Objective To evaluate the accuracy of an expiratory resistance device assisting pulse pressure variation (PPV) in predicting volume responsiveness in the spontaneously breathing patients.Methods Forty spontaneously breathing patients of both sexes,aged 22-61 yr,weighing 51-73 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation,were enrolled.Before induction of anesthesia,mean arterial pressure (MAP),heart rate (HR),central venous pressure (CVP),cardiac index (CI) and pulse pressure variation (PPVB) were recorded after haemodynamics were stable.Then the expiratory resistance device was used,and MAP,HR,CVP,CI,and PPVA were recorded.The device was then removed.Volume expansion was carried out.6％ hydroxyethyl starch 130/0.4 6 ml/kg was infused over 10 min.MAP,HR,CVP,CI and PPVB were recorded within 3 min after volume expansion.The device was used again,and 1 min later MAP,HR,CVP,CI and PPVA were recorded.The device was then removed.The patients were divided into 2 groups according the percentage of increase in CI after volume expansion (△ CI):△ CI≥ 15％ considered to be a positive response group (group P),and ACI＜15％ considered to be a negative response group (group N).A receiver-operating characteristic (ROC) curve for PPV was plotted.According to the ROC curve,the diagnostic threshold,sensitivity,specificity,area under the curve,and 95％ confidence interval of the expiratory resistance device assisting PPV in predicting volume responsiveness were determined.Results The area under the curve (95％ confidence interval) of PPVA was 0.880 (0.70-0.98),the diagnostic threshold was 13.5％,and the sensitivity and specificity in determining volume responsiveness were 87％ and 88％,respectively.Compared with the value before administration of the loading dose,the CVP and CI were significantly increased,and PPVB and PPVA were decreased after volume expansion in group P,and the CVP and CI were significantly increased after volume expansion in group N (P＜0.05).Compared with group P,the PPVA was significantly decreased before volume expansion,and the CI was increased after volume expansion in group N (P＜0.05).Conclusion The expiratory resistance device can assist PPV in predicting volume responsiveness in the spontaneously breathing patients.

Aim To investigate the effect of acacetin on cell proliferation and the influence of acacetin on estrogen receptor expression in vitro.Methods The proliferation rates and the cell cycle changes of acace-tin-treated T47D cells were measured by sulforhodam-ine B(SRB)assay and flow cytometry,respectively. Moreover,the mRNA expressions of estrogen receptor-alpha(ERα),estrogen receptor-beta(ERβ)and pro-liferating antigen(Ki67)were determined by quantita-tive real time PCR (qPCR).Western blot was em-ployed to detect the ERαand ERβprotein expression. Results Acacetin significantly promoted the prolifera-tion and increased the amount of cells arrested in S and G2 /M phase under the concentration of 0.001 ~1 0μmol·L -1 .Ki67 mRNA level and the ERαprotein level in T47D cells were remarkably upregulated after acacetin treatment.To clarify which estrogen receptors played a role in acacetin induced the proliferation of T47D cells,the combination treatment of acacetin and ERαinhibitor (MPP)/ERβ inhibitor (PHTPP) was employed.We found that MPP could reverse the cell proliferation,the cell arrested in S and G2 /M phase and the increased Ki67 mRNA level induced by acace-tin.PHTPP also alleviated the T47D cell proliferation induced by acacetin,whereas no significant changes were found in cell cycle and Ki67 mRNA level.Con-clusion Acacetin stimulates the cell proliferation of T47D cells in the concentration from 0.001 μmol · L -1 to 1 0 μmol·L -1 ,which is mainly mediated by ERα.

Aim To investigate the protective effects of dihydroquercetin(DDQ) against myocardial ischemis reperfusion injury(MIRI) in rats.Methods Male Sprague-Dawley rats were randomly divided into 4 groups(n=10):normal,control,I/R model, and I/R model+DDQ(5,10 mg·L-1).This study used an isolated Langendorff rat heart model.The left ventricu-lar developed pressure(LVDP),heart rate(HR) and the maximum rise and fall rate of the left ventricular pressure(±dp/dtmax) were monitored and documented using a physiological recorder.The levels of lactate dehydrogenase(LDH) and creatine kinase(CK) were analyzed using enzyme-linked immunosorbent assay(ELISA).Infarct size was measured using 2,3,5-triphenyltetrazolium chloride staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA), as well as the ratio of glutathione/glutathione disulfide(GSH/GSSG) were measured via ELISA.HE staining was used to observe the pathological changes of myocardial tissue.Results Compared with the I/R model group, the I/R model+DDQ groups raised hemodynamic parameters, SOD level, and GSH/GSSG ratio;and reduced the amount of CK, LDH, MDA levels.Moreover, the I/R model+DDQ groups had lower infarct size and pathological changes in myocardial tissue than I/R model group.Conclusion DDQ exertes cardioprotective effects against I/R via improving the oxygen free radical scavenging ability, the inhibition of oxygen free radical and reducing lipid peroxidation.

Objective To evaluate the efficacy of ultrasound for placement of laryngeal mask airway (LMA) in comparison with fiberoptic bronchoscope in adult patients.Methods Fifty-eight ASA physical status Ⅰ or Ⅱ patients,aged 18-57 yr,weighing 50-70 kg,with body mass index 20-30 kg/m2,scheduled for gynecological operation under general anesthesia,underwent standard general anesthetic technique with 4 # LMA-ClassicTM.After clinical assessment of correct placement of LMA,the position of the LMA was confirmed by transverse neck ultrasound,and reconfirmed using fiberoptic bronchoscopy.The peak airway pressure and oropharyngeal leak pressure were recorded.Results When the outcome of clinical assessment of correct placement of LMA was considered as satisfactory,the rate of ideal anatomic placement assessed by ultrasound evaluation was 69 %,and the rate of ideal anatomic placement assessed by fiberoptic bronchoscopy was 59 %,and it showed that there was no significant difference in detecting the ideal placement of the LMA (P ＞ 0.05).The oropharyngeal leak pressure was significantly higher when ultrasound was used for confirmation of the correct placement of LMA than that when fiberoptic bronchoscope was used (P ＜ 0.05).Conclusion Ultrasound provides better efficacy for placement of LMA in indicating sealing of LMA than fiberoptic bronchoscope and is helpful in improving ventilation conditions in adult patients.

Objective To establish an analytical method of chromatographic fingerprint of cortex moutan in Dianjiang County through HPLC;To provide reference for the quality control and general evaluation. Methods HPLC with Shim-pack VP-ODS C18 column (4.6 mm×250 mm, 5μm) was used;paeonol was taken as standard;the mobile phase was MeOH-H2O with liner gradient eluation;the delection mavelength was at 274 nm for paeonol and 230 nm for paeoniflorin;the flow rate was 1.0 mL/min. Fourteen batches of samples were analyzed to establish the fingerprint with paeonol and paeoniflorin as reference. Results The results of the 14 batches of samples and similarity evaluation showed that the similar degrees to the 10 batches among the 14 samples were between 0.968-0.998, which illustrated the good similar degrees among samples. Conclusion The established fingerprint with characteristics of stability, good reproducibility and simplicity, can be used for the quality evaluation and control of cortex moutan.

Objective To discuss curative effect and security comparison of epidural (CEA) and combined spinal-epidural (CSEA) labor analgesia with ropivacaine and sulfentanyl. Methods A total of 90 cases of primiparas with uterogestation were selected and divided into CEA group and CSEA group at random. The primiparas in CEA group were given 10 mL intermixture of 0.75% Ropivacaine and 0.5 μg/mL by epidural injection, while the primiparas in CSEA group were given 3 mg 0.1% Ropivacaine and 5 μg Sulfentanyl by intrathecal injection given patient-controlled epidural analgesia pump (PCEA). Results The 1st stage of labor,2nd stage of labor,3rd stage of labor,total stage of labor and occurrence rate of untoward effect in CSEA group were all shorter or lower than those in CEA group (P<0.05). After comparing the Apgar scores of primiparas in two groups upon 1 minute and 5 minutes after the birth of neonates in two groups were compared, no statistical differences appeared (P>0.05). VAS of primiparas in two groups at T0 showed no obvious differences(P>0.05),which were improved at T1,T2,T3 and in either group(P<0.01),and the improvement range in CSEA group was much better than that in control group (P<0.05 or P<0.01). Conclusion Com-pared with CEA, CSEA labor analgesia with ropivacaine and sulfentanyl has favorable curative effect, less influence on stage of labor,less untoward effect and etc.

Objective:To investigate the clinical efficacy of traditional Chinese medicine combined with Western medicine in the treatment of periappendiceal abscess . Methods :A total of 78 patients with periappendiceal abscess in Jiading hospital of Traditional Chinese Medicine were randomly divided into observation group and control group ,with 39 cases in each group . The control group received conservative treatment of periappendiceal abscess according to routine treatment of Western medicine .Based on the treatment scheme of control group ,the observation group received self‐made traditional Chinese medicine orally .After seven days which was one course of treatment ,the clinical efficacy ,the subsiding time of abdominal pain ,fever and periappendiceal abscess ,and the days of hospital stay were compared between the two groups .Results:The total effective rate in the observation group was significantly higher than that in the control group (P< 0 .01) .The subsiding time of abdominal pain ,fever and periappendiceal abscess ,as well as the days of hospital stay in the observation group was significantly less than that in the control group (P< 0 .05) .Conclusions :Traditional Chinese medicine combined with Western medicine could significantly improve the clinical efficacy in the treatment of periappendiceal abscess , shorten the treatment period , and accelerate the improvement of the patients’ clinical symptoms .

Objective To investigate the influences of whistle behavior on the cross-sectional area of the internal jugular vein and catheterization .Methods The study investigated 90 patients who had internal jugular vein catheterization in ICU or the Operating Room of Yinzhou People′s Hospital of Ningbo University Medical College from July 2014 to August 2015 .The participants were divided into whistle group ( B group ) , Valsalva group (V group), and the control group (C group) using random number table , with 30 participants in each group .All the participants did calm breathing , whistle , and Valsalva behavior in turn .Meanwhile , the images of internal jugular vein cross-section on the right sternocleidomastoid triangle apex level were captured and measured , and the catheterization time of internal jugular vein were recorded under ultrasound guidance . Results The cross-sectional area of the internal jugular vein were (101 ±28), (185 ±46), (196 ±59)mm2 when patients had calm breathing , whistling, and Valsalva behavior (F=5.716,P<0.05), but the differences of whistling and Valsalva behavior had no statistical significance (P >0.05).The catheterization time of internal jugular vein for B, V, C group were (123 ±26), (137 ±31), and (174 ±46)s (F=3.618,P<0.05).The differences had statistical significance for B and V group compared with C group (P<0.05), but had no differences between B and V group (P>0.05).Conclusions The whistle and Valsalva behavior had similar effects on the dilatation of internal jugular vein and the reduction of catheterization time .

Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients. Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS). Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.

Objective To investigate the efficacy and safety of dexmedetomidine intravenous assisted epidural anesthe-sia for labor analgesia. Methods Forty full term puerperant who had a single fetus were randomly divided into two groups, Group C (n=20), a catheter was advanced into epidural space,anesthetic drugs (0.125%ropivacaine with fen-tanyl 1.5μg/mL)of 10 ml was infused,then implement PCEA(bolus 4 mL with 15 min lockout interval,background in-fusion 4mL/h).Group D (n=20)assisted the routine epidural block anesthesia with intravenous injection of dexmedeto-midine,which was infused 0.2 μg/(kg·h). ECG,RR,BP,SpO2,analgesic effect were assessed by VAS,labor process,mode of delivery,Apgar score of neonates and side effects of analgesia were recorded. Results The VAS during the first and second stages of labor in group D were better than group C (P<0.05),there was no significant difference in Apar score between two groups. The second stage of labor in group C had an extended period of time(P<0.05). There was no significant difference in vital signs,fetal heart rate and uterine contraction between two groups. Conclusion Intravenous dexmedetomidine can optimize the traditional labor analgesia mode and reduce the dosage of PCEA.The puerperants can be more comfortable and effective in accouchement.