Objective Cardiac valve replacement with cardiopulmonary bypass ( CPB ) can induce myocardial ischemia-reperfusion injury , which is bad for cardiac function recovery .The aim of the study was to evaluate the myocardial ischemia-reperfusion injury effect of breviscapine intravenously injected before CPB in patients undergoing cardiac valve replacement with CPB . Methods 40 patients scheduled for cardiac valve replacement were randomly divided into two groups :control group and breviscapine group ( n=20).Normal saline 15 mL and breviscapine 0.75 mg/kg was administered with pump within 30 mins after the induction of anesthesia in control group and breviscapine group respectively .Blood samples were taken from jugular vein at each of the five time points: before surgical incision (T0) and at 30mins, at 6, 12, 24h after aortic unclamping (T1-T4) for determination of plasma concentration of car-diac troponin-I (cTnI), creatine kinase isoenzyme (CK-MB) and superoxide dismutase (SOD). Results Compared with T0, the cTnI and CK-MB in both groups significantly increased at T 1-T4 and peaked at T 2 , the SOD in both groups significantly decreased at T 1-T4(P<0.05).Compared with control group, cTnI and CK-MB significantly decreased, while SOD activity significantly increased at T1-T4in breviscapine group (P<0.05). Conclusion The intravenous infusion of breviscapine 0.75 mg/kg before the staring of CPB can relieve myocardial ischemia-reperfusion injury in patients undergoing cardiac valve replacement with CPB , and the mechanism may be related to the anti-oxidative stress effect .

Objective To probe into the anatomy and clinical application of the facial nerve canal surface by multislice spiral CT image curved planar reformation. Methods Fifty patients with facial nerve disease were selected as study group from January to November in 2010, 50 healthy subjects were selected as control group, using models of multislice spiral CT scan for the patient, scanning from the upper edge of the orbital under external auditory canal edge of the connection as a horizontal line, ranging from the lower edge of mastoid process to the petrous bone on the edge of the data obtained in the Wizard workstation reconstruction. All the measurements were more than two measurements of the average physician. Results Normal facial nerve canal in control group could be displayed clearly in an image, display rate was 100.00%(50/50), and the segment data could be accurately measured; axial reconstruction, reconstruction of coronal and sagittal reconstruction of the three comparison of measured direction, fan sections, horizontal and vertical segments of the length and diameter were not significantly different (P＞0.05), and the first and second bending angle of bending angle was no significant difference (P ＞ 0.05 ). Compared with control group, the patients with vascular disease in study group showed significantly decreased rate, the difference was significant (P ＜ 0.05). Conclusion Curved planar reformation of multislice spiral CT diagnosis of facial nerve canal disease has great clinical significance, should be widely applied.

Objective To explore oral contrast-enhanced ultrasonography findings in superior mesenteric artery syndrome (SMAS).Methods Twenty-nine patients with SMAS were examined using oral contrast-enhanced ultrasonography,which was confirmed by contrast-enhanced spiral computerized tomography.Results Abdominal ultrasonography with oral contrast-enhanced ultrasonography revealed a significant reduction of the SMA angle and diminished SMA-aorta distance in 29 subjects.Duodenum was showed the indentation and funnel shaped or dumbbell shaped findings which was caused by pressure of the SMA in patients with recumbent position.The proximal part of duodenum expanded distinctively with contrast media movement fro.Ultrasonography and CT examinations had a good agreement in diagnosing pathological aortomesenteric angle and distance.Conclusions Oral contrast-enhanced ultrasonography presents characteristic findings in patients with SMAS,which is useful in epidemiological screening of suspicious cases of SMAS in children.

Objective To investigate the effectiveness of deep brain stimulation (DBS) treating Parkinson's disease.Methods Forty cases of Parkinson's disease were selected from March 2014 to August 2015.The clinical symptoms of these patients were described and quantitatively analyzed with Unified Parkinson's Disease Rating Scale (UPDRS) before and after the procedure of DBS surgery.Results After deep brain stimulation surgery,the symptoms including muscle stiffness,static tremor,bradykinesia were improved,UPDRS scores were significantly lower and the demanding dosage of Parkinson disease drugs such as L-dopa/benserazide and L-dopa/carbidopa were also reduced.Conclusion Deep brain stimulation for Parkinson's disease is safe and effective.It can obviously control the symptoms,reduce the dosage of oral drugs,and improve the quality of life.

Objective To evaluate the effect of dexmedetomidine administered locally on the median effective concentration ( EC50 ) of ropivacaine for paravertebral nerve block ( PVNB) . Methods Forty?eight ASA physical status Ⅰ or Ⅱ female patients, aged 20-64 yr, with body mass index<24 kg∕m2 , scheduled for elective unilateral segmental mastectomy under PVNB, were randomly divided into 2 groups ( n=24 each) using a random number table: ropivacaine group ( group R) and ropivacaine mixed with dexmedetomidine group ( group RD) . PVNB was performed at T4 on the operated side guided by ultrasound and nerve stimulator. Ropivacaine 20 ml and a mixture of ropivacaine and 20 μg dexmedetomidine 20 ml were injected locally in group R and group RD, respectively. The concentration of ropivacaine was determined by up?and?down sequential allocation. The initial ropivacaine concentration was set at 0. 35%, and the ratio between the two successive concentrations was 1. 2. The EC50 and 95%confidence interval of ropivacaine were calculated using Dixon?Massey method. Results The EC50 ( 95%confidence interval) of ropivacaine was 0.27% (0.23%-0.30%) and 0.22% (0.18%-0.25%) in group R and group RD, respectively. Compared with group R, the EC50 of ropivacaine was significantly decreased by 19% in group RD. Conclusion Small dose of dexmedetomidine administered locally can significantly enhance the efficacy of PVNB with ropivacaine.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.

Objective To discuss the relevance of serum visfatin(VF), lipoprotein-a(LP-a) and homocysteine(HCY) in diabetic nephropathy (DN). Methods 168 patients with diabetes were selected from October 2011 to July 2015 in our Hospital.According to whether associated with kidney disease were divided into without nephropathy group (82 cases) and nephropathy group (86 cases),on the basis of urinary albumin excretion rate (UAER), nephropathy group were divided into low volume nephropathy group (UAER≤300 mg/24 h, 58 cases) and high volume nephropathy group(UAER>300 mg/24 h, 48cases),at the same time,a medical health personnel 30 cases were chosen as normal group, enzyme-linked immunosorbent method was used to detect the serum VF, LP-a, HCY levels, Pearson correlation analysis was used to analyse the relationship between UAER and serum VF, LP-a, HCY levels.Results The serum LP-a in nephropathy group was significantly higher than that of without nephropathy group and normal group, the serum LP-a, HCY in high volume nephropathy group was significantly higher than the low volume nephropathy group, the difference was statistically significant (P<0.05);the serum VF level in high volume nephropathy group>low volume nephropathy group>without nephropathy group>normal group ( P<0.05 );Pearson correlation analysis showed that, UAER were positively correlated with LP-a(r=5.013,P<0.05),VF(r=5.864,P<0.05),HCY(r=7.246,P<0.05) levels in serum.Conclusion The serum VF, LP-a, HCY levels is associated with the development of DN, and it is associated to patients with renal function changes.It is helpful to the physician monitoring disease progression in patients with DN via detecting the levels of VF, LP-a and HCY.

Objective To explore the epidemiological characteristics,clinical manifestations,diagnosis and treatment of Fasciola gigantica infection,and to provide reference for future diagnosis and treatment.Methods Four cases of confirmed Fasciola gigantica infection were analyzed retrospectively for epidemiological information,clinical manifestations,laboratory results,imaging findings,diagnosis and treatment outcomes.Results Four Fasciola gigantica infection cases were farmers from Binchuan County,Yunnan Province.All presented with fever,hepatalgia,percussion pain,hepatomegaly,eosinophilia,hyperglobulinemia,neutrophilia and anemia.Computed tomography (CT) scans showed multiple low density shadows scattered in the liver parenchyma.Eggs of Fasciola gigantica were detected in feces of the patients,and results of antibody against Fasciola gigantica detected by enzyme-linked immunosorhent assay (ELISA) were positive.Triclabendazole treatment was effective.Conclusion Human Fasciola gigantica infection is rare,without specific clinical manifestations,and triclabendazole is the first choice of treatment.

BACKGROUND:Poly(D,L-lactide-co-glycolide)(PLGA)may produce lactic acid and glycolic acid when PLGA degrades,thus leading to the acid accumulation and inducing the inflammatory reaction locally.OBJECTIVE:To investigate the effect of lysine,histidine and arginine on regulating the acid accumulation of PLGA copolymer during the degradation.DESIGN:Repeated measurement and experiment.TIME AND SETTING:The experiments were performed in the College of Bioengineering.Chongqing University from July 2006 to August 2007.MATERIALS:PILGA(80:20)was produced by Sigma(USA);Lysine,histidine and arginine(purlty>99%)were purchased from Sigma(USA);Chitosan(deacetylation degree:85%)was purchased from Chengdu Kelong Chemical Reagent Factory;Algin(viscosity:1.05-1.15)was purchased from Tianiin Damao Chemical Reagent Factory.METHODS:Lysine,histidine and arginine were added into PLGA with the proportion of 5%(w/v)and 10%(w/v)respectively.The resultant film sample was put into a bottle with tri-distilled-water for 2-month degradation at 37℃.The pH value of degradation solution was detected by pH meter;Each film sample was taken out and lyophilized 12 hours to get its dry weight and calculate mass loss ratio.Each variety of the solution was sampled three specimens,the average pH value,average initial weight and average finial weight of these three specimens were taken as the indices at each sampling time point,respectively.Accordingly,the regulation effect of basic amino acid was comparexl with that of algin,chitosan and NaHCO3.MAIN OUTCOME MEASURES:The changes of pH value of degradation solution;the mass loss ratio of the composite.RESULTS:Each basic additive could relieve the acid accumulation,among them,NaHCO3 was the strongest,while algin and chitosan showed a lowest capacity,basic amino acid was moderate;The suitable regulation effect could be achieved at a level of 5%lysine.CONCLUSION:Basic amino acid can effectively regulate the acid accumulation after PLGA degrades,and the optimal concentration of lysine is 5%.

Objective To explore the clinical features,efficacy and prognosis of different treatments for children with achalasia of cardia(AC).Methods In this retrospective study,the clinical features,laboratory examination and treatment of 36 children with AC who had been admitted to Department of Gastroenterology,Beijing Children's Hospital,Capital Medical University from August 2006 to September 2015 were reviewed,and the efficacy and prognosis of different treatments were compared.The symptoms of the children were graded using the AC clinical symptom score(Eckardt score),and the Eckardt score ≤ 3 scores was defined as the effective treatment.SPSS 19.0 statistical software was used to analyze the data,and P<0.05 for the difference was statistically significant.Results Thirty-six children with AC included 24 boys and 12 girls.Ages ranged from 1.4 to 15.5 years old,with a mean age of(10.0±3.4)years old.Course of disease ranged from 1 month to 9 years,with a mean course of 0.5(0.2,3.0)years.In the 36 children,33 cases(91.7％)had vomiting,23 cases(63.9％)had dysphagia,16 cases(44.4％)had weight loss,and 9 cases(25.0％)had chest pain.The effective rates of treatment in surgical treatment group and drug treatment group were 100.0％(13/13 cases)and 71.4％(5/7 cases),respectively in 3 months,and there was no significant difference between the 2 groups(P=0.111).The effective rates of treatment were 100.0％(13/13 cases)and 50.0％(3/6 cases),respectively in 6 months,and the difference was statistically significant between the 2 groups(P=0.021).Within 12 months,there was no recurrence in surgical treatment group and the effective rate was 100.0％.Children in drug treatment group had 1 case who stopped taking medicine,while the other children received surgical treatment in other hospitals due to poor drug treatment.Conclusions Drug and surgical treatment of AC both have good short-term effect,however,the medium and long-term efficacy of surgical treatment is higher than that of drug treatment in children.Symptomatic relief is more stable,and symptom is not easy to relapse for the children with surgical treatment.