Objective To compare the effects of dobutamine with those milrinone on myocardial strain in patients undergoing valve replacement surgery.Methods Fifty-five patients udergoing valve replacement surgery, 27 males and 28 females, aged 40-75 years, falling into ASA physical statusⅡ orⅢ, New York Heart Association (NYHA) ⅡorⅢ, were included in this study.They were divided into 3 groups by using a random number table:intravenous infusion dobutamine group (group D, n=18), intravenous infusion milrinone group (group M, n=20) and intravenous infusion saline group (group C, n=17).All patients were used general anesthesia.In groups D, the patients received intravenous infusion dobutamine (4μg·kg-1·min-1) for an hour starting from 15 min after termination of CPB.In group M, the patients did intravenous infusion milrinone (0.4μg·kg-1·min-1) in the same way.In group C, the patients got intravenous infusion saline also.After induction of anesthesia, these patients were recorded for hemodynamic measurement at three points after induction of anesthesia and before splitting of sternum (T0), starting from 15 min after termination of CPB (T1), intravenous infusion medicine for 30 min (T2), intravenous infusion medicine for one hour (T3):HR, CVP, cardiac output (CO), left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), cardiac index (CI) and systemic vascular resistance index (SVRI) and strained indicator:global longitudinal strain of left ventricle (S-LVL), global circumferential strain of the left ventricle (S-LVM), global longitudinal strain of right ventricle (S-RV).Results Compared with group M, HR in group D at T2 and T3 was higher (P<0.05).Compared with group C, HR in group D at T3 was higher (P<0.05).And CI in group D at T2 was higher than that in groups C and M (P<0.05).Compared with groups C, S-LVMin groups D and M at T2 and T3 were stronger, S-LVL, S-RV in group D and S-RV in group M at T3 were stronger (P<0.05).Conclusion Intravenous infusion dobutamine can improve S-LVM, S-LVLand S-RV;Intravenous infusion milrinone can improve S-LVMand S-RV.

Objective To evaluate the effect of dobutamine or milrinone on intraventricular syn-chronization in the patients undergoing cardiac valve replacement with cardiopulmonary bypass ( CPB). Methods Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 40-75 yr, of New York Heart AssociationⅡorⅢ, scheduled for elective cardiac valve replacement with CPB, were divided into 3 groups (n＝20 each) using a random number table: control group ( group C), dobutamine group ( group D) and milrinone group ( group M). Dobutamine 4 μg·kg-1·min-1was intravenously infused for 60 min starting from 15 min after termination of CPB in group D. Milrinone 0. 4 μg·kg-1·min-1was intravenously infused for 60 min starting from 15 min after termination of CPB in group M. The equal volume of normal saline was given instead in group C. The parameters of heart function were monitored using transesophageal echocardiography. After induction of anesthesia and before splitting the sternum (T0), at 15 min after termination of CPB (T1), and at 30 and 60 min of dobutamine, milri-none or normal saline infusion (T2, average value at two time points), the parameters of intraventricular synchronization were calculated with QLAB software (9. 1 version): standard deviation of time to peak sys-tolic velocity of the left ventricular longitudinal strain 7 segments (LVSDt-L), standard deviation of time to peak systolic velocity of the right ventricular longitudinal strain 7 segments (RVSDt), standard deviation of time to peak systolic velocity of the left ventricular circumferential strain 6 segments (LVSDt-C). Results Compared with group C, LVSDt-C, LVSDt-L and RVSDt were significantly decreased at T2in group D (P＜0. 05), and no significant change was found in the indices mentioned above at each time point in group M (P＞0. 05). RVSDt was significantly higher at T2in group M than in group D ( P＜0. 05). Compared with the baseline at T0, LVSDt-L was significantly increased at T2in group C, and RVSDt was significantly in-creased at T2in group M ( P＜0. 05). Conclusion Intravenously infusing dobutamine after CPB can im-prove the ventricular synchronization, however, intravenously infusing milrinone may increase the right ventricular asynchronization in the patients undergoing cardiac valve replacement.

Objective To investigate the effects of intravenous infusion of methoxamine and phenylephrine on blood pressure and coronary artery blood flow in elderly patients with post volume treatment hypotension after cardiopulmonary bypass (CPB ) undergoing coronary artery bypass grafting (CABG).Methods Forty patients,physical status ASA Ⅱ or Ⅲ,>65 years old,undergo-ing CABG,following CPB,with a mean arterial pressure (MAP)<70% of baseline,despite adequate volume replacement (based on achieving a normal CVP),were randomly assigned to me-thoxamine group (group M,n=20)or phenylephrine group (group P,n=20).The initial infusion rate was 3 μg·kg-1·min-1in group M and 0.24 μg·kg-1·min-1in group P,respectively.The rate was increased or decreased by one third of initial dose in order to maintain the MAP at the target level (±20% of baseline MAP).Coronary sinus (CS),systolic blood flow velocity time integral (SV-TI),diastolic velocity time integral (DVTI),CS blood flow (CSBF)were recorded before adminis-tration,at 3,5,10,15,30 min after administration.Results Compared with pre-administration,SV-TI,DVTI,CSBF were increased at each point in the two groups (P<0.05 or P<0.01).SVI was in-creased at 15 min and 30 min in group M (P<0.05).Compared with group P,DVTI and CSBF at 10,15 min and 30 min was higher in group M (P<0.05 or P<0.01).There were 2 cases of atrial fibrillation and 1 case of frequent ventricular premature beat after operation in group M;1 case of bradycardia and 1 case of frequent ventricular premature beats after operation in group P.Conclusion Intravenous infusion of methox-amine and phenylephrine both can correct post volume treatment hypotension after CPB in elderly patients undergoing CABG,but methoxamine increases coronary blood flow more significantly and may be more ben-eficial to patients with coronary heart disease.

ObjectiveTo investigate the relationship between lower limb muscle strength and walking speed in older adults, and to analyze the mediating role of flexibility and dynamic balance. MethodsFrom November to December, 2021, a total of 155 older adults at the Shanghai Senior Sports and Health Home were included. Their basic health information was collected, and the lower limb muscle strength, flexibility, dynamic balance and walking speed were tested. A mediated effects analysis was conducted. ResultsThere was a pairwise correlation among lower limb muscle strength, flexibility, dynamic balance and walking speed in older adults (r > 0.210, P < 0.01). In the mediated effects model, after controlling for age and gender, lower limb muscle strength did not directly predict walking speed in older adults (β = 0.029, P = 0.699), however, lower limb muscle strength could influence walking speed through the partial mediation of dynamic balance (effect = 0.0130, 95% CI 0.0073~0.0197) and the chain mediation of lower flexibility and dynamic balance (effect = 0.0019, 95% CI 0.0003~0.0043). ConclusionLower limb muscle strength can indirectly affect walking speed in older adults through the mediators of flexibility and dynamic balance, or the dynamic balance alone.

ObjectiveOvarian cancer is the third most common gynecologic cancer worldwide， with the second highest mortality rate among gynecologic cancers， and age-standardized rates are gradually increasing in many low- and middle-income countries. At present， its etiology and pathogenesis are not clear. There are no obvious symptoms in the early stage， and when the symptoms become obvious， it often indicates the advanced stage. The 5-year survival rate of the advanced stage is only 17%， which poses a great threat to women's health. Therefore， an in-depth study of the etiology and pathogenesis of ovarian cancer is very important to the exploration of prevention and treatment methods for ovarian cancer. Based on the clinical characteristics of ovarian cancer in traditional Chinese and Western medicine， and combined with the existing evaluation methods of animal models， this study evaluated the animal model of ovarian cancer， and provided analysis and suggestions. MethodThis study searched China National Knowledge Infrastructure （CNKI）， Wanfang data， VIP information database， and PubMed database using the keywords "ovarian cancer" and "animal model"， excluded the articles that did not meet the criteria， and then classified the remaining studies. Combined with the clinical diagnostic criteria of Western medicine and traditional Chinese medicine syndrome differentiation， the related indicators of ovarian cancer animal models were assigned and the degree of agreement was evaluated. ResultThe use of the transplanted animal model exhibited the highest frequency， followed by that of the induced model. The degree of agreement of traditional Chinese medicine for each model was lower than that of Western medicine. The induced ovarian cancer model had a high degree of clinical agreement and was similar to human ovarian cancer in terms of tumor growth pattern， disease progression and complications， which is an ideal animal model of ovarian cancer. Although this animal model can simulate the etiology and pathogenesis of ovarian cancer to a certain extent and reflect some indicators of traditional Chinese and Western medicine， it lacks differentiation of traditional Chinese medicine syndromes. ConclusionOn the basis of the original model， the animal model of ovarian cancer was added with Qi deficiency syndrome， blood deficiency syndrome， Qi stagnation syndrome， blood stasis syndrome， heat-toxin syndrome， and Yang deficiency syndrome to establish an animal model combining traditional Chinese medicine disease and syndrome of ovarian cancer， which could better simulate the clinical actual situation of traditional Chinese and Western medicine and lay a solid foundation for the study of integrated traditional Chinese and Western medicine for the treatment of ovarian cancer.