Objective: To observe the effect and safety of application of combined spinal and epidural anesthesia to hip surgery on the elderly.Methods: 47 patients aged over 70 years underwent hip surgery;All patients were given combined spinal and epidural anesthesia with 7.5mg~10mg of 0.5% bupivacaine(1~1.4ml of 0.75% bupivacaine was attenuated with 0.5~1ml of cerebrospinal fluid;density: 1.010).The time to anesthesia?sensory block levels and the effect of analgesia and muscle relaxation were recorded;BP?HR and SPO2 were monitored.Results: Foot febrile and lower limb numbness appeared in 40 patients immediately after drug administration;foot febrile appeared in 7 patients 3min after drug administration.There were 3 patients at the highest sensory block levels(T6)?40 patients at T10~12 and 7 patients at T7~9.Combined spinal and epidural anesthesia could provide 100% satisfactory analgesia and muscle relaxation during operation.BP and HR had no obvious variation after anesthesia.Conclusion: The application of combined spinal and epidural anesthesia has the advantage of low-dosage?fast-acting?consummate analgesia?satisfactory muscle relaxation and small interference with recirculating and respiratory system;etc,and so it is safe and effective for hip surgery on the elderly.

Objective To investigate the effect of pretreatment with penehychidine hydrochloride(PHCD) on NF-κB activity in the lung tissue following acute lung injury(ALI)induced by hemorrhagic shock in rats.Methods Twenty-four Wistar rats of both sexes weighing 200-250 g were randomly divided into 3 groups (n=8 each):group Ⅰ sham operation (group S);group Ⅱ ALI and group Ⅲ PHCD.The animals were anesthetized with intraperitoneal chloral hydrate 350 mg/kg.Hemorrhagic shock was produced in group Ⅱ and Ⅲ.Right carotid artery was cannulated for BP monitoring.Left femoral artery was cannulated for blood letting.MAP was reduced to 35-45 mm Hg within 10 min and maintained for 1 h in group ALI and PHCD(group Ⅱ andⅢ).The animals were then resuscitated with blood and normal saline.PHCD 2 mg/kg was given iv immediately before blood-letting in group PHCD.Blood samples were obtained from artery at 6 h after hemorrhagic shock wag induced for blood gas analysis and from right auricle for determination of plasma TNF-α concentration by ELISA.The lungs were then harvested for microscopic examination and determination of the expression of NF-κB p65 by immuno-histochemistry and W/D lung weight ratio.Results The plasma TNF-α concentration and expression of NF-κB p65 in the lung tissue were significantly increased in group ALI and PHCD as compared with group S and were significantly lower in group PHCD than in group ALI.There was less damage to the lung tissue in group PHCD than in group ALI.Conclusion PHCD pretreatment can attenuate ALl induced by hemorrhagic shock by inhibiting NF-κB activity.

Survivin is the strongest member of the inhibitor of apoptosis protein(IAP)family. Smac is the second mitochondria-derived activator of cysteine proteases,which can promote apoptosis by combining with IAP. Abnormal expression of them is closely related with occurrence,development,treatment tolerance and prognosis of ovarian cancer. It is prompted that Survivin and Smac are expected to play important roles in the early diagnosis and targeted therapy of ovarian cancer.

Compared with the traditional teaching methods,multimedia teaching has specific advantages and has been widely used. Meanwhile,the defects in multimedia teaching must be attached great importance to. This paper focuses on some problems widely existing in the multimedia teaching and sets forth several proposals of promotion in the use of multimedia teaching.

AIM: To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.
METHODS:Totally 90 patients (94 eyes) in our hospital who had undergone the phaco-surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3. 2mm scleral tunnel incision at the direction of 10:00 ~11:00 points. The group B was those with 3.2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups, patients with preoperative corneal astigmatism<1. 00D, 1. 00 ~2.00D and > 2. 00D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.
RESULTS:The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism <1. 00D and 1. 00 ~ 2. 00D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism <1. 00D was lower than that in the group A.
CONCLUSION: On the basis of preoperative corneal astigmatism, 3. 2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism < 1. 00D, and accordingly improve the uncorrected visual acuity.

Objective To investigate the effects of propofol on lipopolysaccharide (LPS)-induced brain injury in rats.Methods Fifty-four pathogen-free SD rats of both sexes, aged 6 weeks, weighing 200-250 g, were randomly divided into 3 groups: control group (group C, n = 6) ; LPS group (group L, n = 24) ; propofol group (group P, n = 24) . Brain injury was produced by injection of LPS 1 mg/kg via the left internal carotid artery in L and P groups. Propofol 100 mg/kg was injected intraperitonealry immediately after the LPS administration in group P, while the equal volume of normal saline was given instead of propofol in group L. The equal volume of normal saline was given instead of LPS and propofol in group C. Six rats in each group were sacrificed and the brain tissues were immediately removed at 24 h after intraperitoneal administration in group C, and at 6, 24, 48 and 72 h after intraperitoneal administration in L and P groups for determination of brain water content, high-mobility group box 1 ( HMGB1) expression and NF-κB activity, and microscopic examination. Results The brain water content and NF-kB activity were significantly increased, and HMGB1 expression was up-regulated in group L as compared to group C (P ＜ 0.05) . The brain water content, expression of HMGB1 and NF-kB activity were significantly lower in group P than in group L ( P ＜ 0.05) . The microscopic examination showed that brain injury was attenuated in group P compared with group L. The brain water content was positively correlated with the HMGB1 expression and NF- κB activity (r = 0.692 and 0.769 respectively, P ＜ 0.05). Conclusion Propofol can reduce the LPS- induced brain injury by reducing inflammatory response of the brain tissues.

Objective To investigate the effect of penehyclidine (PHCD) pretreatment on Toll-like receptor 4 (TLR4) mRNA expression in the lung following acute lung injury (ALI) induced by hemorrhagic shock in rats. Methods Forty healthy SD rats of both sexes weighing 200-250 g were randomly divided into 5 groups( n = 8 each): group Ⅰ sham operation (group S); group Ⅱ ALI (group ALI); group Ⅲ, Ⅴ, PHCD 0.3,1.0, 3.0 mg/kg were given iv respectively at 30 min before hemorrhagic shock (P1-3). Hemorrhagic shock was induced by exsanguinations. MAP was maintained at 35-45 mm Hg for 60 min. The animals were killed at 4 h after resuscitation. Their lungs were removed for microscopic examination, W/D lung weight ratio and determination of TLR4 mRNA expression in the lung tissue (by RT-PCR). NF-κB p65 protein expression in the lung tissue was determined (by immuno-histochemical staining). Results Hemorrhagic shock significantly increased TLR4 mRNA and NF-κB p65 protein expression in the lung tissue and W/D lung weight ratio. Pretreatment with PHCD 1.0 or 3.0 mg/kg significantly inhibited hemorrhagic shock-induced increase in TLR4 mRNA and NF-κB p65 protein expression in the lung and W/D lung weight ratio. The lung injury was significantly ameliorated in group P2,3 as compared to group ALI. Conclusion PHCD pretreatment can attenuate ALI induced by hemorrhagic shock through down-regulation of TLR4 mRNA expression and decreasing NF-κB activity in the lung.

Animals ; Cells, Cultured ; Female ; Granulosa Cells ; metabolism ; Pituitary Adenylate Cyclase-Activating Polypeptide ; genetics ; metabolism ; Platelet Activating Factor ; pharmacology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

Acute Disease ; Cardiomyopathies ; chemically induced ; Chemical and Drug Induced Liver Injury ; Critical Illness ; Ethylene Oxide ; poisoning ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; Occupational Diseases ; chemically induced ; Respiratory Tract Diseases ; chemically induced

Objective To explore therapeutic effects and indications of stereotatic puncture and drainage under multi-parameter orientation in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 56 patients with HICH underwent stereotatic puncture and drainage from October 2003 to May 2005.The entrance position,the puncture plane,the puncture angle and depth,and the length of side hole of drainage tube were accurately designed before operation,and,if necessary,multiple drainage tubes were introduced via one hole.Results According to the Glasgow Outcome Scale(GOS) scores,12 patients recovered well(21.4%),29 patients were moderate disability(51.8%),and 12 patients were severe disability(21.4%).No longstanding coma was noted.Three patients died(5.4%). Conclusions Stereotatic puncture and drainage under multi-parameter orientation has better therapeutic effects and less damages than open operation.The procedure is suitable for 10~60 ml hematoma,especially in elderly patients and deep-located hematoma.The best operation timing is 3~6 hours after the onset of hemorrhage.