Objective To compare the myocardial damage in patients with severe valvular heart disease undergoing open heart surgery under propofol and sevoflurane combined anesthesia.Methods Thirty-two patients with severe heart valvular disease undergoing open heart surgery were randomized into 3 groups:midazolam group (group M,n =8),propofol group (group P,n =12) and sevoflurane group (group S,n =12).Midazolam 1-5 mg,vecuronium 0.15 mg/kg and fentanyl 10-20 μg/kg were injected intravenously in group M.Propofol 1-2 mg/kg,vecuronium 0.15 mg/kg and fentanyl 10 μg/kg were injected intravenously in group P.In group S,the patients inhaled sevoflurane until the eyelash reflex disappeared,the end-tidal concentration of sevoflurane was 0.5 ％-2.0％,and vecuronium 0.15 mg/kg and fentanyl 10μg/kg were injected intravenously.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with iv infusion of midazolam 0.1 mg· kg-1 · h-1,fentanyl 0.2 μg· kg-1 · min-1,and vecuronium 0.12 mg· kg-1 · h-1 in group M,with iv infusion of propofol 150 μg· kg-1 · min-1 and fentanyl μg· kg-1 · min-1 in group P,or with inhalation of 0.5％-2.0％sevoflurane in group S.CPB was established routinely.The concentration of sevoflurane was 0.5 ％-1.0％ during CPB.Venous blood samples were collected before anesthesia (T1),at 20 min and 2 h after aortic unclamping (T2,3),and at 24 h after operation (T4) for determination of the levels of plasma lactic dehydrogenase (LDH),creatine kinase (CK),creatine kinase MB (CK-MB),cardiac troponin Ⅰ (cTnⅠ),superoxide dismutase (SOD)and tumor necrosis factor (TNF)-α.Myocardial tissues were taken at T2 for determination of heme oxygenase-1 (HO-1) expression and for examination of the myocardial ultrastructure.Results Compared with group M,the levels of plasma LDH,CK-MB,and CK were significantly decreased at T2-4,the levels of plasma SOD and cTnⅠ were significantly increased at T2,3,and the expression of HO-1 was up-regulated at T2 in groups P and S,and the levels of plasma TNF-α were significantly decreased at T2-4 in group P and at T2,3 in group S (P ＜ 0.05).The pathologic changes induced by I/R were less severe in groups P and S than in group M.Conclusion Both propofol and sevoflurane can attenuate the myocardial damage in patients with severe valvular heart disease undergoing open heart surgery and the effects are comparable.

Objective: To investigate the effects of selenium enriched yeast on antioxidative activities and immune functions in pregnant dairy cows. Methods: Twenty-four healthy Holstein-Friesian dairy cows were used for the experiment. All of them were pregnant as comfirmed by rectal palpation and divided into 4 groups, of which 3 were assigned for test groups(TI, T2, T3) and one served as control (C). Three different selenium (Se) sources namely Se-yeast (Sel Plex50, from Alltech ), mixture of Se compounds (70% Sel Plex 50 + 30% Na selenite ) and Na selenite were respectively supplemented to 3 test groups. Whole feeding experiment lasted for 168 days. During the experiment, the blood GSH-Px activity, serum Se concentration, erythrocyte superoxide dismutase(SOD) activity, malonaldehyde(MDA) level in serum, lymphocyte transformation rate and T cell count were determined. Results: Blood GSH-Px ,serum Se concentration and erythrocyte SOD activity,T1, T2 and T3 were higher (P

Objective:To explore the diagnostic performance of patella-tilt angle and congruence angle in episodic patellar dislocation (EPD) and the quantitative measurements of the patellar and femoral axial parameters as well as their correlation with and contributions to the patellofemoral joint alignment with the knee extended.Methods:A case control study was conducted to analyze the radiological data of EPD patients (EPD group, n=106) and patients without patellar instability (control group, n=106) admitted to Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University from January 2016 to December 2019. Each group consisted of 55 females and 51 males with the age range of 14-45 years [(23.0±5.3)years], showing 1∶1 match. Axial parameters included patellar parameters (patellar width, patellar thickness, Wiberg angle and Wiberg index), femoral parameters [trochlear sulcus angle, trochlear sulcus depth, trochlear sulcus height, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial), lateral trochlear inclination and trochlear groove medialization], and patellofemoral joint parameters (patellar tilt angle and congruence angle). The receiver operating characteristic (ROC) curve of patellofemoral joint parameters for the prediction of EPD was analyzed. Univariate analysis was performed to determine the difference of those axial parameters between the two groups. Pearson correlation analysis was used to identify the correlation between those bony parameters and patellofemoral joint parameters. Stepwise regression model was further established to determine the influencing factors and corresponding contributions for patellofemoral joint parameters. Results:When the optimal cut-off values of patellar tilt angle and congruence angle were 17.2° and 25.5°, the area under the ROC curve (AUC) for predicting EPD was 0.91 (95% CI 0.87-0.95, P<0.01) and 0.92 (95% CI 0.87-0.95, P<0.01), and the Youden index was 0.745 (sensitivity=83.96%, specificity=90.57%) and 0.717 (sensitivity=81.13%, specificity=90.57%). Univariate analysis showed that Wiberg index, femoral parameters and patellofemoral joint parameters were significantly different between the two groups (all P<0.01). For all patients, Pearson correlation analysis showed that patellar tilt angle was moderately to strongly correlated with Wiberg index, trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial) and lateral trochlear inclination ( r=0.51, 0.41, -0.62, 0.43, -0.49, -0.65, all P<0.01) and that congruence angle has a moderate correlation with trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial) and lateral trochlear inclination ( r=0.43,-0.59,0.38,-0.51, all P<0.01). For all patients, Stepwise regression model analysis showed that lateral trochlear inclination, trochlear sulcus depth, trochlear sulcus angle, Wiberg index and trochlear height ratio (lateral/medial) could explain 60% of the variation of patellar tilt angle ( R 2=0.60, P<0.01) and that trochlear sulcus depth, lateral trochlear inclination, trochlear groove medialization, trochlear sulcus angle and Wiberg index could explain 44% of the variation of congruence angle ( R 2=0.44, P<0.01). Conclusions:The patellar tilt angle and congruence angle are reliable quantitative indicators representing patellofemoral axial alignment, with a good diagnostic performance for EPD. Variations in the patellar and femoral bony structures of EPD patients are related to the patellofemoral axial alignment, with the axial parameters differently contributing to the patellofemoral alignment.

OBJECTIVE： To prepare Baicalin-loaded Polyethylene glycol-derivatized phosphatidylethanolamine （BAI@PEG-PE） nanomicelles， and to characterize it and study its cytotoxicity. METHODS： BAI@PEG-PE nanomicelles were prepared by film hydration method and their appearance characteristics were observed. The particle size， polydispersity index， Zeta potential， drug-loading amount and encapsulation efficiency of the nanomicelles were detected. Drug release of BAI raw material and BAI@PEG-PE nanomicelles in pH 7.4 phosphate buffer were compared within 1-84 h. Using coumarin 6 as fluorescent probe， the distribution of PEG-PE nanomicelles in H9c2 cardiomyocytes were observed. H9c2 cardiomyocytes were divided into model group， BAI raw material group and BAI@PEG-PE nanomicelles group. After treated with serum-free DMEM medium containing no or corresponding drugs for 0.5 h， isoproterenol was used to induce cardiomyocyte apoptosis. Nuclear morphology， cell apoptosis rate and protein expression of Bcl-2 and Bax were compared with among 3 groups. RESULTS： Prepared BAI@PEG-PE nanomicelles were uniform globular shape. The particle size was （16.7±0.8） nm， PDI was 0.11±0.01 and Zeta-potential was （－18.4±0.6） mV； drug-loading amount was （7.84±0.65）％， encapsulation efficiency was （85.7±4.9）％ （n＝3）. Accumulative release rate was 76.5％ within 84 h. BAI raw material was released completely within 24 h. PEG-PE nanomicelles could strengthen the intake of coumarin 6 in H9c2 cardiomyocytes， mainly gathering around mitochondria. Compared with model group， the apoptosis morphology of cardiomyocytes were improved significantly in BAI raw material group and BAI@PEG-PE nanomicelles group； apoptosis rate was decreased significantly； protein expression of Bcl-2 was increased significantly； protein expression of Bax was decreased significantly with statistical significance （P＜0.05 or P＜0.01）. Above effects of BAI@PEG-PE nanomicelles group were more significant （P＜0.05 or P＜0.01）. CONCLUSIONS： BAI@PEG-PE nanomicelles are prepared successfully， and show significant sustained-release effect and myocardial targeting， and can prevent cardiomyocyte apoptosis.