Objective To evaluate the effect of sevoflurane on left ventricular function in patients undergoing elective coronary artery bypass grafting (CABG) .Methods Thirty-five ASA Ⅱ or Ⅲ patients of both sexes (30 males, 5 females) aged 53-75 yr weighing 46-100 kg undergoing CABG were enrolled in this study. Transesophageal echocardiography (TEE) probe was placed. The TEE variables including cardiac index (CI), left ventricular short axis shortening (FS), left ventricular ejection fraction (LVEF), low propagation velocity ( Vp), E wave velocity (E) , A wave velocity ( A) , systolic wave velocity ( S) , diastolic wave velocity ( D), AR wave velocity, E/A ratio and S/D ratio were recorded before inhalation of sevoflurane (T_1 ) , and 5 min (T_2) and 15 rain ( T_3) after inhalation of sevoflurane after splitting of sternum, and before inhalation of sevoflurane (T_4 ), 5 min (T_5) and 15 min (T_6) after inhalation of sevoflurane after the closure of sternum. The end-tidal concentration of sevoflurane corresponded to 1 MAC. Anesthesia was induced with midazolam 0.05 nig/kg, sufentanil 0.5μg/kg and rocuronium 0.9 mg/kg and maintained with infusion of propofol at 4-6 mg·kg~(-1) ·h~(-1), remifentanil at 0.2-0.4μgkg~(-1)·h~(-1) and atracurium at 0.5 mg·kg~(-1)·h~(-1). The patients were mechanically ventilated after tracheal intubation (V_T 8 ml/kg, RR 12 bpm, I:E 1:2, FiO_2 70%-80% ) .Results (1) MAP and CI were significantly decreased at 5 and 15 min after sevoflurane inhalation. LVEF and FS were also decreased. (2) There was no significant change in diastolic function indexes after sevoflurane inhalation including E and A wave velocity, systolic wave velocity, diastolic wave velocity, E/A ratio and S/D ratio. (3) Cardiac function improved after CABG. CI, LVEF and FS were significantly increased after CABG as compared with preoperative values. Conclusion In patients undergoing elective CABG, sevoflurane (the end-tidal concentration corresponding to 1 MAC) can depress left ventricular systolic function but does not affect left ventricular diastolic function.

Objective To evaluate the role of syndecan-4 (SDC-4) in inflammatory responses of rats with ventilator-induced lung injury (VILI).Methods Twenty-four healthy male wild type Sprague-Dawley rats and 24 male SDC-4 gene knockout Sprague-Dawley rats,aged 2-3 months,weighing 200-220 g,were assigned into 2 groups (n =12 each) using a random number table:control group (group C)and VILI group.The animals were anesthetized with pentobarbital sodium and tracheostomized.The rats kept spontaneous breathing in group C.The rats were mechanically ventilated for 4 h in group VILI.Blood samples were taken from the femoral artery at the end of mechanical ventilation for detection of arterial oxygen partial pressure (PaO2).The animals were sacrificed after blood sampling.The left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was collected for determination of the tumor necrosis factor-α (TNF-α),interleukin-1beta (IL-1β) and IL-18 concentrations (by enzyme-linked immunosorbent assay) and total protein concentrations (by BCA assay).The right lungs were removed for determination of the wet to dry weight ratio (W/D ratio) and expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues (by real-time polymerase chain reaction) and for examination of the pathological changes (with a light microscope).The lung injury scores were recorded.Results Compared with group C of wild type rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of wild type rats (P＜0.05),and no significant change was found in the variables mentioned above in group C of gene knockout rats (P＞0.05).Compared with group C of gene knockout rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of gene knockout rats (P＜0.05).Compared with group VILI of wild type rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of gene knockout rats (P＜0.05).Conclusion SDC-4 can inhibit inflammatory responses of rats with VILI and is involved in the endogenous protective mechanism.

Objective To explore the relationships among mobile phone dependence and attachment,social support among adolescent students.Methods 900 students from two vocational colleges in Shandong province were recruited by stratified sampling.They were assessed with Experiences in Close Relationships Inventory (ECR) Chinese version,Social Support Rating Scale and Mobile Phone Addiction Tendency Questionnaire.Results There were no significant differences of adolescent students'mobile phone dependence on gender,child status,and native place.The score of middle vocational school students'mobile phone dependence (45.84 ± 12.64)was significantly higher than that of higher vocational college students (40.68 ± 9.72),and there was significant difference between them (P ＜ 0.01).Mobile dependence was significantly positively related with attachment anxiety (r =0.469,P ＜ 0.01),and was significantly negatively related with social support (r =0.149,P ＜ 0.01).Attachment anxiety and social support were the direct predictors of mobile phone dependence,and social support played the partial mediating role between attachment anxiety and mobile phone dependence.Conclusions Mobile phone dependence is a common phenomenon among adolescent students,and the middle vocational school students' mobile phone dependence is more serious than that of the higher vocational college students.There are close relationships between mobile phone and attachment,social support.Attachment anxiety is not only directly but also indirectly associated with mobile phone dependence by social support.

Objective To investigate CT findings of atypical pheochromocytoma.Methods 18 cases of atypical pheochromocytoma were verified with operation and pathology.2 cases were extra-adrenal pheochromocytoma,3 cases were bilateral or multiple pheochromocytoma,7 cases were non-function pheochromocytoma and malignant pheochromocytoma were 6 cases.Results All atypical pheochromocytoma showed equivalent density mass with necrosis in CT scanning,calcification was rare.Most of them had strong enhancement in parenchyma.Conclusion (1)Atypical pheochromocytoma has high tendency to malignance.(2)CT has high locational and qualitative rate in diagnosing atypical pheochromocytoma but can not different malignance from benign pheochromocytoma,except the mass has metastatic signs.The diagnosis of non-function pheochromocytoma has to consider biochemical and other examination.

Objective To investigate CT features of adrenal neoplasms.Methods 9 cases of rare adrenal neoplasms were verified with operation and histology.3 cases were ganglioneuroma,2 cases were neuroblastoma and the remaining four were cyst,neurofibroma,lipoma and mesenchymoma.Results Adrenal cyst,neuroblastoma and lipoma had their obvious CT features.All adrenal ganglioneuroma,neurofibroma and mesenchymoma had low or equivalent density.Ganglioneuroma and neurofibroma had no enhancement but mesenchymoma had slight or moderate enhancement.Conclusion It is difficult or impossible to distinguish these tumors,except cyst,neuroblastoma and lipoma,from non-function adenoma or pheochromocytoma.

Objective To evaluate the role of spinal RhoA/ROCK signaling pathway in the development of lipopolysaccharide (IP)-induced inflammatory pain(IP) in rats.Methods Fifty-two male Sprague-Dawley rats, weighing 180-220 g, were equally randomized into 4 groups using a random number table: normal saline group (group NS) , LPS group, RhoA inhibitor C3 exoenzyme group (group LC) , and ROCK inhibitor Y27632 group (group LY).Inflammatory pain was induced by injecting LPS 25 μl (300 ng) into the plantar surface of hindpaws in IP, LC and LY groups, while the equal volume of normal saline was injected instead in NS group.C3 exoenzyme 10 pg and Y27632 10 nmol were injected intrathecally at 30 min prior to LPS administration in LC and LY groups, respectively.Before LPS injection (T0) , and at 1, 3, 5, 12 and 24 h after LPS injection (T1-5) , the mechanical and thermal pain thresholds were measured.Five rats in each group were sacrificed after pain thresholds were measured at T3, and L4.5 segments of the spinal cord were removed for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) mRNA expression in spinal dorsal horns by real-time reverse transcriptase-polymerase chain reaction.Results Compared with group NS, the mechanical and thermal pain thresholds were significantly decreased at T2-5in IP, LC and LY groups, and TNF-α and IL-1β mRNA expression was up-regulated at T3 in IP group.Compared with group IP, the mechanical and thermal pain thresholds were significantly increased at T2-5, and TNF-α and IL-1β mRNA expression was down-regulated at T3 in LC and LY groups.Conclusion Spinal RhoA/ROCK signaling pathway is involved in the development of LPS-induced IP in rats.

Objective To investigate the effects of dexmedetomidine on inflammatory responses in brain tissues of the patients undergoing carotid endarterectomy.Methods A total of 40 ASA physical status Ⅱ or Ⅲ patients,aged 65-80 yr,scheduled for elective unilateral carotid endarterectomy under general anesthesia,were randomly divided into 2 groups (n =20 each) using a random number table:dexmedetomidine group (group Dex) and control group (group C).In group Dex,dexmedetomidine 0.03 μg · kg-1 · min-1 was infused over 10 min before induction of anesthesia,and after tracheal intubation dexmedetomidine was then infused at a rate of 0.3 μg · kg-1 · min-1 until 30 min before the end of operation.The equal volume of normal saline was given in group C.At 20 min before induction of anesthesia (T0),10 min after induction of anesthesia (T1),15 min after carotid artery clamping (T2),15 min after carotid artery unclamping (T3),and at 6 and 24 h after operation (T4,5),blood samples were drawn from the ispilateral jugular bulb for determination of serum concentrations of malondialdehyde (MDA) (by TBA) and S100B,tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) (by ELISA).Results Compared with group C,the serum S100B concentrations were significantly decreased at T3-5,the serum TNF-α and IL-6 concentrations were decreased at T2.5,and the serum MDA concentration was decreased at T3 in group Dex.Conclusion Dexmedetomidine can reduce the brain damage through mitigating inflammatory responses in brain tissues of the patients undergoing carotid endarterectomy.

Objective To evaluate the clinical practicality of two different D-dimer assays by studying the correlation of the testing results by two different D-dimer reagents with fibrin degradation products (FDP)result values and analyzing the Clinical alignment.Methods A representative cross-sectional study of 762 clinical patients’plasma specimens were taken to measure the results of D-dimer and FDP by using Sysmex CA-1500 automated coagulation analyzer,D-DIMER detection rea-gent respectively Siemens Innovance D-DIMER and Dade Behring D-DIMER Plus reagents.Then rating frequency analysis and Spearman correlation test were applied to analyze the correlation of measurement results.Results Overall,to the same patient,the correlation of D-dimer tested by Siemens Innovance D-DIMER Reagent with FDP level was significant positive (r= 0.954,P<0.01),better than that tested by Siemens DD Plus Reagent (r=0.885,P<0.01);and this correlation had an increasing trend when D-dimer level raised.When D-dimer level > 5 mg/L FEU,the correlation was the best (P<0.01). And by calculating the amount of positive FDP (FDP>5μg/ml)and FDP positive rate in both different cases when D-dimer results was also positive,FDP positive rate in Innovance D-DIMER Reagent group (about 65.76%)was lower than DD Plus Reagent group,it indicated that D-dimer results tested by Innovance D-DIMER Reagent could raise before FDP reacted,so D-dimer had a higher sensitivity than FDP.Conclusion It can provide a more precise clinical diagnosis and treatment infor-mation when using Siemens Innovance D-DIMER Reagent to detect D-dimer values and combined FDP values at the same time.

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) pathway in the protective effect of remifentanil or ischemic preconditioning (IPC) against hepatic ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four male SD rats,weighing 200-250 g,were randomly assigned into 6 group ( n =24 each):sham operation group (group S),I/R group,remifentanil group (group R),IPC group,SB203580 (a specific p38MAPK inhibitor) + remifentanil group (group SB + R),and SB + IPC group.The animals were anesthetized with intraperitoneal 20％ urethane 1 mg/kg.Partial liver ischemia was produced by clamping the hepatic pedicle supplying left lobe and middle lobe for 30 min,followed by 120 min reperfusion.In group R,remifentanil was infused intravenously at 2μg· kg- 1 · min- 1 starting from 30 min before ischemia until the end of reperfusion.In IPC group,the rats were subjected to 3 episodes of 5 min ischemia at 5 min intervals before I/R.SB203580 0.2 mg/kg was injected intravenously at 5 min before remifentanil infusion or IPC in groups SB + R and SB + IPC,and the equal volume of normal saline was given in the other groups.Six rats in each group were selected at 30,60,90 and 120 min of reperfusion and venous blood samples were taken from inferior vena cava for measurement of serum ALT and AST activities and concentrations of TNF-a and 1L-1β.The rats were then sacrificed and liver tissues were taken for microscopic examination and determination of phosphor-p38MAPK expression by Western blot.Results Compared with group S,serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased at each time point (P ＜ 0.05) and pathological injury was aggravated in group I/R.Compared with group I/R,serum AST and ALT activities and serum levels of TNF-a and IL-lβ were significantly decreased and phosphor-p38MAPK expression was up-regulated at 90 min of reperfusion in groups R and IPC ( P ＜ 0.05).The serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased,phosphor-p38MAPK expression was down-regulated at 90 min of reperfusion ( P ＜ 0.05),and pathological injury was aggravated in group SB + R compared with group R,and in group SB + IPC compared with group IPC.Conclusion Activation of p38MAPK pathway and inhibition of inflammatory response may be involved in the mechanism by which remifentanil or IPC reduces the hepatic I/R injury in rats.

Objective To evaluate the effect of dexmedetomidine on left ventricular function in patients undergoing coronary artery bypass grafting (CABG) by transesophageal echocardiography (TEE).Methods The study was a prospective,randomized and placebo-control clinical trial.Eighty patients undergoing CABG with cardiopulmonary bypass (CPB) were divided into dexmedetomidine group (group D)and control group (group C) by random digits table method with 40 cases each.A loading dose of dexmedetomidine 0.5 μg/kg was injected intravenously 10 min after induction followed by infusion at 0.4 μ g/(kg· h) until the end of operation in group D,while equal volume of normal saline was given in group C.Left ventricular function was assessed by transesophageal echocardiography before the infusion of dexmedetomidine (T1),at the end of the infusion of loading dose (T2),before CPB (T3) and at the end of the operation (T4).Results Compared with those at T1,left ventricular ejection fraction and fractional area change decreased significantly [(58.0 ± 12.0)％,(60.0 ± 9.6)％ vs.(63.0 ± 8.6)％ and (46.0 ± 9.3)％,(48.0 ± 8.4)％ vs.(51.0 ± 6.7)％] (P ＜ 0.05 or ＜ 0.01),E/A ratio increased significantly (1.05 ± 0.27,1.07 ±0.31 vs.0.98 ±0.19)(P ＜0.05 or ＜0.01) and myocardial performance index (MPI) decreased significantly (0.46 ± 0.14,0.45 ± 0.12 vs.0.51 ± 0.14) (P ＜ 0.05) at T2 and T3 in group D,while stroke volume was not significantly changed (P＞ 0.05).Compared with that in group C,E/A ratio and rapid filling fraction in group D was significantly higher [1.06 ± 0.18 vs.0.97 ± 0.18,(62.0 ± 7.1)％ vs.(58.0 ± 7.3)％],and S/D ratio and MPI was significantly lower at T4(1.17 ± 0.21 vs.1.29 ± 0.22,0.43 ± 0.15 vs.0.50 ± 0.15),and there were significant differences (P ＜ 0.05).There was no difference in the parameters indicating left ventricular systolic function (P ＞ 0.05).Conclusions Dexmedetomidine restrains left ventricular systolic function in the patients undergoing CABG,but does not decrease the cardiac output,and improve relaxation dysfunction of left ventricular diastolic function.Global left ventricular function is improved by dexmedetomidine after CABG.