Objective To investigate the effect of different doses of dexmedetomidine on myocardial injury (in perioperative peri‐od) on cardiopulmonary bypass (CPB) in patients with rheumatic heart valve replacement surgery .Methods Patients undertook rheumatic heart valve replacement surgery with mitral stenosis were divided into three groups (n=20) in randomized and double‐blind method :control group (group C) ,dexmedetomidine 0 .3 μg/kg group (DEX1 group) ,dexmedetomidine 0 .6 μg/kg group (DEX2 group) .Central venous blood was drawn respectively before anesthesia induction (T0 ) ,2h after CPB (T1 ) ,24 h after CPB (T2 ) ,48 h after CPB (T3 ) ,72 h after CPB (T4 ) .Plasma muscle calcium protein I (cTnI) and creatine kinase (CreatineKinase MB , CK‐MB) were measured and mean arterial pressure and heart rate were recorded at each time point .Furthermore ,extubation time , ICU stay ,postoperative inotropic score 24 h after operation ,drainage 24 h after operation ,cardio auto‐resuscitation rates and ad‐verse cardiovascular events were recorded .Results Compared with T0 ,HR was significantly lower in the T1 time point in DEX2 group .Compared with group C ,HR ,plasma CK‐MB ,inotropic score 24 h after operation and cardiovascular adverse events was sig‐nificantly reduced in the T1 time points in DEX1 group (P<0 .05) ,but the heart auto‐resuscitation rate did not significantly im‐proved .HR at T1 ,plasma CK‐MB values at T1 and T2 ,and plasma cTnI values at T2 -T4 were significantly reduced ;the heart re‐suscitation significantly increased ,myocardial contraction power ratings 24 h after operation and the incidence of cardiovascular e‐vents was significantly lower in DEX2 group (P<0 .05) .The extubation time ,ICU stay time and drainage 24 h after operation did not change significantly in both groups .Conclusion Dexmedetomidine has a protective effect on perioperative myocardial injury in patients with rheumatic heart valve replacement surgery ,and the effect would be better when the dexmedetomidine was infused at 0 .6 μg · kg -1 · h-1 after a loading dose of 0 .6 μg/Kg continuously .

OBJECTIVE:To explore consumers’perceptions for pharmaceutical care by community pharmacist when purchas-ing OTC drugs. METHODS:Semi-structured interview was conducted for 100 consumers who were recruited in Xingqing District, Jinfeng District and Xixia District of Yinchuan,Ningxia Hui Autonomous Region,their expection for pharmaceutical care by com-munity pharmacists was summarized. RESULTS:Totally 100 residents were interriewed,and 97 completed a full interview with ef-fective interview rate of 97%. Consumers still did not clearly on distinguishing the OTC drugs. The majority of consumers chosen OTC drugs were based on experience and brand,a handful of consumers were under the guidance of community pharmacists. Con-sumers were most concerned about the efficacy,adverse reactions and drug quality in using OTC drugs. Most consumers were not satisfied with the pharmaceutical care in purchasing OTC drugs. Nevertheless,due to a lack of medicine knowledge,consumer had a great demand for pharmaceutical care and willingness to accept it. Low professional level of community pharmacist and staff in current community pharmacy and lack of effective communication between pharmacist and consumer were the obstacles of develop-ing pharmaceutical care. CONCLUSIONS:Because of their distrust on competence of community pharmacist,consumers seek less pharmaceutical care of OTC drugs at community pharmacy though they had expectations on pharmaceutical care of OTC drugs by community pharmacist. Consumers’rely on self-choice of drugs make them exposed to more drug risks.

Free radicals are highly reactive molecules generated predominantly during cellular respiration and normal metabolism. Imbalance between cellular production of free radicals and the ability of cells to defend against them is referred to oxidative stress (OS). OS has been implicated as a potential contributor to the pathogenesis of ischemic cerebrovascular diseases. After brain injury by ischemia, the production of reactive oxygen species (ROS) may increase, leading to tissues damage via several different cellular molecular pathways. Radicals can cause damage to cardinal cellular components such as lipids, proteins, and neucleic acids, leading to subsequent cell death by modes of necrosis or apoptosis. Treatment with antioxidants may prevent propagation of tissues damage and improve both the survival and neurological outcome. The present paper reviews the antioxidants therapy in ischemic cerebrovascular disease, discusses probable reasons of inconsistency between animal experiments and clinical trials on antioxidants, and puts forward strategies against oxidative stress in the treatment of ischemic cerebrovascular diseases.

Objective: To observe whether transforming growth factor-beta 1 (TGF-β1) can improve the mechanical properties of tissue engineered heart valve (TEHV) prepared by TGF-β1 and myofibroblasts. Methods: Myofibroblasts were isolated, cultured, identified, and seeded onto the decellularized aortic valve leaflet. In the experimental group, TEHV were cultured with DMEM containing 10 ng/ml TGF-β1 for 14 days. In the control group, TEHV were cultured with DMEM only for 14 days. The contents of lysyl oxidase (LOX) and hydroxyproline, the expression of LOX and COLL-1 mRNA, and the mechanical properties of the TEHVs were analyzed in each group. Results: The contents of LOX and hydroxyproline, expression of LOX and COLL-1 mRNA, Max-load, and Max-stress were significantly higher in the experimental group than those in the control group (all P<0.05). However, the experimental and control group showed comparable values of Max-strain and elastic modulus. Conclusion: TGF-β1 can increase expression of LOX and COLL-1 mRNA in the seeded cells during TEHV construction, increasing the production and cross-linking of collagen, and improve the mechanical properties of the TEHV.

To increase efficiency of automated leucocyte pattern recognition using lower feature dimensions, a novel inter-class distinctive feature selection method for chromatic leucocyte images was proposed based on attribute hierarchical relationship. According to the attribute constraints in formal concept analysis, we established a knowledge representation and discovery method based on the hierarchical optimal diagram by defining attribute value and visual representation of optimized hierarchical relationship. It was applied to human peripheral blood leucocytes classification and 12 distinctive attributes were simplified from 60 inter-class attributes, which contributes significantly to reduced feature dimensions and efficient inter-class feature classification. Compared with the classical experimental data, the inter-class distinctive feature selection method based on hierarchical optimal diagram was proved to be usable and effective for six leucocyte pattern recognition.
Humans ; Leukocytes ; classification ; Pattern Recognition, Automated

Objective To analyze the risk factors associated with postoperative respiratory failure (PRF) in elderly patients undergoing noncardiac surgery. Methods In a prospective randomized joint study, 582 patients conforming to the criteria established by the four medical centers were enrolled for analysis. Univariate analysis and multivariate logistic regression analysis were used to examine the relations between perioperative risk factors and PRF. PRF was defined as mechanical ventilation after operation lasting for more than 48h or reintubation and mechanical ventilation within 6h after extubation.Results Fifty-one patients developed PRF (8.8%) . Multivariate logistic regression analysis identified that the type of surgery, ASA physical status classification, history of COPD and plasma albumin upper abdominal surgery and peripheral vascular surgery. The reason that neurosurgery topped the list was that most neurosurgical patients suffered from severe head injury and postoperative mechanical ventilation was prolonged because of coma. Our study showed that physical status was also a significant predictor of PRF. According to ASA classification, one class higher increased the risk by 6.325 time s. Conclusion Based on these predictors of PRF, in high risk elderly patients necessary measures can be taken to decrease the development of PRF.

Background It is very important for us to understand retinal function change in the patient with diabetic mellitus in clinic. At present,the study about diabetic mellitus associated with macular edema includes fundus fluorescense angiography ( FFA) and multifocal electroretinogram ( mfERG) etc.. However, seldom research is performed in the mfERG findings for different types of diabetic macular edema. Objective This study aimed to investigate the mfERG change in different types of diabetic macular edema compared with normal population. Methods Fifty-seven eyes with diabetic macular edema from 40 patients and 35 eyes from age-and gender-matched normal subjects were enrolled in this study. The eyes with diabetic macular edema were assigned to local macular edema group (n=16) ,diffuse macular edema group (n = 22) and cystoid macular edema ( n = 17 ) based on the manifestation of FFA. MfERG was recorded in all the individuals. The informed consent was obtained from each subject prior to any the medical examination. Results In focal diabetic macular edema group,the response density of P1 wave was significantly attenuated in ring 1 , showing a statistical difference in comparison with controls (t =2. 170,P = 0.038) ,and the latencies of P1 and N1 waves showed obvious prolong in ring 4 and 5 (t = 2.519,P = 0. 017 ;t = 2. 451 ,P = 0. 020). In diffuse diabetic macular edema group,the response densities of P1 and N1 waves were declined in ring 1,3,5 and ring 1,3,4,5 respectively,and the latencies of P, in ring 3,4 were significantly delayed respectively in comparison with controls (all P < 0. 05 ). In cystoid diabetic macular edema group, the response densities of P1 and N1 waves were lowed from ring 1 through 5 respectively, and the latencies of P1 and N1 waves were significantly longer from ring 3 through 5 and ring 4 respectively with the statistically significant difference from controls (all P<0. 05). The visual function of fovea was badly damaged. Conclusion These studies indicate that the most serious damage of visual function is in foveal area in cystoid diabetic macular edema group, and is then parafoveal area of diffuse diabetic macular edema group and perifoveal area in focal diabetic macular edema group. The outcome of mfERG presents a good consistency with FFA findings in the patients with diabetic macular edema.

Objective:To study the long-term stability of 6MV photon beam on TrueBeam, which is a new linear accelerator introduced by Varian Medical System. Methods:QA BeamChecker Plus (QABC+, Standard Imaging Inc., Middleton, USA) was used to measure 6MV X-ray on TrueBeam linac as daily quality assurance (Daily QA). Dosimetric parameter, including output Constancy, flatness and symmetry, were employed to evaluate the dose delivery stability of TrueBeam linac. Results: Daily QA results of 18 months showed the dose output delta was (0.0%±0.7%), only once out of tolerance of 2%. The constancy of Flatness was excellent with the delta of (0.1%±0.1%). The symmetric of axial and transverse varied within 1%. Conclusion:The output constancy of TrueBeam with 6MV is very stable, as well as flatness and symmetry. It’s stable and reliable to implement Truebeam linear accelerator in clinical.

The occurrence and development of malignant glioma are closely related to abnormal overexpression and activation of receptor tyrosine kinase (RTK) signal transduction pathways.Targeted therapeutic drugs such as RTK inhibitors,RTK downstream signaling pathway inhibitors and multi-target inhibitors can targeting treat malignant glioma at molecular level,some of which have been investigated in clinical trials and achieved good therapeutic effects.

Objective To study the influence of laparoscopic gastric surgery on the gut barrier function (GBF).Methods There were 64 gastric cancer patients undergoing respectively laparoscopic radical procedures (32 cases) and open gastric surgery (32 cases).Blood was drawn on day one before surgery,day 1,day 3 and day 7 after the surgery for the measurement of plasma D-lacate and plasma diamine oxidase activity by using ultraviolet spectrophotometry.Results There was no statistical difference among demographic,clinicopathological characterastics between the two groups (P ＞ 0.05).The difference on the operative time,blood loss and the time starting to take food after the surgery was significant between the two groups,P ＜ 0.05.The differences of plasma D-lacate level and the diamine oxidase (DAO) on perioperatively respective all time points were not significant between the two groups,P ＞ 0.05.Conclusion Laparoscopic radical gastrectomy is comparable to open procedures in causing damage to patient's gut barrier functions.