Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P＜0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P＜0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P＜0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P＜0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P＜0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.

Objective To evaluate the accuracy of BIS value for monitoring the depth of sevoflurane-nitrous oxide in children. Methods Seventy-two ASA Ⅰ or Ⅱ children aged 1-14 yr undergoing abdominal surgery were randomly assigned into 3 groups ( n = 24 each) :sevoflurane group (group S), sevoflurane + 30% N2O group (group SN1 )and sevoflurane + 60% N2O (group SN2 ). Anesthesia was induced with atropine, lidocaine, propofol, rocuronium and remifentanil. After tracheal intubation, the patients were mechanically ventilated. PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with 2.5% sevoflurane combined with 0, 30% and 60% nitrous oxide in group S, SN1 and SN2 respectively. The end-tidal sevoflurane concentration (CETSev) was maintained at 2.5%, 2.0% and 1.5%. Each CETSev was maintained for at least 10 min after the begining of the surgery. Then the CETSev was modified to maintain BIS value at 40-60. BIS value was recorded before anesthesia induction and each stable CETSev. CETSev was recorded at maintaining BIS value of 40-60 for at least 20 min ( C50 ).Results BIS value and C50 were significantly lower in group SN2 than in group S and SN1 ( P ＜ 0.05), while no significant difference was found between group S and SN1 ( P ＞ 0.05). BIS value was negatively correlated with CETSev in all 3 groups (r = -0.736, -0.817, -0.729, P ＜ 0.01).There was no significant difference in the correlation coefficients among the 3 groups ( P ＞ 0.05 ). Conclusion BIS value can accurately reflect the depth of sevoflurane-nitrous oxide anesthesia in children.

Objective To study the expression of forkhead box 2(FOXC2)and delta-like liGand 4 (DLL4)in invasive ductal carcinoma(IDC)of breast and the clinical siGnificance. Methods The expression of FOXC2 and DLL4 in l22 cases of IDC(Grade Ⅰ33,Grade Ⅱ40,GradeⅢ 49)were observed by tissue chip and immunohistochemistry. The relationship of the expression with clinicopatholoGical characteristics and between FOXC2 and DLL4 were statistically analyzed. PCR experiment was performed in normal breast tissue,ductal carcinoma in situ(DCIS)IDC Grade Ⅰ,Grade Ⅱ and Grade Ⅲ(l0 cases respectively). Results The positive rate of FOXC2 and DLL4 in IDC was 77. 87% and 74. 59% respectively. A hiGher expression was observed in GradeⅢ than in GradeⅠand Ⅱ( P<0. 05 ). The expression of FOXC2 was related to the neGative expression of ER. The expression of DLL4 was related to the tumour size,clinical staGe and lymph node metastasis( P<0. 05). The RCR of FOXC2 and DLL4 were Gradually increased in normal breast tissue,DCIS,IDC GradeⅠ, Grade Ⅱ and Grade Ⅲ(P<0. 05). Moreover the expression of FOXC2 was related to the expression of DLL4(r=0. 233,P=0. 0l0). Conclusion FOXC2 and DLL4 miGht toGether have influence on the proGression and outcome of breast carcinoma,and could be important markers of proGnosis. DLL4 miGht be reGulated by variety of factors includinG FOXC2 at the same time.

ObjectiveTo compare the efficacy of intravenous infusion of dexmedetomidine and midazolam for premedication in children.MethodsNinety-two ASA Ⅰ or Ⅱ children (46 cases aged 1-3 yr and 46 cases aged 4-6 yr) scheduled for elective general or urologic surgeries,were enrolled in this study.The children were randomly divided into 2 groups (n =46 each):midazolam group (group M) and dexmedetomidine group (group D).The children accompanied by their parents were admitted to the anesthesia preparation room at about 20 min before induction of anesthesia,and midazolam 0.1 mg/kg òr dexmedetomidine 1 μg/kg was infused intravenously over 10 min.Anesthesia was induced with proporol-rocuroniume-remifentanil,and maintained with sevoflurane-remifentanil-rocuroniume.Modified Yale Preoperative Anxiety Scale (mYPAS) score,sedation score,HR,mean arterial pressure (MAP),respiratory rate (RR) and SpO2 were recorded before premedication (T1),before separation from their parents (T2) and when entering the operating room (T3).The incidence of sleep (a sedation score of 4) was recorded at T2,3.The end-tidal concentration of sevoflurane,infusion rate of remifentanil,laryngeal air way removal time,emergence time,duration of stay at the recovery room,incidence of delirium during recovery period,the percentage of patients requiring rescue analgesic,and adverse effects were also retorded.ResultsCompared to that at T1,the mYPAS score was significantly decreased at T2,3,and the sedation score was significantly increased at T2,3 in both groups ( P ＜ 0.05),HR at T2 and MAP at T2,3 were significantly decreased in group D,and HR at T3 was significantly increased in group M ( P ＜ 0.05 ).Compared to group M,the sedation scores and the incidence of sleep were significantly increased at T2,3,and the HR was significantly decreased at T2 in group D ( P ＜ 0.05).There was no significant difference in the mYPAS score,RR,MAP,SpO2,end-tidal concentration of sevoflurane,infusion rate of remifentanil,laryngeal air way removal time,emergence time,duration of stay at the recovery room,incidence of delirium during recovery period,the percentage of patients requiting rescue analgesic,and incidence of adverse effects between D and M groups ( P ＞ 0.05).ConclusionThe sedative efficacy of iv dexmedetomidine is superior to that of iv midazolam when infused for premedication in children,but it exerts much influence on hemodynamics,and the changes in hemodynamics should be noted.

Objective To compare the efficacy of closed-loop infusion of propofol for surgery in pe-diatric patients of different ages. Methods Forty-five pediatric patients of both sexes, weighing 10-63 kg, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective urologic sur-gery under general anesthesia, were divided into 3 groups(n=15 each)according to the age: infant group (1-3 yr), pre-school group(4-6 yr)and school-age group(7-12 yr). The bispectral index(BIS)moni-tor was connected to the closed-loop anesthesia delivery system, and the system automatically regulated the target plasma concentration of propofol to achieve a target BIS value of 45-55 during maintenance of anes-thesia. Remifentanil was given by target-controlled infusion at a target plasma concentration and rocuronium was intravenously injected when necessary during surgery. BIS40-60time percentage(percentage of time of BIS value maintaining at 40-60 in time of closed-loop infusion), median performance error(MDPE), me-dian absolute performance error(MDAPE), wobble and global score were recorded. The consumption of propofol, mean target plasma concentration and regulating frequency and consumption of remifentanil and rocuronium were recorded during surgery. Extubation time or laryngeal mask airway removal time, time to eye-opening and time of regaining consciousness were recorded. Results The BIS40-60time percentage was significantly higher, MDPE, MDAPE, wobble and global score were lower in pre-school and school-age groups than in infant group(P<005). Compared with pre-school group, the consumption of remifentanil was significantly decreased(P<005), and no significant change was found in BIS40-60time percentage, MDPE, MDAPE, wobble or global score in school-age group(P>005). There was no significant differ-ence in the consumption of propofol, mean target plasma concentration, regulating frequency, consumption of rocuronium, extubation time or laryngeal mask airway removal time, time to eye-opening or time of regai-ning consciousness among the 3 groups(P>005). Conclusion Closed-loop infusion of propofol produces better stability for surgery in pre-school and school-age children than in infants.

Preeclampsia is a kind of idiopathic disease during pregnancy. Its pathogenesis may involve many factors, such as mother, placenta and fetus. The study found that the abnormal metabolism of blood glucose and blood lipid during pregnancy may be closely related to the onset of preeclampsia. This paper reviews the research progress of abnormal glycolipid metabolism in preeclampsia at home and abroad in order to better guide the management of related aspects during pregnancy.