Objective To evaluate the hemodynamic effects of rocuronium in patients with rheumatic heart disease during induction of anesthesia.Methods Twenty patients of either sex (ASA classes Ⅲ -Ⅳ ;NYHA classes Ⅱ -Ⅲ) scheduled for valve replacement were included in this double blinded study. Their ages ranged from 34 to 62 yr and weights from 48 to 70 kg. The patients were premedicated with intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.3mg. Radial artery was cannukted for direct BP monitoring and Swan-Ganz catheter was placed via right internal jugular vein for hemodynamic monitoring before induction of anesthesia.TOF,BIS,ECG and SpO2 were also monitored throughout anesthesia. Anesthesia was induced with midazolam 0.05-0.1 mg?g-1 and fentanyl 10-15?g?kg-1. The patients were randomized to receive either rocuronium 0.6 mg?kg-1 (group Ⅰ,n=10) or vecuronium 0.1 mg?kg-1(group Ⅱ,n=10) to facilitate tracheal intubation when BIS value dropped to 60%.The patients were mechanically ventilated (VT 8-10 ml?kg-1 ,RR 10-12 bpm).Systolic arterial pressure (SAP),MAP,HR,cardiac output (CO), PCWP, CVP, mixed venous blood O2 saturation (SvO2), BIS and TOF were recorded and stroke volume (SV), stroke index (SI), LVSWI and rate-pressure product (RPP) were calculated before anesthesia (To), 1 min after administration of muscle relaxant (T1), when TOF reached 0 (T2) and 1,2,3,4,5,7,10,15,20,25,30 min after tracheal intubation (T3-13).Results The demographic data including age, sex and body weight were comparable between the two groups. In rocuronium group HR increased by 17.43% -7.54%,SAP increased by 16.94% - 12.3% and RPP increased by 13.96% - 22.67% respectively during 1-7 min after intubation (T3-8) as compared with the baseline values (To), significantly higher than those in vecuronium group (P

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

BACKGROUND: Nucleus raphe magnus(NRM) is an important nucleus located in the median raphe of ventral medulla. Many studies have been focused on the crucial role which plays in acupuncture analgesia, cardiovascular regulation, respiratory regulation and other aspects of health. However,little attention has been paid to its role in the regulation of digestive system heretofore.OBJECTIVE: To investigate the effect of NRM on gastric movement and gastric electric activity in rabbits.DESIGN: Comparative study based on the experimental animals.SETTING: A laboratory of functional medicine in a traditional Chinese medical university. PARTICIPANTS: From September 2002 to April 2004, the study was conducted in the functional medicine laboratory of Heilongjiang University of Chinese Medicine(Provincial Key Laboratory). Seventy healthy New Zealand white rabbits were used including male and female, which weighed 2 - 2. 5 kg on average, supplied by the Laboratory Animal Center of Heilongjiang University of Chinese Medicine(Class I) . The rabbits were randomly divided into 7 groups: saline group, 5-hydroxytryptamine(5-HT)group, cyproheptadine group, substance P group, substance pantagonist group, morphine group and noradrenaline group.METHODS: Through cannula, microinjection of 5-HT, cyproheptadine, substance P, substance P antagonist, morphine and noradrenaline were given into NRM. Synchronously, gastric movement and changes in the amplitude and frequency of gastric electric slow wave in rabbits were recorded.MAIN OUTCOME MEASUREMENTS: Gastric movement and gastric electric activity were observed after microinjection of 5-HT, cyproheptadine,substance P, substance P antagonist, morphine and noradrenaline into NRM.RESULTS: After microinjection of 5-HT and substance P into NRM,gastric movement and gastric electric slow waves in rabbits were inhibited ( P ＜ 0. 05, P ＜ 0. 01 ). After microinjection of cyproheptadine, substance P antagonist, gastric movement and gastric electric slow waves in rabbits were increased( P ＜ 0.05, P ＜ 0.01) . Meanwhile, it turned out that microinjection of morphine and noradrenaline into NRM had no effect on gastric movement and gastric electric slow waves in rabbits ( P ＞ 0.05).CONCLUSION: 5-HT and substance P in NRM contribute to the regulation of gastric movement and gastric electric slow wave in rabbits by NRM, while morphine and noradrenaline presumably have no relation with the regulation.

Ceramics ; Dental Alloys ; chemistry ; Dental Porcelain ; Dental Restoration, Permanent ; Humans ; Metal Ceramic Alloys ; chemistry

Objective To investigate the clinical effect of ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculus.Methods A total of 72 cases of ureteral calculus was treated with stone fragmentation from April to November 2004,by using the Lumenis VersaPulse PowerSuite 100W Holmium Laser system and the Circon ACMI Micro Ureteroscope.Under ureteroscopic visualization,the laser lithotrite was introduced to the stones,and holmium laser intraluminal stone fragmentation was carried out. Results The operation time was 14~83 min(mean,28 min).Three cases of fragmentation failure were due to upper ureteral stones migrating to the renal pelvis.The success rate of fragmentation on one session was 95.8%(69/72),which was 92.1%(35/38) for upper segment calculi and 100%(34/34) for middle-to-lower segment calculi.Intraoperative complications included 3 cases of ureteral perforation(4.2%),9 cases of stone migration(12.5%),and 72 cases of hematuria(100%).Postoperative complications included 45 cases of lumbago(62.5%),72 cases of hematuria(100%),and 5 cases of urinary tract infection(6.9%), without ureteral stricture.The kidney,ureter,and bladder(KUB) X-ray radiograph on the first postoperative day showed a stone-free rate of 86.1%(62/72),and the remaining residual stones were thoroughly expelled within following 2 weeks.The length of postoperative hospital stay was 2~5 d(mean,3 d).Re-examinations with B-ultrasonography or intravenous urography(IVU) at 3 months after operation in 46 cases revealed no ureteral stricture.Hydronephrosis subsided by 1.4?0.5 cm in 28 cases and completely disappeared in 21 cases.Conclusions Ureteroscopic holmium laser lithotripsy for treating ureteral calculus offers satisfactory clinical effects and low complication rates.

Aim To investigate the effect of fluvastatin(FV)on the expression of IL-1? mRNA of left ventricular(LV) myocardium in rats with heart failure after acute myocardial infarction(AMI).Methods 6 h after ligating left coronary artery,surviving AMI female SD rats were randomly assigned to: ①AMI control;②AMI+FV;③sham-operated group,which was randomly selected as non-infarction control.After 8 weeks of therapy,we assessed cardiac function,hemodynamics,ventricular remodeling parameters and IL-1? mRNA expression in the infarcted and non-infarcted area(IA,NIA).Results Compared with the sham-operated group,LV end-diastolic dimension(LVEDD),LV end-diastolic volume(LVEDV),E-wave,E-wave deceleration,E/A ratio,LV end diastolic pressure(LVEDP),relative weight(LVRW),right ventricular relative weight(RVRW),collagen volume fraction(CVF) and IL-1? mRNA in NIA were all significantly increased in the AMI group(all P

Objective To explore the clinical characteristics, surgical methods and outcome of recurrent retinal detachment in silicone oil-filled eyes after vitreoretinal surgery. Design Retrospective, observational case series. Participants 55 patients (55 eyes) diagnosed as recurrent retinal detachment with silicone oil-filled eyes. Methods To analyze the clinical manifestations of recurrent retinal detachments and adopt different methods to make retina reattach including vitreoretinal surgery with or without silicone oil removal and scleral buckle revision alone. Patients were followed up for 3 months. Main Outcome Measures Clinical manifestations, retinal re-attachment and visual acuity. Results The characteristics of recurrent retinal detachment in silicone oil-filled eyes were inferior location mainly, less than 2 quadrants, with proliferation and hole. Fifty of the 55 patients underwent repeat surgical repair. Surgical methods included re-vitreoretinal surgery in 39 eyes with silicone oil removal, re-vitreoretinal surgery in 9 eyes without silicone oil removal and scleral buckle revision alone in 2 eyes. After a follow-up of 3 months, retina re-attached in 41 eyes, partially attached in 7 eyes, and detached in 2 eyes. Conclusions Repair of recurrent retinal detachment in silicone oil filled eye is challenging. Favorable anatomic outcome may be achieved in selected patients with proper surgical measures according to the characteristics of recurrent retinal detachment.

BACKGROUND:Bone marrow mesenchymal stem cells can survive under the lethal dose of radiation in response to hematopoietic stem cells, and stil maintain the typical characteristics of stem cells to promote hematopoietic recovery after radiation. However, autophagy is an important mechanism for cellular adaptation under stress, which may be involved in radiation tolerance of bone marrow mesenchymal stem cells. OBJECTIVE:To investigate the role of autophagy in human bone marrow mesenchymal stem cells in response to irradiation. METHODS:Passage 3 bone marrow mesenchymal stem cells cultured in vitro at logarithmic phase were col ected and randomized into control, 3-mehyladenine, rapamycin, irradiation, irradiation+3-mehyladenine and irradiation+rapamycin groups. The autophagy reactions of bone marrow mesenchymal stem cells were regulated by 5 mmol/L 3-mehyladenine and 200 nmol/L rapamycin for 12 hours in the 3-mehyladenine and rapamycin groups, respectively. Two-hour 6 Gy X-ray irradiation was performed in the irradiation group and two complication groups undergoing 12-hour corresponding drug intervention. RESULTS AND CONCLUSION:The proportions of cells with autophagic vacuoles and apoptotic cells were higher in the irradiation group than the control group, moreover, autophagic+apoptotic cells were increased in the irradiation group. 3-mehyladenine intervention could decrease the proportion of cells with autophagic vacuoles,and increase the number of apoptotic cells. But there was no difference in the proportion of autophagic+apoptotic cells between the 3-mehyladenine and irradiation groups. After rapamycin intervention, the proportion of autophagic cells was higher than that in the irradiation group, but no difference in the proportion of apoptotic cells between the two grups, as wel as there were no autophagic+apoptotic cells. The expression of microtubule-associated protein 1 light chain 3-II was ranked as fol ows:the control and 3-mehyladenine groups

5-lipoxygenase (5LO) is the key enzyme in the synthesis of leukotrienes, which are potent biological mediators of inflammation and anaphylaxis.After lock out of the 5LO gene by homologous recombination in embryonic stem cells, 5LO deficient-mice can develop normally and stay healthy, with a selective opposition to certain inflammatory insults. The cellular distribution of 5LO in unstimulated cells among different cell types is different; it can present in the cytosol, the nucleus, or both. 5LO was also found capable of shuttling in and out of the nucleus under certain conditions. It is suggested that 5LO might have other functions besides its traditional catalytic role.

Objective To assess the effect of xiaojin wan plus nimesulide on patients with subacute granu-lomatoas thyroiditis(SAT). Methods 70 SAT cases were divided into nimesulide group(nimesulide 0.1 g,2/d) and combined group(nimesulide 0.1 g,2/d and xiaojin wan 1.2 g,2/d). When the patients' conditions were re-lieved after 3-4 weeks treatment,half doses of the medicines were given in two groups for 8 weeks. The efficacy,safe-ty and relapse rate after withdrawing medicines for 12 weeks were observed. Results The effective rates were 82.90% (29/35) in nimosulide group and 85.7% (30/35)in combined group, but both groups' effective rate was 50.0% (3/6) in patients with high temperature (higher than 39 ℃). The time for fever relieved in two groups were similar (P>0.05), but the thyroid pain smoothing time, normalized rates of blood sedimentation after 1 week therapy, enlarged thyroid or thyroid nodule after 3 week therapy, relapsed rate were significantly more efficacious in combined group than in nimesulide group (P<0.05). There was no severe side effects in the two groups. Conclu-sious There is a synergic effect of xiaojin wan plus nimesulide on patients with SAT, that is an effective and safe therapeutic regimen for SAT patients without high temperature.