Objective To evaluate the effect of esmolol on refractory veatricular fibrillation just after aortic declamp during cardiopulmonary bypass.Methods 40 patients undergoing valve replacement occurring refractory ventricular fibrillation after release of aortic cross-clamp was randomly given esmolol (prepared to 10 mg/ml) 1 mg/kg(group esmolol,n =20),or Lidocaine (prepared to 10 mg/ml) 1 mg/kg(group control,n=20),the endocardial electric defibrillation was continued after 2min.If the fibrillation still can not be reversed after another two times defribrillation,the routine clinical method would beused.The time of aortic cross-clamp,rectal temperature,MAP,and the value of serum Lactic acid,potassium,and PH were recorded.After intervention,the times of defibrillation,heart rate and rhythm 5 min after reversal were recorded.At the end of CPB,the CPB time and the dosage of positive inotropic drugs were also recorded.Results The success rate of defibrillation was higer in group esmolol than control group(P ＜0.05).Heart rate after reversal in group esmolol were slower than that in control group(P ＜ 0.05).The CPB time of control group was longer than group esmolol (P ＜ 0.05),and the dosage of positiveinotropic drugs was significantly higher in control group(P ＜ 0.01).Conclusion When occurring refractory ventricular fibrillation just after aortic declamp during CPB,Using esomolol by way of intravenous infusion can apparently reduce the frequency of defibrillation,and improve the rate of rewersal.It can also be favorable to cardiac function,and decrease the dependency of positive inotropic drugs,and shorten the time of CPB.

Objective To investigate the efficacy of one-stage posterior procedure including reduction, segmental instrumentation, foraminal enlargement and interbody compressive fusion in treating traumatic thoracolumbar fracture and dislocation. Methods 17 patients, which were 11 males and 6 females with a mean age of 37.1 years (range, 23-56 years) were recruited. The injury mechanism consisted of motor vehicle accident, falling from the height and horizontal compression crash. The preoperation neurological function were complete paraplegia in 4 cases, and incomplete paraplegia in 13 cases. Laminectomy and bilateral partial facetectomies were performed in injuried levels to free the nerve roots, followed by intervertebral foraminal enlargement and distraction through inserted pedicle screws. Intervertebral disc including upper and lower endplate were removed with rongeur, and morselized cancellous bone were fulfilled into cavity. Reduction and interbody compressive fusion were achieved through compression on the segmental pedicle screw system to make contact the posterior wall of adjacent vertebrae. Results No intraoperative and postoperative complications were observed. All patients except one underwent successful follow-up for an average of 25.6 months, ranging from 19 to 37 months. The neurological function of the patients were restored partially or complete during follow-up. The thoracolumbar spine were stable during physical examination, and all patients were satisfied with surgery. Radiographic evaluation showed close conjunction of adjacent posterior edges of vertebral body in 12 cases, and all cases demonstrated solid bony fusion without loss of reduction. No implant failure or neurological complication were found during follow-up. Conclusion Interbody compressive fusion by pedicle screws with foraminal enlargement procedure is a reliable and effective method in the management of thoracolumbar fracture and dislocation, which can achieve early stabilization and interbody bony fusion.

Objective To observe the efficacy and toxicity of low dose thalidomide combined with VAD regimen contained one-week dexamethasone in treatment on patients with multiple myeloma (MM). Methods 42 patients with MM were diagnosed in our hospital.The VAD regimen contained one-week dexamethasone was vincristine 0.4 mg/d, adramycin 10 mg/d and dexamethasone 40 mg/d for 4 days. At the same time, thalidomide is given 150-200 mg/d. Results The overall response rate (ORR) is 80.95%. Before and after treatment, all the detection indicators in MM patients were statistically different (P＜0.001). There is small adverse reactions. Conclusion Low dose thalidomide combined with VAD regimen contained one-week dexamethasone in treatment of MM has more merits such as less side effects, good tolerance, convenient administration and significant curative effects, so it should be recommended in clinical works.

Objective To evaluate the effect and safety of the intermittent deferoxamine therapy on relieving iron overload caused by transfusion in senile. Method Twenty-three senile with iron overload caused by transfusion were administered in a total daily dose of 20 - 50 mg/ ( kg·d ) for 5 - 6 days per week every 4 -6 weeks,the maximal dose was 2000 mg/d, add in 0.9％ sodium chloride 500 ml, continuous intravenous drip for 6 h. Result Nine months after therapy, serum ferritin fell from (2771.5±735.3)μg/L to (2483.7 ±724.4) μg/L (P＜0.01), and urine ferritin elevated from (9.68 ±5.39)μg/L to (12.14±5.50) μ g/L (P＜0.01 ). Conclusion It shows that intermittent deferoxamine therapy can reduce the serum ferritin with no significant toxicity.

Objective To identify the risk factors associated with intraoperative acute cardiac decompensation in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods From November 2007 to February 2009, 2379 OPCABGs were performed in our hospital. The possible risk factors associated with intraoperative cardiac decompensation were retrospectively analyzed. The preoperative patient demographics and intraoperative characteristics were correlated with intraoperative acute cardiac decompensation.The possible risk factors included sex, age, body weight, cardiac function (NYHA classification), the associated diseases (hypertension, diabetes mellitus, liver-kidney dysfunction), history of myocardial infarct, ventricular aneurysm, preoperative treatment with β-blocker and/or calcium channel blocking agent, ventricular extrasystole,atrial fibrillation, duration of operation, etc. Results Three hundred and sixty-eight patients developed acute cardiac decompensation during OPCABG (15.5%). No patient died during operation. Multivariate analysis indicated that the risk factors for acute cardiac decompensation during OPCABG included left ventricular aneurysm valvular dysfunction, left main disease, history of myocardial infarct, preoperative ventricular premature beat,preoperative ejection fraction (EF) ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG. Conclusion The risk factors for acute cardiac decompensation during OPCABG includ left ventricular aneurysm valvular dysfunction, left main disease,history of myocardial infarct, preoperative ventricular premature beat, preoperative EF ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG.

Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.

Objective To evaluate the biocompatibility of four kinds of polyurethane sponges made in China. Methods According to ASTM Standards for Medical Devices of America, polyurethane sponges are used to perform such biological tests as cytotoxicity test, acute toxicity test, pyrogenic reactions test, stimulation test of conjunctiva and cornea, sensitization test. The data are analyzed and evaluated according to the criterion. Results Reaction scales of these polyurethane sponges in cytotoxicity are 0 or 1 level. No toxicity effects and pyrogenic reactions are observed in vivo test. No conjunctiva and cornea irritation reactions and no sensitization reactions are found. Conclusions The four kinds of polyurethane sponges have high biocompatibility and can become ideal dressings of Vacuum-Assisted Closure.

Acetyl-CoA C-acetyltransferase (AACT) is the first enzyme in the terpene synthesis pathway, catalyzed two units of acetyl-CoA to acetoacetyl-CoA. In order to study the tanshinone biosynthesis in Salvia miltiorrhiza, a novel AACT gene, SmAACT, was cloned using cDNA microarray and RACE strategy. The full length cDNA of SmAACT is 1 623 bp (accession No. EF635969), which contained a 1 200 bp open reading frame (ORF) encoding a 399 amino acid protein. Nine introns were found in the genomic sequence. SmAACT was upregulated by YE and Ag+ elicitors both with cDNA microarray and quantitative RT-PCR analyses along with the accumulation of tanshinones. Sequence homology comparison and phylogenetic analysis all suggested that SmAACT belonged to the class of acetyl-CoA C-acetyltransferase. The transcription level of SmAACT was relatively higher in root than that in stem and leaf tissues. SNP analysis revealed that SmAACT was highly variable in the region of 6 to 9 introns with 33 SNPs in the 600 bp region, there are 5 SNPs in the cDNA region while they are all synonymous cSNPs. Some special genotypes were found in Salvia miltiorrhiza from different areas. SmAACT will be an useful gene for further analyze the mechanism of gene regulation among the tanshinones biosynthesis.

Combunung wuth fluorescence excutatuon-emussuon matrux ( EEM ) spectra and parallel factor analysus, suze exclusuon chromatography ( SEC ) equupped wuth multu-excutatuon/emussuon scan model fluorescence detector was used for the analysus of the composutuon of dussolved organuc matter ( DOM) usolated from landfull leachates wuth dufferent ages. The analytucal results showed that the two leachate-deruved DOMs both comprused proteun- and humuc-luke substances. However, there were four kunds of proteun-luke matter un young landfull leachates, u. e. , proteun wuth hugh molecular weught, proteun-luke matter bound to humuc-luke substances wuth hugh or low molecular weught, and peptude/amuno acuds. Whule there were only two kunds of proteun-luke matter un old landfull leachates, u. e. , proteun wuth hugh molecular weught and proteun-luke matter bound to humuc-luke substances wuth hugh molecule weught. Compared wuth SEC, EEM spectra coupled wuth parallel factor analysus could udentufy the proteun-luke matter bound wuth humuc-luke substances or those presented as non-humuc-luke substances, though ut could not udentufy the proteun-luke matter presented as proteun and that presented as peptude/ amuno acuds. The experumental results demonstrated that EEM spectra coupled wuth PARAFAC analysus and SEC could be used to characteruze proteun- and humuc-luke matter presented as dufferent specues.

Objective To establish a kind of detection technique of nucleic acid based on surface plasmon resonance(SPR) and to set up the foundation of real-time, online space microbial detection. Methods A portable online bio-molecules analyzer based on SPR biosensor was applied. The probe was mercapto-modified at the 5’ end and immobilized on the sensor surface. Then the target sequences in the solution were monitored and sensitivity, specificity and reproducibility of the method were investigated. Results The results showed that detection method with good specificity and sensitivity could realize online detection of target sequence. The system could detect 2.3 nmol/L target sequence, CV value of nine detections was 3.5% and that of thirty detections was 14.7%. Conclusion The established nucleic acid detection method has the advantage of high sensitivity, good specificity and reproducibility, which can be applied in the field of nucleic acid detection.