Objective To observe the effect of single and low dose propofol administered near the end of surgery on the cardiovascular and adverse response during extnhation in patients undergoing ovarian cancer operation. Methods Fifty ASA Ⅰ - Ⅱ patients undergoing selective ovarian cancer operation were randomly allocated into group S and group P,with 25 patients in each group. In group S, inhalation of sevoflurane was discontinued at about 2 minutes before the end of operation. In group P, inhalation of sevoflurane was discontinued at about 5 minutes before the end of operation,and at the same time,0.5 mg/kg of propofol was administered intravenously. The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and recovery time of consciousness were recorded at 5 min before extubation (t_1),during extubation (t_2), 1 min after extubation (t_3), and 5 rain after extubation (t_4). The incidence of agitatian,bucking,nausea and vomiting were recorded by an observer who was blind to this study. Results There were statistical differences in HR,SBP,DBP at t_2-t_4 between two groups. The recovery time was (10.39 ± 1.26) min in group P,and(9.57 ± 1.25) min in group S,there was significant difference between group P (2 cases) and group S (9 cases)(P< 0.05). There was significant difference in the incidence of agitation between two groups (P< 0.05). Conclusion Low dose propofol before extubation can inhibit stress and cardiovascular response and decrease the incidence of agitation, bucking, nausea and vomiting.

ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

Objective To investigate the expressions of protein kinase B (PKB/Akt) and glycogen synthase kinasc-3β in the hippocampus in mice with vascular dementia (VaD) induced by repetitive bilateral common carotid artery occlusion.Methods Forty-eight healthy adult male C57B1/6 mice were randomly allocated into 3 group:normal group,sham operation group,and model group (n =16 in each group).A mouse VaD model was induced by intermittent blocking the bilateral common carotid artery for 3 times in the model group.The sham group only separated the bilateral common carotid artery,but did not block it.The normal group did not receive any treatment.The behavioral changes of the mice were observed using the water maze and step-down tests at 4 weeks after procedure.HE staining was used to observe the histopathological changes of hippocampal tissue.The Western blotting was used to detect the expressions of Akt,p-Akt (Ser473),GSK3β and p-GSK3β (Ser9) proteins.Results In the water maze test,the time of swimming the entire distance was prolonged at the learning stage and memory stage (learning stage:F =19.389,P ＜0.05; memory stage:F =27.929,P ＜ 0.05),the number of errors increased (learning stage:F =7.228,P ＜ 0.05; memory stage:F =21.189,P＜0.05) in the model group.In the step-down test,the response time was prolonged (F=19.162,P ＜0.05) at learning stage and the number of errors increased (F =6.562,P ＜ 0.05),the latency time was shortened (F=10.634,P＜0.05) and the number of errors increased (F=12.890,P＜0.05) in the model group.At the same time,HE staining showed the reduction of neurons and the proliferation of glial cells in the hippocampal CA1 region in the model group; p-Akt (Ser473) (F=37.849,P＜0.05) and p-GSK3β (Ser9)(F =67.725,P ＜0.05) protein expressions were up-regulated significantly (F =37.849,P ＜0.05; F =67.725,P＜0.05) at 4 weeks after procedure compared to those in the sham operation group,while there were no significant differences in Akt (F =1.004,P ＞0.05) and GSK3β(F =0.329,P ＞0.05) total protein expressions among all groups.Conclusions The repetitive bilateral common carotid artery occlusion may result in learning and memory impairment and severe damage in the hippocampus in mice.The Akt and GSK3β expressions may be involved in the mechanism of VaD.

Objective To analyze the imaging features and to enhance the understanding of pancreatic and renal involvement in yon Hippel-Lindau disease (VHLD). Methods CT and MRI appearances and clinical data of six patients with pancreatic and renal involvement in VHLD were studied retrospectively.Six patients underwent CT scanning, and two of them also had MRI.Results Pancreatic cysts found in all six patients varied from several small cysts to cystic replacement of the entire gland.Calcifications were detected in four patients. Multiple bilateral renal lesions were detected in six patients.The renal lesions were classified as cystic, cystic with solid components and solid.Multiple combined renal lesions were found in five patients, and multiple simple cysts in one patient.Unilateral nephrectomy was performed in two patients, and the renal masses were diagnosed as clear cell carcinoma by pathology.Bile carcinoid was found in one patient, and retroperitoneal metastasis in another.Conclusion Multiple pancreatic cysts and/or multiple and bilateral combined renal lesions are highly suggestive of VHLD.

OBJECTIVETo observe the efficacy and safety of Qizhi Jiangtang Capsule (QJC) in treating stage 3b diabetic kidney disease (DKD) patients with macroalbuminuria.

METHODSPatients who conformed to the diagnostic criteria of stage 3b DKD were randomly assigned to two groups according to random digital table, the experiment group and the control group, 84 in each group. All patients received a two-week elution period, and then were treated with basic Western therapy. Patients in the experiment group took QJC, 5 pills per time, 3 times a day, while those in the control group took Valsartan Capsule 160 mg each time, once daily. The observation period of follow-ups was limited within 6 months, and the time points were set as the baseline, 1st month, 3rd month, and 6th month. Systolic blood pressure (SBP), diastolic blood pressure (DBS), 24 h urine protein quantitative (24 h UPQ), plasma albumin (ALB), and serum creatinine (SCr) were detected and recorded, and estimated glomerular filtration rate (eGFR) was calculated. The occurrence of hypoglycemic reaction, coagulation disorder, gastrointestinal tract reaction, allergy, hyperkalemia, doubling of creatinine, and overall adverse events were observed and recorded at same time.

RESULTSFinally 81 patients in the experiment group and 80 patients in the control group were effectively included. Compared with the baseline level, SBP and DBS obviously decreased in the control group at month 1 of treatment (P < 0.05), and more significantly decreased at month 6 of treatment (P < 0.01). SBP at month 1, 3, and 6 of follow-ups; DBS at month 6 of follow-ups was lower in the control group than in the experiment group (P < 0.05). At month 1, 3, and 6 of follow-ups, 24 h UPQ of the experiment group was significantly lower than the baseline level (P < 0.01). It was also significantly lower than the level of the control group at the same time point (P < 0.05). There was no significant difference in 24 h UPQ at month 1, 3, and 6 of follow-ups between the control group and the baseline level (P > 0.05). ALB of the experiment group showed an increasing trend. It was significantly higher than the baseline level at month 6 (P < 0.05), which was also higher than that of the control group at same period (P < 0.05). There was no significant difference in the ALB level in the control group (P > 0.05). SCr of two groups showed an increasing trend. SCr of the experiment group was significantly higher at month 1, 3, and 6 follow-ups than the baseline level (P < 0.05). But the increment of SCr was higher in the control group than in the experimental group, and obviously higher than the baseline levels (P < 0.05). eGFR of both groups showed a decreasing trend. The decrement was higher in the control group than in the experimental group (P < 0.05). The proportion of progression of renal functions at month 1, 3, and 6 of follow-ups in the experimental group was 0.0% (0 case), 9.55% (8 cases), and 21.4% (18 cases), while they were 8.3% (7 cases), 21.4% (18 cases), and 40.5% (34 cases) in the control group. There was no statistical difference in the proportion of progression of renal functions between the two groups at month 3 and 6 of follow-ups (P < 0.05). There was no statistical difference in the incidence of adverse reactions between two groups (P > 0.05).

CONCLUSIONQJC could effectively reduce urinary protein of patients with stage 3b DKD, and delay the progression of renal functions.

Adult ; Albumins ; analysis ; Albuminuria ; drug therapy ; Blood Pressure ; drug effects ; Creatinine ; blood ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Tetrazoles ; therapeutic use ; Treatment Outcome ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

Objective To explore the localization of epileptogenic focus and select the appropriate surgical procedures for post-traumatic epilepsy. Methods The clinical data of 21 patients with post-traumatic epilepsy were studied retrospectively. Epileptogenic focus was located by comprehensively analyzing data of electro-neurophysiology, neurological imaging and clinical manifestation. Surgical procedures were performed in all patients, including resection of lesion and peripheral cortex in 12 patients, epileptogenie focus resection plus low power bipolar coagulation in five, anterior temporal iobectomy plus amygdalohippocampectomy in three and corpus callosotomy in one. Results All patients were followed up from 6 months to 3 years, which showed satisfactory outcome in eight patients, marked improvement in six, improvement in five and slight improvement in two. The total effective rate was 90%. Conclusions Surgical procedure is important for intractable post-traumatic epilepsy. The good efficacy depends on precise localization of epileptogenic focus and combined application of various surgical procedures.

ObjectiveTo investigate effects of pamidronate on the proliferation and differentiation of osteoblasts of rats in vitro.MethodsOsteoblasts isolated from newborn rat calvaria were treated with various concentrations of pamidronate, the proliferation of osteoblasts was evaluated with the method of methyl thiazole tetrazolium (MTT) and activity of alkaline phosphatase (ALP) in medium was measured with kit of ALP detecting.ResultsThe proliferation of osteoblasts increased under the stimulation of Pamidronate range 10-6-M-10-12 M(P<0.05), but was inhibited at the concentration of high level (10-4 M). The activity of ALP decreased in the experiment.ConclusionPamidronate can act on the osteoblasts directly and increase the proliferation of bone cells, but inhibit the differentiation of the same cells.

Objective To investigate the associations of variants in signal transducer and activator of transcription 4 (STAT4) in Chinese Han population with rheumatoid arthritis (RA). Methods The study was performed in 228 RA cases and 228 controls. Haplotypes from the HapMap database Chinese population were used to select tag-single-nucleotide polymorphisms (SNPs) (r2=0.9) in STAT4 gene. Twenty-three SNPs located in STAT4 gene were examined by multiplex polymerase chain reaction (PCR) and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The Hardy-Weinberg equilibrium (HWE) was tested by a chi-square and Fisherˊs analysis. Differences in genotypes of the STAT4 polymorphism variants were evaluated using a Chi-square test. All statistical analyses were done with Haploview 4.1 software. Results Significant difference was detected in three SNPs (rs11685878, rs129888 and rs16833437) in allele frequencies analysis (χ2=6.014 8, 4.024 8, 5.539 1, P<0.05). Association was detected for three SNPs (rs11685878, rs16833437 and rs12988825) in genotype analysis ( χ2=6.814 9, 6.098 7, 6.691 7, P<0.05). Conclusion STAT4 may associate with susceptibility in Chinese Han population.

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.

Objective The aim of our study was to investigate the prevalence of target organ damage (TOD) in elderly hypertensive inpatients.Methods Data of the present retrospective survey were collected and analyzed from the computerized medical records of 17 682 aged 60 years or older inpatients with the diagnosis of essential hypertension ( EH ) from January 1993 to December 2008 in our hospital. The evidences of hypertensive TOD and associated risk factors with TOD including age,gender,presence of diabetes ( DM ),body mass index ( BMI ),systolic blood pressure ( SBP ) and diastolic blood pressure (DBP),serum lipids were analyzed. Results The overall prevalence of stroke,coronary artery disease (CAD),chronic kidney disease (CKD) and aortic dissection (AD) was 32.19％,27.33％,10.12％ and 0.77％,respectively.Incidence of TOD was 68.03％ in male and 31.70％ in female patients.CKD stage 3 - 5 was more prevalent in males than in females ( 12.75％ vs.5.40％,P＜0.01),while the prevalence of CAD (31.31％ vs.27.96％,P=0.06),Stroke (28.23％ vs.25.81％,P=0.08) and AD (0.89％vs.0.74％,P=0.72) was similar between men and women.One TOD was presented in 23.20％ patients and two or more TODs were found in 47.19％ patients. Higher age and BMI,longer history and lower control rate of hypertension,severe degree of hypertension and higher level of SBP,pulse pressure,TC,LDL-C,estimated GFR(eGFR) and Hey were risk factors for TOD.BMI,fasting plasma glucose,incidence of DM,prevalence of stage 1 and 2 hypertension,control rate of hypertension,eGFR and TG levels were all significantly higher while the prevalence of hypertension stage 3 and level of TC and LDL-C were significantly lower in female TOD patients than in male TOD patients ( all P ＜ 0.05 ).In patients without TOD,TG was significantly higher while SBP,fasting plasma glucose and LDL-C were significantly lower and history of hypertension was significantly shorter in female patients than in male patients ( all P ＜ 0.05 ). The prevalence of CAD,stroke and CKD increased with age ( P ＜ 0.001 ).Conclusion The prevalence of TOD is high in elderly hypertensive inpatients and higher age and BMI,longer history and lower control rate of hypertension,severe degree of hypertension and higher level of SBP,pulse pressure,TC,LDL-C,eGFR and Hcy are risk factors for TOD.