Objective Calcitonin gene-related peptide (CGRP), neurotensin (NT) and atrial natriuretic polypeptide (ANP) have strong vaso-dilating and positive inotropic action, whereas neuropeptide Y (NPY) and endothelin (ET) have vaso-constricting effect. They all have profound effects on hemodynamics. The purpose of this study was to examine the changes in the 5 neuropeptides in elderly hypertensive patients under general anesthesia.Methods The control group comprised eight men and six women without hypertension with a mean age of (69?8)yr. The hypertension group included nine men and five women with a mean age of (71?9)yr. The patients in the hypertension group had different degrees of myocardial hypertrophy and ST-T changes. All 28 patients underwent upper abdominal surgery. Anesthesia was induced with propofol 2mg?kg -1 and fentanyl 2?g?kg -1 and intubation was facilitated with succinylcholine 2mg?kg -1. The patients were mechanically ventilated after intubation. Anesthesia was maintained with 50% N 2O and enflurane or isoflurane inhalation supplemented with intermittent doses of vecuronium. Venous blood samples were taken before anesthesia, 3min after intubation, 60 min after start of surgery, at the end of surgery and 24 h after operation for determination of plasma levels of CGRP, NT, ANP, NPY and ET by radioimmunoassay.Results In hypertension group plasma level of ANP decreased and NPY increased significantly at the end of operation and 24 h after operation (P

Objective To analyse the effects of anastomat to the resection surgery in 1800 esophageal and gastric cardiac carcinoma patients. Methods The Esophagus-gaster and Esophagus-intestine were stapled by anastomat in the cervical region in 182 cases、 intrathoracically in 1296 cases and intraperitoneal in 322cases. The occurrence of complications caused by anastomat, including anastomotic fistula,anastomotic stricture,anastomotic bleeding and mechanical failure,were observed. Results Anastomotic fistula occurred in 15 cases ( 15/1800,0.83% ,ten cases took Shanghai-made GF-I anastomat ,five cases took YH-W single disposable single anastomat ), among which 6 cases had the cervical anastomosis; Anastomotic stricture occurred in 41 cases ( 41 /1800,3.11%, fifteen cases took Shanghai-made GF-I anastomat, twenty-six took YH-W single disposable single anastomat) ,but all of them recovered after dilatation; Anastomotic bleeding occurred in 21 cases (21/18001.16%, thirteen cases took Shanghai-made GF-I anastomat, eight took YH-W single disposable single anastomat) ;Anastomat mechanical failure in operation occurred in 14 cases( 14/1800,0. 78% ,ten cases took Shanghai-made GF-I anastomat, four took YH-W single disposable single anastomat). Conclusion Anastomat is an effective method in reducing the postoperational complications of esophageal and gastric cardiac carcinoma resection. Disposable single anastomat has higher clinical value.

Objective To explore the treatment of the ICU ventilator associated pneumonia(VAP),and the prevention strategy.Methods Analyzed the clinical features and microbiological data of 80 ICU VAP patients. Results The main pathogenic bacterias of VAP were acinetobacter baumannii and pseudomonas aeruginosa,which were Gram negative bacteria.A total of 200 strains pathogenic bacteria were isolated,in which,Gram negative bacteria reached to 76.0%,which mainly including:acinetobacter baumannii strains,klebsiella pneumoniae,pseudomonas aeruginosa and so on.24.0% was Gram positive bacteria,including staphylococcus aureus accounted for 10.5%,and the epidermis staphylococcus,hemolysis staphylococcus and so on.Proportion of fungi was 11.0%.According to the results of microbiological data,the effective anti-microbial treatments were administered.After treatments for 10 days, the VAP infection parameters(including temperature,the white blood cell count and the number of strains)were grad-ually back to normal.Conclusion The main VAP pathogenic bacteria are Gram negative bacteria,patients commonly are infected by two or more bacterias,which lead to the multiple infection,the treatment should be fully based on mi-crobiology and clinical monitoring data,and the formulating personalization antibacterial treatment.

Objective The objective of this study was to investigate the imaging findings of 18 F-FDG PET-CT in patients with multiple myeloma(MM).Methods Fifteen patients with multiple myeloma were enrolled in our hospital from January 2014 to October 2016.The clinical data of these patients were retrospectively analyzed to obtain the range of SUVmax values by 18F-FDG PET-CT imaging performance.Results Fifteen MM patients with 18F-FDG PET-CT showed a total number of lesions 202,the number of lesions 176 in PET and the number of lesions 171 in CT.The SUVmax range of 18F-FDG PET-CT imaging in the diagnosis of MM was 1.41 ～ 16.28.Fourteen cases of 15 MM patients were found varying degrees of bone destruction;one case showed a slightly increased bone density and also slightly increased FDG metabolic activity.Bone destruction was more performance for the chisel-like,osteolytic,swelling and flaky bone destruction.The osteogenesis lesions were rare.Conclusion 18F-FDG PET-CT imaging can clearly show the imaging features of MM by combining functional metabolic and anatomical information,and provide more clues for clinical diagnosis,which can improve the diagnostic accuracy of MM.

Objective To investigate the effects of body-weight support treadmill training(BWSTT) on function of lower limbs.Methods 46 hemiplegic patients after stroke were randomly divided into the therapy group(n=23) and control group(n=23).The subjects of both groups were administered with standardized rehabilitation program.The therapy group was also given BWSTT in addition.Both groups were evaluated before and after treatment using Functional Ambulation Category(FAC),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS).Results Before treatment,there was no significant difference between these 2 groups in terms of scores with FAC,FMA and BBS.After treatment,both groups were significantly improved regard to their scores with FAC,FMA and BBS(P<0.01),with the therapy group scored significantly better than the control group(P<0.01).Conclusion BWSTT can significantly improve walk ability and balance function of the hemiplegic patients after stroke.

Objective To evaluate the efficacy of T-joint endoscopy mask for fiberoptic bronchoscopy (FOB)-guided awake nasotracheal intubation in patients with cervical spinal cord injury.Methods Forty patients of both sexes aged 21-64 yr with fracture of cervical spine complicated by spinal cord injury scheduled for anterior decompression and interbody fusion under general anesthesia were randomly divided into 2 groups according to the technique for awake nasotracheal intubation (n =20 each):group nasal catheter and group T-joint endoscopy mask.Topical anesthesia of nasal cavity,pharynx,larynx and trachea with 2％ lidocaine was conducted and then remifentanil was continuously infused at 0.05-0.15 μg· kg-1 · min-1 in both groups.The incidence of hypoxemia and intubation time were recorded.Arterial blood samples were obtained for determination of PaO2 and PaCO2 before topical anesthesia (baseline),immediately before and 1 min after placement of FOB and immediately after nasotracheal intubation was accomplished.Results The incidence of hypoxemia was significantly lower in group Tjoint endoscopy mask (0) than in group nasal catheter (25％) (P ＜ 0.05).The PaO2 during nasotracheal intubation was significantly higher in group T-joint endoscopy mask than in group nasal catheter (P ＜ 0.05).There was no significant difference in PaCO2 and intubation time between the 2 groups (P ＞ 0.05).Conclusion T-joint endoscopy mask facilitates awake nasotracheal intubation without affecting oxygen inhalation in patients with cervical spinal cord injuries.

Objective To evaluate the efficacy of an airway topical anesthesia catheter for topical anesthesia using a spray-as-you-go technique via the fiberoptic bronchoscope (FOB).Methods Forty American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients with obstructive sleep apnea syndrome,aged 20-64 yr,with body mass index of 23-35 kg/m2,with no upper respiratory tract infection within 1 week before operation,scheduled for elective uvulopalatopharyngoplasty,were divided into 2 groups (n =20 each) using a random number table:routine control group (group C) and FOB-airway topical anesthesia catheter group (group F).In group C,the pharynx and larynx were sprayed with lidocaine FOB by using a laryngo-tracheal mucosal atomization device,and cricothyroid membrane puncture was performed and then lidocaine was injected.In group F,airway topical anesthesia was performed using a spray-as-you-go technique via the FOB with an airway topical anesthesia catheter spraying lidocaine via the nose.At 5 min after topical anesthesia of the airway,FOB-guided intubation was performed,and dexmedetomidine was intravenously infused at 0.1 μg · kg-1 · min-1 for sedation in both groups.Ramsay sedation scores were assessed after topical anesthesia and before intubation.The scores for the intubating condition and tolerance of tracheal tube were assessed during FOB-guided intubation.Successful intubation and the development of responses to intubation and hypoxemia were recorded.The patients were followed up one day after the end of operation,and parents' satisfaction with the procedure of intubation was recorded.Results Compared with group C,the intubating condition score,tolerance of tracheal tube score,success rate of intubation at first attempt and rate of parents' satisfaction with the procedure of intubation were significantly increased,and the incidence of responses to intubation was decreased (P＜0.05),and no significant change was found in Ramsay sedation scores before intubation and incidence of hyoxemia in group F (P＞0.05).Conclusion When the FOB is used to guide awake nasotracheal intubation,the airway topical anesthesia catheter provides better efficacy,better intubating conditions,and fewer side effects when applied for topical anesthesia using a spray-as-you-go technique via the FOB,it can be easily accepted by the patients and the efficacy is better that of routine airway topical anesthesia.

Objective To investgate the changes in the expression of hepatocyte growth factor (HGF)and c-met in the lungs in a rat model of pulmonary hypertension.Methods Eighty 7 week old male SD rats weighing 180-250 g were randomly divided into 2 groups ( n =40 each ):control group (group C) and pulmonary hypertension group (group PH).Pulmonary hypertension was induced by left pneumonectomy and subcutaneous monocrotaline (MCT) 60 mg/kg 2 weeks later.Pulmonary artery pressure and the ratio between the weight of right ventricle and left ventricle + interventricular septum ( RV/LV + S) were measured at 7,14,21 and 28 d after MCT administration.HGF and c-met protein and mRNA expression and TGF-β content in the lung tissue were determined.Results Pulmonary hypertension and right ventricular hypertrophy associated with hypertrophy of pulmonary artery tunica media and muscularization of small pulmonary arteries developed after MCT administration in PH group.In PH group HGF protein and mRNA expression in the lungs was significantly down-regulated as compared with group C.There were no significant differences in c-met protein and mRNA expression in the lungs between the 2 groups.The TGF-β content in the lungs was significantly increased in group PH as compared with group C.Conclusion Decrease in HGF production in the lungs plays an important role in the pulmonary hypertension.Increasing of pulmonary TGF-β may play an important role in the down-regulation of pulmonary HGF expression during pulmonary hypertension.

Objective To construct F344 rat bone marrow mesenchymal stem cell line (MSC) modified with human hepatocyte growth factor (hHGF) gene.Methods Recombinant virus containing hHGF was obtained by transfecting the packaging cell line 293 FT with lentiviral vector pLV/EF1α-hHGF-IRES-eGFP.MSCs derived from F344 rat bone marrow were then tranfected with packed lentiviral vector.Purified MSCs expressing hHGF was obtained by screening culture with G418.MSCs and MSCs transfected with empty vector were used as control.The expression of hHGF protein was detected by Western blot (eGFP-MSCs).The hHGF-transfected MSCs were cultured in osteoblast-inducing culture medium and osteoblast phenotype was assayed by alizarin Red staining.The cells were also cultured in adipogenesis medium and stained with Oil Red O for identification.Results The expression of hHGF protein was significantly up-regulated in the hHGF-MSCs as compared with MSCs and eGFP-MSCs.hHGF-MSCs readily differentiated into mineralizing cells or adipocytes when incubated in differentiation medium.Conclusion A F344 rat MSC line that stably expresses HGF is successfully established.

Objective To investigate the correlation between serum bone metabolism biomarkers and bone mineral density (BMD) in chronic kidney disease (CKD) patients with different stages. Methods Seventy-eight CKD patients were enrolled in this study and were assigned to different groups according to their ereatinine clearance (Cer). Patients with Cer ≥ 15 ml/min were divided into 4 groups based on clinical CKD 1-4 stage standard, and those with Ccr<15 ml/min were divided into two groups of hemodialysis (HD) and non-HD. Their levels of serum calcium, phosphorus, alkalinity phosphatase (ALP), urea, Ser, osteocalein (gla-protein, OC), calcitonin (CT), intact parathyroid hormone (iPTH), osteoprotegerin (OPG) and BMD were detected respectively. Results (1) The serum levels of OPG, iPTH and phosphorus increased significantly in stage 3, 4, 5, respectively (P<0.01), and serum OPG level was elevated to (5.1±1.34) ng/L after HD, which was significantly higher than (3.35±0.76) ng/L before HD (P<0.05). The levels of serum OC, CT, calcium, ALP were not significantly different among patients with different CKD stages, while the level of OC was elevated in HD patients (P<0.05). The femoral WARDS triangle BMD of CKD stage 4 patients decreased to 0.77±0.09, which was less than the value of CKD stage 1 patients (P<0.01), with litde influence from hemodialysis treatment. (2) The level of serum OPG was positively correlated with the levels of serum phosphorus, iPTH, OC (r = 0.51, 0.39, 0.36,all P<0.01), and it was negatively correlated with the level of Ccr (r =-0.70, P<0.01). The femoral WARDS triangle BMD was negatively correlated with the levels of iPTH, OC, phosphorus and OPG (r =-0.59,-0.51,-0.45,-0.48, all P<0.05). Conclusions Most of serum bone metabolism biomarkers change according to the declined level of Cer. Compared with serum phosphorus, the levels of iPTH, BGP and femoral WARDS triangle BMD, serum OPG may be early diagnosticmarkers of renal osteodystrophy in CKD patients.