Objective To investigate the effect of desflurane anesthesia on the autonomic nervous system in patients at high risk for coronary artery disease.Methods Thirty patients at high risk for coronary artery disease scheduled for elective abdominal operation were selected. Heart rate variability (HRV) was assessed at preoperation, inhalation of 05,10,15 and 20 MAC of desflurane with Holter electrocardiography Results Low-frequency component increased markedly inhaling low concentration of desflurane. With the increase of the concentration of desflurane, both the high-frequency and low-frequency components decreased significantly (P0 05).Conclusions Desflurane balanced anesthesia dose not increase the activity of sympathetic nervous system.

Objective:To explore the propagable experience and methods of controlling the rate of cesarean sec-tion through the summary of the innovative measures in four counties. Methods:The cases of natural birth and cesare-an section from 2009 to 2013 in four counties were analyzed respectively. The interventions of controlling cesarean section rate have been summarized. Results:The average cesarean section rate of four counties in five years is on the decline, since 2009 the rate were 60. 2%,62. 3%,59. 3%,51. 4%,48. 1%. Conclusions: The interventions really worked, but did not do the best. Improving the social attention on these innovative measures, strengthening surveil-lance mechanism, regulating the medical behaviors of delivery hospitals, enhancing the midwifery training and promo-ting the interventions under the coordination of local government can further reduce the rate of cesarean section.

Long-term tachycardia may cause tachycardiomyopathy(TCM),clinical manifestation is similar to the dilated cardiomyopathy.But,after treatment,cardiac function can be partially or completely recovered.By the explanation of definition,etiology,pathogenesis,diagnosis and treatment progress of TCM,the aim of the thesis is to enrich the knowledge of clinician about the diagnosis and treatment of TCM.

Toxoplasma gondii is a globally distributed Apicomplexan Protozoa which can infect all warm-blooded animals and cause serious diseases in immunocompromised host.More attention has been paid to wide distribution and opportunistic pathogenesis of T.gondii.This paper is summarized the history,the lastest hotspots in Toxoplasma and future challenges in toxoplasmosis control.

Annexin A1 (ANXA1) is a kind of endogenous scaffold protein. Previous research showed that ANXA1 could increase markedly with multiple increase of drug resistance in K562/imatinib cell lines in vitro. Here the stable transfection cell strains K562-pEGFP-N1 which was the native control and K562-pEGFP-N1-ANXA1 which can stably express ANXA1 were established using the Lipofectamine 2000 in order to find whether ANXA1 involved in the drug resistance. Cell growth inhibition experiment via MTT and cell proliferation experiment via MTS showed that K562-pEGFP-N1-ANXA1 cell strain was more sensitive to imatinib than the K562-pEGFP-N1 cell strain, and however the ability of proliferation of K562-pEGFP-N1-ANXA1 cell strain did not change compared with the negative control. Western blotting results showed that the expression of proteins in Annexin family did not change; drug resistance proteins, Bcr-Abl/p-Bcr-Abl (Tyr245), Src family kinase for example, did not change; proteins related with cell proliferation and cell cycle, such as ERK1/2MAPK, p-38MAPK, CDK1 and Wee 1, did not change either in the K562-pEGFP-N1-ANXA1 cell strain compared with the negative control. The co-immunoprecipitation result showed that the interaction between ANXA1 and beta-actin in the K562-pEGFP-N1-ANXA1 cell strain increased markedly. The deduction was that ANXA1 may make the K562-pEGFP-N1-ANXA1 cell strain more sensitive to imatinib due to the increased uptake of imatinib via the increase of ANXA1 and the interaction between ANXA1 and beta-actin in the K562-pEGFP-N1-ANXA1 cell strain in vitro.

Objective To study the difference of Han male children and adolescent bone age of wrist-hand in Beijing and Guangzhou.Methods Bone age (BA) of left hand-wrist was assessed using X-ray by two radiologists based on CHN atlas method in 993 healthy children and adolescents (age range:1.0-19.0 years).The radiologists were blinded to the chronological age (CA) of those children.The interobserver variations were analyzed for evaluating the reliability of CHN Atlas method.The difference between CA and BA were separately assessed,and were analyzed by t test.Results Close correlation was found between BA and CA (r =0.969,0.957,P ＜ 0.01) in both two regions.The bone age was advanced at 1.0-3.9,and 7.0-15.9 years in Beijing boys,and at 1.0-2.9,6.0-7.9 years in Guangzhou bpys.There was significant difference at 1.0-1.9,9.0-14.9 years between Beijing and Guangzhou.Conclusions The bone age of Han male children adolescent in Beijing and Guangzhou area has the characteristic of acceleration.There is significance difference at some years between Beijing and Guangzhou,and the results can provide potential value for the further study of BA and clinical medicine.

Objective To explore the repair effect of methylcobalamin treatment of nerve after spinal cord injury.Methods 108 cases of patients with acute spinal cord injury were selected treated in our hospital from 2010 April to 2014 April , including 60 cases of male, female 48 cases, were randomly divided into Mecobalamin group(n=56) and control group(n=52), mecobalamin group was treat with a cobalt amine, control group was given conventional treatment (dexamethasone intravenous drip note).According to American spinal cord injury score (ASIA) to set sensory function, motor function and spinal cord function score criteria, observed and record ed the sensory function, motor function, recovery of neurological function and complications the two groups of patients were treated for 6 weeks and followed up for 6 months.Results Spinal cord injury patients after 6 weeks and 6 months follow-up, the improvement of sensory and motor function of mecobalamin group were significantly better than the control group ( P <0.01 );Mecobalamin group patients after first to 3 weeks of recovery of neurological function was higher than those of the control group (P<0.05);the 2 groups were found urinary tract infections, lung infections, vomiting, reaction of ulcer complications, but the difference was not statistically significant ( P>0.05).Conclusion In patients with acute spinal cord injury treated by mecobalamin treatment can improve the nerve function damage condition, improve the prognosis and quality of life.

Objective To investigate the effectiveness and safety of endovascular coiling and microsurgical clipping for ruptured intracranial aneurysms. Methods Patients w ith ruptured intracranial aneurysm treated w ith endovascular coiling or microsurgical clipping w ere enrol ed retrospectively. The demography, baseline clinical data, outcome, and complications in patients received endovascular coiling and microsurgical clipping w ere compared. Results A total of 85 patients w ith ruptured intracranial aneurysm were enroled, including 40 were treated with microsurgical clipping (surgical clipping group) and 45 were treated w ith endovascular coiling (endovascular coiling group). There w ere no significant differences in the proportions of the patients in male (37.5%vs.40.0%; χ2 =0.056, P=0.813), hypertension (30.0%vs. 33.3%; χ2 =0.109, P=0.742 ), smoking ( 50.0%vs.48.9%; χ2 =0.010, P=0.918 ), drinking (45.0%vs.46.7%; χ2 =0.024, P=0.878), aneurysm site (anterior communicating artery: 50.0%vs. 48.9%;posterior communicating artery:35.0%vs.33.3%; middle cerebral artery:10.0 %vs.11.1%;vertebral artery: 5.0%vs.6.7%; al P>0.05), aneurysm maximum diameter < 10 mm (80.0%vs. 77.8%;χ2 =0.063, P=0.802), Hunt-Hess grade 1-2 (55.0%vs.57.8%; χ2 =0.066, P=0.797), Fisher grade 1-2 ( 60.0%vs.57.8%; χ2 =0.043, P=0.835 ), and time from onset to treatment < 72 h (62.5%vs.64.4%; χ2 =0.035, P=0.853) in the surgical clipping group and endovascular coiling group. There w ere no significant differences in the complete occlusion rate of aneurysms ( 97.5%vs.91.1%;P=0.364) and the good outcome rate (65.0%vs.68.9%; χ2 =0.145, P=0.703) betw een the surgical clipping group and the endovascular coiling group. No patients died in the surgical clipping group and 1 patient died in the endovascular coiling group, and there w as no significant difference ( P=1.000). One patient (2.5%) had cerebral infarction in the surgical clipping group and no patients had cerebral infarction in the endovascular coiling group, and there w as no significant difference ( P=0.471). Conclusions The efficacy and safety of microsurgical clipping are the same as those of endovascular coiling for ruptured intracranial aneurysms.

Objective To compare the efficacy, complications, safety and prognosis of the minimally invasive puncture approach and key hole in the treatment of hypertensive cerebral hematoma.Methods A totol of 68 patients with hypertensive cerebral hematoma confirmed by CT from April 2012 to October 2013 in Nongken Sanya Hospital were randomly divided into key hole evacuation group(n=32) and minimally invasive puncture group (n =36).Comparisons were made between the two surgical methods in the operative time, postoperative complications, the fatality and the postoperative re-haemorrhagia rate, neurological function deficit score also been observed and evaluated in the 1 st,2nd and 4th weeks after surgery.Results The NFDS scores of the two groups both decreased in the 1st week after surgery,but compare with preoperative the difference was not statistically significant (P ＞ 0.05).In the 2nd weeks and 4th weeks after surgery, NFDS scores further decreased in both group,and there was statistically significant compare with preoperative(the key hole evacuation group : (26.2±4.5) vs.(17.8 ± 3.6) vs.(44.1 ± 5.4) scores;the minimally invasive puncture group: (22.1 ± ±3.7) vs.(15.4±2.8) vs.(43.9±6.2)scores;P＜0.05) ,but during the same period there was no significant difference between the two groups with NFDS scores(P＞0.05).The rebleeding rate of the minimally invasive puncture group was significantly lower than the key hole evacuation group (4.08％ vs.16.33％, x2=6.56, P＜0.05).There was no significant difference in mortality rate and long term total effect between two groups (P＞0.05).Conclusion Although both key hole and minimally invasive puncture are effective measures for treatment of hypertensive cerebral hemorrhage, but minimally invasive puncture with less trauma, definite curative effect and higher security advantages in clinical.