Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each):the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.

The level of serum soluble interleukin-2 receptor(sIL-2R)was measured in 103 patientswith hepatitis B and 26 hepatitis B virus(HBV)carriers by enzyme-linked assay.The sIL-2Rconcentration were elevated significantly in each type of hepatitis B patients and HBV carriers,compared with control group(P

Objective To evaluate the effect of goal-directed fluid therapy on postoperative rehabili-tation in elderly patients undergoing surgery in the prone position.Methods Sixty patients of both sexes,aged 60-75 yr,of American Society of Anesthesiologists physieal status Ⅱ or Ⅲ,scheduled for elective lumbar surgery in the prone position under general anesthesia,were divided into 2 groups (n =30 each) using a random number table:conventional fluid therapy group (group C) and goal-directed fluid therapy group (group G).The CNAP system was used to monitor stroke volume variation and cardiac index continuously in group G.Mean arterial pressure was maintained at 60-110 mmHg,central venous pressure at 6-12 emH2O and urine volume more than 0.5 ml · kg-1 · h 1 using conventional fluid therapy in group C.In group G,goal-directed fluid therapy was performed under the guidance of stroke volume variation,and cardiac index was maintained at 2.5-4.0 L · min-1 · m 2.The requirement for crystalloid and colloid solution,total volume of fluid infu sed,blood loss,urine volume and requirement for vasoaetive agents were recorded during operation.After anesthesia induction,at 1 h after turning to the prone position and at the end of operation,blood samples were collected fromn the left radial artery for blood gas analysis,and the blood lactate concentration was recorded.The volume of drainage within 3 dlays after operation,perioperative blood transfusion,early postoperative cardiovascular and pulmonary complications,development of oliguria and anuria,emergence time and length of hospital stay were recorded.Results Compared with group C,the requirement for crystalloid solution,total volume of fluid infused,urine volume and requirement for vasoactive agents were significantly decreased during operation,the requirement for colloid solution was increased during operation,the blood lactate concentration was decreased at 1 h after turning to the prone position and at the end of operation,the length of hospital stay was shortened,and the incidence of postoperative cardiovascular and pulnonary eomplications was decreased in group G (P＜0.05).Conclusion Goal-directed fluid therapy can promote postoperative rehabilitation and shows a certain clinical value in elderly patients undergoing surgery in the prone position.

Objective:The present study was designed to test the hypothesis that inflammation is involved in the end-organ damage(EOD) induced by sinoaortic denervation(SAD) in rats.Method:SAD was performed in male Sprague-Dawley rats at the age of 10 weeks.Under anaesthesia,aortic nerves were cut and the sinus region of the carotid artery was stripped and painted with 10% phenol.Pathological evaluation of EOD and the determination of plasma or tissue levels of the factors related to inflammation,including thromboxane B2(TXB2) interleukin-1(IL-1),tumour necrosis factor α(TNF-α) and reactive oxygen species(ROS) were performed at 16 weeks after SAD.Pathological evaluation of EOD included heart weigh ratio,myocardial and blood vessel hydroxyproline and collagen volume fraction,glomerular injury score and number of infiltrating inflammatory cells.Indomethacin(20 mg/kg per day,orally) or vitamin E(100 mg/kg per day,orally) was administered for 12 weeks,beginning from4 weeks after SAD,to observe their effects on SAD-induced EOD.Results:There were significant fibrosis and inflammatory infiltration in the myocardium and blood vessels,represented by higher hydroxyproline and collagen volume fraction,and a large amount of inflammatory cells in the tissues of SAD rats.Heart weight and kidney glomerular injury score were significantly higher in ed significantly after SAD.Indomethacin and vitamin E significantly decreased the contents of some factors related to inflammation in SAD rats.Both drugs also alleviated myocardial and vessel fibrosis,inflammatory infiltration and kidney damage.Conclusion:Inflammation is involved in the organ damage induced by SAD in rats.

Objective:The present study was designed to test the hypothesis that inflammation is involved in the end-organ damage(EOD) induced by sinoaortic denervation(SAD) in rats.Method:SAD was performed in male Sprague-Dawley rats at the age of 10 weeks.Under anaesthesia,aortic nerves were cut and the sinus region of the carotid artery was stripped and painted with 10% phenol.Pathological evaluation of EOD and the determination of plasma or tissue levels of the factors related to inflammation,including thromboxane B2(TXB2) interleukin-1(IL-1),tumour necrosis factor α(TNF-α) and reactive oxygen species(ROS) were performed at 16 weeks after SAD.Pathological evaluation of EOD included heart weigh ratio,myocardial and blood vessel hydroxyproline and collagen volume fraction,glomerular injury score and number of infiltrating inflammatory cells.Indomethacin(20 mg/kg per day,orally) or vitamin E(100 mg/kg per day,orally) was administered for 12 weeks,beginning from4 weeks after SAD,to observe their effects on SAD-induced EOD.Results:There were significant fibrosis and inflammatory infiltration in the myocardium and blood vessels,represented by higher hydroxyproline and collagen volume fraction,and a large amount of inflammatory cells in the tissues of SAD rats.Heart weight and kidney glomerular injury score were significantly higher in ed significantly after SAD.Indomethacin and vitamin E significantly decreased the contents of some factors related to inflammation in SAD rats.Both drugs also alleviated myocardial and vessel fibrosis,inflammatory infiltration and kidney damage.Conclusion:Inflammation is involved in the organ damage induced by SAD in rats.

Objective To explore the clinical effect and application value of four-point internal fixation technique (internal fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique) for traumatic atlantoaxial instability.Methods A total of 16 patients with traumatic atlanto- axial instability,who had reducible atlantoaxial dislocation with reduction after traction and irreducible at- lantoaxial dislocation with traction reduction after anterior laxation,were treated with four-point internal fixation technique using autologous bone grafts.Results All patients' symptoms were improved to some extent,and no severe complications,such as injury of nerve blood vessels were found.All patients were followed up for 8-26 months (average 16 months).Bony fusion was obtained in all cases.The spinal cord function improvement was marked in 5 cases (31%),good in 8(50%),mild in 2(13%),but un- changed in 1 (6%).No deterioration occurred in all cases.There was no loosening or breakage of screws and clamps.Conclusion Fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique can atlain four-point internal fixation,and can provide three-dimensional stability of atlantoaxial complex and excellent biomechanics environment for bony fusion if the structure of the posterior arch of C_1-C_2 is intact.

Aged ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; immunology ; Prognosis ; T-Lymphocyte Subsets ; immunology

To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini-Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow-up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.
Anxiety ; Atropine ; Cognition ; Cognition Disorders ; Depression ; Depressive Disorder, Major ; Electric Stimulation Therapy ; Electroconvulsive Therapy ; Follow-Up Studies ; Humans

OBJECTIVETo observe the relationship of Chinese medicine (CM) syndrome pattern with heart function detected by ultrasonic cardiography and brain natriuretic peptide (BNP) level in patients with heart failure (HF).

METHODSOne hundred and sixteen inpatients of HF hospitalized in Dongfang Hospital from January, 2007 to January, 2009 were assigned to three groups according to their CM syndrome pattern differentiated, the qi-yin deficiency group (QYD), the qi-deficiency and blood-stasis group (QDBS) and the yang-deficiency with water overflowing group (YDWO). Ultrasonic cardiographic (USCG) parameters, including left ventricular end-systolic diameter (LVEDs), left ventricular end-diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected, and blood level of BNP was measured.

RESULTSLVEF was decreased while BNP was increased in patients with syndrome patterns in the order of QYD --> QDBS --> YDWO, and showed significant difference between groups (P < 0.01); CM syndrome patterns was related with all the USCG parameters and BNP level, especially the BNP (r = 0.71, P < 0.05) and LVEF (r = -0.34, P < 0.05).

CONCLUSIONLVEF and BNP can reflect the severity of heart failure, and they could be taken as the beneficial objective and quantitative indices for syndrome pattern differentiation.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Heart Failure ; diagnostic imaging ; metabolism ; physiopathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Stroke Volume ; physiology ; Ultrasonography ; Ventricular Function ; physiology ; Young Adult

AIMTo investigate the coordinated role and its mechanism of the high protein and hypercholesterol intake on inducing rat myocardial fibrosis.

METHODSThe tissue level of the collagen in left ventricule, the concentrations of the plasma and the cardiac tissue angiotensin II (Ang II) and Aldosterone (Ald), the serum concentration of nitrite (NO2-), in the Wistar rats on diet which adding 20% protein or/and 100 mg/d cholesterin in the rat standard foods for 8 weeks, were measured by the colorimetric analysis of the hydroxyproline, by the radioimmunoassay, and by the assay of Griess, respectively.

RESULTS1.69 times left ventricular collagen contents, 0.7 times plasma concentrations of total cholesterin, 1.5 times levels of the plasma Ang II and 1 time myocardial ald contents were higher, and the serum NO2- concentration was significant lower, in the rats of the high protein and hypercholesterol intake than in the rats of the high protein intake. That 0.48 times left ventricular collagen contents, 0.23 times plasma Ang II in the high protein and hypercholesterol intake rats were higher than in the high cholesterin intake rats.

CONCLUSIONThe excessive protein and cholesterin intake can induce the coordinated effect on developing the myocardial fibrosis of rats. And the mechanism of the fibrosis in rat left ventricule maybe result with the activation of RAAS and the endothelial injury.

Animals ; Cardiomyopathies ; etiology ; pathology ; Cholesterol, Dietary ; adverse effects ; Dietary Proteins ; adverse effects ; Fibrosis ; Male ; Myocardium ; pathology ; Rats ; Rats, Wistar