Objective To assess the changes in the effect compartment concentration (Ce) and bispectral index (BIS) during a step-by-step TCI of propofol in the elderly.Methods Ten ASA Ⅰ -Ⅱ patients (6 male, 4 female) aged 67-77yr and weighing 51-78kg, undergoing elective surgery were studied. Patients with severe cardiovascular disease were excluded. The patients were unpremedicated. Anesthesia was induced with propofol administered by a TCI system (Diprifusor) . The target concentration (Ct) of propofol was increased step-by-step from 1?g?ml-1 to 4?g?ml-1 in 6 steps. At each step Ct increased by 0.5?g?ml-1 and the interval between the two steps was 2min. The changes in Ce (calculated and displayed by Diprifusor) and BIS were recorded. Modified OAA/S sedation score were measured. Blood samples were taken from artery for determination of blood concentration of propofol (Cb) before TCI (T0 ) and when Ct was 1, 2, 3, and 4?g*******ml-1 (T1-4) in 5 randomly selected patients.Results (1) Ce consistently increased with the increase in Ct and there was a delay between Ct and Ce. When Ct was increased to 4?g*******ml-1, it took (14.4 ? 0.5) min to achieve the balance between Ct and Ce. (2) Cb of propofol was higher than Ct of propofol at each step. MDPE and MDAPE was 9.7% and 11.2% respectively. (3) There was a close correlation between BIS and Ct, Ce and OAA/S score( r = - 0.878, - 0.888 and 0.913 respectively , P

Objective To explore the health inspector effect on the score of hygienic degree of hostels. Methods Using the scale for hygienic degree of hostels, 38 health inspectors from 9 sections in the Bureau for Health Inspection and Supervision of Haidian District in Beijing, scored 621 hostels in the district. The multilevel statistics model has been used to analyze the health inspector effect, of which the index is intra-class correlation (ICC), in the double level model structured by hostels as the level 1 unit and inspectors as the level 2 unit, and in the triple level model structured by hostels as the level 1 unit, inspectors as the level 2 unit and the sections as the level 3 unit. Results In the double level model, ICC of the level 2 unit is 0.142 8. In the triple level model, ICC of the level 2 unit is 0.0000 and ICC of the level 3 unit is 0.154 1. Conclusion There is inspector effect influencing the score of hygienic degree. And the effect seems to be more similar in one section comparing with the other ones.

Objective To explore the basic health state of the hotels in Haidian District. Methods 736 hotels were chosen to investigate on the hygiene state, in Haidian District, Beijing, during Feb.-Jul., 2006, based on the tables for the hygienic quantified and classified management of hotel health supervision. Results The hygienic quantified and classified standard score of 736 hotels was 53.7?22.6, and the standard score of the common hotels, one or two stars hotels and three or more stars hotel were 50.9?21.5, 58.9?24.7, 76.4?17.1. 50 households (6.8%) within them were A degree, 144 households (19.6%) were B degreee, 121 households(16.4%) were C degree and 421 households(57.2%) were D degree. Conclusion The general hygienic state of the hotels should be paid more attention to. The hygienic state changes with the level of the hotels.

Objective To investigate the safety and medium-and long-term effects of endovascular stenting,axilloaxillary bypass (AAB),carotid-subclavian bypass (CSB) in patients of subclavian arterial occlusion.Method From 2001 to 2013,311 consecutive patients with subclavian arteriosclerosis obliterans were treated with endovascular stenting (n =191),axilloaxillary bypass (n =96) or carotidsubclavian bypass(n =32).We collected patients' medical data,calculated patency of the graft or stent with life-table method and compared patency between three approaches with Log-rank.Results The incidence of perioperative complications was 4.1％ in the stenting group vs.11.5％ in AAB group vs.18.7％ in CSB group.There was significant statistical differences between the stenting group and bypass group about the incidence of perioperative complications.The primary patency rates at 1,3 and 5 years were 90.3％,84％,81.6％ in stenting group vs.95.3％,92.6％,88.9％ for AAB group vs.100％,96.4％,96.4％ for CSB group.There was significant statistical differences between the stenting group and bypass group about the primary patency rates.Conclusions Both endovascular stenting and extrathoracic surgical bypass are safe and effective treatments for subclavian arteriosclerosis obliterans.However,effect of extrathoracic surgical bypass is more durable in the medium-and long-term.

AIM: To investigate the expression and functional role of p38MAPK in the kidney after unilateral ureteral obstruction in rats. METHODS: Unilateral ureteral obstruction (UUO) models were induced by ligating the left ureter. Rats were sacrificed at 1 h, 3 h, 6 h, 12 h, 1, 3, 5, 7, 14, 21, and 28 days after UUO was initiated. p38MAPK activity was assayed by immunohistochemical staining and specific substrate phosphorylation with immunoprecipitation and Western blotting. TGF? mRNA and protein expression were analyzed with in situ hybridization and immunohistochemical stainning. RESULTS: A basic p38MAPK activity was detectable in the normal kidney(0.22?0.06). p38MAPK pathway was rapidly activated at 1 hour(0.45?0.14 vs control, P

Objective To evaluate the changes of left ventricular regional function in normal subjects with aging and the influencing factors by Doppler tissue imaging. Methods One hundred and twelve normal subjects were divided into four groups according to age: I group with age≤18 years old ; II group with 18 60 years old. Using a quantitative tissue velocity analysis system and tissue tracking, the peak velocities of different ventricular segments at systole, early and late diastole (Vs, Ve,Va) , the Ve/Va ratios were obtained and the effects of age, gender, heart rate and STd were analyzed. Results (1) Peak velocities of different segments of each wall were decreased one by one from mitral annulus, the basal, middle segment to the apical portion. (2) Peak velocities of different ventricular walls were significantly different, with the antero- and posterio-inter-ventricular septum being the lowest CVe (6. 89?2. 60) ,(7. 94?2. 64)cm/s]and with the latero-,posterio-,antero, and inferior walls of the left ventricle being higherCVe (9. 85?3. 02) , (9. 80?3. 09), (8. 86?3. 16), (8. 23?2. 48) cm/s] . (3) Peak velocities of different segments were associated with age, STd, BMI, heart rate and not associated with gender. (4) The Ve/Va ratios were increased one by one from mitral annulus, basal, middle segment to apical portion, and were significantly lower in III group and IV group than in I group and II group. Conclusions Peak velocities of different segments at different walls change regularly and age is the most important influencing factor to the diastolic velocities.

Objective To investigate the function role and mechanism of p38 mitogen-activated protein kinase(p38MAPK) in up-regulating osteopontin mRNA expression in rat glomerular mesangial cells induced by interleukin-1?.Methods Activation of p38MAPK was detected with Western blotting,The effect of p38MAPK specific blockade SB203580 on the expression of osteoponlin mRNA in rat mesangial cells induced by interleukin-1? was measured with RT-PCR. Results interleukin-1? could activate p38MAPK in time- and dosage-dependent manner,and up-regulate osteopontin mRNA expression in rat glomerular mesangial cells. SB203580 obviously inhibited the up-regulation of osteopontin mRNA induced by interleukin-1? in dosage dependent manner. Conclusion p38MAPK may play an important role in the up-regulation of osteopontin in rat glomerular mesangial cells induced by interleukin-1?.

Objective To investigate the safety and feasibility of early intervention treatment for aneurysmal subarachnoid hemorrhage in the elderly. Methods Within 6 to 72 hours after hemorrhage,89 aneurysms were detected by overall brain angiogram in 84 elderly patients(aged above 60 years)Who were diagnosed as subarachnoid hemorrhage on CT.HUNT-HESS grade was as following:26 cases of grade Ⅱ,31 cases of grade Ⅲ,25 cases of grade Ⅳ,2 cases of grade Ⅴ.Interventional embolization treatment was performed immediately.Aceording to the structure of the aneurysm,pure coil embolization,balloon assisted technique and combined with stent technique were performed.Anhydration,fluid expansion,vessel dilatation,lumbar puncture and/or lumbar drainage were performed after procedure.At the same time,the complications were treated. Results Eighty-three aneurysms were embolized successfully in 89 patients.The Success rate of the technique was 93.3%.The Glasgow Outcome Seale(GOS)score at 3 months post procedure showed a good result in 68 patients.medium disability in 7 patients,severe disability in 4 patients,death in 5 patients (1 case was related to the technique). Conclusions Interventional embolization iS a safe and effective therapeutic approach in elderly patients with subarachnoid hemorrhage.

Objective To summarize the effect of supra-arch branches bypass combined with endovascular aortic repair for aortic diseases.Methods From January 2012 to August 2015,120 cases of thoracic aortic diseases (aortic dissection 103,aortic aneurysm 16,penetrating aortic ulcer 1) received hybrid operation in Guangdong Cardiovascular Institute.Vascular bypass was established among the brachiocephalic arteries,followed by endovascular repair through femoral artery either one-stage or two-stage.Patients were followed up for 3-24 months.Results Technical success was achieved among all the patients.Five patients died after the operation(one patient had retrograde aortic dissection,2 patients had pericardial tamponade,one patient had apnea,and one patient had respiratory and cardiac arrest.The death rate is 4.1％),4 patients had stroke,among them,symptoms were relieved in three patients,one patient was not cured.Total 92 patients were followed-up and had no symptoms of up-limb ischemia or dizziness.CT scan showed bypass graft and endovascular stent patency.6 patients had endoleak (type Ⅰ b 2 cases,type Ⅱ 3 cases,and type Ⅲ 1 case),distal aortic dissection occurred in one patient,three patients had mild contrast agent leakage around the distal endovascular stent,type A aortic dissection occurred in one patient,there were no late stage death.Conclusion Supraarch branches bypass combined with endovascular aortic repair for treating aortic disease is minimally invasive,safe,and can reduce the incidence of postoperative complications.

Objective To investigate the effect of early inflamation on the efficacy of gene(LacZ gene)(transfer) to vein graft by adenovirus vector.Methods The liquid containing adenovirus vector was infused through external carotid vein and the segment of carotid vein was resected.The veins were inflated naturally.After 30min incubation,the veins were transplanted into carotid artery in experimental group,and the(circulation) was restored in control group.The veins with transferred gene were collected on day 3,day 14 and day 21.The mark gene expression in the veins was studied with X-Gal stain and activities of ?-galactase were measured.ICAM-1 and VCAM-1 expressions were observed by immunohistochemistry stain in transgenic veins.Results The activities of ?-galactase in mark gene expressed for 14 days was decreased and in 21 day nearly disappearred.VCAM-1 and ICAM-1 expression upregulated after day 3 in transplanted veins and there was leucocyte infiltration and shedding of endothelial cells with endothelial disruption.On the other hand,there was no expression of VCAM-1 and ICAM-1 in control group veins and integrity of endothelium was intact.The positive ECs expressed mark gene was obviously reduced in transplanted veins compared to control group.But the number of positive SMCs were not significently different between to two groups.(Conclusions) The inflammation of vein grafts in early stage of transplantation may be the cause of(endotheliocyte) damage and is related to rapid depression of gene expression.