Objective to compare the LMA and intubation in elderly patients with coronary heart disease hemedynamics,respiratory function and the impact of stress hormones.Methods 32 cases of elderly patients with coronary heart disease ASA II level under general anesthesia in the implementation of gastrointestinal surgery,were randomly divided into LMA group and endotracheal intubation group.Before the induction of anesthesia (T0),insert the LMA/endotracbeal tube before(T1),insert the LMA/tracheal tube immediately after(T2),insert the LMA/endotracbeal tube after 5 min(T3) ,10 min(T4),15 min(T5) and the skin incision,(T6) ,immediately after extubation (T7) record SBP,DBP,HR.Application BICORE monitor respiratory function 16 indicators,select T0,T3,T4,T5,T7 record at the suction tidal volume (,VTI),breath tidal volume (VTE),minute ventilation (VE),Inspiratory peak velocity(PIFR),peak expiratory flow rate (PEFR) ,peak inspiratory pressure(PIP) and the average airway resistance (RAWM).Patients in each group T0,T1,T2,T6,T7 at the application of high performance Iiqnid chromatography analysis of plasma epinephrine(AE),norepinephrine(NE),dopamine (DA) level.Results intubation group T2 at the SBP,DBP,HR significantly higher than the LMA group (P＜0.05) ;,VTI,VTE,VE,PIFR,PEFR,PIP and RAWM group there was no significant difference,AE,NE,DA in T2,T7,were significantly higher than the LMA group (P＜0.05).Conclusion Laryngeal Mask Airway general anesthesia for elderly patients with coronary heart disease is better than intubation,easy to maintain stable bemedynamics,the stress response minor,after the restoration of a smooth general anesthesia.

Objective To evaluate and compare the advantages and disadvantages and the clinical applica- _ tion between abdominal hysterectomy (AH) and laparoscopically hysterectomy ( LAH) on the benign lesions of Non-prolapsed Uterus. Methods 400 patients with benign lesions of Non-prolapsed Uterus were divided into two groups. They were AH group (202 cases) and LAH group (198 cases). The effects of clinical treatment of the two groups were compared. Results In LAH group anal exhaust time,postoperative morbidity,length of stay were less than those in AH group,the difference was statistically significant(P <0. 05 ). The cost of LAH group was higher,and all symptoms were relieved after opreation. In LAH group,the average recovery time of the surgery to return to work time was(21 ± 7) d, but in AH group that was( 36 ± 8 ) d. The differences of recovery rime between two groups were statistically significantly ( P < 0.05). In two groups B-myoma were not found obvious by follow-up. Conclusion Different surgical patterns of hysterectomy had their distinctive advantages. The key point of a successful operation was to avoid complications of the operation.

Esophageal cancer morbidity and mortality are high,but it is also the most difficult to treat and cure one of the malignant tumors.At present,immunoinhibitors have made breakthroughs in the treatment of cancer,and related research,Which have become a hot field for the clinical study of immunological checkpoint procedural death molecule 1 (PD-1) and its ligand PD-L1 antibody.In this paper,we reviewed the progress of PD -1/PD-L1 in esophageal squamous cell carcinoma.

Objective:To compare the effects between estrogen and Prasterone(Dehydroepiandrosterone,DHEA) on improving atherosclerosis of ovariectomized rabbits. Methods: Thirty female New Zealand white rabbits of three months old were randomly divided into five groups: Group A: normal control;Group B: sham operation + high cholesterol feeding;Group C: ovariectomized + high cholesterol feeding;Group D: ovariectomized + high cholesterol feeding+ estradiol benzoate;Group E: ovariectomized + high cholesterol feeding+ DHEA.Twelve weeks later,all rabbits were sacrificed,the serum TC,TG,LDL-C,HDL-C,NO and estradiol levels were measured.The aortas and uterus were harvested for histomorphometrical evaluation with light and scanning electron microscope.The area ratios of atherosclerotic lesion to endothelium,and the thickness and area ratios of endothelium to the medium were determined by computer. Results: ①Following the treatment for 12 weeks,no significant difference was found in serum TC、LDL-C、HDL-C levels among four groups except in group A.②There were significant differences between the serum triglyceride(TC)levels of group D and group C.③The serum No levels of group D and group E were significantly higher than that of groupC.④The serum estradiol levels of group D and group E were significantly higher than that of groupC.⑤The area ratios of atherosclerotic lesion to endothelium and the thickness and area ratios of endothelium to the medium in group D and group E were significantly lower than that of group C.⑥Endometrial hyperplasia of group D was significant,while there was no such Phenomena in group E. Conclusion: Estrogen and DHEA can alleviate the early pathological changes of atherosclerosis of the ovariectomized rabbits,prevent and reduce the formation of atherosclerosis.

Objective To investigate the relationship between cystatin C (CysC) and severity of the disease and changes of renal function in patients with acute cerebral infarction .Methods A total of 84 patients with acute cerebral infarction (study group) and 84 healthy individuals (control group) were enrolled and serum CysC levels were detected ,and its relationship with the degree of neurological impairment was analysed .500 mL/d (group A) and 375 mL/d (B group) 20% mannitol treatment were used ,and changes of serum CysC levels and renal function before treatment and 5 days and 14 days after treatment were analyzed .Results Serum CysC levels in patients with large ,medium and small infarcts were significantly higher than that in the control group (P<0 .05) .Serum CysC levels in patients with heavy ,medium and mild nerve function defect were significantly higher than that in the control group (P<0 .05) .After treatment ,serum levels of CysC ,creatinine (Cr) and blood urea nitrogen (BUN) in group A and B were increased ,in which serum CysC levels were significantly higher than that before treatment (P<0 .05) .5 and 14 days after treatment ,serum levels of CysC ,Cr and BUN in group A and B were without significant differences(P>0 .05) .Conclusion CysC might be closely related with the severity of acute cerebral infarction ,which could be more useful for monitoring renal function of patients with cerebral infarction than Cr and BUN .

Cornea is an important part of the refractive media.Healthy cornea is clear and avascular.Corneal avascularity is necessary for the preservation of optimal vision and is maintained by a balance between angiogenic and antiangiogenic factors.In a variety of pathologic conditions,the balance between angiogenic and antiangiogenic factors may be tipped towards angiogenic molecules,leading to corneal neovascularization (CNV).Recent research showed that vascular endothelial growth factor (VEGF) is an important factor responsible for CNV.Over the past several years,the safety and efficacy of several new agents targeting VEGF or VEGF receptor (VEGFR) have been verifies in many ocular neovascularization diseases such as age-related macular degeneration, diabetic retinopathy, neovascular glaucoma,retinopathy of prematurity and CNV.These agents not only have revolutionized the therapy of ocular neovascularized disease but also have great potential for other blinding conditions such as CNV.These agents have great potential for the treatment of CNV.This article reviewed the most promising anti-VEGF/VEGFR therapies.

Child ; Hemophilia A ; diagnosis ; therapy ; Humans ; Practice Guidelines as Topic

OBJECTIVE:To probe into the characteristics and regularity of adverse drug reactions(ADR)reports in our hospi-tal,and to promote rational use of drug. METHODS:In retrospective study,317 ADR cases reported by clinical departments of our hospital from 2013 to 2014 were analyzed statistically in respects of patient's gender,age,drug type,route of administration, organs or systems involved in ADR,clinical manifestation. RESULTS:Of 317 ADR cases,female who occurred were slightly more than male;the 41-70 year-old patients held the highest peroportion of 53.94%,35.65% were induced by anti-infective drugs, 74.76% induced by intravenous dripping;30.28% manifested as lesion of skin and its appendants. CONCLUSIONS:ADR is asso-ciated with a variety of factors including drug property,individual differences and route of administration,etc. It is important to fo1low indications in drug use and strengthen ADR monitoring to promote rational use of drugs.

Objective To determine the impact of fear of progression on hope level of liver cancer patients. Methods A total of 186 liver cancer patients were recruited from two first-class hospitals in Suzhou by convenience sampling method. They were investigated with fear of progression questionnaire-short form and Herth hope index. The relationship between fear of progression of liver cancer patients and hope level was analyzed. Results The total score of hope level in liver cancer patients was (27.32±5.18) points. There were significant negative correlations between score of fear of progression of liver cancer patients and score of hope level. Regression analysis showed that the factor scores of fear of progression such as physical health and social family could explain 34.8%of the variance for hope level of liver cancer patients after controlling demographic variables. Conclusion Reducing the level of fear progression in patients with liver cancer will help raise the level of hope for patients with liver cancer.

Some results obtained by others showed the limitation of cyclic 3', 5'-adenosine monophosphate (cAMP) increase within the brain might be an important factor in endogenous pyrogen (EP) hyperthermic ceiling (HC) or endotoxin (ET) HC. The results obtained from our experiments indicated: (1) Lateral cerebro-ventricular administration of dibutyryl cAMP (Db-cAMP) induced dose-dependent fever in rabbits. But there was no further increase in body temperature when the fever reached a certain height, even if Db-cAMP doses were increased progressively, "a flat slope" appeared in the dose response curve. This is termed "cAMP HC" by the authors. (2) Level of fever cavsed by non-HC dose Db-cAMP with non-HC dose EP was markedly higher than that of non-HC dose EP or non-HC dose Db-cAMP, and was similar to the sum of action caused by non-HC dose Db-cAMP and non-HC dose EP. (3) Similar were the levels of HC caused by EP, Db-cAMP and Db-cAMP with the charge of HC dose EP. But the level of HC caused by ET or Db-cAMP HC with the charge of HC dose ET was higher than that of cAMP.The authors deduce that the cAMP may be an important central mediator in pyrogen-induced fever; the cAMP HC developed may be a result of saturation of cAMP action site within the brain or the limitation of production of other mediators induced by cAMP; the formation of EP HC or ET HC may be influenced not only by the limitation of cAMP increase, but also by the saturation of cAMP action site, within the brain; ET fever and ET HC differed greatly from those of EP; besides cAMP, other factors may be involved in the formation of ET HC.