Anthracycline-based antitumor drugs are one of the highly effective broad-spectrum anti-cancer drugs that are commonly used clinically. However, anthracyclines have the serious side effect of cumulative dose-related cardiotoxicity. Clinically, intake of myocardial protective drugs is one of the most important strategies for the safe use of anthracyclines in chemotherapy. Numerous cancer patients un-dergoing chemotherapy also require surgery, during which general anesthesia is commonly used. Various studies have shown that propofol and sevoflurane, the most commonly used general anesthetics, present a significant protective effect in myocardial ischemia-reperfusion damage. Therefore, for patients who have just undergone chemotherapy with anthracyclines, anthracycline-induced myocardial injury may occur at the acute or chronic phase of surgery. Consequently, if the effect of anesthetics on the cardiotoxicity of anthracyclines is similar to the protective effect of these drugs for myocardial ischemia-reperfusion damage, this protective effect on cardiotoxicity will have significant impact on the recovery of cardiopulmonary function of patients after surgery. Thus, further studies are needed to establish the effect of anesthetics on the cardiotoxicity of anthracyclines.

Objective To compare the efficacy of different does of remifenanil combined with propofol for colonoscopy.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 35-63 yr,weighing 45-72 kg,scheduled for elective painless outpatient colonoscopy,were randomly divided into 3 groups (n =30 each):remifentanil 0.2 μg/kg group (group Ⅰ),remifentanil 0.5 μg/kg group (group lⅡ) and remifentanil 1.0 μg/kg group (group Ⅲ).In groups Ⅰ-Ⅲ,remifentanil 0.2,0.5 and 1.0μg/kg were injected over 60 s,respectively,and then propofol 1.0 mg/kg was injected intravenously for induction.The colonoscope was inserted after loss of eyelash reflex.When body movement appeared during examination,remifentanil 0.1 μg/kg + propofol 0.5 mg/kg,remifentanil 0.25 μg/kg + propofol 0.5 mg/kg,and remifentanil 0.5μg/kg+ propofol 0.5 mg/kg were added in groups Ⅰ,Ⅱ and Ⅲ,respectively.The operation time,induction time,emergence time,examination room discharge time,and body movement,hypotension,bradycardia,hypoxemia and respiratory depression during operation were recorded.Results There was no significant difference in the operation time,induction time,emergence time,and examination room discharge time between the three groups (P ＞ 0.05).Compared with group Ⅰ,the incidence of body movement was significantly decreased,and the incidences of hypotension and respiratory depression were increased in group Ⅱ,and the incidence of body movement was significantly decreased,and the incidences of hypotension,hypoxemia,bradycardia and respiratory depression were increased in group Ⅲ (P ＜ 0.05).The incidences of hypoxemia,bradycardia and respiratory depression were significantly higher in group Ⅲ than in group Ⅱ (P ＜0.05).Conclusion The optimum dose of remifentanil is 0.5 μg/kg when combined with propofol for colonoscopy.

Alcohol is closely related to the occurrence and prognosis of cerebral ischemia.Researches on the relationship between alcohol and cerebral ischemia using different animal models draw different conclusions.This paper summarizes the common alcohol intervention methods in making animal models of cerebral ischemia, and evaluates the advantages and disadvantages of these models to provide reference for the future research.

Objective: To analyze the effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type Ⅱ respiratory failure. Methods: From January 2015 to June 2017, 120 patients of AECOPD with typeⅡrespiratory failure in Jincheng People's Hospital were randomly divided into three groups by the random number table, with 40 cases in each group.The suction pressure of A group was set to 10-14cmH₂O.The suction pressure of B group was set to 15-19cmH₂O, while the suction pressure of C group was set to 20-25cmH₂O.The clinical curative effect of three groups was compared. Results: The PaO₂ level of three time points among the three groups were compared by repeated measurements of variance.The results showed that after treatment for 24h, the PaO₂ levels of A group, B group and C group were (57.15±5.03)mmHg, (60.28±5.21)mmHg and (58.38±6.06)mmHg, respectively.After treatment for 72h, the PaO₂ levels of A group, B group and C group were (63.02±6.08)mmHg, (80.16±5.28)mmHg and (70.07±5.23)mmHg, respectively.After treatment for 168h, the PaO₂ levels of A group, B group and C group were (70.11±60.28)mmHg, (86.35±5.01)mmHg, (79.26±5.16)mmHg, respectively.The results showed that the difference in PaO₂ of different groups was statistically significant (F=8.514, P<0.001), and there was significant difference in PaO₂ at different time points (F=13.681, P<0.001), and there was interaction between groups (different processing formulas) and time points (F=9.872, P<0.001). There was an interaction between PaCO₂ and PaO₂/FiO₂ in the groups and time points (P<0.001). The rank sum test was used to compare the curative effect among the three groups.The Z value was 17.512 (P<0.001), and the comparison with the cutting probability method showed that the effective rate of B group was significantly higher than that of A group and C group (P<0.012). Conclusion 15-19cmH₂O inhalation pressure can significantly improve the effect of non invasive mask BiPAP treatment for AECOPD with type II respiratory failure, and the improvement of blood gas index is better with time.

Objective: To analyze the pulmonary function and clinical features of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) , coal worker's pneumoconiosis and COPD, in order to improve the diagnosis and treatment of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease. Methods: Selected patients in respiratory department of General Hospital of Jincheng Coal Industry Group were classified as pneumoconiosis complicated with COPD group (n=52) , pneumoconiosis group (n=70) and COPD group (n=50) . Clinical data were collected and compared between three groups, including age, history of smoking, BMI, pulmonary function, CAT score and complication with Hypoxemia and respiratory faliure. Results: The mean age, smoking index and BMI of the three groups were not significantly different. The FEV1% pred, FEV₁/FVC%, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than pneumoconiosis group (P<0.05) ; The FEV₁% pred, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than COPD group (P<0.05) , but, the FEV₁/FVC% was no significant different between pneumoconiosis complicated COPD group and COPD group (P>0.05) ; The CAT score for clinical symptoms of pneumoconiosis complicated with COPD group was significantly higher than that of pneumoconiosis group (P<0.05) , but there was no significant difference between pneumoconiosis complicated COPD group and COPD group (P>0.05) . The rate of hypoxemia in coal workers' pneumoconiosis combined with chronic obstructive pulmonary disease was 78.8%, which was higher than that of coal workers' pneumoconiosis group (61.4%) and chronic obstructive pulmonary disease group (72%) ; The respiratory failure rate of coal worker's pneumoconiosis combined with chronic obstructive pulmonary disease group was 44.2%, which was higher than that of coal worker's pneumoconiosis group (4.3%) and chronic obstructive pulmonary disease group (16%) . Conclusion In pneumoconiosis patients, once complicate with COPD, the pulmonary function indexes are worse, the clinical symptoms are heavier, and the probability of hypoxemia and respiratory failure are higher. Compared with the COPD group, the patients with pneumoconiosis complicated with COPD have more restrictive ventilation dysfunction and diffuse dysfunction, and the clinical symptoms are heavier, and the probability of combined respiratory failure is higher.

Objective To investigate the effect of acute exhausted exercise in high temperature environment on the expression of myocardial HSP70 and plasma ANP level of in rats. Methods Forty eight male Sprague-Dawley rats was randomly and equally assigned to the following six groups:control group(C),exercise group(E),one-hour heat exposure group (H), heat exposure and exercise group (HE), exercise and 24 hours after exercise group(E'),heat exposure and 24 hours after exercise(HE'). Each group consisted of 8 rats. Rats in E,HE,E' and HE' ran on a treadmill until exhaustion, while rats in H and H' were exposed in a high temperature environment (33℃ ,50%RH) for one hour. Rats in C,E,HE and H were killed immediately after exercise or heat exposure. Rats in HE' and E' were killed 24 hours after exercise. Samples from myocardium and serum were collected for determining HSP70,ANP and CK-MB. Results(1) HSP70 levels in groups E and E' are significantly higher than that in group C(P<0.05 and P<0.01,respectively),and the level in group HE' is significantly higher than that in groups H and E'(P<0.01 );The HSP70 level in group H is significantly higher than that in group C. (2) The ANP and CK-MB levels in group E are Significantly higher than that in group C.and in group HE is higher than in group H (P<0.05);The HSP70 levels in group E' and HE' significantly decrease comparing to that in groups E and HE (P<0.01). Conclusions(1)Both heat exposure and exercise can induce the increased expression of myocardial HSP70 in rats and the peak expression is seen 24 hours after exercise. The increased expression of HSP70 may have protective effects on the heat-induced myocardial injury. (2) The increased ANP levels in plasma immediately after exhausted exercise improves the blood circulation in myocardium and hints the potential possibility of myocardial damage. However,the high temperature environment does not strengthen the increase of plasma ANP level that caused by exhaustive exercise.

BACKGROUND:Finite element analysis has been widely used for the research of bone and joint biomechanics, but the reports about finite element analysis of distal tibial articular surface defect are rare at home and abroad. OBJECTIVE:To establish ankle three-dimensional finite element model, produce distal tibial articular surface defects with different areas, and to simulate the distal tibial articular surface deformation and displacement under the different phases, thus predict the maximum al owable degree of distal tibial articular surface defect and explore the mechanics pathogenesis of ankle traumatic arthritis. METHODS:Continuous tomographic images were obtained by multi-slice spiral CT scan of a normal adult male ankle, and then the images were imported into the Mimics medicine modeling software to generate a entity model;the large general-purpose finite element analysis software ANSYS 13.0 was used for meshing, material property assignment and generating a finite element model. Restricted boundary conditions and simulated ankle distal end axial force, and then the stress distribution and displacement results of distal tibial articular surface in different phases were obtained. RESULTS AND CONCLUSION:The total number of units of the established finite element model of ankle joint was 157 990, and the total number of nodes was 193 801. On three phases, with the increase of the distal tibial defect area, the contact area was gradual y decreased, especial y in plantar flexion with the defect diameter of 13 mm, the change of the area was most obvious;The contact area of the neutral position was largest;with the increase of the distal tibial defect area in the neutral position and dorsiflexion, the peak stress was increased gradual y, and significantly increased after the diameter changed into 11-13 mm;in the neutral position and 10° of dorsiflexion, the peak stress mainly concentrated in the posteromedial and posterolateral quadrant;in 10° of plantar flexion, the change was complex, and when the diameter was 11-13 mm, the peak stress was increased gradual y with the increasing of defect area, when the diameter increased to 13 mm, the peak stress reached maximum. The maximum diameter of distal tibial articular surface defect was considered to be 11-13 mm. The joint function wil be affected when the diameter of distal tibial articular cartilage and bone bed defects was more than 11-13 mm.

BACKGROUND:An amyloid-beta (Aβ) aggregation in the brain can induce nerve cel apoptosis, loss of synapses and functional damage. However, there is stil no effective intervention. Improving the synaptic plasticity provides an important direction for the treatment of early Alzheimer’s disease. OBJECTIVE: To screen the best model of Alzheimer’s disease and to explore the expression of synapse-associated proteins in Aβ25-35-injured PC12 neurons. METHODS:PC12 cels were induced by 50 μg/L nerve growth factor to differentiate into neuronal-like cels. Then, these cels were treated with Aβ25-35 at different concentrations. Consequently, cel survival rate was detected using cel counting kit-8; neurogranin and neuregulin immunofluorescence stainings were used to observe morphological changes of model cels; western blot used to detect the expression level of neurogranin, calmodulin kinase II, postsynaptic density-95 proteins. RESULTS AND CONCLUSION:Over time, the survival rate of PC12 neurons induced by Aβ25-35 was decreased in a dose-dependent manner. Shortened synaptic length, neuronal atrophy and sparsely interconnected neurons were visible. Expression levels of neurogranin, calmodulin kinase II and postsynaptic density-95 proteins were al down-regulated. These findings indicate that to screen the cel model of Alzheimer’s disease, the optimal concentration and interventional time of Aβ25-35are 10 μmol/L and 48 hours, respectively.

Objective:To investigate the effect of controlled low central venous pressure (CLCVP) combined with hepatic blood occlusion on blood loss and hemodynamics in hepatectomy. Methods:Sixty hepatocellular carcinoma patients with American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ undergoing hepatectomy were randomly divided into two groups. One was the group of hepatic blood occlusion (group I);the other was the group of CLCVP combined with hepatic blood occlusion (group II). During the parenchy-mal transection phase of surgery, 60.05). Likewise, no significant difference was noted in MAP and HR at different time points of the two groups (P>0.05). The CVP in groupⅡwas significantly lower than that in groupⅠat the beginning of and 20 min after the paren-chymal transection phase of the surgery. Conclusion:CLCVP combined with hepatic blood occlusion can reduce blood loss effectively during hepatectomy.

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.