Objective To evaluate the accuracy of bispectral index(BIS)and entropy index in monitoring the depth of anesthesia in patients during target-controlled infusion(TCI)of propofol on induction of anesthesia.Methods Fifty ASA grade Ⅰ-Ⅱ of chronic sinusitis patients who performed the surgery of nasal sinus patency were enrolled in this study.After into operation room(T0),anesthesia was induced with TCI of propofol,and it was added 0.3 μ g/ml after 30 seconds once the plasma drug level was 2.1 μ g/ml(T1)until loss of consciousness(T2),and added 0.5 μg/ml(T3).When tracheal intubation,the patients was injected 0.6 mg/kg rocuronium in their intravenous at the prospective plasma drug level(T4).Each case was monitored with BIS,state entropy index(SE)and response entropy index(RE).The data at following time were recorded:T0-T4,tracheal intubation(T5),1 minute and 3 minutes after tracheal intubation(T6,T7),skin incision(T8).Results The value of BIS,SE and RE were significantly decreased compared with T0 (P ＜0.05).Mean arterial pressure(MAP)and heart rate were in normal range.The value of RE was significantly higher than SE at all the time points(93 ± 9 vs.87 ± 5,88 ± 12 vs.82 ± 12,73 ± 25 vs.72 ± 21,57±21 vs.56±22,46± 16vs.43 ± 17,39± 14 vs.37± 12,36± 14vs.34± 11,35 ± 11 vs.32±9,39±15 vs.36 ± 12)(P ＜ 0.05),but there was no significantly difference between BIS and SE at all the time points(P ＞ 0.05).The value of BIS had significantly positive correlation with SE and RE(r =0.887,0.901 ;P ＜ 0.01).Conclusions During deep hypnosis,BIS,SE and RE all can provide information about the level of consciousness during TCI of propofol on induction of anesthesia.RE is more preponderant as a monitor than BIS and SE.

HM(hibernating myocardium)is an adaptive phenome-non of myocardium against sustained ischemia,which maintains its tissue vitality through balancing energy supply and demand.It widely exists in patients suffering from coronary heart disease. HMhas its own metabolic pattern,instead of regular FAO(fatty acid β-oxidation)-based metabolism,glycolysis became main pro-cedure.Reduction of FAO,TCA (tricarboxylic cacidcycle),ETC (electron transport chain)enzyme has been observed,ROS(reac-tive oxygen species)and UCP2(uncoupling protein 2)have been up-regulated.UCP2,which promotes proton leak across innermembrane of mitochondrial and leads to ATP reduction,has e-merged as an important regulator of the energy production.It is regulated by up-stream proteins such as AMPK,PPARs,PGC-1α,and other factors like FFA(free fat acid),ROS and purine nucleotide.HM has potential function of ischemic myocardium, which can improve cardiac function through reasonable interven-tion.Modulation of UCP2 can optimize energy production,and is essential to HM metabolism.

Objective To investigate the value of quantitative analysis in the diagnosis of renal lesions with contrast-enhanced ultrasound.Methods Sixty cases with renal lesions confirmed by surgery and pathology underwent contrast-enhanced ultrasound preoperatively and quantitative analysis retrospectively.The Sonoliver software was applied in the analysis of CEUS imaging and in the recoustruction of quantitative parameter,s.Five parameters were calculated,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results There were statistically differences in parameters RT,mTT and AUC ( P ＜ 0.05) and significant differences in parameter IMAX ( P ＜0.01).In malignant tumors,the RT and mTT were less than that of the benign while IMAX and AUC were more than that of the benign.Conclusions Contrast-enhanced ultrasound using a quantitative parametric analysis offers more information and is a promising tool in the diagnosis and differentiation of renal masses.

Objective: To study the relationship between plasma level of N-terminal B-type natriuretic peptide (NT-proBNP) and ventricular diastolic dysfunction in elder hypertensive patients without target organ damage.
Methods: A total of 66 relevant patients treated in our hospital from 2012-03 to 2014-03 were studied. According to the standard of ventricular diastolic dysfunction, the patients were divided into 2 groups: Study group, n=27 patients with diastolic dysfunction and Control group, n=39 patients without diastolic dysfunction. The patients in Study group were further divided into 3 sub-groups based on Doppler classification of diastolic dysfunction:Grade 1, the patients with E/A<1.0, DT≥240 ms, IVRT>90 ms, n=8. Grade 2, the patients with E/A>1.5, DT (150-220) ms, IVRT<90 ms, n=13. Grade 3-4, the patients with E/A>1.5, DT≤150 ms, IVRT<70 ms, n=6. Plasma levels of NT-proBNP and Doppler ultrasound findings were compared to study the relationship between
NT-proBNP and ventricular diastolic dysfunction.
Results: Plasma level of NT-proBNP was higher in Study group than that in Control group. NT-proBNP level in Grade 3-4 sub-group was obviously higher than those in Grade 1 and Grade 2 sub-groups, NT-proBNP level in Grade 2 sub-group was higher than that in Grade 1 sub-group. Pearson correlation analysis indicated that NT-proBNP level was positively related to systolic blood pressure, diastolic function and E/E’ (r=0.211, P=0.037, r=0.442, P=0.004 and r=0.556, P=0.000), while negatively related to E’/A’ (r=-0.372, P=0.000).
Conclusion: The increased plasma level of NT-proBNP are highly support for ventricular diastolic dysfunction in elder hypertensive patients without target organ damage, NT-proBNP level is related to ventricular diastolic function.

AIM:The direct renin inhibitor aliskiren displays antihypertensive and antialbuminuric effects in humans and in animal models . Emerging evidence has shown that aliskiren localizes and persists in medullary collecting ducts even after treatment was discontinued . The purpose of the present study was to investigate whether aliskiren regulates renal aquaporin expression and improves urinary concen -trating defect induced by lithium .METHODS:The mice were either fed with normal chow or LiCl diet (40 mmol/kg dry food per day for first 4 days and 20 mmol/kg dry food per day for last 3 days ) for seven days .Some mice were intraperitoneally injected aliskiren ( 50 mg/kg BW per day in saline ) .RESULTS:Mice injected aliskiren developed decreased urine output and increased urine osmolal -ity when compared with controls .Aliskiren significantly increased protein abundance of AQP 2 and phosphorylated-S256 AQP2 in the kidney inner medulla .Immunohistochemistry and immunofluoresence showed increased apical and intracellular labeling of AQP 2 and pS256-AQP2 in collecting duct principal cells of kidneys in mice treated with aliskiren .Aliskiren treatment prevented urinary concen-trating defect in lithium-treated mice , and improved the downregulation of AQP 2 and pS256-AQP2 protein abundance in inner medulla of the kidney .In primary cultured rat inner medulla collecting duct cells , aliskiren dramatically increased AQP 2 protein abundance which was significantly inhibited either by PKA inhibitor H 89 or by adenylyl cyclase inhibitor MDL 12330, indicating an involvement of the cAMP signalling pathway in mediating aliskiren-induced increased AQP 2 expression .CONCLUSION: The direct renin inhibitor aliskiren upregulates AQP 2 protein expression in inner medullary collecting duct principal cells and prevents lithium -induced nephro-genic diabetes insipidus ( NDI) likely via PKA-cAMP pathways .

0.05).Conclusion:The abnormal expression of HLA-G protein in eutopic and ectopic endometrium tissues may play a key role in the pathogenesis of adenomyosis.

Objective To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in ureteral lesions.Methods The ultrasonogram of conventional ultrasound and CEUS were retrospectively analyzed in 19 confirmed ureteral lesions cases by operation and pathology.The size,inner echoes,boundary and color blood signal of ureteral lesions were observed by conventional ultrasound.The modality and phases of enhancement,including arrival time,peak time,washout time and appearance of internal structure,were observed by CEUS.Results The 19 ureteral tumors were of maximum widths between 2.1 to 7.7 cm.Conventional ultrasound showed 7 hypoechoic masses,10 isoechoic masses,1 hyperechoic mass and 1 unclear mass.Color Doppler flow imaging showed fairly rich blood signal in 8 tumors,a small amount of blood signal around tumor in 6 tumors and no blood signal in the rest.In early phase,CEUS showed enhancement in all 19 ureteral lesions,including synchronously enhancement in 8 tumors and delayed enhancement in 11 tumors.In peak time,hypoechogenicity compared to the normal renal cortex was shown in 3 tumors,hyperechogenicity in 11 tumors and isoechogenicity in 5 tumors.In late phase,fast wash-out was displayed in 16 tumors,isochronously wash-out in 1 tumor,delayed wash-out in 1 tumor and unclear in 1 tumor.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 74% (14/19),16% (3/19),50% (8/16) by conventional ultrasound respectively.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 100% (19/19) ,58% (11/19) ,94% (15/16) by CEUS respectively.The change of these performances was statistically significant between conventional ultrasound and CEUS.Conclusions CEUS can improve blood supply,boundary and the diagnostic sensitivity of ureteral lesions.

Objective To compare and analyze the similarities and differences of the blood perfusion characteristics of the renal pelvic carcinoma displayed by contrast-enhanced ultrasonography(CEUS) and contrast-enhanced computed tomography(CECT).Methods The characteristics of CEUS and CECT were anzlyzed retrospectively in 40 confirmed renal pelvic carcinoma cases by operation and pathology.The modality and phases of enhancement,including wash-in and washout time,as well as the perfusion appearances,were observed by CEUS and CECT.Results CEUS detected the cortical phase enhancement in all renal pelvic tumors,including synchronously enhancement in 14 tumors and delayed enhancement in 26 tumors.At peak times,hypoechogenicity compared to the normal renal cortex was shown in 31 tumors,hyperechogenicity in 4 tumors and isoechogenicity in 5 tumors.Fast wash-out in medulla phase was displayed in 35 tumors,isochronously wash-out in 2 tumors and delayed wash-out in 3 tumors.The minimum diameter in 40 renal pelvic tumors was 1.5 cm.CECT showed the enhancement in 38 tumors,mostly mild to moderate homogeneous enhancement,and enhancement was lower than the surrounding renal parenchyma.The diagnostic accuracy of CEUS was 77.5％ (31/40),and the diagnostic accuracy of CECT was 82.5 ％ (33/40).The difference was not statistically significant between CEUS and CECT ( P ＞0.05).Conclusions CEUS and CECT have higher diagnostic accuracy of the renal pelvic carcinoma,so the joint detection can increase the detection rate of early diagnosis of the renal pelvic carcinoma.

ObjectiveTo explore the relationship of the fragmented QRS (fQRS) and the fQRS time limit with ventricular arrhythmia in old myocardial infarction (OMI) patients through contrasting the incidence of ventricular arrhythmia in OMI patients whether fQRS or not and ventricular arrhythmia in different fQRS time limit.MethodsAccording to the routine electrocardiogram,321 OMI patients were divided into group A (fQRS appearance,167 cases) and group B(fQRS non-appearance,154 cases).The lead with fQRS extense was ehosen and traced another 50 mm/s electrocardiogram,and 3 consecutive fQRS time limit were measured and them average was taken in group A.According to the fQRS time limit,the patients in group A were divided into 3 groups: group X( ≤0.100 s,96 cases),group Y (0.101-0.119 s,54 cases) and group Z( ≥0.120 s,17 cases).All the patients were continuously monitored with 24 hours dynamic electrocardiogram,and the incidence of ventricular arrhythmia was analyzed.ResultsThe incidence of ventricular arrhythmia in group A [ 78.4％ ( 131/167 ) ] was higher than that in group B [ 63.6％(98/154) ] (P＜ 0.01 ).The incidence of premature ventricular contraction(PVC) ＞ 720/24 hours in group A [ 28.7％(48/167 ) ] was higher than that in group B[ 17.5％(27/154) ] (P ＜ 0.05 ).The incidence of multifocal PVC,coupled PVC,nonsustained ventricular tachycardia and Lown 3-5 grades PVC was 16.2％ (27/167),33.5％ (56/167),12.0％ (20/167),34.1％ (57/167) in group A,7.8％ (12/154),21.4％ (33/154),4.5％(7/154),23.4％(36/154) in group B,there were significant differences between two groups (P＜ 0.05 ).The incidence of ventricular arrhythmia in group Z [ 100.0％( 17/17 ) ] was significantly higher than that in group Y [79.6％(43/54)] and group X [74.0％(71/96)](P＜ 0.05).The incidence of Lown 3-5 grades PVC in group Z[ 70.6％( 12/17 )] was significantly higher than that in group Y[ 42.6％(23/54)] and group X [ 22.9％(22/96) ],and the incidence of Lown 3-5 grades PVC in group Y was significantly higher than that in group X (P＜ 0.05).ConclusionsOMI patients with fQRS have higher incidence and severe degree in ventricular arrlhythmia than those without fQRS.With the fQRS time limit widened,PVC and Iown 3-5 grades PVC significantly increased.So fQRS is a new predicting index of OMI,and fQRS time limit has definite value in predicting the heart event for OMI patients.

Malignant pleural effusion is a common complication of advanced cancer.The present study employed chest circulating hot infusion chemotherapy for 55 cases of malignant pleural effusion.The outcomes were complete remission (n =23,41.8％),partial remission (n =25,45.5％),stable disease (n=4,7.3 ％) and progressive disease (n =3,5.5％).And the effective rate was 87.3％.After treatment,the levels of interleukin-10 (IL-10) and interleukin-6 (IL-6) were significantly lower than those before treatment (P ＜ 0.05).And the levels of interleukin-2 (IL-2) and interferon-gamma (IFN-γ) were significantly higher than those before treatment (P ＜ 0.05).Pleural circulation perfusion chemotherapy is both safe and effective in the treatment of malignant pleural effusion.And it helps to enhance immune functions and improve the quality-of-life of patients.