Objective To explore and analysis feasibility of the prevention of edaravone on myocardial ischemia after beating cor-onary artery bypass grafting .Methods From June 2011 to December 2012 ,78 patients which accepted beating heart coronary artery bypass grafting were randomly divided into treatment group (39 cases) and control group(39 cases) .After induction of anesthesia , the treatment group were continued to intravenous edaravone 60 mg ,while the control group were continued infusion of equivalent saline .The serum superoxide dismutase(SOD) ,malondialdehyde(MDA) levels were compared between the two groups at different times which were before surgery (T1) ,after incision 1 h(T2) ,surgery (T3) ,and after 24 h(T4) ,plasma brain natriuretic peptide (BNP) ,troponin I(cTnI) levels were compared at T1 and T4 .Left ventricular ejection fraction(LVEF) were also be compared .Re-sults The two groups of patients before treatment ,there were not statistically significant difference between the two groups on SOD ,MDA ,CK-MB ,BNP and cTnI(P> 0 .05) .At T2 ,T3 ,T4 point ,the SOD activity of the treatment group was significantly higher than that of control group(P<0 .05) .The MDA ,CK-MB value were significantly lower than that of control group (P<0 . 05) .At T4 ,the BNP and cTnI in the treatment group were less than that of control group (P<0 .05) .The postoperative LVEF% in treatment group were significantly higher than that of control group (P<0 .05) .Postoperative ventilator treatment time and ICU stay time and total hospitalization time of the treatment group were all significantly less than that of control group (P<0 .05) .Con-clusion For the beating heart coronary artery bypass surgery patients ,edaravone can effectively scavenge oxygen free radicals and reduce the release of enzymes ,reduce injury caused by myocardial ischemia-reperfusion and protect myocardial cells .

Objective To compare the quality of life at baseline and at 3 months after coronary artery bypass grafting(CABG) and investigate the related risk factors. Methods The prospective study included 121 consecutive patients reaching inclusion criteria and undergoing CABG between June 2009 and May 2016. Health status survey was measured with short form-36(SF-36)at baseline and at 3 months after CAGB. Change of quality of life and influencing factors and quality of life were analyzed. Results Eight domains including physical functioning ,role-physical ,bodily pain,general health,vitality,social functioning,role-emotional and mental health and two component summaries including physical component summary(PCS)and mental component summary (MCS)of SF-36 were significantly improved at 3 months following CAGB(all P<0.01). Moreover,advanced age, women,diabetes mellitus,assisted ventilation time,hospital stay and use of t-PA were relative to the PCS after CAGB. Conclusions The findings demonstrate quality of life is significantly improved at 3 months post CAGB. Advanced age,underlying disease,serious disease,women and lower PCS score prior to CAGB are linked with low PCS after CAGB.

Objective To observe the clinical efficacy of acupuncture plus Chinese medicinal fumigation in treating chronic pelvic inflammatory disease (CPID).Method Totally 120 CPID patients were randomized into group A, group B and group C, 40 cases in each group. Group A was intervened by acupuncture plus Chinese medicinal fumigation, group B was by dry acupuncture treatment, while group C was by Chinese medicinal fumigation alone. After 3 treatment courses, the clinical efficacies were observed, and the relapse rates among the cured cases in 8 months after the whole treatment were compared among the 3 groups.Result The total effective rate and recovery rate were respectively 95.0% and 70.0% in group A, versus 82.5% and 45.0% in group B, and 57.5% and 32.5% in group C, and the total effective rate and recovery rate in group A were significantly different from that in group B and group C (P<0.05). The treatment duration for the recovered cases in group A was significantly different from that in group B and C (P<0.05). The relapse rate in the recovered cases in the 8-month follow-up was 10.7% in group A, versus 44.4% in group B and 53.8% in group C, and the relapse rate in group A was markedly lower than that in group B and C (P<0.05).Conclusion Acupuncture plus Chinese medicinal fumigation is an effective method in treating CPID, and its advantages include content efficacy, short treatment duration, and low relapse rate, etc.

Objective To evaluate the efficacy of dexmedetomidine for improvement of postoperative analgesia with sufentanil in pediatric patients with a large area of burn after tangential excision and skin grafting.Methods Forty-two pediatric patients of both sexes with a large area of burn,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 2-10 yr,weighing 13-36 kg,scheduled for elective tangential excision and skin grafting under combined propofol-remifentanil-sevoflurane anesthesia,were randomly divided into 2 groups (n=21 each) using a random number table:sufentanil group (group Suf) and dexmedetomidine plus sufentanil group (group Dex-Suf).The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg and granisetron 100 μg/kg in 100 ml of normal saline in group Suf,and contained dexmedetomidine 2.5 μg/kg,sufentanil 1.5 μg/kg,and granisetron 100 μg/kg in 100 ml of normal saline in group Dex-Suf.The PCA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of sufentanil 0.1 μg/kg.When Faces Pain Scale score＞2,sufentanil 0.1 μg/kg was injected intravenously as rescue analgesic.The consumption of sufentanil was recorded within 48 h after operation.Ramsay sedation scores at static and dynamic (during dressing changes) conditions were assessed after operation.The parents' satisfaction,requirement for rescue analgesics and incidence of adverse reactions such as agitation,nausea and vomiting were recorded after operation.Results Compared with group Suf,Ramsay sedation scores at static and dynamic conditions and patients' satisfaction scores were significantly increased,and the consumption of sufentanil,requirement for rescue analgesics and incidence of agitation,nausea and vomiting were significantly decreased after operation in group Dex-Suf (P＜0.05).Conclusion Dexmedetomidine significantly improves postoperative intravenous analgesia with sufentanil in the pediatric patients with a large area of burn after tangential excision and skin grafting,and combination of dexmedetomidine and sufentanil is recommended for this type of pediatric patients.

AIM: To inhibit the expression of tyrosinase gene in murine B16 melanoma cells by antisense nucleotide. METHODS: The antisense recombinant pcDNA3.1(-)-tyr was constructed and was used to infect murine B16 melanoma cells for expression of tyr antisense nucleotide. The effect of antisense nucleotide of tyr on the expression of tyr gene was detected by determination of the activity of tyrosinase and of the production of melanin, Dopa staining and electronic microscope. RESULTS: The tyr antisense recombinant was successfully constructed and injected into murine B16 melanoma cell. The activity of tyrosinase in B16 cells infected with pcDNA3.1 (-)-tyr decreased to 0.0498?0.0036, compared to the tyrosinase activity of 0.0916?0.0132 in the control cells without treatment (P

Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.

Objective To evaluate the effect of dexmedetomidine on Toll-like receptor 4 ( TLR4)/myeloid differentiation factor 88 ( MyD88)/nuclear factor Kappa B ( NF-κB) signaling pathway in the pe-ripheral blood mononuclear cells of elderly patients with diabetes mellitus undergoing lower extremity surger-y. Methods Forty elderly patients of both sexes with type 2 diabetes mellitus, aged 65-80 yr, with body mass index of 18. 5-27. 9 kg/m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰ or Ⅱ, undergoing lower extremity surgery with tourniquets under general anesthesia, were divided into 2 groups ( n=20 each) by using a random number table method: control group ( group C) and dexmedetomidine group ( group D) . Combined intravenous-inhalational anesthesia was applied. Dexmedetomidine was infused over 15 min in a dose of 1μg/kg after induction of anesthesia, fol-lowed by a continuous infusion of 0. 5 μg·kg-1 ·h-1 until the end of surgery in group D, while the equal volume of normal saline was given instead of dexmedetomidine in group C. Before using the the tourniquet and at 15 min, 1 h and 24 h after loosing the tourniquet, arterial blood samples were collected for determi-nation of the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells and concentra-tions of tumor necrosis factor-alpha ( TNF-α) , interleukin-1β ( IL-1β) , cardiac troponin I ( cTnI ) and creatine kinase-MB ( CK-MB) in plasma. Results Compared with group C, the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells was significantly down-regulated, and the concentra-tions of TNF-α, IL-1β, cTnI and CK-MB in plasma were decreased at each time point after loosing the tourniquet in group D ( P＜0. 05) . Conclusion The mechanism by which dexmedetomidine reduces myo-cardial damage may be related to inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing systemic inflammatory responses in elderly patients with diabetes mellitus undergoing lower extremity surgery.

OBJECTIVE:To study the protective effects and the mechanism of Rabdosia serra water extract(RWE)on hepatic fibrosis(HF)induced by carbon tetrachloride(CCl4)in rats. METHODS:Sixty male SD rats were randomly divided into normal group,model group,colchicine group(0.12 mg/kg),and RWE low-dose,medium-dose and high-dose groups(4,8,16 g/kg,by crude drug),with 10 rats in each group. Except for intraperitoneal injection of olive oil for normal group,other groups were given 40% CCl4olive oil solution intraperitoneally to induce HF model. Since the first day of modeling,each treatment group was given relevant medicine (10 mL/kg) intragastrically, while normal group and model group were given constant volume of water intragastrically,once a day,for consecutive 6 weeks. After medication,biochemical process or ELISA were used to determine the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum,the activities or contents of SOD,GSH-Px,MDA,TNF-α,IL-6 and IL-1β in liver tissue. Pathological changes of liver tissue in rats were observed by HE staining. The expression of α-SMA and TGF-β1 in liver tissue were detected by Western blot. RESULTS:Compared with normal group,the contents of ALT,AST,LN,HA,PCⅢ and Ⅳ-C in serum,the contents of MDA,TNF-α,IL-6 and IL-1β in liver tissue were all increased significantly in model group (P＜0.01);the activities of SOD and GSH-Px in liver tissue were decreased significantly(P＜0.01). Liver fibrosis was obvious, and the relative expression of α-SMA and TGF-β 1were increased significantly (P＜0.01). Compared with model group,the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum as well as the contents of MDA,TNF-α and IL-6 in liver tissue in colchicines group and RWE groups,the contents of IL-1 β in liver tissue of rats in colchicines group,RWE medium-dose and high-dose groups were all decreased significantly (P＜0.05 or P＜0.01). The activities of SOD and GSH-Px in liver tissue of rats were increased significantly in colchicines group and RWE groups(P＜0.05 or P＜0.01). The fibrosis degree of liver tissue was significantly reduced, while the relative expression of α-SMA and TGF-β 1decreased significantly (P＜0.01). CONCLUSIONS:RWE can protect CCl4-induced HF model rats,the mechanism of which may be associated with regulating lipid metabolism,relieving liver lipid peroxidation injury and anti-oxidative stress response,inhibiting the release of inflammatory factors and the expression of TGF-β1.

Objective:To investigate the clinical and imaging features of basal ganglia germinoma in children and adolescents, so as to improve the accuracy of early diagnosis.Methods:The clinical symptoms and imaging findings of 10 cases of basal ganglia germinoma diagnosed by surgical examination or diagnostic radiotherapy in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2010 to December 2019 were analyzed retrospectively.Results:There were 9 males and 1 female, aged from 5 to 15 years, with an average age of 9.7 years.There were 10 cases of limb weakness or mild hemiplegia, 1 case of headache and vomiting, and 1 case of extrapyramidal tract sign. There were 9 cases of computed tomography (CT) examination, 5 cases of high density, 4 cases of mixed density, and 3 cases of intrafocal calcification. 10 cases of routine magnetic resonance imaging (MRI) examination, MR T1-weighted imaging (T1WI): 5 cases of low signal, 3 cases of slightly low signal, 1 case of equal low signal, 1 case of equal slightly low signal; MR T2-weighted imaging (T2WI): 3 cases of high signal, 5 cases of slightly high signal, 2 cases of high and low mixed signal; T2 fluid attenuated inversion recovery (T2FLAIR): 1 case of low signal, 2 cases of slightly high signal, 1 case of iso-high signal, 5 cases of high signal, 1 case of high and low mixed signal; Diffusion weighted imaging (DWI): 2 cases of low signal, 1 case of equal signal, 1 case of equal slightly high signal, 4 cases of slightly high signal, 2 cases of high signal; 1 case of functional imaging susceptibility-weighted imaging (SWI): 1 case of low signal; 10 cases of MRI enhancement: 2 cases of no enhancement, 5 cases of mild enhancement, 3 cases of moderate/obvious enhancement, and the enhancement methods can be seen in spot, patch, mass and ring enhancement; Functional imaging magnetic resonance angiography (MRA) in 2 cases: 1 case had slender middle cerebral artery, fewer branch arteries than the opposite side, and 1 case showed no obvious abnormality; 2 cases of positron emission (PET)-CT: the metabolism of methionine (MET) on the affected side was significantly increased in 2 cases.Conclusions:Germinoma in the basal ganglia of children and adolescents are more common in men, with weakness or mild hemiplegia as the main symptom. The imaging findings have certain characteristics. Imaging findings combined with relevant clinical data can improve the accuracy of early diagnosis of germinoma in the basal ganglia.

Solitary cervical submental nodule is a relatively rare case in clinical procedure and prone to miss diagnosis.Differential diagnosis with various head and neck diseases is necessary.This article reported a case of solitary cervical submental metastasis of papillary thyroid carcinoma received in the department of surgery,Civil Aviation Shanghai Hospital,Ruijin Gubei Branch,Shanghai Jiao Tong University School of Medicine.The patient came to the outpatient clinic for treatment due to"consciously larger submental tubercle than before".Ultrasound examination revealed suspicious lesions in both the thyroid and submental regions.Ultrasound-guided final needle aspiration biopsy diagnosed as malignant tumor.Surgical resection was performed and the central group lymph nodes dissected Pathological examination confirmed papillary thyroid carcinoma with solitary submental metastasis.This article reported the clinical diagnosis and treatment of this case,in order to improve the disease recognition for clinicians,and make differential diagnosis with other rare neck diseases,and avoid missing diagnoses.