Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

Liver plays a central role in regulation of nutrition.Due to metabolic abnormalities,patients with end-stage liver disease often demonstrate undernutrition,which has a close relationship with the prognosis of the patients.Correct nutritional assessment and nutrition support is therefore very important.Dietary intake alone could not meet the nutritional needs of patients with end-stage liver disease.In recent years,the use of enteral and parenteral nutrition formulation has significantly improved the nutritional status of such patients,but there still lacks a gold standard. How to develop appropriate nutrition support regimens is a challenge for clinicians.This paper summarizes nutrition-related issues in patients with end-stage liver disease,aiming to provide a reference for individualized nutritional intervention for patients with end-stage liver disease.

Objective To investigate the effect of urotensin Ⅱ on myocardial fibrosis in rats.Methods The pressure overload animal model was established in rats by abdominal aorta coarctation.The rats were divided into sham operation group,modeled for 4,8 and 12 weeks group.The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲ,and PKA in cardiac tissues was detected by Western blot.Isolated and cultured cardiac myofibroblasts (CFs) from new-born SD rats were treated with U Ⅱ,KT5720 or SB-611812,and then the proliferation of CFs was observed by micro scope and CKK-8.Results The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲand PKA increased markedly in cardiac tissues of model rat,which were time-dependent.U Ⅱ promoted the proliferation of CFs (P＜0.05),which could be inhibited by KT5720 or SB-611812.Conclusions U Ⅱ/UT system promotes the occurring and development of myocardial fibrosis.

Objective To summarize our experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial (SMA) embolism. MethodsSeven cases with extensive small bowel necrosis from acute SMA embolism were treated from 1991 to 1999. Results In this group small bowel of 28～ 30 cm and 70～90 cm were remained respectively in 3 and 4 cases after surgery. Two patients died of septic shock while the other 5 developed short or ultra short bowel syndrome and were finally cured by means of combined intravenous nutrition and oral feeding. 5 patients were followed up for 18～36 months, all are in good health. Conclusions Timely diagnosis and prompt operation are important to elevated survival rate. SMA embolectomy helps in preserving living intestine. For patients with short or ultra short bowel syndrome, comprehensive measures of intravenous nutrition and stepwise oral feeding in combination can quickly restore digestive and absorptive function of the residual intestine.

Objective To evaluate the different value of color Doppler ultrnsonography and Doppler vascular examinations in diagnosis for deep venous thrombosis(DVT)in the lower extremities.Methotis Imaging of color Doppler ultrasound scanning was employed as diagnostic criteria for DVT on 178 lower extremities of 146 suspected patients,as compared to the result by Doppler vascular examinations.Results Color Doppler ultrasonograph showed hish accuracy in diagnosis for DVT,as compared to that by Doppler vascular examination with 97.9 percent(142/145)positive for the femoral and popliteal veins and relatively lower positive diagnostic vallie for thrombosis in the inferior vena cava,iliac vein,anterior tibial vein,posterior tibial vein and calf veins.Conclusions Color Doppler ultrasonography is superior to Doppler vascular examination in determining DVT of the lower extremities and can be used as a main diagnostic method for it.Doppler vasculiar examination can be used as an initial screening method for DVT and deep venous angiography should not be used as a routine diagnostic measure for it.

Objective To evaluate the diagnostic role of color Doppler ultrasonogarphy(CDU),Doppler ultrasound(DU)in the diagnosis of lower extremity deep venous thrombosis(DVT). Methods In this study,84 patients(92 lower extremities)of lower extremity DVT were underwent CDU and DU and lower extremity deep venous angiography respectively. Results Total consistent rate,sensitivity,specificity,omission diagnostic rate,mistake diagnostic rate,Youden index,Odd product.positive predictive value,negative predictive value and Kappa of CDU in diagnosing lower extremity DVT was respectively 96.7%,95.7%,97.8%,4.3%,2.2%,0.935,990.0,97.8%.95.7%and 0.935(P=0.037).As Kappa of CDU(0.935)＞0.75 and its P(0.037)＜0.05.CDU can theoreticallv substitute for deep venous angiography;Above-mentioned indexes of DU were respectively 89.1%,87.2%,91.1%,12.8%,8.9%,0.783,70.0,91.1%,87.2%and 0.783(P=0.065). Conclusion CDU iS becoming preferred and more reliable noninvasive method in diagnosing lower extremitv DVT.

Objective To study the effects of pulmonary function training on the lung function and surgical tolerance of lung cancer patients with different degrees of obstructive ventilatory defect.Methods Pulnonary function training was performed with 103 lung cancer patients with obstructive ventilatory defects (26 mild cases,53 moderate cases,24 severe cases).The duration of the intensive training was 5-7 days.Vital capacity (VC),vital capacity percentage (VC％),forced vital capacity (FVC),forced vital capacity percentage (FVC％),forced expiratory volume in one second (FEV1),percentage of the forced expiratory volume in one second (FEV1％),maximum voluntary ventilation percentage (MVV％),peak expiratory flow percentage (PEF％),fraction of the forced expiratory volume in one second (FEV1/FVC),and maximum mid-expiratory flow percentage (MMEF％) were measured before and after the training.Any postoperative complications were recorded.Results The average MMEF％ improved significantly among the moderate patients after their training.Eventually 19/26 patients (73.08％) in the mild group,34/53 patients (64.15％) in the moderate group,and 8/24 patients (33.33％) in the severe group met the requirements to undergo lung operations.These were significant differences among the groups.Among those operated on,27 (44.26％) suffered from postoperative complications,a significantly higher percentage than among the normal controls (20.00％).Conclusion Lung function exercises can improve the operation tolerance of lung cancer patients with obstructive ventilation dysfunction,but the risk of operating is still much higher than for patients with normal ventilation function.

Objective To explore the effect of predictively nursing care for children with congenital large-sized nevus.Methods 142 cases of children with congenital large-sized nevus were treated by surgical resection,based on the principle of voluntary and informed patients,and order of children admitted to hospital were randomly divided into control group and observation group,and the two groups of children were 71 cases.Children in the control group received routine care;children in the observation group received nursing care support.Comparison of the two groups of children with treatment compliance and the satisfaction of paediatric patients' family,postoperative recovery and complicatians were observed.Results Observation group of patients treatment compliance was significantly higher;the difference was significant (P＜0.05).Observation group of children family satisfaction was significantly higher [97.2 ％ (63/71) vs 88.7 ％ (63/71)],the difference was significant (P ＜ 0.05).1,3,6,and 9-month postoperative follow-up was observed in children with recovery of the observation group were better than the control group;the difference was significant (P＜0.05).After nine months the two groups of children were cured.Group of children were observed without serious complications;redness developed in 1 patient in the control group and skin graft necrosis developed in 2 patients.Conclusions Pediatric patients with congenital large-sized nevus with predictively nursing care measures have better clinical efficacy,worthy of promoting.

AIM　To study the effects of Phe-Met-Arg-Phe-NH2 (FMRFa) on Na+/Ca2+ exchange and its specificity for Na+/Ca2+ exchange in rat ventricular myocytes. METHODS　Na+/Ca2+ exchange current and other currents of ion channels were measured using whole cell voltage clamp techniques. RESULTS　A dose-related inhibition of tetrapeptide FMRFa on Na+/Ca2+ exchange was observed in rat ventricular myocytes. Inward and outward INa+/Ca2+ were inhibited by 60.1% and 56.5%, respectively, at highest concentration (100 μmol*L-1) and its IC50 were 20 μmol*L-1 and 34 μmol*L-1 in inward and outward INa+/Ca2+, respectively. Inward and outward INa+/Ca2+ were inhibited 38.7% and 34.9%, respectively, at FMRFa 5 μmol*L-1. FMRFa 5 μmol*L-1 and 20 μmol*L-1 did not affect L-type calcium current, sodium current, transient outward current and inward rectifier potassium current. CONCLUSION　These data indicate that FMRFa is a specific inhibitor of Na+/Ca2+ exchange in intact rat ventricular myocytes.