Objective To evaluate the efficacy of α2 adrenergic agonists for the prevention of postoperative adverse cardiac events in patients with coronary disease.Methods MEDLINE,EMBASE,CINHAL,Web of Science,CBM and CNKI were searched to identify all randomized controlled trials on the efficacy of α2 adrenergic agonists for the prevention of postoperative cardiac complications following operation performed under general anesthesia in patients with coronary artery disease.The incidence of myocardial ischemia,myocardial infarction,bradycardia and hypotension were evaluated.Meta-analysis was conducted using the RevMan 5.1 software.Results Fifteen trials included 9 high-quality trials,4 medium-quality trials and 2 low-quality trials.A total of 3422 patients were included in this meta-analysis.1790 patients received α2 adrenergic agonists (clonidine and dexmedetomidine) and 1632 patients received placebo; 724 patients underwent non-cardiac surgery and 2698 patients underwent cardiac surgery.Meta-analysis indicated that α2 adrenergic agonists reduced incidence of myocardial infarction following non-cardiac surgery and myocardial ischemia following non-cardiac surgery and cardiac surgery.Alpha-2 adrenergic agonists significantly increased the incidence of postoperative bradycardia.Conclusion Alpha-2 adrenergic agonists can decrease postoperative cardiac adverse events in patients with coronary disease,but can induce bradycardia,and the efficacy of clonidine is consistent with that of dexmedetomidine.

Objective To systematically review the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery.Methods PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,CBM and CNKI were searched to identify all randomized controlled trials involving the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidences of postoperative cardiac death,myocardial infarction and ventricular arrhythmias and postoperative inotropic drug requirement.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Twelve randomized controlled trials (8 high-quality trials and 4 medium-quality trials) involving 626 patients were included in our Meta-analysis.Meta-analysis indicated that ischemic proconditioning significantly reduced the incidence of postoperative ventricular arrhythmias and postoperative inotropic drug requirement (P ＜ 0.05) and had no effect on the incidences of postoperative cardiac death and myocardial infarction (P ＞ 0.05).Conclusion Ischemic preconditioning can reduce the postoperative ventricular arrhythmias and have no effect on postoperative cardiac death and myocardial infarction in patients undergoing open heart surgery.

Objective To investigate the Cardioprotective effects of sevoflurane postconditioning on surgery patients undergoing cardiopulmonary bypass with diabetes mellitus ,in order to provide theoretic basic for clinical practic. Methods 180 patients of undergoing cardiopulmonary bypass sugery were divided into 3 groups:A group:64 patients undergoing heart valve replacement with Type II diabetes. B group:64 patients Pa-tients undergoing heart valve replacement without diabetes ,the group A and B were treated by sevoflurane post-conditionging for 10 minutes before the end of cardiopulmonary bypass. C group:60 patients undergoing heart valve replacement without diabetes,no sevoflurane postconditionging;Three groups of patients detect perioperative tro-ponin T and Creatine Kinase Isoenzyme-MB ,observed and following up the occurrence of postoperative com-plications. Results CK-MB and cTnT were compared at 8 and 24 hours after operation:two biochemical indi-cators of group A and C at different time points after operation were significantly higher than those in group B (P < 0.05),With significant statistical difference , The number of patients with heart failure and malignant arrhythmia in group A and C was higher than group B(P < 0.05),Differences in 30 day mortality and other clinical data between the three groups were not statistically significant. Conclusion Sevoflurane postconditionging has significant myocardial protection effect for patients undergoing valve replacement surgery without diabetes , however ,the myocardial protective effect of patients who undergoing valve replacement surgery with diabetes was weakened.

Objective To analyze MRI features and diagnostic value in adenomyosis.Methods Clinical and MRI data of 31 cases of adenomyosis confirmed by pathology were retrospectively analyzed.Turbo FSE T2WI,SE T1WI,and sagittal Turbo FSE T2WI examination were performed in all cases,10 of them were added to anatomic and sagittal fat-suppression(FS) T2WI scan.MR features of adenomyosis were analysed.Results In 19 cases of diffuse uterine adenomyosis,11 cases mainly showed diffusely thichened junctional zone of posterior wall.12 cases were focal uterine adenomyosis,the lesions located at posterior wall in 7 cases,front wall in 4 cases and bottom part in 1 case.28 cases displayed hypointensive masses like the intensity of junctional zone on T2WI and vesicular hyperintensive foci were found within the hypointensive lesions.The lesions in 21 cases were similar to that of myometrium on T1WI,9 of them displayed vesicular hyperintensive foci.Focal round-like junctional zone low signal intensity lesion in myometrial layer was found in 3 cases.Conclusion MRI can clearly determine the size and site of adenomyosis.FS is the valuable examination way.

Objective To clone injury-regeneration-related genes after primary neurons of spinal cord were injured in rat, and to elucidate the molecular mechanism of injury and regeneration in CNS. Methods An in vitro spinal cord primary neuron injury model was replicated in rat. The differentially expressed genes during injury and regeneration periods of spinal cord primary neurons were cloned by improved subtractive hybridization. Results Twenty-seven differentially expressed sequences were obtained, 23 were known genes and the others were unknown. Among these known sequences, cDNA for synuclein and clusterin, together with several other gene sequences, were closely related with nerve degenerative diseases. Conclusion Primary neuron injury-regeneration-related genes of the spinal cord can be successfully cloned by improved subtractive hybridization.

A method for the rapid enantioseparation of five β-blocker drugs, including alprenolol, propranolol), mexiletine, metoprolol and pindolol was developed by a 5-cm short column packed with perphenylcarbamoylated β-cyclodextrin(CD) chiral stationary phase by HPLC. The results showed that except for alprenolol), the other 4 β-blocker drugs were completely separated using ACN-0.1% thriethylammonium acetate(TEAA), 40∶ 60, V/V, pH=4.0) as mobile phase. The 5-cm short CD-based column exhibited rapid separation ability to the above β-blocker drugs within 5 min, which indicated that the separation has high efficiency. According to the chemical structures of the β-blockers and their chromatographic behavior, related separation mechanisms were also discussed. The proposed method was rapid, effective and repeated.

Objective To analyse the kidney damage situation of the elderly health examination people,and identify its characteristic.Methods A cross-sectional study was held which enrolled 1088 elderly health examination people.Urine routine,random urine albumin/creatinine ratio (ACR),serum creatinine,urea nitrogen were detected by biochemical analyzer,and estimated glomerular filtration rate (GFR) with CKD-EPI formula.Kidney structure change was examined by Color doppler ultrasound detector.Results The prevalence of hypertension,hyperlipemia,diabetes mellitus was 61.5％,62.1％,11.6％,respectively.The abnormal detection rate of urine routine was 19.0％,including 2.6％ proteinuria,14.1％ hematuresis and 5.4％ leucocyturia.The abnormal detection rate in the people with was higher than those without (P＜0.01).However,the albuminuria detection rate with random urine ACR was 25.1％,obviously higher than that of urine routine (P＜0.01).The ultrasound results showed that 6.8％ of the total were examined with elderly characteristic kidney change,the proportion of renal cyst was the highest,accounted for 21.8％.70.7％ of all people were in the level of eGFR more than 60 ml· min-1 · 1.73 m-2.The level of eGFR＜60 ml· min-1 · 1.73m-2 in the people with was higher than those without (P＜0.01).eGFR was declined with age.When age increased every 10 years,eGFR was decreased 7 ml · min-1 · 1.73 m-2.Conclusions No matter in structure or function,the elderly people's kidney damage has its characteristic.We should make it clear to correctly diagnose and cure elderly kidney disease.

Objective To investigate the level of care burden and self efficacy of caregivers of patients with spinal cord injury,and analyze their correlation.Methods By convenience sampling method,150 cases of spinal cord injury patients and their caregivers were investigated with Zarit Caregiver Burden Scale and general self-efficacy scale.Results The score of care burden of caregivers with spinal cord injury was (52.91 ± 11.56) points,self-efficacy score of caregivers was (19.63 ± 4.85) points.The score of care burden of caregivers and self-efficacy was highly negatively correlated.Conclusions We should pay more attention to improve the self-efficacy of caregivers of patients with spinal cord injury (SCI),in order to mitigate the care burden,improve care ability and health level of the patients' families.

Objective To investigate the value of prothrombotic state (PTS) in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.Methods One-hundred and twenty-eight ASA physical status Ⅰ or Ⅱ elderly patients (NYHA class Ⅰ or Ⅱ) of both sexes,aged 6575 yr,undergoing elective abdominal surgery,were enrolled in the study.Total intravenous anesthesia was performed during surgery.Venous blood samples were collected for detection of the levels of D-dimer,thrombus precursor protein and P-selectin (molecular markers of PTS).Detection of PTS was based on the three indexes mentioned above.The patients were divided into 2 groups according to the cardiac events occurred during surgery and within 3 days after surgery:non-cardiac event group and cardiac event group.The general data of patients and each index during surgery were recorded.Logistic regression analysis was used to pick out the potential risk factors for cardiac events.Results Twenty-nine patients developed cardiac events.There was no significant difference in age,obesity,ratio of diabetes,duration of operation,and ratio of PTS between non-cardiac event and cardiac event groups (P ＜ 0.05 or 0.01).Logistic regression analysis showed that old age,diabetes,prolonged duration of operation,and PTS were independent risk factors for cardiac events (P ＜ 0.01).Conclusion PTS produces some value in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.

Objective To observe the effect of wound specialist group on preventing and managing pressure ulcer in operation. Methods The knowledge about pressure ulcer and ability of risk assessment for pressure ulcer of operating room nurses were tested and the incidenc-es of pressure ulcer were compared before and after the intervention of the wound specialist group. Results After the intervention of the wound specialist group, the passing rate of nurses in operating room increased from 58.23%to 94.11%in pressure ulcer theory (χ2=29.63, P<0.001) and from 56.96%to 95.29%in new type of dressings paste (χ2=33.80, P<0.001), and the rate of pressure ulcer risk factor assessment increased from 56.38%to 93.35%(χ2=5828.07, P<0.001), accuracy of assessment increased from 56.23%to 96.78%(χ2=4674.89, P<0.001). The incidence of intraoperative acute pressure ulcer decreased from 1.5‰to 0.22‰(χ2=17.59, P<0.001). Conclusion The intervention of wound specialist group may improve the awareness of assessing risk factors of pressure ulcer in the operation room and standardize the oper-ation to prevent pressure ulcer, and reduce the incidence of pressure ulcer in operation.