Objective To observe the preventive effect of epidural injection with low - dose of ketamine on postanesthesia shivering(PAS) undergoing percutaneous nephrolithotomy. Methods Sixty ASA Ⅰ～Ⅱ grade patients aged 35 ～ 72 years undergoing PCNL were randomly divided into kctamine group (n = 30, Epidural injection of 0.5mg/kg of ketamine) ,Control group(n = 30, Epidural injection of 10ml saline). The rate of shivering was observed and recorded during operation,and blood pressure and respiration were measured. Results The rate of shivering in ketamine group(10%) was significantly lower than that in control group(46.7%, P ＜ 0.05) ,There were no significant differences of blood pressure and respiration between two groups (P ＞ 0.05). Conclusion Epidural injection 0.5 mg/kg of ketamine on postanesthesia can prevent shivering in PCNL.

Islet amyloid polypeptide (IAPP) is an important etiologic factor for the type 2 diabetes mellitus.To investigate the biological functions and the applications of IAPP,we used text mining to explore the development of the research about IAPP biochemical reagents and test kits in this study.

Children with hematological diseases usually accompanied by low autoimmune function,and repeated chemotherapy exacerbated the damage to their immune system and hematopoietic function.Those lead to high incidence of nosocomial infection,most of infection were caused by multi-drug resistant bacteria and fungi.The major infections in hematological children are the following:multi-drug resistant Escherichia coli/Klebsiella pneumonia bacteria;multi-drug resistance Pseudomonas and Acinetobacte;Methicillin-resistant coagulase negative Staphylococcus and aureus;multi-drug resistance Enterococcus faecium.This review presents updated treatment strategies from the published clinical literature and provides recommendations for clinical treatment of multi-drug resistant bacteria in children with hematonosis.

OBJECTIVE:To compare the efficacy and safety of Pingxiao capsule and Shendan Sanjie capsule combined with CP program in the treatment of non-small cell lung cancer (NSCLC) in stage Ⅳ. METHODS:132 NSCLC patients in stage Ⅳwere randomly divided into CP group,CP+Pingxiao group and CP+Shendan Sanjie group. CP group was treated with CP program;based on it,CP+Pingxiao group was orally treated with 6 Pingxiao capsules,3 times a day;CP+Shendan Sanjie group was orally treated with 6 Shendan Sanjie capsules,3 times a day. 21 d was a treatment period,and the efficacy was evaluated after 2 treat-ment periods,improvement of life quality,progression-free survival,1-year survival rate and toxicity reactions were observed. RE-SULTS:The recent effective rate,disease control rate,total improvement rate of life quality,progression-free survival and 1-year survival rate in CP+Pingxiao group and CP+Shendan Sanjie group were significantly higher than CP group,incidences of leukope-nia,thrombocytopenia,gastrointestinal tract and decreased hemoglobin were significantly lower than CP group,the differences were statistically significant(P<0.05);however,there was no significant difference between CP+Pingxiao group and CP+Shendan Sanjie group(P>0.05). CONCLUSIONS:Both Pingxiao capsule and Shendan Sanjie capsule can be combined with CP program in the treatment of NSCLC in stageⅣ,with good safety.

Objective To investigate the effect and safety of long-term use of atorvastatin on carotid atherosclerosis in advanced elderly patients.Methods Totally 61 elderly patients with carotid atherosclerosis were permitted into study.They were treated with atorvastatin (20 mg/d) and followed-up for five years.The carotid atherosclerosis parameter and the serum levels of TC,TG,LDL-C,HDL-C,fasting blood glucose (FBG),ALT,AST,STB,CB,Bun,Cr and creatine kinase (CK) were measured before and 5 years after treatment.Results During fellow-up,2 patients died of severe pneumonia and 1 patient died of operation complications of intestinal obstruction,with mortality rate of 4.9％.2 patients (3.4％) gave up treatment because of muscle-related side-effect.Data was collected in 56 patients achieving study end.There was significant decrease in LDL-C (P＜0.05) and increase in HDL-C (P＜0.05),but there was no change in serum levels of TC,TG,FBG,ALT,AST,STB,CB,BUN,Cr and CK (P＜0.05) after 5 years.The total area of carotid atherosclerosis plaque was reduced [(0.63±0.41)cm2 vs.(1.07±0.67)cm2,P＜0.05] and echo of carotid atherosclerosis plaque was enhanced (2.67±0.52 vs.1.53±0.44,P＜0.01),but carotid intima-media thickness(IMT) appeared no change after five years.Conclusions Atorvastatin is safe in the treatment of advanced elderly patients,it can make carotid atherosclerosis plaque smaller and stable after long-term treatment.

Objective To explore the role of non-receptor tyrosine kinase(c-Src)in sevoflurane pretreatment for relieving myocardial ischemia-reperfusion injury.Methods By using the random number table,the healthy male Wistar rats were randomly divided into 5 groups (n=10):sham operation group (Ⅰ),ischemia-reperfusion group(Ⅱ),sevoflurane pretreatment group(Ⅲ), sevoflurane pretreatment plus dimethyl sulfoxide(DMSO,Ⅳ)and sevoflurane pretreatment plus c-Src specific inhibitor SU6656 group(Ⅴ)groups.The group Ⅲ,Ⅳ and Ⅴ were performed the sevoflurane aftertreatment before reperfusion;the group Ⅴ was in-jected by SU6656 at 5 min before reperfusion;the group Ⅳ was given the equal volume DMSO.The arterial blood sample in each group was collected at 120 min after reperfusion for detecting serum LDH level and CK-MB activity.Rats were killed for taking the heart and separating the left ventricle to calculate the area of myocardial infarctio;the expression levels of Src,phosphorylated Src (p-Src),CAT and SOD in myocardial tissue were detected in each group.Results Compared with the groupⅠ,the level of serum CK-MB and LDH activity,myocardial infarct area and p-Src/Src,CAT,SOD in the other 4 groups were increased significantly (P <0.05);comparing with the group Ⅲ,the serum CK-MB and LDH activity,myocardial infarct area and SOD,CAT,in the group Ⅱ,Ⅳ and Ⅴ were increased,however the level of p-Src/Src was decreased significantly (P <0.05).Conclusion The c-Src-reactive ox-ygen signaling pathway might mediate the role of sevoflurane pretreatment for reducing myocardial ischemia-reperfusion injury in rat.

Objective To elucidate the related risk factors for the cardiorenal syndrome(CRS),and to provide a reference for the prevention and treatment of CRS. Methods A retrospective study was conducted on 269 patients with chronic heart failure. The subjects were divided into two groups in accordance with estimated glomerular filtration rate(eGFR):patient group(CRS group),eGRF<60 mL/(min ! 1.73 m2)and control group,eGRF≥60 mL/(min!1.73 m2). The patients'general information as well as the related clinical lab indices and accessory examination indi-ces were collected. The risk factors for chronic heart failure and renal insufficiency were analyzed with multivariate logistic regression analysis. Re?sults The prevalence of chronic heart failure patients suffering from CRS was 26.39%. The single factor analysis showed that there were statistically significant differences between the two groups in terms of age,body weight,history of hypertension,and history of diabetes(all P<0.05). Compared to the control group,uric acid,cystatin C,serum urea nitrogen,brain natriuretic peptide,glycosylated hemoglobin,high-sensitivity C-reactive pro-tein,and left ventricular end-diastolic diameter in the CRS group were significantly higher;white blood cell count,hemoglobin,albumin,and left ventricular ejection fraction were significantly lower(all P<0.05). There was no statistically significant difference(P>0.05)between the two groups in regard to white blood cell count,glutamic-pyruvic transaminase,glutamic oxalacetic transaminase,cholesterol,triglycerides,high density lipoprotein,low density lipoprotein,troponin I,serum free triiodothyronine,serum free thyroxine,or thyroid stimulating hormone. Multivariate logis-tic regression analysis showed that older age,low body weight,history of hypertension,history of diabetes,hypoalbuminemia,superb sensitivity C-re-active protein levels,high uric acid,high cystatin C hyperlipidemia,and low ejection fraction were independently associated with the occurrence of CRS. Conclusion Older age,low body weight,history of hypertension,history of diabetes,hypoalbuminemia,high-sensitivity C-reactive protein levels,high uric acid,high cystatin C hyperlipidemia,and low ejection fraction are the high risk factors for CRS in heart failure patients and are inde-pendently associated with the occurrence of CRS. Early identification and control of these risk factors are important for the prevention and treatment of CRS.

Objective To investigate the effects of Acanthopanax Senticosus Injection (ASI) on free radical metabolism and apoptosis in the hepatic tissue after hepatic ischemia-reperfusion in rats.Methods A total of 100 rats were randomly divided into 5 groups: a sham operation group, a model group, and groups of high-, medium- and low-dose ASI, 20 rats in each group. Seven days before modeling, the drugs had been given by intraperitoneal injection. The rats in the high-, medium- and low-dose groups were given ASI 40, 80 and 120 mg/kg, respectively, and the rats in the sham operation and model groups were given equivalent volume of normal saline. A rat model of hepatic ischemia reperfusion was induced by partial hepatic pedicle clamping followed by reperfusion. 2 h after reperfusion, the activities of SOD, GSH-Px, GST and the MDA level in the hepatic tissue were determined; the activities of ALT and AST in serum were also determined; the histopathological changes and hepatocyte apoptosis were observed using the HE staining and the TUNEL staining, respectively.Results In comparison with the model group, the activities of SOD (11.16 ± 2.31 U/mg, 10.63 ± 1.92 U/mgvs.7.34 ± 1.78 U/mg;P<0.01 orP<0.05), GSH-Px (15.48 ± 2..91 U/mg, 13.23 ± 1.87 U/mgvs. 10.35 ± 2.04 U/mg;P<0.01 orP<0.05), GST(1.76 ± 0.25 U/mg, 1.55 ± 0.22 U/mgvs.0.94 ± 0.18 U/mg;P<0.01 orP<0.05) in the hepatic tissue in the ASI high- and medium-dose groups were significantly increased; and the MDA level in the hepatic tissue significantly decreased (4.67 ± 1.24 nmol/mg, 4.93 ± 1.53 nmol/mgvs.10.29 ± 2.41 nmol/mg); the serum levels of ALT(671.82 ± 338.37 U/L, 803.91 ± 441.63 U/Lvs.1 416.22 ± 538.94 U/L;P<0.01 orP<0.05), AST(329.02 ± 161.88 U/L, 417.26 ± 182.37 U/Lvs.751.93 ± 262.75 U/L;P<0.01 or P<0.05) were significantly decreased; the histopathological changes and hepatocyte apoptosis in the ASI high-, medium - and low-dose groups were significantly reduced.Conclusions ASI could effectively attenuate oxidative stress in the, improve the histopathological changes, inhibit hepatocyte apoptosis, and protect against hepatic ischemia reperfusion injury in rats.

Objective To investigate the effects of rapamycin eluting stent(Cypher~(TM)) and metal bare stent on the prognosis and C-reactive protein(CRP) in elderly patients with acute myocardial infarction(AMI).(Methods The) immediate angiographic and clinic follow-up outcomes of 45 elderly patients with AMI reciving Cypher~(TM) and bare stent were retrospectively analyzed.CRP levels in Cypher~(TM) and bare stent groups were determined before implantation,6 h,1 d,7 d and 30 d after implantation.Clinical follow-up and major coronary events analysis were developed after operation.Results 27 rapamycin eluting stents were implanted in patients of Cypher~(TM) group and(26 bare) stents were implanted in patients of bare stent group.The Cypher~(TM) stents were successfully implanted with 100%.In patients of Cypher~(TM) group,no serious complications were found in the term of operation and in hospital.There was no restenosis,revascularization and events.In patients of bare stent group,except for(1 patients) with sudden death,angina pectoris occurred in 2 patients,repeat angiography showed that there were new lesions in other coronary arteries of these patients.Restenosis attacked in 2 patients.The concentrations of CRP in Cypher~(TM) and bare stent groups 6 h and 7 d after operation were much higher than that of(pre-operation (P

Objective To observe the effects of recombinant staphylokinase (r-SAK) on platelet activation parameters in patients with acute myocardial infarction(AMI) by intravenous thrombolysis in order to investigate the clinical thrombolytic efficacy of r-SAK therapy in AMI comparing with recombinant tissue-type plasminogen activator(rt-PA) therapy.Methods Thirty-three patients with AMI within 12 h after the onset were selected and divided randomly into the r-SAK therapy group(n=17) and rt-PA therapy group(n=16).Coronary artery angiography(CAG) was performed 90 min after thrombolytic therapy in patients.Thrombin-antithrombin complex(TAT) and alpha granule membrane protein(GMP-140) were measured by similar commercial enzyme-linked immunosorbent assay(ELISA).Results In r-SAK group and rt-PA group,the plasma contents of GMP-140 2 h after thrombolytic therapy were significantly higher than before therapy(P0.05).In rt-PA group,the plasma content of TAT 2 h after thrombolytic therapy increased significantly(P0.05).) Conclusion r-SAK has similar effect with rt-PA and it will become available for highly fibrin-selective thrombolytic therapy of AMI.Thrombolytic treatment with r-SAK can improve the injury of myocardial microperfusion.