Objective To investigate the effect of desflurane anesthesia on the autonomic nervous system in patients at high risk for coronary artery disease.Methods Thirty patients at high risk for coronary artery disease scheduled for elective abdominal operation were selected. Heart rate variability (HRV) was assessed at preoperation, inhalation of 05,10,15 and 20 MAC of desflurane with Holter electrocardiography Results Low-frequency component increased markedly inhaling low concentration of desflurane. With the increase of the concentration of desflurane, both the high-frequency and low-frequency components decreased significantly (P0 05).Conclusions Desflurane balanced anesthesia dose not increase the activity of sympathetic nervous system.

This paper demonstrated the importance of Homocysteine detection. It was proved that Hyperhomocysteinemia has the evident relationship to the Cardiovascular and cerebrovascular diseases and homocysteine is a new independent factor of danger and prediction, and more attentions should be given on homocysteine in clinic. As regard to the situation that Homocysteine detection has not been popularly used in China, the authors give some advice in homocysteine detection, such as: population choosing, normal range defining, quality insurance and so on.

As the change of concept of health,the aim of medicine is not only to prolong life and improve the function of organs,but also to help patients to integrate to social life.Previous studies always pay much attention to clinical outcomes ineluding mortality,morbidity,long-term or short-term survival,but patients with liver cancer usually have long disease history and with background diseases such as liver cirrhosis.Traditional liver transplantation and liver resection ale both effective modalities for liver cancer,but liver resection has disadvantages of hish recurrence rate and repeated hepatic artery interventional therapy,and liver transplantation is high-cost.So the health economics and life quality of patients should not be ignored when comparing liver transplantation and liver resection.

AIM: To compare the therapeutic effects, adverse reactions and the costs between recombinant human growth hormone(rhGH) and human serum albumin(HSA) in treatment of liver cirrhosis patients with hypoproteinemia METHODS: Using pharmacoeconomic cost-effectiveness analysis , rhGH was compared with HSA in treatment of 66 liver cirrhosis patients with hypoproteinemia(divided into two groups). RESULTS:After 4 weeks treatment, the effective rates of rhGH and HSA we- re 69.70% and 84.85%, the cost-effectiveness ratios were 27.36, 38.89, respectively. After 8 weeks treatment, the effective rates of rhGH and HSA were 78.79% and 54. 57% ,the cost-effectiveness ratios were 2420, 60.47, respectively. CONCLUSI- ON: rhGH can effectively treat liver cirrhosis with hypoproteinemia and can obviously increase serum albumin level. From a Long-term point of view, its cost effectiveness ratio is superior to that of HSA.

0 05),the cost-effectiveness ratios were 762 49 and 111 85 respectively(P

ve To evaluate the effects of desflurane and sevoflurane on postoperative cognitive function in the elderly to see if there is any difference. Methods Seventy ASA Ⅰ-Ⅱ patients agedl≥65yr undergoing total knee or hip replacement were randomly assigned to one of the two anesthetic groups of thirty-five patients each:desflurane group and sevoflurane group. All patients were premedicated with midazolam 1 mg iv. Anesthesia was induced with fentanyl 1.0-1.5?g?kg-1, propofol 1.0-2.0 mg?kg-1 and succinylcholine 1 mg?kg-1 and maintained with either 2%-4% desflurane or 1.0%-1.5% sevoflurane combined with N2 O in O2 (1:1) and intermittent iv boluses of vecuronium. MAP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of desflurane or sevoflurane were monitored continuously during operation. After tracheal intubation the patients were mechanically ventilated and PETCO2 was maintained at 30-40 mm Hg. The Mini-Mental State (MMS) test was used to assess cognitive function before and at 1, 3, 6 and 24h after surgery. Results Compared with the baseline values the MMS scores decreased significantly at 1h after operation in both groups. However the MMS scores returned to preoperative baseline levels within 6h after surgery in both groups. There were no significant differences in MMS scores between the two groups before and after operation. At 1h after operation 51% of the patients in desflurane and 57% in sevoflurane group experienced cognitive impairment. But at 3h after surgery the percentage of the patients with cognitive dysfunction decreased to 11% in desflurane group and 9% in sevoflurane group. Conclusions In the elderly the postoperative cognitive dysfunction is temporary lasting only a few hours and the effects of desflurane and sevoflurane are similar.

Objective To study the expression of the fibronectin (FN) and ? 1 integrin (? 1) in epiretinal membranes(ERM) of eyes with proliferative vitreoretinopathy(PVR). Methods Twenty epiretinal membranes were obtained from eyes undergone vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical methods. Results Overexpression of FN and ? 1 were observed in 18 and 16 membranes respectively. Conclusion The synergism of FN and ? 1 in their action mignt be one of the important roles in the development of PVR.

Objective To investigate diagnostic methods and treatment of subcutaneous fat necrosis in neonate (ScFN). Methods The clinical data of a case with ScFN was reported and the etiology, pathogenesis, and differential diagnosis were reviewed. Results The case was a 2 days female newborn delivered via cesarean section at full-term, and she came to hospital because of indurated nodules and plaques in the back and shoulders. Anti-infection treatment after admission was not effective. On the 10th day in hospital, the back lesions appear as soft and lfuctuant and then diagnosed as ScFN by biopsy which showed a small amount of inflammatory cell infiltration and fatty degeneration. The patient was followed up with good prognosis. Conclusions ScFN is a benign self-limiting fat disease, mostly occurred in the first four weeks of full-term newborns with history of abnormal childbirth.

Objective To investigate the mechanism of 5′adenosine monophosphate-activated pro-tein kinase ( AMPK) in the regulation of LPS-induced secretion of inflammatory cytokines in mouse alveolar macrophages.Methods Alveolar macrophages were isolated from wild type and AMPKα1-/-C57BL/6J mice.ELISA was used to measure the concentrations of IL-1βand TNF-αin the culture supernatants of LPS treated alveolar macrophages with or without 5-amino-1-β-D-ribofuranosyl-imidazole-4-carboxamide ( AICAR ) stimulation.Western blot assay was performed to analyze the expression of AMPKα1 and AMPKα2 in alveolar macrophages isolated from wild type and AMPKα1-/-mice as well as the LPS-induced changes of p-AMPKαactivity in wild type mice.Results The LPS-induced secretion of inflammatory cyto-kines in alveolar macrophages isolated from AMPKα1-/-mice were significantly higher than that of wild type mice.The activities of p-AMPKαin wild type mice were suppressed by LPS treatment.Treatment of AICAR inhibited the LPS-induced secretion of TNF-αand IL-1β.Conclusion The LPS-induced secretion of in-flammatory cytokines was enhanced in AMPKα1-deficient mice, but could be suppressed upon the treatment of AICAR, an agonist of AMPK.AMPK was involved in the regulation of LPS-induced secretion of inflamma-tory cytokines by alveolar macrophages in mice.

ObjectiveTo evaluate magnifying endoscopy combined with flexible spectral imaging color enhancement(FICE)for diagnosis of early gastric cancer.MethodsThe suspicious small depressive lesions(SDL) was further studied with magnifying endoscopy or magnifying endoscopy combined with FICE from April 2009 to March 2011 in our hospital.The endoscopic diagnostic criteria of early gastric cancer was made according to the structure of the pit,the microvascular and the demarcation line.ResultsIn 74 SDL,17 were pathologically diagnosed as cancer,and 56 were noncancer.The sensitivity,specificity and accuracy of magnifying endoscopy were 41.18％,94.74％and 82.43％,respectively,which were 86.67％,96.49％ and 91.89％,respectively for magnifying endoscopy combined with FICE.The diagnostic sensitivity of magnifying endoscopy combined with FICE was significantly higher than that of magnifying endoscopy (P ＜0.05 ).ConclusionMagnifying endoscopy combined with FICE can reveal the structure of the pit,microvascular and demarcation line more clearly.The endoscopic diagnostic criteria is a more comprehensive description of the mucosal micro-morphological features of early gastric cancer.