Objective To determine the incidence of pre- and postoperative myocardial ischemia (MI) in patients undergoing noncardiac surgery and to identify the predictors of perioperative MI. Methods One hundred and fifty patients (99 male, 51 female) aged 42-89 yr, weighing 35-87 kg undergoing elective noncardiac surgery were enrolled in this study. Patients with left or right bundle branch block, left ventricular hypertrophy, low voltage on ECG using limb leads, being treated with digoxin or on artificial pacemaker were excluded from the study. The patients were premedicated with intramuscular atropine 0.5 mg and phenobarbital sodium 0.1 g, and were monitored continuously with dynamic ECG (DMS Holler 5.0 USA) for at least 12 h before surgery and 48 h after surgery. The incidence of MI, the number of ischemic episodes, the duration of MI and the area under the ST curve per hour were computed pre- and postoperatively. Factors that could affect MI including age, sex, weight, ASA class, history of cardiac disease, cardiac risk factors, cardiac medication, anesthesia, surgery, laboratory and other physiological data were also recorded. The potential predictors of perioperative MI were identified by univariate model and were then entered into multivariate logistic models. Results The incidence of preoperative MI was 4.7% and postoperative MI was 22.7 % . The incidence of MI and number of ischemia episodes achieved peak levels at 12-24 h after operation, while the duration of MI and the area under the ST curve peaked at 0-12 h after operation. Predictors of postoperative MI were : preoperative MI identified by ECG, age ≥ 65 yr, ASA class ≥ Ⅲ , history of angina, or hypertension or diabetes and high VAS score. Conclusion Postoperative MI usually develops on the first day after surgery. The patients at high risk for developing postoperative MI can be identified by predictors.

It is confirmed that the adult cells can be re-programmed to embryonic stem cells(ESCs) by presenting some certain factors in oocytes in the clone process of animals. In recent years, some transcription factors that can induce pluripotent stem cells(iPS) have been identified and which made it possible to obtain induced pluripotent stem cells similar to embryonic stem cells. iPS provides a unique platform to study the pluripotent mechanism and to establish some specific disease models. This major scientific discovery can not only avoid the use of ES which involves ethics debate, but also lead the stem cell research to a new field.

Objective To investigate the effects of kidney transplantation in sensitized recipients receiving conventional human leukocyte antigen(HLA) and cross-reactive groups(CREG) matching.Methods The HLA and CREG matching were used to select the best donors for 82 recipients with high titer of panel reactive antibody(PRA),and adjunctive application of plasma exchange and intravenous immunoglublin were conducted.Results The successful rate was 90%(74/82) and mortality rate was 1%(1/82).The incidence of hyperacute rejection,accelerated acute rejection,acute rejection and delayed graft function was 4%(3/82),6%(5/82),28%(23/82) and 21%(17/82),respectively.The incidences of acute rejection in groups of broad sensitized,HLA class Ⅰantibody positive recipients,HLA antibody positive recipients of post-transplantation and donor specific antibody were higher than those in groups of mild sensitized,HLA classⅡantibody positive recipients,HLA antibody positive recipients of pre-transplantation non-donor and specific antibody respectively(all P

In recent years,with the continuous development of medical technology and progress,knowledge regaming respiratory disease become deepening,especially in lower respiratory tract infection bacterial resistance,application of macrocyclic ester antibiotics,severe and refractory mycoplasma pneumonia,refractory asthma,interstitial lung diseases,pediatric interventional bronchoscopy,and stem cell therapy which all have made great progress.In this review,the related hotspot,difficulty and research progress are summarized.

Objective Analyze the relationship between high sensitivity C‐reactive protein (hs‐CRP) ,homocysteine (Hcy) ,D‐di‐mer (D‐D) levels and atherosclerosis (AS) .Methods A total of 92 patients with AS were analyzed retrospectively ,including acute coronary syndrome (ACS) group with 61 cases ,stable angina pectoris (SAP) group with 31 cases .According to the result of coro‐nary artery plaque CT detection was further divided into plaque group ,non plaque group ,stable plaque subgroup ,and unstable plaque subgroup .Meanwhile 42 healthy subjects were selected as control group .The levels of the three indicators were compared . Results The serum hs‐CRP ,Hcy and plasma D‐D concentration in the ACS group and SAP group were significant higher than those of the control group (P< 0 .05) ,and those of the ACS group were significant higher than those of the SAP group(P< 0 .05) . The serum hs‐CRP ,Hcy and plasma D‐D concentration in the plaque group were significant higher than those of the non plaque group ,those in the unstable plaque subgroup were significant higher than those of the stable plaque subgroup(P< 0 .05) .The serum hs‐CRP ,Hcy and plasma D‐D concentration of the ACS patients were all correlated positively .Conclusion Serum hs‐CRP ,Hcy and plasma D‐D levels are closely related to the development of AS ,the combined detection of three indexes is value for the prevention , treatment and prognosis of AS .

Objective To investigate the activity of autonomic nervous system (ANS) in elderly patients with diabetes mellitus ( DM) after non-cardiac surgery. Mehtods Thirty ASA Ⅰ-Ⅲ patients aged ≥ 60 yrs undergoing elective abdominal surgery or operation on the lower limbs were assigned to one of 2 groups ( n =15 each) : DM group and non-DM group. The patients were monitored with Holter (DMS Co, U.S. A) the day before and on the 1st and 2nd day after operation. Heart-rate variability (HRV) including total power (TP), high frequency (HF), low frequency (LF), very low frequency (VLF) and LF/HF ratio were recorded. Results TP and HF were significantly lower in DM group than in non-DM group before operation ( P

The lumber ligaments play an important role in spinal bsomechanics. The results of three-dimensional finite element analysis showed that one of functions of lumbar ligaments is transmission of the tensile load between the lumbar vertebrae. The anterior longitudinal ligament is loaded in extension of lumbar spine and the resistance to the tensile load in flexion is provided by other ligaments. These ligaments are subject to much more tension with degsneration of the intervertebral disc so that a series of pathological changes occur. Relevant significance in clinical aspect is also discussed.

Objective To evaluate the inhibition effects of shuanghuanglian injection powder and its active components on the activities of CYP1A,CYP 2D and CYP 3A in rats liver microsomes. Methods Three probe substrates including phenacetin for CYP1A,dextromethorphan for CYP2D and midazolam for CYP3A were incubated with shuanghuanglian injection powder and the active components (baicalin,phillyrin,forsythiaside A,lutin,chlorogenic acid,coffeic acid and lutiolin) in rat liver microsomes. Contents of three probe substrates were simultaneously determined by HPLC to evaluate the metabolic rates. Results Shuanghuanglian injection powder and baicalin inhibited the activities of CYP2D and CYP 3A, but didn 't affect CYP1A. The other active components showed no effect on CYP1A,CYP2D and CYP3A. Conclusion Drug-drug interactions may occur when combining shuanghuanglian powder injection with CYP2D and CYP 3A substrates and baicalin may be the effector substance responsible for the interactions.

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

Aged ; Ear Neoplasms ; pathology ; Ear, Middle ; pathology ; Female ; Humans ; Papilloma ; pathology