Objective:To summarize our experience on the anesthetic management,cardiopulmonary bypass,and protection of major organs in total aortic arch replacement in patients with DeBakey type Ⅰaortic dissection.Methods: From June 2005 to June 2006,5 patients with acute DeBakey type Ⅰ aortic dissection received total aortic arch replacement under general anesthesia and deep low temperature.The 5 patients,including 3 man and 2 women,with an age range of 49-76 years,all received emergent operation.The clinical data were retrospectively analyzed and the experience on anesthesia management was summarized.Results: All the 5 patients had uneventful anesthesia with propofol.The time of cardiopulmonary bypass was 111-148 min,with a mean of(127.2?16.6) min.The priming solution was Ringer acetate solution.The selective cerebral perfusion time was 11-18 min,with a mean of(15.2?2.8) min.The lowest temperature was 19-22℃,with a mean of(20.4?1.5)℃.Modified pH-stat technique was employed for temperature lowing and the rate of rewarming was controlled strictly.The right axillary artery cannulation was routinely performed for cardiopulmonary bypass and selected cerebral perfusion.The blood transfusion was 600-1 400 ml.The auditory evoked potentials index was 0 during lower body arrest.There were no serious cerebral complications after operations.Four patients survived and one died of renal failure 6 days after operation.Conclusion: General anesthesia combined with deep low temperature and selected cerebral perfusion provides a safe condition for ascending arota and total arotic replacement.

Objective To analyze the causes of poor compliance of elderly patients with diabetes mellitus , and put forward corresponding countermeasures to control blood glucose level and delay the occurrence of complications .Methods A total of 113 elderly patients with type 2 diabetes mellitus aged 60 years and over were recruited in endocrinology department of our hospital.The self-made questionnaire was used to investigate the compliance and the factors that affected the compliance.Results There were 48 patients (42.48%) with good compliance and 65 patients (57.52%) with poor compliance.Univariate analysis showed that the level of education, monthly income, drug types, understanding of diabetes-related knowledge and whether the elderly living alone affected compliance ( P<0.05 ) .Multivariate Logistic regression analysis showed that patients with low education level, poor monthly income, medication types and living alone were the main factors that influence the compliance of elderly patients with diabetes mellitus (P<0.05).And the level of education, monthly income level and the compliance of diabetic medication was positively correlated, medication types and living alone and diabetes compliance were negatively correlated (P<0.05).Conclusion The low level of education, poor monthly income, medication types and living alone are the main factors that affect the compliance of elderly patients with diabetes.The social and family support can effectively improve the compliance of elder patients with diabetes.

Alzheimer′s disease(AD)is one of the most common causes of cognitive impairment.“Aβhypothesis”and“tau protein aggregation hypothesis”are two representative hypotheses in relation to AD pathology. But recently,therapeutic strategy target?ing on reducing Aβdeposition failed in clinical trials. On the other hand,as the phosphorylation of tau protein is regulated by multiple upstream kinases,inhibition of a single kinase usually cannot effectively suppress the aggregation of the tau. While blocking multiple kinases at the same time will produce serious side effects. Currently,targeting on Aβand tau protein get into awkward situations. In view of this,researchers are looking for new drug targets for improving cognitive function. Phosphodiesterase 4(PDE4 4)is an enzyme responsible for the hydrolysis of cAMP in the body. There are four subtypes for PDE4,and PDE4A,B and D are highly expressed in the central nervous system. Inhibition of PDE4 causes activation of cAMP/PKA/CREB/BDNF signal pathway,which is beneficial for the strengthening and consolidation of learning and memory. This review will focus on the most recent evidence regarding the role of PDE4 in learning and memory.

anthracycline-induced cardiotoxicity in patients with lymphoma.Methods Thirty-two adult patients with nonHodgkin' s lymphoma who received chemotherapy including anthracyclin were studied.After anthracyclin reached the cumulative doses of 200 and 400 mg/m-2,the changes in plasma BNP and echocardiography indices were investigated.Results After the cumulative anthracyclin reached doses of 200 and 400 mg/m2,serum BNP were respectively (292±7) ng/ml and (387±4) ng/ml,and were significantly increased when compared to the untreated (134±6) ng/ml (P ＜ 0.05).The parameter of diastolic functions ratio of peak early to peak late low velocity (E/A ratio)were 1.14±0.37 and 0.90±0.06,both showing significant decreases compared to the control (1.33±0.27) (P ＜ 0.05).In contrast,systolic function parameters left ventricular ejection fraction (EF) and fractional shortening (FS) remained unchanged (P ＞ 0.05).After the cumulative anthracyclin reached 200 and 400 mg/m2,significant negative correlations were observed between the plasma BNP and the E/A ratio (r =-0.689,P=0.042; r=-0.557,P =0.006),but no associations between EF and FS were found (P ＞ 0.05).Conclusion Plasma BNP concentration appears to be a sensitive parameter for the early assessment of anthracycline-induced cardiotoxicity.

Objective To analysis the causes of cardic arrest during liver transplantation, and investigate the preventive measures. Methods Clinical records about 5 patients with cardiac arrest in liver transplant were studied retrospectively. Results Occurrence of cardiac arrest was 2.1 % (5/240). All the events happened at 3-6 min after graft reperfusion, and arrest lasted 3-8 min. Two patients died of resuscitation failure. After graft reperfusion, CVP and MPAP were much high in 5 patients. All of them had hypothermia and hypocalcemia. Three of them also had acidosis and two complicated with hyperkalemia. In one case, the difference between PaCO_2 and P_ETCO_2 was 47 mm Hg. Conclusion Many factors, such as disturbances of electrolyte and acid-base equilibrium or hypothermia, seemed to have some contribution to cardiac arrest occurrence after reperfusion. Various methods should be used to counter it.

ObjectiveThrough the study of cervical lesions vagina inmage to investigate the micro-syndrome identified methods for cervical lesions. MethodsThrough the methods of retrospective study, collecting cases of HR-HPV infection (HC Ⅱ positive) and colposcopy detection, the objective evaluation of micro-syndrome differentiation was primarily established. ResultsRGB mode quantitative analysis for colposcopy images showed category 3 (the purple samples) occupied 44.4％, category 2 (the red samples)occupied 12.6％; category 1 (the white samples) occupied 43％. ConclusionsRGB mode quantitative analysis for colposcopy images was appropriate exploration of micro-differentiation in cervical lesions. There is a close relationship between traditional Chinese medicine syndrome and mucosai color differentiation by colposcopy.

Objective To explore the relationship between retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in myopia eyes.Methods 91 cases (91eyes) were selected from ophthalmological outpatients including 28cases with low myopia ( spherical equivalence [ SE ] ＞ -3.0D), 33 cases with moderate myopia (SE -0.3D ～ -6.0D) and 30 cases with high myopia (SE ＜ -6.0D).All patients received ocular standard examination including intraocular pressure, refraction, slitlamp biomicroscopy and fundus examination.Other ocular diseases except refractive error were excluded.RNFL thickness and CCT were measured by RTVue Fourior-OCT ( Optovue Inc, USA).Refraction diopter was shown as SE.Results The mean RNFL thickness and CCT was ( 108.5 ± 10.1 ) μm, (524.7 ±36.8)μm respectively.These were no significantly different among low, moderate and high myopia ( P ＞ 0.05 ).Temporal RNFL thickness( tl1 ,tu1 ) was significantly positive related with CCT( r =0.281,0.093 of tl1, r= 0.352,0.167 of tu1 respectively in single and multiple variable analysis; P ＜ 0.05 ), nasal ( nl2, nu2)and inferior nasal RNFL thickness( in2,in1 )was significantly positive related with SE( P ＜0.05), inferior temporal RNFL thickness( it2)was significantly negative related with SE( P ＜0.05), and RNFL thickness in other regions were not significant related with CCT and SE ( P ＞ 0.05 ) in single and multiple variable regressive analysis.Conclusion Relationship between RNFL thickness of local paradisc region and CCT in myopia eyes suggested that CCT should be correlative with some sensible structural parameters in glaucomatous neuropathy and might be important in the diagnosis and therapy of glaucoma.

Objective:To investigate the oral Candida albicans(CA)distribution in Uyghur children and to explore the gene type of CA in the children with high caries.Methods:The oral CA of 144 Uyghur children aged 3 -5 years was detected and identified by CHROMagar Candida medium culture,biochemical identification and PCR respectively.Gene type in 25 samples of high caries was de-tected by PCR25r-genotyping.Results:CA was found in 35(24.3%)of the children,and 25 of them with high caries.The gene type of CA was divided into type A,B and C,A was the major(72.0%).Conclusion:Oral Candida albicans may be related to childhood caries of Uygur population.Candida albicans with genotype A may be more cariogenic in Uygur children.

Objective:To elucidate the effects of calcitonin gene-re la ted peptide(CGRP) on the gene expression of osteoprotegerin(OPG) and receptor ac tivator of nuclear factor-?B ligand(RANKL) in rabbit osteoblasts. Meth ods:Osteoblasts were cultured in media containing 10 -10～10 -7 mol/L of CGRP. After 24-hour incubation,semi-quanitative RT-PCR was perfor med to detect the expression of OPG and RANKL mRNA,and with ?-actin mRNA as th e internal control. Results:CGRP increased the mRNA expressio n of OPG with the maximal effect at the concentration of 10 -8～10 -7 mol/L. CGPR downgulated the mRNA expression of RANKL dose-dependantly.C onclusion:CGRP may regulate the activities of osteoclasts by regulating gene expression of OPG/RANKL.

Objective To investigate the efficacy of transurethral electroresection combined with intravesical irrigation with epirubicin for cystitis glandularis.Methods From January 2000 to January 2006,130 patients with cystitis glandularis were treated with transurethral electroresection.The whole depth of diseased mucosa and adjacent normal mucosal tissues(1 cm away)were resected.One week after the operation,intravesical irrigation with epirubicin were carried out(50 mg per time,once a week for 8 weeks,and then once a month for 2 years).Results Five of the patients developed urethral stenosis after the electroresection,and were cured by dilating the urethra at a regular interval.No complications occurred in the other patients.Bladder symptoms disappeared in 98 patients;23 cases had urinary symptoms occasionally,but cystoscopy showed normal vesical mucosa.Nine of the patients had recurrent cystitis,5 of which showed non-irrigation-induced hematuria 6-12 months after the operation,and 4 were found during regular re-examination by cystoscopy.Transurethral electroresection was performed again on these 9 patients,after they were diagnosed by biopsy;and then intravesical irrigation with hydroxycamptothecin(20 mg per time)were given.They were followed up for 12 months,during which no one had recurrence.Conclusions Transurethral electroresection combined with intravesical chemotherapy is effective for cystitis glandularis.The method is worth being widely used.