ObjectiveTo observe the effects of different doses of Xuebijing on cerebral cortex apoptosis factors bcl-2 and bax in rats at early stage after cardiopulmonary resuscitation (CPR).Methods Thirty-two healthy SD rats aged 12 weeks were divided into four groups by using a random number table method (each,n = 8); all the rats were intubated through the opening of tracheotomy, and the blood pressure was measured through the left/right femoral artery catheter. Asphyxiation was applied to rats, resulting in cardiac arrest (CA), and then cardiopulmonary resuscitation (CPR) was carried out. After restoration of spontaneous circulation (ROSC), 0.9% normal saline 8 mL/kg, 0.9% normal saline 4 mL/kg + Xuebijing 4 mL/kg, 0.9% normal saline 2 mL/kg + Xuebijing 6 mL/kg and Xuebijing 8 mL/kg were given to model group, Xuebijing low dose group, middle dose group and high dose group respectively. The rat body weight, time of CA, CPR-ROSC time, ROSC ratio and the amounts of dopamine and 0.9% saline used in 24 hours were recorded. The positive protein expression levels of bcl-2 and bax in rat cerebral cortex and the ratio of bcl-2/bax was measured at 24 hours after ROSC.Results Compared with the model group, the amount of 0.9% normal saline (mL: 4.2±1.2, 2.6±1.0, 2.5±1.0 vs. 5.5±1.1,P < 0.05) and of dopamine used in 24 hours (μg: 1865±189, 1376±197, 1215±145 vs. 3526±141,P < 0.05), the levels of positive protein expression of bcl-2 (%: 33.4±4.3, 25.5±4.6, 26.1±4.2 vs. 38.5±5.1), and of bax at 24 hours after ROSC (%: 39.5±4.3, 32.8±3.8, 31.9±3.7 vs. 44.3±5.1) and the ratio of bcl-2/bax (0.87±0.16, 0.72±0.13, 0.71±0.14 vs. 0.89±0.11) was significantly decreased in low, middle and high dose groups (allP < 0.05). Compared with the low dose group, the amount of 0.9% normal saline and dopamine used in 24 hours, protein expression levels of bcl-2 and bax at 24 hours and the ratio of bcl-2/bax in middle dose and high dose groups were all lower than those in low dose group (allP < 0.05).Conclusion Xuebibing 6 mL/kg applied at early stage after CPR in rats may show relatively good protective effect on cerebral cortex.

Objective To observe the effect of total intravenous anesthesia (TIVA) on intrapulmonary shunt fraction and arterial oxygenation during one-lung ventilation (OLV) for thoracoscope surgery.Methods Forty patients scheduled for thoracoscope surgery were randomly assigned to two groups ( n =20),group of TIVA (A) and group of intravenous anesthesia combined with inhalational anesthesia(B).After inducing and intubating,patients were assigned to maintenance of anesthesia with propofol ( group A)or with sevoflurane ( group B) in order to maintain a BIS between 40 and 60.Mean arterial pressure (MAP),heart rate (HR),SpO2 and Paw were measured in four phases,always in the lateral position,10min after beginning two-lung ventilation (TLV),15 min after beginning OLV (OLV + 15 ),30 rain after beginning OLV ( OLV + 30) and 60 min after beginning OLV ( OLV + 60).Blood samples were drawn simultaneously and analyzed within 5 min.The Qs/Qt at each phase was calculated.Adverse events including hypotension,bradycardia,hypoxemia,delayed emergence and restlessness in recovery period were recorded.Results In all patients,a decrease in PaO2 and an increase in the Qs/Qt occurred during OLV were observed.But PaO2 values in group A were significantly higher than those in group B ( 177 ±88 vs 125 ±63;150 ±65 vs 110 ±67;188 ±69 vs 128 ±52) ( P ＜0.05).The Qs/Qt in group B was significantly higher than those in group A (34.2 ±5 vs 28.8 ±2;38.4 ±8 vs 32.1 ±6;37.1 ±2 vs 29.5 ±2,P ＜0.05).MAP values in group A were significantly lower than those in group B at the phase:OLV + 15 and OLV +30(72 ± 10 vs 88 ± 14;74 ± 12 vs 89 ± 10) ( P ＜ 0.05 ).The incidence of hypotension and delayed emergence in group A was higher than those in group B ( 10 case vs 4 case;9 case vs 2 case).The incidence of restlessness in recovery period in group B was more than those in group A (9 case vs 3 case).The differences between two groups were significant ( P ＜ 0.05).Conclusions Compared with sevoflurane-sufentanyl combined anesthesia,TIVA with propofol can efficiently decrease intrapulmonary shunt fraction and improve arterial oxygenation during OLV for thoracoscope surgery,which is good for the prevention of hypoxemia.

ObjectiveTo evaluate the effect of auscultation, partial pressure of carbon dioxide in end-expiration (PETCO2), transillumination technique to judge whether the endotracheal tube is misplaced into the esophagus. Methods A blinded randomized controlled trial was conducted. Sixty patients with American Society of Anesthesiology (ASA) gradeⅠ-Ⅱundergoing endotracheal intubation in Fengxian Central Hospital admitted from September 2014 to February 2015 were enrolled. Two endotracheal tubes with the same size were respectively inserted into the trachea and esophagus for the same depth after general anesthesia by the same person. Two blinded anesthetists with different experience checked the tube position using three methods including auscultation, PETCO2, and transillumination technique, respectively. The order of the tubes tested (trachea or esophagus) and the method used were randomized according to randomise numbers table. The experienced anesthetists conducted the test first, followed by an inexperienced anesthetist conducting the same methods. The numbers of right and wrong determinations with different methods by different anesthetists were recorded.Results Sixty patients underwent the procedures for 180 times, with intratracheal intubation for 90 times, and esophageal intubation for 90 times. It was shown that the results were not different in two groups [96.7% (174/180) vs. 92.2% (166/180),χ2 = 3.500,P = 0.057]. By using auscultation, the correct rate of experienced anesthetist was higher than that of inexperienced (95.0% vs. 78.3%,χ2 = 5.786,P = 0.013). Using PETCO2, both anesthetists were correct in all cases, and the accuracy was 100%. Using transillumination, the experienced anesthetist was mistaken in 3 cases (accuracy was 95.0%), while the inexperienced mistook in 1 case (accuracy was 98.3%), and no significant difference was found between two groups (χ2 = 0.500,P = 0.250). The correct rate of using transilluminaion was significantly higher than that of using auscultation (χ2 = 7.563,P = 0.004). The sensitivity and specificity of the auscultation was 70.0% and 80.0%, that of transillumination technique was 96.7% and 93.3%,and PETCO2 was 100%, respectively, for two groups.ConclusionsPETCO2 is the most reliable method for determining tube position, and it is superior to auscultation and transilluminaion. Transillumintaion technique is superior to auscultation, irrespective of anesthetists' experience, while the accuracy of auscultation showed an obvious relationship with the anesthetists' experience.

Objective To research the relationship between free/total prostate specific antigen (f/t PSA), PSA density(PSAD) and prostate cancer(PCa), to explore healthy middle and old-aged,the patients with BPH, the scope of reference value of PSA,frce PSA(fPSA), f/t PSA and PSAD in patients serum with PCa. Methods To de-tect 307 cases of healthy gerontism male,236 of BHP and 41 of PSA and fPSA in patients with PCa,to calcuLate f/t PSA and PSAD, to investigate the dependability between PSA ,I"PSA ,f/t PSA ,P SAD and healthy male, the patients ofBHP,the PCa ,to determine the scope of reference value PSA,fPSA,f/t PSA and PSAD fitting for Chinese. Results PSA and fPSA in patients with PCa are obviously higher than normal control(P <0.01). f/t PSA is obviously lower than the BPH and normal control(P < 0.01). When PSA is 9.25 and f/t PSA is 20%, there are better value of clini-cal diagnosis,when PSAD is 0.18 (AUC = 0.635), we can get best aceuration of diagnosis. Conclusions f/t PSA and PSAD are better than PSA in clinical diagnosis. When PSA is more than 9.25,f/t PSA is less than 20% or PSAD is more than 0.18 is significance for diagnosis. The normal reference value of PSA less than 9.25,f/t PSA more than 20%, PSAD less than 0.18 is fit for Chinese.

Objective To explore the connections between psychological intervention and pregnancy outcome of preg nant women with advanced maternal age. Methods All 196 primipara with advanced maternal age who received antenatal examination and gave birth to children in our hospital were randomly allocated to observation group(n=98)and control group(n=98). The control group received routine nursing while the observation group received psychological interven-tion. Mental conditions, pregnancy outcome and related complications were compared and analyzed between the two groups of pregnant women before and after the intervention. Results Scores of SCL-90 and Athens insomnia scale in the observation group after the intervention were significantly lower than those in the control group (P<0.01);all new-borns delivered by primipara with advanced ma ter nal age were alive; rate of natural childbirth in observation group(70.41%)was significantly higher than that in the control group (27.55%),and the difference was statistically signifi-cant (χ2=21.562,P<0.01). Rate of cesarean section in the control group (68.37%) was significantly higher than that in the observation group (27.55%), and the difference was statistically significant (χ2=15.208, P<0.01). Incidence of complications such as hypertension, premature birth, postpartum hemorrhage and full-term infants with low birth weight in the observation group were all lower than those in the control group,and the differences were statistically sig-nificant(P<0.05). Conclusion Psychological intervention is capable of effectively improving the mental status of preg-nant women with advanced maternal age,and therefore ameliorates the pregnancy outcome.