Objective This study was designed to determine the clinical pharmacokinetics ofcisatracurium in Chinese patients. The purpose of this study was twofold: the determination of ED50 and ED95 of cisatracurium and the intubating conditions and changes in BP and HR produced by 2×ED95 and 3 ×ED95 . Methods 100 patients scheduled for elective surgery, aged 30-65 years, served as the experimental subjects. Anesthesia was induced with propofol 2mg/kg and fentanyl 4μg/kg. 5 min after BP and HR were stabilized the study was started. The study consisted of two parts according to the purpose of the study. In part Ⅰ 70 patients were included and randomized to 7 groups based on the doses of cisatracurium the patients received. The doses were 25, 30, 35, 40, 45, 50 and 55 μg/kg from group Ⅰ to Ⅶ. Neuromuscular transmission was assessed by measuring the responses of adductor pollicis muscle to stimulation of ulnar nerve with TOF pulses.The maximal depression of Tt was measured after administration of cisrtracurium, and ED50 and ED95 were calculated. In part Ⅱ 30 patients were included and divided into two groups to receive 2×ED95 (group Ⅷ ) or 3×ED95 (group Ⅸ ) of cisatracurium. The intubating conditions were evaluated. The onset time and time of recovery from paralysis as well as the changes in BP and HR after administration of cisatracurium were recorded. ResultsED50 and ED95 for cisatracurium were 30.7μg/kg and 53.4μg/kg respectively. The onset times for 2×ED95 and 3×ED95 were (254±84)s and (190±59)s. The durations of action was (38.8±6.1)min and (53.28.8)min respectively. Recovery indexes were (16.4±4.9) min and (15.6±5.2) min. There were little changes in BP and HR after administration of cisatracurium in both group Ⅷ and Ⅸ. The intubating conditions were not significantly different. ConclusionsED50 and ED95 for cisatracurium are 30.7μg/kg and 53.4μg/kg in Chinese patients. The onset time is shorter and duration of action longer with 3×ED95 which does not significantly affect BP and HR.

Objective To detect the expression of BMI-1, and to discuss its role in the development of gastric cancer. Methods The expression of BMI-1 protein and mRNA in gastric cancer and adjacent tissues was detected by immunohistochemical P-V method (78 cases) and semi-quantitative RT-PCR (30 cases). Results The positive expression rate of BMI-1 protein in gastric cancer patients was 66.7 % (52/78), and it was 19.2 % (15/78) in adjacent tissues, the difference was statistically significant (χ2= 35.815, P= 0.000). The expression of BMI-1 mRNA in 30 gastric cancer tissues was 0.23 ± 0.12, it was 0.03 ± 0.12 in adjacent tissues, the difference was statistically significant (t=8.372, P=0.000). The expression of BMI-1 protein and mRNA was correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and TNM staging (all P< 0.05). Conclusion The expression of BMI-1 is closely related to the occurrence and development of gastric cancer, which may provide guidance for molecular pathogenesis, targeted therapy and prognosis of gastric cancer.

Objective To explore the dynamic changes of abdominal and peripheral arteries in the patients with familial hypercholesterolemia(FH). Methods The intima-media thickness(IMT), stenotic degree and hemodynamics change of arteries were measured by ultrasonography in three children in 3 FH pedigrees. Results The plaques number and IMT of carotid and femoral arteries in the patients with FH significantly increased. The IMT of vertebral artery, subclavein artery, abdominal aorta, renal artery, illac artery and popliteal artery did not obviously changed. Conclusion Noninvasive vascular ultrasound was a preferred imaging technique to follow up the vascular change in the patients with FH.

Objective To access the left internal thoracic artery (LITA) graft late postoperative patency after coronary artery bypass grafting (CABG) by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging (CDCFI).In contrast with angiography,try to find available flow parameter to access graft patency.MethodsForty-six patients with CABG more than 1 year postoperatively followed-by angiography were detected by ultrasound.The LITA graft and left anterior descending artery were examined.Systolic and diastolic peak velocity(Smax,Dmax),velocity time integral(VTIs,VTId)of each segment were measured separately.The ratio of diastolic and systolic peak velocity (D/S),and diastolic velocity time integral fraction(DVTIF) were calculated.All patients were divided into groups according to angiography results.ResultsThirty -one LITA grafts were patent,11 were dysfunctional,4 were occlusive.According to the angiography results,the flow parameters of the proximal segment of LITA graft were significant.The D/S and DVTIF of patent group was higher than that of dysfunctional group.The diastolic peak velocity of distal segment of LAD of patent group was higher than that of dysfunctional group.ConclusionsPeripheral blood vessel ultrasound combined with CDCFI could provide the evidence to access the patency of the graft.It was an effective method for the clinical follow-up.

Objective To assess the effect of aortic valve replacement (AVR) on left ventricular (LV) twist function in severe aortic stenosis (AS) patients with preserved LV ejection fraction (LVEF) by speckle tracking imaging (STI).Methods Twenty-eight severe aortic stenosis (AS) patients (17 male,age 64.1 ± 10.4 years) with normal LVEF (≥50％) were examined by STI before and six months after AVR.The standard mitral valve and apical short-axis views were obtained to analyze LV basal and apical peak systolic rotation.LV peak systolic twist was calculated as the different between apical rotation and basal rotation.LV fractional shortening (LVFS) was calculated as the percentage fall of LV systolic dimension with respect to diastolic dimension.The data were compared with 28 age and sex-matched normal controls.Results In patients,LVEF remained unchanged after AVR.LV twist increased before (19.7° ± 5.7° vs 12.9° ± 3.2°,P ＜0.001) because of increased apical rotation (13.0° ± 5.8° vs 7.6° ± 2.6°,P ＜0.001),and normalized after AVR (14.4°± 5.2°,P ＜0.001).In controls,LV twist correlated with LVFS (r =0.81,P ＜ 0.001),this relationship was reversed in patients before (r =0.52,P ＜0.01) and after AVR (r =0.34,P ＞0.05).Conclusions In patients with severe AS and normal LVEF,LV twist is exaggerated suggesting potential compensation for reduced long axis function.These disturbances normalize within six months of AVR but lose their relationship with basal LV function.

Objective To evaluate the feasibility and accuracy of real-time three-dimensional transesophageal echocardiography(TEE) in assessment of left atrial appendage(LAA) function. Methods Forty-two atrial fibrillation patients underwent real-time three-dimensional TEE. LAA ejection fraction based on two-dimensional area measurements(EFA-2D), three-dimensional area measurements(EFA-3D) and three-dimensional volume measurements(EFv-3D) were calculated and related to LAA peak empty velocity (PEV). The variability within observer and interobserver were tested. Results EFA-2D was significantly higher than EFA-3D[(62.84 ± 17.27)% vs (45.39 ± 16.58)%, P = 0.000] and EFv-3D [( 62.84 ±17.27) % vs (48.35 ± 19.37) %, P = 0.001 ], whereas EFA-3D and EFv-3D had no significant difference ( P = 0.158). In a simple linear correlation,the degree of association between EFv-3D and PEV was higher as between EFA-3D and PEV ( r = 0.662 vs 0.604,both P ＜0.05). No significant correlation was observed between EFA-2D and PEV ( r = 0.529, P = 0.130). Variabilities within observer and interobserver were no significant differences by the three methods( P ＞0.05). Conclusions LAA ejection fraction calculation by real-time three-dimensional TEE is feasible and more accurate than by 2D TEE.

Aim To study clinical efficacy of valsartan,in comparison with amlodipine, in hypertentive patients with left ventricular hypertrophy. Methods 65 hypertentive patients with left ventricular hypertrophy is divided into two groups, with 33 cases in valsartan group and 32 cases in amlodipine group Valsartan 80～160mg and amlodipine 5～ 10 mg were taken by the patients in the two groups for 6 months respectively. 24 h ambulatory blood pressure monitoring ( 24 h ABPM) and color echocardiography were performed in the two groups before and after treatment. Results The parameters of 24 h ABPM ( 24 h SBP? 24 h DBP?dSBP?dDBP?nSBP?nDBP) and color echocardiography (IVST?PWT?LVMI)after treatment in the two groups were significant decreased compared with those before treatment respectively (P0.05). Conclusion Valsartan can lower significantly the blood pressure level and make left ventricular hypertrophy remarkably dispelled in hypertensive patients with left ventricular hypertrophy and has the effect similar to that of amlodipine.

Objective To describe the characteristics of the criss-cross heart with comprehensively segmental echocardiographic scanning in order to explore the diagnostic value of the echocardiography.Methods Ten cases of criss-cross heart were retrospectively reviewed with 2-dimensional,color Doppler echocardiography to summarize the main diagnostic methods.Results The right ventricle was located superiorly and the left ventricle inferiorly in 9 patients and paralleled alignment in 1.The solitus situs was observed in 9 patients and dextrocardia in 1;the atrioventricular connections were concordant in 8 patients and discordant in 2.Echocardiography revealed that 5 patients presented with transposition of great artery and 5 with double outlet of right ventricle as well as all with ventricular septum defect.Conclusions Clear visualization is available with echocardiography to show the crossing inflow streams at the level of atrial-ventricular valve,abnormal alignment of the ventricular septum as well as the associated abnormalities.

Objective To discuss the worthiness of real-time three-dimensional echocardiography in researching normal fetal heart ventricle growth and systolic function. Methods End-systolic volume(EDV),end-diastolic volume(ESV), struggle volume(SV) and ejection fraction(EF) of 54 normal fetal were acquired from 3-D data by Qlab software. The relation between ventricular growth with pregnant week was analysed and the difference of the volume and systolic function between left ventricle with right ventricle were compared. Results Ventricular volume of normal fetal heart (EDV,ESV,SV) were all increased with the gestational ages,there was linear relativity between them,while EF was not increased with pregnant weeks,there was no linear relativity between them. There was no statistics difference on EDV and ESV between left ventricle and right ventricle, while there was statistics difference on SV, EF between them. Conclusions The image of fetal endocarium could be derived clearly by real-time three-dimensional echocardiography, which help to get fetal heart ventricular volume and to study fetal heart growth and function.

Objective To study the difference ofLeonurus japonicus germplasm resources and provide good materials for breeding.Methods Totally 20 wildLeonurus japonicus germplasm resources from different places of China were collected. Experiment was conducted in homogeneous garden in Quzhou City of Zhejiang Province. Phenological phase, cold endurance and habitat adaptability were observed; the plant height, fresh weight and dry weight in early flowering were measured; the contents of stachydrine hydrochloride and leonurine hydrochloride were determined in early flowering and out-of-season cultivation.Results Considering the habitat adaptability, dry plant weight in early flowering, the contents of stachydrine hydrochloride and leonurine hydrochloride separately in early flowering and out-of-season cultivation, it was believed that the germplasms from Linbao County, Sheqi County in Henan Province and Guidong County in Hunan Province were better, in which Linbao germplasm was the best: the dry plant weight was 30.6 g, the content of stachydrine hydrochloride and leonurine hydrochloride were 1.31% and 0.19% respectively in early flowering, and were 3.44% and 0.37% respectively under anti-season cultivation, and it can be well adapted in Zhejiang Province.Conclusion The germplasm ofLeonurus japonicas from Lingbao can be the best materials for breeding.