AIM: To investigate the effects of angiotensinⅡ receptor type Ⅰ antagonist irbesartan and angiotensin-converting enzyme inhibitor perindopril on the myocardial expression of connexin 43 (CX43), desmin and cardiac troponin T (cTnT) in the pressure overload-induced rat cardiac hypertrophy. METHODS: 40 male adult Sprague-Dawley rats were divided into 5 groups (8 animals for each): sham operation group and other four groups with ventricular hypertrophy caused by banding aortic artery. Drugs were given one week after operation as follows: sham operation group, normal saline (2 mL?kg~-1?d~-1 ig) was given; Operative groups: animals with ventricular hypertrophy were treated with normal saline 2 mL?kg~-1?d~-1 ig; Treatment groups: animals with ventricular hypertrophy were treated with perindopril 2 mg?kg~-1?d~-1 ig, irbesartan 20 mg?kg~-1?d~-1 ig or irbesartan 20 mg?kg~-1?d~-1 ig plus perindopril 2 mg?kg~-1?d~-1 ig, respectively. Left ventricular mass index (LVMI), transverse diameter of myocardial cell (TDM), and myocardial expression of CX43, desmin and cTnT by immunohistochemistry were performed at the end of 8 weeks of drug intervention. RESULTS: LVMI, TDM were remarkably decreased after drug intervention, compared to animals of operative group (P

Objective To evaluate the influence of right ventricular outflow tract septal ( RVS) pacing with right ventricular apical ( RVA) pacing on left ventricular remodeling and brain natriuretic peptide ( BNP). Methods Sixty patients with indication of pacemaker implantation were randomized into two groups, RVA group and RVS group. BNP was measured with ELISA, and echocardiography was performed to measure the left ventricular end diastolic volume ( LVEDD), left ventricular end systolic volume ( LVEDV) and left ventricular ejection fraction (LVEF) at pre-operation,and after 6,12,24 months pacing. The difference of cardiac remodeling and BNP in the two groups was observed. Results Compared to BNP at pre-operation (( 60. 2 ± 15. 7 ) ng/L) , BNP increased significantly in the RVA group at the 6th,12th and 24th month after operation( ( 108. 2 ±29. 8) , ( 190. 3 ±46. 7) ,(308. 2 ±56. 5)ng/L,respectively) (P <0. 05). In the RVS group,BNP increased only at 24 months after pacing ( (75. 2 ± 15. 8) ng/L vs. (63. 9 ± 15. 1 ) ng/L) (P < 0. 05). There was significant difference on BNP between the two groups. LVEDD,LVEDV increased,LVEF declined at 12 months after pacing in the RVA group,which were not observed in the RVS group. There was significant difference on LVEDD,LVEDV and LVEF in the RVA group (P< 0. 05) between the 12th month and pre-operation,and there were no significant difference in the RVS group (P > 0. 05). Conclusions Compared to RVA pacing,RVS pacing was more beneficial to improve heart function,prevent cardiac remodeling and decline the activation of nerve-endocrine.

Objective To observe the effect of sevoflurane and target controlled infusion (TCI)propofol on the oculocardiac reflex (OCR) in patients with paediatrie strabismus surgery.Methods One hundred and thirty-eight patients ASA Ⅰ-Ⅱ undergoing strabismus surgery were randomly allocated to six greups(propofol groups:P_1,P_2,P_3 group; sevoflurane groups:S_1,S_2,S_3 group,23 cases for each) according to target bispectral index (BIS) of 60,50 and 40.In propofol groups continuous infusion of propofolremifentanil [0.2μg/(kg·min)] was adjusted towards target BIS value.The sevoflurane-remffentanil [0.2μg/(kg·min) ] concentration with 50% N2O/O2 was adjusted toward target BIS too.The incidence of OCR and the lowest heart rate(HR) and BIS were recorded.Results The incidence of OCR were 73.9%(17/23),39.1%(9/23),17.4%(4/23),56.5%(13/23),26.1%(6/23),8.7%(2/23)in P_1,P_2,P_3,S_1,S_2,S_3 soup,P_2 and P_3 group were lower than P_1 group,S_2 and S_3 soup were lower than S_1 group,P_3,S_3,S_2,P_2 group were lower than S_1 and P_1 soup,S_1 soup was lower than P_1 group,S_2 soup was lower than P_2 group,S_3 group was lower than P_3 group,there was significant difference(P < 0.05 ).The densities of TCI propofol in P_2 and P_3 soup were higher than that in P_1 group [ (4.3 ±0.2),(5.5±0.1 ) mg/L vs (3.2±0.1 ) mg/L ] (P <0.05),and the densities of sevoflurane in S_2 and S_3 group were higher than that in S_1 group [ ( 1.8±0.3 )%,(2.3±0.2 )% vs(1.3±0.2 )% ] (P<0.05 ).The end-tidal concentration was different with difference of BIS too.Conclusions OCR is relevant to the depth of anesthesia.BIS values of 40-50 seem adequate for the inhibition of OCR.The results suggest that BIS may be a valuable tool during propofol-remifentanil or sevoflurane-remifentanil anesthesia for strabismus surgery in children.The incidence of OCR is higher in propofol than in sevoflurane at the same BIS.

Objective:To investigate the effects of micro course in teaching of thoracic surgery.Methods:According to the teaching content of thoracic surgery and the previous teaching experience of the Department of Thoracic Surgery, the micro learning resource base with characteristics was established. We enrolled 20 students of Grade 2014 as the experimental group and 20 students of Grade 2013 as the control group. The micro learning resource base was used for teaching in the experimental group, and the traditional course teaching was carried out in the control group (the teachers were not changed). The teaching effect was evaluated through questionnaires and examinations.Results:The micro learning resource base of thoracic surgery consisted of 11 modules. The learning interest, effect and acceptance in the experimental group were significantly higher than those in the control group (all P<0.05), and there was no significant difference in understanding ability ( P>0.05). Moreover, the experimental group revealed much higher scores in the basic knowledge [(85.3±10.6) vs. (72.5±9.6)] and clinical ability [(87.3±11.5) vs. (75.9±12.2)] than the control group (both P<0.05). Conclusion:It is worth popularizing to establish a micro learning resource base and teaching application model suitable for thoracic surgery, which can help improve students' interest in learning and achieve better learning results through students' targeted and active learning.

Objective To investigate the epidemiological characteristics of non-toxic goiter and non-toxic thyroid nodules in the regions with different iodine intakes and the factors influencing the occurrence, development and outcome of goiter and thyroid nodules. Methods 3 385 subjects, who had taken part in the previous survey in 1999 with the ultrasonic examination of thyroid, were composed of individuals in Panshan with chronic mild iodine deficiency,in Zhangwu with more than adequate iodine "after iodine supplementation and in Huanghua with excessive iodine. These 3 groups of subjects were followed up in 2004. Results (1) The cumulative incidences of diffuse goiter in Panshan ,Zhangwu and Huanghua were 7.1% ,4.4% and 6.9% ,respectively ,being the lowest in Zhangwu (P<0.01) and those of nodular goiter were 5.0% ,2. 4% and 0.8%, respectively, being the highest in Panshan (P<0.01). (2) The incidences of single nodule were 4.0% ,5.7% and 5.6%, respectively, and those of multiple nodules 0.4%, 1.2% and 1.0%, respectively. (3)The result of logistic analysis showed that iodine deficiency,iodine excess and positive thyroid autoantibodies (TAA) were the independent risk factors for the occurrence of goiter. (4)In Zhangwu ,the incidence of non-toxic goiter in the group with positive TAA was higher than that in the group with negative TAA(P<0.01) ,while there were no such differences in Panshan and Huanghua. (5)In these three regions, the rates of positive TAA in the individuals with diffuse non-toxic goiter were higher than those in the healthy subjects (P<0.05). And in Huanghua,the rate of positive TAA in subjects with non-toxic nodular goiter was also higher than that in the healthy individuals (P<0.05). Conclusion Iodine deficiency and iodine excess may both induce the raising incidence of goiter. Nodular goiter is prevalent in iodine deficient district and diffuse goiter is the predominant form in places with iodine excess. Thyroid autoimmunity is associated with occurrence and maintenance of goiter, and this phenomenon is more obvious in the community with previous iodine deficiency followed then by treatment with more than adequate iodine.