;whereas PVR,blood hFABP and cTnI levels were lower than those of group B (P ＜ 0.05 ). The incidence of arrhythmogenesis of group A [20%(4/20)] was lower than that of group B [45%(9/20)](P＜0.05). Conclusion Sodium phosphocreatine has good protective effect on the myocardium in the patients with myocardial ischemia during perioperative period.

Objective To explore the clinical application value of duodenum-preserving total pancreatic head resection by modified Takada procedure in the treatment of pancreatic head lesions.Methods Thc clinical data of 6 cases of modified Takada duodenum-preserving total pancreatic head resection in Zhangzhou Affilicated Hospital of Fujian Medical University and Zhangzhou Zhengxing Hospital from Sep 2013 to Sep 2014 was retrospectively analyzed.Results The mean operative time was (281.7 ± 42.6) minutes,the mean intraoperative blood loss was (300 ± 187) ml.The mean time to recovery to oral food-intake was (3.7 ± 1.6) days.Average length of hospital stay after operation was (9 ± 4.3)days.Of these cases,all preserved duodenal papilla and Vater ampulla and one-stage end-to-end anastomosis of the pancreatic duct in situ was done.Postoperative complications developed in 2 cases,one was pancreatic leakage and other one was bile leakage,all were cured conservatively.No perioperative deaths occurred.Postoperative pathology proved chronic pancreatitis in 3 cases and primary pancreatic tumors in another.3 Follow-up time ranged from 6 to 17 months,median was 13 months.There was no case of recurrence.Conclusions The modified Takada duodenum-preserving total pancreatic head resection removes pancreatic head where the lesion lies totally.One-stage end-to-end pancreatic duct reconstruction in situ is safe,ensuring fast and uneventful recovery.

Objective To study the effect of tranexamic acid of reducing the bleeding and transfusion on total hip arthroplasty and the recovery of joint function.Methods The clinical data of 62 patients who underwent total hip arthroplasty from February 2013 to February 2015 were randomly divided into the control group(31 cases)and the observation group(31 cases).Patients treated with tranexamic acid for hemostasis were the observation group and patients without tranexamic acid for the control group.The Hct,Hb and Harris scores were compared before and after operation.The total blood loss,intraoperative blood loss,postoperative drainage,occult blood loss and blood transfusion were compared between the two groups.Results The preoperative Hct,Hb and Harris scores in observation group were 0.43±0.06,(131.13±18.52)g/L and(23.45±10.24)points,respectively,0.42±0.05,(130.42±14.36)g/L and(24.36±9.34)points,respectively in control group.Postoperative 1st,3th d Hct in observation group were 0.35±0.05,0.28±0.05,in control group were 0.30±0.06,0.25±0.03,postoperative Hb in observation group were(111.58±20.32)g/L,(121.26±18.28)g/L in control group.Postoperative 2nd,6th,12th weeks Harris scores in observation group were(54.88±6.14)points,(67.79±12.05)points,(83.55±12.12)points,in control group were(50.21±5.01)points,(58.17±13.24)points,(74.38±12.67)points,compared with before treatment were improved,and three indexes in the observation group were significantly higher than those in control group(F between grouP=3.213,P=0.023,F across grouP=3.213,P=0.036,F inner grouP=3.327,P=0.032;F between grouP=3.277,P=0.002,F across grouP=2.865,P=0.006,F inner grouP=3.564,P=0.001;F between grouP=3.327,P=0.016,F across grouP=32.912,P=0.005,F inner grouP=3.614,P=0.001).The patients total blood loss,the amount of hemorrhage,postoperative drainage volume,the hidden blood loss and blood transfusion in the observation group were(1 820.9±367.6)ml,(685.5±363.62)ml,(561.3±366.1)ml,(530.8±410.7)ml and(210.1±25.9)ml,respectively,less than the control group((2 229±564.6)ml,(1 010.3±415.11)ml,(725.9±257.8)ml,(798.4±279.5)ml,(701.2±51.2)ml,with significant differences between the two groups(t=3.373,3.281,2.047,2.999,47.655,P＜0.05).Conclusion Intraoperative hemostasis of tranexamic acid in total hip arthroplasty can effectively reduce the amount of blood loss and blood transfusion,and to promote patients recovery of joint function,clinical promotion,with great value of clinical promotion.

Traditional Chinese medicine health tourism based on the rich Chinese herbal medicine resources and tourism resources, supported with the broad and profound traditional culture of Chinese medicine, is a new form of the combination of the traditional Chinese medicine and the tourism industry. In recent years, it has been different levels of development around the country. On the basis of summarizing research at home and abroad, the author makes in-depth analysis of the connotation and denotation of traditional Chinese medicine health tourism, the main way, development status and the existing problems, and puts forward the corresponding solutions to these problems.

Objective To evaluate the clinical application value of epicardial transesophageal echocardiography (ETE) in cardiac surgeries. Methods Using the transesophageal multi-plane ultrasonic probe of GE company, ETE were performed for a total of 53 patients undergoing cardiac surgeries with extracorporeal circulation and heart re-beat, evaluating valvular function, left ventricular systolic function and residual shunts. Results Qualiifed ETE images were obtained in all of the 53 cases without complications of infection, bleeding and serious arrhythmia. Intraoperative regional left ventricular systolic dysfunction happened in 5 cases and was promptly handled. Residual mitral regurgitation after valvular replacement was found in one case, which was reduced by valvuloplasty. One case showed moderate tricuspid regurgitation and another two cases indicated residual shunt. All the problems in the above cases were corrected in immediate surgeries. Moreover, the pressure gradient of one hypertrophic obstructive cardiomyopathic patient fell significantly to 8 mmHg after successful myectomy (the blood flow velocity fell from 3.2 m/s to 1.4 m/s). Conclusion Epicardial transesophageal echocardiogramphic examination is easy to handle and useful in monitoring abnormalities in cardiac surgery by providing hemodynamic and anatomic information.

Objective To know the correlation about PetCO_2 and PaCO_2, the meanings of PetCO_2monitoring in respiratory failure patients with mechanical ventilation, and then summarize the related nurs-ing points. Methods Divided 112 patients in ICU into the A group(58 eases) and the B group(54 cas-es) according to their station of hemodynamics. Mechanical ventilation were used in both the two groups,PetCO_2 and PaCO_2 were monitored at the same time, and then observed the correlation of PetCO_2 and Pa-CO_2 in both the two groups. Results There was a significant corrlation in the A group about PetCO_2 and PaCO_2, while the correlation in the B group was not significant. Conclusions PetCO_2 and PaCO_2 had sat-isfactory corrlation in patients with stable hemedynamies, PetCO_2 monitoring can take place of PaCO_2 in these patients with its sensitive, atraumatic, consecutive and convient merits.

Objective: To study the correlation of blood stasis syndrome or its accompanied syndromes with Gensini score in patients with coronary heart disease (CHD) in stable condition. Methods: The syndrome types of traditional Chinese medicine (TCM) and blood stasis score in 131 CHD patients confirmed by coronary angiography were recorded. Gensini score was calculated according to the coronary pathological characteristics showed by angiography. The correlations of blood stasis syndrome and its accompanied syndromes with coronary lesion and Gensini score were analyzed. Results: Among the TCM syndrome types, blood stasis, turbid phlegm and qi deficiency were the most common syndromes, revealed in 85 patients (64.9%), 83 patients (63.4%) and 85 patients (64.9%), respectively. The coronary lesion length and Gensini score in the patients with blood stasis syndrome were much higher than those in the patients with non-blood stasis syndrome (P<0.05 or P<0.01). In the subtypes of blood stasis, the coronary lesion length and Gensini score in the patients with blood stasis accompanied by turbid phlegm syndrome were higher than those in the patients with non-blood stasis syndrome (P<0.05). And in the patients whose blood stasis syndrome score was more than 9 points, the coronary lesion length was higher than that in the patients whose blood stasis syndrome score was less than 9 points (P<0.05). Besides, with bivariate analysis, the blood stasis syndrome score showed no correlation with Gensini score (Pearson correlation coefficient was 0.104, P=0.241). Conclusion: Blood stasis syndrome is the most common TCM syndrome in CHD patients in stable condition. The blood stasis syndrome score is proportional to coronary lesion length, and reflects the severity of coronary lesion.

BACKGROUND:Self-made Distraction Reduction Fixation System is characterized by Distraction Reduction Fixation functions,which can completely fuse to the design of steel plate,and by no need to provide many surgical instruments,by reduction of bleeding and trauma.OBJECTIVE:To test changes in the stiffness of porcine short spinal segments in integrity and following destabilizing and internal fixation of the Distraction Reduction Fixation System.DESIGN,TIME AND SETTING:The control observation experiment was performed at the Laboratory of Biodynamics,Institute of Onhopedics,General Hospital of Chinese PLA from December 2004 to December 2005.MATERIALS:Twelve fresh porcine lumbar spines(T11-S2 segments)were bought from a market.Upper and lower segments were crossed and inserted with Kirschner wire to make porcine spine samples of the L1-7 segments.METHODS:Stiffness of intact samples was recorded during forward-bending,backward-bending,lateral-bending and axial rotation.Intervertebral discs,facet ioints,anterior and posterior longitudinal ligaments were removed to loose the spine.Stifrness of each motion was measured.Stiffness tests were repeated again after internal fixation on short segments using Distraction Reduction Fixation System.MAIN OUTCOME MEASURES:Stiffness in the intact,unstable and internal fixed spines during each motion.RESULTS:The stiffness iu unstable porcine spine were significantly lower than those in intact porcine spine(P<0.05),but the stiffness after internal fixation was significantly higher than in unstable porcine spine(P<0.05).No significant difference was detected in stifiness during forward-bending,lateral-bending and axial rotation(P>0.05)except that it was significantly higher during backward.bending after internal fixation compared with the intaet spine(P<0.05).CONCLUSION:Biodynamics confirms that the stiffness in short-segment fixation porcine after using Distraction Reduction Fixation System is markedly increased than in unstable porcine spine,except during backward-bending,which is comparable with that in intact porcine spine.

Objective To investigate the molecular mechanism of Loureirin A mediated anti-hepatic fibrosis by evaluting its effects on proliferation , secretion ofα-smooth muscle actin (α-SMA) and transforming growth factor-beta1 (TGF-β1), and expression of rat hepatic stellate cells in vitro . Methods Primary hepatic stellate cells were isolated and cultured from Sprague-Dawley rats. After activating and inducing primary hepatic stellate cells from qHSC to aHSC, the activated hepatic stellate cells model in vitro was established. Then we observed the morphological changes of static hepatic stellate cells and activated hepatic stellate cells with inverted phase contrast microscope. Cultured hepatic stellate cells were treated with different concentrations of loureirin A and the inhibitory rate of HSCs proliferation was measured by MTT assay. The expression of Frizzled-4 was measured by western blot analysis. The content ofα-SMA and TGF-β1 in the cultured HSCs'supernatant were measured by enzyme-linked immunosorbent assay (ELISA) . Results Loureirin A the proliferation of inhibited activated hepatic stellate cells in a time-dose-dependent manner compared with the control group,IC50=0.30 μg/μL. After loureirinA treatment of the HSCs, western blot analysis showed that Frizzled-4 expression level was obviously lower than control group. Loureirin A also inhibitedα-SMA and TGFβ1 (P<0.05) secretion in the cultured HSCs'supernatant in different degree by the assay of ELISA. Conclusions The molecular mechanism of Loureirin A and Wnt signaling pathway mediated anti-hepatic fibrosis and anti-angiogenesis may involve down-regulation the expression of Frizzled-4, inhibiting the synthesis and secretion ofα-SMA,TGF-β1and the proliferation of HSCs.