Objective To evaluate the effect of HTK solution on myocardial protection during valve replacement surgery.Methods 42 patients with rheumatic heart disease were randomized to receive 4∶1cold blood (control group,n =21 ) and HTK ( protective gronp,n =21 ) cardioplegic solution during valve replacement.The changes of CO and CI were collected at different time points including pre-operation,postoperative 6 hours,12 hours and 24 hours.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery and inotropic drugs application were calculated,and mechanical ventilation support time and the incidence of arrhythmia were recorded.Results The measurements of CO and CI showed that there was significant higher level in protective group at postoperative 12 hours and 24 hours [ 12 h:(4.82 ± 0.18 ) L/min vs ( 3.50 ± 0.32 ) L/min,( 3.80 ± 0.48 ) L/( min · m2 ) vs (2.79 ± 0.39) L/( min · m2 ) ;24 h:(4.97±0.45)L/min vs ( 3.81 ±0.19)L/min,(4.22±0.17)L/(min · m2) vs (2.91 ±0.21)L/(min·m2 ),P ＜ 0.05].The clinical parameters including aortic clamping time,incidence of cardiac arrhythmia,inotropic support,duration of mechanical ventilation and length was lower than in control group [ (53.6 ±24.3 ) min vs ( 68.9 ± 26.1 ) min ; ( 1.8 ± 1.3 ) min vs ( 2.3 ± 1.2 ) min ; ( 33 ± 11 ) min vs ( 42 ± 13 ) min ;(10.2±2.1) μg/(kg · min) vs (15.7 ±3.8) μg/(kg · min);(14.6 ±4.8)h vs (20.7 ±5.1)h,P ＜0.05].The auto-beating rate was higher than in control group (90％ vs 67％,P ＜0.05).Conclusions HTK solution is better than classical blood cardioplegia in myocardial protection during valve replacement.

Objective To evaluate endoscopic ultrasonography (EUS) in preoperative staging of gastric carcinoma,and to study the molecular biologic basis of its ultrasonic manifestation.Methods Sev-enty-four patients with gastric carcinoma were referred to EUS and staged preoperatively.The staging esults of EUS were compared with the histopathological staging and the expression of PTEN.Results The verall accuracy rate of EUS for determination of T staging was 82.4%(61/74),for T1,T2,T3 and T4 were 100.0%,72.7％,85.O％ and 78.9％,respectively.For N staging,EUS had the overall accuracy rate of 74.3%(55/74),with sensitivity and specificity of 80.8％ and 59.1％,respectively.The preoperative EUS for T and N staging of gastric carcinoma was of inverse correlation with the expression of PTEN.Conclusions EUS is an accurate staging modality in determining carcinoma invasive depth and lymph node involved,with a few exceptions of overstaging and understaging.However,EUS criteria to differentiate benign from malignant nodes still need to be further defined by future studies.The preoperative EUS for T and N staging could well display the molecular pathologic basis of gastric carcinoma.

Objective To investigate clinical efficacy and side effects of long-acting risperidone microsphere injection for treatment of patients with schizophrenia. Methods A total of 82 patients with schizophrenia were randomly divided into two groups,study group with long-acting risperidone microsphere injection and control group with atypical antipsychotics treatment for 24 weeks. The Positive and Negative Syndrome Scale (PANSS),The Personal and Social Performance (PSP) and Treatment Emergent Symptoms Scale (TESS) were used to evaluate efficacy and adverse effects of treatment at the end of 1st ,2nd,4th, 12nd and 24th week. Results The therapeutic efficacy in control group was similar to that in study group,and there was no significant difference between the two groups (P＞ 0.05 ). But the therapeutic efficacy in study group was better than that in control group at the end of the 4nd week (P＜0.05 ) , and study group was more likely to improve social function(P ＜ 0. 05 ). Incidence of adverse effects in study group was lower than that in control group , but the difference was not significant (P ＞0.05 ). The incidence of akathisia symptom in study group was higher than that in control group,but the difference was not significant (P＞0.05). The incidence of drowsiness symptom in study group was significantly lower than that in control group(P＜0.05 ). Conclusion Long-acting risperidone microsphere injection is as effective as atypical antipsychotics for treatment of patients with schizophrenia, but it has better efficacy in improving social function of the schizophrenia with lower side effects.

Humans ; Minimally Invasive Surgical Procedures ; Neurosurgery ; methods

Objective To investigate the effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease.Methods 200 patients with COPD were selected.They were divided into two groups randomly.The high dose group (102 cases) were given anmbroxol hydrochloride in high doses.The low dose group (98 cases) were given anmbroxol hydrochloride in low doses.The effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease was evaluated by the efficacy,TNF-α,CRP,pulmonary function indexes and adverse reaction during treatment.Results The effective rate was 89.2％ in the high dose group and 75.5％ in the low dose group.The effective rate of high dose group was higher than that of the low dose group (P ＜ 0.05).Before treatment,there were no statistical significance on CRP and TNF-α between two groups.After treatment,the CRP and TNF-α were decreased in two groups and lower in the high dose group (P ＜ 0.05).Before treatment,there were no statistical significance on FVC,FEV1 and FEV1/FVC％ between two groups.After treatment,FVC,FEV1 and FEV1/FVC were increased and higher in the high dose group (P ＜ 0.05).During treatment,there were no statistical significance on adverse reaction between two groups.Conclusion High dose of ambroxol was effective and safe for COPD.It could reduce inflammation and improve pulmonary ventilation with clinical use.

ObjectiveTo study the etiology, preoperative diagnosis and treatment of nonocclusive mesenteric ischemia(NOMI). MethodsClinical data of 3 cases of NOMI from 1992 to 1998 were analyzed retrospectively. ResultsMajor clinical presentations were abdominal pain, gastrointestinal bleeding and abdominal irritation. None was correctly diagnosed preoperatively. Partial ileectomy in 2 cases and right colectomy in 1 case was performed with a mortality of 2/3. Conclusion Early diagnosis and accurate assessment of the bowel viability in exploration were quite difficult. Resection of the infarcted bowel or ′second-look procedure′ were recommended if necessary.

Objective To develop a method for the determination of Hesperidin,magnolol from "He-Wei-Yin" Mixture,and for its quality control,high-performance liquid chromatography (HPLC) is used.Method After plenty of study about the condition,the final result choosed was as following:an analytical column of HypersiC18(200mm?4.6mm,5?m ) maked by HP was utilized. The column number was 13164421196.The mobile phase was adapted gradient with methanol-1% acetum solution,according to the following profile:0～30min,methanol concentration from 30% to 70%;30～40min,from 70% to 80%;40～50min,from 80% to 30%. The flow rate was 1.0ml/min with the column kept at ambient temperature. All the components had come out in 45 min with the detection wavelength at 294nm. It followed the order of Heperidin,Magnolol according to the retention times in the chromatography.Results In the result,the regression equations were as following:Hesperidin was Y=139.718X+4.511 with a good linearity (r=0.99994). Magnolol was Y=1456.342X+106.506 with a good linearity (r=0.99957) between the peak area and the mass of the standard.The recoveries of the method were as following:in the "He-Wei-Yin" Mixture,for hesperidin,precision of the method RSD=1.87%(n=5),recovery of the method 96.53%(RSD=3.36%,n=3);for Magnolol,precision of the method RSD = 0.34% (n=5); recovery of themethod 93.17%(RSD=4.69%,n=3).At the same condition as above,the determination of content was carried out for six different dose and batch No.Conclusion The method is simple and reliable,easy to operate,suitable for the quality control of Hesperidin and Magnolol in "He-Wei-Yin" Mixture.

Objective: To examine the causal relationships between obesity, peripheral blood lipid indicators and non-small cell lung cancer (NSCLC) using Mendelian randomization (MR) method, so as to provide the basis for developing NSCLC prevention and control strategies. Methods: Genetic variation data of three obesity evaluation indicators, including body mass index (BMI), body fat ratio (BFR) and waist-to-hip ratio (WHR), and seven peripheral blood lipid indicators, including triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and lipoprotein a [LP (a)] were collected through genome-wide association studies (GWAS) and related public databases. Potential causal relationships between obesity, peripheral blood lipid indicators and NSCLC were analyzed using inverse-variance weighted (IVW) method and multivariable MR analysis upon a random effect model. Heterogeneity and horizontal pleiotropy of instrumental variables were evaluated using Cochran's Q test and MR-Egger regression. Results: There was statistically association between BMI with NSCLC (OR=1.256, 95%CI: 1.087-1.451); there were no statistically associations between BFR, WHR, seven peripheral blood lipid indicators and NSCLC (all P>0.005). There was heterogeneity in the association between BMI, BFR, WHR, TG, HDL-C and NSCLC (all P<0.05); no horizontal pleiotropy of instrumental variables was found (all P>0.05). There was no statistically association between BMI and NSCLC after adjusting BFR (OR=1.367, 95%CI: 0.878-2.128); there was still statistically association between BMI and NSCLC after adjusting WHR and peripheral blood lipid indicators (both P<0.05). Conclusions The increase of BMI is associated with the increased risk of NSCLC incidence. BFR may be a potential influencing factor for the association between BMI and NSCLC.

Objective To summarize the experience on diagnosis and treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 91 PHPT patients treated in Beijing Jishuitan Hospital from November 1992 to December 2008 were analyzed retrospectively.Results Among 91 PHPT cases,88 were diagnosed as parathyroid adenoma(96.7%),3 were diagnosed as parathyroid carcinoma (3.3%).Serum calcium and PTH levels increased in all cases.Main clinical manifestations were osteodynia and kidney stones.The accuracy rate of preoperative B-ultrasound.CT and ECT~(99m)Tc-MIBI on location was 83.5%(76/91),60.9%(14/23)and 98.6%(69/70)respectively.Parathyroidectomy was performed in all but one cases,in which parathyroid carcinoma was managed by ipsilateral hemithyroidectomy and modified neck dissection.The cure rate of primary operation was 97.8%(89/91).Ninety cases were followed-up from 8 months to 14 years postoperatively,87 cases with parathyroid adenoma achieved complete remission,2 with parathyroid carcinoma suffered from tumor recurrence and 1 died.Conclusion Patients with chronic bone diseases,repeatedly recurrent nephrolithiasis,peptic ulcer disease should be a suspect of PHPT.The routine examinations of serum calcium and phosphorus are to be conducted.UItrasonography and ECT~(99m)Tc-MIBI should be considered as the methods of first choice for preoperative localization.

Objective To investigate effect of alendronate on OPG and RANKL in periprosthetic osdeolysis induced by polyethylene particles.Methods Twelve rabbits which had been implanted a titanium plug in femur by intercondylar notch were divided into two groups randomly,polyethylene particles were injected into the left knee joint,one received alendronate,and the other placebo as control.After 12 weeks,all rabbits were sacrificed.Periprosthetic tissues were observed by ELISA.Results The concentration of OPG in the experimental group was not higher than that of the control (P ＞0.05 ).But the concentration of RANKL in the experimental group was lower(P ＜0.01 ).And specific value of OPG/RANKL was higher in the experimental group ( P ＜ 0.05 ).Conclusion The therapy of alendronate can change the concentration of RANKL and specific value of OPG/RANKL in periprosthetic osdeolysis induced by polyethylene particles,inhibit aseptic loosening of prosthesis in rabbits.