0.05),as well as in the composite of MACCE(0.47% vs 1.14%) between the two groups.Also,no significant difference existed in the rate of target vessel revascularization(3.48% vs 3.28%,P=0.958),occlusion of lower extremity artery(0.67% vs 0.82%,P=0.857) and hemorrhagic events(0.67% vs 0.82%,P=0.613) between the two groups.Kaplan-Meier survival analysis showed the cumulative hazard rate for the MACCE was similar(P=0.521).There were 5 and 4 CR patients in the Plavix group and the clopidogrel bisulfate group,respectively.Dose enlargement in addition to dual antiplatelet therapy decreased significantly the PAR of CR patients in both groups(78.2%?11.9%,76.2%?10.5%,vs 80.8%?13.2%,81.8%?12.2%,P

A total of 116 hospitalized patients between May 2006 and March 2012 were divided into observation(n =39),treatment control (n =41) and blank control group (n =36).All groups received standard doses of chemotherapy with 5-fluorouracil.Patients in observation group received a daily intravenous infusion of 100 mg magnesium isoglycyrrhizinate plus chemotherapy while those in the treatment control group a daily 1.2 g reduced glutathione intravenous infusion plus chemotherapy.And the blank control group accepted chemotherapy alone.The parameters of liver function,including aspartate aminotransferase,alkaline phosphatase,gamma glutamyl transferase,lactate dehydrogenase,total bilirubin and albumin,were recorded and compared at Week 1.No significantly difference in the above parameters was found in observation group(P ＞ 0.05).However,in treatment control and blank control groups,significant statistical differences existed in some of the parameters (P ＜ 0.05).Magnesium Isoglycyrrhizinate is an efficient protector of liver function for patients on chemotherapy with 5-fluorouracil.

onclusions Both three-dimensional CT and MR images integrated into an CARTO system can be successfully used to perform catheter ablation for AF and there was no difference in registration accuracy between the two groups.

Objective Comparing the effect of different anesthetic inductions in pediatric pa-tients undergoing bronchial foreign body removal.Methods Thirty pediatric patients,aged 9-58 months,undergoing emergency bronchial foreign body removal,were randomly into 3 groups (n=10 each):group sevoflurane (group S),group propofol (group P),and group ketamine (group K).Pa-tients in group S were inducted with sevoflurane 8% inhalation,group P with propofol 2.5 mg/kg in-travenous injection,group K with ketamine 5 mg/kg intramuscular injection.Three groups of pa-tients breathed spontaneously during operative period and received topical anesthesia of lidocaine be-fore the placement of rigid bronchoscopy.Combination of intravenous target-controlled infusion of propofol (target plasma concentration of 3-3.5 μg/ml)and remifentanil (target plasma concentration of 2-3 ng/ml)was used for maintenance of anesthesia.The rigid bronchoscopy was inserted after pre-oxygenation for 3 min.Rigid bronchoscopy was performed and the placement time,the first place-ment successfully rate,hypoxemia and side effects as well as postoperative awaking time were recor-ded.Results The first placement successfully rate,group S 90%,group P 70%,group K 40%,with significant difference among three groups (P<0.05).The incidence of side effects were not signifi-cant difference in three groups;In group S and group P,the placement time and the anesthesia awa-king time was significant shorter than that in group K (P<0.05).Conclusion Compared with propo-fol intravenous induction and ketamine intramuscular induction,the high concentration sevoflurane in-duction can provide faster induction,shorter waking time,and reduceside effects in childen undergo-ing bronchial foreign body removal.

ObjectiveTo evaluate the effects of dexmedetomidine on the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.MethodsSixty ASA Ⅰ -Ⅲ patients,aged ≥65 yr,undergoing elective orthopedic operation,were randomly assigned to one of 3 groups ( n =20 each):control group (group C) ; dexmedetomidine 0.25 μg/kg group (group D1 ) and dexmnedetomidine 0.50 μg/kg group (group D2).In groups D1 and D2,15 min befone anesthesia induction,dexmedetomidine 0.25 μg/kg and 0.50 μg/kg were infused over 15 min respectively,while the equal volume of normal saline 15 ml was given instead of dexmedetomidine in group C.After anesthesia induction,tracheal intubation was performed and the patients were mechanically ventilated.General anesthesia was used in the three groups.Flurbiprofen 1 mg/kg was injected intravenously immediately before skin incision.The time for recovery of spontaneous breathing,emergence time,extubation time,and adverse reactions were recorded.Pain was assessed with verbal rating scale (VRS) at 5 min after emergence from anesthesia.ResultsCompared with group C,the incidence of agitation,bucking,and adverse cardiovascular events and VRS score were significantly decreased,and the rate of effective analgesia was significantly increased in groups D1 and D2,and the emergence time and extubation time were significantly prolonged in group D2(P ＜0.05).Compared with group D1,the emergence time and extubation time were significantly prolonged in group D2(P＜0.05).There was no significant difference in VRS score,the rate of effective analgesia and the incidence of adverse renctions between groups D1 and D2(P＞0.05).ConclusionⅣ infusion of dexmedetomidine 0.25 μg/kg before induction of general anesthesia can effectively improve the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.

Objective To investigate the mechanism of the protective effects induced by intrathecally remote morphine preconditioning (RMPC) against myocardial ischemia-reperfusion (I/R) injury in rats.Method Male SD rats weighing 280 ～ 320 g were used in this study. A needle was inserted through a surgically created hole into the spinal cord space. Sixty male SD rats, in which intrathecal needle was successfully placed without complication, were randomly (random number) divided into 10 groups of 6 animals each. In group Ⅰ myocardial I/R was produced (I/R). In group Ⅱ morphine was given intrathecally in 3 repeated doses of 1 μg/kg at 5 mtn intervals before ischemia (RMPC). Antagonists CGRP8-37 (CGRP receptor antagonist), 8-SPT (adenosine receptor antagonist), HOE-140 (bradykinin B2 receptor antagonist) and HEX (autonomic nerve antagonist) were given intrathecally in group Ⅲ , Ⅳ, Ⅴ and Ⅳrespectively at 10 min before RMPC. In group Ⅶ, Ⅷ, Ⅸ and X CGRP8-37, 8-SPT, HOE-140 and HEX were given intrathecally respectively at 40 min before ischemia. Myocardial I/R was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion. At the baseline and the end of 120 min reperfusion venous blood samples were taken for determination of LDH activity. The animals were then killed and hearts removed for measurement of area at risk (AAR) and infarct size area (IS). IS/AAR was calculated. Results The size of infarct area was smaller and IS/AAR ratio lower and significantly less LDH was released at the time of 120 min reperfusion in RMPC group (group Ⅱ) than in group I/R (group Ⅰ). The protective effects of RMPC was abolished by intravenously pretreatment with CGRP8-37, 8-SPT,HOE-140 and HEX. Conclusions CGRP, adenosine, bradykinin and autonomic nerve are involved in the protective effects of intrathecally remote morphine preconditioning against myocardial I/R injury.

Objective To measure the effect of tetrandrineon (Tet) on inflammatory mediators and endogenous neural stem cell proliferation after spinal cord injury (SCI) in rats.Methods A total of 162 Wistar rats were separated into injury group,Tet group and sham operation group according to the random number table,with 54 rats per group.Allen' s method was used for induction of experimental SCI.Animals in Tet group were given Tet (22.5 mg/kg) through the tail vein at 30 min,24 h and 48 h postinjury.The same volume of normal saline was given to other two groups.Spinal cord tissue samples were taken from the rats after injury to measure levels of tumor necrosis factor (TNF)-α,interleukin (IL)-1 β and IL-10,and tissues were examined with HE staining and Nestin immunohistochemistry staining.Results Levels of TNF-α,IL-1 βand IL-10 in injury and Tet groups increased compared to these in sham operation group at 6 h,12 h,1 d,3 d,5 d and 1 week postinjury (P ＜ 0.05).At the same time point,level of IL-10 was higher in Tet group than in injury group,but inversely for TNF-α and IL-1 β (P ＜ 0.05).More Nestin-positive cells were present in injury and Tet groups than in sham operation group at 1 d,3 d,1 week,2 week,3 week and 4 week postinjury (P ＜ 0.05).Additionally,more Nestin-positive cells were found in Tet group than in injury group at 1 d,3 d,1 week,2 week and 3 week postinjury (P ＜ 0.05).Conclusion Tet is effective to relieve inflammatory reaction,increase neural stem cell number and promote neurological recovery after SCI.

Objective To investigate the effects of intrathecal morphine remote preconditioning (MRPC) on protein-serine-threonine kinases-endothelial nitric oxide synthase (Akt/eNOS) signaling pathways and cardiac myocyte apoptosis in rats.Methods Male SD rats weighing 280-320 g were used in this study.A needle was inserted through a surgically created hole into the sub-dural space of spinal cord.Thirty-six rats in which intrathecal needle was successfully placed without complication were randomly divided into 3 groups (n =12 in each).In group Ⅰ sham operation was performed (Sham).In group Ⅱ myocardial I/R was produced (I/R).In group Ⅲ morphine was given intrathecally in 3 repeated doses of 1 μg/kg at 5 min intervals before ischemia (MRPC).Myocardial I/R was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion.The animals were then sacrificed and hearts removed for measurement of area at risk (AAR) and infarct size area (IS).IS/AAR ratio was calculated.Myocardial apoptosis was detected by TUNEL and apoptotic index (the number of apoptotic myocardial cells/the total number of myocardial cells) was calculated.The levels of Akt,phosphorylated Akt (p-Akt) and eNOS was determined by Western blot.Results The infarct size,myocardial cell apoptotic index and pAkt level were higher and eNOS level was significantly lower in I/R group than those in group Sham (P ＜ 0.01).MRPC significantly reduced the infarct size and myocardial cell apoptotic index,and pAkt and eNOS level up-regulated in group RMPC compared with group I/R (P ＜ 0.01).Conclusions Akt/eNOS signaling pathways probably participate in the protective effects of intrathecal morphine remote preconditioning against myocardial I/R injury and myocardial cell apoptosis in rats.

Objective To discuss the effect of tetrandrine on endogenous neural stem cell proliferation and differentiation after spinal cord injury in rats. Methods 78 rats were randomly divided into 3 groups: control group(n=36), Tet-treated group(n=36), sham-operated group(n=6). Control group and Tet-treated group were adapted with Allen's combat modeling method. Rats in Tet group were injected Ted with a dosage 22.5 mg/kg in 30 minutes, 24 hours and 48 hours after ASCI, and the same dose of saline was injected into injured group as control .Samples were dissected from the spinal cord injury sites at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks after ASCI, and tested by HE staining for morphology and by immunolfuorescence staining for the expression of BrdU and nestin. Results A little Nestin positive cells and BrdU positive cells were found in control group and Tet-treated group at 1 day after injury. A large number of positive cells were found in both groups at 1 week after injury and reached the peak which lasted for 2 weeks and then decreased gradually. The expression of Nestin positive cells and BrdU positive cells in control group and Tet-treated group were decreased significantly at 4 weeks after injury, but were still more than that in sham operation group. The number of Nestin positive cells and BrdU positive cells in Tet-treated group were more than that in control group at each time point after injury. The expression was higher in Tet-treated group than control group at 1 day, 3 days, 1 week, 2 weeks, 3 weeks after injury and had no difference at 4 weeks after injury. Conclusions Tetrandrine could increase the number of Nestin positive cells, BrdU positive cells and endogenous neural stem cells though improving the microenvironment, and it is beneficial for the recovery of spinal cord injury in rats.

Objective To discuss the short-term curative effect and the safety of percutaneous vertebroplasty using high viscosity bone cement for the treatment of severe osteoporotic vertebral body compression fractures. Methods The clinical data of 100 patients with severe osteoporotic vertebral body compression fractures (compression degree>70%), who received percutaneous vertebroplasty by using high viscosity bone cement during the period from December 2010 to May 2013, were retrospectively analyzed. All the patients were followed up for at least one month. Both preoperative and postoperative visual analogue scale (VAS) and quality of life (QOL) scores, as well as the incidence of bone cement leakage, were recorded and the results were used to evaluate the curative effect and the safety of percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Results One week after the treatment, significant pain relief was obtained in 92 patients (92%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (2.0±1.5), and QOL scores increased from preoperative (30±5.0) to postoperative (80±18.0);the differences were statistically significant (P<0.01). One month after the treatment, significant pain relief was seen in 91 patients (91%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (1.5 ±1.0) and QOL scores increased from preoperative (30±5.0) to postoperative (80±15.0); the differences were statistically significant (P<0.01). No statistically significant differences in VAS scores and QOL scores existed between the data determined at one week after the treatment and the data determined at one month after the treatment (P>0.05). Leakage of bone cement was observed in 40 patients (40%), resulting no severe neurological symptoms; among the 40 patients, intervertebral disc leakage at above and below the vertebral body was detected in 28 patients (70%), vertebral anterior edge leakage was observed in 11 patients (27.5%) and vertebral posterior edge leakage was seen in one patient (2.5%). Conclusion For the treatment of severe osteoporotic vertebral body compression fractures, percutaneous vertebroplasty by using high viscosity bone cement is safe and effective.