ObjectiveTo analyze the influence of different anesthesia methods on the stress response and hemodynamic of elderly patients undergoing laparoscopic cholecystectomy(LC).Methods Fifty-eight elderly patients who needed LC were selected and divided by random digits table method into GAEA group received general anesthesia combined with epidural anesthesia and GA group received general anesthesia with 29 cases each.The stress response and changes of hemodynamic were observed.Results Blood pressure and heart rate (HR) were elevated during pneumoperitoneum in both groups.Blood pressure and HR returned to normal at 30 minutes after pneumoperitoneum in GAEA group,which were recovered more slowly in GA group.There was no significant difference in systolic blood pressure (SBP),diastolic blood pressure (DBP),HR between two groups before and after anesthesia (P＞0.05).SBP,DBP,HR of GAEA group were ( 123.8 ± 25.9) mm Hg ( 1 mm Hg =0.133 kPa),(85.9 ± 8.4) mm Hg,(83.2 ± 7.4) times/min during pneumoperitoneum,respectively,(118.2 ±21.1) mm Hg,(84.4 ±8.3) mm Hg,(82.8 ±7.5)times/min at 10 min after pneumoperitoneum,( 114.9 ± 20.7) mm Hg,(80.2 ± 7.6) mm Hg,(78.5 ± 10.4)times/min at 30 min after pneumoperitoneum.SBP,DBP,HR of GA group were (138.3 ±26.7) mm Hg,(91.2 ± 8.8) mm Hg,(89.3 ± 10.1 ) times/min during pneumoperitoneum,( 130.3 ± 21.3) mm Hg,(89.2 ±8.6) mm Hg,(88.2 ± 9.7) times/min at 10 min after pneumoperitoneum,( 126.2 ± 20.7) mm Hg,(85.2 ±8.4) mm Hg,(84.9 ± 9.6 ) times/min at 30 min after pneumoperitoneum,respectively.SBP,DBP,HR during pneumoperitoneum,at 10 min and 30 min after pneumoperitoneum in two groups had significant differences (P ＜0.05).The anesthesia onset time in GAEA group was(73.2 ±24.9) s,and the awake time after operation was (31.6 ± 10.2) min,while those in GA group were (78.1 ± 22.4) s and (35.9 ± 14.3) min.The anesthesia onset time and awake time after operation in GAEA group were shorter than those in GA group,but had no significant difference (P＞ 0.05 ).Postoperative visual analogue score of GAEA group [ ( 13.4 ± 8.2)scores] was obviously lower than that of GA group[(26.3 ± 10.1) scores] (P ＜0.05).The incidence of adverse reactions between GAEA group [27.59％(8/29)] and GA group [6.90％(2/29)] had statistical difference (P ＜ 0.05).ConclusionsCompared with general anesthesia,general anesthesia combined with epidural anesthesia during LC for elderly patients can reduce the occurrence of intraoperative stress responses and have more steady hemodynamic,better anesthetic effect and faster recovery.But it may cause the incidence of nausea,headache and other postoperative adverse reactions increase.

Objective To compare the therapeutic effect of routine dose of calcitriol and large dose impulsion therapy on hemodialysis patients with secondary hyperparathyroidism(SHPT). Methods 48 uremic hemodialysis patients were divided into group A(routine group, n = 22) and group B(control group, n = 21 ). In group A,22 pa-tients were administered with calcitriol for 6 months at the dosage of 0.25～0.5μg/d,adding calcium agents simul-taneously;the patients in group B were not given calcitriol for economic reason. In group C,21 patients were given calcitriol twice a week at the dosage of 2μg/time after hemodialysis for 3 months. Results Comparing to group B,serum PTH,AKP in group A had no significant difference,but serum hypocalcium and hyperphasphate were partly corrected,symptoms of bone pain, muscular convulsion and akin pruriter were improved. Comparing to group A,serum hypocalcium and hyperphasphate in group C were corrected, serum PTH, AKP were significantly decreased( t=2.031,P<0.05;t =3.317,P<0.001),and no hypercalcium oecurred. Conelosion Routine dose of calcitriol can not control uremic-SHirr,while impulsion therapy with lower dose oral calcitriol is effective and safe.

Objective To learn the correlation between thyroid function and arteriosclerosis in elderly popu-lation,and to provide research data for early clinical intervention.Methods 7 1 elderly patients with hypothyroidism were selected as A group,76 elderly patients with subclinical hypothyroidism were selected as B group,70 healthy elderly cases were selected as C group.Triiodothyronine (FT3 ),tetraiodothyronine (FT4 ),thyrotrophin (TSH ), triglyceride (TG),total cholesterol (TC ),low density lipoprotein cholesterol (LDL -C ),high density lipoprotein cholesterol (HDL-C),C reactive protein (CRP)levels of the three groups were detected.Carotid artery intima media thickness (CIMT)was examined by color Doppler ultrasonography.Results FT4 levels of A group,B group were (5.25 ±4.17)pmol/L,(10.74 ±5.02)pmol/L respectively,which were lower than (18.53 ±6.38)pmol/L of C group.TSH levels of A group,B group were (16.45 ±6.96)mU/L,(6.25 ±3.84)mU/L respectively,which were higher than (3.37 ±1.13)mU/L of C group (t=14.650,8.232,15.522,6.037,all P<0.05).FT4 level of A group was lower than that of B group,TSH level of A group was higher than B group (t=7.185,11.097,P<0.05).TC, LDL-C levels of A group,B group were (5.96 ±1.01)mmol/L,(4.15 ±1.69)mmol/L,(5.64 ±0.94)mmol/L, (3.64 ±1.17)mmol/L respectively,which were higher than those of C group [(5.17 ±1.12)mmol/L,(3.20 ± 1.06)mmol/L](t=4.400,2.754,3.992,2.374,all P<0.05).TC,LDL-C levels of A group were higher than B group (t=1.990,2.139,all P<0.05).CIMT,CRP levels of A group,B group were (0.90 ±0.23)mm,(6.20 ± 1.31)mg/L,(0.79 ±0.17)mm,(4.55 ±1.05)mg/L respectively,which were higher than those of C group [(0.68 ±0.11)mm,(3.12 ±0.88)mg/L](t=7.229,4.599,16.364,8.878,all P<0.05).CIMT,CRP levels of A group were higher than B group (t=3.312,8.453,all P<0.05 ).CIMT and TSH,LDL -C,CRP levels were positively correlated (r=0.789,0.647,0.583,all P<0.05),CIMT and FT4 levels were negatively correlated (r=-0.636,P<0.05 ).Conclusion Hypothyroidism,subclinical hypothyroidism are associated with atherosclerosis in elderly population,and elderly patients with hypothyroidism,subclinical hypothyroidism are at high risk of atherosclerosis.

OBJECTIVE:To establish a RP-HPLC method for the determination of the content of emodin in Compound shouwu mixture.METHODS:The determination was performed on Diamonsil C_(18) column(150 mm?4.6 mm,5?m) with the mobile phase consisted of methanol- 0.1%phosphoric acid(68:32).The detective wavelength was set at 220 nm.RESULTS: The linear range of emodin was 7.8～78.0?g?mL~(-1)(r= 0.999 8) with an average recovery rate of 98.25%(RSD = 1.09%,n=9).CONCLUSION:The method is accurate,sensitive and reproducible,and it is applicable for the quality control of the Compound shouwu mixture.

Objective To investigate the influence of kaempferol on transforming growth factor(TGF)-β1/Smads signal trans-duction in liver tissue of mice with schistosomiasis liver fibrosis. Methods Forty BALB/c mice were randomly divided into a normal control group(8 mice),a praziquantel group(8 mice ),and 4 praziquantel+kaempferol groups with different kaempfer-ol dosages(5,10,15,20 mg/kg respectively,6 mice each group). Besides the normal control group,all the mice in the other 5 groups were infected with Schistosoma japonicum. After the infection for 6 weeks,the praziquantel group and the 4 praziquantel+ kaempferol groups were treated with praziquantel 500 mg/(kg · d) for 2 d,then the mice in the praziquantel group were drenched with normal saline for 6 weeks,and those in the 4 praziquantel+kaempferol groups were drenched with kaempferol 5, 10,15,20 mg/kg respectively for 6 weeks. After the treatment,all the animals were sacrificed by the cervical dislocation meth-od,and the area of egg granuloma and the degree of fibrosis in the livers of the mice were observed by HE and Masson staining. The expressions of TGF-β1,Smad2/3,Smad7 proteins were measured by the immunohistochemical method,and the mRNA lev-els of the 3 proteins were detected by RT-PCR. Results Compared with the mice in the praziquantel group,the areas of egg granuloma of the liver of the mice in the 4 praziquantel+kaempferol groups were smaller,and the degrees of the hepatic fibrosis of the mice were lesser,and their expressions of Smad2 and Smad3 at protein and their mRNA levels were significantly lower (all P<0.05),while the expression of Smad7 at protein and its mRNA level were significantly higher(all P<0.05). Conclu-sion By decreasing the expressions of TGF-β1 and Smad2/3,and increasing the expression of Smad7,kaempferol can signifi-cantly reduce the degrees of hepatic fibrosis and granuloma caused by schistosome eggs after the praziquantel treatment.

AIM: This study aimed at investigating the effects and mechanism of total alkaloids from Rhizoma Coptidis (TA) on ethanol-induced gastric mucosal injury in rats. METHODS: The experimental gastric damages were established by intragastric ethanol, and the protective effects of TA were evaluated by calculating lesion indices contents and superoxide dismutase (SOD) activity from rat gastric mucosa were measured to explore the interrelation between therapeutic effects of TA and these factors. The expressions of neuronal nitrogen monoxide synthase (nNOS), endothelial NOS (eNOS), and inducible NOS (iNOS)from ethanol-damaged gastric mucosa in rats were analysised using immunohistochemical method. RESULTS: TA significantly inhibited the gastric injury induced by ethanol ,in dose-dependent manner,and the effect of TA was superior to that of Berberine (Ber). TA obviously antric mucosa. TA significantly suppressed ethanol-induced decreasing nNOS and eNOS expression and elevation of iNOS expression in rat gastric mucosa. CONCLUSION: Rhizoma Coptidis is a potent candidate in therapeutic drugs of human alcohol-induced gastric injury. Its anti-injury effects involve in Ber and other ingredients of TA. The protective mechanisms of TA involve in inhibiting generation of oxygen-derived free radical, accelerating scavenging of free radicals, relieving lipid peroxidation, and maintaining NO content in normal level by inhibiting decreasing of nNOS and eNOS expression and elevation of iNOS expression.

High intensity focused ultrasound (HIFU) is a new and exciting medical treatment. Cavitation is the focus in the field of HIFU research. Cavitation and the relationship between cavitation, echo and the thermal effects of HIFU treatment were reviewed in this article.

Objective To study the clinical and genetic features of Lowe syndrome. Methods The clinical data and test results of OCRL gene from two children with Lowe syndrome were analyzed. The related literatures were reviewed. Re-sults Two male patients all presented with low molecular proteinuria, hypercalciuria, rickets and nephrolithiasis. Patient 2 had renal tubular acidosis, glycosuria and cryptochism. Patient 1 was found to have abnormal vision and congenital cataract soon after birth and treated surgically. Patient 1 also had psychomotor retardation and the cranial magnetic resonance ima-ging (MRI) showed agenesis of the corpus callosum. Patient 2 did not have obviously extra-renal symptoms, but was found to have mild cataract by a meticulous ophthalmological examination. MRI showed cerebral hypoplasia and myelination delay and mental retardation was gradually appeared during follow-up. Two OCRL gene mutations were detected. A splice site mutation NG_008638.1:g.46846-46848delTAA/insC was found in patient 1 and a frame shift mutation NM_000276.3:c.321delC in exon 5 was found in patient 2. Both mutations were not reported previously. Conclusions The diagnosis of Lowe syndrome is mainly by clinical manifestations and test of OCRL gene. Lowe syndrome needs to be included in the differential diagnosis of a patient with congenital cataract and renal tubulopathy. Two novel mutations in the OCRL gene were identiifed.

Objective To evaluate the efficacy of transarterial embolization(TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepato-cellular carcinoma(HCC).Methods 50 cases with ruptured HCC were divided into 4 groups according to the type of their previous treatment:group A,TAE followed by elective hepatectomy 12;Group B,TAE alone 12;Group C,emergency operation 13;Group D,medical conservative management.Results Celiac arterio-graphy done before the present treatment showed extravasation of contrast material in 6(25%) of the 24 patients in group A and B,and hypervascular tumor was observed in the rest.The hemostasis success rate of group A,B and C were 100%,which were much higher than that of group D(40%)(P