Objective To compare the efficacy of sevoflurane combined anesthesia and propofol combined anesthesia in elderly patients undergoing abdominal surgery.Methods Sixty patients aged 65-80 yr scheduled for elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n = 30 each): sevoflurane group (group S) and propofol group (group P).Anesthesia was induced with TCI of sufentanil and propofol.The initial target effect-site concentration (Ce) of sufentanil was set at 0.25 ng/ml and initial target plasma concentration (Cp) of propofol set at 2.0 μg/ml,and then both concentrations were increased in 0.5 μg/ml increment when they reached the balance until loss of consciousness.Tracheal intubation was facilitated with rocuromitm 0.6 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration set at 1.0%-2.0%) in group S,TCI of prepofol (Cp set at 2-4 μg/ml) in groups P, and sufentanil by TCI ( Ce set at 0.15 ng/ml) and iv infusion of vecurenium 0.15 mg·g-1·h-1 in both groups. .BIS value was maintained at 40-60,and changes of MAP and HR were less than 30% of the baseline value in both groups.The use of vasoactive drugs during perioperative peried,time of awakening,extubation and consciousness were recorded and compared between the 2 groups.Results The usage rate of urapidil was significantly decreased,and the awakening time,extubation time and consciousness time shortened in group S compared with group P.Conclusion Sevoflurane-sufentanil combined anesthesia provides better hemodynamic stability and faster recovery than propofol-sufentanil combined anesthesia in elderly patients.

Objective To explore the mechanism of Xiao Chaihu decoction in t he treatment of endometriosis in rats.Methods The rat model of endometriosis w as established. Fas and Caspase- 3 protein expression in the eutopic endometriu m and eutopic endometrium were observed by immunohistochemical method.Results The protein expression of Fas and Caspase- 3 in ectopic endometrium of Xiao Cha ihu decoction group was higher than that in the eutopic endometrium, while the r esult in the control group was just the opposite. No significant difference was shown in Danazol group. Conclusion The therapeutic mechanism of Xiao Chaihu de coction for endometriosis may be related to the promotion the apoptosis of ectop ic endometrium tissue by increasing Fas protein expression.

Adult ; Female ; Hematologic Tests ; Hexanes ; adverse effects ; Humans ; Male ; Occupational Exposure ; adverse effects ; Young Adult

Objective To evaluate the influencing factors for postoperative odynophagia in elderly patients undergoing intraoperative transesophageal echocardiography (TEE) examination for cardiac surgery.Methods A total of 96 patients with intraoperative TEE examination for cardiac surgery was divided into two groups:the elderly group (patients aged ≥65 years,n=60) and the young group (patients aged ＜ 65 years,n =36).Clinical data were retrospectively analyzed.Postoperative odynophagia was assessed by number rating scale (NRS) scores.Characteristics of postoperative odynophagia were compared between the two groups.Influencing factors for postoperative odynophagia were analyzed by multivariable logistic regression analysis.Results The incidence of postoperative odynophagia and the average NRS score were higher in the elderly group thanin the young group [88.3％ vs.66.7％,(2.6±1.7) vs.(1.4±0.9),P＜0.05 or 0.01].Multivariate logistic regression analysis showed that preoperative oral lidocaine plasmagel,oropharyngeal mucosal injury and duration of TEE insertion were independent influencing factors for postoperative odynophagia (all P＜0.01).Conclusions The incidence of postoperative odynophagia is higher and the degree of odynophagia is more serious in elderly patients undergoing intraoperative TEE examination for cardiac surgery.Postoperative odynophagia can be relieved by applying the preoperative oral lidocaine plasmagel,reducing oropharyngeal mucosal injury and shortening the duration of TEE insertion.

Objective To study the effect of Taohongsiwu decoction(THSWD) on the VEGF expression and the micrangium regeneration of callus tissue in bone stump. Methods 65 Japanese rabbits were divided into four groups randomly, three groups were given orally with THSWD, Yandining tablet, distilled water respectively after the right radial bone fracture model was established by operation, and the other group served as control. At the 7th,15th,21th and 35th day after fracture, immunohistochemical method was used to detect the expression of VEGF, and the histochemical staining was used to detect the micrangium change of callus tissue in bone stump. Then the data were compared and analysed. Results VEGF expression level was higher in THSWD intvervening group than that in the other groups, and the decrease of VEGF expression was not obvious after the peak value at 15th day. The callus micrangium regeneration and the remodeling of callus in THSWD intervening group were better in all phase than those in the other groups. Conclusion THSWD could improve the VEGF expression of callus tissue, accelerate the micrangium regeneration in bone stump and promote the healing of fracture.

Objective: To investigate the oil yield, components and antimicrobial activity of the essential oil of Cinnamomi Cortex from different growth environments and growth years. Methods: Cinnamon oil was extracted by steam distillation, the chemical components were separated and identified by GC-MS, and the relative content of each component was determined by area normalization. The diameter of the inhibition zone and the minimum inhibitory concentration (MIC) were measured using filter paper method and micro dilution method. The antimicrobial effect of seven copies of cinnamon oil on three common pathogens of respiratory tract were evaluated. Results: The highest oil yield was 10-year-old cinnamon (6.41%), the lowest was 20-year-old (1.75%), and sparse planting (4.48%) was the best among 15-year-old cinnamon. A total of 44 compounds were identified in the seven samples. The major common components with a relative content of more than 1% were trans-cinnamaldehyde (16.23%-73.08%), α-copaene (7.39%-41.70%), β-cadinene (2.22%-12.30%), and α-muurolene (1.00%-9.16%). The antibacterial experiments showed that essential oil of cinnamon from different growth environments and growth years had obvious inhibitory effect on the tested strains of Staphylococcus aureus and Escherichia coli, but weaker inhibitory effect on Pseudomonas aeruginosa. Among them, volatile oil of 15-year-old sparse planting and close planting cinnamon had better antimicrobial activity. Conclusion: Oil yield, essential oils components and antimicrobial activity of cinnamon were affected by growth environments and growth years. Cinnamon oil contains other effective antimicrobial components besides cinnamaldehyde and α-copaene.

Objective:To explore the effect of different tidal volumes (VT) on the hemodynamics of right heart in acute respiratory distress syndrome (ARDS) rats induced by oleic acid (OA).Methods:Sixty adult male Sprague-Dawley (SD) rats were divided into control group ( n = 20), ARDS model group ( n = 20), low VT (LVT) group ( n = 10) and high VT (HVT) group ( n = 10) by random number table. ARDS model was reproduced by injecting OA 0.15 mL/kg through a jugular vein. The control group was given the same amount of normal saline. The success of modeling was judged by the oxygenation index (PaO 2/FiO 2) 2 hours after modeling, at the same time, the lung tissues were collected, the wet/dry weight (W/D) ratio was determined, and the lung histopathological changes were measured by lung injury score. The rats in the LVT group and HVT group were given mechanical ventilation with VT of 6 mL/kg or 20 mL/kg for 4 hours, respectively at 2 hours after modeling. The rats in the control group and the ARDS model group maintained spontaneous breathing. After mechanical ventilation for 4 hours, the heart rate (HR), right ventricular systolic pressure (RVSP), the maximum rate of rising of right ventricular pressure (dp/dt max), and the blood pressure (BP) were measured. Meanwhile, arterial blood samples were collected for blood gas analysis, including pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2) and PaO 2/FiO 2. Results:The rats in the ARDS model group showed symptoms of respiratory distress 1 hour after modeling, and the lung tissue samples showed obvious patchy bleeding 2 hours after modeling, while the control group showed no such changes. The PaO 2/FiO 2 in the ARDS model group was significantly lower than that in the control group [mmHg (1 mmHg = 0.133 kPa): 294.3±5.9 vs. 459.0±4.4, P < 0.01], and the lung W/D ratio and lung injury score were significantly higher (lung W/D ratio: 8.24±0.25 vs. 4.48±0.13, lung injury score: 0.60±0.03 vs. 0.12±0.02, both P < 0.01). It indicated that ARDS model was successfully reproduced. The arterial blood gas analysis and hemodynamic parameters of the ARDS model group were significantly worse than those of the control group. After 4-hour mechanical ventilation, the blood gas parameters of the LVT group were better than those of the ARDS model group and the HVT group [pH value: 7.36±0.02 vs. 7.24±0.02, 7.13±0.01; PaO 2 (mmHg): 92.4±2.1 vs. 61.8±2.3, 76.6±2.2; PaCO 2 (mmHg): 49.6±1.7 vs. 61.8±1.8, 33.6±1.3; PaO 2/FiO 2 (mmHg): 440.0±10.2 vs. 274.3±21.4, 364.7±10.5; all P < 0.05]. HR, BP and dp/dt max in the LVT group were significantly higher than those in the ARDS model group and the HVT group [HR (bpm): 346.9±5.4 vs. 302.3±10.1, 265.5±12.2; BP (mmHg): 125.4±2.2 vs. 110.0±2.5, 89.2±2.8; dp/dt max (mmHg/s): 1 393.3±30.3 vs. 1 236.4±20.5, 896.1±19.5; all P < 0.05], and RVSP was significantly lower than that in the ARDS model group and the HVT group (mmHg: 31.3±0.4 vs. 34.0±1.0, 38.8±0.9, both P < 0.05). Conclusion:Mechanical ventilation with low VT can improve the hemodynamic parameters of the right ventricle and protect the function of the right heart in ARDS rats.

Objective To investigate if glucose-insulin-potassium (GIK)would relieve the liver injury induced by endotoxemia in rats.Methods Sixty SD male rats,weight 200-250g,were randomly divided into three groups (n = 20):control group (group C),lipopolysaccharide group (group LPS,LPS 8 mg/kg)and Glucose-insulin-potassium group(group GIK,8 mg/kg LPS+GIK 4 ml·kg-1 ·h-1 ).All the rats were injected with 20 mg/kg ketamine intraperitonealy before trial. Erythrocin was daubed on the wound to avoid infection.The rats of group LPS and group GIK were injected LPS 8 mg/kg intraperitoneal,then,rats in group LPS and group GIK received saline(4 ml·kg-1 ·h-1 )or GIK(Glucose 200 g/L,Insulin 60 IU/L,KCL 60 mmol/L)infusion continuously. Liver and serum samples were collected on before injection,3 days after injection and 5 days after in-jection.Serum concentrations of ALT and AST were measured.TNF-αlpha of liver homogenate was detected by ELISA.The severity of liver damage was assessed by an approprite histopathological sco-ring system and apoptosis of parenchymal cells were assessed by TUNEL immunofluorescence assay. Results Compared with group control,the level of serum ALT and AST in group LPS and group GIK were significantly higher at 3 days after injection.The level of hepatic TNF-α,the hepatic damage score and the index of hepatic apoptosis in group LPS and group GIK were significantly higher on 3 days after injection and 5 days after injection.(P<0.05).Compared with group LPS,the level of hepatic TNF-αand the hepatocyte apoptosis rates decreased significantly in group GIK on 3 days after injection.The level of serum ALT and AST,hepatic TNF-α,the hepatic damage score and the hepatocyte apoptosis rates decreased significantly in group GIK at 5 days after injection(P <0.05).Conclusion Intraperitoneal injection of endotoxin can cause liver injury in rats,resulting in the liver hepatdysfunction and hepatocyte damage.GIK has protective effects on LPS induced liver injury in rats.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.

Child ; Female ; Gastroscopy ; Humans ; Pylorus ; abnormalities