Objective The purpose of this study was to investigate the effects of ropivacaine and bupivacaine on energy supply and mitochondrial oxidation phosphorylation of isolated rabbit heart muscle in order to compare the cardiotoxicity of the two local anestheties and explain the mechanism Methods Twenty four New Zealand rabbits weighing (2135?345)g were randomly divided into three groups of 8 animals each: control group(C); ropivacaine group(R) and bupivacaine group (B) The animals were anesthetized with intraperitoneal urethane 2g?kg -1 and heparinized (heparin 4mg?kg -1 ) Heart was quickly removed and connected to Langendoff preparation and perfused with oxygenated Krebs Henseleit buffer solution at normothermia(37℃) via aorta After 15 min perfusion, ropivacaine (group R) or bupivacaine(group B) was added to perfusate(500ng?ml -1 ) The heart was then perfused for another 10 min Myocardial tissue was taken from ventricle for determination of ATP, ADP and AMP content with high performance liquid chromatography Myocardial mitochondria was prepared and its oxidation of pyruvate and palmitoylcarnitine was measured using Clark electrode Results Myocardial ATP and ADP decreased significantly in group R and B as compared with those in group C The decrease in ATP and ADP in group B was more than that in group R (P

Objective To study the effects of heart ischemia reperfusion on conductive function of atrioventricular node (AVN) in rabbits. Methods Animal models of ischemia reperfusion of AVN were established by ligating and reopening the right coronary artery of rabbits. A total of 60 adult rabbits were divided into control groups ( n =10), right coronary artery occlusion group ( n =10), and ischemia reperfusion groups with ligation of the right artery occlusion for 10, 30, 60 and 120 min respectively ( n =10 for every subgroup). The hemodynamics, His bundle electrography and epicardial electography were carried out and recorded. Results After occlusion of right coronary artery, 94.8% animals in experimental groups were found to have prolonged atrial His interval (AH) ( P

At present, the level of diagnosis and treatment of early gastrointestinal cancer has a larger gap between China and developed countries. In recent years, the advent of new endoscopic imaging techniques has improved the detection rate of early gastrointestinal cancer. Along with this, endoscopic submucosal dissection(ESD) enables radical resection for early cancer. In this article, we discuss how to improve the level of endoscopic diagnosis and treatment of early gastrointestinal cancer.
China ; Endoscopy, Digestive System ; Gastrointestinal Neoplasms ; diagnosis ; surgery ; Humans

ObjectiveTo study the effect of hyperbaric oxygen therapy on the cholinergic neurons of hippocampus and praxiology of vascular dementia rats.MethodsThe vascular dementia models were made and divided into control and therapy group. After 30 days of HBO therapy, abilities of learning and memory of rats were tested by using the Morris water maze. Immunochemistry staining was used to observe the number of cholinergic neurons of CA1 subfield of hippocampus. ResultsAbilities of learning and memory of rats and the number of the neurons positive to ChAT like immunoreaction in the CA1 subfield of the hippocampus significantly increased in therapy group.ConclusionHyperbaric oxygen therapy is effective on the vascular dementia model rats.

Objective To evaluate the significance of standardized ultrasound examination of fetal structures in the ifrst trimester (11-13+6 weeks). Methods The ultrasound data of 29 858 fetuses who underwent the ifrst trimester screening were analyzed retrospectively in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2010 to December 2012 and followed up the cases with structural abnormalities and increased nuchal translucency (NT). Results Among 29 858 fetuses, 328 structural defects were detected in 284 fetuses (0.95%) by ultrasound in the first trimester, including fetal hydrops (124 cases), choroid plexus cysts (36 cases), exencephaly (32 cases), gastroschisis (24 cases), exomphalos (22 cases), cardiac defects (19 cases), megacystis (14 cases), spine abnormalities (10 cases), meningoceles/encephaloceles (9 cases), alobar holoprosencephaly (8 cases), hydrocephaly (7 cases), abnormalities of extremities (7 cases), acrania (6 cases), amniotic band syndrome (4 cases), abdominal cyst (3 cases) and conjoined twins (3 cases). Pregnancy was terminated in all cases (115) with exencephaly, gastroschisis, exomphalos, meningoceles/encephaloceles, alobar holoprosencephaly, hydrocephaly,abnormalities of extremities, acrania, amniotic band syndrome and conjoined twins, and the defects were verified by the gross appearance of fetuses. Two cases of megacystis were turned out to be normal during follow-up while 1 case was proved to be aneuploid and 1 other case progressed to multiple abnormalities during the second trimester. Most choroid plexus cysts, except 1 case of aneuploid, were normal during the second and the third trimester follow-ups by ultrasound. Thirteen cases of fetal hydrops were found to be aneuploids and 4 hydrops cases were proved to be complicated with other structural defects during the second and the third trimester. NT was increased in 422 cases (1.41%), among which 122 cases (28.91%) were complicated with structural defects and/or fetal hydrops. Ninty-nine cases with increased NT underwent chromosomal examination and 38 cases were found to be aneuploides. During the follow-up of 298 cases with increased NT who continued pregnancy, 21 structural abnormalities were found, including cardiac defects (14 cases), neural abnormalities (4 cases) and diaphragmatic hernia (3 cases). Conclusion The standardized fetal ultrasound in the first trimester is a effective tool for the screening of aneupolides and major structural abnormalities.

Objective To examine the white matter micro structural changes of hippocampus in the mid-die-aged major depression, and hypothesis that the hippocampal neurogenesis during the effective antidepressants can be found by diffusion tensor imaging(DTI) technology. Methods Middle-aged patients with major depression were enrolled, twenty patients received open but controlled with SSRIs for 10 weeks,twenty age, gender, education-matched healthy controls were involved as control group. All the subjects were scanned by DTI,using both whole-brain,voxel-based analysis(VBA) and Regions of interests (ROIs) methods to analyze the data. Results The VBA analysis found the post treatment patients made significant improvement in the fight inferior frontal lobe, left cingulate gyms of iimbic lobe and the right sub-gyral of occipital,but no significant difference in the hippocampus were found between any groups (all P<0.01, cluster>20). For the hippocampal relative FA of ROIs analysis,there were no significant difference between the patients before and after treatment, even no difference between the prior-treatment patients and healthy control,the remitted patients and the healthy controls(P<0.05). Conclusions Micro structural white matter changes in the frontal gyms, temporal and cingulated gyms are associated with mid-die-aged depression,no changes were found in the hippocampus. These findings do not support the hypothesis that the hippocampal neurogenesis can be found by DTI technology.

Objective To discuss the application of implantation temporary cardiac pacing by balloon-tipped floating catheter for peroperative period patients. Method Thirty-three patients with severe bradyarrhythmia were received the balloon-tipped floating catheter to RV by Seldinger puncture technique.Meantime, the pacing signals of ECG were observed. The threshold and QRS waves to ensure the electrode position were determined. Result All of 33 cases were successfully punctured and 32 cases get paced, except 1 case had the electro - mechanical dissociation (EMD). Pacing threshold was less than 0. 9V, and mean remaining time was 12.47 ～ 161 (67. 05 ±34. 48) hours. Apical pacing was operated in 23 patients,and right ventricular outflow tract pacing in 10 patients. No severe complications were occurred. Conclusion The implantation method of temporary cardiac pacing by balloon-tipped floating catheter was convenient and safe. It could help the patients get safety in anesthesia and peroperative period.

Objective To study the clinical and pathologic features of chromphobe renal cell carcinoma (ChRCC) and to evaluate the conventional pathologic prognostic parameters in prognosis.Methods Seventy-five cases (42 males and 33 females) with pathological confirmed ChRCC (36 on the left and 39 on the right kidney) after nephrectomy during 1998 to 2009 were retrospectively analyzed. Patient's age ranged from 25 to 74 years, with a mean age of 56 years. Evaluation of conventional prognostic parameters was carried out. Kaplan-Meier survival curve was used to study the survival relationship. Results The mean tumor diameter was 7.3 cm. The majority of tumor macroscopic surface color was gray and yellow or gray and red. The majority of tumor cells were big polygon chromphobe cell or small round eosinophils. The TNM stages of these ChRCC were as follows: 30 cases in T1N0M0, 1 in T1N0M1, 26 in T2N0M0, 1 in T2N0M1, 11 in T3N0M0, 3 in T3N0M1, 1 in T3 N1 M0, 1 in T4 N0 M1 and 1 in T4 N1 M1. The pathologic grade of ChRCC was G1 in 3 cases, G2 in 24cases, G3 in 46 cases and G4 in 2 cases. All the 75 cases were followed up for 9 to 93 months (mean 44months), 7 patients died and others were alive without recurrence and metastasis. 3-year and 5-year survival rates were 93.3% and 90. 7%, respectively. The univariable analysis showed that tumor size (P=0. 028), TNM stage (P＜0. 001) were associated with tumor progression. The multivariable Cox regression model revealed that TNM stage was an independent predictor of aggressive ChRCC. Conclusions The ChRCC tumors are generally larger than other types of RCC and with a favorable prognosis. Fuhrman nuclear grade is not suitable for ChRCC. TNM stage is an independent predictor of aggressive ChRCC.

AIM: To study influence of ischemia-reperfusion(IR) on apoptosis and expression of apoptosis-related genes Fas-L, Bax and Bcl-2 of sinoatrial node(SAN) cells in rabbits in vivo. METHODS:Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I 10 min , I 30 min , I 60 min and I 120 min ) and IR groups (I 10 min R 4h , I 30 min R 4h , I 60 min R 4h and I 120 min R 4h ). IR injury model of SAN was established by occluding and loosening the start section of right coronary artery. The apoptosis of SAN cells was detected by TUNEL staining. The expression of Fas-L, Bax and Bcl-2 of SAN cells was detected by immunohistochemistry. RESULTS:①No obvious apoptosis of SAN cells was observed in control group, I 10 min and I 30 min groups. Apoptosis of different degrees in SAN cells were found in 68.3%(41/60) rabbits in I 60 min , I 120 min and 4 subgroups of IR. ②The highest expression of Fas-L and Bax was observed in I 120 min group and that of Bcl-2 was in I 60 min group. ③The highest expression of Fas-L and Bax was observed in I 60 min R 4h group. The peak level of Bcl-2 was observed in I 30 min R 4h group. ④The expression of Fas-L and Bax was significant higher in IR group than that in ischemic group at the same time point. CONCLUSION:Ischemia and IR induced apoptosis of SAN cells in rabbit in vivo . Fas-L、Bax、Bcl-2 may participate in the regulation of apoptosis and the injury during IR aggravates the apoptosis of SAN cells.

Objective To study the effect of ischemia reperfusion(IR) on electrophysiological function of sinoatrial node(SAN) in rabbits. Methods Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I) 10(I10 min), 30(I30 min), 60(I60 min) and 120 min(I120 min) and IR groups (10, 30, 60 and 120 min ischemia followed by 4 h reperfusion respectively)(I10 minR4 h, I30 minR4 h, I60 minR4 h and I120 minR4 h). There were 10 rabbits in the control group and each subgroup. IR injury model of SAN was established by occluding and loosening the start section of right coronary artery(RCA). The changes of AA interval and arrhythmia were recorded by electrocardiography and cardiac chamber electrography synchronously. Results ① There was no significant difference in AA interval between different time points in the control group. ② Sinus arrest(SA), sinus bradycardia with arrhythmia(SB), or atrial tachyarrhythmia(AT) were found in 51 rabbits (63.75%) out of 80 rabbits in I and IR groups in ischemic period. The incidence rate of arrhythmia increased in a time dependent manner. The AA intervals also increased by at least 40 ms in 54 rabbits (67.5%). ③ Sinus or atrial arrhythmia during ischemic period was found in 26 out of the 40 rabbits in IR group, but 15 returned normal after reperfusion. ④ Increased AA intervals were found in 27 out of the 40 rabbits in IR group during ischemic period. Most of them recovered to pre occlusion level within 10 min after reperfusion, but the AA intervals prolonged again in I60 minR4 h and I120 minR4 h groups as the reperfusion elongated. Conclusion ① These findings suggest that about 2/3 of the rabbit sinus node arteries may stem from right coronary artery. ② Electrophysiological changes due to ischemia of SAN resemble the electrocardiogram of sick sinoatrial node syndrome. ③ Reperfusion arrhythmia can be induced by reperfusion after a long time of ischemia.