Objective To evaluate the effect of sevoflurane on left ventricular function in patients undergoing elective coronary artery bypass grafting (CABG) .Methods Thirty-five ASA Ⅱ or Ⅲ patients of both sexes (30 males, 5 females) aged 53-75 yr weighing 46-100 kg undergoing CABG were enrolled in this study. Transesophageal echocardiography (TEE) probe was placed. The TEE variables including cardiac index (CI), left ventricular short axis shortening (FS), left ventricular ejection fraction (LVEF), low propagation velocity ( Vp), E wave velocity (E) , A wave velocity ( A) , systolic wave velocity ( S) , diastolic wave velocity ( D), AR wave velocity, E/A ratio and S/D ratio were recorded before inhalation of sevoflurane (T_1 ) , and 5 min (T_2) and 15 rain ( T_3) after inhalation of sevoflurane after splitting of sternum, and before inhalation of sevoflurane (T_4 ), 5 min (T_5) and 15 min (T_6) after inhalation of sevoflurane after the closure of sternum. The end-tidal concentration of sevoflurane corresponded to 1 MAC. Anesthesia was induced with midazolam 0.05 nig/kg, sufentanil 0.5μg/kg and rocuronium 0.9 mg/kg and maintained with infusion of propofol at 4-6 mg·kg~(-1) ·h~(-1), remifentanil at 0.2-0.4μgkg~(-1)·h~(-1) and atracurium at 0.5 mg·kg~(-1)·h~(-1). The patients were mechanically ventilated after tracheal intubation (V_T 8 ml/kg, RR 12 bpm, I:E 1:2, FiO_2 70%-80% ) .Results (1) MAP and CI were significantly decreased at 5 and 15 min after sevoflurane inhalation. LVEF and FS were also decreased. (2) There was no significant change in diastolic function indexes after sevoflurane inhalation including E and A wave velocity, systolic wave velocity, diastolic wave velocity, E/A ratio and S/D ratio. (3) Cardiac function improved after CABG. CI, LVEF and FS were significantly increased after CABG as compared with preoperative values. Conclusion In patients undergoing elective CABG, sevoflurane (the end-tidal concentration corresponding to 1 MAC) can depress left ventricular systolic function but does not affect left ventricular diastolic function.

Objective To detect the protein expression of gonadotropin-releasing hormone (GnRH) and its receptor (GnRH-R) in various endometrial tissues, and to investigate its significance. Methods Immunohistochemistry was employed to analyse the protein expression and localization of GnRH and GnRH-R from endometriosis(EMS), endometrial hyperplasia, endometrial carcinoma and control group. Results GnRH and GnRH-R are expressed at the protein level in all eutopic endometrium, in 50% ectopic endometrium and 92.3% endometrial hyperplasia, while the expressional rate in endometrial carcinoma are 58.8% and 82.4%, respectively. The majority of GnRH and GnRH-R existed in the plasma of glandular epithelium cells and some stroma cells. Conclusions There exists GnRH and its receptor proteins in endometrial tissues, and their abundant expression in endometriosis, endometrial hyperplasia and in endometrial carcinoma may imply that they could be used in clinical diagnosis and treatment.

This essay investigated the in vitro tumoricidal activity of Con A primed murine LAK cells (Con A-LAK), discussed the role of mTNF-? in the killing effect. The results showed that Con A-LAK cells could kill NK sensitive YAC-1, TNF sensitive L929 and H-2 low/non expression HCa-F target cells; The cytotoxicitity of Con A-LAK cells was performed by direct contact, the non-secretary pathway mediated by interaction of surface ligands of effector cells and receptors of target cells play an important role; Con A-LAK cells expressed mTNF-?, which participated in the killing of TNF sensitive tumor cells and might be one of the important effector molecules in MHC non-restricted, antigen non-specific cvtotoxicitv.

Objective To evaluate the value of Disposcope-guided the left-sided double-lumen tube (DLT) intubation.Methods Fifty ASA physical status Ⅰ or Ⅱ patients,aged 47-69 yr,without difficult airway,scheduled for elective thoracic surgery,were randomly divided into 2 groups (n =25 each) using a random number table:Disposcope (group D) and Macintosh direct laryngoscope (group M).Anesthesia was induced with iv injection of midazolam,propofol,sufentanil and rocuronium.Before induction (baseline,T1),before intubation (T2),immediately after successful intubation (T3),and at 1 and 3 min after intubation (T4-5),systolic blood pressure (SBP),mean airway pressure (MAP) and heart rate (HR) were recorded,and rate-pressure (SBP) product (RPP) was calculated.Arterial blood samples were obtained at T1-5 for measurement of plasma epinephrine (E),norepinephrine (NE),and dopamine (DOPA) concentrations.The success rate of DLT intubation at first attempt,total success rate of DLT intubation,intubation time,and development of sore throat within 24 h after surgery were recorded.Results Compared with group M,the intubation time was significantly shortened,the success rate of DLT intubation at first attempt was increased,the incidence of sore throat was decreased,and the levels of MAP,HR,RPP,E,NE and DOPA were decreased at T3-5 in D group (P ＜ 0.05).Compared with the baseline value at T1,the levels of MAP,HR,RPP,E,NE and DOPA were decreased at T3-5 in M group (P ＜ 0.05),and no significant change was found in D group (P ＞ 0.05).Conclusion Disposcope-guided left-sided DLT intubation provides significant clinical value.

Objective To determine if the cardiac index (Cl) measured with FloTrac-Vigileo system agrees with that measured with pulmonary artery catheter (PAC).Methods Forty-three ASA Ⅱ or Ⅲ patients aged 53-75 yr weighing 46-100 kg undergoing off-pump coronary artery bypass grafting were included in this study.Anesthesia was induced with midazolam,sufentanil,propofol and rocuronium and maintained with propofol,remifentanil and atracurium.One MAC sevoflurane was inhaled at breast bone splitting and closing.Cl was measured with FloTrac-Vigileo system and PAC before,and at 5,15 min of sevoflurane inhalation and recorded.All data were compared by Bland-Altman analysis and with kappa coefficient for agreement and percentage error was calculated.Results Bland-Altman comparison of FloTrac-Vigileo system and PAC:matching data of 258 measurements:Cl (2.8 ± 0.6) L·min-1 ·m-2,bias was 0.23 L·min-1 ·m-2 and limit of agreement was (-0.57,1.02) L·min-1 ·m-2,resulting in κ =0.546 and an overall percentage error of 28.6％.Conclusion Cl values obtained by FloTrac-Vigileo system agrees well with that obtained by thermodilution technique using PAC in patients undergoing off-pump coronary artery bypass grafting.

Objective To evaluate the effect of dexmedetomidine on left ventricular function in patients undergoing coronary artery bypass grafting (CABG) by transesophageal echocardiography (TEE).Methods The study was a prospective,randomized and placebo-control clinical trial.Eighty patients undergoing CABG with cardiopulmonary bypass (CPB) were divided into dexmedetomidine group (group D)and control group (group C) by random digits table method with 40 cases each.A loading dose of dexmedetomidine 0.5 μg/kg was injected intravenously 10 min after induction followed by infusion at 0.4 μ g/(kg· h) until the end of operation in group D,while equal volume of normal saline was given in group C.Left ventricular function was assessed by transesophageal echocardiography before the infusion of dexmedetomidine (T1),at the end of the infusion of loading dose (T2),before CPB (T3) and at the end of the operation (T4).Results Compared with those at T1,left ventricular ejection fraction and fractional area change decreased significantly [(58.0 ± 12.0)％,(60.0 ± 9.6)％ vs.(63.0 ± 8.6)％ and (46.0 ± 9.3)％,(48.0 ± 8.4)％ vs.(51.0 ± 6.7)％] (P ＜ 0.05 or ＜ 0.01),E/A ratio increased significantly (1.05 ± 0.27,1.07 ±0.31 vs.0.98 ±0.19)(P ＜0.05 or ＜0.01) and myocardial performance index (MPI) decreased significantly (0.46 ± 0.14,0.45 ± 0.12 vs.0.51 ± 0.14) (P ＜ 0.05) at T2 and T3 in group D,while stroke volume was not significantly changed (P＞ 0.05).Compared with that in group C,E/A ratio and rapid filling fraction in group D was significantly higher [1.06 ± 0.18 vs.0.97 ± 0.18,(62.0 ± 7.1)％ vs.(58.0 ± 7.3)％],and S/D ratio and MPI was significantly lower at T4(1.17 ± 0.21 vs.1.29 ± 0.22,0.43 ± 0.15 vs.0.50 ± 0.15),and there were significant differences (P ＜ 0.05).There was no difference in the parameters indicating left ventricular systolic function (P ＞ 0.05).Conclusions Dexmedetomidine restrains left ventricular systolic function in the patients undergoing CABG,but does not decrease the cardiac output,and improve relaxation dysfunction of left ventricular diastolic function.Global left ventricular function is improved by dexmedetomidine after CABG.

ObjectiveTo determine ff the cardiac index (CI) measured with FloTrac-Vigileo system agrees with that measured with pulmonary artery catheter (PAC).MethodsForty-three ASA Ⅱ or Ⅲ patients aged 53-75 yr weighing 46-100 kg undergoing off-pump coronary artery bypass grafting were included in this study.Anesthesia was induced with midasolam,sufentunil,propofol and rocuronium and maintained with propofol,remifentanil and atracurium.One MAC sevoflurane was inhaled at breast bone splitting and closing.CI was measured with FloTrac-Vigileo system and PAC before,and at 5,15 min of sevoflurane inhalation and recorded.All data were compared by Bland-Altman analysis and with kappa coefficient for agreement and percentage error was calculated.ResultsBland-Altman comparison of FloTrac-Vigileo system and PAC:matching data of 258 measurements:CI (2.8 ± 0.6 ) L· min - 1 · m- 2,bias was 0.23 L* min- 1 · m - 2 and limit of agreement was ( - 0.57,1.02)L · min- 1 · m- 2,resulting in κ ＝ 0.546 and an overall percentage error of 28.6 ％.ConclusionCI values obtained by FloTrac-Vigileo system agrees well with that obtained by thermodilution technique using PAC in patients undergoing off-pump coronary artery bypass grafting.

Objective To evaluate insulin resistance and ?-cell function in patients with systemic lupus erythematosus(SLE).Methods The study group included thirty-two female SLE patients who were hospitalized or received outpatient treatment in our hospital;the control group consisted of twenty-two healthy females.Their fasting plasm glucose and serum insulin were all tested.Homeostasis model assessment(HOMA) was used to calculate HOMA-IR and HOMA-?-cell function,and these parameters were compared between the study group and control group.Results Compared with control group,the SLE patients had significantly higher fasting insulin levels(12.13?4.32 vs.8.84?2.19,P0.05).Conclusion Patients with SLE have a higher risk of insulin resistance and abnormal insulin secretion than controls.

Objective To study the clinical applications of SIVP detecting hepatocarcinoma in cirrhosis.Methods 40 cases of cirrhosis combined with hepatocarcinoma diagnosed by operation and pathology were collected.Control group were scaned with conventional technique,experimental group were scaned with SIVP.Results Only 5 cases catched the optimal scan timing in control group,the accuracy of diagnosis in hepatocarcinoma was 70%;All the cases found the optimal scan timing in experimental group,the detectable rate of hepatocarcinoma was 95%.Conclusion SIVP can find out the optimal timing,which greatly improved accuracy of diagnosing hepatocarcinoma in cirrhosis.

Objective To study the effect and mechanism of increase in radio sensitivity of kidney cancer cells(GRC-1) induced by ?-elemenen in vitro. Methods GRC-1 cells were divided into 3 groups, blank group (added with 2 mL culture medium), emulsion group (added with 2 mL blank emulsion culture medium) and drug group (added with 2 mL 50 mg?L -1 ?-elemenen culture medium). After been cultivated for 24 hours, the cells were irradiated using 6MeV X-linear accelerator in different doses at the rate of 400cGy per minute. Number of cell clones was counted, and radiation-survival curve of GRC-1 cells was drawn. Flow cytometry (FCM) was used to measure cell cycle and apoptosis. Cells of climbing flake were dyed by immunocytochemical method, the gene expression of bcl-2 and PCNA was measured by imaging system. Results The cell cycle showed that the G 2M blocking caused by 50 mg?L -1 ?-elemenen was enhanced with time increase. It reached peak at 24 hours. FCM showed that the level of apoptosis increased with increase in drug dose and action time. The gene expression of bcl-2 was decreased by 20% in drug group than that in blank group, but there was no expression of PCNA in the two groups. Conclusion The radiosensitivity of GRC-1 cells can be enhanced by ?-elemenen. The mechanism of effect may be associated with the cell cycle blocking, inducing cell apoptosis and down-regulating expression of bcl-2 gene.