[Objective]To assess whether calcitonin exerts an chondroprotective action in unstable knees which induce experimental osteoarthritis.[Method]Twenty 6-month New Zealand rabbits were divided into two groups randomly.All rabbits underwent anterior cruciate ligament transection(ACLT) on the right knee.Rabbits of experimental group began to receive a daffy subcutaneous injection of salmon calcitonin at a dose of 5 IU per kg of body weight on day 7 postsurgery;in contrast,control group received normal saline(NS) at the same dose.All rabbits were killed on day 42 postsurgery.The knee joints were examined grossly and histologically and scored;the medial condyle sections were stained with Safranin O and immunohistochemistry of collagen II.We applied a computer graphic technology to assess the glycosaminoglycans(GAG) and collagen II of articular cartilage.[Result](1) In control group,compared uninjured knee joints with operative knee joints,the appearance of operative knee joints accorded with OA and histologic score of operative knee joints were higher than that of uninjured knee joints,P

Objective To compare the cerebral oxygenation in the patients undergoing gynecological laparoscopic surgery under sevoflurane-versus propofol-based anesthesia.Methods Fifty adult patients,aged 18-56 yr,weighing 55-72 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with hemoglobin≥ 110 g/L,undergoing elective gynecological laparoscopic surgery under general anesthesia,were equally and randomly divided into sevoflurane group (group S) and propofol group (group P) using a random number table.Anesthesia was induced with iv midazolam 0.04 mg/kg,sufentanil 1.5-2.0 μg/kg,rocuronium 0.9 mg/kg,and propofol 1.5-2.0 mg/kg.Anesthesia was maintained with inhalation of sevoflurane (2.0％-2.6％) in group S,or with target-controlled infusion of propofol (plasma concentration 2.5-4.0 μg/ml) in group P.The concentrations of sevoflurane and propofol were adjusted to maintain bispectral index value at 40-50.In both groups,remifentanil was given by targetcontrolled infusion (target plasma concentration 2 ng/ml),and vecuronium 0.06-0.08 mg/kg was injected intermittently to maintain muscle relaxation.The regional cerebral oxygen saturation (rSO2) was recorded after induction and at 10 min before pneumoperitoneum (T1),at 10 min of pneumoperitoneum in the Trendelenburg position (T2),and at 10 min after the end of pneumoperitoneum (T3).The occurrence of cerebral oxygen desaturation was recorded during surgery.Results The rSO2 was significantly higher at T2,3 in group S than in group P (P＜0.05).Compared with the value at T1,no significant change was found in rSO2 at T2,3 in group S (P＞0.05),and the rSO2 was significantly decreased at T2,3 in group P (P＜0.05).The incidence of cerebral oxygen desaturation was 12％ in group P,and cerebral oxygen desaturation was not detected in group S.Conclusion Sevoflurane-based anesthesia produces no effect on rSO2,however,propofol-based anesthesia can decrease rSO2 in the patients undergoing gynecological laparoscopic surgery,and sevoflurane-based anesthesia is more suitable for gynecological laparoscopic surgery.

Objective To evaluate the effectiveness of combination technique in treating descending thoracic aortic dissection with coronary heart disease by endovascular graft exclusion (EVGE) and percutaneous coronary intervention(PCI). Methods From April, 2002 to October, 2013, a total of 40 in-hospital patients with descending thoracic aortic dissection and coronary heart disease who underwent EVGE and PCI were analyzed for outcomes. All patients were performed EVGE before they underwent PCI in 3~7days of time. Long-term treatment were observed. Results For dissection tears, 40 trunk tectorial membrane stents were used. The rate of success of EVGE implantation was 100%. No paraplegia, death and other complications. 59 stents were placed to 54 target vessels of 40 patients. The success rate of PCI procedure was 100%and no severe complication occurred. All patients were followed up for average 56±31 months. The rate of followed up was 92.5%(37/40). During follow-up, 3 patients died including two patients died of cerebral hemorrhage and one case of malignant tumor. The major adverse cardiac events (MACE) rate was 6.9% in the 29 cases of patients who underwent EVGE and PCI during the clinical follow-up. Conclusions It is safe and feasible that treating descending thoracic aortic dissection with coronary heart disease by combination technique of EVGE and PCI.

OBJECTIVE:To investigate the effects of different doses of tanshinone ⅡAon hemodynamics in patients underwent non-extracorporeal circulation coronary artery bypass grafting(NECCABG). METHODS:A total of 66 patients underwent selective NECCABG during Nov. 2016-Apr. 2017 were selected and divided into control group(33 cases)and observation group(33 cases) according to random number tablet. Both groups were given Tanshinone ⅡAsodium sulfonate injection with loading dose of 0.4 μg/kg for 10 min at the beginning of surgery. Control group was given Tanshinone ⅡAsodium sulfonate injection 0.2 μg/(kg·h) continuously till the end of surgery;observation group was given 0.4 μg/(kg·h)continuously till the end of surgery. HR,MAP, central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),pulmonary capillary wedge pressure(PCWP),cardiac index(CI),systemic vascular resistance index(SVRI),pulmonary circulation resistance index(PVRI)and the occurrence of ADR were observed in 2 groups before anesthesia induction(T0),5 min after tracheal intubation(T1),at the moment of sternum cut(T2),at the end of anastomosis of anterior descending branch(T3),at the end of anastomosis of right coronary artery(T4),at the end of operation(T5). RESULTS:At T0,there was no statistical significance in HR,MAP,CVP,MPAP,PCWP, CI,SVRI or PVRI between 2 groups(P>0.05). At T1-T5, HR,MAP,CVP,MPAP,PCWP,SVRI and PVRI of control group were significantly higher than at T0,with statistical significance(P<0.05). There was no statistical significance in CI of control group among at T1-T5and with at T0;there was no statistical significance in HR,MAP,CVP,MPAP,PCWP,SVRI or PVRI of observation group between at T1-T5with at T0 (P>0.05). At T1-T5,CI of observation group was significantly higher than at T0and than control group;HR,MAP,CVP, MPAP,PCWP,SVRI and PVRI were significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during medication. CONCLUSIONS:Tanshinone ⅡA0.4 μg/(kg·h)is helpful to keep hemodynamics stable and improve heart function in patients with NECCABG with good safety.

BACKGROUNDThe occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).

METHODSThe AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.

RESULTSThe AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92 1.16 (n = 992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow = 1.1%, AGEFmid = 2.3% and AGEFhigh = 5.8%, P < 0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio = 4.96, 95% CI: 2.32-10.58, P < 0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P < 0.001).

CONCLUSIONThe AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).

Acute Kidney Injury ; physiopathology ; Contrast Media ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Renal Insufficiency, Chronic ; physiopathology