Objective To evaluate the efficacy and safety of distal embolic protection device(DPD) on acute myocardial infarction(AMI) with ST-segment elevation.Methods Two hundred and sixty-seven patients with ST-segment elevation AMI treated in emergency with percutaneous coronary intervention(PCI) from Jan.1,2004 to Dec.31,2005 in the Department of Cardiology,Xijing Hospital were studied retrospectively.169 patients were included in control group and 98 in DPD group.Patients in control group were treated with emergency PCI,while those in DPD group were treated with DPD during emergency PCI.The incidence of "no-reflow" phenomenon,thrombolysis in myocardial infarction(TIMI) 3 flow,and ST segment resolution were observed,and mortality in-hospital and left ventricular ejection fraction(LVEF) at 1 week after PCI were compared between the two groups.Results The incidence of "no-reflow" was 3.06%(3/98) in DPD group and 13.61%(23/169) in control group(P

Purpose To construct a recombined antitumor peptide and to analyze its bioactivity. Methods Constructing a recombined gene and inserting the pGEX-4T-3 vector. The recombined protein was expressed in E. coli BL21 and purified with Amylose Resin. Then, citrostatin was subjected to the following tests separately: inhibition of endothelial cell proliferation, MTT test of cytotoxicity and inhibition of endothelial cell tube formation on ECMatrix. Results Citrostatin significantly inhibited the proliferation of human endothelial cell ECV304(IC_(50) = 2.28 μmol/L) .It also significantly inhibited the proliferation of human tumor cell 1990 and NCI-H64O(IC_(50) = 9.24,2.74 μmol/L) ,and the inhibitory effect became more marked with the increase of citrostatin concentration. The inhibitory effects of citrostatin on endothelial cell tube formation was also confirmed . Conclusion An antitumor peptide, citrostatin, has been successfully constructed and purified, which showed anti-angiogenesis effect and direct cytotoxic effect on tumor cells.

Objective To investigate the effect of different doses of dexmedetomidine(Dex)on sevoflurane consumption in patients undergoing laparoscopic oophorocystectomy.Methods Eighty ASA Ⅰ or Ⅱ patients aged 25-50 yr with body mass index 18-25 kg/m2 undergoing laparoscopic oophorocystectomy were randomly divided into 4 groups (n =20): control group (group C),low dose Dex group(group DL),medium dose Dex group(group DM) and high dose Dex group(group DH).Normal saline 20 ml and Dex 0.3,0.6,0.9μg/kg was infused iv over 10 min at 10 min before skin incision in groups C,DL,DM and DH,respectively.End-tidal sevoflurane concentration (ETsev) was recorded before Dex administration(T1 ),skin incision(T2 ),immediately after pneumoperitoneum (T3 ),10 min of pneumoperitoneum(T4 ) and the end of surgery (T5 ).Duration of anesthesia,consumption of sevoflurane,emergence time,extubation time were recorded and restlessness at 10 min after extubation was also recorded.The concentrations of blood glucose and corticosteroid were measured by quickly by glucose analyzer and radio-immunity gefore anethesia induction (T0) and at T3,T4,T5 respectively.Results The consumption of sevoflurane per hour,ETsev at T2-5,concentrations of blood glucose and corticosteroid at T3-5 were decreased gradually in groups C,DL,DM and DH ( P ＜ 0.05).The emergence time and extubation time were shorter and the incidence of restlessness was lower in groups DL,DM and DH than in group C ( P ＜ 0.05 ).Conclusion Dexmedetomidine can reduce the consumption of sevoflurane in a dose-dependent manner in patients undergoing laparoscopic oophorocystectomy.

Objective To evaluate the role of interleukin-4 receptor (IL-4R) in renal fibrosis following renal ischemia-reperfusion (I/R) injury in mice.Methods Twelve male wild type BALB/C mice and 12 IL-4Rα gene-knockout mice,aged 8-10 weeks,weighing 20-30 g,were used in the study.The mice of either type were divided into 2 groups (n =6 each) using a random number table:sham operation group (group S) and group I/R.In group I/R,renal I/R was induced by occlusion of the right renal artery for 1 h with atraumatic microclips followed by 2 weeks of reperfusion.The right renal artery was only isolated in group S.At 2 weeks of reperfusion,blood samples were taken from the orbital vein for determination of the concentrations of serum blood urea nitrogen (BUN) and creatinine (Cr).The renal tissues were obtained,and the renal fibrosis area was measured by Sirius Red staining.The expression of fibronectin (FN),collagen Ⅰ (COL-Ⅰ) and α-smooth muscle actin (α-SMA) in renal tissues was detected by immunofluorescence.The expression of signal transducer and activator of transcription 6 (STAT6) and phospho-STAT6 in renal tissues was determined by Western blot.The ratio of phoshop-STAT6 to STAT6 was calculated to reflect the phosphorylation of STAT6.Results Compared with group S of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly increased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly up-regulated,and the phosphorylation of STAT6 in renal tissues was significantly increased in group I/R of wild type and IL-4Rα KO mice (P＜0.05).Compared with group I/R of wild type mice,the serum BUN and Cr concentrations and renal fibrosis area were significantly decreased,the expression of FN,COL-Ⅰ and α-SMA in renal tissues was significantly down-regulated,and the phosphorylation of STAT6 in renal tissues was significantly decreased in group I/R of IL-4RαKO mice (P＜0.05).Conclusion The mechanism of renal fibrosis following renal I/R injury is partially related to IL-4R,and IL-4R results in renal fibrosis through promoting activation of STAT6 signaling pathway in mice.

Objective To comparatively analyze the in vitro antiviral mechanism( s) of eugeniin and quercetin against varicella-zoster virus ( VZV) by using a novel antiviral assay based upon a reporter cell line (MV9G cells) for VZV. Methods Selection indexes (SIs) of potential antiviral compounds extracted from Chinese herbs or plants including eugeniin, eugenol, morin, curcumin, myricetin and quercetin for in vitro inhibition of VZV were calculated. The compounds with relatively higher SIs were screened out for fur-ther investigation of their in vitro inhibitory mechanisms with a cell-free virus ( CFVs) direct-infection assay and a cell-associated virus (CAVs) co-culture assay established with MV9G cells in our previous study. The inhibitory mechanisms analyzed in this study included direct inactivation of CFVs, inhibition of the adhesion and/or penetration capabilities of CFVs to MV9G cells, inhibition of the intracellular replication of CAVs and inhibition of the transcription and / or expression of viral immediate early gene 62 ( IE62 ) . Results Among the tested compounds, eugeniin and quercetin showed relatively higher SIs of 5. 82 and 8. 97, respec-tively. Eugeniin rather than quercetin directly but partly inactivated CFVs and inhibited their attachment to and penetration into MV9G cells in a concentration-dependent manner. Both eugeniin and quercetin revers-ibly inhibited the intracellular replication of CAVs and the transcription and expression of viral IE62 gene, for which eugeniin needed to be added within 12 hours after infection. Conclusion Eugeniin and quercetin had different in vitro inhibitory mechanisms against VZV, but inhibiting the transcription and expression of viral IE62 gene was a common mechanism shared by both of them.

Objective To evaluate the effects of the right stellate ganglion block on the expression of β3adrenoceptor (β3-AR) in rabbits with heart failure.Methods Forty-eight Japanese white rabbits of both sexes,weighing 2.5-3.0 kg,were randomly divided into 3 groups (n =16 each):sham operation group (group S),heart failure group (group HF) and right stellate ganglion block group (group RSGB).Heart failure was induced by occlusion of left anterior descending branch of coronary artery and confirmed by ultrasonic cardiography 4 weeks later.A PE-10 catheter was inserted into the right stellate ganglion for administration of drugs.0.25％ bupivacaine 2 ml was injected through the catheter once a day for 2 weeks in group RSGB,while the equal volume of normal saline was injected instead of bupivacaine in S and HF groups.The left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD),ejection fraction (EF) and left ventricular fractional shortening (LVFS) were measured at 1 day before ligation (T0),before catheter insertion (T1),before 8th administration (T2),and 1 day after the last administration (T3).Eight rabbits were sacrificed at T1 and T3 in each group and myocardial specimens were obtained from the apex of the left ventricle for determination of the expression of β3-AR by Western blot.Results Compared with group S,the LVEDD and LVESD were significantly enlarged and LVEF and LVFS were decreased at T1-3,and the expression of β3-AR was up-regulated at T1,3 in groups HF and RSGB (P ＜ 0.05).Compared with group HF,the LVEDD and LVESD were significantly decreased,LVEF and LVFS were increased,and the expression of β3-AR was significantly down-regulated at T3 in group RSGB (P ＜ 0.05).Conclusion The right stellate ganglion block can improve the cardiac function of rabbits with heart failure through down-regulating the expression of β3-AR in myocardium.

BACKGROUND:Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present.
OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity.
METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated.
RESULTS AND CONCLUSION:The postoperative fol ow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P<0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity.

Objective To compare the quality of emergence from TCI of sufentanil and remifentanil supplementing propofol-sevoflurane anesthesia in patients undergoing radical colo-rectal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 40-64 yr undergoing elective radical colo-rectal cancer resection were allocated into 2 groups ( n =20 each):sufentanil group (group S) and remifentanil group (group R).Anesthesia was induced with propofol TCI at plasma concentration (Cp) of 4.0 μg/ml in both groups and sufentanil TCI (effect-site concentration Ce =0.4 ng/ml ) or remifentanil TCI ( Cp =4.0 ng/ml).Tracheal intubation was facilitated with vecuronium 0.1 mg/kg.The patients were mechanically ventilated (VT =8-10 ml/kg,RR =12-16 bpm).PErCO2 was maintained at 30-40 mm Hg.Anesthesia was maintained with propofol TCI-sevoflurane supplemented with sufentanil (Ce=0.25 ng/ml) or remifentanil (Cp=2.5 ng/ml).The depth of anesthesia was maintained at Narcotrend index of 37-56 by adjusting Cp of propofol TCI and sevoflurane concentration.The infusion of sufentanil was discontinued at 40 min before the conclusion of the operation while remifentanil was administered until the end of surgery.The incidence of postoperative adverse events,the time from the end of operation to eye openg and the time to extubation were recorded.Reesults The two groups were comparable with respect to demographic data.Neither group developed prolonged emergence and respiratory depression but the time from the end of operation to eye opening and the time to extubation were significantly longer in group S than in group R.The incidence of hypertension and tachycardia,agitation,shivering aad coughing were significantly lower in group S than in group R.Conclusion The quality of emergence from sufentanil supplementing propofol-sevoflurane anesthesia is higher than that from remifentanil.

Objective To determine the optimum dose of dexmedetomidine (DEX) for endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients when combined with propofol.Methods Ninetytwo ASA physical status Ⅰ or Ⅱ] elderly patients,aged 65-80 yr,with body mass index 18-25 kg/m2,scheduled for elective ERCP,were randomly assigned into 4 groups (n =23 each) using a random number table:fentanyl group (F group),low-dose DEX group (D1 group),medium-dose DEX group (D2 group) and high-dose DEX group (D3 group).Fentanyl 1.0 μg/kg and DEX 0.4,0.7 and 1.0 μg/kg (in normal saline 20 ml) were infused over 10 min via a pump in F,D1,D2 and D3 groups,respectively.At the end of infusion,propofol targetcontrolled infusion was started with the target plasma concentration set at 4 μg/ml,and after the mirror passed through the throat,the target plasma concentration of propofol was adjusted to 2.5 μg/ml.At 10 min after admission to the operating room,immediately after completion of fentanyl or DEX infusion,immediately after the effect-site concentration of propofol reached 4 μg/ml,immediately after the mirror passed through the throat,while pulling the stone,at end of surgery and when the patients were awake,the depth of sedation (NT value) was reccorded and the development of hypoxemia was also recorded.Arterial blood samples were collected at 10 min after admission to the operating room and at the end of operation to record PaCO2.The consumption of propofol,duration of ERCP,and emergence time were recorded.The body movement and requirement for vasoactive drugs were also recorded.Results Compared with F group, NT value and the incidence of hypoxemia were significantly decreased in D1-3 groups,PaCO2,the incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,and the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜0.05).Compared with D1 group,the PaCO2,NT value,incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜ 0.05).Compared with D2 group,the consumption of propofol was decreased,the emergence time was prolonged,aud the requirement for atropine was increased in D3 group (P ＜ 0.05).Conclusion The optimum dose of dexmedetomidine is 0.7 μg/kg for ERCP in elderly patients when combined with propofol.

Objective To study the profiles of decompression sickness(DCS) in various kinds of animals and to find out the target organ of decompression sickness by providing a basic experimental method for establishing animal models.Method Eleven kinds of animals were exposed to different pressures for different times at different compression/decompression rates.They were monitored at the precordial regions with Doppler flow meter for bubble sounds after decompression to normal pressure,to obtain a record about the developing course of the DCS.Pathological examinations of the bulbar conjunctiva were also made. Result Bubble sound of grade IV were recorded at the precordial regions after decompression.Among them,75%~100% incurred DCS with a diverse extent. Animals developed DCS showed vascular spasm,dysfunction and endothelial tumefaction.Conclusion Each of the 11 kinds of animals can serve as a model of DCS and the processes of development of DCS in various animals are similar.Blood vessels are the target organs of decompression sickness.