Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.

Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Long non-coding RNAs (lncRNA) play important roles in many biological processes.However,compared with other types of RNAs,limited research has been conducted on lncRNA,mostly concerning its relationship with tumor,and there are much fewer studies on its relationship with atherosclerosis.In this article,we summarized the latest research findings in this field,with an emphasis on the importance of IncRNA in atherosclerosis.The value of lncRNA in targeted therapy of atherosclerotic disorders is also discussed.

Objective: This experiment was designed to study the change of nitric oxide (NO) content in different parts of brain in rats suffering from iodine deficiency(ID) and hypothyroidism since their fetal period. Methods: Iodine deficiency animal model was made and NO content in hippocampus(HPC), cerebellum (CE) and cortex(CO) were measured by using NO test kit. Results: Urinary iodine and serum T 3?T 4 concentrations significantly decreased and learning-memory capacity was impaired in ID rats. NO content was significantly lower in HPC and CE in ID rats than in control rats.(HPC:11.61?2.31/2.3?1 18 ?mol/g Prot;CE:10.77?5.16/4.70?1.95 ?mol/g Prot).No difference was found in cortex. Conclusion: Iodine deficiency and hypothyroidism since fetal period could affect NO level in rat brain. Different parts of brain have different sensitivity to ID and hypothyroidism.The changes of NO content in hippocampus may contribute to the learning-memory impairment in ID rats.

Objective To explore the effects of Shihusan on the intracellular free calcium of human retina cells and the protection from the damage of glutamate. To investigate its function and mechanism in retinal degeneration diseases, and to offer the basis on which to treat the similar disease clinically. Design Experimental study. Participants Retinal cells from normal human eye. Methods Cultivation of human retinal neural cells was perfonned. The changes of fluorescent density of intracellular free calcium of cultured cells labeled with Fluo3/AM before and after adding Shihusan and verapamil were detected with laser scanning confocal microscopy. In addition, the effect of Shihusan on calcium overload provoked by glutamic acid was observed. Main Outcome Measures The level of intracellular free calcium of retinal cells. Results The retinal cells adhered, spread and grew well in vitro. The fluorescence intensity increased 88% in glutamic acid group, decreased 14.8% and 57.3% in Shihusan group and verapamil group respectively. Shihusan couldn't decrease the intracellular Ca2+ that was increased by glutamic acid, but could inhibit the increasing tendency induced by glutamic acid. The difference was significant compared to control group (P=0.000). Conclusions Shihusan might decrease the level of intracellular free calcium in cultured human retinal cells, and resist the damage of glutamate. Its mechanism was related possibly to resisting calcium overload and inhibiting apoptosis.

Objective To analyze the risk factors for the external hydrocephalus (EH) after traumatic brain injury in the infants. Methods The clinical data of 178 cases of infants and young children with traumatic brain injury from March 2004 to April 2009 were retrospectively analyzed. Univariate and logistic regression analysis were performed to identify the clinical risk factors for EH after traumatic brain injury. Results By univariate regression analysis, age, GCS score after trauma, coma duration, brain contusion, subarachnoid hemorrhage and epilepsy were risk factors for external hydrocephalus in the infants and young children (Ps < 0.05). Gender,traumatic wet lung and usage of mannitol were less relevant to EH (Ps >0. 05). The incidence of EH after traumatic brain injury in the infants and young children was 14% (25/178 ). Age ( OR = 0.5743 ) , coma duration after trauma (OR =3.0628) ,subarachnoid hemorrhage (OR =3.7093),brain contusion(OR = 4.7892) and post-trauma epilepsy (OR =2. 9976) were risk factors for EH (Ps < 0. 05). Conclusion Younger than 2 years old, low GCS score, long coma duration, brain contusion, subarachnoid hemorrhage and epilepsy would increase the risk of EH after traumatic brain injury in the infants and young children. This study provides information for the prevention of EH after traumatic brain injury in the infants and young children.

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.

ObjectiveTo observe the effect of irbesartan and triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area.MethodsFifty patients with diabetic nephropathy (24-hour urine protein excretion over 1.0 g and serum creatinine level below 265.2 μmol/L) at high altitude area were randomly divided into two groups,the control group were treated with irbesartan 150 mg/d for three months,and the treatment group received irbesartan 150 mg/d combined with triptolide 40 mg/d for three months.24-hour urine protein concentration,arterial pressure,liver function and renal function were measured before and after the treatment.Results After three months' treatment,the levels of 24-hour urine protein and arterial pressure were significantly lower in both control and treatment group (P ＜ 0.01 ).Twenty-four hour urine protein in treatment group were reduced from ( 8.34 ± 1.29) g before treatment to (6.42 ± 0.95 ) g after treatment ( t =5.994,P ＜ 0.001 ).Twenty four-hour urine protein in control group were reduced from (8.57 ± 0.53 )g before treatment to (7.10 ± 0.79 )g after treatment( t =7.730,P ＜ 0.001 ).Systolic pressure in treatment group were reduced from ( 152.04 ± 18.80)mm Hg before treatment to ( 131.24 ± 10.56)mm Hg after treatment(t =4.817,P ＜ 0.001 ) ; Diastolic pressure in treatment group was reduced from (93.60 ± 11.36 )mm Hg before treatment to ( 82.68 ± 7.30) mm Hg after treatment ( t =4.053,P ＜ 0.001 ).Systolic pressure in control group were reduced from ( 151.20 ± 10.17 ) mm Hg before treatment to ( 130.00 ± 10.10 ) mm Hg after treatment(t =7.396,P ＜ 0.001 );Diastolic pressure in treatment group were reduced from (92.76 ± 7.03 )mm Hg before treatment to (84.20 ± 7.56)mmHg after treatment (t =4.147,P ＜ 0.01 ).No statistic differences were observed in liver function and renal function before and after the treatment ( P ＞ 0.01 ).Conclusion Irbesartan and triptolide combination can reduce 24-hour urine protein to a certain extent and donot adversely affect liver function and renal function in patients with diabetic nephropathy at high altitude area

Objective Although heart transplantation surgery has become more common,little is known about the psychological status of patients waiting for a heart transplant.Method Ninety-three patients registered for heart transplantation from March 2013 to March 2014 in a large general hospital in Shanghai were assessed by a psychiatrist using the Hamilton Depression Scale (17 items) and the Hamilton Anxiety Scale.Out of them 36 were preoperatively admitted to the Cardiac Surgery Department.The scales were assessed repeatedly at the 1st day,3rd day,7th day,10th day and so on until the operation took place.Result The mean scores of HAMD and HAMA of 93 patients in the waiting list were separately 13.11 ±3.81 and 14.20±4.57.Among them 18(19.4％) were classified as moderately depressed,31(33.3％) had moderately anxious symptoms,and 14(14.1％) had severe anxious symptoms.Thirty-six patients were preoperatively admitted to hospital.Their mean scores of HAMD and HAMA were separately 13.19-± 3.82 and 16.17 ± 4.35.Among them 7(19.4％) were classified as moderate depression at the time of admission,16 (44.4％) had moderately anxious symptoms and 9 (25.0％) had severe anxious symptoms.The scores of HAMD had significant difference (t =3.383,P =0.002) before and after admission.Paired t test was separately conducted to analyze the first assessment and the 3rd-day assessment of HAMA and HAMD total scores after admission of all the inpatients.The results showed the scores were statistically different (for HAMA,t =2.786,P =0.009; for HAMD,t =14.024,P =0.000).Repeated ANOVA was used to analyze the recipients who had three assessments.The results had statistical difference (for HAMA,F =4.568,P=0.020; for HAMD,F=5.626,P =0.034) and the difference of HAMD score at different time points had a linear trend (F =8.273,P =0.013).Conclusion After hospital admission,the depression symptoms will be significantly alleviated.When waiting for the transplant in the hospital,the anxiety symptoms alleviate slightly in three days and then aggravate significantly.The depression symptoms alleviate slightly continuously.

Objective To explore the bone marrow stromal cells,anti-late antigen-4 (VLA-4) antibody (aVLA-4),cytarabine (Ara-C) on the proliferation and apoptosis of leukemia HL-60 cells.Methods The experiment was divided into five groups:HL-60 cells were cultured alone (control group),HL-60 cells and stromal cells group (stromal cells group),HL-60 cells + stromal cells + aVLA-4 (antibody group),HL-60 cells + stromal cells + Ara-C group (drug group),HL-60 cells + stromal cells + aVLA-4 + Ara-C group (antibody +drug group).Cell proliferation or inhibition rate was detected by CCK-8 method,the HL-60 cells apoptosis was detected by flow cytometry.The expression of anti-apoptotic gene bcl-2 in HL-60 cells was determined by Western blot.Results After 24 h and 48 h,treatment,the number of the stromal cells group HL-60 cells were higher than that of the control group with significant difference cultured [(7.2±0.3)×1O5/ml vs (5.3±0.4)×105/ml,(8.4±0.2)×105/ml vs (6.8±0.3)×105/m1,P ＜ 0.001],while the HL-60 cell proliferation inhibition rate [(24.3±2.1) ％,(37.0±2.6) ％,(65.6±3.8) ％] and apoptosis rate [(5.7±0.6) ％,(8.0±0.5) ％,(10.4±0.9) ％,(16.5±0.7) ％] of antibody group,drug group,antibody + drug group were higher than the control group with a difference of statistically significant (P ＜ 0.05),and the increase of antibody + drug group was most obvious.With the decreasing of the bcl-2 protein expression,which was most the decrease of antibody + drug group was most obvious.Conclusion Bone marrow stromal cells can stimulate the proliferation of leukemia cells,aVLA-4 interference the interaction between stromal cells and leukemia cells can enhance the chemosensitivity of leukemia cells to Ara-C.