Objective To explore the narcotic effects of different puncture in combined spinal-epidural block anesthesia for urological Surgery.Methods 108 cases of urologic surgery were selected.The patients were randomly divided into the two groups according to digital meter (each group had 54 cases).Both groups were treated with combined spinal-epidural anesthesia.The anesthesia puncture of group A were in lumbar intervertebral 2-3,the anesthesia puncture of Group b were in lumbar intervertebral 3-4.The respects of the two groups were observed and compared such as blood pressure before and after anesthesia,initial anesthesia plane,the time the drug arrived to the sixth thoracic vertebrae,additional lidocaine dose during the operations anesthesia quality rate and anesthesia side effects.Resuits The blood pressures of the patients of group A were significantly lower than those of group B 5 minutes after anesthesia (t =2.73,2.29,2.29,all P ＜ 0.05),the incidence of adverse reactions of Group B such as nausea,vomiting,low blood pressure,difficulty in breathing (24.1％,14.8％),was significantly lower than incidence of group A (44.4％,and 13.0％,x2 =4.97,5.07,4.86,all P ＜ 0.05) the set of initial plane of anesthesia of group a was significantly higher than that of group B (t =2.91,P ＜ 0.05),the time the drug arriving to the sixth thoracic vertebrae,of group A was significantly shorter than group B (t =2.42,P ＜ 0.05) the amounts of additional lidocaine dose of Group A during the operations were significantly less than group A (t =2.61,P ＜ 0.05).There were no significant differences in the anesthesia quality rate (P ＞ 0.05).Conclusion Selecting L3-4 puncture points in combined spinalepidural anesthesia can significantly reduce incidence of adverse reactions such as nausea,vomiting,low blood pressure and difficulty in breathing compared with selecting L2-3 puncture during urology surgery procedure.It can also reduce pain during operations.Though there are significant differences in initial level of anesthesia,the time the drug arrive to the sixth thoracic vertebrae and additional lidocaine doses,leading no effects on superior rate of anesthesia.Thus the clinical significance is not very big.

Objective To explore the effects of different processes on the contents of three alkaloid ingredients in Coridalis Rhizoma.Methods The contents of three alkaloid ingredients (protopine, dehydrocorydaline, tetrahydropalmatine) were determined by HPLC. Agilent HC-C18(2) column (4.6 mm × 250 mm, 5μm) was set at 35℃; acetonitrile-0.1% phosphoric acid solution (triethylamine adjusted pH 5.3) (26:74) was set as mobile phase; the flow rate was 1.0 mL/min and detection wavelength was set at 280 nm; the injection volume was 10μL. The three components were separated well under these chromatographic conditions. The linear relationship between the mass of each component and the peak area was good (r2≥0.9996). The average recoveries were 100.31%, 99.34%, and 99.34%, respectively (RSD≤2.70%).Results The contents of protopine, dehydrocorydaline, tetrahydropalmatine and the total contents of three alkaloids were higher than other groups in large size samples (diameter of fresh products was 2.0–3.0 cm) which were boiled 5–6 minutes, the medium size samples (diameter of fresh products was 1.5–1.9 cm) which were boiled 2–4 minutes and the small size samples (diameter of fresh products was 0.7–1.4 cm) which were boiled 1–2 minutes. The contents of alkaloid in boiled process were lower than steamed process.Conclusion The Results of study provide an experimental basis for origin processing of Coridalis Rhizoma.

Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.

The effect of nateglinide or sequential treatment with metformin on glycemic stability in newly diagnosed type 2 diabetes was investigated. Thirty-four cases of newly diagnosed type 2 diabetes received nateglinide therapy, or sequential treatment with metformin according to fasting and postprandial blood glucose, and were classified into isolated nateglinide therapy group(n=14) and sequentially treated with metformin group(n=20). Glycemic stability, reflected by mean amplitude of glycemic excursions(MAGE) and HbA1C, was determined in all patients before and after therapy for three months. HbA1C and MAGE in two groups were all improved after treatment(P＜0.05). The therapy of nateglinide alone or combined with metformin can significantly improve glycemic stability in newly diagnosed type 2 diabetes.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ ) and losartan on the expression of small ubiquitin-related modifier(SUMO) protein (SUMO1 ,SUMO2/3) in cultured rat glomerular mesangial cells(GMCs) .Methods In vitro cul-tured HBZY-1 rat GMCs were divided into 5 groups:normal control group(NC group) ,different concentrations of Ang Ⅱinterven-tion groups(A1 ,A2 ,A3 groups) and losartan treatment group(MT group) .The expression of SUMO1 and SUMO2/3 protein and mRNA of each group was measured by Western blot and RT-PCR .Results Compared with the NC group ,the expression of SU-MO1 and SUMO2/3 protein and mRNA in the Ang Ⅱintervention groups and the losartan treatment group was increased signifi-cantly (P<0 .01);Compared with the Ang Ⅱintervention groups ,the expression of SUMO1 and SUMO2/3 protein and mRNA in the losartan treatment group had no statistically significant difference .Conclusion Ang Ⅱ up-regulates the expression of SUMO protein in rGMCs by a dose-dependent manner in certain range ,this effect is not blocked by losartan ,Ang Ⅱ may be involved in the pathogenesis of diabetic nephropathy .

ObjectiveTo observe the effect of the combined therapy of ginkgo-dipyridimolum and mecobalamin for diabetic peripheral neuropathy (DPN).MethodsA total of 102 DPN cases were randomly divided into treatment group(n =50) and control group(n =52).The treatment group was given ginkgo-dipyridimolum and mecobalamin, and the control group was given only mecobalamin for 4 weeks.We observed the change of symptom and sign of both groups before and after treatment,and the MNCV and SNCV of median nerve,ulnar nerve and peroneal nerve were detected.ResultsIn the treatment group, the improvement of DPN symptoms (x2 = 10.090, P ＜ 0.01) and nervous conducting speed were much more obvious than that in the control group(MNCV of median nerve, ulnar nerve and peroneal nerve was(49.12 ± 3.32) m/s, (52.11 ± 3.12) m/s and(47.32 ± 3.21) m/s respectively; SNCV of median nerve,ulnar nerve and peroneal nerve was(47.13 ± 2.56) m/s, (55.12 ± 2.31) m/s, (46.78 ± 2.66) m/s respectively,all P ＜0.05).ConclusionThe combined therapy of ginkgo-dipyridimolum and mecobalamin could effectively improve the therapeutic outcome of DPN, and the treatment was safe and worthy of widespread use.

Bevacizumab has been widely used in tumor targeting therapy,while the most common adverse reaction is renal impairment,manifested as proteinuria. The main mechanisms may include interfering podocytes-endothelial vascular endothelial growth factor(VEGF)axis signals,increasing glomerular pressure caused by secondary hypertension,subacute renal thrombotic microangiopathy caused by endothelial damage and so on. Thrombotic microangiopathy is the main renal pathological type,and other rare types include glomer-ular lesions,renal interstitial disease,and benign renal arteriolar nephrosclerosis. Therefore,urine protein excretion and renal function should be closely monitored during bevacizumab treatment period for timely treat-ment,dose reduction or even withdrawal if necessary to ensure renal function.

Objective To evaluate the value of calcifications in the diagnosis of benign and malignant breast diseases. Methods In 270 female individuals,calcifications had been found in mammography and confirmed by pathology ,biopsy or followed-up. The characteristics of calcifications in benign and malignant breast diseases were analyzed and compared retrospectively. Results In mammography, significant difference characteristics exists in the characteristics of calcifications between the two kinds of breast diseases( P

Objective:To assess the prevalence of depressive symptoms in type 2 diabetic patients with hypertension.Methods:A systematic electronic search was conducted in CNKI,Wanfang database,SinoMed,Pubmed and Embase.Literatures that reported the depressive symptoms status of type 2 diabetic patients with hypertension were included.All patients were divided into case group and control group,according to with or without hypertension.Meta-analysis was performed with Statal2.0 software after data extraction and the quality of studies assessment.Results:A total of 11 articles involving 8031 type 2 diabetic patients were included in the meta-analysis,including 4711 patients in case group and 3320 patients in control group.The pooled prevalence of depressive symptoms in case group was 43.5％ (95％ CI:26.1％-60.8％).The pooled prevalence of depressive symptoms in control group was 34.0％ (95％ CI:19.6％-48.5％).The pooled odds ratio was 1.32 (95％ CI:1.05-1.67,P ＜0.05).Conclusion:Hypertension increases the risk of developing depressive symptoms in type 2 diabetic patients.Therefore,medical staff should pay more attention to the mental health of this population.

Objective: Our purpose was to study the effect of anisodamine on the injury of myocardium after myocardial ischemia reperfusion. Methods: Eighteen patients (ASA grade Ⅱto Ⅲ) scheduled for valve replacement, were randomly divided into 2 groups during extracorporeal circulation. Anisodamine (0.25 mg/kg) was given intravenously in the anisodamine group before reperfusion. Equivalent volumes of normal saline were administered in the control group. The central venous blood samples were collected at different time after ischemia and reperfusion. We then measured the concentrations of lactic dehydrogenase (LDH), creatine kinase (CK), and malondiadehyde (MDA) with biochemical methods. Results: The levels of serum LDH, CK, and plasma MDA increased significantly in the control group during ischemia and reperfusion. In the anisodamine group, the levels of serum LDH and CK increased. But the values were lower at corresponding time than those in the control group (P<0.05) during reperfusion. The plasma level of MDA unchanged in the anisodamine group during ischemia and reperfusion. The postoperative cardiac function recovered much more better in the anisodamine group. Conclusion: Anisodamine can reduce the degree of reperfusion injury. A certain protective effect on myocardial ischemia reperfusion injury exsists during valve replacement.