Objective To assess the cerebral protective effects of different doses of propofol during mild hypothermic cardiopulmonary bypass (32℃-35℃) .Methods Thirty consecutive ASA Ⅱ-Ⅲ patients aged 18-50 years, undergoing elective cardiac surgery under mild hypothermic CPB were randomly divided into 3 groups: in group Ⅰ and Ⅱ the patients were given a bolus of propofol 1 mg kg-1 at the beginning of CPB followed by propofol infusion at a rate of 3 mg ? kg -1? h -1 (group Ⅰ ) or 6 mg? kg-1 ?h-1 (group D ) till the end of CPB and in group Ⅲthe patients received midazolam infusion at 0.2 mg? kg-1 h-1 instead of propofol. Anesthesia was induced with intravenous midazolam 0.15 mgkg-1 ,fentanyl 5 ?g kg-1 and vecuronium 0.1 mg? kg-1 .After tracheal intubation fentanyl 30-50 ?g kg-1 was infused during CPB and muscle relaxation was maintained with intermittent iv boluses of vecuronium. Surgery was performed with mild hypothermic CPB(32℃-35℃ ) .Arterial blood pH and PaCO2 were maintained within normal range and MAP was maintained at 50-80 mm Hg during CPB. Hematocrit was maintained at 25%-30% .Internal jugular vein(IJV) was cannulated and the catheter was advanced retrogradely till jugular bulb. Naso-pharyngeal temperature was monitored. Blood samples were taken simultaneously from artery and UV befor CPB (A) ,when mild hypothermia was being stably maintained(B) ,when the patients were rewarmed to 361 (C)and 30min(D),4-6 h(E)and 24 h(F) after discontinuation of CPB, for determination of cerebral oxygen metabolism and balance, cerebral lactate production (CLP), blood malondialdehyde (MDA) and superoxide dismutase (SOD) levels. CLP was calculated from arterial-cerebral venous blood lactate difference /arterial blood lactate concentration. Lactate oxygen index (LOI) was calculated from arterial-cerebral venous blood lactate difference /arterial-cerebral venous blood O2 content difference.Results In group I (low propofol dose) 30% patients developed cerebral O2 inbalance during rewarming but blood MDA, CLP and LOI were decreased. In midazolam group (group Ⅲ) cerebral O2 balance was improved but there was no depression of blood MDA, CLP and LOI. In groupⅡ (high propofol dose) cerebral oxygenation was improved and blood MDA level, CLP and LOI were significantly decreased.Conclusion The study shows that propofol infusion at a rate of 6 mg?kg-1? h-1 during CPB can improve cerebral oxygenaton, inhibit blood MDA level, CLP and LOI, and plays a role in the cerebral protection during cardiac surgery with CPB, but more vasoconstrictors are needed.

Objective To evaluate the effects of IL-1? and combination of IL-1?,IL-11,LIF and GDNF on inducing human neural stem cells(hNSCs)to differentiate into dopaminergic(DA)neurons in vitro. Methods A great deal of neurospheres was obtained by the technology of serum-free culturing and single-cell cloning,and was splitted into 3 groups,which were cultured in different media.In control group,the differentiation medium used only contained 10%FBS.In IL-1? group,the medium contained IL-1? and 10%FBS.In united factors group,the medium contained IL-1?,10%FBS supplemental with IL-11,LIF and GDNF.After 3 weeks,the tyrosine hydroxylase(TH)positive cells were detected by using immunofluorescence,and image processing about the number,the induced differentiational rate,the cell bodies' areas and the cells' perimeters of TH positive neurons was carried out.TH/MAP-2 double-immunofluorescence labeling was used to calculate the percentage of DA neurons in total neurons. Results In the control group,there were few TH positive neurons with poorly developed morphology.The presence of IL-1? induced more DA neurons,but these cells were still immature.In the united factors group,the number of maturer TH positive DA neurons was the most. Conclusion IL-1? has an obvious effect on inducing hNSCs derived from human fetal mescenphalon to DA neurons.The utilization of IL-1?,IL-11,LIF and GDNF in combination has a cooperative effect on inducing differentiation of hNSCs to mature DA neurons.

Objective To observe the effect of several antihistamines,including epinastine,on the release of leukotriene B4(LTB4),interleukin 4(IL-4)and interleukin 5(IL-5)from spleen lymphocytes of allergic mice challenged by ovalbumin(OVA).Methods OVA-sensitized BALB/c mice were used as animal model of allergy.Spleen lymphocytes isolated from these mice were treated with epinastine(0.1,1.0,10 μmol/L),ebastine(10 μmol/L),cetirizine(10 μmol/L),and dexamethasone(1.0 μmol/L),respectively,followed by incubation with OVA.Those cells without pretreatment with antihistamines served as the control.One hour after the challenge,enzyme-linked immunosorbent assay(ELISA)was applied to measure the level of LTB4,IL-4 and IL-5 in the cell culture supernates.Results Following the incubation with OVA,the levels of LTB4,IL-4 and IL-5 increased significantly in culture supernates of control spleen lymphocytes.Epinastine significantly inhibited the release of LTB4,IL-4 and IL-5 in a dose-dependent manner.At the concentration of 10 μmol/L,the inhibitory effect of epinastine was more potent than that of ebastine and cetirizine for IL-5 and LTB4 release(all P＜0.05):for IL-4,the efrect of epinastine was similar to that of ebastine (P＞0.05)but more potent than that of cetirizine(P＜0.05).Conclusion Epinastine has a potent anti-inflammatory effect.

Injury to the inferior vena cava (IVC) resulting from stab wound carries a high mortality rate. 1 Conventional open repair of the inferior vena cava is very challenging. Its morbidity and mortality ranges from 33-66%. 2 The predictors determining the outcome are the mechanism and type of injury, the initial blood pressure, the hemodynamic response to fluid resuscitation, the location of the vena caval injury, the presence of multiple other vascular and solid organ injuries.

Objective To study the effect of Danxuan Koukang(DXKK) drug serum on proliferation and proliferating cell nuclear antigen(PCNA) production of human oral mucosal fibroblasts(FB) induced by areca nut extract(ANE).Methods Human oral mucosal FB were cultured in vitro,100 ?g/mL ANE was used as inducement and 10% DXKK drug serum as intervenor.The cell proliferation rates were measured by MTT assay,PCNA productions were examined by immunocytechemistry.Results MTT assay showed OD value in DXKK groups were significantly decreased compared with the induced group(P

Objective To study the effect of proprioceptive neuromuscular facilitation (PNF) on knee hyperextension in patients withstroke. Methods 60 patients with stroke were divided into treatment and control groups (30 cases each group). Both groups accepted medicineand routine rehabilitation, while the treatment group accepted PNF of knee additionally. Results The incidence of knee hyperextensionwas 7 (23.3%) in treatment group and 18 (60.0%) in control group (P<0.01) 3 months after treatment. The timed "up & go" improved morein the treatment group than in the control (P<0.01). Conclusion PNF of the knee at early stage of stroke can prevent knee hyperextensionand improve the walking.

A total of 306 Malaysian university students and staff were surveyed to ascertain the physical and emotional effects of the polluted haze on them. All subjects completed self-reported questionnaires. Analysis of the results indicated that the majority of subjects reduced their outdoor activities and sports, and also reported an increase in emotional and physical health problems. The results indicated that there was a general increase in emotional problems such as feeling depressed, lacking in energy, not feeling like doing anything, feeling anxious and afraid, difficulty sleeping, feeling agitated and irritable, and having no appetite. There was also an increase in physical symptoms such as itchy or red eyes, itchy or running nose, dry throat/cough, headaches, nausea, and fever. This study indicated that emotional and behavioural problems are just as common during the haze, when compared with physical health problems. The study also suggests that there are a broad range of problems which health care and human resource departments need to be aware of and take precautions to minimize during a haze.

Adult ; Aneurysm, Dissecting ; Humans ; Male ; Pulmonary Artery

Objective To evaluate the safety and efficacy of Voriconazole on invasive fungal infections in very elderly patients.Methods Clinical data of 24 very elderly patients with invasive fungal infections who had sought treatment at the Department of Geriatrics of our hospital from April 2013 to April 2014 were retrospectively investigated.The classifications and quantities of fungi,accompanying symptoms,adverse reactions,blood tests,and liver and kidney function indicators were recorded and analyzed before and after treatment.Results Each of the 24 cases was found to have been infected with one or more of 17 fungal strains belonging to the genus of Candida.The rate of complete fungal elimination after treatment was 70％ (12/17).Of the 24 cases,5 achieved a full recovery(20.8 ％),10 (41.7 ％) had significant improvement,5 (20.8 ％) had some improvement,and 4 cases(16.7％)showed no therapeutic benefits,with a total effectiveness rate of 62.5 ％.There was no significant difference in liver and kidney function before and after treatment(P＞0.05).A transient increase in serum creatinine occurred in 1 case and defective vision in another patient during Voriconazole treatment.Conclusions The incidence of invasive fungal infections is high in very elderly patients,with Candida as the main pathogen.Voriconazole is effective in treating invasive fungal infections in very elderly patients,and close monitoring of liver and kidney function is required during voriconazole treatment.