Objective To investigate the effects of isoflurane and sevoflurane at the same dose on expression of Caspase-3 of primary somatosensory cortex (SI) and expression of micmmbule associated protein 1B (MAP1B)in cortical neuronsin neonatal SD rats.Methods Fifty-five neonatal SD rats at postnatal day 7 (eleven rats each litter,altogether 5 litters)were assigned randomly into control group(C group),isoflurane group (I group)and sevoflursne group(S group)in average.The rats in I group,S group or C group were exposed to 1.1% isoflurane or 1.8% sevoflurane (equivalent to 0.5MAC)or air 4h.The brain of neonatal rats were perfused and embedded by paraffin,Caspase-3 positive expression in the SI cortex of brain was detected by immunohistochemistry staining.Besides,the fresh cortex was dissected at O h in C group and at 2h,4h in I group and S group,microtubule associated protein 1 B expression was detected by West blot staining.Results Caspase-3 positive cells in the SI cortex were increased by 561.23%in I group(t=4.45,P<0.01)and 194.46% in S group(t=5.17,P<0.01)when compared with C group,and increased by 124.45% in I group(P<0.05)when compared with S group.The MAP1B protein was increased by 557.15%at 2h(t=16.54 P<0.01)and 475.21% at 4h(t=32.97,P<0.01)in I group while increased by 693.11%at 2h(t=9.45,P<0.001)and 268.15% at 4h(t=2.79,P=0.049) in S group when compared with C group.In S group,MAP1B protein at 4h reduced by 53.65%(P<0.01) when compared with that at 2h.Conclusion 0.5 MAC isoflurane can induce more apoptosis in the cortex in the neonatal rats'brain at postnatal day 7 than sevoflurane.They can both significantly promote the expression of MAP1B in the cortex to start the self-reparation.

Objective To evaluate experience for early diagnosis of pulmonary tembolism alter thoracic injury or surgery. Methods The 9 patients after thoracic injury or surgery with highly-suspected pulmonary embolism underwent chest radiograph of X-ray, helical CT pulmonary angiography, electrocardiogram, radionuclide pulmonary ventilation perfusion imaging, D dimer assay and arterial blood gas analysis respectively and the clinic data and results were analyzed. Results All patients were diagnosed and recovered after 8 patients received thrombolytic therapy and another patient received anticoagulant therapy. Conclusion If there were some symptoms such as suddenly severe dyspnea, cyanosis, with/without chest pains and the feeling of fear to death unable to be explained by original disease on those patients alter thoracic injury or surgery, it's very important for pulmonary embolism to be recognized, and early diagnosis and quickly efficient treatment is the key to prevent death. Helical CT pulmonary angiography is a safe, cheap, noninvasive and effective method for the diagnosis of pulmonary embolism with high sensitivity and specificity.

OBJECTIVE:To provide the new idea for clinical pharmacists providing pharmaceutical care in oncology depart-ment. METHODS:Applying the principles and methods of clinical pathway,the pharmaceutical care of anti-tumor drugs could be divided into before medication,during medication,after medication and patient education,according to the sequence of taking med-icine. On the basis of evidence-based medicine,the care contents of each unit were established,and the pharmaceutical care path-way (PCP) was formed. During chemotherapy duration for a breast cancer metastasis patient with liver function injury,clinical pharmacists conducted pharmaceutical care for drug pretreatment,ADR monitoring and disposal,patient education,as well as put forward the proposal of drug treatment as supplementing calcium,adjusting the dose of epirubicin and paclitaxel targeting on PCP of zoledronic acid,epirubicin and paclitaxel. RESULTS:Physicians adopted the pharmacist’s recommendations. The patient suf-fered from joint and muscle pain during chemotherapy,and the symptom was relieved after symptomatic treatment by celecoxib;chest and back discomfort was relieved significantly after chemotherapy,and the disease condition kept stable. The patient was dis-charged from the hospital. CONCLUSIONS:PCP focus on the time,content and countermeasures of pharmaceutical care,the pro-gram and treatment results of pharmaceutical care,and promote standardization,formalization,simplification and procedure of pharmaceutical care. Clinical pharmacists conduct individualized pharmaceutical care rapidly targeting on PCP so as to deepen the communication of clinical pharmacists with physicians,nurses and patients,and promote the development of pharmaceutical care smoothly.

AIM:To investigate the changes of connexin 43 (Cx43) via establishing a model of sympathomi-metic atrial fibrillation ( AF) .METHODS:The mongrels ( n=15) were randomly divided into control group , rapid atrial pacing (RAP) group and isoprenaline (ISO) perfusion+RAP group (ISO+RAP group).All mongrels’ hearts were taken out rapidly by median sternotomy to establish the cardiac model with Langendorff perfusion in vitro.The atrial effective re-fractory period ( AERP) and AF inducability were tested .The expression and distribution of tyrosine hydroxylase ( TH) were analyzed by immunohistochemistry .Total protein level of Cx 43 and phosphorylation of Cx 43 were determined by West-ern blot.The distribution of Cx43 were also observed by immunofluorescence staining .The cell apoptosis was analyzed by TUNEL staining.The generation of reactive oxygen species ( ROS) in the mitochondria was measured by fluorescence spec-trophotometry .RESULTS:No significant change of AERP was found between control group and RAP group , while that in ISO+RAP group was significantly decreased (P<0.05) and induced AF.Compared with control group, the expression of TH, apoptotic index and the generation of ROS increased gradually (P<0.05), while the content of Cx43 decreased grad-ually both in the total protein and the phosphorylation levels in RAP group and ISO +RAP group (P<0.05).The fluores-cence intensity of Cx43 was also attenuated and Cx43 were lateralized apparently in RAP group , while Cx43 were character-ized as punctate distribution in ISO +RAP group.CONCLUSION:Sympathetic nerves may activate autophagosome at in-tercalated discs and trigger cell apoptosis , resulting in remodeling and downregulation of Cx 43 via oxidative stress , thus having effects on mediating and maintaining AF .

Objective To make comparisons of the three models of acute and chronic rheumatic carditis to find out an optimal animal model.Methods AntigenⅠwas a emulsifier mixed by complete freund’ s adjuvant( CFA) and Group A streptococcus(GAS).AntigenⅡwas mixed by incomplete freund’s adjuvant(IFA) and GAS.Female Lewis rats were randomly divided into four groups: A, B, C treatmeat groups were immuned with antigenⅠat the foot pad firstly. Subsequently, rats in group A、B、C were injected antigenⅠ, antigenⅡand activated GAS respectively to make the models of RHD.Rats in control group D were immunized with the same protocol outlined as treatment groups but without GAS. Respectively 7, 12, 24 weeks the rats were sacrificed 24 ( each group was 6).The blood biochemical item and Hematoxylin-eosin( HE) staining of hearts were detected.Results In group C the mortality was 25%.In group A, the incidence of carditis was the highest.Histopathological manifestations of group A, C was not only revealed acute damage such as inflammatory cell infiltrate as well as group B, but also the Aschofflike cells in the myocardial cells interstitial.But in group A and C there had a great degree of the inflammatory cells infiltration than group B.At 24th week rats in group A detected the rate and degree of valve fibrosis in chronic damage were higher than group B and C.None of rats in group D presented carditis or valvulitis.Conclusion In group A, giving the GAS with continuous stimulation after using the mixed emulsification of CFA and GAS to immune Lewis rats for five times was a appropriate method which could provide an optimal animal model for experimental study of acute and chronic rheumatic heart disease.

Objective To explore the effectiveness of a respiratory function training instrument with stable chronic obstructive pulmonary disease (COPD) patients.Methods Sixty-seven COPD patients in the stable period were randomly divided into a treatment group of 36 and a control group of 31 using a random number table.Both groups were given conventional pulmonary rehabilitation,including half-closed lip respiration,abdominal respiration and upper limb training.The treatment group was additionally provided with 30 minutes of respiratory training using a respiration function training instrument 5 times per week for 6 months.Both groups were assessed for their mobility,life quality and pulmonary function using the 6-minute walk test (6 MWT),a COPD assessment test (CAT),the BODE index,forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and surface electromyography (SEMG) of the respiratory muscles before and after the 6-month intervention.Results Before the treatment there were no significant differences between the two groups in terms of any of the measurements.After the treatment,significant improvement was observed in the average 6 MWT,CAT,BODE index and SEMG results in both groups,but with significantly greater improvement in the treatment group.The average FVC and FEV1 results did not improve significantly,so after the intervention there was still no significant difference between the groups.Conclusions Respiratory training using the pulmonary function training instrument can improve the mobility,life quality and the functioning of the respiratory muscles of COPD patients in the stable period.

Aim To study the influence of estradiol on peripheral blood stem cells and angiogenesis in a rat model of myocardial infarction.Methods Acute myocardial infarction(AMI)model was bulit by ligation of left anterior descending coronary in ovariectomized SD rats.Then,they were treated with different doses of estradiol benzoate.CD34+ cells in myocardium at 24 h after AMI were detected by immunohistochemistry,and CD34+ cells in peripheral blood were measured by flow cytometry on day 1,3 and 7 after AMI.The expression of stromal cell-derived factor-1(SDF-1)in myocardium on day 1,3 and 7 after AMI and capillary density in myocardium at 28 days after AMI were evaluated by immunohistochemistry.Results CD34+ cells in peripheral blood and myocardium,the expression of SDF-1 and capillary density at 4 weeks after AMI in ovariectomized rats were obviously lower than those in ovary intact rats.However,after indication with different doses of estrogen,CD34+ cells in peripheral blood and myocardium,the expression of SDF-1 and microvascular density were increased in ovariectomized rats with AMI,this effect was strongest especially in estrogen replacement therapy group.Conclusions Estrogen could improve the mobilization and homing of bone marrow stem cells into myocardium,increase capillary density and improve prognosis after AMI,and this mechanism could be mediated by promotion of expression of SDF-1 in myocardium.Moreover,the effect of estrogen replacement before AMI was better than estrogen therapy after AMI.

Objective To evaluate the feasibility and establish the corresponding scanning plan through the clinical application of low-dose CT on diagnostic imaging for 111 AIDS patients with pnenmocystsis carinii pneumonia (PCP)and normal weight .Methods The thesis applied American GE(General Electric Company )FII double-row spiral CT scanner and the kV value is fixed to be 120 kV with the conventional dose (automatic mAs) and low-dose scanning applied respectively during the diagnosis .Meanwhile ,the low-dose scanning was carried out randomly in 50 mAs(50 mAs group) ,40 mAs(40 mAs group) and 30 mAs(30 mAs group) ,and then ,the iconographical imaging quality and radiation dose were analyzed ,the respective low-dose scanning plans was formulated at last .Results The high-quality film ratios for conventional close and 50 mAs group were 70 .3% and 62 .2% respectively ,and the good film ratios were 29 .7% and 37 .8% ,while no poor films occurred in both groups .The high-quality film ratios for conventional close and 40 mAs were 67 .6% and 56 .8% ,the the good film ratios were 32 .4% and 43 .2% and no poor films ,either .The high-quality film ratios for conventional close and 30 mAs were 70 .3% and 56 .8% ,the good were 29 .7% ,43 .2% and no poor films showed between both groups .From the results ,the consequential imaging films mainly show high and good quality ,all films meet the imaging diagnosis requirements and the difference are not statistically significant (P> 0 .05) .The radiation doses of conventional dose and low dose scanning (50 mAs ,40 mAs and 30 mAs groups) were 7 .6 mGy ,2 .6 mGy ,2 .1 mGy and 1 .5 mGy respectively , while the least radiation doses was for 30 mAs group and the corresponding dose is only 19 .8% of the original .The results from 111 patients applied conventional dose (automatic mAs) and low dose scanning all meet the imaging diagnosis requirements without any missed or erroneous diagnosis .Conclusion The chest low-dose CT scanning for AIDS patients with PCP and normal weight can fully meet the clinical diagnosis and treatment ,so it is practical and feasible .Meanwhile ,the conventional-dose scanning can be ap-plied at first and low-dose CT scanning later for reexamination to ensure the stability of image quality .For low-dose chest CT scan-ning ,the voltage fixed is 120 kV and the current 30 mAs .

Objective: To explore the expression of myocardial levels of connexin 43(Cx43), Cx40 in experimental dog model of sympathomimetic atrial fibrillation (AF). Methods: 15 mongrels dogs were randomly divided into 3 groups: Control group, Rapid atrium pacing (RAP) group and RAP+isoprenaline (ISO) perfusion group. n=5 in each group. The hearts were taken to establish in vitro langendorff cardiac perfusion model. Atrial effective refractory period (AERP) and AF inducing rate were tested;intracellular expression and distribution of nerve growth factor (NGF) and tyrosine hydroxylase (TH) were examined by immunohistochemistry, total protein contents of Cx43 and Cx40 were measured by Western blot analysis, mitochondria morphology was observed by transmission electron microscope and mitochondria reactive oxygen species (ROS) generation was detected by fluorescent colorimetric method. Results: AERP was similar between Control group and RAP group (166±5.1) ms vs (160±3.2) ms which cannot induce AF; while it was shortened in RAP+ISO group (148±3.7) ms, P<0.05 which may successfully induce AF.Compared with Control group, mitochondria was slightly swollen in RAP group and the matrix was intact, while mitochondria was obviously swollen in RAP+ISO group and part of matrix was transparent; total protein contents of Cx43 and Cx40 were lower in both RAP group and RAP+ISO group, P<0.05; in addition, they were even lower in RAP+ISO group than RAP group, P<0.05. Compared with Control group and RAP group, RAP+ISO group had increased expression and distribution of NGF, TH and mitochondria ROS generation, P<0.05; NGF, TH and ROS in RAP group were higher than Control group, P<0.05. Conclusion: Sympathetic AF has been related to the contents and changes of myocardial levels of CX43 and Cx40; sympathetic nerve might trigger AF by oxidative stress induced down-regulation of myocardial CX43 and Cx40 in experimental dog model.

Objective    To compare the surgical efficacy of Da-Vinci robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC). Methods    Online databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM from inception to 18 February, 2022 were searched by two researchers independently. The references of related studies were also searched to re-enroll the potential studies. The quality of the studies was evaluated with Newcastle-Ottawa Scale (NOS). The meta-analysis was performed by RevMan 5.3. Results     A total of 43 studies including 33 089 patients were enrolled in the final study. The NOS scores of the included studies were ≥6 points. The results of meta-analysis showed that the operation time was longer [MD=8.50, 95%CI (1.59, 15.41), P=0.020], the blood loss was less [MD=−46.58, 95%CI (−62.86, −30.29), P<0.001], the dissected lymph nodes stations were more [MD=0.67, 95%CI (0.40, 0.93), P<0.001], the dissected lymph nodes were more [MD=2.39, 95%CI (1.43, 3.36), P<0.001], the conversion rate was lower [OR=0.52, 95%CI (0.46, 0.59), P<0.001], the time of chest tube drainage was shorter [MD=−0.35, 95%CI (−0.58, −0.11), P=0.004], the length of hospital stay was shorter [MD=−0.32, 95%CI (−0.45, −0.19), P<0.001], and the recurrence rate was lower [OR=0.51, 95%CI (0.36, 0.72), P<0.001] in the RATS group than those in the VATS group. The rate of overall postoperative complications [OR=0.95, 95%CI (0.89, 1.01), P=0.110] and postoperative mortality rate [OR=0.85, 95%CI (0.62, 1.16), P=0.300] were not significantly different between the two groups. Conclusion    Compared with VATS, although RATS prolongs the operation time, it does not increase the incidence of postoperative complications and mortality rates. Moreover, RATS can dissect more lymph nodes, effectively control intraoperative bleeding, shorten the duration of chest drainage tube indwelling and shorten the postoperative hospital stay to a certain extent.