Objective To evaluate the effects of dexmedetomidine on the hemodynamics and the heart rate variability(HRV)in patients under-going lower limbs operations with application of tourniquet. Methods Forty patients undergoing lower limbs operations with application of tourni-quet were randomized assigned to dexmedetomidine group(group D,n=20)or control group(group C,n=20). After combined spinal-epidural anesthesia,group D received a continuous infusion of dexmedetomidine(0.5μg/kg for 10 min for loading dose and followed by 0.2μg·kg-1·h-1) until tourniquet deflation. The control group received normal saline instead. Mean arterial pressure(MAP),heart rate(HR),saturation of pulse ox-imetry(SpO2),low frequency power(LF),high frequency power(HF)and LF to HF ratio(LF/HF)were recorded at regular time points:imme-diately before loading dose(T0),before tourniquet inflation(T1),15 min after tourniquet inflation(T2),30 min after tourniquet inflation(T3),45 min after tourniquet inflation(T4),60 min after tourniquet inflation(T5),1 min after tourniquet deflation(T6),5 min after tourniquet deflation (T7)and 10 min after tourniquet deflation(T8). Results Compared with T0,the MAP of group D significantly decreased at T6-T8(P<0.05). Compared with T0 and T1,the MAP of group C increased at T2-T5(P>0.05). Compared with T2-T5,the MAP of group C significantly decreased at T6(P<0.05). Compared with group C,the MAP of group D significantly decreased at T6 and T7(P<0.05). Compared with T0,the HR of group D significantly decreased at T1-T8(P<0.05). Compared with T0,the HR of group C had no significant change at T1-T5(P<0.05). Compared with T1-T5,the HR of group D and group C significantly increased at T6(P<0.05). Compared with group C,the HR of group D significantly decreased at T1-T4 and T6(P<0.05). Compared with T0,the SpO2 of group D and group C significantly decreased at T6(P<0.05). Compared with group C,the SpO2 of group D significantly decreased at T1-T3(P<0.05). Compared with T6,LF of group D and group C significantly increased at T7(P<0.05). LF were comparable between groups D and C(P>0.05). Compared with T0,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Compared with group C,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Conclusion The appropriate dose of dexmedetomidine(loading dose 0.5μg/kg and maintenance dose 0.2μg · kg-1 · h-1)can significantly increase vagal tone and improve cardiac sympathetic and parasympathetic balance during tourniquet appli-cation.

BACKGROUND:The phenomenon of temporary ischemia of the tissues and organs caused by injury is common in the clinic. However, there are few studies on the treatment of ischemia/reperfusion injury. It is significant to investigate the effect of TanshinoneⅡA on improving uterine ischemia/reperfusion injury in a rat model. OBJECTIVE:To observe the effect of TanshinoneⅡA intervention on improving uterine ischemia/reperfusion injury in rats. METHODS:The rat models of uterine ischemia/reperfusion injury were established by suture method. The rats that were intraperitonealy injected with Sodium Tanshinone IIA Silate injection (20 mg/kg) at 5, 3, 1 days and 30 minutes before the operation were included in the experimental group. Model and sham operation groups were established for comparison. RESULTS AND CONCLUSION:Spectrophotometry and immunohistochemical staining results showed that at 1 and 3 hours of ischemia/reperfusion, the malondialdehyde concentration and Bax protein expression in the injuried rat uterine tissue were significantly decreased (P < 0.05), superoxide dismutase (SOD) activity and Bcl-2 protein expression were significantly increased (P < 0.05) in the experimental group than in the model group. The results confirm that TanshinoneⅡA has a protective effect on uterine ischemia/reperfusion injury in rats.

Objective To assess the effect of opiod pretreatment on etomidate induced myoclonus. Methods The pertinent literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,and CHKD. Then the meta?analysis was performed by using RevMan 5.2 and STATA 12.0 software. Results A total of 24 RCTs involving 2 396 pa?tients were included for the study. Pretreatment ofμorκ?receptor agonists reduced myoclonus with RR=0.19(95%CI 0.14 to 0.27)and RR=0.22 (95%CI 0.12 to 0.40),respectively. Conclusion Pretreatment of opiods can reduce the incidence of etomidate induced myoclonus.

Apoptosis is the autonomous death of cells,which is controlled by the genes and to maintain the homeostasis of the body.Apoptosis is the important mechanism in the cell's growth and development.Recent studies have found that apoptosis can affect the neighboring cells physiological process in microenvironment through directly contact or release a series of regulatory factor,which plays an important roles in the construction of tumor microenvironment.Therefore,understanding the roles of apoptosis in the normal and tumor microenvironment has great significance for further study the pathogenesis,prevention and treatment of tumor.

OBJECTIVE: To compare the effectiveness of sequential treatment for subjective and objective benign paroxysmal positional vertigo(BPPV). METHOD: The efficacy of sequential treatment for nineteen vertical semicircular canal S-BPPV patients(Group A) and forty-five vertical semicircular canal O-BPPV patients(Group B) who were admitted to our hospital between January 2014 and July 2015 was retrospectively analyzed and compared, treatment of five cases with horizontal semicircular canal S-BPPV was reported here as well. RESULT: The number of repositioning maneuver for Group A was 2 - 6 times (average: 4. 21±1. 18) while 2 - 3 times (average: 2. 29 ± 0. 46) for Group B. There was significant difference between the two groups(P<0. 01). The effective rate of initial treatment for Group A was 78. 9%(15/19) while 82. 2%(37/45)for Group B. After one weeks treatment, the effective rate for Group A changed to be 89. 5% (17/19)while 88. 9% (40/45) for Group B. Non-significant difference was found in the two groups neither in the initial nor one weeks treatment. On three months' follow-up, one in Group A and two in Group B relapsed, and they were cured after treated in the initial treatment. The recurrence for Group A was 5. 3%(1/19) while 4. 4%(2/45) for Group B and there was non-significant difference. The five cases with horizontal semicircular canal S-BPPV were completely free of disease after undergoing treatment. CONCLUSION The sequential treatment is effective for both vertical semicircular canal S-BPPV and vertical semicircular canal O-BPPV, but the former needs more repositioning maneuver times. The repositioning maneuver, combined with drug therapy and head-shake-in-supine-position method is recommended for horizontal semicircular canal S-BPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Recurrence ; Retrospective Studies ; Semicircular Canals ; physiopathology ; Treatment Outcome

CYP2D6 genetic polymorphism results in individual difference of therapeutic effect and adverse reaction of related drugs this article made an overview for that.

Objective To improve the understanding of primary pulmonary artery sarcoma(PAS)and its early diagnosis and treatment.Methods The clinical data of 3 PAS patients in Beijing Anzhen Hospital and related literature,the clinical features,diagnosis and therapy of the disease were retrospectively studied.Results Pulmonary artery sarcoma had similar clinical presentations to pulmonary thromboembolism(PTE).Although CT pulmonary angiography and Color Doppler echocardiography etc were helpful to the diagnosis of the entity,the confirmed diagnosis needed the operation.The surgery was main therapy for the disease.Conclusion Pulmonary artery sarcoma is easily misdiagnosed as PTE.The clinicians should pay more attention to the disease so as to early diagnose and treat it.

OBJECTIVE:To provide the basis for the formulation of the health intervention strategy for medical and health insti-tutions'pharmacists and provide reference for other related research. METHODS:A total of 180 medical and health institutions' pharmacists in Heilongjiang province were investigated and evaluated by work satisfaction MMSS scale(modified)and quality of life(SF-36)scale,and the relevant data were analyzed statistically. RESULTS:A total of 180 questionnaires were distributed and 134 valid questionnaires were collected. The effective recovery rate was 74.44%. The average score of work satisfaction degree was (3.44±0.79),which was at the middle level. The highest score was the relationship with colleagues and the lowest score was wel-fare. The physical function,the physiological function and the social function dimension of the respondents were higher thanChi-nese norm. The scores of physical pain,general health,vitality,emotional function and mental health were lower thanChinese norm,and there was statistical significance between the scores of the other dimensions andChinese norm(P<0.05),except for the physiological function and vitality dimension. Multivariate analysis showed that gender,duties,education,length of service and work satisfaction score had an effect on quality of life(P<0.05),among these factors,work satisfaction score was positively correlated with quality of life. CONCLUSIONS:The quality of life of medical and health institutions'pharmacists still needs to be improved,which is related to many influential factors,and job satisfaction is an important influential factor.

Objective To evaluate the effects of curcumin pretreatment on the expression of Nrf2 protein during ventilator-induced lung injury in rabbits.Methods Twenty-four healthy male New Zealand white rabbits,aged 3-6 months,weighing 2.5-3.0 kg,were randomized into 3 groups (n =8 each) using a random number table:two-lung ventilation (TLV) group; one-lung ventilation (OLV) group; and curcumin pretreatment group (group Cur).In group Cur,curcumin 40 mg/kg (dissolved in 2 ml of 1％ sodium carboxymethylcellulose) was given via a gastric tube into the stomach twice a day for 7 consecutive days starting from 7 days before ventilation,while the equal volume of sodium carboxymethylcellulose was given via a gastric tube instead of curcumin in TLV and OLV groups.All the rabbits were tracheostomized,and a tracheal tube was inserted to perform TLV in TLV group,and a tracheal tube was inserted into the right bronchus to establish OLV in OLV and Cur groups.Volumecontrolled ventilation was used in the three groups and the ventilatory parameters were regulated to maintain SpO2 ＞ 90 ％.Immediately before beginning of ventilation (T0) and at 1,2 and 3 h of ventilation (T1-3),arterial blood samples were obtained for blood gas analysis and determination of PaO2.The oxygenation index was calculated.At the end of ventilation,the rabbits were sacrificed and right lungs were removed for determination of wet/dry lung weight ratio (W/D ratio).The right lower lobe was isolated and puhmonary specimens were obtained for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity (using colorimetric method) and the expression of Nrf2 and HO-1 protein (by Western blot) in lung tissues and for microscopic examination of pathological changes of the lung which were scored.Results Compared with group TLV,the W/D ratio,pathological scores,MDA content,and expression of Nrf2 and HO-1 were significantly increased,and the SOD activity and oxygenation index at T2,3 were decreased in OLV and Cur groups (P ＜ 0.05).Compared with group OLV,the W/D ratio,pathological scores,and MDA content were significantly decreased,and the SOD activity,oxygenation index at T3,and expression of Nrf2 and HO-1 were increased in group Cur (P ＜ 0.05).Conclusion Curcumin pretreatment reduces ventilator-induced lung injury through promoting the expression of Nrf2 protein in lung tissues in rabbits.

Objective To assess the value and safety of SonoVue in ultrasonic diagnosis of abdominal diseases. Methods A total of 204 patients (149 male, 55 female) with abdominal examination of contrast-enhanced ultrasonography (CEUS) with SonoVue from August 2007 to February 2009 were reviewed. Results Definitive diagnosis were obtained 215 times in 204 patients (233 times) with abdominal CEUS. The diagnostic accuracy of CEUS was 92.27%, significant higher than that of conventional ultrasonography (62.23%). Anaphylactic shock happened 1 time (0.43%) in 1 patient. Conclusion CEUS with SonoVue can provide a high diagnostic accuracy with relatively safety of the possibility of serious adverse event.