Objective:To compare etomidate in propylene glycol(Eto-PG) with a new galenic preparation of etomidate solved in a lipid emulsion of soya-bean oil(Eto-Lip).Method:Sixty patients were randomly divided into 2 groups:Eto-PG group and Eto-Lip group.The dosage of etomidate was 0.3mg/kg.Hemodynamic change and side effects(pain on iv-injection,involuntary movement, phlebitis, thrombophlebitis etc.) were observed.Result:There were no difference between the two groups in the incidence of involuntary movement.Side effects at the site of injection,both immediate and after operation,were encountered with Eto-PG but were not encountered in the lipid emulsion. Conclusion:Eto-Lip can reduce some undesired side effects without changing its pharmacodynamics.

Objective To evaluate the effect of surgical trauma on the cognitive function and expression of hepcidin and ferroportin 1 (FP1) in hippocampus in aged rats.Methods One hundred male Sprague-Dawley rats,aged 18 months,weighing 400-500 g,were randomly divided into 2 groups with 50 rats in each group:control group (group C) and surgical trauma group (group ST).The rats were anesthetized with chloral hydrate,but underwent no operation in group C.The rats Were anesthetized with chloral hydrate and underwent 30 min of modified exploratory laparotomy in group ST.Ten rats were chosen from each group at 24 h after operation and the cognitive function was assessed using Morris water-maze test for 6 consecutive days.Ten rats were sacrificed on 1st,3rd,5th and 7th days after beginning of Morris water-maze test and brains were removed for determination of hepcidin and FP1 expression in hippocampus by PCR and Western blot.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant and frequency of crossing the original platform were decreased on 3rd,4th and 5th days after beginning of Morris water-maze test,and the expression of hepcidin was up-regulated and the expression of FP1 was down-regulated at each time point in group ST (P ＜ 0.05).Conclusion Surgical trauma can decrease the cognitive function in aged rats and the mechanism may be related to up-regulation of hepcidin expression and down-regulation of FP1 expression in hippocampus.

Objective To explore the neuroprotective mechanism of propofol by comparing the influence of propofol and isoflurane on inflammatory cytokines ( TNF-α、IL-1、ICAM-1 ) in patients with intracranial tumors. Methods One hundred and sixty-eight patients with intracranial neoplasm were randomly divided into two groups:the propofol ( Group P) and isoflurane (Group I),84 cases in each. Patients were given with propofol (3-6 μg·mL-1) by plasma target-controlled infusion or with continuously inhaled isoflurane ( 1%-2%) , respectively. The serum levels of TNF-α, IL-1 and ICAM-1 were detected before anesthesia and at 0,24,and 48 h after operation. Results The serum levels of TNF-α,IL-1 and ICAM-1 were significantly increased after operation as compared to baseline in both groups. The serum level of TNF-α was(69. 11±8. 95) and (76. 26±11.28) μg·mL-1,IL-1 was(21.57±3.19) and (29.58±4.38) ng·L-1,and ICAM-1 was (1.63±0.24)and (1.94±0.29) g·L-1 at 24 h post operation in Group P and Group I,respectively. These inflammatory cytokine levels were significantly higher in group I compared to group P at 24 and 48 h after operation (P<0. 05 or P<0. 01). Conclusion The target-controlled infusion of propofol brings about lower level of inflammatory reaction than isoflurane inhalation in patients with intracranial neoplasm,which may attribute to the mechanism of brain protection against injury.

Objective To explore the endovascular treatment of Budd-Chiari syndrome (BCS) in young child. Methods The clinical data of one young child diagnosed with BCS and treated with endovascular therapy were retrospectively analyzed. Results The 23-month-old female suffered from repeated abdominal distension for 3 months and was diagnosed with BCS by vascular ultrasound Doppler and magnetic resonance examination. After confirmation of the diagnosis, endovascular treatment was performed. Then the occluded blood vessels resumed blood stream, urine output increased, and abdominal distension was significant relieved. Conclusions In young children, BCS is rare, the condition is complex, and endovascular therapy is effective.

Background::The association and its population heterogeneities between low-density lipoprotein cholesterol (LDL-C) and all-cause and cardiovascular mortality remain unknown. We aimed to examine the dose-dependent associations of LDL-C levels with specific types of cardiovascular disease (CVD) mortality and heterogeneities in the associations among different population subgroups.Methods::A total of 2,968,462 participants aged 35-75 years from China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) (2014-2019) were included. Cox proportional hazard models and Fine-Gray subdistribution hazard models were used to estimate associations between LDL-C categories (<70.0, 70.0-99.9, 100.0-129.9 [reference group], 130.0-159.9, 160.0-189.9, and ≥190.0 mg/dL) and all-cause and cause-specific mortality.Results::During a median follow-up of 3.7 years, 57,391 and 23,241 deaths from all-cause and overall CVD were documented. We observed J-shaped associations between LDL-C and death from all-cause, overall CVD, coronary heart disease (CHD), and ischemic stroke, and an L-shaped association between LDL-C and hemorrhagic stroke (HS) mortality ( P for non-linearity <0.001). Compared with the reference group (100.0-129.9 mg/dL), very low LDL-C levels (<70.0 mg/dL) were significantly associated with increased risk of overall CVD (hazard ratio [HR]: 1.10, 95% confidence interval [CI]: 1.06-1.14) and HS mortality (HR: 1.37, 95% CI: 1.29-1.45). Very high LDL-C levels (≥190.0 mg/dL) were associated with increased risk of overall CVD (HR: 1.51, 95% CI: 1.40-1.62) and CHD mortality (HR: 2.08, 95% CI: 1.92-2.24). The stronger associations of very low LDL-C with risk of CVD mortality were observed in individuals with older age, low or normal body mass index, low or moderate 10-year atherosclerotic CVD risk, and those without diagnosed CVD or taking statins. Stronger associations between very high LDL-C levels and all-cause and CVD mortality were observed in younger people. Conclusions::People with very low LDL-C had a higher risk of all-cause, CVD, and HS mortality; those with very high LDL-C had a higher risk of all-cause, CVD, and CHD mortality. On the basis of our findings, comprehensive health assessment is needed to evaluate cardiovascular risk and implement appropriate lipid-lowering therapy for people with very low LDL-C.