Objective To explore the efficacy and mechanism of exogenous reduced glutathione(GSH)on cardiotoxicity induced by epirubicin(EPI).Methods 60 postoperative patients with breast cancer were randomly divided into the treatment group and control group with 30 cases in each group.The treatment group received 6 cycles of chemotherapy with CEF regimen plus the reduced GSH.The control group also received 6 cycles of chemotherapy only with CEF alone.The cardiotoxicity of all patients were estimated by the ECG,myocardial enzymes,troponin Ⅰ(cTnⅠ),ultrasoundcardiogram and tissue Doppler technique before hemotherapy and after 3 cycles and 6 cycles of chemotherapy.Results After 3 cycles of chemotherapy,there were no significant differences in ECG,cTnⅠ,left ventricle ejection fraction(EF),fraction shortening(FS),E/A,decline time(DT)and myocardial creatine kinase(CK),isoenzyme of creatine kinase containing M and B subunits(CK-MB),lactate dehydrogenase(LDH)between two groups(P>0.05);While,there was a significant difference in Em/Am between two groups(P<0.01).After 6 cycles of chemotherapy,there were also no significant differences in EF,FS,myocardial CK,CK-MB,LDH between two groups(P>0.05);there were significant differences in ECG,cTnI,E/A,DT and Em/Am between two groups(P<0.01).Conclusion The reduced GSH can prevent the cardiotoxicicy induced by EPI,which may be related with the ability of GSH against the oxidant injury and inhibiting calcium overload.

ObjectiveTo investigate the effects of comprehensive psychotherapy on depression,anxiety and gastrointestinal reactions in patients with lung or breast cancer.Methods96 cases with lung or breast cancer were randomly divided into psychotherapy group(n=48) and control group(n=48) which were both treated with routine chemotherapy.Those in the psychotherapy group concomitantly received comprehensive psychotherapy for 2 weeks.Their characters of Symptom Checklist 90(SCL-90) were measured,while those of Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were also measured before and after treatment.ResultsThe scores of SCL-90 in patients with lung or breast cancer were increased compared with Chinese norm in somatization,depression,anxiety,phobic anxiety(P<0.01).From the 3rd week,the scores of SDS(41.2±3.7) and SAS(34.6±5.8) in the psychotherapy group were significantly lower than those in the control group(P<0.01),as well as the gastrointestinal reactions.ConclusionPsychotherapy can obviously decease the severity of depressive and anxious emotions and the gastrointestinal reactions.

Objective To investigate pathogen bacteria distribution and clinical analysis of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery for guiding the rational clinical use of antimicrobial drugs.Methods The clinical data of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery were retrospectively analyzed for microbiologically documented infection.Bacterial identification was performed in an automatic VITEK2Jr expression system and antimicrobial susceptibility testing by Kirby2Bauer method.The results of antimicrobial susceptibility testing were performed in WHONET 5.0 system software.Results There were 16 strains of pathogenic bacteria in 2010,Gram-negative bacteria 9 stains (Klebsiella pneumoniae 18.75％,Acinetobacter baummannii 12.5％),gram positive coccus 6strains (Streptococcus 18.75％),Fungi 1 strain.There were 32 strains of pathogenic bacteria in 2011,Gram-negative bacteria 24 stains (Acinetobacter baummannii 31.25％,Klebsiella pneumoniae 25％,Pseudomonas aeruginosa 6.25％),gram positive coccus 8 strains (Enterococcus 12.5％,Streptococcus 6.25％).There were 42 strains of pathogenic bacteria in 2012,Gram-negative bacteria 38 stains (Acinetobacter baummannii 26.19％,Klebsiella pneumoniae33.33％,Pseudomonas aeruginosa 21.42％),gram positive coccus 4 strains (Enterococcus 4.76％).Acinetobacter baummannii remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Meropenem,Imipenem,Klebsiella pneumonia remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Cefoperazone/Sulbactam,Meropenem,Imipenem,trimethoprim-sulfamethoxazole,Ciprofloxacin.Pseudomonas aeruginosa only remained sensitive to Levofloxacin and Piperacillin/Tazobactam.Gram-positive cooci proportion in pathogenic bacteria decreased year by year,Streptococcus and Enterococcus had major proportion in Gram-positive cooci,Staphylococci decreased,There was no Staphylococcus,Enterococcus and Staphylococci resistant to vancomycin.Conclusions Gram-negative bacteria was the major pathogenic bacteria in ventilator-associated pneumonia with congenital heart disease postoperative infants and young children,Acinetobacter baummannii Klebsiella pneumoniaeand Pseudomonas aeruginosa had major proportion in gram-negative bacteria and drug resistance increased.Rational use of antibacterials was very important to reduce drug resistant strains.

Sixty gynecological patients undergoing laparoscopic surgery during October 2010 to June 2011were randomly divided into 2 groups:laryngeal mask airway proseal ( PLMA group,n =30 ) and laryngeal mask airway classic (CLMA group,n =30).Laryngeal mask was inserted after induction.The heart rate (HR),mean arterial pressure (MAP),airway sealing pressure,the average time of placement,the pulmonary satisfaction and complications were recorded.There was no significant difference in heart rate and MAP between the two groups(P＞0.05).The airway sealing pressure [ (26 ±6) cm H2O ( 1cm H2O =0.098 kPa) vs.(16±5) cm H2O],the average time of placement [(36±5) vs.(24±6) s)] and the excellent lung ventilation(90％ vs.73％ ) in the PLMA group were more significantly increased than those in the CLMA group(P ＜0.05).PLMA can assure good airway sealing and is more suitable for gynecological patients undergoing laparoscopic surgery.

Objective To discuss the predictable factors for the occurrence of intraoperative aneurysm rupture(IAR) of anterior circulation aneurysm treated by clipping.Methods The clinical data of 96 patients with 115 aneurysms treated by clipping were retrospectively analyzed.The univariate analysis and Logistic regression analysis was performed for the risk factors of IAR such as history of hypertension,pre-operative Hunt-Hess scale,aneurysm location,aneurysm sac,aneurysm dome/neck ratio,aneurysm direction,and operation time.Results Twenty-one patients occurred IAR [18.3 ％ (21/115) of aneurysms,21.9％ (21/96) of patients] during the operation,2 patients died and 94 patients were estimated by Rank scale:0 score was for 66 patients,2 scores was for 10 patients,3 scores was for 6 patients,4 scores was for 4 patients,5 scores was for 6 patients and 6 scores was for 2 patients at 6 months after surgery.Statistic analysis revealed that history of hypertension (P =0.037),pre-operative Hunt-Hess scale (P =0.040),aneurysm direction (P =0.009),aneurysm sac (P =0.010),operation time (P =0.001) and aneurysm dome/neck ratio (P =0.029) were the predictable factors for the occurrence of IAR,while aneurysm location was not included (P =0.198).Conclusion The history of hypertension,pre-operative Hunt-Hess scale,aneurysm direction,aneurysm sac,operation time and aneurysm dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors lead to the occurrence of IAR.

Aim To investage the effects of ?、?、?-receptor on hyperlocomotor and analgesia in mice.Methods Locomotor activity experiment and hot-plate pain experiment were measured.Results Oxycodone dose-dependently enhanced locomotor response in mice.Naloxone,a unselective opioid receptor antagonists and naltrindole(?-selective opioid receptor antagonist)could attenuate the increase of locomotor acitivity induced by oxycodone,but naloxonazine,a ?-receptor antagonist had no such effect.?-receptor antagonist nor-Binltorphimine increased hyperlocomotion induced by oxycodone.In antinociceptive experiment,naloxonazine and naltrindole could not attenuate the that of oxycodone,but nor-Binaltorphimine could attenuate the antinociceptive effects of oxycodone.Conclusion Oxycodone-hyperlocomotor is probably mediated by ? opioid receptor,and antinocieptive effects of oxycodone is probably mediated by ? opioid receptor.

Objective Human serum albumin ( HSA) is a kind of plasma protein , which can transport various small molecu-lar substances to the body.A disulfide bond breaking strategy is used to fabricate HSA-curcumin nanoparticles(NPs-CCM) in order to improve the solubility and tumor targeting capability of curcumin . Methods NPs-CCM were fabricated with dithiothreitol as the re-ducing agent .The size and shape of the nanoparticles were observed with high resolution electron microscopy .We explored the change of hydrophobic region during the process of degeneration of albumin , the releasing behavior in the solution and the tumor targeting capa-bility in vivo and vitro of NPs-CCM. Results The diameter of NPs-CCM was about 150 nm.The determination of surface hydropho-bicity showed that ANS fluorescence intensity decreased gradually as the extension of degeneration time , at the time 0 min, 2 min, 5 min and 10 min, ANS relative fluorescence intensity was 5492(5432-5673), 2486(2319-2878), 1998(1904-2317), 1503 (1280-1584) respectively.The hydrophobic region of albumin gradually reduced during the degeneration time .The curcumin re-leased from NPs-CCM amounted to about 50% within 40 h, and the NPs-CCM can be absorbed by tumor cells and accumulation in tumor tissue. Conclusion Albumin can improve the solubility and tumor targeting capability of curcumin , and it has potential clinical application value.

ObjectiveTo observe the effects of psychological intervention on anxiety, depression, and postoperative cardiovascular complications in adult patients with lung cancer. Methods96 patients (aged ≤55 years) with lung cancer and undergoing thoracic operation were divided into intervention and control groups. The control group was only given routine care advice and health education, while the intervention groups was combined with various psychological intervention before and after operation. All the patients were assessed with self-rating of anxiety and depression scale (SAS, SDS) and the blood pressure were measured at admission, 1 d before operation, 5 d after operation, and the heart were monitored pre- and post-operation. ResultsThe SAS, SDS score, and blood pressure were not statistically significant between two groups at admission, but significant 1 d before operation and 5 d after operation. The incidence of cardiovascular complications was significantly different after operation (P<0.05). ConclusionThe individual psychological intervention can reduce the anxiety and depression, stabilize blood pressure, and decrease the incidence of cardiovascular complications in adult lung cancer patients undergoing thoracic operation.

Objective To study the effect of network peer education on the 131I treatment adherence in patients with thyroid cancer.Methods A total of 120 patients with thyroid cancer who performing 131 I treatment from April 2012 to April 2014.They were divided into intervention group 61 cases and control group 59 cases according to the hospital ward number.Control group was given routine health education and intervention group was given network peer education.The data from the habits,drug therapy,grasp the situation,the equivalent monitoring of the relevant knowledge of 4 different dimensions of treatment adherence for patients were investigated and compared before discharge by using questionnaire and examination method.Results The incidence of the good habits,drug therapy,grasp the situation,and the equivalent monitoring reaching the standard were 96.7％(59/61),98.4％(60/61),96.7％(59/61),100.0％(61/61) in intervention group,and 54.2％(32/59),76.3％(45/59),79.7％(47/59),89.8％(53/59) in control group,there were significant differences,x2=29.54,13.38,8.47,4.56,P＜0.01 or ＜0.05.Conclusion Network peer education for patients with thyroid cancer during the 131I treatment can effectively improve the patient's treatment adherence,has positive significance for the treatment.

Objective To investigate the therapeutic efficacy of somatostatin on chylothorax after congenital heart disease surgery in children.Methods Retrospective analysis was performed in 13 postoperative chylothorax cases from Jan.2003 to Dec.2012,who were divided into control group (n =6) and treatment group (n =7),and there was no significant difference in age,weight,and time of occurrence between the 2 groups.The diagnosis standard for chylothorax was the same.The changes of chylous volume during the treatment were analyzed between 2 groups,and healing time and other data were analyzed too.Results Control group:clinical cure in 3 cases,conservative treatment failed in 3 cases(2 cases recovered after operation and 1 case died).The chyle volume of control group reduced obviously compared with post treatment from beginning [(256.6 ± 124.2) mL/d] to 1 week [(155.5 ± 85.7) mL/d] and 2 weeks [(142.3 ± 110.3) mL/d] later(t =4.623,2.099 ; P =0.002,0.044).But it did not reduce obviously in 3 weeks later[(139.4 ± 113.4) mL/d] (t =1.745,P =0.07).Treatment group:6 cases in treatment group were successful in recovery after conservative treatment and 1 case underwent operation.The chyle volume of treatment group reduced obviously compared with post treatment from beginning to 1 week [(51.2 ± 18.7) mL/d] and 2 weeks [(19.3 ± 7.05) mL/d] later (t =5.549,6.638 ;P =0.001,0.001).Compared with the control group,the difference between 2 groups in post treatment (1 week later,2 weeks hater) was of statistical significance (t =2.900,2.412 ; P =0.014,0.034).The healing time of conservative treatment in 2 groups (only for recovery) had obvious difference [(32.8 ± 1.8) d,(25.2 ± 1.7) d] (t =2.512,P =0.028).Conclusions The use of somatostatin can significantly promote the recovery of chylothorax in children,and it should be actively used in early conservative treatment.