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 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 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 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.

ObjectiveTo determine ff the cardiac index (CI) measured with FloTrac-Vigileo system agrees with that measured with pulmonary artery catheter (PAC).MethodsForty-three ASA Ⅱ or Ⅲ patients aged 53-75 yr weighing 46-100 kg undergoing off-pump coronary artery bypass grafting were included in this study.Anesthesia was induced with midasolam,sufentunil,propofol and rocuronium and maintained with propofol,remifentanil and atracurium.One MAC sevoflurane was inhaled at breast bone splitting and closing.CI was measured with FloTrac-Vigileo system and PAC before,and at 5,15 min of sevoflurane inhalation and recorded.All data were compared by Bland-Altman analysis and with kappa coefficient for agreement and percentage error was calculated.ResultsBland-Altman comparison of FloTrac-Vigileo system and PAC:matching data of 258 measurements:CI (2.8 ± 0.6 ) L· min - 1 · m- 2,bias was 0.23 L* min- 1 · m - 2 and limit of agreement was ( - 0.57,1.02)L · min- 1 · m- 2,resulting in κ ＝ 0.546 and an overall percentage error of 28.6 ％.ConclusionCI values obtained by FloTrac-Vigileo system agrees well with that obtained by thermodilution technique using PAC in patients undergoing off-pump coronary artery bypass grafting.

Objective To investigate the effect of propofol on transforming growth factor (TGF)-β1/Smad2 signaling pathway in lung tissues in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Fifty-six male Wistar rats,aged 7-8 weeks,weighing 260-300 g,were randomly divided into 5 groups:control group (group A,n =8) ; LPS group (group B,n =12); 3 propofol groups (groups C,D,E,n =12).ALI was induced by intravenous LPS 8 mg/kg in groups B,C,D and E.In groups C,D,E,propofol 5 mg/kg was injectedintravenously before LPS administration and at 0 and 1 h after LPS administration,respectively,followed by infusion of propofol at 10 mg· kg-1 · h-1 until 5 h after LPS administration.Group A received the equal volume of normal saline.Arterial blood samples were collected immediately before LPS administration and 1,3 and 5 h after LPS administration for determination of pH value and PaO2.Then the animals were sacrificed and the lungs were immediately removed for calculation of the wet/dry lung weight ratio and for determination of the expression of TGF-β1-mRNA and Smad2 in lung tissues.Results Compared with group A,pH value and PaO2 were significantly decreased,wet/dry lung weight ratio was increased and the expression of TGF-β1 mRNA and Smad2 was up-regulated in groups B and E (P ＜ 0.05).Compared with group B,pH value and PaO2 were significantly increased,wet/dry lung weight ratio was decreased and the expression of TGF-β1 mRNA and Smad2 was down-regulated in groups Cand D,and PaO2 was significantly increased in group E (P ＜ 0.05).Conclusion The mechanism by which propofol alleviates ALI induced by LPS is related to inhibition of TGF-β1/Smad2 signaling pathway.

Objective To evaluate the clinical efficacy of MRA in the arteries of the pelvis and lower extremity with automatic table movement (MobiTrak).Methods 12 cases suspected of pelvis and lower extremity artery diseases underwent dynamic 3D contrast enhanced MRA and automatic table movement at the same time.Three cases underwent artery angiography,four cases were detected by operation.Results All diseased arteries were well demonstrated.Among them,lower extremity artery occlusion 8,failing vascular grafts 2,artery aneurysms 2.Conclusion Automatic table movement is of value in assessing pelvis and lower extremity artery diseases accurately.And it is a reliable and potential new technique.

Objective To analysis diagnostic CT findings of adrenocortical carcinoma.Methods To collect 13 adrenocortical carcinomas verified by operation and pathology from 1990 to 1999.Results 8 cases were functional tumor and 5 were non-function mass.The diameter of 10 cases was more than 5 centimeters.The density of carcinoma was not equality and necrosis was often be found.The edge of 6 cases were clear and 7 were not clear,3 cases had local invade and metastasis.Conclusion CT can diagnose most of functional adrenocortical carcinoma with clinic syndrome but can not differentiate non-function adrenocortical carcinoma from pheochromocytoma.

Objective To investigate the clinical value of MRI in evaluating the cardiac structures and function of congenital heart diseases.Methods Fifteen cases with surgically proved different types of CHD were examined by the techniques of magnetic resonance imaging ( MRI) and echocardiography (ECG).The results were compared to determine their values in showing the abnormalities of cardiac structures and function.Results In 15 cases,20 malformations were diagnosed correctly by MRI within 24 abnormalities confirmed by operation(20/24),21 by ECG (21/24).MRI was better than ECG in displaying great vascular diseases, while ECG was better in valvular diseases.There was no significant difference between MRI and ECG in examining cardiac function.Conclusion MRI can clearly show the abnormalities of cardiac anatomy and function.