OBJECTIVE:To investigate the regulation effects of oleanolic acid on the mitochondrial nitric oxide synthase(mt-NOS) in human umbilical vein endothelial cells (HUVECs) with oxidative damage. METHODS:HUVECs in exponential phase were divided into normal group,model group and oleanolic acid low,medium and high dose groups(5,20 and 35 μmol/L). After drug acting for 24 h,all groups were given culture solution containing 100 μg/ml ox-LDL to reproduce oxidative damage except normal group. CCK-8 was used to detect cell viability. The mitochondria in cells were extrated,enzyme chemical method was used to detect mtNOS activity and mtNO content,fluorescence microplate method was used to detect fluorescence intensity of reactive oxygen species(ROS),and western blot was used to detect expression of cytochrome C(Cyto-C). RESULTS:Compared with nor-mal group,the cell viability in model group was decreased;mtNOS activity,mtNO content,ROS fluorescence intensity and Cy-to-C protein expression were increased,with significant differences (P<0.05). Compared with model group,the cell viability in oleanolic acid low,medium and high dose groups was increased;mtNOS activity,mtNO content,ROS fluorescence intensity and Cyto-C protein expression were decreased,with significant differences(P<0.05),and they had positive correlation with concentra-tions. CONCLUSIONS:Oleanolic acid can decrease the mtNOS activity of HUVECs,reduce the production of mtNO and Cyto-C, by a mechanism that may be related to the decrease of ROS expression.

Objective To investigate the potential contributing effects of metabolic syndrome (MS) on cardiovascular events and mortality in maintenance hemodialysis (MHD) patients.Methods According to the diagnostic criteria for MS set by Chinese Diabetes Society,201 subjects undergoing MHD were assigned into MS group(n =78) or non-MS group (n =123),in August 2009.General and laboratory data were collected for cross-sectional analyses,and the participants were followed up for 36 months.Cardiovascular events,cause of death and time were recorded for longitudinal analyses.Results Prevalence of MS was 38.8％.Weight,waist circumference,triglyceride,total cholesterol,low density lipoprotein,fasting glucose level,uric acid and high-sensitivity C-reactive protein were significant higher in MS group compared to non-MS group,but duration of dialysis and high-density lipoprotein were lower (P ＜ 0.05).During the 36 months follow-up,cumulative incidence of cardiovascular events,cardiovascular and all-cause mortality were 41.0％ (32/78),19.2％ (15/78),28.2％ (22/78),in MS group respectively.Those of non-MS group were 22.8％ (28/123),10.6％ (13/123),17.1％ (21/123).There was significant difference between patients with and without MS in cumulative incidence of cardiovascular events (x2 =7.601,P =0.006).There was relationship between the number of metabolic syndrome parameters and cardiovascular events (r =0.236,P =0.001).Kaplan-Meier curves showed the relationship between two groups did not remained statistically significant in cardiovascular and all-cause mortality.Impaired glycometabolism in 5 parameters of MS was a cardiovascular mortality risk factor in MHD patients.Conclusions The prevalence of MS is high in MHD patients.MS is a risk factor of cardiovascular events,but it is not associated with cardiovascular and all-cause 3-year mortality in patients with MHD.

0.05) . Conclusion It is safe to use soda lime containing more than 6.08% of water during enflurane or desflurane anesthesia with low flow (FGF = 500 ml?min-1 ) in children.

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.

AIM:To explore the effect of erythropoietin ( EPO) on the expression of myocardial NADPH oxi-dase (Nox) in the pressure overload rats.METHODS:Male SD rats (n=36) were used to establish a pressure overload myocardial hypertrophy model by abdominal aorta ligation.The animals were divided into model group, control group ( sham, without narrowing abdominal aorta, the rest of the operation was the same as the model) and recombinant human erythropoietin ( rhEPO) treatment group ( intraperitoneal injection of rhEPO postoperatively, 4 000 U/kg, twice a week) . After 8 weeks, the cardiac ultrasound imaging and hemodynamic evaluation were conducted to determine the cardiac func-tions.Masson staining was used to observe the degree of myocardial fibrosis.The expression of Nox2 and Nox4 at mRNA and protein levels was detected by real-time quantitative PCR and Western blotting.The protein levels of myocardial inflam-matory factors CD45, F4/80 and TGF-βwere determined by Western blotting.RESULTS:Compared with model group, the left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-systolic pressure (LVESP) and left ventricular pressure maximum rising and falling rates ( ±dp/dtmax) increased significantly in EPO treatment group (P<0.01).At the same time, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter ( LVEDD) and left ventricular end-diastolic pressure ( LVEDP) were decreased in EPO treatment group (P<0.01).EPO reduced the degree of myocardial fibrosis caused by pressure overload (P<0.01) and decreased the ex-pression of Nox2 and Nox4 at mRNA and protein levels in the myocardium (P<0.05 or P<0.01), and reduced the pro-tein expression of myocardial inflammatory factors CD45, F4/80 and TGF-β.CONCLUSION: EPO inhibits rat myocar-dial fibrosis induced by pressure overload, improves heart functions by decreasing NADPH oxidase activity and inhibiting myocardial oxidative stress levels and myocardial inflammatory reaction.

Objective To investigate the potential correlation between serum magnesium and malnutrition-inflammation-atherosclerosis (MIA) syndrome in maintenance hemodialysis (MHD) patients.Methods A total of 120 patients who received MHD in Department of Blood Purification of Beijing Chaoyang Hospital from March to August 2013 were enrolled.Anthropometric and laboratory data were collected for the analysis of correlation between serum magnesium and indicators relating to malnutrition,chronic inflammation,and atherosclerosis,and the analysis of relevant factors of MIA syndrome.Results In the 120 MHD patients,the mean serum magnesium level was (1.11 ±0.14) mmol/L.44 patients had malnutrition (36.7％),whose serum magnesium level was significantly lower than that of patients in normal nutritious status [(1.04 ±0.12) mmol/L vs.(1.14 ±0.15) mmol/L,t =3.576,P =0.001] ; 43 patients had chronic inflammation (35.8％),with serum magnesium level significantly lower than that of patients without inflammation [(1.07 ±0.13) mmol/L vs.(1.13 ±0.15) mmol/L,t =2.138,P =0.035]; 79 patients had atherosclerosis (65.8％),whose serum magnesium level was significantly lower than that of patients without atherosclerosis [(1.08 ±0.12) mmol/L vs.(1.15 ±0.08) mmol/L,t =0.385,P =0.019] ; and 26 patients had MIA syndrome (21.7％),whose serum magnesium level was significantly lower than that of non-MIA patients [(1.02 ± 0.10) mmol/L vs.(1.13 ± 0.14) mmol/L,t =3.534,P =0.001].Serum magnesium level was found negatively correlated with high-sensitivity C-reactive protein (hs-CRP,r =-0.237,P =0.010) and carotid intima-media thickness (IMT,r =-0.331,P =0.000),and positively correlated with serum albumin,blood urea nitrogen,serum creatinine,uric acid,serum potassium,triceps skin-fold thickness,mid-arm circumference,mid-arm muscle circumference and hemoglobin (r =0.191,P =0.037; r =0.345,P =0.000; r =0.242,P=0.008; r =0.282,P=0.002; r=0.254,P=0.005; r=0.265,P=0.011; r=0.233,P=0.018; r=0.282,P=0.007; r=0.374,P =0.000).Multivariate logistic regression analysis showed that age (OR =1.142,95％ CI =1.026-1.271,P=0.049),hs-CRP (OR=1.415,95％ CI=1.152-1.740,P=0.001),IMT (OR =1.386,95％ CI=1.009-1.904,P=0.044),serum albumin (OR =0.944,95％ CI=0.910-0.978,P=0.002) and serum magnesium (OR =0.886,95％ CI =0.788-0.996,P =0.042) were related factors of MIA syndrome.Conclusions Serum magnesium level is correlated to malnutrition,inflammation,atherosclerosis,and MIA syndrome in MHD patients.

Objective To investigate the potential contributing effects of fasting plasma glucose on cardiovascular events in diabetic patients treated with maintenance hemodialysis.Methods According to fasting plasma glucose,154 patients undergoing maintenance hemodialvsis in our department were assigned into group A (n =84) nondiabetic with normal fasting blood glucose,group B (n =41) diabetic with good control of fasting blood glucose,and group C (n =29) diabetic with poor control of fasting glucose.Anthropometric and laboratory data were collected,and the participants were followed up for 36 months.Cardiovascular events and hypoglycemia were recorded and analyzed.Results Highly-sensitive C reactive protein (hs-CRP),triglyceride,and waist circumference were significantly higher in group B and group C compared with group A.Bodv mass index in group C was the highest while high density lipoprotein-cholesterol and intact parathyroid hormone levels were the lowest among 3 groups (P＜0.05).During the 36 months follow-up,47 cases of cardiovascular events occurred.Kaplan-Meier curves showed that cumulative incidence of cardiovascular events was significantly higher in group C than group A and B (both P＜0.01),and no significant difference was found between group A and B.Cox regressive analysis revealed that fasting plasma glucose and hs-CRP were independant risk factors for cumulative incidence of cardiovascular events (P＜0.05 or P＜0.0l).Conclusions If fasting plasma glucose is contmlled within the range of 5.6 to 7.2 mmol/L,cardiovascular outcomes may be significantly ameliorated in diabetic patients treated with maintenance hemodialysis.

Objective To investigate the accurancy of somatosensory evoked potential (SSEP) and motor evoked potential (MEP) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing carotid endarterectomy (CEA).Methods Ninety patients (71 males, 19 females, aged 18-80 years, ASA physical status grade Ⅱ or Ⅲ) undergoing CEA using general anesthesia were studied.Bilateral SSEP and MEP were monitored during CEA and the intraoperative changes of SSEP and MEP amplitude and latency were analyzed before, during and after ICA cross-clamping until CEA ended.Neurological dysfunction was investigated within 5 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of neurological dysfunction.Results Fourteen cases (15.6%) were diagnosed as post-operative neurological dysfunction.The sensitivity, specificity of SSEP in detecting the occurrence of intraoperative brain ischemia were 79%, 92%, respectively.The sensitivity, specificity of MEP was 86%, 89% respectively.The sensitivity, specificity, of SSEP+MEP was 79%, 99% respectively.Conclusion During the carotid endarter ectomy,SSEP predicts the occurrence of cerebral ischemia with a high specificity.MEP has a high sensitivity.The combination monitoring of SSEP+MEP can improve the specificity, make up for the shortcomings of single monitoring.

Objective To investigate the levels of interleukin 1? (IL 1?) and tumor necrosis factor ? (TNF ?) in both serum and CSF in patients with Alzheimer's disease Methods Eleven patients with Alzheimer's disease,13 patients with vascular dementia (VD) and 13 healthy controls were analyzed by using commercial ELISA kits Results The average serum level of IL 1? was found higher in AD patients(60 13?17 81 pg/ml) than in VD patients(38 51?14 39 pg/ml) and in healthy controls(33 98?16 31 pg/ml)( P