Objective To evaluate the hemodynamic effects of rocuronium in patients with rheumatic heart disease during induction of anesthesia.Methods Twenty patients of either sex (ASA classes Ⅲ -Ⅳ ;NYHA classes Ⅱ -Ⅲ) scheduled for valve replacement were included in this double blinded study. Their ages ranged from 34 to 62 yr and weights from 48 to 70 kg. The patients were premedicated with intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.3mg. Radial artery was cannukted for direct BP monitoring and Swan-Ganz catheter was placed via right internal jugular vein for hemodynamic monitoring before induction of anesthesia.TOF,BIS,ECG and SpO2 were also monitored throughout anesthesia. Anesthesia was induced with midazolam 0.05-0.1 mg?g-1 and fentanyl 10-15?g?kg-1. The patients were randomized to receive either rocuronium 0.6 mg?kg-1 (group Ⅰ,n=10) or vecuronium 0.1 mg?kg-1(group Ⅱ,n=10) to facilitate tracheal intubation when BIS value dropped to 60%.The patients were mechanically ventilated (VT 8-10 ml?kg-1 ,RR 10-12 bpm).Systolic arterial pressure (SAP),MAP,HR,cardiac output (CO), PCWP, CVP, mixed venous blood O2 saturation (SvO2), BIS and TOF were recorded and stroke volume (SV), stroke index (SI), LVSWI and rate-pressure product (RPP) were calculated before anesthesia (To), 1 min after administration of muscle relaxant (T1), when TOF reached 0 (T2) and 1,2,3,4,5,7,10,15,20,25,30 min after tracheal intubation (T3-13).Results The demographic data including age, sex and body weight were comparable between the two groups. In rocuronium group HR increased by 17.43% -7.54%,SAP increased by 16.94% - 12.3% and RPP increased by 13.96% - 22.67% respectively during 1-7 min after intubation (T3-8) as compared with the baseline values (To), significantly higher than those in vecuronium group (P

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

BACKGROUND: Nucleus raphe magnus(NRM) is an important nucleus located in the median raphe of ventral medulla. Many studies have been focused on the crucial role which plays in acupuncture analgesia, cardiovascular regulation, respiratory regulation and other aspects of health. However,little attention has been paid to its role in the regulation of digestive system heretofore.OBJECTIVE: To investigate the effect of NRM on gastric movement and gastric electric activity in rabbits.DESIGN: Comparative study based on the experimental animals.SETTING: A laboratory of functional medicine in a traditional Chinese medical university. PARTICIPANTS: From September 2002 to April 2004, the study was conducted in the functional medicine laboratory of Heilongjiang University of Chinese Medicine(Provincial Key Laboratory). Seventy healthy New Zealand white rabbits were used including male and female, which weighed 2 - 2. 5 kg on average, supplied by the Laboratory Animal Center of Heilongjiang University of Chinese Medicine(Class I) . The rabbits were randomly divided into 7 groups: saline group, 5-hydroxytryptamine(5-HT)group, cyproheptadine group, substance P group, substance pantagonist group, morphine group and noradrenaline group.METHODS: Through cannula, microinjection of 5-HT, cyproheptadine, substance P, substance P antagonist, morphine and noradrenaline were given into NRM. Synchronously, gastric movement and changes in the amplitude and frequency of gastric electric slow wave in rabbits were recorded.MAIN OUTCOME MEASUREMENTS: Gastric movement and gastric electric activity were observed after microinjection of 5-HT, cyproheptadine,substance P, substance P antagonist, morphine and noradrenaline into NRM.RESULTS: After microinjection of 5-HT and substance P into NRM,gastric movement and gastric electric slow waves in rabbits were inhibited ( P ＜ 0. 05, P ＜ 0. 01 ). After microinjection of cyproheptadine, substance P antagonist, gastric movement and gastric electric slow waves in rabbits were increased( P ＜ 0.05, P ＜ 0.01) . Meanwhile, it turned out that microinjection of morphine and noradrenaline into NRM had no effect on gastric movement and gastric electric slow waves in rabbits ( P ＞ 0.05).CONCLUSION: 5-HT and substance P in NRM contribute to the regulation of gastric movement and gastric electric slow wave in rabbits by NRM, while morphine and noradrenaline presumably have no relation with the regulation.

Ceramics ; Dental Alloys ; chemistry ; Dental Porcelain ; Dental Restoration, Permanent ; Humans ; Metal Ceramic Alloys ; chemistry

With the development of imaging technology,the reports of spontaneous isolated superior mesenteric artery dissection become more frequently,but there is no consensus on the therapeutic plans which consist of conservative therapy,endovascular treatment and surgical treatment.Therefore,the related questions of the spontaneous isolated superior mesenteric artery dissection will be discussed in order to improve the diagnosis and treatment of vascular diseases of digestive tract with a review of literatures.

Objective To measure the erythrocyte dielectric response variation of patients with KaschinBeck disease,to explore the pathogenesis of Kaschin-Beck disease and seek more effective means for evaluating the effectiveness of early diagnosis and control measures against Kaschin-Beck disease.Methods According to the principle of dielectrophoresis and cell dielectric response phenomena,dielectrophoretic pool was manufactured and dielectrophoretic detection and separation system was established.Patients with Kaschin-Beck disease (438) were selected in Kaschin-Beck disease areas of Aba County,Sichuan.At the same time,healthy persons (480) in KaschinBeck disease areas and non-Kaschin-Beck disease areas in Aba County were selected.Anticoagulant blood samples from patients with Kaschin-Beck disease and healthy persons were collected,erythrocytes were separated,cell suspension (10s cells/ml) was prepared and 200 μl cell suspension was added to the dielectrophoretic pool to measure erythrocyte dielectric response rate.Results Erythrocyte dielectric response rates were significantly different between patients living in Kaschin-Beck disease areas with Kaschin-Beck disease [(75.87 ± 5.89)％] and healthy persons living in Kaschin-Beck disease areas and non-Kaschin-Beck disease areas [(92.43 ± 4.45)％,(92.81 ±5.01)％,F =1.843,P ＜ 0.01).Erythrocyte dielectric response rate was significantly reduced in patients with Kaschin-Beck disease compared with that of healthy persons (all P ＜ 0.01);erythrocyte dielectric response rate of adult patients with Kaschin-Beck disease was lower [(69.57 ± 6.87)％] than that of pediatric patients with Kaschin-Beck disease [(82.17 ± 4.91)％,P ＜ 0.01].Erythrocyte dielectric response rates were significantly different in patients with different degrees of Kaschin-Beck disease (F =1.647,P ＜ 0.01).Erythrocyte dielectric response rate of patients with Kaschin-Beck disease was negatively correlated with prevalence of the disease (r =-0.87,P ＜ 0.01).Conclusions Erythrocytes of patients with Kaschin-Beck disease have some degree of pathological damage.The more severe the disease,the more serious the damage of red blood cell.The change of erythrocyte dielectric response properties may be used as an index to judge the prevalence of Kaschin-Beck disease and for early diagnosis.

Since Reich completed the first laparoscopic hepatectomy (LH) in 1991,LH has been developed rapidly with the continuous improvement of surgeons' technique and the technological changes in devices and related processes.This article elaborates on the safety and efficacy of LH,the value of 3D visualization,3D printing technology,and 3D laparoscopic technology in guiding precise hepatectomy,control of hemorrhage during LH,and safety and efficacy of robotic hepatectomy.

Objective To investigate the value of Helicobacter pylori (HP),blood carcinoembryonic antigen (CEA),carbohydrate antigens 72-4 (CA72-4) and CA24-2 in the screening of gastric cancer.Methods The contents of HP,blood CEA,CA72-4 and CA24-2 in 50 healthy controls,45 patients with benign gastric lesions mnd 70 patients with gastric cancer were detected.According to the number of positive cases,the positive rate of single detection and the positive rate of combined detection were calculated.Sensitivity,specificity,and accuracy of serum tumor markers were calculated according to HP single and combined detection.Results The positive rate of each individual detection and 4 joint detection in gastric cancer group was significantly different from that in the benign lesion group and the normal control group (P ＜0.01).The positive rate of 4 joint detection in gastric cancer group was 89.25％,and the difference was statistically significant (P ＜0.01).There was no significant difference in the positive rate of the single test and the 4 joint detection in benign stomach group and normal control group (P ＞ 0.05).The sensitivity,specificity and accuracy of HP,blood CEA,CA72-4,CA24-2 joint detection were significantly higher than single detection (P ＜ 0.05).Conclusions Joint detection was significandy better than single detection,and can significantly improve the detection rate of gastric cancer.

Objective To observe the effeet of cotransduction of wt-p53,B7-1 and GM-CSF genes mediated by recombinant adenovirus on cell growth, apoptosis and immunogenicity of neuroblastoma cell line SH-SY5Y, Methods We transfected SH-SYSY cells separately with recombinant adenovirus, recombinant adenovirus mediating human wild type p53(wt-p53) gene and BB-102.We separately named them with SH/Ad,SH/p53 and SH/BB-102 group.The protein expression of p53, B7-1 and GM-CSF were measured by Western blot, FCM and enzyme linked immunosorbent assay. Cell number was counted and growth curves were drawed. Cell apoptosis was tested by FCM. Lymphocyte proliferation and cytokine secretory was evaluated by mixed lymphocyte culturing. Results After transection with BB- 102, p53, B7-1, and GM-CSF, high-efficiency expression of target genes were found. Growth of the cells was inhibited, apoptosis was induced in the SH/p53 and SH/BB-102 groups. Proliferation of lymphocytes was stimulated and cytokine increased visorously in the SH/BB-102 group. Condusions After transfection with BB-102, growth of the SH-SY5Y cells was inhibited,apoptosis was induced,and immunogenicity was greatly enhanced.

Apigenin is a plant flavonoid which has various biological activities and pharmacological effects including anti-tumor, antioxidant, anti-inflammatory, sedative and so on, particularly in the anti-tumor areas. It can inhibit proliferation, invasion, metastasis and angiogenesis of tumor cells. In addition, it can also induce apoptosis and enhance chemotherapy sensitivity.