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.

This essay investigated the in vitro tumoricidal activity of Con A primed murine LAK cells (Con A-LAK), discussed the role of mTNF-? in the killing effect. The results showed that Con A-LAK cells could kill NK sensitive YAC-1, TNF sensitive L929 and H-2 low/non expression HCa-F target cells; The cytotoxicitity of Con A-LAK cells was performed by direct contact, the non-secretary pathway mediated by interaction of surface ligands of effector cells and receptors of target cells play an important role; Con A-LAK cells expressed mTNF-?, which participated in the killing of TNF sensitive tumor cells and might be one of the important effector molecules in MHC non-restricted, antigen non-specific cvtotoxicitv.

Objective To detect the protein expression of gonadotropin-releasing hormone (GnRH) and its receptor (GnRH-R) in various endometrial tissues, and to investigate its significance. Methods Immunohistochemistry was employed to analyse the protein expression and localization of GnRH and GnRH-R from endometriosis(EMS), endometrial hyperplasia, endometrial carcinoma and control group. Results GnRH and GnRH-R are expressed at the protein level in all eutopic endometrium, in 50% ectopic endometrium and 92.3% endometrial hyperplasia, while the expressional rate in endometrial carcinoma are 58.8% and 82.4%, respectively. The majority of GnRH and GnRH-R existed in the plasma of glandular epithelium cells and some stroma cells. Conclusions There exists GnRH and its receptor proteins in endometrial tissues, and their abundant expression in endometriosis, endometrial hyperplasia and in endometrial carcinoma may imply that they could be used in clinical diagnosis and treatment.

Objective: To evaluate the efficacy and tolerability of rhGM-CSF in prevention of neutropenia caused by chemothera- py of cancer patients. Methods: A muticenter, randomized,match and crossover clinical study was conducted. 64 enrolled patients were randomized into AB and BA groups and each patient received two cycles of combination chemotherapy.Results:59 patients were evaluted for clinical efficacy.rhGM-CSF significantly increased the number of WBC and ANC at the stage of nadir. The period when the patients, rhGM-CSF also resulted in a hastening recovery from leucopenia and neutropenia.Conclusion: The administraton of rhTM-CSF ensures the implement of sheduled combination chemotherapy. The main side effects such as fever, osteomyalgia,skin rash were generally tolerable.

AIM: To investigate the effect of premedication with clonid in e on the concentrations of catecholamine (CA), angiotention Ⅱ (AⅡ), cortisol a nd carbohydrate metabolism during tracheal extubation. METHODS: Twenty-two patients scheduled for general anesthesia with tracheal intubation were randomly divided into two groups: clonidine group and control group. Oral p remedication with clonidine 5 ?g?kg -1 was taken in clonidine group 6 0 min before anesthesia induction in addition to some common premedication in bo th groups. The change of hemodynamics,arterial plasma concentrations of CA, A Ⅱ, cortisol, blood sugar and lactic acid were measured before anesthesia, befor e intubation and 1,2,5, 10 min after tracheal extubation, respectively. RESULTS: The levels of CA, AⅡ, cotisol, blood sugar and lactic acid were significantly increased during tracheal extubation in both groups,but the levels in control group were higher than those in clonidine group. The change of hemodynamics was more stable in clonidine group than that in control group. CONCLUSION: Oral premedication with clonidine can alleviate stress response during tracheal extubation.

Objective To study the clinical applications of SIVP detecting hepatocarcinoma in cirrhosis.Methods 40 cases of cirrhosis combined with hepatocarcinoma diagnosed by operation and pathology were collected.Control group were scaned with conventional technique,experimental group were scaned with SIVP.Results Only 5 cases catched the optimal scan timing in control group,the accuracy of diagnosis in hepatocarcinoma was 70%;All the cases found the optimal scan timing in experimental group,the detectable rate of hepatocarcinoma was 95%.Conclusion SIVP can find out the optimal timing,which greatly improved accuracy of diagnosing hepatocarcinoma in cirrhosis.

Objective To analysis the CT features and differential points of adrenal myelolipoma.Methods The CT and clinical information of 9 adrenal myelolipomas were collected.Results CT diagnosed 8 cases of adrenal myelolipoma except 1 case misdiagnosing as adenoma.All mass measuring 2.8～10.5 cm in diameter with clear edge,low attenuation value of fat and irregular linear shadow of soft tissure might be seen in mass.Conclusion CT is the best examination of diagnosing,which could show the position,component of the mass and organs around it.

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 analysis the CT features in 7cases of rare adrenal interstitial tissue tumors.Methods 7 cases of rare adrenal interstitial tissue tumors were verified with operation and histology.2 cases were cyst and 2 were lipoma,neurofibroma,neurilemoma and mesenchymoma was 1 case,respctively.Results Adrenal cyst and lipoma appered the density of water and fat.neurofibroma and neuriemoma were slightly low density mass,without enhancement.There were cystic lesion in neurilemoma.Mesenchymoma had slight or moderate enhancement.Conclusion It is difficult or impossible to distinguish nuerofibroma,neurilemoma or mesenchymoma from non-function adenoma or pheochromocytoma except adrenal cyst and lipoma.