Ear Diseases ; congenital ; epidemiology ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Female ; Humans ; Male

Objective To investigate the efficacy and safety of carvedilol in patients with chronic heart failure (CHF).Methods Forty-six patients with CHF were randomly divided into carvedilol group (n=26) and control group (n=20) on the basis of standard therapy including digitalis, diuretics and ACEI. Before and after treatment, NYHA class, echocardiography and adverse reaction were observed. Results The mean dose of carvedilol was titrated to 25.14?3.05mg/day. After treatment, NYHA class was improved in both groups. Left ventricular end-diastolic diameter (LVEDD) measured by echocardiography reduced [(58.79?8.99)mm vs (64.68?10.12) mm,P

ObjectiveTo study possible mechanism through investigating the pathological and ultrastructural characters of secondary injury to perihematoma in intracerebral haemorrhage (ICH) rats.MethodsSprague Dawley male rats were subjected to ICH models. They were randomly divided into test group and control group. The rats in the test group were divided into 7 subgroups at 1h,3h,12h,24h,48h,72h and 7d after ICH; while those in control group were divided into 3 subgroups at 3h,24h,72h after saline injection. Each subgroup contained 5 rats. 2 rats from each group were stained by 2% triphenyltetrazolium chloride(TTC) to observe the pathological change.3 rats were picked up from each group to do optical microscope and electric microscope investigation on perihematoma tissue and ipsilateral cortex.ResultsHematoma tissue was demonstrated as black brown by TTC staining, no white infarcted area was detected around hematoma. In addition, there was a transitional zone between hematoma and normal tissue under microscopy; the involved tissue looked loose with varied edematous cells. Astrocytes appeared swollen and neural cells looked degenerated and necrosis. Meanwhile, capillary hyperplasia around hematoma with foot plate swollen were detected, no remarkable neural cells change was observed. 24 h after blood injection, astrocytes started to swell, part of them became degenerated and necrosis. Neural cells appeared mild degenerated and blood brain barrier were destroyed. 72 h after ICH, astrocytes showed highly swollen with neural cells degenerated.ConclusionSecondary injury to perihematoma has been identified and the pathological and ultrastructural changes have been observed.

Objective To investigate the effects of propofol on the changes in myocardial Toll-like receptor 4 (TLR-4)and TNF-αand NF-κb protein expressions in ischemia-reperfusion injury (I/R).Methods Thirty healthy male SD rats weighing 250-320 g were randomly divided into 3 groups (n=10 for each):Group A,sham operation;Group B,I/R;and Group C,propofol + I/R.In Groups B and C myocardial I/R was induced by occlusion of the left anterior descending artery (LAD)for 30 min,followed by 120 min reperfusion.In Group C propofol was given intravenously 1 0 min before myocardial ischemia,followed by continuous infusion of propofol at 5 mg/(kg·h)until the end of 120 min reperfusion.In Groups A and B normal saline instead of propofol was given. The myocardial tissues were taken at the end of 120 min;ultrastructural changes of myocardial cells were observed under X-ray electron microscope and the expressions of TLR-4 mRNA as well as TNF-αand NF-κb protein were determined.Results Ultrastructural observation under electron microscope showed significantly worsened damage in myocardial tissue structure and mitochondria in Groups B and C compared with Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were significantly higher in Groups B and C than in control Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were down-regulated in Group C compared with Group B.Conclusion Intravenous injection of propofol can protect against myocardial damage.Propofol can suppress the increase in myocardial TLR-4 and TNF-αand NF-κb protein expressions induced by I/R.

Objective To evaluate the value of MSCT scores on surgery method selection and its difficulty estimation for hepatic cystic echinococcosis. Methods Based on the CT features of hepatic cystic echinococcosis ( HCE), an integral system including 7 items wasestablished. Images of preoperative CT examination performed on 71 cases of hepatic cystic echnococcosis were retrospectively analyzed by the integral system and compared with actual surgical. Total 93 cystic lesions were divided into 3 groups based on CT scores: Group A suitable for total cystectom (0 to 5 score), Group B suitable for subtotal cystectom (6 to 10 score), and Group C suitable forendocystectomy ( ≥11 scores, or4 score in one item). Spearman rank correlation was used to analyze the relationship between WHO classification of cystic echinococcosis and actual surgery methods, the relationship between operation mode forecasted by CT scores and actual surgery methods, the relationship between vessel scores of cyst and actual surgery methods, and that between biliary score of cyst and actual surgery methods. Fisher exact test and Chi-square test were used to evaluate the incidence of residual cavity in patients with different biliary scores. Results Thirty nine cysts got 0 to 5 scores, 45 cysts got 6 to 10 scores and 9 cysts got more than 10 scores. Total cystectom was performed on 30 cysts, subtotal cystectomy on 40 cysts and performed endocystectomy on 23 cysts, actually. Actual operation methods were correlated with that predicated by CT scores ( r = 0. 741, P ＜ 0. 01 ), and with vessels score and biliary score (r = 0. 587,0. 327 respectively,P ＜ 0. 01 ). The higher the biliary score, the higher the incidence of postoperative biliary tract complications. Conclusions Preoperative CT scoring was an easy and objective way to accurately predict the surgery methods and its difficulty for hepatic cystic cnechnococosis.

Objective To evaluate how to select operation procedures for different CT manifestation of splenic artery aneurysm ( SAA) with posthepatitic cirrhosis. Methods In 61 cases with SAA,the CT manifestation ( location,number,size,portal vein,varicose vein,proxi-mal splenorenal shunt and spleen changes) of SAA,clinical features of cases,and operation approach were were retrospectively analyzed. Re-sults 4 patients who have the primary tumors located in the distal splenic artery with diameter 1. 0~2. 0 cm,spleen kidney shunt and mega-losplenia were given aortic aneurysm exclusion and branch aneurysms embolism by stages. Amiong the 15 cases of tumors resection,splenecto-my and devascularization,there were 4 cases of the primary tumors located in the middle of splenic artery and 11 cases in the distal splenic artery. There were 15 cases whose diameter of the primary tumor were lager than 2. 0 cm and 13 cases whose diameter of the primary tumor were 1. 0~2. 0 cm. There were 4 cases of cavernous transformation of portal vein,5 cases of splenic and gastric varices,15 cases of esophage-al and gastric varices,4 cases of splenic and gastric venous shunt,15 cases of megalosplenia and 4 cases of splenic infarction. Tumors resec-tion and branch aneurysms embolism by stages were conducted in 7 cases. The primary tumors located in the proximal splenic artery occured in 7cases,and the diameter of the primary tumor were 1. 0~2. 0 cm occured in 7 cases. Esophageal and gastric varices occured in 2 cases and splenomegaly occured in 7 cases. And there were 4 cases whose diameter of the tumor were 1. 0~2. 0 cm were given tumor resection and re-construction of splenic artery and continuity, including 1 case of proximal splenic artery,2 cases of medial splenic artery and 1 case of distal splenic artery. Conclusion Operation procedures were confirmed by CT findings such as location,number,size,portal vein,varicose vein, proximal splenorenal shunt and spleen changes of SAA combined with age,gender,body mass index and history.

OBJECTIVE: To establish a HPLC - UV method for determination of hydroxycamptothecin(HCPT) in rabbit tissues (liver, kidney, stomach, lung, spleen, heart, intestine) .METHODS: After homogenization, tissue samples and internal standard, eamptothecine, were precipitated with CH3OH-CH3CN( 1 : 1) and then centrifugalized.20?l of supernatant was injected and measured by HPLC - UV method.The chromatographic column was Lichrospher C18 column: (250mm ? 4.6mm, 5?m), CH3CN - 0.075mol/L NH4AC buffer(pH6.4) (30 : 70, contain 5mol/L tyiethylamine) served as mobile phase with flow rate of 1.0ml/ min .Detection wavelength was 384nm .RESULTS: The retention time of hydroxyeamptothecin was 4.5min.A good linearity was shown in the concentration range of (40- 1 600)ng/ml .The recovery was between 95.24% and 107.58% . The intra day RSD was less than 7.70% and the inter - day RSD was less than 6.69% .CONCLUSION: This method is simple,pratical and accurate.It could be applied to pharmacokinetic study of hydroxyeamptothecin.

Objective To determine the median effective dose(ED50)of etomidate inhibiting responses to endotracheal intubation when combined with dexmedetomidine in the patients with obstructive jaundice. Methods American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients with obstructive jaundice,aged 45-63 yr,with body mass index of 18-30kg/m2,scheduled for elective operations under general anesthesia,were divided into control group(group C)and dexmedetomidine group(group D)using a random number table. At 15min before induction of anesthesia,normal saline 0.1 ml/kg was infused intravenously in group C,and dexmedetomidine 0.4 μg/kg was infused intravenously in group D. Anesthesia was induced with midazolam 0.05 mg/kg,fentanyl 4 μg/kg,etomidate and cisatracurium 0.15 mg/kg. The ED50 of etomidate was determined using Dixon′s up-and-down method. Etomidate was injected intravenously at the initial dose of 0.2 mg/kg in the first patient in each group. Each time the dose increased/decreased in the next patient according to whether or not the increase in mean arterial pressure and/or heart rate ≥ 20% of the baseline value within 3min after endotracheal intubation. The ratio between the two successive doses was 1.1. The number of patients in whom inhibition was effective or ineffective was recorded,and the ED50 and 95% confidence interval of etomidate inhibiting responses to intubation were calculated using Probit analysis. Results The ED50 (95% confidence interval)of etomidate inhibiting responses to intubation was 0.185(0.162-0.201)mg/kg in group C,the ED50(95% confidence interval)of etomidate inhibiting responses to intubation was 0.129(0.093-0.143)mg/kg in group D,and there was significant difference between the two groups(P<0.05).Conclusion When combined with dexmedetomidine,the ED50 of etomidate inhibiting responses to endotracheal intubation is 0.129 mg/kg in the patients with obstructive jaundice.

Objective To observe the clinical efficacy and safety of Shenxiong glucose injection and lipo PGE1 injection in treating the lower extremity arteriosclerotic occlusive disease (LEAOD).Methods 80 patients with LEAOD were randomly divided into control group and treatment group. Both groups were given conventional therapy, including reducing blood pressure, blood sugar, blood lipid and anti-infection therapy.Control group was additonally given intra-femoral arterial infusion with urokinase 150000 units plus 15mL 0.9% sodium chloride and 10 mg anisodamine alternately every other day, 5 days for one course, stopping 3 days after another course.Treatment group was treated with intravenous injection Lipo PGE1 injection plus 10 mL 0.9% sodium chloride and intravenous Shenxiong glucose injection per day for 14 days.Clinical efficacy, changes in clinical symptoms, whole blood viscosity, high sensitivity C-reactive protein(hs-CRP), fibrinogen, ankle-brachial index(ABI), the inner diameter of the dorsalis pedis and the peak systolic velocity( PSV) of dorsalis pedis were compared and analyzed pre and post-treatment.Adverse drug reactions were recorded during the treatment.ResuIts The efficiency for the patients in the treatment group (90.0%) was higher than that in control groups(72.5%) (P<0.05).The symptoms of numbness and cold limbs, whole blood viscosity, ABI, hs-CRP improved more significantly in the treatment group (P<0.05).No adverse event occurred in the treatment group and 2 patients in control group had mild dry mouth.ConcIusion Shenxiong glucose injection combined with lipo PGE1 injection for the treatment of LEAOD is effective and safe and should be introduced in clinical practice.

[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.