Coronary Disease ; diagnosis ; drug therapy ; Humans ; Nitrates ; adverse effects ; therapeutic use ; Prognosis ; Vasodilator Agents ; adverse effects ; therapeutic use

Atrial Fibrillation ; prevention & control ; Humans ; Primary Prevention

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Atrial Fibrillation ; prevention & control ; Humans ; Mineralocorticoid Receptor Antagonists ; therapeutic use ; Renin-Angiotensin System

Objective To compare the neuromuscular blocking effects of rocuronium given by intermittent bolus injection, continuous infusion and target-controlled infusion during liver transplantation. Methods Thirty-six patients with hepatic failure of both sexes aged 21-63 yr weighing 48-80 kg undergoing liver transplantation were studied. The donor livers were obtained from living donors. The patients were divided into 3 groups according to the mode of rocuronium administration ( n = 12 each): group Ⅰ intermittent bolus injection (group Ⅳ); group Ⅱ continuous infusion (group CI) and group Ⅲ target-controlled infusion (group TCI). Neuromuscular block was assessed by TOF stimulation of ulnar nerve (TOF-Watch SX). Anesthesia was induced with midazolam 5 mg,fentanyl 4-6 μg/kg and propofol 1.0-1.5 mg/kg, and rocuronium was administered using different modes of administration. A bolus of rocuronium 0.6 mg/kg was given during induction and supplemental rocuronium 0.15 mg/kg was given when T1 was returned to 25% in preanhepatic stage and T4/T1 (TOFR) returned to 25% in anhepatic and neohepatic stages in group Ⅳ. TCI at an initial target effect-site concentration of 3 μg/ml was started during induction, the concentration was adjusted to maintain T1 at 5%-10% , TCI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then TCI at a target effect-site concentration of 0.1 μg/ml was started again and the concentration was adjusted to maintain T1 at 5%-10% in group TCI. A bolus of rocuronium 0.6 mg/kg was given during induction, the initial infusion rate was set at 30 μg· kg-1 ·min-1 and then adjusted to maintain T1 at 5%-10% in preanhepatic stage, CI was temporarily suspended at the beginning of anhepatic and neohepatic stages, and then it was started again at 1 μg· kg-1 · min-1 in preanhepatic stage and the infusion rate was adjusted to maintain T1 at 5%-10% in group CI. Tracheal intubation was performed when the maximal effect was achieved. The administration was stopped after suture of the peritoneum. The onset time, the maximal depression of T1 , intubation condition, recovery time and the total amount of rocuronium consumed were recorded.Results There was no significant difference in onset time, the maximal depression of T1, intubation condition,ecovery time and the total amount of rocuronium consumed among the 3 groups ( P ＞ 0.05). Conclusion There is no significant difference in the onset and recovery when neuromuscular blocade was induced by rocuronium via Ⅳ, CI and TCI, but neuromuscular blockade induced by rocuronium via TCI and CI is more stable than that induced by rocuronium via Ⅳ during liver transplantation.

Objective To compare the therapeutic effect between routine shunting and selective shunting in patients with moderate and severe carotid artery stenosis undergoing carotid endarterectomy (CEA). Methods One hundred and ninety-two patients with moderate and severe carotid artery stenosis undergoing CEA were selected, and the patients were divided into control group (routine shunting) and observation group (selective shunting) according to the random digits table method with 96 cases each. The intraoperative carotid artery occlusion time and incidences of stroke event 30 d after operation were recorded. Results In the observation group, the rate of carotid artery shunting was 35.4％ (34/96), among which the rate of carotid artery shunting in patients with contralateral severe carotid artery stenosis or occlusion was 8/13, the rate of carotid artery shunting in patients with unilateral carotid stenosis was 31.3％ (26/83), and there was statistical difference (χ2 = 13.006, P<0.01). There was no statistical difference in intraoperative carotid artery occlusion time between control group and observation group ( t=2.091, P>0.05). In the observation group, the intraoperative carotid artery occlusion time in patients with carotid artery shunting was significantly shorter than that in patients without carotid artery shunting:(4.36 ± 0.48) min vs. (10.15 ± 0.91) min, and there was statistical difference (t=7.884, P<0.05). There was no statistical difference in the incidence of stroke event 30 d after operation between control group and observation group (χ2 = 1.189, P>0.05). Conclusions The selective shunting during CEA can reduce the incidence of postoperative stroke event in patients with carotid artery stenosis, and especially it can give a good clinical effect in the patients with contralateral severe carotid artery stenosis or occlusion.

0.05). The onset time of 0.2mg/kg and 0.4mg/kg cisatracurium was significantly shorter than that of 0.1mg/kg cisatracurium and 0.5mg/kg atracurium (P

Objective The study was designed to compare the effects of desflurane and isoflurane on the vecuronium-induced neuromuscular block in the elderly patients. Methods Thirty ASA class I - II elderly patients aged over 70 yr undergoing elective surgery under general anesthesia were randomly divided into 3 groups: desflurane group ( I , n = 10) ; isoflurane group ( II , n = 10) and 3 control group ( III , n = 10). Anesthesia was induced with midazolam 0.02-0.05 mg? kg-1 , propofol 0.5-2.0 mg ? kg-1 and fentanyl 2-5?g? kg-1 maintained with inhalation of 6% desflurane(1 MAC) +50% N2O in oxygen (group I ) or 1.15% isoflurane + 50% N2O in oxygen(group II ) or 50% N2O in oxygen (group III ) supplemented with intermittent iv boluses of propofol and fentanyl when necessary. Neuromuscular block was monitored using accelograph (TOF GUARD , Denmark) .A total dose of vecuronium 40 mg ?kg-1 was divided with 4 equal doses of 10?g ? kg-1 , which was administered accumulatively in each patient. The next dose was given when the effect of the previous dose had reached its peak (T1 was no longer depressed in the height of 3 successive stimuli) .The cumulative dose-response curves of the 3 groups were established. The onset time and maximum depression of T1 of the initial dose and 3 incremental doses were recorded. After the last increment of 10 ?g?kg-1, the time for T1 to returned to 25% ,75% ,90% and TOF ratio(T4/T1) to 70% were recorded. The recovery index was also calculated.Results The demographic data were comparable between the 3 groups. The ED50 and ED95 were significantly lower in desflurane and isoflurane groups than those in control group(P 0.05 ) . The time for T1 to return to 25 % , 75 % and 90 % was significantly longer in desflurane and isoflurane group than that in the control group. The recovery from vecuronium-induced neuromuscular block was slower in desflurane group than that in isoflurane group( P

Some types of bacteria swim through rotating their flagella. The swimming mechanism of bacteria during flagella bundling and tumble process is analyzed. The effects of body rotation and flagellum′s polymorphic transitions on bundling processes and the wall effect phenomenon are also discussed. Finally, based on dynamics similarity, a new microrobot module is put forward to further studying the flagella swimming phenomena. The research would be very helpful for constructing the bionic swimming robots under the low Reynolds number.

Objective To observe the impact of IL-1β on the expression of lectin-like oxidized LDL receptor 1 (LOX-1) and ATP-binding cassette transporter A1 (ABCA1) in human mesangial cell line (HMCL), and its association with cholesterol homeostasis of HMCL. Methods Levels of LOX-1 and ABCA1 of HMCL induced by IL-1β were examined by using real-time PCR and Western blot. Results IL-1β up-regulated LOX-1 mRNA and protein expression. Treated with 5 μg/L IL-1β, the levels of LOX-1 mRNA and protein reached the peak after 6 h and 24 h of stimulation and were 6.87 folds and 1.88 folds of control rspectively. The expression of ABCA1 mRNA and protein of lipid-loaded HMCL was down-regulated by IL-1β Stimulated with 5 μg/L IL-1β the expression of ABCA1 mRNA and protein decreased to the lowest level, 19.0% and 50.62% of the baseline respectively. Conclusions The expression of LOX-1 can be up-regulated while the expression of ABCA1 can be decreased by the stimulation of IL-1β. IL-1β can enhance dyslipidemia and influence the balance of cholesterol homeostasis of HMCL.

Objective To investigate the role of LPL in enhancing VLDL uptake in mesangial cells and modulating VLDL-mesangial interaction. Methods Human wild type LPL (LPLwt), catalytically inactive LPL (LPL194) or control alkaline phosphatase (AP) were expressed in human mesangiai cell line (HMCL) via adenoviral vectors. The expression of LPL mRNA and protein was detected by RT-PCR and immunoehemistry staining, respectively. LPL activity was assayed by radioisotope labeled liposome substrate. Cellular lipid deposition was visualized by oil red O staining and analyzed quantitatively by standard enzymatic procedures. Effect of LPL on HMCL proliferation was evaluated by colorimetric assay using MTr. MCP-1 mRNA and protein levels in treated HMCLs were determined by real-time quantitative BT-PCB and enzyme-linked immunosorbent assay respectively. For adhesion study, HMCLs were treated with VLDL for six hours, followed by one-hour incubation with Tamm-Horsfall protein-1 (THP-1) cells. Results Compared with HMCLs transfected by Ad-AP, the lever of cellular triglyceride content was sharply increased in Ad-LPLwt Wansfected HMCLs [(109.11±5.01) mg/g protein vs (23.98±3.23) mg/g protein,P<0.01] and was slightly increased in Ad-LPL194 transfected HMCLs [(36.33±2.64) mg/g protein vs (23.98±3.23) mg/g protein, P<0.05]. LPLwt amplified VLDL-driven mesangial cells proliferation. Compared to the HMCL-Ad-AP, MCP-1 mRNA and protein expression increasd by 39% (P<0.05) and 171% (P<0.01) in HMCL-Ad-LPLwt, and the amount of THP-1 cells adhering to HMCL-Ad-LPLwt was increased by 1.69-fold (P<0.05), without significant difference between HMCL-Ad-LPLI94 and HMCL-Ad-AP. Conclusions Overexpression of either active or inactive LPL in HMCLs accelerates VLDL-induced triglyceride accumulation, and enzymolysis action of LPL may be the major factor in this process. Active LPL significantly amplifies VLDL-induced proliferative effect on mesangial cells and enhances monocyte adhesion to mesangial cells through up-regulation of MCP-1. Hence, LPL may be an important contribution to initiation and progression of renal injury mediated by triglyceride-rich lipoproteins.