Objective To investigate the effects of methylprednisolone on lung function and inflammation during one-lung ventilation in patients undergoing pulmonary lobectomy.Methods Sixty patients (46 males, 10 females, aged 18-60 years, ASA grade Ⅰ or Ⅱ) scheduled for pulmonary lobectomy were randomly divided into two groups (n=30 each) using a random number table: the control group (group C) and the methylprednisolone group (group M).Patients in group M were treated with methylprednisolone before induction of anesthesia within 30 min, whereas patients in group G received equal volume of normal saline at the same time.The heart rate (HR), mean arterial pressure (MAP), peak airway pressure (Ppeak), plateau airway pressure (Pplat), and dynamic lung compliance (Cdyn) were recorded at the momment before OLV (T1), 30 min after OLV (T2), 1 h after OLV (T3), 10 min after resuming two-lung ventilation (T4) and the end of the surgery (T5).The arterial blood gas analysis were performed at the above time points in order to determined the oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2), then the oxygenation index (OI), alveolar to arterial difference of oxygen tension (A-aDO2) and respiratory index (RI) of each patient was evaluated.The concentration of serum TNF-α, IL-6 and IL-10 were determined by ELISA at T0, T4, 6 h (T5) and 24 h (T6) after surgery using venous blood samples.The incidence of pulmonary complications at 72 h after operation were also recorded.Results Compared with T0, the MAP and Cdyn was decreased, whereas the Ppeak and Pplat was increased significantly in both group at T1, T2 (P＜0.05), the OI was decreased and the A-aDO2, RI was increased significantly at T1-T4 (P＜0.05), and the concentration of serum TNF-α, IL-6 and IL-10 at T4-T6 was increased significantly in both group (P＜0.05).Compared with group C, the Cdyn was increased, the Ppeak and Pplat were decreased significantly in group G at T1, T2 (P＜0.05), the concentration of serum TNF-α and IL-6 were decreased, and IL-10 was increased significantly in group G at T4-T6 (P＜0.05).The incidence of postoperative pulmonary complications had no statistically signifcant differences between the two groups.Conclusion Methylprednisolone can significantly improve the pneumodynamics and lung compliance, alleviates the inflammatory responses, but have no significant effect on intrapulmonary oxygenation and gas exchange during one-lung ventilationin patients undergoing pulmonary lobectomy.

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.

In central nervous system only a limited number of vesicles exist in the presynaptic terminals. The size and fusion modes of the vesicles were particularly important because of their potential impact on neuronal communications. Efficient methods were needed to analyze the recycling kinetics of synaptic vesicle and the size of readily releasable pool (RRP). In this study, fluorescent dyes with different affinity for membranes (FM1-43 with high affinity and FM2-10 with low affinity) were used to stain the functional synaptic vesicles of cultured hippocampal neurons and the kinetics of vesicle recycling was measured. The results showed that the destaining proportion was larger for FM2-10 than that for FM1-43 during the first trial, while it was greater for FM1-43 than FM2-10 during the second and third trials (first round, 93.0%+/-5.9% versus 57.9%+/-3.5% for FM2-10 and FM1-43, respectively, P<0.0001; second round, 1.4%+/-3.8% versus 24.0%+/-2.3%, P<0.0001; third round, 2.3%+/-1.6% versus 8.6%+/-1.5%, P=0.005). The results indicated that rapid endocytosis existed not only in the first round but also occurred when the vesicles were reused. Moreover, Both high-frequency stimuli and hypertonic sucrose stimuli were used to estimate the RRP sizes in the mix cultured hippocampal inhibitory neurons at 13-14 days in vitro (DIV). We found that the RRP size estimated by hypertonic sucrose stimuli [(200+/-23.0) pC] was much larger than that estimated by high-frequency stimuli [(51.1+/-10.5) pC]. One possible reason for the discrepancies in RRP estimates is that in mix cultured conditions, one neuron may receive inputs from several neurons and hypertonic sucrose stimuli will cause RRP of all those neurons release, while using dual patch recording, only the connection between two neurons was analyzed. Thus, to exclude out the impacts of inputs numbers on RRP sizes, it is more reasonable to use high-frequency stimuli to estimate the RRP size in mix cultured neurons.
Cells, Cultured ; Endocytosis ; Hippocampus ; cytology ; Neurons ; physiology ; Synaptic Vesicles ; physiology

AIM: To determine the concentration of escitalopram in human plasma by HPLC-MS/MS and investigate the pharmacokinetics of escitalopram. METH-ODS: The method involved protein precipitation with methanol. The chromatographic separation was achieved within 6.0 min by using methanol-water with 15 mmol·L-1 ammonium acetate-formic acid (72:28:O.1, v/v/v) as mobile phase and a Lichrospher CN 150 mm×4.6 mm analytical column. The analytes were detected using an electrospray ionization tandem mass spectrometry in SRM mode. Detection of the ions was performed by monitoring the transitions of m/z 325.0 to 234.0 for escitalopram and m/z 409.1 to 238.1 for amlodipine (intemal standard), respectively. RESULTS:The standard curve was linear ( r = 0. 999) over the concentration range of 0.20 - 50.00 ng· ml- 1. Accuracy and precision were below the acceptance limits of 15%. The recoveries of escitalopram ranged from 96.0% to 103.6%. The lower limit of quantification for escitalopram was 0.20 ng· ml-1 using 200 μl plasma sample.The pharmacokinetic parameters of escitalopram after a single oral dosing of escitalopram oxalate tablet (10 rog)to ten healthy male volunteers were achieved. The Cmax, Tmax, AUC0-t, AUC0-∞, t1/2 and Ke of escitalopram were 9.21±2.10 ng·ml-1 , 3.75±1.04 h, 514.6±152.3 ng·h·ml-1 ,540.5±162.3 ng·h·ml-1 , 34.06±7.71 h and 0.021±0.004 h-1,respectively. CONCLUSION:The determination of concentration of escitalopram in human plasma by HPLC-MS/MS method was repid, sensitive and reliable. It can be used for clinical pharmacokinetic study of escitalopram.

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.

BACKGROUNDSeveral randomized controlled trials (RCTs) have compared endoscopic and symptomatic relapses in patients with erosive gastroesophageal reflux disease (GERD). We have summarized current evidence for rabeprazole 10 or 20 mg once daily for GERD maintenance treatment over 1 or 5 years.

METHODSMEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched, through August 2012, for eligible RCTs of adults with erosive GERD. The efficacies of rabeprazole 10 and 20 mg/d were compared.

RESULTSThe search identified 288 citations, and five RCTs containing 1480 patients were considered eligible. Heartburn relapse rates did not differ significantly between patients treated with rabeprazole 10 and 20 mg/d for 1 year (relative risk (RR) = 1.29; 95% confidence interval (CI): 0.97-1.72), but differed in patients treated for 5 years (RR = 1.274; 95% CI: 1.005-1.615). Endoscopic relapse rates differed significantly between rabeprazole 10 and 20 mg/d for 1 year (RR = 1.92; 95% CI: 1.21-3.06), for 5 years (RR = 1.667; 95% CI: 1.073-2.589), and in combined 1- and 5-year maintenance trials (RR = 1.785; 95% CI: 1.298-2.456).

CONCLUSIONRabeprazole 20 mg/d was superior to rabeprazole 10 mg/d in preventing endoscopic relapse of erosive GERD, but that the two dosages were equivalent in symptomatic relief over 1 year.

Dose-Response Relationship, Drug ; Gastroesophageal Reflux ; prevention & control ; Humans ; Proton Pump Inhibitors ; therapeutic use ; Rabeprazole ; therapeutic use ; Randomized Controlled Trials as Topic ; Recurrence

Objective: To compare therapeutic effect and safety of dabigatran and warfarin anticoagulant therapy during catheter ablation in patients with atrial fibrillation (AF). Methods: Clinical data of 325 AF patients, who received catheter ablation in our hospital from Jan 2011 to Aug 2014, were retrospectively analyzed. According to perioperative anticoagulant therapy plan, patients were divided into dabigatran group (n=187) and warfarin group (n=138). General data, international normalized ratio (INR), activated coagulation time (ACT), success rate of pulmonary vein isolation (PVI), operation time and incidence rate of complications were compared between two groups. Results: Compared with warfarin group, there were significant reductions in percentages of diabetes mellitus (20. 3％ vs. 11. 8％), chronic heart failure (19. 6％ vs. 10. 2％) and left atrial diameter [(47±10) mm vs. (44± 9) mm]in dabigatran group, P＜0. 05 or＜0. 01. INR of dabigatran group was significantly lower than that of warfarin group [(1. 3±0. 3) vs. (2. 4±0. 4), P=0. 001], and there were no significant difference in ACT, success rate of PVI and operation time between two groups (P＞0. 05 all). Incidence rate of main complications in dabigatran group was significantly lower than that of warfarin group (0. 5％ vs. 5. 1％, P=0. 025). Conclusion: Compared with warfarin, there is significant reduction in INR and incidence rate of main complications during catheter ablation in dabigatran group, which is worth extending.

AIMTo assess the parameters of cardiac structure and function of male Balb/c mice by the echocardiography.

METHODSA total of 27 male Balb/c mice (from five to seven week old) were examined with a 13-MHz transthoracic linear-array transducer, hearts were removed from mice anesthetized with Nembutal, and the left ventricular (LV) mass were weighed.

RESULTSComplete 2-dimensional echocardiography for cardiac structure and function were obtained. Hemodynamic parameters were recorded. A correlation existed between LV weight (x) and echocardiographic LV mass (y) with the 2D) guided M-mode method: y = 1.15x + 3.26, (r = 0.80).

CONCLUSIONEchocardiography appears to be a promising approach for noninvasively assessing LV mass and function in mice.

Animals ; Echocardiography ; Heart ; physiology ; Heart Ventricles ; diagnostic imaging ; Male ; Mice ; Mice, Inbred BALB C ; Ventricular Function, Left

OBJECTIVETo investigate the association between Arg16Gly polymorphism of beta(2)-adrenergic receptor (ADRB2) gene and blood pressure levels.

METHODSA total of 487 hypertensive individuals were recruited from YueXi county of Anhui province. 672 patients' parents and siblings were also invited to take part in the study and used as genomic control. Blood pressure was measured and a standardized questionnaire regarding social-economic characteristics, general health status, occupational history and life-style and dietary factors was administered for each participant. The ADRB2 Arg16Gly polymorphism was genotyped by using a PCR-Restriction Fragment Length Polymorphism (RFLP) method. The association between the ADRB2 polymorphism and hypertension in hypertensive adults was determined by utilizing a family-based association test analysis.

RESULTSIn this study population, carriers of the ADRB2 Arg16 allele had lower systolic (P < 0.01) and diastolic (P < 0.01) blood pressure, suggesting that the genetic effect on blood pressure was more likely to fit an additive model.

CONCLUSIONOur results suggest a probable association between Arg16Gly polymorphism of ADRB2 gene and hypertension.

Adult ; Asian Continental Ancestry Group ; genetics ; Blood Pressure ; China ; epidemiology ; Female ; Genotype ; Humans ; Hypertension ; epidemiology ; genetics ; Male ; Middle Aged ; Pedigree ; Polymorphism, Single Nucleotide ; Receptors, Adrenergic, beta-2 ; genetics ; Young Adult

AIM:To observe the effects of trimetazi- dine on myocardial ischemia and heart rate variability (HRV)in patients with non ST-elevation acute coronary syndrome(NSTEACS).METHODS:74 patients with NSTEACS were chosen and randomly assigned into two groups:one group was given conventional therapy with as- pirin,isosorbide mononitfate,fluvastatin and metoprolol, trimetazidine was added on the base of conventional thera- py in the other group.The total observation time of thera- py was 8 weeks.The heart rote,blood pressure,frequen- cy and persistence time of chest pain,numbers of times of using Nitroglycerin every day,the extent anti degree of myocardial isehemia,HRV of patients were observed be- fore and after treatment.RESULTS:The therapeutic ef- fect of trimetazidine treatment group(with the effective rate 94.4%,excellence rate 72.2%)was obviously bet- ter than that of the conventional treatment group(with the effective rate 65.8%,excellence rate 36.8%)(P