AIM: To observe dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section.METHODS: According to the dosage of 0.75% ropivacaine,120 full-term and single-birth puerperants were randomly divided into four groups of 30 people each.The dosage of group Ⅰ,Ⅱ,Ⅲ and Ⅳ were 1.5,1.8,2.1 and 2.4 mL respectively.The sensory and motor block of each group within 30 minutes after the injection were observed,and the hemodynamic changes and adverse effects were recorded.RESULTS:(1) Within 30 minutes after the injection,the intermediate zone of pain disappeared highest block level of group I-IV were T10,T8,T6 and T5 respectively.(2) During the period of the first 30 minutes,there were 3 cases in group Ⅲ(10%) and 8 cases in group Ⅳ(27%) appeared chest distress and dyspnea,and the blood pressure of 5 cases in group Ⅲ(17%) and 12 cases in group Ⅳ(40%) dropped to 90 mm Hg(1 mm Hg=0.133 kPa).There were significant difference compared with group IV(P0.05),there were significant difference between group IV and other groups(P

Objective: To observe the effect of valsartan and amlodipine on the reduction of blood pressure in aged hyperpietic patients,as well as on the improvement of left ventricular diastolic function,endothelium function and insuline resistence. Methods: We divided 40 cases of aged hypertension patients(1 to 2 grade) into Valsartan and Amlodipine groups at random,giving valsartan 80-160 mg or amlodipine 5-10 mg,respectively,for 12 weeks as a treating period.We measured the blood pressure twice a week,observed the differences of blood pressure and heart rate before and after the treatment,as well as the changes of insuline sensitivity,left ventricular diastolic function and endothelium vascular disatolic function. Results and Conclusion: Both valsartan and amlodipine can effectivly reduce the blood pressure of aged hypertension patients(l to 2 grade).They can also improve the diastolic function,insuline resistance and endothelium dependent vascular diastolic function.

Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera?tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col?lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P<0.05).(1)In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction(POCD)were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper?ative depression in patients underwent CABG.(2)In PCI group, ratio of female gender, blood pressure, incidence of Diabe?tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa?tients underwent revascularization is high. Female is the dependent risk factor in both CABG group and PCI group. Com?pared with PCI, CABG had greater influence on development of depression in postoperative patients.

Objective To investigate the short-term outcome of vacuum sealing drainage (VSD) in the treatment of infection early after tibiofibular fracture surgery.Methods A retrospective analysis was performed on 19 patients sustaining early infection after tibiofibular fracture surgery from December 2012 to December 2014.The patients consisted of 13 males and 6 females,aged from 26 to 57 years [(37.0 ± 5.3) years].There were 4 cases of isolate tibial fracture,2 isolate fibular fracture,and 13 tibial and fibular fracture.Open fractures were noted in 13 cases and close fractures in 6 cases.Infection occurred 14-21 days [(18.0 ± 3.3) days] after open reduction and internal fixation and was treated with gentamicin and VSD.Parameters were monitored dynamically after operation,including white blood cell count (WBC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and limb perimeter.Results The wound was basically debrided 7-10 days after VSD.Eighteen cases had one-stage wound closure with instrumentation preservance,and one case with progressed infection from soft tissue to bone marrow had instrumentation removal and wound suture.VSD decreased markers of inflammation including WBC,CRP,and ESR as well as limb perimeter.A follow-up of 6-24 month [(11.0 ± 2.3)months] showed fracture healing,without complications of detectable deformity growth,dysfunction,or chronic osteomyelitis.Conclusion VSD results in sufficient wound drain,reduction of swelling,decreased levels in CRP and ESR and controlled wound infection,which facilitates wound closure.

Objective To investigate the gross tumor volume (GTV) changes in nonoperatively treated lung cancer patients during radiotherapy by off-line analysis using kilovoltage cone-beam computed tomography (KVCBCT).Methods Eighteen nonoperatively treated lung cancer patients were divided into group A (n =13) to receive conventional radiotherapy (1.8-2.2 Gy/fraction) and group B (n =5) to receive accelerated radiotherapy (5-8 Gy/fraction).Group A was further divided into subgroup A1 (n =10) and subgroup A2 (n =3) according to GTV changes.Each patient in group A underwent KVCBCT scan before treatment once a week,and each patient in group B underwent KVCBCT scan before each treatment.KVCBCT and CT images were registered in the treatment planning system to analyze GTV changes.Results Of all patients in group A,77％ showed ＞ 20％ GTV reduction.Subgroup A1 had the maximum GTV reduction in the 4th week of treatment (the 20th treatment) ;Subgroup A1 had a mean reduction of (0.94 ± 9.94)％,with a maximum value of-56.76％.Subgroup A2 showed no correlation between GTV changes and treatment time.Group B had a mean GTV reduction of (-7.41 ± 1.76)％,with a maximum value of -15.91％.Of all patients in group B,71％ showed ≤ 10％ GTV reduction.Small GTV changes were observed in group B.Conclusions There are no regular GTV changes in nonoperatively treated lung cancer patients during radiotherapy.Adaptive radiotherapy is recommended in the cases where GTV is reduced over 20％ in the 20th treatment.

ObjectiveTo investigate the safety, efficacy and therapeutic mechanism of focused ultrasound surgery (FUS) on focal epilepsy of brain functional area in cat. MethodsThe focal epileptic models in the cats' motor cortex by penicillin were established. The different techniques were apphed in the animals epilepsy model. FUS, cortex thermocoagulation and multiple subpial transaction (MST) were compared in seizure control and functional preservation by observing behavior and electroencephalogram ( EEG), and the therapentic mechanism was compared by analysis of histopathology in the damaged cortex. ResultsIn seizure control and EEG changes, three kinds of techniques were similar without prominent difference in statistics (P ＞ 0.05). The same pathologic changes were showed in FUS group and cortex thermocoagulation group, ischemic change and coagulative necrosis of superficial layer nerval cells.The major pathologic change in MST group was an irregular crevice which was vertical with the surface of the cortex. The edema and mild gliosis were found around the crevice. ConclusionsThe focused ultrasound can effectively destroy and cut off the association of cortical horizontal fibre, meanwhile, the cortical function still to be reserved.Therefore, FUS is safe and effective as well as MST and cortex thermocoagulation on focal epilepsy in brain functional area.

Objective To evaluate the contrast-enhanced 64-slice spiral CT(64-SCT) features and pathologic findings of coloniccancer comparatively.Methods 56 cases of colonic cancer underwent 64-SCT dynamic enhancement scans.All cases were classifiedaccording to 64-SCT features of arterial phase and then analysed pre-operatively with pathological comparation.Results There werecharacteristic manifestations on arterial phase of contrast-enhanced CT scan in all cases,the tumors with well differentiation appeared as slight-medial homongeneous enhancement in 23 cases,while undifferentiation tumors appeared as obviously inhomogeneous enhancement or layer-like enhancement in 33 cases.The tumors were classified according to their features on contrast-enhanced CT,the accuracy rate was 91.07%,the accuracy rate evaluated pre-operation was 92.86%.Conclusion 64-SCT dynamic scan has distinctive superiority in diagnosis and treatment of the colonic tumor.

AIM: The effects of selenium dioxide (SeO_2) on proliferation, apoptosis, intracellular reactive oxygen species (ROS) and Ca~(2+) levels in three leukemia cell lines NB4, K562 and HL-60 were investigated. METHODS: Three leukemia cell lines were treated with 3-30 ?mol/L SeO_2. Flow cytometry was used to detect apoptosis rate, and analyze the changes of ROS and Ca~(2+) level within cells. RESULTS: SeO_2 at 10 and 30 ?mol/L inhibited proliferation in three leukemia cell lines. Treatment with 30 ?mol/L SeO_2 for 48 h induced 54.0%, 46.5%, 49.6% apoptosis in NB4, K562, and HL-60 cells, respectively, and also markedly decreased ROS and Ca~(2+) levels among three cell lines. The rate of ROS positive cells in NB4 and HL-60 decreased with the increase in SeO_2 concentrations. ROS was clearly reduced with 30 ?mol/L SeO_2 in K562. Ca~(2+) levels were tardily declined with 10, 30 ?mol/L SeO_2 in NB4 and HL-60 cells. Ca~(2+) levels were clearly reduced with 30 ?mol/L SeO_2 in K562. CONCLUSION: SeO_2 induces apoptosis in three leukemia cells. The declines of intracellular ROS and Ca~(2+) levels are involved in apoptosis induced by SeO_2.

Objective To compare two different revascularization methods in type 2 diabetes mellitus (T2DM) patients with multivessel coronary artery disease treated by percutaneous coronary intervention (PCI) and coronary artery bypass graft ( CABG) .Methods T2DM patients with multivessel disease undergoing success-ful PCI or CABG were enrolled in the study .They were diagnosed by coronary angiography ( CAG) in Tianjin Chest Hospital from May 2009 to May 2010 whose.The patients were followed up for 3 years.The information of patients including physical performance , clinical features , and laboratory examination results were collected .The major ad-verse cardio cerebral events(MACCE)including death, myocardial infarction(MI), revascularization, angina pecto-ris, heart failure, and stroke were collected.Results During the 3 years of follow-up, MACCE(31.58% vs 17.68%, P<0.01), death(4.82%vs 1.10%, P<0.05), MI(4.39%vs 1.10%, P<0.05), angina pectoris (17.27%vs 10.50%, P<0.05)occurred more frequently in PCI group than in CABG group .Conclusion Evi-dences now tend to support CABG for revascularization in T 2DM patients with multivessel disease .

Objective To study the clinical value of color Doppler ultrasonography in the persistent sciatic artery.Methods The ultrasonographic images of eleven patients with persistent sciatic artery diagnosed by CT angiography or digital subtraction angiography were retrospective analyzed,the ultrasonographic features were summarized.Results The sciatic artery showed the enlarged internal iliac artery,which continued into the thigh in a posterior location,the sciatic artery described a tortuous course toward the knee,slowly filling normal-appearing popliteal artery in 8 cases,there were no connection with popliteal artery in 1 cases.The common femoral artery and superficial femoral artery was dysplasia in 7 patients,which was thinner than the popliteal artery.Conclusions The ultrasonography is the effective imaging method for diagnosis of the persistent sciatic artery.