Three methods of anesthetic induction were studied in 60 patients undergoing mitral replacement with cardiac function of class Ⅲ~IV. The patients divided into three groups based on methods of induction. The results showed that thiopen-tothal might further depress their impaired cardiovascular function in both group I and Ⅱ. The results also showed that MAP, HR, and CVP were more stable in group Ⅲ than In group I and Ⅱ . It is suggested that induction of anesthesin using diazepam 0.2mg/kg, r-OH 50mg/kg,fentanyl 8-10ug/kg and pancuronium 0.1-0.2 mg/kg, or atracurium 0.5mg/kg is quite safe especially in patients with poor cardiac reserve. However, r-OH should be avoided in patients with bradycardia, When derease in. HR occurs following the use of r-OH, atropinc should be given intravenously

Effects of verapamil-potassium cardioplegic solution (CPS) OB myocardial protection were studied durig the ischemic period of aortic cross-ciatnping in patients undergoing valve replacement. 165 patients were divided into two groups.Croupl (n = 84) with cold potassium CPS, in which, Img/L of verapamil was added.Group 2 (n = 81) as control, with cold potassium CPS alone. As compared to the control group the results showed that (1) hearts were rapidly arrested in diastolic phase, electrocardiac activity was depre ssed more completeli; ( 2 ) before cardiac arret or following reperfusion the incidence of ventricular fibrillation were obviously less than control group,recovery of cardiac function after bypass was better ,and incidence of serious low-output syndromewas lower; (3) electron microscopic examination demonstrated myocardial ultrastructural changes, particularly mitochondrial damages were less and milder. It is concluded that verapamil intensifies the myocardial protective effect of cold CPS

Fcntanyl-atracurium-isoflurane (FAI) balanced anesthesia was used in open-heart surgery, and was compared with the results of fentanyl-pancuronium-isoflurane (FPI) balanced anesthesia. The does of fentanyl 20-30 g/kg, atracurium 0.3 mg/kg or pa-ncuronium 0.2 mg/kg was used for muscle relaxation, and intermittently isoflurane was inhaled. The results showed that(1 )greater increase in heart rates and blood pressure was observed during endotracheal intubation in FPI group than in group FAI, (2)atracurium had minimal hcmodynamic responses during the whole course, and po-stoperalive recovery of respiration was more rapid and satisfactory. It is concluded that fentanyl-atracurium-isoflurane balanced anesthesia is a preferable anesthetic technique in cardiac surgery

Objective To evaluate the clinical value of cardiac troponin I(cTnI) in the diagnosis of myocardial ischemic injury.Methods Twenty patients were randomly divided into two groups: group I (cold crystalloid cardioplegia, n=10) and group Ⅱ (cold blood cardioplegia, n=10). The central venous blood samples were taken at various times during perioperation to measure the serum levels of cTnI,CK MB and CK . Myocardial samples were obtained 10 min before aorta clamping and 30 min after aotra unclamping, to observe myocardial ultrastructure .Results cTnI,CK and CK MB levels were normal before operation, increased markablely following aotra unclamping ,reached the peak 1 h after aorta unclamping to 24 h after operation, and decreased progressively to be normal in two groups. The serum cTnI level was significantly lower in group Ⅱ than that in group Ⅰ 24 h and 48 h after operation. The serum CK MB activity was lower in group Ⅱ than that in group Ⅰ 1 h after aorta unclamping. There was positive significant correlation between aorta cross clamping time and cTnI peak level.Conclusions cTnI can be used to evaluate the degree of myocardial injury and myocardial protective effect in open heart surgery during CPB. As indicators for reflecting the myocardial injury, the sensitivity and specificity of cTnI are more valuable than those of myocardial enzymes.

Objective:To determine the influence of cardiopulmonary bypass(CPB) on human pancreatic bate cell function. Method:Twenty patients were divided into 2 group, groupⅠ(congenital heart disease,n=10). group Ⅱ(valvular heart disease,n=10). Blood samples were obtained from 20 patients at the following intervals:before anesthesia, before CPB, 15 min following CPB, 5 min after relaxing aorta, 20 min after CPB. The plasma insulin and C-peptide levels were measured with radioimmunoassay double-antibody technique,and blood glucose level with GOD-POD method. Result:The significant increases of blood glucose and insulin levels were observed during and after CPB in both groups(P

Objective: To observe the balance of modified coagulation and fibrinolysis in patients undergoing open heart surgery with cardiopulmonary bypass (CBP). Method: The balance of modified coagulation-fibrinolysis in 20 cases were measured by coagulation-fibrinolysis dynamicography instrument (FD-Ⅲ) at the pre-CPB, post-CPB, 24, 48 and 168 hours postoperatively. Result: At the post-CPB, coagulation starting time(CST), maximum coagulation time (MCT), whole time of fibrinolysis reaction (WFT) and balance time (BLT) were significantly more than at pre-CPB (P

Objective To evaluate the risk factors related to the failure of internal fixation for intertrochanteric fracture in Chinese patients.Methods A comprehensive Meta analysis of the clinical research from January 2005 to August 2016 on the failure of internal fixation for intertrochanteric fracture in Chinese patients was conducted after Pubmed,CNKI,Wanfang Data,et al.,had been searched.Revman5.0 was used to perform the heterogeneity test and calculate the OR value and 95％ CI after quality assessment and retrieval of the qualified data.Results Included for this analysis were 23 studies involving 4,031 patients of whom 588 failed.The factors related to the failure of internal fixation for intertrochanteric fracture included patient age [OR =0.51,95％ CI (0.30,0.90),P ＜ 0.05],osteoporosis [OR =1.91,95％ CI (1.05,3.47),P ＜0.05],fracture pattern[OR=0.23,95％ CI (0.18,0.30),P ＜0.05],quality of fracture reduction [OR =0.25,95％ CI (0.17,0.35),P ＜0.05],tip-apex distance (TAD) [OR =0.13,95％ CI (0.05,0.32),P ＜0.05],time for full weight bearing [OR=5.32,95％ CI (1.71,16.57),P ＜ 0.05],and associated internal diseases [OR =3.76,95％ CI (1.19,11.91),P ＜0.05].The relationship was not determined between the failure of internal fixation for intertrochanteric fracture and the following factors:gender [OR=0.78,95％ CI (0.54,1.11),P ＞ 0.05],injury cause [OR=1.68,95％ CI (0.66,4.25),P＞ 0.05] or type of internal fixation [OR=0.37,95％CI (0.06,2.14),P＞0.05].Conclusions High age,concomitant osteoporosis,complicated fracture pattern,unsatisfactory fracture reduction,TAD ≥ 25 mm,time for full weight bearing ＜ 6 weeks,and concomitant internal diseases may be the risk factors closely related to the failure of internal fixation for intertrochanteric fracture in Chinese patients.There has been no sufficient evidence to show that gender,injury cause or type of internal fixation may be associated with the failed internal fixation for intertrochanteric fracture.