Objective To evaluate the outcome of AF ablation in patients with paroxysmal atrial fibrillation (AF) related tachycardia-bradycardia syndrome. Methods Fifty consecutive patients with paroxysmal AF and prolonged symptomatic sinus pauses on termination of AF referred to our hospital for ablation were evaluated (ABL group). In another 61 patients, paroxysmal AF was treated with anti-arrhythmic drug and a pacemaker was implanted due to AF related tachycardia-bradycardia syndrome. These patients were used as control (PM group). Results A total of 50 patients in the ABL group fulfilled Class I indication for pacemaker implantation at baseline but they actually underwent AF ablation. Re-evaluation at the end of follow-up showed that 47 (94%) patients no longer needed a pacemaker (Class III indication) because of free from AF with no recurrences of pre-syncopal or syncopal events or documented sinus pauses after the last procedure. More patients in the PM group were on AADs (PM 42.6%, ABL 6.0%, P < 0.001) while sinus rhythm maintenance at the end of follow-up was remarkably higher in the ABL group (82.0%vs. 21.3%in PM group, P < 0.001). The total rates of cardiac related re-hospitalization was not significantly different between the two groups, but hospitalizations caused by tachyarrhythmia was significantly higher in the PM group (PM group 14.8%, ABL group 2.0%, P=0.020).The embolic events, heart failure and death rate were not significantly different between the two groups. Conclusions In patients with paroxysmal AF related tachycardia-bradycardia syndrome, AF ablation seems to be superior to a strategy of pacing plus AAD. Pacemaker implantation can be waived in the majority of patients after a successful ablation.

Objective To evaluate the effects of epidural capsaicin on pain threshold and nerve tissue structure in adult rats. Methods Twenty-four adult male Wistar rats weighing 250-300 g were used in this study. A catheter was inserted into epidural space at L5,6 according to the method of Philippe. 0.4 ml of capsaicin 0.1% (group A), 0.25% (group B) or 0.5% (group C) or 10% Tween 80 (control group) was injected via the epidural catheter. Pain threshold was measured by thermal stimulation of the tail before (baseline) and on the 3rd, 7th and 14th day after epidural capsaicin. The animals were then killed. The lumbar segment (L4-6) of the spinal cord and spinal nerve roots were removed immediately for light and electron microscopic examination. Results Pain threshold was significantly higher in group A, B and C than in control group (P

Objective To evaluate the accuracy of performance of Engstrom Eas 9010 vaporizerMethods Using Datex Capnomac AS/3 monitored the output of Gambro-Engstrom Eas 9010 anesthetic agent vaporizer under various situations l Determing the output of vaporizer at different gas flow rates of 0 5,1 0,2 0,4 0,6 0 and 8 0 L?min -1 2 The effects resulting from up stream oxygen flushing 3 The effects due to additional nitrous oxide as carrier gas 4 Effects of different airway pressure at the same flow rate Results 1 The output of the vaporizer was highly correlated with the dial setting at various gas flow rate except dial setting was more than 8% and gas flow rate less than 0 5L?min -1 2 Upstream oxygen flush could not decrease the concentration remarkably 3 The output of the vaporizer was not affected by additional carrier gas 4 The effect on vaporizer output was not remarkable under different airway pressure at the same flow rate Conclusions The anesthetic vaporizer principle used in the Gambro-Engstrom Eas 9010 apparatus is innovative Electronically controlled vapor quanta injection is used with safety feed back Its accuracy can't be influenced by temperature,pressure and carrier gas indicating to be safely applied to the low or even minimal flow anesthesia

Objective To evaluate the effects of different doses of epidural capsaicin on pain threshold, neurological function and spinal neurons.Methods Thirty-six male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups (n = 9 each): control group and 3 capsaicin groups (Cap 1, 2, 3). The animals were anesthetized with 10% chloral hydrate 50-75 mg?kg-1 i.v. . An intrathecal catheter was inserted at L6,7 interspace and correct placement was confirmed by outflow of CSF. 1 ml of 0.1 % ( Cap1) , 0.25 % ( Cap2 ) or 0.5% (Cap3 ) capsaicin was injected intrathecally 24 h after IT catheter was placed. Threshold to noxious thermal stimuli was measured and gait of the hind limbs were assessed using Johnson score (5 = normal, 0 = completely paralyzed), before and 1, 3, 7, 10, 15, 20, 25, 30 days after IT injection. On the 2nd day after IT injection 3 animals were killed in each group and the lumbar segment of spinal cord (L6,7) was immediately removed for light and electron microscopic examination. Results The threshold to noxious thermal stimuli was significantly higher in the 3 capsaicin groups than in control group ( P

Objective:To observe the therapeutic effect ofcapsaicin at different concentrations on chronic knee arthritis pain model in mice.Methods:Choosing 50 healthy adult male Kunming mice builded chronic knee arthritis pain model by injecting 0.01 mL CFA (Complete Freund's Adjuvant,CFA) into left joint cavity.The model would be succeed in building after 3 weeks.The successful model mice were divided into five groups randomly (n=10):The first experimental group (saline group),the second experimental group (capsaicin excipient group),the third experimental group (0.5 ％ of capsaicin),the fourth experimental group (3 ％ of capsaicin) and the fifth experimental group (8 ％ of capsaicin).All of the mice would be observed the time of withdrawal latencies from the thermal heated surface after administration of one,four and seven hours,and thermal withdrawal time within 60 days after the injection.Results:①The physiological saline group compared with excipient group,the thermal withdrawal time had no statistically significant difference (P＞0.05)after administration of one,four and seven hours,and thermal withdrawal time within 60 days.②The acute pain duration of the third group would disappear after capsaicin injection 7 hours,four hours for the fourth group,and one hour for the fifth group.③The duration of analgesia of the third group,lasted for 18.9± 1.1 days;The analgesia time of the fourth group lasted for 33.7± 1.0 days;The analgesia time of the fifth group lasted for 58.2± 1.2 days.Conclusions:Capsaicin has analgesic effects on chronic knee pain model in mice induced by CFA,and the days of analgesia increases with the concentration of capsaicin.

Eighty patients(American Society of AnesthesiologistsⅠ-Ⅱ)scheduled for elective unilateral inguinal hernia surgery with spinal anesthesia between January and June 2016 were randomized into two groups with 40 in each group.Patients were intravenously injected with normal saline (5 ml) in control group or hydromorphone 5 μg/kg (diluted to 5 ml) in intervention group after spinal anesthesia.Tympanic temperature and the incidence of shrivering were measured before and after spinal anesthesia at predetermined intervals.Side effects during surgery and the first 48 h after surgery were recorded.Rescue drug tramadol 0.5 mg/kg was given intravenously to patients with grade ≥2 shivering for more than 5 min duration.Tympanic temperature decreased significantly compared to the baseline from 20 min in control group and from 10 min in intervention group after spinal blocking(P<0.05),while there were no significant differences in tympanic temperature at the same time points between two groups(P>0.05).The incidence of shivering was significantly lower in intervention group [17.5%(7/40)] than that in control group [47.5%(19/40),χ2=8.205,P=0.004].The incidence of nausea and vomiting was 5.0%(2/40)in intervention group and 0.0% (0/40) in control group (χ2=2.051,P=0.494).The incidence of sedation was not significantly different between control group [0.0%(0/40)] and intervention group[10.0%(4/10),χ2=4.211,P=0.116].The use of rescue tramadol was more frequently in control group [32.5%(13/40)] than that in intervention group [7.5%(3/40),χ2=7.812,P=0.01].The results indicate that intravenous hydromorphone can significantly attenuate the incidence of shivering after spinal anesthesia for inguinal herniorrhaphy repair surgery with minimum side effects.

BACKGROUND:The oxygen free radicals and apoptosis play an important role in limb ischemia/reperfusion injury, so we can al eviate limb ischemia/reperfusion injury by inhibiting the production of oxygen free radicals and apoptosis.
OBJECTIVE:To discuss the application and effect of edaravone on limb ischemia/reperfusion injury in rats.
METHODS:Of the 30 female Sprague-Dawley rats, 20 rats were randomly selected to make models of limb ischemia/reperfusion injury by ligating the root of right lower limb with a self-made bal oon cuff at 40 kPa pressure to block blood flow for 4 hours and reperfusing. After success model establishment, they were randomly assigned to two groups. In the edaravone perfusion group, edaravone 3 mg/kg was injected via the left femoral vein at 5 minutes before reperfusion. In the model group and normal group (the remaining 10 rats), an equal volume of physiological saline was given at the same time point. At 24 hours after reperfusion, the right anterior tibial muscle of each group was removed and these ultrastructural changes were observed by transmission electron microscope. Bcl-2 mRNA and Bax mRNA of rat anterior tibial muscle of each group were semiquantitatively detected with the RT-PCR and the ratio of bcl-2/bax was calculated.
RESULTS AND CONCLUSION:(1)Electron microscope results:compared with the model group, the muscle fibers were neater;the M line and the N line were clearer;the swel ing of mitochondria was al eviated;the numbers of mitochondria and mitochondrial crista were also increased in the edaravone perfusion group. (2)RT-PCR results:At 24 hours after reperfusion, the relative expression of bcl-2 mRNA and the ratio of bcl-2 mRNA to bax mRNA in right anterior tibial muscle were lower in the model group compared with the edaravone perfusion group (P<0.05). However, relative expression of bax mRNA was greater in the model group than that in the edaravone perfusion group, which were both higher than the normal group (P<0.05). Results indicated that the free radical scavenger edaravone relieved limb ischemia/reperfusion injury by improving the mitochondrial ultrastructure and promoting expression of bcl-2 mRNA and inhibiting expression of bax mRNA, and could provide a new choice for the treatment of limb ischemia/reperfusion injury.

Objective To evaluate the diagnostic value of computed tomography enteroclysis/enterography (CTE),magnetic resorance enteroclysis/enterography (MRE) and ultrasonography (US) in Crohn's disease (CD) by Meta-analysis.Methods Segmental intestinal wall thickening and strengthening was taken as image diagnostic indicators in CD.Endoscopic and histopathologic findings and follow-up results were set as diagnostic standard.Retrieve and literature inclusion criteria were developed.The papers of CD diagnosed by CTE,MRE and US which met the criteria were searched and screened.The quality of the papers was evaluated by quality assessment of diagnostic accuracy studies (QUADAS).The diagnostic efficacy of CTE,MRE and US was compared,which included sensitivity,specificity,positive likelihood ratio and negative likelihood ratio,positive predictive value (PPV) and negative predictive value (NPV).Results Among the 2197 retrieved literature,a total of 12 papers met the criteria and nine of which were blinded study.The papers were grouped by three different imaging techniques and underwent QUADAS scale scoring.One paper was about CTE and MRE comparative study,so there were six papers in CTE group,the scores of all the six papers were over 10 and all of them were blinded study.There were four papers in MRE group,the scores of three papers were over 10 and all of them were blinded study.There were three papers in US group,the score of one paper was over 10 and two of these three papers were blinded study and one with unclear evaluation.The sensitivity of CTE group was the highest (89 ％),while the specificity (90 ％) was lower than that of US group (95％).The PPV (93％),NPV (95％),positive likelihood ratio (15.16) and negative likelihood ratio (0.17) of US group were the highest,those of CTE were secondary (PPV 91％,NPV 82％,positive likelihood ratio 6.25 and negative likelihood ratio 0.15).The sensitivity (74％),specificity (84％),PPV (80％),NPV (80％),positive likelihood ratio (4.18) and negative likelihood ratio (0.33) of MRE group were lower than both US group and CTE group.Conclusions The sensitivity of CTE in CD diagnosis is better than that of MRE and US,while other diagnostic indicators are poorer than US.Even though US has high diagnostic value in CD,more well designed large sample study were still needed for further evaluation.

Objective To investigate the effect of rosiglitazone (RGTZ) on anti-oxidation in aging rat kidney. Methods Twenty-four-month-old male Sprague-Dawley rats were randomly divided into three groups (n=10): control group (CON), rosiglitazone group (RGTZ) and caloric restriction group (CR). The CON rats were allowed ad libitum access to feed and tap water.The RGTZ rats received intragastric administration of RGTZ (4 mg·kg-1·d-1),and the CR rats were provided with a vitamin and mineral fortified version of the same diet at a level of 40% less food (by weight) than the CON rats. After 12 weeks all the animals were sacrificed by decapitation, and both the body weight and the percentage of kidney and heart in each group were measured.Western blot was performed to analyze the expression of PPARγ protein. The content of MDA and the activity of SOD and GSH-PX in kidney tissue were detected. Besides, frozen sections of kidney tissue were stained for senescence-associated-13 galactosidase (SA-β-Gal). Results The body weight of CR rats decreased obviously, in contrast, which did not change in CON and RGTZ group. Percentage of kidney and heart to body weight was normal in CR or RGTZ group after intervention. Western blot result showed that PPARγ protein expression in rat kidney was significantly higher in RGTZ and CR group as compared to CON group (P<0.05). Compared with RGTZ and CR rats, obviously lower activities of SOD and GSH-Px were noted in CON rats, however, the content of MDA was higher in CON rats. Additionally, the positive staining area of [3-Gal in CR and RGTZ group was significantly smaller than that in CON rats (P<0.05, P<0.01 ). Conclusion RGTZ can defer the kidney aging in senescence SD rat, and the mechanism may be related to amelioration of oxidative damage and enhancement of antioxidation.

Objective To observe the month age distribution of peroxisome proliferators activated receptor gamma (PPARγ) expression in rat kedney. Methods Wistar rats aged 3 months,12 months and 24 months were made as models who represented young, middle-aged and old group respectively. Western blotting, immunohistochemical (IHC) and in-situ hybridization (ISH) were used to detect the expression and location of protein and mRNA of PPARγ in rat kidney. Results Western blotting results showed that the expression of PPARγ protein was higher in 3 months group than in 24 months group (0.94±0.05 vs. 0.78±0.02, P＜0.01) and 12 months group (0.87±0.04, P＞0.05), and it reduced in 24 months group than in 12 months group (P＞0.05). By IHC,the PPARγ protein was localized predominantly in the nuclear of tubular epithelia and collecting duct cells in each group. In old age group, PPARγ protein was also detected little in the mesangial and Bowman's capsule epithelial cells. Meanwhile, the distribution of PPARγ mRNA with ISH was consistent with above findings. Additional, semi-quantitative analysis of ISH results verified that the level of PPARγ mRNA decreased with ageing. Conclusions As a nuclear transcription factor,PPARγ participates in the regulation of rat kidney aging.