Objective:To investigate the effects of dexmedetomidine on perioperative cardiac adverse events in elderly patients with coronary heart disease.Methods:Sixty elderly patients,who were diagnosed as coronary heart disease and underwent gastric cancer operation,were randomly divided into 2 groups (n=30):the dexmedetomidine group (Dex group) and the control group.In the Dex group,dexmedetomidine was administered intravenously at 0.5 μtg/(kg.h) after a bolus infusion at 0.5 μg/kg for 10 min before anesthesia induction.In the control group,equal volume of normal saline was infused instead of dexmedetomidine.The 2 groups received the same anesthesia treatment.The venous bloods were collected at the preoperative 0 h and postoperative 24 h.The concentrations of cardiac troponin (cTnⅠ),N-terminal pro-brain natriuretic peptide (NT-proBNP) and hypersensitive C-reactive protein (hs-CRP) were determined.The ECG was monitored at the above time and the postoperative incidence of cardiac adverse events was recorded.Results:The levels of cTnⅠ,NT-proBNP and hs-CRP in serum were elevated in the 2 groups after the operation.Compared with the control group,the levels of cTnⅠ,NT-proBNP and hs-CRP were significantly decreased in the Dex group (P＜0.05).Compared with the control group,the incidence ofbradycardia were significantly increased,while the myocardial ischemia and tachycardia were significantly decreased in the Dex group during the operation (P＜0.05);the incidence of silent myocardial ischemia and arrhythmia was significantly reduced at 3 days after operation in the Dex group (P＜0.05).Conclusion:Dexmedetomidine could decrease the incidence of cardiac adverse events in elderly patients with coronary heart disease.

Objective To compare the postoperative analgesic effect of the single dose of oxycodone and dezocine in patients who underwent gynecological laparoscopic operation. Methods Sixty patients who underwent elective gynecological laparoscopic operation were randomly divided into two groups (n=30): oxycodone group (group O) and dezocine group (group D). Fifteen minutes before the end of surgery, oxycodone 0.1 mg/kg was given in O group, and dezocine 5 mg was given to D group. Twenty minutes before the end of surgery, tropisetron 5 mg was given to both groups. Analgesia was maintained by propofol-remifentanil with TCI. The mean arterial pressure (MAP) and heart rate (HR) of T1, T2, T3 and T4 were recorded respectively in both two groups. After the operation, pain of visual analogue scale (VAS) was assessed in 2 h ,4 h , 6 h and 24 h, respectively. Results There were no significant differences in MAP and HR between two groups at T1, T2, T3 and T4 (P＞0.05). The VAS score was significantly lower in group O than that of group D (P＜0.05). There was significant difference in the incidence of nausea between the two groups (P＜0.05). Conclusion Single dose of oxycodone 0.1 mg/kg can be used for postoperative analgesia after gynecological laparoscopic operation, and which has better analgesia than that of dezocine, except for the adverse reaction of nausea.

Objective To investigate clinical significance of soluble CD30/CD30L and CD40/CD40L system imbalance in ovarian serous tumors.Methods 40 patients of serous cystadenoma and 30 patients of serous cystadenocarcinoma were selected,and 40 age-and weight-matched healthy women were also recruited as the control group.Peripheral venous blood (3 ml) of the healthy control and patients with ovarian serous tumors before surgery and 7 days after surgery were collected.After separation of serum,ELISA was used to detect levels of sCD30,sCD30L,sCD40 and sCD40L.Results Compared to the control group,levels of sCD30,sCD30L,sCD40 and sCD40L in both serous cystadenoma and serous cystadenocarcinoma groups were significantly in creased (P＜0.05).And in those serous cystadenocarcinoma group,levels of such soluble proteins were much higher than in serous cystadenoma group (P＜0.05).7 days after surgery,levels of such soluble proteins were significantly decreased in both serous cystadenoma and serous cystadenocarcinoma groups (P＜0.05).Conclusion Detection of serum sCD30/sCD30L and sCD40/sCD40L is possible to have a certain guiding significance to early diagnosis of ovarian tumors and the prognosis of patients.

Aim To observe the effect of 5-FU and L-Arg on the human liver carcinoma model in nude mice and study the mechanism.Methods We established the human liver carcinoma model in nude mice with BEL-7402 cell and gave normal saline,5-FU,5-FU+L-Arg by intraperitoneal injection. The tumor size was measured.The necrotic degree and range were observed by the microscope. Immunohistochemistry method and chemical colorimetry were performed to determine the expression and activity of iNOS. Nitrate reductase method was adopted to test the concentration of NO in the tumor tissue. The one-way ANOVA,Bonferroni and Kruskal-Wallis H tests were adopted for the statistical analysis.Results 5-FU combined with L-Arg promoted the tumor suppressive action apparently. The necrotic range enlarged. The expression and activity of iNOS increased. The production of NO also increased.Conclusions 5-FU combined with L-Arg has agonist effects on the inhibition of the growth of human liver carcinoma in nude mice.It may be related with inducing the synthesis of iNOS and the increase of NO.

This paper will address the development of disaster psychology and its important contribution regarding its theoretical and practical frameworks as it applies to the psychological counseling for survivors suffering from the consequences of natural disasters.This paper will also analyze how the approach of disaster psychology can be applied to work with survivors suffering from natural disasters and to alleviate psychological challenges and its influential factors which affect these individuals.Several strategies have been discussed and proposed.In addition,relevant theoretical and integrated approaches for psychological intervention support and guidance,and rehabilitation have been established.

Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.

Pulmonary fibrosis is a common respiratory disease in the clinic. Until now, the pathogenesis is still un-clear. Using clotting mechanism as the starting point, this article mainly explored abnormal changes of the coagula-tion - fibrinolysis system in the development of pulmonary fibrosis. The effective treatment through the activation of blood circulation to remove stasis in traditional Chinese medicine (TCM) point of view was also observed on the man-agement of interstitial pulmonary fibrosis. It considered that to carry out the anticoagulant therapy for abnormal coag-ulation, which may become a new target for clinical treatment of interstitial lung diseases. It provided new ideas and theoretical support for clinical treatment of pulmonary interstitial fibrosis.

Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Enzyme Inhibitors ; pharmacology ; Fluorouracil ; pharmacology ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; antagonists & inhibitors ; metabolism ; Nitric Oxide Synthase Type II ; Tumor Cells, Cultured ; drug effects

OBJECTIVETo evaluate the effect of endogenous nitric oxide (NO) on the ability of 5-fluourouracil (5-FU) to induce apoptosis in the liver carcinoma Bel7402 cell line, and to observe the anti-tumor mechanism and effective adjuvant of 5-FU.

METHODSCells were cultured under routine conditions with Dulbecco's modified Eagle's medium (DMEM) without L-Arginine (L-Arg). We observed the expression of inducible nitric oxide synthase (iNOS) and apoptosis of cells induced by 5-FU with L-Arg added to the medium. The production of nitric oxide was determined by the cell expression of iNOS detected by immunohistochemical staining, and by the concentrations of nitrite and nitrate in the supernatant.

RESULTS5-fluourouracil significantly increased the iNOS expression to 0.1687 +/- 0.01968 (P < 0.05, vs control group), and the concentration of nitric oxide to 213 +/- 30.2 micromol/L (P < 0.05, vs control group). The apoptotic cell rate increased significantly to 17.85 +/- 0.78%, while the necrotic cell rate decreased to 3 2.99 +/- 0.83% (P < 0.05,compared with the 5-FU group). N(omega)-nitro-L-Arginine methyl ester (L-NAME), the antagonist of L-Arg, can block the apoptotic effects of endogenous nitric oxide.

CONCLUSIONS5-FU had a synergistic effects with L-Arg by increasing the production of endogenous nitric oxide. Endogenous nitric oxide plays an important role in the process where 5-FU induces apoptosis in liver carcinoma cells. L-Arg may be a good adjuvant for chemotherapy with 5-FU.

Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Arginine ; pharmacology ; Fluorouracil ; pharmacology ; Humans ; Immunohistochemistry ; Liver Neoplasms ; pathology ; Nitric Oxide ; biosynthesis ; Nitric Oxide Synthase ; analysis ; Nitric Oxide Synthase Type II ; Tumor Cells, Cultured

OBJECTIVE: To evaluate the role of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in the pathogenesis of pulmonary artery hypertension, we observed the dynamic expression of TGF-β1 and CTGF in rats with high blood flow. METHODS: Fifty adult male SD rats were randomly divided into 5 groups: a sham group (group S) and groups with right pneumonectomy for 1, 2, 4 and 6 weeks (PE1, PE2, PE4 and PE6 group), 10 rats per group. The mean pulmonary arterial pressure (mPAP), vessel morphometry and right ventricle hypertrophy index (RVHI) were measured. TGF-β1 and CTGF protein expression in the lung tissues were determined with immunohistochemistry and Western blot. The expression of TGF-β1 mRNA and CTGF mRNA in the lung tissues was evaluated by RT-PCR. RESULTS: Compared with group S, the mPAP and RVHI in the rats were significantly increased in group PE1, PE2, PE4, and PE6 (P<0.05); the indicators of vascular remodeling [(MA+PMA)%, RMT, and RMA] were markedly elevated in group PE4 and PE6 (P<0.05), but not in group PE1 and PE2. Immunohistochemical staining of TGF-β1 and CTGF were more prominent in all of the right pneumonectomy groups than in the sham group. Western blot showed that the level of TGF-β1 protein was significantly increased in all of the right pneumonectomy groups (P<0.01), and the peak was observed in group PE2, whereas the level of CTGF protein was markedly elevated in group PE4 and PE6 (P<0.05), but no change was noticed in group PE1 and PE2. Compare to group S, the mRNA level of TGF-β1 was dramatically increased in all right pneumonectomy groups (P<0.01), peaked at group PE2, and remained high in group PE4 and PE6. In contrast, the elevation of mRNA level of CTGF was not significant in group PE1, but group PE2, PE4 and PE6 demonstrated significant mRNA level of CTGF (P<0.01). Correlation analysis showed that the protein and mRNA levels of CTGF were positively correlated with RMT and RMA ( r=0.743, r=0.906; P<0.05), while no correlation between the protein and mRNA level of TGF-β1 with RMT or RMA. There was no correlation between the mRNA level of TGF-β1 and CTGF. CONCLUSION TGF-β1 and CTGF play a role in the pathogenesis of increased pulmonary blood flow-induced pulmonary hypertension.
Animals ; Connective Tissue Growth Factor ; metabolism ; Hypertension, Pulmonary ; metabolism ; Lung ; metabolism ; Male ; Pulmonary Artery ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism