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.

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

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.

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.

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 discuss the feasibility and clinical significance of detecting circulating tumor cells(CTCs) in peripheral blood of patients with lung cancer in early stage. Methods Three groups of patients (Group A: 15 cases with early stage lung cancer; Group B: 20 cases with benign pulmonary disease; Group C: 20 healthy volunteers) were enrolled for detection of CTCs using immunomagnetic separation(IMS)+ immunocytochemistry(ICC) method and RT-PCR method. The patients in Group A were followed up for 6-9 months. Results By using IMS+ICC it was revealed that in 5 cases of Group A the result was positive, while it was negative in all cases of Group B and Group C. By using RT-PCR method, the result was positive in 7 cases of Group A, 8 cases of Group B and 6 cases of Group C. In the follow-up period, 2 patients of Group A, who were found positive for CTC before and after operation, showed recurrence. Conclusion IMS + ICC method was a sensitive method to detect CTCs in patients with early stage NSCLC. The detection of CTCs in patients with early stage lung cancer might be a relationship with the clinical prognosis of the patient.

Objective To discuss the efficacy and safety of sodium tanshinone ⅡA combined with edaravone in treatment of acute cerebral infarction.Methods 100 cases of acute cerebral infarction were randomly divided into two groups.The control group (50 cases) was treated with edaravone.The observation group (50 cases) was treated with sodium tanshinone ⅡA combined with edaravone.The efficacy of sodium tanshinone ⅡA combined with edaravone in treatment of acute cerebral infarction was evaluated by the efficacy at 1 month after treatment,ESS scores,SF-36 scores before and after treatment and adverse reaction during treatment.Results After treatment,the effective rate of observation group was 90.0％ and control group was 72.0％.The effective rate of observation group was higher than that of the control group (P ＜ 0.05).Compared with the value before treatment,the ESS scores of two groups were increased after treatment (P ＜ 0.05).3 d,7 d,14 d after treatment,the ESS scores of observation group was higher than that of the control group (P ＜ 0.05).Before treatment,there were no statistical significance on SF-36 between two groups.After treatment,the SF-36 scores were increased in two groups (P ＜ 0.05).During treatment,there were no statistical significance on adverse reaction between two groups.Conclusion Sodium tanshinone ⅡA combined with edaravone had a good therapeutic effect on acute cerebral infarction.It could improve the quality of life and neurological function with high safety.It was worthy of clinical application.

Theinnate immunity system of human body has more and more attention for its antibacterial, antiviral, maintainingimmunehemostasis and promoting tissue damage and repair and other physiological functions.As members of NOD-like receptors(NLRs), NOD1 and NOD2 receptors are identified as intracellular pattern recognition receptors(PRRs), can be identified with molecular damage endogenous(damage-associated molecular patterns, DAMPs)and exogenous injury-molecular pathogen associated molecular(pathogen-associated molecular patterns, PAMPs), and initiation of innate and specific immune response, maintain the steady balance of body.Recently, a bunch of evidence have demonstrated that the importance of NOD1 receptor and NOD2 receptor is not limited in field of anti-infection, and the insulin resistance, kidney and liver damage recovery, cardiovascular disease and tumorigenesis are also closely related with these two receptors.So the aim of this article is to interpret the NOD1 and NOD2 general structure and function, and summarize the link between these two PRRs and tumorigenesis and finally make a clue for cancer immunotherapy.