[Summary] Robotic totally endoscopic coronary artery bypass on beating heart (BH-TECAB), a minimally invasive surgical approach with rapid postoperative recovery , is becoming the future trend of minimally invasive coronary surgery , which demands a higher standard for anesthetic management . It comprises pressured pneumothorax , unilateral lung ventilation , transesophageal echocardiography monitoring , hemodynamics maintaining , preparation for cardiopulmonary bypass and conversion to sternotomy , and ventricular fibrillation treatment , which require anesthesiologists to achieve more refined perioperative management and pathophysiological regulation .

BACKGROUND:In the whole world, spinal cord injuries caused by trauma lead to more than 180 000 people presenting with permanent impairment annualy. A large number of experiments have confirmed in recent years, under physiological conditions, microRNA has specific expression and plays an important role in the nervous system. OBJECTIVE: To discuss the changes in microRNA expression induced by injuries as wel as the pathophysiological significance in spinal cord injury, and to explore the development potential of microRNA in tissue-engineered and clinical repair of spinal cord injury. METHODS:A computer-based search of PubMed and Chinese Journal Database was performed for related articles published from January 2000 to December 2014 using the keywords of “SCI, microRNA, transcriptional control, clinical research progress” in English and Chinese. Finaly, 38 articles were included for result analysis. RESULTS AND CONCLUSION: Mechanical injury initialy triggers a series of complex secondary damages, including nervous, vascular and immune systems, which can influence the severity of spinal cord injury to a great extent. Secondary damage to the spinal cord is mainly attributed to the activation and deactivation of some specific genes associated with celular and biochemical mechanisms, such as cysteine aspartate specific protease (caspase) gene family, apoptosis related protein Fas and its ligand Fasl system, P53 gene, apoptosis related gene Bcl-2 family. Recent studies have proved that the functional activation of microRNA expression is the key to spinal cord injury. With the development of biological information engineering, studies and controling technologies associated with microRNA expression have been gradualy dominated, some clinical application based on microRNA technology has entered the clinical trial stage. It is believed that with the continuous development of technology and decrease of cost, permanent dysfunction due to spinal cord injury can be regulated and repaired through the microRNA technology at gene level in the future.

Objective Previous studies have found that micheliolide(MCL) could improve the sensitivity of breast cancer cells to chemotherapeutic drugs such as cisplatin and induce the apoptosis of breast cancer cells.This article aims to study the proliferation inhibition effect of micheliolide on lung cancer cells H460 and its underlying mechanism.Methods Human lung cancer cell line H460 was treated with different concentrations of micheliolide(30,60,90μmol/L).Then the cell proliferation was measured by-CCK8 and plate colony formation assays.The apoptosis and the cell cycle were detected by flow cytometry.Western blot was used to determine the mechanism of how MCL affecting cancer cell H460.Results Compared with the control (275.00±7.21), the clone numbers after 30μmol/L,60μmol/L and 90μmol/L MCL treatment(199.00±5.66,166.00±1.41, 90.00±7.81) were significantly decreased (P<0.05).Meanwhile, the CCK-8 results showed that compared to the control group, A value was significantly increased after 30μmol/L MCL treatment for 72h and 96h, and 60μmol/L or 90μmol/L MCL treatment for 48h,72h and 96 h (P<0.05).Compared with the control apoptotic ratio [(2.90±0.03)％], the ratio of early and late apoptotic cells after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment [(5.23±0.76)％, (9.06±0.47)％, (19.00±0.64)％] were significantly increased (P<0.05).Compared with the control group, the ratio of G2/M phase cells[(12.52±0.88) ％ ,(17.22±0.43)％, (19.84±0.31)％] was gradually increased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment, and there was statistically significant difference after 60μmol/L and 90μmol/L MCL treatment (P<0.05).The ratio of S+G1/G0 phase cells[(87.53±1.06)％ ,(82.94±0.67)％ ,(79.79±0.21)％] was gradually decreased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment, and there was statistically significant difference after 60μmol/L and 90μmol/L MCL treatment (P<0.05).The expression level of notch4 was significantly decreased after 30μmol/L, 60μmol/L and 90μmol/L MCL treatment (P<0.05), while the expression level of cleaved caspase3 was significantly upregulated (P<0.05).Conclusion MCL exerted an inhibitory effect on lung cancer cell H460.

Objective To observe the curative effect of Weifuchun combined with Shenqifuzheng pills in the treatment of chronic atrophic gastritis.Methods 85 cases patients were divided into the control group of 42 cases and the treatment group of 43 cases.The control group were treated with omeprazole enteric -coated capsules and colloidal bismmth pectin,while the treatment group were treated with Weifuchun and Shenqifuzheng pills.The course of treatment was two months.The patients were treated by endoscopy and pathological review after the treatment,then the datas were comparedwith that before treatment.Results The total effective rate of the treatment group was 67.44%,which of the control group was 40.48%,the was statistically significant difference between the two groups (χ2 =6.22,P <0.05).The symptom scores of stomach tingling,stomach fullness,facial darkness,anorexia and melena in the two groups had statistically significant differences (t =6.14,P <0.05).Conclusion Weifuchun combined with Shenqi-fuzheng pills have good curative effect in the treatment of chronic atrophic gastritis.It should be popularized in clinic.

Objective To investigate the effect of high mobility group box-1 protein (HMGB1) on inter-leukin-2 (1L-2) and interleukin-2 receptor α (IL-2α) expressions in human T lymphocytes and its potential regulat-ing mechanism in vitro. Method Human T lymphocytes were isolated and suspended, the cells were cultured with 20 μg/mL phytohemagglutinin (PHA) in 5% CO_2 at 37 ℃, recombinant human HMGB1 (rhHMGB1, 0, 10, 100, 1000 ng/mL) was added with the PHA and cultures were centrifuged at 12 and 48 hours for cell collect-ing. Reverse transcription polymerase chain reaction (RT-PCR) amplification was perfomed to determine gene ex-pressions of IL-2, IL-2Rα. IL-2, sIL-2R protein levels in cell culture supematants were measured by ELIZA. Re-sults After coincubated with rhHMGB1 (10, 100, and 1000 ng/mL) for 12 hours, IL-2 levels in cell culture su-pernatants respectively were 0 . 064 ± 0. 017 μg/L, 0.076±0.033 μg/L, and 0.061 ±0.02 μg/L, which were significantly higher compared with the untreated cells (0.045±0.011 μg/L, P < 0.05 or P < 0.01). Mean-while, IL-2 mRNA expression was markedly up-regulated following rhHMGB1 stimulation in various doses (F = 4.6872, P < 0.01). At 48 bourn, however, both IL-2 mRNA expression and protein production tended to de-crease along with an increased dose of dd-IMGB1 stimulationn. IL-2/sIL-2R ratio in 1000 ng/mL rhHMGB1 was markedly lower than that in 10 ng/ml rhHMGB1 (0.036±0.015 vs.0.055±0.017, P <0.05), together with down-regulation of IL-2Rα mRNA expression(P <0.01). Conclusions These data indieated that HMGBI could marked influence the IL-2/IL-2R expression in human T lymphocytes. With the increase in stimulating doses and prolongation of time, HMGBI might down-regulate T cell-mediated immune response of human lymphocytes.

Objective To study the effect of Jiaweiyunvjian on periodontitis in the old.Methods A total of 180 periodontitis patients were randomly recruited into a treatment group and a control group,90 patients in each.The control group was treated with calculus removal and oral metronidazole,while the treatment group was treated with Jiaweiyunvjian on the basis ofthe control group.After both groups were treated for 7 days,therapeutic effects were observed.Results The total effective rate was 90.4%and 73.3%in the treatment group in the control group respectively.There was significant diffefence (P<0.01).In the 6-month follow-up,there were 7 cases(7.4%)relapsed in the treatment group and 16 cases(18.6%)relapsed in the control group,also showing significant difference(P<0.05).Conclusion Jiaweiyunvjian has curative effects on periodontitis of the old people.

[Objective]To investigate the endogenous erythropoietin expression of neural stem cells(NSCs) of rats after hypoxia.[Method]We used a rat NSCs culture model.EPO expression after 4 hours of hypoxia was studied.It was examined again following 12 hours of hypoxic lethal insult which was applied various times after hypoxic preconditioning.EPO expression was studied by western blotting.[Result]Following the preconditioning,expression of EPO increased immediately and reached a peak 4 hours later.It lasted till 8 hours later.While applied the lethal hypoxia,EPO expression of cells in preconditioning 24 hours group were was significantly increased than that in preconditioning 4 hours group.[Conclusion]The hypoxic preconditioning can lead an increased endogenous EPO expression and decrease the threshold of EPO expression against subsequent lethal stimulation during a certain period.

[Objective]To observe the growth status and osteogenic potential of gene transferred mesenchymal stem cells with Ad-BMP-2 planted on allogenetic acellular and decalcified bone matrix served as tissue engineering scaffold.[Method]Rabbit mesanchymal stem cells transferred with Ad-BMP-2 were seeded on allogenetic acellular and decalcified bone matrix,the growth status of gene transferred MSCs on the scaffold was observed by scanning electron microscopy and the ostengenic potential was observed by testing contents of ALP and BGP and secretion of Collagen I in the culture supermatant.[Result]The MSCs transfected with Ad-BMP-2 grew well on the tissue engineering scaffold,the osteogenic ability of the gene transfected MSCs showed great significant difference compared with that of the control group.[Conclusion]The MSCs transfected with Ad-BMP-2 can grow well on the acellular and decalcified bone matrix and the osteogenic potential can be great improved by gene transfection.

Objective To inveatigate the effect of 15-HETE, a metabolite of arachidonic acid, on isolated hypoxic pulmonary arterial ringa ( PARs) , trying to find appropriate treatment for pulmonary hypertension and its complications during anesthesia in order to avoid hypoxemia. Methods Sixteen healthy Wistar rats of either sex weighing (230 ? 10) g were randomly divided into two groups : A control group breathing fresh air (FiO2 =21%) and B hypoxia group breathing hypoxic air (N2 = 90% , O2 = 10% ) in a hypoxic box. After breathing hypoxic air for 9 days the animals were anesthetized. Heart and lungs were immediately removed and PARs (0.5-1.0 mm in diameter and 3 mm in length) were prepared. Four PARs were prepared from each animal. The PARs were suspended in baths filled with Krebs-Hensleit (K-H) solution maintained at 37℃ and aerated with 95% O2 and 5% CO2. Preload was gradually increased to 0.3 g in 30 min. The isometric tension was measured using a four-channel force-displacement transducer. 15-HETE was added to K-H solution and the concentration was gradually increased from 10-8 to 10-6 mol?L-1 at 5 min intervals. Contractility of PARs was analyzed by a software of Medlab 6.0. Concentration-tension curve was drawn and contraction rates were calculated. 2 mmol?L-1 4-AP, 10-2 mol?L-1 TEA and 10-6 mol?L-1 GLYB were added to separate K-H solution baths and 40 min later 15-HETE was added in order to detennine the effect of difierent potassium channel blockers on contraction response of PARs to 15-HETE. Results With increasing concentration from 10-8 to 10-6 mol?L-1 , 15-HETE increased PARs tension gradually in a dose-dependent manner from 106% ?6% to 139% ? 4% in group A and from 113% ?6% to 163% ?6% in group B. The difference in PARs tension between group A and B was statistically significant (P

Objective Low-dose naloxone has been shown to reduce side-effects of morphine while morphine analgesia is not antagonized and may even be enhanced. The purpose of this study was to evaluate the effects of low-dose naloxone infusion (50 ng? kg-1? h-1 ) on morphine analgesia and plasma levels of opioid peptides in patients after abdominal hysterectomy.Methods Forty-two ASA Ⅰ- Ⅱ patients aged 36-50 yrs, weighing 55-67 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were enrolled in this study. Spinal puncture was performed at L2-3 interspace. The patients received intrathecal 0.75% ropivacaine 2.0-2.6 ml. 2% lidocaine was used for epidural injection. The block height was maintained at T8-6 . For postoperative analgesia the patients were randomized to receive either intravenous morphine infusion at 10 ?g?kg-1 ?h-1 (group M, n = 21) or IV morphine infusion (10 ?g?kg-1?h-1)+ naloxone infusion at 50 ng?kg-1?h-1 (group MN, n = 21). Pain was assessed using VAS (0-10) with 0 representing no pain and 10 representing the worst possible pain. Blood samples were taken from peripheral vein before anesthesia (T0), at the end of surgery (T1) and at 6, 24, 48 h (T2,3,4) after operation for determination of plasma levels of ?-endorphin (?-EP), dynorphin A1-13 (Dyn) and leu-enkepholin (L-EK) .Results The patients were comparable with respect to, age, weight, occupation and duration of operation between the two groups. Two patients (1 patient in each group) were excluded from the study because of their refusal to have repeated blood samples taken. The analgesia was significantly better in group MN than that in group M in terms of VAS scores. Plasma level of ?-EP was significantly lower at 6 h after operation (T2 ) but significantly higher at 24 h postop. (T3 ) in group MN compared with that in group M ( P