0 05); At the 7th day, T?RⅠ mRNAs expression was decreased( P

Objective To evaluate the reliability of transcranial doppler (TCD) in detection spasm of middle cerebral artery (MCA),vertebral artery (VA ) and basilar artery (BA).Methods TCD and digital subtraction angiography (DSA) examination were undertaken in 50 patients with subarachnoid hemorrhage.Results Arterial spasm was diagnosed in 26 MCA by DSA,21 of which were detected by TCD at same time.4 MCA were showed by TCD but not confirmed by DSA. The sensitivity and specificity of TCD in diagnosing MCA spasm were 80.8% and 84.0% respectively. Higher sensitivity was revealed in those with severe MCA spasm. DSA also found out asterial spasm of BA in 18 BA,among which 13 arteries were detected by TCD simutaneously.4 BA were diagnosed by TCD but not proved by DSA. The sensitivity and the specificity of TCD in diagnosing BA spasm were 72.2% and 76.5% respectively.28 VA were diagnosed by DSA,among which 20 arteries were proved by TCD.6 VA were detected by TCD but not proved by DSA. The sensitivity and specificity of TCD in diagnosing VA spasm were 71.4% and 76.9% respectively.Conclusion TCD is reliable in diagnosing the spasm of MCA,BA and VA.

Objective To evaluate the effects of different analgesics combined with propofol of intravenous anesthesia on postoperative analgesia and emotion in patients of artificial abortion. Methods One hundred and twenty-two patients who had underwent painless artificial abortion were selected. The patients were divided into 4 groups by random digits table method: simple propofol group (C group, 29 cases), fentanyl combined with propofol group (F group, 30 cases), oxycodone combined with propofol group (Q group, 30 cases) and sufentanil combined with propofol group (S group, 33 cases). The induced dose of propofol was 2.5 mg/kg. When patients had limb movement during operation, a single addition of propofol 0.5 mg/kg was added until the body movement disappeared. The changes of mean arterial pressure (MAP), heart rate and respiratory rate before and after operation were compared among the 4 groups. The emotional status was assessed with affective scale before operation and 1 h after operation. The visual analog scale (VAS) was used to evaluate the degree of abdominal pain at 10, 30 and 60 min after palinesthesia. The propofol dose, operation time, recovery time and adverse reaction were recorded. Results No obvious adverse reactions were found during the operation. There was no statistical difference in operation time among 4 groups (P>0.05). The propofol dose, recovery time, body movement and the VAS score at 10, 30, 60 min after palinesthesia in F group, Q group and S group were significantly lower than those in C group, and there were statistical differences (P<0.05);but there were no statistical difference among F group, Q group and S group (P>0.05). The MAP, heart rate and respiratory rate at beginning of the surgery and during the surgery were significantly lower than that before anesthesia in the 4 groups, and there were statistical differences (P<0.05); but there were no statistical differences in MAP, heart rate and respiratory rate among 4 groups (P>0.05). The positive affective score after operation in C group, F group, Q group and S group was significantly higher than that before operation: (24.6 ± 5.6) scores vs. (21.7 ± 6.2) scores, (24.6 ± 3.1) scores vs. (20.6 ± 4.6) scores, (28.3 ± 6.3) scores vs. (20.8 ± 5.3) scores and (25.2 ± 5.4) scores vs. (19.9 ± 4.8) scores, and the negative affective score after operation in C group, F group, Q group and S group was significantly lower than that before operation: (17.0 ± 5.3) scores vs. (29.7 ± 7.4) scores, (17.2 ± 3.0) scores vs. (30.8 ± 5.0) scores, (16.1 ± 5.1) scores vs. (30.4 ± 4.9) scores and (17.9 ± 4.0) scores vs. (32.1 ± 5.5) scores, and there were statistical differences (P<0.05). The positive affective score after operation in Q group was significantly higher than that in C group, F group and S group, and there was statistical difference (P<0.05). There was no statistical difference in negative affective score after operation among 4 groups (P>0.05). Conclusions The fentanyl, sufentanil and oxycodone combined with propofol of intravenous anesthesia in patients underwent artificial abortion can reduce propofol dose, shorten recovery time, improve positive affective score, decrease negative affective score and strengthen the analgesic effect, and doesn't increase the adverse reaction. The respiratory and circulatory inhibition effects of different analgesics combined with propofol of intravenous anesthesia were similar, but oxycodone can increase positive affective score.

Objective To observe the clinical value of application of low-dose scanning technology in dual source CT coronary angiography.Methods 200 cases who received coronary artery imaging were randomly selected as the study subjects.Patients were divided into the observation group and the control group using the random number method,100 cases in each group.All patients underwent dual source CT angiography.The observation group was treated by adaptive prospective ECG gated sequence,the control group was treated with retrospective ECG gated sequences.The image quality and radiation dose to bear were compared between the two groups.Results The various stages of image score proportion between the two groups had no significant difference(P＞0.05).The average score of reading image of the observation group was (1.52±0.33)points,which of the control group was (1.48±0.46)points,there was no difference between the two groups(t=0.857,P＞0.05).The CTDL,DLP and ED in the observation group were significantly lower than the control group[the observation group:CTDL(23.41±5.82),DLP(224.61±85.44),ED(3.01±1.12)mSv;the control group:CTDL(34.09±6.77),DLP(82.93±94.28),ED(5.33±2.01)mSv],and the differences were statistically significant(t=11.963,12.443,10.083,all P＜0.05)].Conclusion Prospective ECG gated sequence technology can effectively reduce the radiation dose of the patients under dual source CT coronary angiography,reduce probability of radiation damage,and the image quality is not changed obviously,which meets the needs of clinical diagnosis.

Objective To investigate the effect of sufentanil on norepinephrine (NE)-induced contraction of thoracic aorta isolated from rats with spontaneous hypertension (SH) .Methods Eight male rats with SH weighing 250-300 g were used in this study. The rats were decapitated and their thoracic aortas were isolated and cut into rings 2-3 mm in length. The aorta rings were suspended for isometric tension recording. The aortic rings obtained from SH rats were divided into 4 groups ( n = 8 each) : control group and 3 sufentanil groups. The contraction of aortic rings in response to NE in the absence (control) and presence of 3 concentrations of sufentanil 7 × 10-11 ,2 × 10-10 and 1 × 10-9 mol/L was recorded. Results The amplitude of NE-induced contraction of thoracic aorta was significantly greater in 3 sufentanil groups than in control group. Sufentanil significantly inhibited the NE-induced aortic contration in proportion to concentration. Conclusion Sufentanil can inhibit NE-induced contraction of thoracic aorta isolated from rats with SH in a concentration-dependent manner.

Objective To evaluate the mechanism of altered gastrointestinal motility in portal hypertensive rats. Methods Thirty-two male Sprague-Dawley rats were divided into four groups:sham- operation control (SO, n=8), prehepatic portal hypertension by partial stenosis of the portal vein (PHPH, n=8 ), intrahepatic portal hypertension induced by injection of CCl 4 (IHPH, n=8), and intrahepatic portal hypertension with portacaval shunt (IHPH-PCS, n=8). Gastrointestinal myoelectrical activity and motility were monitored. Gastrointestinal hormones were measured with radioimmunoassay.Results Compared with SO rats, gastrointestinal motor index(MI) were reduced and abnormal myoelectrical activity were recorded (P

ObjectiveTo investigate the influence of fluid balance and model of renal replacement therapy (RRT) on renal function and prognosis of patients suffering from septic acute kidney injury (AKI).Methods A retrospective cohort analysis of 117 septic AKI patients who had undergone RRT between January 2009 and December 2014 was performed in the Second Affiliated Hospital of Nanjing Medical University. The patients were divided into positive fluid balance group (n = 52) and negative fluid balance group (n = 65) according to the total amount of fluid calculated from the difference between fluid administered and fluid lost during the first 1 week of RRT. The incidence of renal recovery and death of the patients by 60 days as the endpoint events were taken to judge the prognosis of two groups. RRT strategies included continuous renal replacement therapy (CRRT) and intermittent renal replacement therapy (IRRT). Multiple factors including estimated glomerular filtration rate (eGFR), sequential organ failure assessment (SOFA) score, RRT model, the accumulation of fluid before initiation of RRT, and negative fluid balance during RRT were analyzed for outcome predictors by Cox proportional hazards model.Results There were no differences between two groups regarding clinical characteristics. The percentage of receiving CRRT in the negative fluid balance group was slightly higher than that of the positive fluid balance group (52.31% vs. 36.54%,χ2 = 2.899,P = 0.089). With Kaplan-Meier survival curves, it was shown that the patients of negative fluid balance group had a higher rate of recovery of renal function (χ2 = 4.803,P = 0.028) and significantly lower mortality rate (χ2 = 9.505, P = 0.002). The rate of recovery of renal function by 60 days was higher in the negative fluid balance group than that in the positive fluid balance group (47.69% vs. 28.85%,χ2 = 3.991,P = 0.046), while the mortality rate was significantly lowered in the negative fluid balance group compared with that of the positive fluid balance group (40.00% vs. 67.31%,χ2 = 4.378,P = 0.036). Cox multivariate regression was used for excluding confounding factors. After adjusting for the clinically relevant variables, RRT negative fluid balance was significantly associated with recovery of renal function [hazard ratios (HR) = 2.440, 95% confidence intervals (95%CI) = 1.089-5.464,P = 0.030] and mortality (HR = 0.443, 95%CI = 0.238-0.822,P = 0.010]. Higher eGFR before RRT and CRRT were independent favorable factors for recovery of renal function (HR= 1.014, 95%CI = 1.003-1.026,P = 0.012;HR = 3.138, 95%CI = 1.765-7.461,P = 0.002), and higher SOFA score was associated with a significantly higher risk of death (HR = 1.115, 95%CI = 1.057-1.177, P< 0.001).ConclusionsOnce the patients with septic AKI showed the signs of fluid overload, timely RRT and effective removal of excessive liquid may reverse the adverse prognosis. RRT with negative fluid balance is beneficial for the recovery of renal function, and reduce the mortality in patients with septic AKI, and CRRT model is a good choice.

Objective To investigate the effect of general anesthesia combined with epidural block anesthesia on intestinal barrier function in patients with gastric cancer after radical resection.Methods 90 patients with gastric cancer undergoing laparoscopic radical resection were selected.They were randomly divided into observation group (epidural anesthesia plus general anesthesia) and control group (general anesthesia),45 cases in each group.The intraoperative blood loss,intraoperative infusion volume,postoperative exhaust time,postoperative complications and the function of intestinal barrier effects were compared between the two groups.Results The total incidence rate of postoperative complications in the observation group(8.89％) was significantly lower than that in the control group (28.89％) (x2 =4.83,P ＜ 0.05).The hospital stay in the observation group [(12.5 ± 4.23) d] was significantly shorter than that in the control group [(17.5 ± 5.26) d] (t =3.27,P ＜ 0.05).The two amine oxidase [(3.88 ± 0.98) U/L],D-lactic acid [(7.44 ± 5.23) mg/L],endotoxin [(13.44 ± 2.12) U/L] levels of the observation group were significantly lower than those of the control group [two amine oxidase (11.33 ± 1.25) U/L,D-lactic acid (15.34 ±3.21) mg/L,endotoxin (21.03 ± 0.82) U/L] (t =5.63,5.02,4.19,all P ＜ 0.05).Conclusion Compared with total intravenous anesthesia,total intravenous anesthesia combined with epidural anesthesia is beneficial to the recovery of intestinal barrier function after radical gastrectomy,and can shorten the postoperative hospital stay.It is worthy of clinical application and popularization.

Objective To discuss the feasibility and clinical outcomes of mini-open reduction through lateral deltoid muscle and locking plate fixation in treatment of proximal humeral fractures.Methods A retrospective study was carried out on 39 patients with proximal humeral fractures treated with mini-open reduction through lateral deltoid muscle and locking plate fixation from September 2012 to September 2015.There were 7 males and 32 females,with a mean age of 66.8 years (range,33-86 years).According to the Neer's classification system,there were 26 patients with two-part fracture and 13 with three-part fracture.visual analogue scale (VAS),Constant-Murley shoulder score,time of bone healing and complications were evaluated for all patients.Results All patients were followed up for 12-48 months (mean,21.3 months).All fractures were proved to be bone healing with duration of (12.0 ± 2.7) weeks.The VAS was improved from preoperative (5.7 ± 1.0) points to (0.9 ± 0.6) points at the final follow-up (P ＜ 0.05).The Constant-Murley shoulder score was increased from preoperative (42.3 ±5.1) points to (89.2± 2.5)points at the final follow-up (P ＜ 0.05).Ranges of shoulder motion were improved with satisfactions.There were no complications like axillary nerve injury,loss of reduction,nonunion or humeral head necrosis.Conclusion For proximal humeral fractures,the miniopen reduction through lateral deltoid muscle and locking plate fixation has advantages of minimal invasion,excellent shoulder function,high rate of bone healing and low incidence of complications.

AIM To study the pharmacodynamics of Baijin Granules [Mallotus apelta (lour.) Muell.Arg.,Smilax china L.],Zhuang medicine,on model rats with sequelae of pelvic inflammatory disease.METHODS The rat model for sequelae of pelvic inflammatory disease was built with mixed bacteria (Escherichia coli and Staphylococcus aureus) and mechanical injury.Subsequently,the rats were randomly divided into eight groups,including model,Baijin Granules low-,middle-,high-dose,positive control (dexamethasone and Huahong Granules),blank control and sham operation groups,with ten rats in each group.After 14 days of successive administration,the hemorheology and blood routine in rats' abdominal aorta were measured by collecting blood in 24 hours of last administration.The pathological morphology of uterine tissue was observed.RESULTS The hemorheology indexes,WBC count and neutrophil percentage were significantly decreased in the model rats,and the pathological morphology of uterine tissue was markedly improved.CONCLUSION Baijin Granules have good therapeutic effects on sequelae of pelvic inflammatory disease in rats.