Objective To investigate the curative effect of a new interventional therapy for acute left main coronary artery occlusion.Methods The clinical data of a total of 58 patients with acute left main coronary artery occlusion,who were admitted to authors' hospital during the period from May 2003 to October 2016 to receive treatment,were retrospectively analyzed.Among the 58 patients,14 patients underwent traditional percutaneous coronary intervention (PCI group),and 44 patients (combination treatment group) received small balloon expansion first,and subsequent stent implantation was carried out in 30-40 min after the coronary blood flow restored to grade Ⅲ of TIMI classification.Results In PCI group,8 patients died,the mortality was 57.1％(8/14).In combination treatment group,only 3 patients died,the mortality was 6.8％ (3/44).Conclusion For the treatment of acute left main coronary artery occlusion,combination use of small balloon expansion and subsequent stent implantation is a safe and effective therapy with lower mortality.

Objective To investigate the effect of rocuronium of on the function of acetylcholine receptor (AchR)/channel in cone neurons of hippocampal cortex in rats.Methods SD rats of both sexes (2-5 days old) were killed by decapitation. Brain was immediately removed and hippocampal cortex was cut into slices which were incubated in decalcified and magnesium-free artificial cerebro-spinal fluid (CSF) and mechanically dissociated and then digested in artificial CFS containing 2.5% trypsin. Cell suspension was prepared. The AchR/channel function was studied in the absence and presence of various concentrations of rocuronium (0, 0.05, 0.1, 0.2, 0.4mmol? L-1) and/or atropine 0.1 mmol ?L-1 using patch clamp technique.Results (1) The conductance, open probability (P0) and short term open constant (?01) were significantly higher in R-0.05 group than those in the control group (R-0) , but there was no significant difference in long term open constant (?02) , short term close constant( (?c1) and long term close constant(?c2) between the two groups. The conductance, P0 ,?01 ,?02 , ?c1, and ?c2 were significantly longer or higher in R-0.0, 0.2 and 0.4 groups than those in control group. (2) There was no significant difference in the conductance, P0 , ?01 , ?02 , ?c1 , and ?c2, between R-0.5 and control group but those in R-0.0, 0.2 and 0.4 groups were significantly higher or longer than control group, when rocuronium was used with atropine. Conclusions AchR/channel ( muscarinic and nicotinic ) in cone neuron of hippocampal cortex were excited by different concentrations of rocuronium. The results suggest that adverse effect may be induced on CNS by rocuronium in case it permeates the injured blood-brain barrier.

Local anesthetics have neurotoxicity, which can lead to temporary or permanent sensory and motor dysfunction.And regional anesthesia is commonly used in diabetics undergoing limbs or lower abdominal surgery, so that local anesthetics were widely used in them.However local anesthetics sensitivity in patients with diabetics is not yet clear.In this paper, we will discuss the problem and make a summary.

70% . The patients were mechanically ventilated. VT was set at 10 ml? kg-1 and respiratory rate at 12 bpm. End-tidal PCO2 was maintained at 30-35 mm Hg. End-tidal PCO2, SpO2, ECG and BP were continuously monitored. The respiratory function and mechanics were measured using respiratory monitor CP-100 (BICORE) before and after pneumoperitoneum (intra-abdominal pressure reached 15 mm Hg) and 5,10,15,20,25,30,35 min after vecuronium. The respiratory parameters measured included inspiratory and expiratory VT ( VTi, VTe) , minute ventilation (VE), respiratory rate (RR), peak inspiratory and expiratory flow rate (PIFR,PEFR), PEEP, auto-PEEP, pressure-time product (PTP), inspiratory-time ratio (TI/TTOT ), rate/VT ratio, average airway pressure (PAWM), esophageal pressure (PES), peak inspiratory pressure (PIP), dynamic compliance (CDyn), airway resistance (RAw ) and work of breathing. Results There was no significant difference in the effect of different doses of vecuronium on respiratory function and mechanics including all parameters measured at all time points among the three groups. Mean airway pressure, esophageal pressure peak inspiratory pressure, airway resistance and work of breathing increased significantly but dynamic compliance decreased significantly after CO2 penumoperitoneum. Conclusion Intra-abdominal CO2 insufflation significantly attect respiratory mecnanics. me effect of pneumoperitoneum on respiratory mechanics can not be prevented or attenuated by increasing the dose of muscle relaxant.

Objective To investigate the changes in expression of hippocampal neuronal gap function protein connexin 36 (Cx36) induced by postoperative cognitive dysfunction (POCD) in aged rats.Methods Ninety male SD rats aged 20 months weighing 500-600 g were randomly divided into 3 groups ( n =30 each):group normal control (group C); group sham operation (group S) and group POCD.POCD was induced by splenectomy.Cognitive function was assessed by using open field test and maze test on the 1st,3rd and 7th day after operation (T1,T2,T3 ).The ultrastructure of gap junction in the CA1 region of hippocampas was examined with thin-section transmission electron microscope.The expression of Cx36 was detected by immuno-histochemical method.Results POCD significantly decreased the number of grid cross,the rearing and correct responses and increased the time the animab spent in the central square and total reaction time at T1 in group POCD as compared with group C.Cx36 expression was significantly decreased at T1 in group POCD as compared with group C.The ultrastructure of gap junctions underwent significant change at T1 in group POCD.Conclusion Hippocampal neuronal Cx36 may be involved in the cognitive dysfunction after splenectomy in aged rats.

Objective To observe the short term effects of Rho-kinase inhibitor and Qiliqiangxin capsule on serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in patients with chronic heart failure,and explore the mechanism.Methods 120 chronic heart failure patients received conventional treatment for 4 weeks were divided into blank control group(Group A,n=30),Rho-kinase inhibitor treated group(Group B,n=30), Qiliqiangxin capsules-treated group (Group C,n =30 ),and the other 30 cases were treated with Rho-kinase inhibitor combined with Qiliqiangxin capsules(GroupD,n=30).TNF-α,IL-6 and BNP were measured and cardiac function was evaluated before and after treatment.The difference between 4 groups was analyzed. Results After treatment,the levels of TNF-α,IL-6,BNP in the observation group were lower than that in the control group.The difference was statistically significant(P<0.05 ).The levels of TNF-α,IL-6,BNP in the D group were lower than that in the B and C group.The difference was statistically significant(P<0.05 ).Conclusion Rho-kinase inhibitor combined with Qiliqiangxin capsule can improve cardiac function and reduce levels of serum cytokines associated with chronic heart failure,which is conducive to the treatment of chronic heart failure.

Objective To determine the minimum effective local anesthetic dose (ED50 ) of spinal ropivacaine for arthroscopic meniscecto-my .Methods Twenty-five patients undergoing arthroscopic meniscectomy under combined spinal-epidural anesthesia received intrathecal ropivacaine .ED50 of ropivacaine was determined by the sequence method .The effective criteria were as follows :the level of sensory block reaching at least T12 within 20 min after injection of the local anesthetic ;the motion block reaching the Bromage Scale score ≥2 within 20 min after injection of the local anesthetic ;no supplemental epidural anesthetic at least 1 h after injection of the local anesthetic .The initial dose was 15mg and according to the effective or ineffective results in previous patient ,a dose of ropivacaine 1 mg was decreased or increased . Results ED50 of ropivacaine for the arthroscopic meniscectomy was 12 .24 mg(95% CI 12 .09-12 .39) .Conclusion The dose of ropiva-caine more than 12 .24 mg for arthroscopic meniscectomy is the best .But the anesthetic effect may be related with the specific gravity of the local anesthetic and the patients′factors(height ,weight ,age) .

Objective To investigate the diagnostic value of conventional and dynamic gadolinium-enhanced T1-weighted (T1W) MRI in benign and malignant endometrial polypoid lesions. The pathologic basis of MRI features was also evaluated. Methods The conventional and dynamic contrast enhanced MRI features in 48 cases with clinicopathologically-proved endometrial polypoid lesions were retrospectively analyzed, including 26 cases with malignant tumors (23 eases with endometrial carcinoma and 3 cases with endometrial sarcoma) and 22 cases with benign polypoid lesions (12 cases with endothehal polyps and 10 cases with submucons leiomyomas). The occurrence probability of central fibrous core, intratumoral cysts and intact junctional zone were evaluated by Fisher's exact test. Results Benign and malignant endometrial polypoid lesions had specific characteristics on MRL Endometrial carcinomas usually appeared as homogeneous intermediate or slightly high signal-intensity masses on T2-weighted images, and relatively homogeneous hypedense masses on contrast-enhanced images with myometrial invasion (P < 0.05). An irregular central fthrous core and small non-enhanced intratumoral cysts were seen more frequently in endometrial polyps (P < 0.05) than others. All 3 cases with uterine sarcomas showed obviously inhomageneous intensity on T2WI and demonstrated areas of early and persistent marked enhancement.Submucous leiomyomas demonstrated isodense or slightly low-density masses with defined outline on T2 WI and the endomerium was displaced. The diagnostic sensitivity, specificity and accuracy of malignant polypoid masses were 92.3% (24/26), 83.3% (20/24) and 95.8% (46/48) respectively. Conclusion Conventional and dynamic contrast-enhanced MRI are valuable in characterizing the benign and malignant endometrial polypoid lesions.

Objective The evaluate the accuracy of loss of resistance technique for location of fascia iliaca compartment using ultrasound technique.Methods One hundred and seventy-five patients undergoing hip surgery were enrolled in the study.A line was drawn on the skin from the pubic tubercle to the anterior superior iliac spine and divided in three equal parts.The site of puncture was marked 2 cm distal to the point at which the lateral met the middle third of the line.The needle was inserted until a loss of resistance was felt twice (fascia lata and fascia iliaca),at which point 0.5 ％ ropivacaine 30 ml was infused.Correct puncture was identified by visualized spread of local anesthetic solution under the guidance of ultrasound technique.The effective sensory block was recorded within 20 min after administration.Results The accuracy of loss of resistance method for locating the fascia iliac compartment was 56.6 ％ using ultrasound technique.There were 80 patients in whom fault site of puncture occurred:25 cases in the superficial layer of the fascia iliac and 51 cases in the iliopsoas muscle.The rate of effective block was 98.0 ％ for correct location and 82.9 ％ for fault location.Conclusion Loss of resistance technique cannot accurately locate the fascia iliac compartment.

Objective:To prepare capsaicin liposomes and study the feasibility by in vitro percutaneous penetration test. Meth-ods:Capsaicin liposomes were prepared by a film-ultrasonic method. The best formula was screened by orthogonal test based on single factor studies with the entrapment efficiency as the index. The improved Franz diffusion cells were used to study the transdermal pene-tration of capsaicin suspensions, capsaicin liposomes and capsaicin ointments, and the cumulative penetration amount through the isola-ted rat skin was compared. Results:The optimal formula of capsaicin liposomes were as follows:the ratio of capsaicin to lipids was 1∶5;the amount of Tween-80 was 100 mg;the amount of vitamin E was 50 mg;10 ml dichloromethane was used as the solvent. The op-timal pH value of the external phase was 6. 5 with the volume of 10 ml. The ultrasonic time was 8 min. The order of 12-hour cumulative penetration amount was capsaicin liposomes>capsaicin-PBS suspensions>capsaicin ointments. Capsaicin liposomes had the highest 12-hour cumulative penetration amount and showed obvious sustained-release property. Conclusion:Capsaicin liposomes have high en-trapment efficiency, good percutaneous penetration and sustained-release property, and the preparation technology is simple.