Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

In recent years,with the rapid development of orthopedic surgery and minimally invasive surgery,superficial fascia and its structures are receiving much recognition and more and more attention.Although opinions on naming and definition at different levels still vary,in-depth study of related structures offers clinical surgeons a broad prospect.

ObjectiveTo improve the therapies for recurrent arterial embolism of the extremities. MethodsFrom Dec. 1984 to Dec. 1997, 35 patients of recurrent embolism of the extremities were treated,results were compared to that of 248 patients with first onset.ResultsThe recurrent cases accounted for 12.4% of the disease.One year recurrence developed in 63% of the 35 cases.32 cases suffered from second arterial embolism and 3 cases had third onset with a total of 42 limbs.The rates of cure,mortality and amputation were respectively 54.3%,22.9%, and 2.9% in the recurrent group,compared to 72.6%,10.1%,and 14.9% in the control group.There were statistically significant differences of cure,mortality and amputation rates between the two groups(? 2test, P

Objective To investigate the effect of various adjunctive drugs in patients undergoing abdominal surgery under epidural anesthesia. Methods 60 ASA Ⅱ～Ⅲ patients scheduled for elective abdominal surgery were randomly divided into four groups: Group PP, promethazine 50mg + ephedrine 100mg as one unit; Group DF, droperidol 5mg + fantanyl 0.1mg as one unit; Group MP, midazolam 5mg + pethidine 100mg as one unit; Group MF, midazolam 5mg + fantanyl 0.1mg as one unit. All the drugs were intravenously administered 10 min after the first dose of epidural block. The dose of various combinations was selected to reach sedation degree of Ramsay 4. The blood pressure, heart rate and SpO_2 were monitored, the degree of sedation and the side-effects were recorded during the operation. The patients were postoperatively surveyed to evaluate the degree of amnesia and satisfaction of anesthesia. Results No significant differences in hears rate and SpO_2 were found among the four groups. In group DF there was marked influence on the blood pressure. The time needed to reaching Ramsay 4 degree of sedation in MP group (1.49?1.13min) and MF group (1.64?0.96min) was significantly shorter than that in group PP (4.36?2.11min) and group DF (4.97?2.65min) (P≤0.01). An obvious difference was found in the incidence of responses to surgical exploration. There was a higher risk of glossoptosis in groups MP and MF than in other groups. Conclusion Midazolam combined with fentanyl or ephedrine is the most effective combination to supplement epidural anesthesia for abdominal operations.

Objective The molecular basis for opiate tolerance and dependence remains poorly understood despite extensive investigation in several preparations, including the hippocampus. Recent studies have implicated that the hippocampus played a central role in opiate tolerance, dependence and withdrawal. The current study is to explore the change in guanine nucleotide binding protein-inhabitant (Gi_2) protein in primary cultured hippocampal neurons with morphine treament. Methods The hippocampus was harvested from newborn Sprague-Dawley rats. Primary hippocampal neuronal cultures of 7 days in vitro were used and divided randomly into six groups (n=6), i.e. morphine treatment 4h group (M4), 8h group (M8), 16h group (M16), 24h group (M24), 48h group (M48) and control group (C). All morphine treatment groups were treated with morphine (10?mol/L). C group was treated with saline. The G protein levels were determined with immunofluorscence and laser scanning confocal microscope (LSCM) imaging techniques. Results Gi_2 protein levels in M16, M24 and M48 groups decreased significantly compared with that in C group (P0.05). Among M16, M24 and M48 groups, Gi_2 protein level was lowest in the M48 group. Conclusion The results indicated that Gi_2 protein levels decreased significantly in primary cultured hippocampal neurons with morphine treatment, which might be a potential molecular mechanism of opioid tolerance and dependence.

Objective To investigate the changes in inhibitory guanine nucleotide binding protein Gi_2 in five brain regions of morphine addicted rats: ventral tegmental area, nucleus accumbens, prefrontal cortex, hippocampus and locus caeruleus. Methods 36 adult male SD rats were randomly divided into six groups (n=6): acute morphine dependent group, acute abstinence group, acute control group, chronic morphine dependent group, chronic abstinent group and chronic control group. Morphine dependent models were reproduced. Withdrawal syndrome was induced with naloxone 5mg/kg for 30min in rats of abstinence group. All rats were sacrificed by decapitation. Frozen sections of coronal plane of respective brain regions (ventral tegmental area, nucleus accumbens, prefrontal cortex, locus coeruleus, hippocampus) were prepared. The relative concentrations of Gi_2 protein were determined with immunohistochemical methods. Results Gi_2 proteins in acute morphine dependent group and acute abstinence group were significantly decreased compared with that of acute control group in nucleus accumbens (P

respectively)was significantly higher than that for digital anterograde venography (0.684 and 0.587,P =0.026,respectively).Conclusion Diagnostic accuracy and detection rate of residuaI or recurrent varicose veins with CT phlebography are found to be more superior than that with digital anterograde venography which has high guidance value in preoperation and assesses the efficacy of post-surgery treatment.

Objective To investigate the efficacy of laparoscopic cholecystectomy(LC) followed by endoscopic retrograde cholangiopancreaticography(ERCP) for gallbladder and bile duct stones.Methods A total of 58 patients with both gallbladder and bile duct stones received endoscopic sphincterotomy(EST) in our hospital.After the stones were removed,LC was performed on the patients.Results Of the 58 patients,56 were successfully treated with EST and LC.Two cases were unsuccessful owing to difficulty in intubation during ERCP in one and failure to remove all the stones from the bile duct in the other.These two patients were then cured by LC combined with electronic choledochoscopy.Perioperative complications included bleeding during EST in 1,acute edematous pancreatitis in 2,and mild infection of the puncture site in 1.The overall complication rate was 7.1%(4/56).Retained common bile duct stone was observed in 1 patient,and was successfully removed by subsequent ERCP.Conclusions LC combined with ERCP is a safe and effective minimal invasive method for the treatment of concurrent gallstones and bile duct stones.

0 05); but the data by catheter photography in PDA were obviously smaller (3 5?2 5 vs 5 2?2 3, P

Objective To summarize our experience in percutaneous transluminal angioplasty(PTA) in the management of thoracoabdominal aortic stenosis of Takayasu's arteritis. Methods From 1987～2001, 12 patients of Takayasu's arteritis with thoracoabdominal aortic stenosis underwent PTA. Aortography and pressure of stenotic segment of arota before and after angioplasty were used to evaluate efficacy. Color Doppler ultrasound examination and Doppler segmental pressure measurement were used in follow-up. Results Success was achieved in all cases without mortality and serious complications except for 1 case of acute thrombosis of iliofemoral artery. The residual stenosis were less than 50% in all cases and the pressure gradient was 5 0mmHg～10 5 mmHg with average pressure being 7 2 mmHg after angioplasty ,although they were 25mmHg～46 mmHg averaging of 37 7 mmHg before angioplasty. All cases were followed up for 9(12～72) months and the result was good without lumen restenosis and obstruction. Conclusions PTA is the first choice for Takayasu's arteritis of thoracoabdominal aortic stenosis of local size and proved to be safe, effectiveand economical. It is also effective for long size cases. It is not necessary to dilate aorta stenosis to normal size, and reducing pressure gradient effectively is enough.