Objective To explore the effects of dexmedetomidine on recovery quality of hypertension patients under general anesthesia,so as to provide reference for its clinical application.Methods 31 patients who underwent abdominal surgery were chosen as study subjects.They were randomly divided into observation group(15 patients) and control group(16 patients) according to the digital table.At the time of 15 min before the end of surgery,the patients in the observation group were injected with dexmedetomidine of 0.5g/kg,and the patients in the control group were injected with the same volume of normal saline instead in 15 min.At the time of before anesthesia(T0),before injection(T1),3 min after injection (T2),just before extubation(T3),1 min(T4),5 min(T5),15 min(T6) after extubation,the hemodynamic parameters,the sedation scores at the time of T5 and T6,and the occurrence of cough during extubation were recorded and compared between the two groups.Results During operation and extubation,the levels of SBP,DBP,HR and their fluctuations in the observation group were lower than those in the control group.At the time of T5 and T6,the sedation scores in the observation were lower than those in the control group.The mean rank and scores of the two groups [at the time of T5 were [(12.2±24.6) and (19.5±24.6),respectively,Z=2.27,P=0.022].The mean rank and scores of the two groups at the time of T6 were T6[(12.3±24.7) and (19.5±24.7),respectively,Z=2.25,P=0.024].During the time of extubation,the occurrence of cough in the observation group was lower than that in the control group.The mean rank of the cough score in the observation group and the control group was[(12.2±24.1) and (19.5±24.1),Z=2.33,P=0.020].Conclusion Small dose of dexmedetomidine can reduce the incidences of intraoperative cerebral vascular accident risk,improve the quality of general anesthesia recovery in hypertension patients,and thus should be recommend in clinical application.

Objective:To investigate the effects of Seroxat on Essential Hypertensive subjects with anxiety and depression and to explore its clinical implications. Methods:After evaluating 77 cases with essential hypertension by SDS and SAS, the subjects with positive results who were followed for 12 weeks from baseline assessments were randomly divided into experimental group (routine treatment and Seroxat) and control group(only routine treatment) and the subjects with negative results were regarded as non-anxiety and non-depression group. The time of the amelioration of symptom , the duration of hospitalization, the drug costs and clinical outcome were compared between 3 groups. The scores of SDS\SAS\QOL were compared within and between the experimental and control group.Results: In experimental groups and non-anxiety and non-depression groups, the time of the amelioration of symptom and the duration of hospitalization were shorter, the drug costs were less and clinical outcome was significantly better than those of control group. The scores of SDS and SAS in experimental groups were significantly lower and the scores of 3 items of QOL were significantly higher than those of control groups.Conclusion:The drug therapy on anxiety and depression could shorter the time of the amelioration of symptom, the duration of hospitalization, decrease the drug costs in hospital, significantly improve clinical outcome, and also lower the degree of psychological obstacle, improve quality of life of essential hypertension patients.

Thrombotic thrombocytopenic purpura (TTP) is a kind of thrombotic microangiopathies which has low incidence but highly mortality.The outcome of TTP has been improved significantly since last decade due to the application of plasma exchange,however,early relapse occurs in some patients,and for relapsed/refractory patients the prognosis is still poor.This article reviews the recent progress in treatment and relevant influencing factors of TTP.

Based on the intension as well as extension of campus culture,this paper discusses how to construct campus culture in the medical school.

Objective To investigate the efficacy of dexmedetomidine on anesthesia analgesia and postopera-tive cognitive dysfunction (POCD)in elderly patients with lumbar surgery.Methods Ninety elderly patients with lumbar surgery were randomly divided into dexmedetomidine group (A group with 46 cases)and control group (B group with 44 cases)by the random number table method.A group received load dosage (1μg/kg)dexmedetomidine before anesthesia induction,and this process must last for more than 10 minutes,then the dexmedetomidine was main-tained at a speed of 0.5μg/(kg·h)during the operation.B group were given the same dosage normal saline in the same way instead.The amount of intraoperative sedation drugs was observed and analyzed in the two groups.MMSE was measured at one day before surgery and seven days after surgery.And,the incidence rate of POCD was compared between the two groups.Results The dosage of intraoperative sedation drugs of fentanyl[(0.57 ±0.11 )mg vs (0.78 ±0.13)mg;t =8.286,P =0.000],propofol[(522.5 ±137.2)mg vs (734.2 ±175.8)mg;t =6.384,P =0.000]and remifentanil[(0.92 ±0.26)mg vs (1.38 ±0.73)mg;t =3.947,P =0.000]in A group were significantly lower than those of group B.After treatment for 7 days,the MMSE score in A group[(27.57 ±1.58)points]was higher than that of B group[(25.02 ±2.14)points](t =6.451,P =0.000).The incidence rate of POCD in A group (6.52%)was significantly lower than that of B group (22.73%),and the difference was statistically significant (χ2 =4.779,P =0.028).Conclusion In elderly patients with lumbar surgery,the dexmedetomidine can cut down the dosage of intraoperative sedation drugs,and it also could reduce the incidence of POCD.

Objective To investigate living quality of patients after orthotopic cardiac transplantation and to provide scientific evidence for specific strategy of therapy and improvement of living quality of patients with cardiac transplantation. Methods SF-36 and the social support questionnaire were used to analyze living quality of 79 patients who received orthotopic cardiac transplantation in the Department of Cardiovascular surgery of Affiliated Union Hospital of Fujian Medical University. The mode of SF-36 was from the investigative numerical value of residents in Sichuan province. Description, t-test and Spearman correlation analysis were used to study the related factors. Results Compared with a reference general population, the heart transplant recipients showed a significantly worse living quality score on all domains of the SF-36 scales (P＜0. 05), except the domain of somatic pain. Among the patients after cardiac transplantation, living quality was more significantly improved in ＞2-year survival group than that in ＜one-year survival group (P＜0. 05),except the domain of somatic pain. The relationships between the social support and living quality were analyzed,and it was found that as compared with a reference general population, the heart transplant recipients showed significantly lower scores on all domains of the social support questionnaire (P＜0. 01 ). The total social support scores were positively related to mental health related living quality (P＜0.05, r = 0.223 - 0.710), except the domain of somatic pain. Conclusion Compared with a general population, heart transplant recipients demonstrated a significantly worsened living quality. But evidence showed the living quality can be improved gradually with the prolongation of the survival time after heart transplantation. Social support was related to the living quality of heart transplantation patients. Improvement of availability on social support will probably improve living quality.

Objective To determine the effect of ghrelin on protecting the human umbilical vein endothelial cells (HUVEC) from injury by angiotesin Ⅱ(AngⅡ) in vitro. Methods (1)HUVEC was incubated for 24 h with AngⅡ whose final concentration in the medium varied from 10-9 to 10-6mol/L or pretreated with 10-9to 10-6mol/L ghrelin for 2 h before incubation for 24 h with AngⅡwhose final concentration in the medium was 10-6mol/L. HUVECs were harvested to measure the cell vitality and cell apoptosis. The cell vitality was determined by MTT and cell apoptosis rates were measured by Annexin V-FITC apoptosis detection kit. (2)HUVECs were incubated for 3,6,12,or 24 h with 10-9,10-8,10-7,or 10-6mol/L AngⅡ, respectively. Before HUVECs were incubated with 10-6 mol/L AngⅡfor 24 h, ghrelin (10-9,10-8,10-7, and 10-6 mol/L) was used to pretreat the cells for 2 h. Growth hormone secregogue receptor 1a blocker [D-Lys3]GHRP-6 was added to the cells which were incubated for 24 h with 10-6mol/L AngⅡ and pretreated with 10-6 mol/L ghrelin for 2 h. Cell reactive oxygen species were measured by dichlorofluorescin (DCF) fluorescence probe method. (3)HUVECs were incubated for 24 h with 10-9,10-8,10-7, or 10-6mol/L AngⅡ and ghrelin, respectively,and then were incubated with 10-6mol/L of AngⅡ for 3,6,12,or 24 h. Furthermore,HUVECs were pretreated with 10-9,10-8,10-7, or 10-6mol/L ghrelin for 30 min,1 h,or 2 h, and then were incubated with the inhibitor of mitogen-activated protein kinase /extracellular regulated kinase (MAPK/ERK1/2),PD98059, the inhibitor of phosphoinositide-3-kinase/serine threonine kinase( PI3K/Akt)wortmannin, and [D-Lys3]GHRP-6 for 24 h. NO production was compared among groups. HUVECs were pretreated with ghrelin,PD98059, wortmannin, and [D-Lys3]GHRP-6 for 2 h and co-cultured with 10-6mol/L AngⅡfor 24 h,or pretreated with ghrelin plus PD98059, wortmannin, and [D-Lys3]GHRP-6 before incubation with AngⅡfor 24 h. NO was measured in the endothelial cell supernatants by Griess method. (4)HUVECs were cultivated with blank or AngⅡwith or without pretreatment with ghrelin or both ghrelin and wortmannin. The protein expression of eNOS and phospho-protein expression of Akt were measured by Western blot analysis. Results AngⅡinjuried the endothelial cell vitality,increased the cell apoptosis rates in HUVECs, and decreased NO production in HUVEC supernatants,whereas ghrelin protected HUVECs from AngⅡ injury. Ghrelin decreased the reactive oxygen species in HUVECs induced by AngⅡ. The effect could be attenuated by [D-Lys3]GHRP-6 pretreatment; PD98059 alleviated AngⅡ inhibition of NO production in HUVEC supernatants. Wortmannin and [D-Lys3]GHRP-6 could abolish protection of ghrelin from reducing NO production in HUVEC supernatants. AngⅡreduced the expression of eNOS,but ghrelin increased eNOS expression. Wortmannin could cancel this effect of ghrelin. Ghrelin increased p-Akt expression and reached the peak in 10 and 20 min. Conclusion Ghrelin may protect HUVECs from AngⅡinduced injury, which is related to decreasing oxidative stress, increasing the protein expression of eNOS, and activating PI3K/Akt signal pathway through GHSR1a receptor.

Objective To investigate the effect of budesonide in the treatment of COPD and nursing intervention. Methods 200 cases of COPD patients in our hospital during the period from January 2015 to December 2016 as the object of this study, all patients were randomly divided into control group and study group, 100 patients in each group. The control group the patients using conventional methods of treatment, patients in the study group is to use budesonide treatment on the basis of conventional treatment, while giving appropriate nursing intervention were observed and compared. Results The study group patients in the treatment of lung function improvement after (P<0.05); the average hospitalization time and cough symptoms time were significantly better than the control group, and the difference is significant; the study group after nursing intervention, nursing satisfaction of patients was significantly higher than control group (P<0.05). Conclusion The use of budesonide and implement corresponding nursing intervention on the patients with COPD were treated with remarkable effect, the clinical symptoms of the patients were obviously relieved, can improve the patients' recovery and quality of life.

Humans ; Magnetic Resonance Imaging ; trends ; Molecular Imaging ; trends ; Plaque, Atherosclerotic ; diagnosis