Objective To investigate the effect of ?-blockers on spatial dispersion of ventricular repolarization following acute myocardial ischemia.Methods Twenty sheep were randomized into control(normal saline i.v.)and atenolol group.Acute myocardial ischemia was induced by occlusion of the obtuse marginal coronary artery.Unipolar ECG was simultaneously acquired from 64 epicardial sites in both ischemic and non-ischemic regions.Activation-recovery intervals(ARI)were determined from the epicardial ECGs.The difference between the longest and shortest ARI was defined as ARI dispersion.Results Ischemic zone in the atenolol group was less than that of the control group[(13?2)% vs (19?3)%,P

Objective To study the ultrastructural changes in three different zones of benign prostatic hyperplasia(BPH). Methods The ultrastructural changes in peripheral,transitional and central zones(PZ,TZ and CZ)of prostates from 10 patients with BPH were observed with transmission electron microscopy. Results Glandular epithelia layers in TZ of BPH were increased.The stroma in TZ was mainly composed of smooth muscle cells (SMC) of vigorous proliferation and fibroblasts.Mast cell and lymphocyte with cytoplasma membrane merge were observed in this zone.In PZ and CZ of BPH, SMC showing degenerative changes,such as,nuclear pyknosis,dilatation of perinuclear space and vacuolation of cytoplasma were frequently seen. Conclusions There are significant differences in the ultrastructure of three zones in BPH.

Objective To reveal the effect of lutein on the status of oxidative stress in rats with high homocysteine levels (HHcy) and relevent molecular mechanisms.Methods The wistar rat HHcy model was established by intra-gastric administration with L-methionine suspension and treated with lutein.The oxidative stress status and the gene expression changes of transcription Nf-E2-related factor2 (Nrf2),a regulation factor of down stream antioxidant protein gene expression,were detected in HHcy rats and lutein intervention rats.Results Compared with the rat serum SOD activities (134.32 ± 12.65) U/mL in the control group,the serum SOD activities in the HHcy model group (95.6 ± 10.92) U/mL were significantly lower (P ＜ 0.05).The serum glutathione peroxidase (GPx) activities in the HHcy model group (121.66 ± 18.64) U/mL were also significantly lower as compared with the the control group (183.17 ± 21.29) U/mL,P ＜ 0.05.However,the serum SOD (126.75 ± 11.26) U/mL and GPx activities (167.18 ± 19.66) U/mL in the lutein intervention group were significantly higher as compared with the HHcy model group.As compared with the rat serum malondialdehyde (MDA) content (5.11 ± 0.68) μmol/L as well as the hydroxyl free radical levels (0.53 ± 0.05) U/L in the control group,the serum MDA content (7.65 ± 0.87) μmol/L and the hydroxyl free radical levels (0.92 ± 0.09) U/L in the HHcy model group were significantly higher.The serum MDA content (6.44 ±0.91) μmol/L and the hydroxyl free radical levels (0.74 ± 0.06) U/L in the lutein intervention group were significantly lower as compared with the HHcy model group.RT-PCR and Western blot results also showed decreased expression of SOD2 and GPxl mRNA in aorta epithelial tissues of HHcy model rats.With lutein intervention,the expressions ofSOD2 and GPx1mRNA were significantly increased and the gene expression of Nrf2 also up-regulated.Conclusions The Hhcy model rats were under the status of augmented oxidative stress,and carotenoid lutein could attenuate the Hcy-mediated oxidative stress,and its mechanism might be potentially associated with up-regulating the expression of Nrf2,thereby inducing the expression of its downstream antioxidant proteins.

Objective To observe the effects of therapy of tonifying kidney and replenishing essence on protein expression profile in testes of aged rats.Methods Twenty male SD rats with 22 months old were equally randomized into the blank control group and the treatment group.The treatment group received gastric gavage of herbs at the dose of 0.05g?kg-1.d-1,which has the actions of tonifying kidney and replenishing essence.The treatment lasted 60 days.After treatment,the right testes were taken out from the rats,and the differentially expressed proteins in the rats testes of two groups were analyzed by two-dimensional gel electrophoresis(2-DE).Results Compared with the model group,obvious changes were found in 7 kinds of differentially expressed proteins in rats testes of the treatment group,of which 4 kinds were up-regulated and 3 down-regulated.After digestion and identification by the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrum,5 kinds from the 7 kinds of proteins were identified as phosphatidyl ethanolamine-binding protein(PEBP),heat shock 70 kDa protein 8,triose-phosphate isomerase,glyceraldehyde-3-phosphate dehydrogenase(GAPDH),and glutathione S-transferase Mu 1(GSTM1-1).Conclusion The anti-aging mechanism of therapy of tonifying kidney and replenishing essence is probably related with the regulation of testis protein expression in aged rats.

Objective: To evaluate the anal sphincter function of congenital anorectal malforotation retrospectively.Methods: With continuous pull through technique, the manometry of 22 congenital anorectal malforotation patients and 24 controls were studied and the results were analysed with their clinical scores. Results: Anal resting pressure in the children with neurogenic anorectum induced by myelodysplasia(21.3?3.4) mmHg was lower than that in normal children(66.7?24.0) mmHg.The maximum contractive pressure of anus in the patients(22.4?3.3) mmHg was lower than that in normal children(129.0?18.8) mmHg. The length of high pressure zone in the patients(12.3?4.6 mm) was lower than that in normal children(23.6?4.6 mm). Rectoanal inhibitory reflex was identified in both patients and normal children. Conclusion:Anorectal manometry might be an effective parameter to evaluate the anal sphincter function of congenital anorectal malformation.

Objective To use the multi-slice CT(MSCT)cerebral perfusion imaging and CT angiography(CTA)in the clinical diagnosis of transient ischemic attack(TIA).Methods 20 cases with transient ischemic attack within 48 h were examined with 16-slice CT perfusion imaging(CTPI)and CTA in head and neck.The interesting regional cerebral blood flow(rCBF),cerebral blood volume(rCBV)and the time to peak(rTP)were analyzed.Results The rTP of affected side delay compared with that of the healthy(t=3.04,P=0.008).CTA showed the responsible vascular stenosis or occlusion in varying degrees.There was not significant correlationship between rTP and vascular stenosis(r=0.32,P=0.17).Conclusion Cerebral perfusion imaging and head and neck CTA can provide valuable information for diagnosis and treatment of TIA.

ObjectiveTo evaluate the effect of high frequency oscillation ventilation (HFOV) vs. conventional mechanical ventilation (CV) on the treatment and prognosis of adult patients with acute respiratory distress syndrome (ARDS).Methods Published articles concerning randomized controlled trials (RCTs) about the effect of HFOV vs. CV on the prognosis of adult patients with ARDS published before May 2014 were retrieved from PubMed, EMBase, Cochrane central registry of controlled trials, CNKI and Wanfang Data. The mortality and data of physiological parameters were analyzed with STATA 12.0, and the mortality rate was also analyzed by trial sequential analysis with TSA 0.9, and the line chart was drawn with Microsoft Office Excel 2003.Results Seven trials with 1 731 patients met the criteria, all of them recorded the physiological parameters data, and mortality rate was mentioned in 6 trials (1 705 patients). Compared with CV, HFOV did not show any statistically significant beneficial effects on mortality [relative risk (RR) = 0.93, 95% confidence interval (95%CI) = 0.70-1.24,P = 0.63], and other clinical outcomes, including survival without mechanical ventilation (RR = 1.05, 95%CI = 0.72-1.54,P = 0.80), survival on mechanical ventilation (RR = 1.23, 95%CI = 0.65-2.35,P = 0.52), or treatment failure (RR = 0.89, 95%CI = 0.50-1.56,P = 0.67). The risk factors of adverse events including hypotension (RR = 0.89, 95%CI = 0.07-10.99,P =0.93), acidosis (RR = 1.05, 95%CI = 0.43-2.56,P = 0.91), and air leakage from ventilator (RR = 0.74, 95%CI = 0.31-1.80,P =0.51) were similar. But the physiologic parameters of patients and parameters of ventilator in HFOV group, including oxygenation index, positive end-expiratory pressure, tidal volume, mean airway pressure, arterial pH, partial pressure of arterial carbon dioxide, fraction of inspired oxygen, ratio of partial pressure of arterial oxygen to fraction of inspired oxygen, were better than those in the CV group. Methods adapted from formal interim monitoring boundaries applied to cumulative Meta-analysis showed that the evidence failed by a considerable degree to meet the standards for forgoing studies, and the necessary sample was 3 874 patients. Trial sequential analysis also showed that the accumulatedZ-score did not cross the traditional boundary (P = 0.05) and interim monitoring boundaries. This result indicated that there was no significant difference between CV and HFOV on mortality before the number of needed sample reached (3 874 cases). We could not get a definitive conclusion with current evidences.ConclusionsCompared with CV, the use of HFOV in ARDS was not associated with a significant reduction in mortality. But the physiologic parameters of patients in HFOV group were better than those in the CV group. More RCTs are needed to draw a definitive conclusion.

Objective To apply the multimodal analgesia (MMA) in minimally invasive surgery (MIS) for patients in spine surgery.Methods 21 patients undergoing MIS were selected to be reviewed, including haemodynamics, respiratory parameters, analgesia and sedation scale, side effects, satisfaction of operators and patients in the course of the operation. Results All the MIS was successful with excellent analgesia, conscious sedation, stable haemodynamics, unsuppressed respiratory function, and satisfaction of operators and patients. Conclusion Patients under MMA would accept MIS in a comfortable state and the communication between patients and operators would not be inhibited.

Objective Brain natriuretic peptide(BNP) is released from the cardiac ventricles in response to increased wall tension. The prognostic significance of blood brain natriuretic peptide in Chinese patients with cardiovascular disease has not been established. The purpose of this study was to investigate the value of brain natriuretic peptide for predictin g cardiac death within 1 month in Chinese patients with cardiovascular disease. Methods One hundred and seven inpatients with cardiovascular disease, whose blood brain natriuretic peptide concentration were measured within 1 - 3 days of admission, using triage BNP test, were divided into 2 groups: the survival and the non-survival, according to the results of 1was positively correlated with heart rate, left ventricular end-diastolic dimension, history of heart failure and old myocardial infarction (r=0.28, P=0. 000 4; r=0.49, P＜0. 000 5; r=0.39, P＜0. 000 5; r=Area under the curve of the receiver-operating-characteristic(ROC) of brain natriuretic peptide to predict cardiac death at 1 month in patients with cardiovascular disease was 0.89%, 95% confidence interval 0.79-0. 98, P＜0. 000 5; stepwise logistic regression analysis indicated that brain natriuretic peptide (≥755pg/mL) was the only independent predictor of cardiac death at 1 month in patients with cardiovascular disease (OR= 17.6, 95 % confidence interval, 8.7- 66.5, P＜0. 000 5 ). Conclusion Brain natriuretic peptide might predict cardiac death at 1 month in patients with cardiovascular disease.

Objective To investigate the clinical features of renal tumor patients with yon Hip-pel-Lindau (VHL) disease. Methods Clinical data of 9 renal tumor cases with VHL disease were analyzed and reviewed. The renal tumor characteristics were compared with data of 46 sporadic renal cell cancer (SRCC) cases during the same period. Results In the 9 renal tumor cases with VHL dis-ease presented, significant statistical differences were found in the aspects of bilateralness (7 vs 0), ipsilateral multicentricity(5 vs 2)and cystic growth pattern(6 vs 1) compared with SRCC (P＜0.01). During the average follow-up period of 54 months, no significant difference was found in the median survival between VHL disease patients and SRCC patients(136 vs 42 months). However, a better tendency of VHL disease over SRCC was found in survival curve study. Conclusions VHL disease should be considered when renal tumors present bilateral, multicentric or with cystic growth pattern. Management should be individualized with close watchful waiting in combination with nephron sparing surgery. Nephrectomy should be avoided when possible.