Objective To explore mycocardial protection effect of sevoflurane post-conditioning in off-pump coronary artery bypass grafting (OPCABG) surgery,and the mechanism of mycocardial protection of sevoflurane post-conditioning.Methods Thirty six patients undergoing OPCABG were randomly divided into three groups:at 1.5 MAC (minimum alveolar concentration) for 5 minutes first,with an interruption control group (Cont group),sevoflurane preconditioning group (SPC group),and sevoflurane postconditioning group (SPO group).All patients were administrated by intravenous anesthetic drug,both for induction and maintenance.No special interventions were used in Cont group.However,in SPC group,12 patients inhaled sevoflurane for 10 minutes,then continued for 5 minutes,total 10 minutes before the anastomotic between mammary artery and anterior descending artery.In SPO group,12 patients inhaled sevoflurane at 1.5 MAC for 2 minutes before the anastomosis of last one coronary artery,and continued for 8 minutes.Four time points were focused on including T1 (accomplishment of induction),T2 (1 hour after the coronary revascularization),T3 (6 hour after the coronary revascularization),and T4 (24 hour after the coronary revascularization).Blood samples were drawn from the internal jugular vein for the measurement of the plasma concentrations of TNT-hs (highly sensitive cardiac troponin T),CK-MB (creatine phosphokinase isoenzyme),NT-proBNP (N-Terminal fragment of the prohormone Brain-Type Natri-uretic Peptide),and TNF-α (tumornecrosis factor-α).Results All the patients completed the trials without significant adverse effects.The age,gender,ejection fraction,and operative time among three groups were no statistically significant difference (P ＞ 0.05).Stay time in postoperative ICU and hospital were significantly less than Cont group (P ＜ 0.05).Compared to the pre-operative baseline,all patients'plasma concentrations of TNT-hs,CK-MB,NT-proBNP,and TNF-α were significantly increased at 1 h,6 h,and 24 h after coronary revascularization (P ＜0.05).TNT-hs in Cont group showed a persistent increase,while in other two groups (SPC and SPO),TNT-hs reached the peak concentrations at 6 hours after the coronary revascularization,which were same with CK-MB,TNF-α,and MDA in all groups;NT-proBNP reached the peak at coronary revascularization after 24 h.Compared to Cont group,TNT-hs,CK-MB,and TNF-α in groups SPC and SPO were significantly lower at 6 h,24 h after coronary revascularization; NT-proBNP was significantly lower only at 24 h after coronary revascularization.Conclusions Sevoflurane post-conditioning in OPCABG has identified myocardial protection,which was comparable with sevoflurane preconditioning.

The fetal inlfammatory response syndrome (FIRS) is a subclinical condition characterized by systemic acti-vation of the fetal innate immune system with a large number of pro-inlfammatory cytokines released. FIRS is the fetal coun-terpart of the systemic inlfammatory response syndrome (SIRS) described in adults. Intrauterine infection is the most common reason of FIRS. FIRS has been implicated as a cause of preterm labor, preterm white matter injury, bronchopulmonary dyspla-sia (BPD) and necrotizing enterocolitis (NEC).

The medicine of Yi ethnic plays an important role of the traditional medicine of China. Recently, the facility of Yi ethnic medicine has made great progress on its development process. Now many medicine industries develop the production of Yi ethnic medicine. Thus, this demands a great quantity of Yi ethnic medicine, but it also leads rapid decline with overuse of the medical resources. Here we discussed a series of problems, and put forward the corresponding stradegies of protection of Yi medicine.

Objective To investigate the protective effects of ulinastatin on myocardial reperfusion injury during cardiopulmonary bypass(CPB) in patients underwent valve replacement. Methods 26 ASA Ⅱ-Ⅲ patients scheduled for valve replacement were randomly divided into control group (group C) and ulinastatin group ( group W), each group containing 13 patients. In group W, the patients received ulinastatin 12000U?kg -1 , half dose of which was given before CPB, and the other half was added into the primary solution. Plasma levels of CK,CK-MB and cTnI were measured before operation(T 1), 20 min after starting CPB(T 2), 30 min after declamping aorta (T 3), and 4h(T 4) and 24h(T 5) after operation. Results The plasma level of CK, CK-MB and cTnI increased significantly at T 3, T 4 and T 5 in the both groups compared with T 1(P

Objective To explore the characteristics of occult damage of cerebral white matter in patients with small vessel disease by using diffusion tensor imaging (DTI)technology,and its relationship with cognitive impairment.Methods Twenty-eight patients with CSVD and twenty-three matched volunteers all received T1 WI,T2 WI,DTI examination and montperllier cognitive function scale (MoCA).Then compare the difference between the two groups,and analysis the correlation between ADC and FA value of each re-gion of interested and MoCA score in CSVD group.Results ①FA values on bilateral frontal white matter in CSVD group were lower than control group,and ADC values were higher than control group,the difference was statistically significant (P <0.05 ).There were no significant differences in FA and ADC values on corpus callosum genu and splenium between two groups (P >0.05 );②In CSVD group,the FA value of bilateral frontal lobe white matter were positively correlated with the MoCA score (P <0.05 ),and the ADC value were negatively correlated with the MoCA score (P <0.05 ).there were no significantly correlations between FA and ADC values on corpus callosum genu and splenium and MoCA score (P >0.05 ).Conclusion Bilateral frontal white matter exist fi-ber occult damage in patients with CSVD,and the change of FA and ADC value can reflect the severity of cognitive impairment on a certain degree in patients with CSVD.

[Objective] To observe effects of HQSM on CK, LDH and AST activity in serum of acute myocardial ischemia rats caused by injecting pituitrin.[Method] SD rats were divided into several groups at random: normal control group,model control group, three HQSM groups(210mg/kg,150mg/kg,105mg/kg), positive control group(Huangqi Shengmaiyin and Diao Xinxuekang).The rats were treated with respective drugs by ig for 30 days, and pituitrin was injected respectively by caudal vein 1h after administering at the 29th and 30th days.Blood serum was taken out to determinate the activity of CK, LDH and AST at 1h and 24h after the last injection. [Result] The activity of LDH and AST in serum increased at 1h after injecting pituitrin, the activity of CK in serum increased,meanwhile LDH and AST was still higher than normal control group at 24h. HQSM could decrease the activity of CK and AST(P

Objective To evaluate the effect of sequential intrahepatic arterial FAM for the treatment of metastatic gastric cancer to the liver. Methods 14 patients with multiple hepatic metastases from gastric cancer were treated with sequential intrahepatic arterial FAM using the hepatic artery infusion port. Results Of 14 patients, CR, PR, NC and PD were observed in 1, 7, 4 and 2 cases respectively. The overall median survival was 15 months. The survival rate at 1, 2 and 3 years was 80.0%; 57.1% and 14.3% respectively. No severe complication was observed. Conclusions Sequential intrahepatic artery FAM is effective to increase the survival rate in patients with hepatic metastases from gastric cancer.

Objective To evaluate the efficacy of FAP combined intrahepatic artery with intravenous infusion chemotherapy in the treatment hepatic metastatic carcinoma. Methods 23 patients with metastatic hepatic carcinoma were diagnosed with CT or MRI. EPI 40mg/m 2, CDDP 60mg/m 2 were given intrahepcic arterial by means of one shot infusion and 5-FU 500mg/m2 (d1, d8) intravenously respectively. All patients were reexamined by with CT or MRI after 2～4 weeks. Results The total response rates was 74%. The survival rates at 1 year, 2 year and 3 year were 88 8%?7 9%;66 9%?12 3% and 24 6%?23 4% respectively. The median survival time was 25 months. Conclusions FAP was a traditional regimen,combined intrahepatic arterial and intravenous chemotherapy can improve response rate and prolong median survival to metastatic liver cancer .

Objective To explore the value of center vein catheter thoracostomy in the chemotherapy of malignant pleural effusion. Methods Carboplatin and ?-2b Interferon were infused into pleural cavity by implanted center vein catheter in the group observation (n=17). After repeated thoracocentesis, the same drugs were introduced into pleural cavity in the group control (n=29). At the end of the 1st, 3rd and 6th month after drug administration, follow-up was carried out to assess the response rates. Results At the end of the 1st, 3rd and 6th month after intrapleural therapies, the number of intrapleural therapies in the group observation was (2.2?1.9) times and in the group control (5.3?1.3)times, with statistically significant difference between the two groups (t=5.924, P=0.00). Numbers of complete remission (CR) in the group observation was 10 of 16, 11 of 16 and 10 of 15, respectively and in the group control 9 of 29, 11 of 29 and 5 of 19, respectively, producing significant difference (P=0.043, 0.050, 0.020, respectively). Overall response rates in the group observation were 87.5%, 87.5% and 80.0%, respectively, while in control were 62.5%, 68.7% and 66.7%, respectively, without significant difference (P=0.356, 0.114, 0.178, respectively). Compared with the control, long-term follow-up (six months) showed higher response rates in the group observation: 10 of 15 patients remained CR at 6th month after therapies. No significant difference was seen in respect to adverse effects(?2=2.491,P=0.114). Conclusions Intrapleural chemotherapy by center vein catheter may increase CR and decrease application times of Carboplatin and ?-2b Interferon in the treatment of malignant pleural effusion, with fewer side effects.

Objective To explore the effects of interstitial brachytherapy with permanent seed implants on peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of natural killer cells (NK). Methods Ultrsound-guided or intraoperative implants of radioactive seed 125I were used in 25 patients with pathologically diagnosed and ineradicable malignant tumors. Clinical data of peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of NK cells prior and after the treatment were compared. Results The white blood cells, hemoglobin and platelet prior the treatment were (6 3?2 2)?10 9/L, (122 7?17 3) g/L and (219 9?117 5)?10 9/L, respectively, while at the 1st and 3rd months after the treatment, these were (6 4?1 8)?10 9/L, (114 5?30 9)g/L, (191 5?59 6)?10 9/L, respectively and (6 1?1 2)?10 9/L, (116 3?16 0) g/L, (191 7?108 2)?10 9/L, respectively, without statistically significant differences ( F =1 893, 0 616, 0 596; P =0 072, 0 779, 0 762). In addition, no significant differences were found in values of ALT, AST, BUN, Cr, CK and CK-MB at different times ( F =1 861, 0 551, 1 740, 1 934, 0 412, 0 052; P =0 118, 0 737, 0 142, 0 105, 0 837, 0 998). The values of TB and DB in patients with pancreatic carcinoma obviously decreased within 1 month after the treatment. Interstitial brachytherapy had little effects on T-cell immunity (CD3, CD4 and CD8) and the activity of NK cells ( F =0 287, 0 520, 0 497, 1 101; P =0 752, 0 598, 0 612, 0 342). Conclusions Interstitial brachytherapy with permanent seed implants has no effects on vital organs and immunologic functions, being a safe and minimally invasive technique for cancer.