0.05) observed in short delivery time in induction-delivery (ID0.05) than the emergency group.There were significant (P

Objective:This study was to evaluate the effect of Ropivacaine for the spinal anaesthesia and the quality of analgesia and anaesthesia when clonidine was added.Methods:Spinal anaesthesia was administered to 32 ASA Ⅰ～Ⅱ degree adult patients who were randomly divided into two groups: Ropivacaine group [R=16] and Ropivacaine + Clonidine group .Data collected included;T10 spread time,maximum upper sensory level reached,and onset time and duration of zero power motor blockades,T12 regression time,pain onset time,and sedation score were also recorded.Results:The RC group onset of the T10 spread time was shorter,the maximum upper sensory level reached was higher,the onset time of zero power motor block was faster;The RC group anaesthetic regression time,the duration of zero power motor block,the time of pain onset was longer,and sedation scores was higher.Conclusion:Ropivacaine and ropivacaine combined with clonidine are sufficient to produce good sensory and motor blockade for lower abdomen and lower limb surgery under spinal anaesthesia.Addition of clonidine to Ropivacaine increase the anaesthetic potency by shortening onset time of sensation and motor block,increasing maximum upper sensory block level,prolonging regression time,and prolonging duration of the analgesic period as well as providing some sedation.

Objective To investigate the effects of acidic reperfusion on ischemia-reperfusion injury in isolated rat heart and the role of PI3K/Akt signaling pathway.Methods Seventy adult SD rats weishing 450-550 g were randomly divided into 7 groups(n=10 each):group Ⅰ ischemia-repedusion injury(X/R);groupⅡ ischemic post eonfioning(IPC);group Ⅲ acidic reperfusion(H+);group Ⅳ ischemie postconditioning+alkalotic nsperfusion(IPC+OH-);group Ⅴ alkalotic reperfusion(OH-);group Ⅵ acidic repeffusion+wortmannin (H+wort)and group ⅦVl wortmannin(wort).The animals were anesthetized with intraperitoneal(IP)urethane. Their chests were opened and hearts were excised and passively perfused in a Lsngendorff apparatus with KrebsHenseleit buffer(KHB)saturated with 95%O2-5%O2 at 37℃.The isolated hearts were made globally ischemic for 30 min followed by 120 rain reperfusion.Group II (IPC)WaS subjected to 6 cycles of 15 rain reperfusion and 15 min ischemia at the beginning of reperfusion. In group H+ and OH- (group Ⅲ ,Ⅴ ) the isolated hearts were perfused with KHB of pH 6.9 and 7.8 for 3 rain respectively at the beginning of reperfusion. In group IPC + OH( Ⅳ ) the isolated hearts were perfused with KHB of pH 7.8 for 3 rain followed by IPC. In group H + wort and wort ( Ⅵ,Ⅶ ) the isolated hearts were perfused with wortmannin 100 nmol/L in KHB of pH 6.9 and 7.4 for 3 min respectively at the beginning of reperfusion. LVEDP and ± dp/dtmax were measured before ischemia and at 30 min of reperfusion. Coronary effluent was collected for determination of NO concentration at 30 min of reperfusion. Lnfart size was measured at 120 rain of reperfusion. Results The LVEDP was decreased, ±dp/dt was increased, the infarct size was smaller and the NO concentration in coronary effluent was higher in group IPO and H+ compared with group I/R. Wortmannin abolished the protective effect of acidic reperfusion on isolated rat heart. Conclusion PI3K/Akt signaling pathway may be involved in the protective effects of acidic reperfusion on myocardium against ischemia-reperfusion injury.

Objective To investigate the effect of different methods of endotracheal catheter cuff inflation on cuff pressure and tracheal mucosal damage postoperatively .Methods 120 patients undergoing gynecological tumorectomy as a selective operation with general anesthesia were randomly divided into 3 groups with different methods of cuff inflation :finger kneading method ,spe-cialized cuff pressure meter ,and minimum closing volume method .The cuff pressure were measured by specialized cuff pressure gauge and the tracheal mucous membrane was examined by fibrolaryngoscope at the time of withdrawal of endotracheal tube .The cuff pressure and the tracheal mucosal change with different cuff inflation methods were compared .Results The average cuff pres-sure with finger kneading method(49 ± 11 .8 cm H2 O)was obviously higher than specialized cuff pressure meter group (27 ± 1 .5 cm H2O)and minimum closing volume method group(25 ± 2 .1 cm H2O) .The incidence of tracheal mucosal damage was obviously higher in the group with finger kneading method(87 .5% ) than other groups(20 .0% and 15 .0% respectively) .There were no obvi-ous differences in the incidence of tracheal mucosal damage between the rest two groups (P>0 .05) .Conclusion The cuff pressure in the finger kneading method was higher than the permitted value and it make the incidence of tracheal mucosal damage increase . The cuff inflation with specialized cuff pressure meter and minimum closing volume method can make the cuff pressure properly a-mong the permitted value and decrease the complications related to endotracheal intubation .

Objective To evaluate the role of nicotinamide phosphoribosyltransferase (Nampt in lipopolysaccharide (LPS)-induced myocardial injury in rats.Methods Forty male Sprague-Dawley rats,aged 12 weeks,weighing 210-230 g,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),LPS group and FK866 (specific Nampt inhibitor) group (group F).LPS 4 mg/kg was injected intraperitoneally in LPS and F groups,and then FK866 10 mg/kg was injected intraperitoneally in group F.At 6 h after the end of administration,the blood samples were taken from the abdominal aorta for determination of serum concentrations of cardiac troponin Ⅰ (cTnI).Then the animals were sacrificed and myocardial specimens were removed for determination of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),and malondialdehyde (MDA) contents,glutathion (GSH)/oxidized glutathione (GSSG) ratio,caspase-3 activity and apoptosis rate.Results Compared with group C,the levels of cTnI,TNF-α,IL-6,MDA and caspase-3 were significantly increased,and GSH/GSSG ratio was decreased in LPS and F groups.Compared with group LPS,the levels of cTnI,TNF-α,IL-6,MDA and caspase-3 were significantly decreased,and GSH/GSSG ratio was increased in group F.There was no significant difference in apoptosis rate among the 3 groups.Conelusion Nampt activation can induce inflammatory responses and oxidative damage and promote cell apoptosis,thus being involved in LPS-induced myocardial injury in rats.

Objective To investigate the preoperative diagnosis,surgical treatment and results of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).Methods We retrospectively analyzed the clinical data of 9 patients with ALCAPA who had undergone surgical treatment in Shanxi Children's Hospital from June 2010 to March 2014.Results There were 3 males and 6 females,aged from 4 months to 4 years old and 6 months,average age (1.14 ± 1.33)years,body weight from 5.6 to 18.0 kg,average weight(8.06 ± 3.99) kg.Echocardiography and spiral CT angiography were performed in all patients,one of which underwent cardiac catheter angiography.The cases of mitral regurgitation were mild in 2 cases,mild to moderate in 5 cases,and moderate to severe in 2 cases.Electrocardiogram showed abnormal Q wave,ST segment change and T wave inversion in lead Ⅰ,AVL and V4-6 in 9 cases.The X-ray sign was significant heart enlargement(C/T ratio 0.56-0.73,mean 0.61 ± 0.05).Echocardiography indicated ALCAPA,significant enlargement of left ventricle and decreased myocardial contractility(ejection fraction less than 50％).End diastolic diameter of left ventricle were more than 35 mm in 8 cases and aneurysm formation of left ventricular apex in 1 case.One case was confirmed ALCAPA by catheter angiography.Six cases had radioactive nuclide myocardial imaging,which showed different degree of myocardial infarction.All patients underwent reimplantation of left coronary artery into the aorta,mitral valvoplasty in 7 patients.One case died for low cardiac output syndrome.Others recovered and discharged.Postoperative complications included low cardiac output syndrome in 2 cases,pneumonia in 3 cases and supraventricular tachycardia in 1 case.During a followup of 3 months to 2 years,well development,good heart function,mitral valve regurgitation and ejection fraction improved in all case.Conclusion Echocardiography has important value in diagnosis of ALCAPA,which are confirmed by spiral CT angiography and catheter angiography.Preoperative nuclide examination for determinant of survival myocardium is helpful for surgery and prognosis.Reimplantation of left coronary artery into the aorta is the most ideal surgical procedure.

Objective To investigate the correlation of BRAFV600E mutation with papillary thyroid carcinoma and coexisting Hashimoto's thyroiditis.Methods A retrospective analysis of clinical characteristics was made in 50 patients with PTC and coexisting HT(research group) and 150 PTC patients(control group) from March,2011 to March,2012,regarding the difference in BRAFV600E mutation.Results In research group,the sensitivity of ultrasound in detecting lymphatic metastasis was 88.9％,while the specificity was 50.0％ ; the levels ofTSH,thyroid globulin antibody,and thyroid peroxidase antibody in research group were higher than those in control group (all P＜ 0.01).Rates of lymphatic metastasis (36.0％ vs 54.0％) and metastasis in Ⅱ-V area(22.2％ vs 63.0％) showed statistically significant differences between research group and control group(P=0.041,P=0.004).The respective rates of mutation of BRAFV600Ein two groups were 34.0％ and 70.7％,showing significant difference (P＜0.01).There was a significant correlation between BRAFV600E mutation and lymphatic metastasis in research group (P ＜ 0.01).Conclusions The sensitivity of ultrasound in detecting lymphatic metastasis of PTC is quite satisfactory while with its poor specificity.Combination of ultrasound with the fast frozen section pathology may help assess the scope of surgery.Reduced BRAF V600Emutation in PTC with coexisting HT results in reduction of lymphatic metastasis and may help to improve the prognosis of patients.

Objective: To establish the norm of occupational stress norm, as well as gender normative sample in southwest China. Methods: In this study, cross-sectional study method, and a synthetic way of sorting and randomized sampling were adopted to deal with research targets with revised occupational stress inventory (OSI-R) for 4278 participants.Results: The results of gender show that there were heavier occupational role , stronger interpersonal and physical strain in male than that in female(166.5?27.0/158.5?26.4,25.6?4.4/25.1?4.4,22.6?5.6/21.2?5.2,P

Objective To establish osteochondral scaffolds with remained calcified cartilage zone for finding an ideal scaffold for tissue engineered repair of osteochondral defect.Methods Cartilage zone was harvested from fresh adult porcine knee to fabricate type Ⅱ collagen hydrogel.Bone blocks measuring 8 mm in diameter with calcified cartilage zone were prepared by trephine and acellular treatment was performed.Histological staining was used to identify complete removal of cells.To fabricate the osteochondral models containing calcified cartilage zone,type Ⅱ collagen was seeded onto the acellular bone blocks with calcified cartilage zone,lyophilized,and cross-linked with 10 g/L of genipin ethanol solution.Then cell seeding and scanning electron microscope were performed after the models were established.Results HE staining,toluidine blue staining,solid green staining,safranin O staining,and DAPI staining showed cells were completely removed from bone blocks by decellularized process.Porosity of type Ⅱ collagen sponge was (91.1 ±3.8) ％ and pore size was (79.7 ± 17.1) μm.Porosity of acellular bone blocks was (73.5 ±2.6)％ and pore size was (470.2 ± 158.8) μm.Cells seeded onto osteochondral scaffolds grew well by scanning electron microscope.Conclusion Osteochondral scaffolds with calcified cartilage zone provide good biocompatibility and suitable pore size and porosity and may be an ideal material for repairing osteochondral defect in tissue engineering.

Objective To evaluate the role of cadiocyte connexin 43 (Cx43) in mito-KATP channel mediated cardioprotection against ischemia-reperfusion(I/R) injury induced by sevoflurane preconditioning in isolated rat hearts.Methods Forty hearts from male adult SD rats weghing 200-250 g were excised and perfused in a Langendorff apparatus with K-H solution with 95 ％ O2-5 ％ CO2 at 36.5-37.5 ℃.Their hearts were randomly divided into 5 groups (n =8 each): control group (group C),group I/R,sevoflurane preconditioning group (group S),sevoflurane preconditioning + 5-HD group (group SH) and 5-HD group (group H).Myocardial I/R was induced by occlusion of the anterior descending branch of left coronary artery (LAD) for 30 min followed by 120 min reperfusion.After 10 min of equilibration,group C received continuous perfusion and LAD was exposed but not occluded.Group I/R received continuous perfusion for 30 min and LAD was occluded.In group S,SH and H,3％ sevoflurane,3 ％ sevoflurane mixed with 100μmmol/L 5-HD and 100 tmmol/L 5-HD was added into K-H solution to perfuse for 15 min respectively.After that,the hearts were washed by K-H solution for 15 min.HR,left ventricular systolic pressure ( LVSP),left ventricular diastolic pressure (LVDP) and ± dp/dtmax were recorded before administration (T0),immediately after administration (T1),immediately before ischemia ( T2 ),at 30 min of ischemia (T3) and 120 min of reperfusion (T4).At the end of reperfusion,left ventricular tissue was removed for determination of myocardial infarct size and expression of Cx43 and phosphor Cx43 (p-Cx43) by immunohistochemistry and Western blot respectively.Results Compared with group C,HR,LVSP and ± dp/dtmax were significantly decreased,LVDP was increased and the expression of Cx43 and p-Cx43 were down-regulated in groups I/R,SH and H (P ＜ 0.05).Compared with group I/R,HR,LVSP and ± dp/dtmax were significantly increased,LVDP and myocardial infarct size decreased,and the expression of Cx43 and p-Cx43 up-regulated in group S ( P ＜ 0.05),no significant difference was found in groups S + H and H( P ＞ 0.05 ).Conclusion Sevoflurane preconditioning can open mito-KATP channel,promote cadiocyte Cx43 phosphorylation,attenuate I/R injury in isolated rat hearts.