Objective To investigate the effects of hypothermia combined with sevoflurane on myocardial monophasic action potential (MAP) and transmural dispersion of repolarization (TDR) of the left ventricle in rabbits in vitro. Methods Adult rabbits weighing 1.5-2.0 kg were sacrificed after heparinized and anesthetized.The hearts were immediately removed and perfused with K-H soluation saturated with 95%O2-5%CO2 at 37℃ in a Langendorff apparatus. Forty-eight isolated hearts were randomly divided into 6 groups ( n = 8 each): Ⅰ control group (group C), Ⅱ low concentration sevoflurane group ( group S1 ), Ⅲ high concentration sevoflurane group (group S2 ), Ⅳ hypothermia group (group H), Ⅴ hypothermia + low concentration sevoflurane (group HS1 ) and Ⅵ hypothermia + high concentraion sevoflurane (group HS2 ).Group C received continous perfusion. Group S1and S2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 37 ℃ for 30 min respectively. Group H received perfusion with K-H solution at 30℃ for 30 min. Group HS1 and HS2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 30℃ respectively.MAPs of epicardium, mid-myocardium and endocardium of the left ventricle were recorded. MAP duration at 90%repolarization(MAPD90)and TDR were calculated. Early after-depolarization,delayed after-depolarization and arrhythmia were also recorded. Results Compared with group C, MAPD90 of the 3 layers of ventricle was significandy prolonged, the incidence of arrhythmia increased in group H (P＜0.05). There was no significant difference in TDR among all groups ( P＞0.05). There was no interaction between sevoflurane and hypothermia (P＞0.05), and it only showed that MAPD90 was prolonged by hypothermia (P ＜0.05 ). Conclusion Hypothermia combined with sevoflurane exerts no significant effects on myocardial MAP and TDR of ventricles in rabbits, and sevoflurane decreases the incidence of hypothermia-induced arrhythmia through inhibiting the prolongation of MAPD90.

Objective To investigate the influence of coix seed triglyceride combined with transcatheter arterial chemoembolization (TACE) therapy on AFP, CD4﹢CD25﹢regulatory T (Treg) cells and cellular immune function in patients with advanced primary hepatocellular carcinoma (HCC). Methods A total of 50 patients with inoperable HCC, whose imaging examination showed no distant metastasis, were divided into the study group (n=25) and the control group (n=25). Coix seed triglyceride together with TACE was employed for the patients of the study group, while only TACE was adopted for the patients of the control group. For the patients of the study group, transcatheter hepatic artery infusion of 100 ml coix seed triglyceride was carried out during the performance of TACE, and postoperative intravenous drip of coix seed triglyceride (200 ml/d) was used for 5 days. The peripheral blood samples were collected one week before and one month after the treatment to detect the changes of AFP and T lymphocyte subsets (CD3﹢, CD4﹢, CD8﹢,CD4﹢/CD8﹢ and Treg) levels. One month after the treatment, enhanced CT, MRI or PET-CT was performed to evaluate the necrosis degree of the tumor. Results After the treatment, AFP levels was decreased in both groups, when compared the preoperative data the differences were statistically significant (P<0.01); the tumor necrosis rate of the study group was (57.7 ±8.2)%, which was slightly higher than (57.7±8.2)% of the control group, however, the difference was not statistically significant (P>0.05). In the study group, the percentage of Treg cells decreased from preoperative (8.27±6.65)%to postoperative (4.22± 1.59)%, the difference was statistically significant (P<0.01). The percentages of CD3﹢ and CD4﹢ and the ratio of CD4﹢/CD8﹢ increased from preoperative (55.78 ±13.66)%, (43.98 ±14.00)% and 1.22 ±0.64 to postoperative (62.29±10.78)%(P<0.01),(51.82±16.32)% (P<0.05) and 1.54±0.80 (P<0.05) respectively, while the percentage of CD8﹢decreased from preoperative (45.71±12.94)%to postoperative (39.70±12.41)%(P<0.05). In the control group, no statistically significant differences in the above mentioned indexes existed between preoperative data and postoperative ones (P>0.05). Conclusion In treating advanced primary HCC, coix seed triglyceride combined with TACE can reduce the percentage of Treg cells, thus, influence the patient’s cellular immune status and possibly decrease the recurrence rate of HCC after TACE therapy.

Objective To investigate the effects of hypothermia combined with sevoflurane on expression of myocardial gap junction protein connexin 43 (Cx43) in isolated rabbit hearts.Methods Healthy adult rabbits of both sexes,weighing 1.5-2.0 kg,were sacrificed after anesthetization.The hearts were rapidly excised and perfused in a langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃ in a langendorff apparatus.Forty isolated hearts were randomly divided into 4 groups (n =10 each):control group (group C),hypothermia group (group H) and hypothermia combined with sevoflurane group (group HS).At 15 min of equilibration,the perfusion with K-H solution was continued at 37 ℃ in group C,K-H solution saturated with 2.4％ sevoflurane was perfused at 37 ℃ in group S,K-H solution was perfused at 30 ℃ in group H,and K-H solution saturated with 2.4％ sevoflurane was perfused at 30 ℃ in group HS.At 30 min of perfusion,myocardial specimens were obtained from the anterior wall of the left ventricle for detection of the expression of Cx43 in myocardial cells (by immunohistochemistry and Western blot).Results Compared with group C,Cx43 expression was downregualted in group H (P ＜ 0.05),and no significant change was found in Cx43 expression in S and HS groups (P ＞ 0.05).Cx43 levels distributed mainly in the intercalated disc in S and HS groups,and in H group the distribution of Cx43 levels in the intercalated disc was less,but the percentages of lateralized Cx43 were increased.Conclusion Sevofurane can inhibit hypothermia-induced down-regulation and distribution disturbance of myocardial Cx43 expression,which may be the mechanism by which sevofurane inhibits hypothermia-induced arrhythmia.

Background Patients' experience during phacoemulsification cataract surgery is an important determinant of patient's satisfaction with surgery effectiveness.Local anaesthesia could be associated with different intraoperative visual awareness because of retention of optic nerve function.Relieving the anxiety of patients arose from intraoperative visual awareness is of important clinical significance.Objective This study was to discuss the necessity of preoperative conversation and psychological counseling and to improve the quality of surgery and the satisfaction of patients.Methods One hundred and fifty-three patients who had undergone sequential phacoemulsification and intraocular lens (IOL) implantation in the same operation under local anaesthesia from October,2010 to December,2010 in Tangdu Hospital and Xi'an First People's Hospital,received a standardized questionnaire designed based on similar questionnaires from abroad and surveyed regarding their intraoperative visual experience,including light perception,their detection of color,photopsia,and their detection of the movement of the surgeon,instrument,and changes in light intensity during cataract surgery.In another survey,seventy ophthalmologists in the Xi'an area with ≥ 10 years (33) and ＜ 10 years of experience (37) participated in a questionnaire about their recognition and response to these visual experiences,designed based on the 2010 Chinese Doctors General Questionnaire.Results During the phacoemulsification and IOL implantation,27 patients (17.6％) lost light perception,98 patients (64.1％) had light perception,28 patients (18.3％) detected more than one color,25 patients (16.3％) had photopsia,49 patients (45.1％) sensed the movement of the surgeon,26 patients (17.0％) was able to see surgical instruments,11 patients (7.2％) saw the surgeon's fingers,4 patients (2.6％) saw the surgeons,65 patients (42.5％) detected changes in light intensity and 12 patients (7.8％) saw the IOL loop and others.21.4％ of the 70ophthalmologists believed these patients might have lost light perception;while 78.3％ thought these patients retained light perception.Under local anaesthesia,93.9％ of the more experienced surgeons and 75.6％ of the junior surgeons deemed that good preoperative counseling was helpful for the patients,but only 45.5％ of the more experienced surgeons and 24.3％ of the junior surgeons counseled patients regarding intraoperative visual experience.Conclusions Most patients will experience a variety of visual sensations during phacoemulsification and IOL implantation under local anaesthesia.Many ophthalmologists are aware of these conditions.Most of the ophthalmologists believe that patients suffer from fear from these intraoperative visual experiences and claim that preoperative counseling to patients can relieve that fear,but less of them communicate these possible experiences to patients.This study offers some discussions about preoperative counseling.

OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).

METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.

RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).

CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.

Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective To investigate the role of Catbindin-D28k in the kidney on calcium metabolism.Methods VDR/CaBP-D28k double knockout(KO)mice was made.Body weight,diet intake and serum,urinary parameters and length,density of the long bones,histological staining of the tibia of WT,CaBP-D28(-/-),VDR(-/-)and VDR(-/-)/CaBP-D28k(-/-)mice were determined on regular and high Ca-Lac diet.Results On a regular diet,the double KO mice were growth-retarded more and smaller than VDR KO mice.Compared with VDR KO mice,the double KO mice had higher urinary calcium excretion and rachitic skeletal phenotype,which were manifested with higher serum parathyroid hormone levels,lower bone mineral density,and more distorted growth plate with mole osteoid formation in the trabecular region.On high calcium and high lactose diet,blood-ionized calcium levels were normal in both VDR KO and the double KO mice.However,in contrast to VDR KO mice,the skeletal abnormalities were not completely corrected in the double KO mice.Conclusion These results directly demonstrate that CaBP-D28k plays a critical role in maintaining calcium homeostasis and skeletal mineralization and suggest that its caleemic role can be mostly compensated by CaBP-D9k.

Objective To obtain two-dimensional gel electrophoresis maps of the renal tissue proteins of normal and chronic intermittent hypoxia(CIH) rats for identifying the diferentially expressed proteins in the CIH rats.MethodsCIH rat models were established, and the proteins in the renal tissue underwent two-dimensional gel electrophoresis with immobiline pH gradientisoeleclricfocusingasthefirstdimensionandverticalSDS-PAGEasthesecond dimension.Analysis of 2-DE maps was used to determine differential expression of proteins between the two groups by ImageMaster 2D Platinum 5.0, and four protein spots expressed differently were picked up for further identification by MALDI-TOF-MS.Results Matched and compared with those of control group, 112 protein spots were determined with differently expressive levels in CIH group.By MALDI-TOF-MS, three protein spots of them were identified as ATP synthase delta subunit of mitochondrial precursor, catechol O-methyltransferase, apurinic/apyrimidinic endonudease.Conclusions There is obvious difference in expressive proteomes in renal tissue between normal and chronic intermittent hypoxia rats.The functions of those identified proteins are involved in cellular energy metabolism, apoptosis, signal transduction, anti-cell injury and hormone metabolism,so that proteomics can serve as a new approach in the study of obstructive sleep apnea-hypopnea syndrome to discover new therapeutic targets.

PurposeTo compare measures of coronary flow reserve by an intracoronary Doppler guide wire with results of dipyridamole emission computed tomographic 201T1/ 99m Tc-sestamibi myocardial imaging(SPECT).MethodsThe coronary blood flow velocity were measured by Cardiometrics Flomap Ⅱ and 0. 014 or 0. 018 inches Doppler flowire in 27 patients (55 arteries) with coronary angiography. 8 patients (19 arteries )without underlying diseases of coronary microvascular lesions were studied as the normal control. The proximal and distal average peak velocity (APV), diastolic/systolic velocity ratio (DSVR), CFR and proximal/distal velocity ratio (P/DVR) were measured. The results were compared with that of SPECT before angiography. ResultsAccording to the CFR measured by Doppler fiowire, the arteries were divided into two groups:Group A, consisted of 33 arteries with CFR > 2.0. Group B consistedof 22 arteries with CFR≤2.0. CFR of group A was significantly higher than that of group B (P< 10 - 7). Among 22 arteries with abnormal CFR, SPECT could detect 16. Among 33 arteries with normal CFR, all arteries except 2 showed normal SPECT. With intracoronary Doppler flowire as reference, the sensitivity and specificity of dipyridamole SPECT were 72.73 % and 93.94 %. With results of dipyridamole SPECT as reference, the sensitivity and specificity of intracoronary Doppler CFR were 88.89% and 83.78%. Their conformability rate was 85.45%.Conclusions In evaluating coronary reserve function, results of dipyridamole SPECT was rather conformable to measures of intracoronary Doppler CFR, but they cannot be replaced each other.

Objectives To explore the relevant factors of liver X receptor (LXR) and lipid metabolism in school-age chil-dren with obesity. Methods A total of 80 obese children were selected by indexes of physical growth from pupils in Grades 1-6, aged 7-14 years from June 2011 to October 2011. Fifty-one age and sex matched children with normal BMI were chosen as nor-mal controls. The metabolic indexes including aspartate transaminase (AST), alanine aminotransferase (ALT), glutamyl transpep-tidase (GGT), total cholesterol (CHOL), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipopro-tein cholesterol (LDL-C) and expression of LXR were detected in fasting blood. Results The expression level of LXR in obese children (9.14 ± 1.15) was higher than that in control children (2.84 ± 3.68) with significant difference (t=4.55,P=0.000). Eighty percent (80%) of obese children were LXR>1 (64/80) which was higher than that of control children (23/51, 45.1%), and signifi-cant difference was found between the two groups (χ2=17.01, P=0.000). Compared to controls, the levels of AST, ALT, GGT, CHOL, TG and LDL-C were higher while the level of HDL-C was lower in obese children (P<0.05). The correlation analysis found that AST, ALT, CHOL, LDL-C and BMI were positively correlated with LXR (r=0.18~0.26,P<0.05). Logistic regression ana-lysis showed that AST≥40IU/L (OR=1.076), ALT≥40IU/L (OR=1.036), CHOL≥5.20 mmol/L (OR=2.038), LDL-C≥3.36 mmol/L (OR=2.176) and BMI≥18.9 kg/m2 (OR=1.131) were risk factors for LXR>1 (P<0.05). Conclusions Obesity in school-age chil-dren can up-regulate the expression of liver X receptor and cause liver damage and abnormal lipids metabolism.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion in intervening acute ischemic stroke. Methods: A total of 112 patients were divided into a control group and an observation group by the random number table method, with 56 cases in each group. The control group was treated with conventional treatment, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. The National Institute of Health stroke scale (NIHSS) and modified Barthel index (MBI) were evaluated, and the intracranial hemodynamic indicators including mean velocity (Vm), pulsatility index (PI) and resistance index (RI) were recorded, and the serum levels of superoxide dismutase (SOD) and homocysteine (HCY) were measured before and after treatment. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS scores in both groups decreased significantly (both P<0.05), and the MBI scores increased significantly (both P<0.05). The improvements of NIHSS and MBI scores in the observation group were superior to those in the control group (both P<0.05). Vm in both groups increased significantly (both P<0.05), PI and RI decreased (all P<0.05), and Vm, PI and RI in the observation group were superior to those in the control group (all P<0.05). The serum levels of SOD and HCY in the observation group were significantly improved, and were statistically different from those in the control group (both P<0.05). Conclusion: Conventional treatment plus heat-sensitive moxibustion is effective in intervening acute ischemic stroke. It can promote the recovery of neurological function, improve daily activities, and improve intracranial blood flow, which may be related to the regulation of serum SOD and HCY levels.