Objective To compare the effects of phenylephrine and norepinephrine in patients with restrictive transfusion.Methods 65 patients undergoing laparoscopic resection of rectal cancer were selected.According to the random number table method,the patients were randomly divided into 32 cases of observation group (phenylephrine composite restriction infusion) and 33 cases of control group(norepinephrine combined restrictive transfusion).The operation and hemodynamics of the two groups at different time points were compared.At T0,T1,T2,the central venous blood and arterial blood were collected,the central venous blood saturation (ScvO2),arterial blood lactate (Lac),central venous oxygen partial pressure (PcvO2),PaO2,Hb concentrations,venous oxygen content (CcvO2),arterial oxygen content(CaO2),arteriovenous oxygen content difference (Ca-cvO2) and oxygen uptake rate (ERO2) were compared between the two groups.Results The ASA levels (Ⅰ / Ⅱ grade) of the observation group and the control group were 11 cases/21 cases and 13 cases/20 cases,respectively,the difference was not statistically significant(x2 =5.298,P =0.052).The BMI of the observation group and the control group were (20.61 ± 1.65) kg/m2,(21.57 ± 1.42) kg/m2,respectively,the difference was not statistically significant (t =0.652,P =1.980).The fluid replacement of the observation group and the control group were (1 162 ± 113) mL,(1171 ± 104) mL,respectively,the difference was not statistically significant (t =1.734,P =0.065).The blood loss of the observation group and the control group were (276 ± 41) mL,(294 ± 42) mL,respectively,the difference was not statistically significant (t =0.083,P =1.023).The urine volume of the observation group and the control group were (524 ± 113) mL,(532 ± 109) mL,respectively,the difference was not statistically significant(t =1.834,P =0.053).The operation time of the observation group and the control group were (192 ± 24) min,(197 ± 21) min,respectively,the difference was not statistically significant(t =1.367,P =0.073).The MAP at T1-T2 of the two groups increased,the CVP of the two groups was significantly higher at T1,the HR of the two groups was significantly higher at T2.The MAP,CVP,HR between the two groups had no significant differences (all P ＞ 0.05).The levels of ScvO2,PcvO2 and PaO2 at T1 were significantly higher than those at T0,on the contrary,the levels of ScvO2,PcvO2 and PaO2 at T2 were significantly lower than those at T0,and the Hb in the observation group was significantly lower at T1-T2,the Hb in the control group was significantly lower at T,-T2,which in the observation group was lower than the control group,the differences were statistically significant(all P ＜ 0.05).There was no statistically significant difference in Lac between the two groups (P ＞ 0.05).There were statistically significant differences in CcvO2,CaO2,Ca-cvO2 and ERO2 between the two groups at different time points (all P ＜ 0.05).Conclusion Phenylephrine is more effective than norepinephrine in limiting infusion in elderly patients,and it has more obvious effects on tissue oxygen metabolism.

Benzene ; toxicity ; Gene Expression Profiling ; Oligonucleotide Array Sequence Analysis

Bile acid can not only emulsify fat and facilitate the absorption of fat soluble substances,but also it is an important signaling molecules that plays an important physiological role by activating specific bile acid receptors.Takeda G proteincoupled receptor 5 (TGRS) is a membrane receptor of the bile acid,it can activate G-protein effectors and promote the expression of the second messenger and activate a variety of signal transduction pathways to exert physiological functions.The obstructive jaundice bile acid can cause a series of pathophysiological reactions through activating TGR5,which plays a significant role in the obstructive jaundice.In this article,the latest researches about the function and molecular mechanism of TGR5 in obstructive jaundice were reviewed in order to provide a new idea for exploring the new method and strategy to cure the disease.

AIM:To evaluate the effect of all capsule polishing with polishing mode for decreasing the occurrence of posterior capsular opacification( PCO) .
METHODS: Totally 194 eyes ( 162 patients ) were performed phacoemulsification, posterior chamber intraocular lens were implanted. One hundred eyes were performed with all capsule polishing with polishing mode;94 eyes were performed with the polishing apparatus.
RESULTS:The patients were followed up for 12mo. Six eyes ( 6. 0%) of PCO were found in the 100 eyes with polishing mode group; 15 eyes ( 16. 0%) of PCO were found in the 94 eyes with the polishing apparatus group. The difference was significant (P<0. 05).
CONCLUSION: It can decrease the occurrence of PCO by performing all capsule polishing with polishing mode.

Objective To study the changes of cytokine activation in patients with chronic congestive haert failure(CHF) as indicated by plasma levels of C-reactive protein(CRP)and its relation to adrenomedullin(ADM) and endthelin-1(ET-1).Methods The plasma levels of CRP,ADM and ET-1 of 60 decompensated haert failure(DHF) patients group and 30 essential hypertension patients with compensated cardiac function(CCF) group were tested. CRP was determined by immunoturbidometry,ET-1 and ADM were determined by radioimmunoassay.Results The plasma levels of ET-1 ,ADM and CRP of decompensated heart failure group were significantly higher than the compensated cardiac function group;In the decompensated heart failure group,the plasma levels of CRP and ADM were elevated according to worsening of heart failure(NYHA classification) ;In the decompensated heart failure group,the plasma levels of CRP were positively correlated with ADM(r=0.57).Conclusion There is extensive activation of cytokines,ADM and ET-1 in patients with chronic congestive heart failure.Cytokine activation might play a role in the synthesis of ADM,thus contribute to the hum oral regulation of heart failure,but may not be re- sponsible for the activation of ET-1.

Objective To investigate the influence of aerobic exercise on the vulnerability of atherosclerotic plaques and to observe the concentration of matrix metalloproteinase-9 ( MMP-9 ) and matrix metalloproteinase-14(MMP-14) in carotid atherosclerotic plaques in apolipoprotein E (APoE) gene deficient mice.Methods Eighty male, APoE gene deficient mice were divided into two equal groups: an aerobic exercise group and a limited action control group. Carotid atherosclerotic lesions were induced by perivascular constrictive collars placed on the right common carotid artery. Blood lipid levels in the exercise group were measured after 8 weeks of treadmill running and also in the control group. The morphological characteristics of carotid atherosclerotic plaques were observed in the two groups. Plaque area and fibrous cap thickness were measured. Lipid and collagen positive areas were quantified and the ratios correlated with the entimal areas were calculated. Plaque rupture rate and vulnerable index were calculated.Immunostaining was used to detect MMP-9 and MMP-14 expression in the atherosclerotic plaques. The mRNA levels of MMP-9 and MMP-14 mRNA in the fresh carotid plaques were quantified using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR). Western blotting was performed for examining MMP-9 and MMP-14 protein expression in the fresh carotid plaques.Results No significant difference in serum lipid profiles or plaque area was found between the exercise and control groups. Compared with the control group, mean fibrous cap thickness, cap/core ratio and collagen content were all significantly higher in the exercise group, and lipid content was significantly lower. Plaque rupture rate and the vulnerable index were both significantly lower in the exercise group. Immunostaining showed that MMP-9 and MMP-14 expression were lower in the exercise group compared with the control group.The mRNA expression of MMP-9 and MMP-14 was also significantly lower.Conclusions Aerobic exercise can decrease the expression of MMP-9 and MMP-14 in carotid atherosclerotic plaques in ApoE gene deficient mice. Aerobic exercise may play a role in forestalling atherosclerosis by increasing the stability of plaque and decreasing plaque vulnerability.

Humans ; Injections ; Myocardium ; Tissue Engineering

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; physiopathology ; Trigger Points ; physiopathology ; Vertigo ; physiopathology ; therapy

Tutorial System is beneficial to improving the general disposition of undergraduate students,forming better learning atmosphere,enhancing the scientific research ability,broadening the pathway of contacting society,developing students' cognitive ability,and strengthening employment instructive work.Tutorial system for undergraduate students has been carried out for 4 years in our military medical university.After finding some problems of the work,making a summary of the beneficial experience and analyzing the cause of problems,we try to put forward some suggestions and take some optimization measures.

Aim To investigate the effects of U50488H,a selective ?-opioid receptor agonist,on the blood pressure in the rats and explore their mechanisms.Methods Heart rate(HR),arterial blood pressure(ABP),left ventricular pressure(LVP),contractive function(+ dp/dt_(max)) and diastolic function(-dp/dt_(max)) were examined in rats.Physiological experimental technique was used to collect urine and to determine the volume of urine output;isolated artery perfusion technique was used to investigate the direct action of U50488H on abdominal aorta of rats.Results HR,ABP,LVP and ?dp/dt_(max) in rats were decreased with the administration of U50488H;the urine volume increased significantly with the administration of U50488H.U50488H induced a dose-dependent vasodilation in the aortic artery.These effects of U50488H were totally abolished by nor-BNI,a selective ?-opioid receptor antagonist.Conclusion Stimulation of ?-opioid receptor with U50488H depresses the blood pressure mainly by reducing the strength of cardiac muscle,enhancing the urine volume and relaxing the vessel.