Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in the elderly patients undergoing minimally invasive direct coronary artery bypass (MIDCAB).Methods Thirty six patients of both sexes,aged 65-78 yr,with the left ventricular ejection fraction ≥ 45％,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅰ-Ⅲ),scheduled for elective MIDCAB in the left thorax,were randomly divided into 2 groups (n =18 each):double-lumen endotracheal tube group (group D) and bronchial blocker group (group B).Anesthesia was induced with midazolam 0.05 mg/kg,etomidate 0.3 mg/kg,fentanyl 10μg/kg and cisatracurium 0.15-0.20 mg/kg.The patients were intubated with a left-sided double-lumen endotracheal tube 5 min later in group D.The patients were intubated with a single-lumen endotracheal tube 5 min later,and then Coopdech bronchial blocker was inserted into the primary bronchus in group B.The patients were mechanically ventilated.Before induction of anesthesia,at 2 min before intubation,immediately before and after intubation,and at 1 and 2 min after intubation,mean arterial pressure (MAP),heart rate (HR),and mean pulmonary arterial pressure (mPAP) were recorded and rate-pressure product (RPP) was calculated.The requirement for vasoactive drugs was recorded during induction of anesthesia.Lung collapse developed after the pleura was opened was also recorded.Surgical exposure was scored at the end of operation.Results Compared with group D,MAP,HR RPP and mPAP were significantly decreased after intubation,the requirement for nicardipine and esmolol was decreased,and no significant change was found in the requirement for atropine and metaraminol,rate of lung collapse and score of surgical exposure in group B.Conclusion Compared with doublelumen tube,bronchial blocker can provide sufficient exposure of the surgical filed,and intubation-induced fluctuation of hemodynamics is small in the elderly patients undergoing MIDCAB.

Adolescent ; Antigens, CD20 ; metabolism ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; metabolism ; pathology ; Prognosis

Objective By analyzing the epidemiological characteristics and trends of brucellosis in Ji'nan City,to provide a scientific basis for further prevention and control of the disease.Methods Serum samples of suspected brucellosis patients were collected from every county (city,district) of Ji'nan City from 2008 to 2014,and these samples were screened by Rose-bengal plate agglutination test (RBPT).Then positive samples were confirmed by Standard tube agglutination test (SAT),and experimental data and results were analyzed by statistics.Results Totally 2713 serum samples of suspected brucellosis patients were tested,and 200 were positive by SAT.Temporal distribution:the serum antibody positive specimens were detected each month throughout the year,and the results showed clear seasonal prevalence by concentrating from March to September (82.07％,151/184).Population distribution:the serum antibody positive rate of males was higher than that of females,the ratio was 2.08:1.00,and the cases were found among 15 to 75 years old,while concentrated from 30 to 65 (67.00％,134/200).Spatial distribution:except Huaiyin District,positive samples were detected in all other 10 counties (cities,districts) of Ji'nan City,most of them (92.5％,185/200) in Shanghe,Zhangqiu,Changqing,Shizhong and Licheng counties (cities,districts).Conclusions Brucellosis epidemic in Ji'nan is serious,and cases have occurred mostly in spring,summer and autumn.It is recommended that health propaganda and education should be strengthened in order to enhance selfprotection awareness of the exposed population,and then improve the physical examination for early discovery,early reporting and early treatment.At the same time,it is important to cooperate with the Department of Livestock to prevent and control brucellosis.

0.05).CONCLUSION:It is feasible to reduce the dose of hormone in weekly docetaxel chemotherapy

Objective To evaluate the effects of different doses of dexmedetomidine administered intranasally on the median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion in the pediatric patients.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged 1-3 yr,with body mass index of 20-26 kg/m2,scheduled for elective surgery under general anesthesia,were divided into 3 groups using a random number table:control group (group C),dexmedetomidine 1 μg/kg group (group D1) and dexmnedetomidine 2 μg/kg group (group D2).At 20 min before induction of anesthesia,dexmedetomidine 1 and 2 μg/kg (diluted to 1 ml in normal saline) were intranasally administered in D1 and D2 groups,respectively,and the equal volume of normal saline was intranasally administered in group C.Children were separated from their parents at 20 min after intranasal administration and admitted to the operating room.The target plasma concentration of propofol was determined by modified Dixon's up-and-down method.The initial target plasma concentration of propofol was set at 5.4 μg/ml.The target plasma concentration of propofol was increased/decreased by 10％ in the next patient according to the response to LMA insertion,and the ratio between the two successive concentrations was 1.1.Patients' sedation status and LMA acceptance were evaluated when patients were separated from their parents.Patient's satisfaction with sedation and with LMA acceptance was recorded.Probit analysis was used to calculate the EC50 of propofol inhibiting responses to LMA insertion.Results Compared with group C,the satisfactory rates of sedation and LMA acceptance were significantly increased,and EC50 of propofol inhibiting responses to LMA insertion was decreased in D1 and D2 groups (P＜0.05).Compared with group D1,the satisfactory rates of sedation and LMA acceptance were significantly increased,and the EC50 of propofol inhibiting responses to LMA insertion was decreased in group D2 (P＜0.05).Conclusion Dexmedetomidine 1 and 2 μg/kg administered intranasally both can decrease the EC50 of propofol inhibiting responses to LMA insertion in the pediatric patients,and 2 μg/kg produces better efficacy.

Objective To improve the accuracy and completion rate of long range video electroencephalogram ( V-EEG) in children with epilepsy, strengthen the pediatric patients′coordination ability during V-EEG, and make the parents more satisfied. Methods Pediatric patients who were checked by long-range V-EEG from April 2014 to March 2015 were chronologically divided into experimental group ( n=169 ) and control group ( n =142 ) . The patients of experimental group were cared by unified nursing intervention while the patients of control group were implemented traditional nursing. Contrast was implemented between two groups according to leads and electrode off, sleep deprivation situation, completion of provocation test, rash and trauma. Results After the implementation of V-EEG monitoring nursing regulations, the incidences of leads off, artifact, failure of sleep deprivation, and trauma were lower than those of the control group (P<0. 05); the cooperation of children having hyperventilation increased in the experimental group with low failure rate of opening and closing eyes stimulation and flush stimulation (P<0. 05). The parent′s satisfaction increased from 78.87% to 94.08% (P <0. 01). Conclusions Standardized nursing can effectively improve the quality of V-EEG monitoring, decline the incidence of artifact, make the V-EEG report more accurate and completed, and promote parent′s satisfaction.

OBJECTIVETo examine the protective effect of Ginkgo biloba leaf extract (GbE) on learning and memory deficit induced by aluminum chloride (AlCl(3)), and explore its mechanisms.

METHODSThe rat models with learning and memory deficit were induced by administering via gastrogavage and drinking of AlCl(3) solution. And the model rats were treated with GbE at the dose of 50, 100, 200 mg/kg every day for 2 months accompanied with drinking of AlCl(3) solution, respectively. Their abilities of spatial learning and memory were tested by Morris water maze, and the acetylcholinesterase (AChE) activity in serum was assayed with chemical method, the AChE expression in hippocampus was observed by immunohistochemistry assay, and then quantitative analysis was done by BI 2000 image analysis system.

RESULTSLearning and memory deficit of rats could be induced by AlCl(3) solution (P < 0.01), and AChE expressions in rats hippocampus were increased (P < 0.01); GbE ameliorated learning and memory deficit and reduced AChE expression in rats hippocampus in a dose-dependent manner, while GbE significantly increased serum AChE activity at the dose of 200 mg/kg each day (P < 0.05).

CONCLUSIONGbE can ameliorate learning and memory deficit induced by AlCl(3), which may be due to its inhibition of the AChE expression in hippocampus.

Acetylcholinesterase ; metabolism ; Aluminum Compounds ; toxicity ; Animals ; Chlorides ; toxicity ; Dose-Response Relationship, Drug ; Ginkgo biloba ; Hippocampus ; enzymology ; Immunohistochemistry ; Male ; Maze Learning ; drug effects ; Memory Disorders ; chemically induced ; prevention & control ; Neuroprotective Agents ; therapeutic use ; Phytotherapy ; Plant Extracts ; therapeutic use ; Plant Leaves ; Plant Structures ; Rats ; Rats, Wistar ; Reaction Time

Objective To explore the effect of carvedilol on ACE2 gene and protein expression in chronic heart failure rats after myocardial infarction.Methods The heart failure model was induced by acute myocardial infarc- tion (AMI) through ligating the left anterior descending coronary artery.One month after operation,rats were randomized to receive placebo or carvedilol 2 mg/(kg?d),by gavage.Sham-operated rats were used as the control group.Hemodynamies,body mass and left ventrieular mass index,plasma and myocardial level of angiotensin Ⅱ were determined.ACE2 gene and protein expression was assessed by using RT-PCR and Western Blot.Results The mortality of placebo and Carvedilol groups were 20%,compared with 0% in sham operated rats.Carvedilol significantly improved LVEDP,LVSP,+dp/dt_(max) and-dp/dt_(min) in CHF rats but all the hemodynamics data were still inferior than that of controls.Plasma and myocardial angiotensin Ⅱ level were increased significantly in CHF placebo rats than those of control rats (plasma Ang Ⅱ:CHF:194?19 vs controls:132?15 ng/L,myocardium Ang Ⅱ:CHF:6.7?0.4 vs control:3.8?0.3 ng/g,P

The in-vitro fertilization and embryo transfer technique has been widely applied in human insemination. The rate of successful insemination is gradual y rising, and the in-vitro fertilization directly determine the insemination outcome.
OBJECTIVE:To evaluate the difference between the two common using insemination methods, microdrop and open, in in-vitro fertilization and embryo development.
METHODS:A randomized study was conducted to compare microdrop and open insemination methods among non-male factor patients undergoing in-vitro fertilization and embryo transfer. A total of 1 175 cases were enrol ed in the research. There were 573 cases in the microdrop group, and 602 cases in open insemination group. The fertilization rate and embryo development in the two groups were compared.
RESULTS AND CONCLUSION:The fertilization failure rate [total fertilization failure rate+low fertilization rate (<25%oocytes fertilized)] in the microdrop insemination group was higher than in the open insemination group (11.9%, 3.3%, P<0.001), while the good quality embryo rate and pregnancy rate did not differ significantly between the two groups (al P>0.05). The open insemination method is a simple insemination method with a lower fertilization failure rate. As the fertilization is a highly complicated process involving many extrinsic and intrinsic factors, further study is needed to confirm the effects of the two insemination methods on in-vitro fertilization outcome.