Objective To compare the anesthetic effect of ropivacaine and bupivacaine in combined spinal-epidural anesthesia(CSEA)for cesarean section,and their influence on the incidence rate of supine hypotension syndrome(SHS).Methods 200 patients with cesarean section surgery in our hospital from February 2016 to July 2016 were randomly divided into observation group and control group,all of cases were given CSEA.100 patients in the observation group(the group L)were given ropivacaine in spinal anesthesia,the other 100 patients in the control group(the group B)were given bupivacane in spinal anesthesia.Recorded the relevant indicators,compared the incidence rate of SHS,the effect of anesthesia and neonatal score.Results The incidence rate of SHS of the group L was lower than the group B(χ2 =9.261,P<0.01).The effect of anesthesia and Apgar score of two groups had no statistically significant differences(all P>0.05).Conclusion The application of ropivacaine in CSEA for cesarean section not only has exact anesthesia effect,but also can effectively prevent SHS without any side effects.

Objective To investigate the changes of estrogen receptor expression in mast cells of bronchial mucosa from female asthmatic patients.Methods 12 cases of female asthmatic patients and 9 cases of control female patients were enrolled in this study.The bronchial mucosa was obtained from the third grade bronchial by fiexible bronchofiberscope.Mast cells were marked by anti-mast cell tryptase monoclonal antibody,the expression of estrogen receptor(ER)were detected by anti-human estrogen receptor(ER)monoclonal antibodies.Results Mast cells and estrogen receptor positive cells of bronchial mucosa in female asthmatic patients were significantly higher than that in control group(P＜0.01).Coincident with the known features of bronchial asthma,the cells positive for estrogen receptor were morphologically similar to the mast cells.The cells stained for estrogen receptors by dual immunostaining coincided exactly with cells labeled as mast cells.Conclusion The result suggested the estrogen may be involved in the pathogenesis of female asthmatic patient through the changes of estrogen receptor expression in mast cells of bronchial mucosa.

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

Objective To investigate the efficacy and safety of percutanous transhepatic intrahepatic portosystemic shunt(PTIPS)for chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension.Methods The clinical and imaging data of 38 patients with chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension, who received PTIPS in our hospital from November 2009 to June 2016,were analyzed retrospectively.The differences of the portosystemic pressure gradient(PPG)measured before and after PTIPS procedure was analyzed by a paired samples t-test. All the patients were followed up and the curative effect and operation-correlated complications were observed.Results The PTIPS procedure was technically successful in 36 patients.The other two patients with unsuccessful PTIPS underwent medical treatment,and one of them died of recurrent variceal bleeding 25 months later. Effective portal decompression and free antegrade shunt flow were achieved in 36 patients with successful PTIPS.And the mean PPG was decreased from(25.2±2.9)to(13.2± 1.3) mmHg (1 mmHg=0.133 kPa) before and after PTIPS respectively and the difference was statistically significant(P<0.05).During the procedure,arterial hemorrhage occurred in two patients who subsequently underwent embolization. Biliary injury occurred in one case and percutanous transhepatic biliary drainage (PTBD)was then performed.The mean follow-up period of the 36 patients was(26.7±10.4)months(range from 3.0 to 74.0 months).Hepatic encephalopathy appeared in 4 cases,among which,3 patients recovered after receiving medical treatment, while 1 patient experienced Grade 3 hepatic encephalopathy and recovered after implanting a smaller cover-stent.Shunt dysfunction occurred in 10 cases,of which 8 cases recovered after shunt revision with stent implantation or ballon angioplasty, while 2 cases underwent anticoagulation by warfarin only. During follow-up period, 7 patients died of liver failure(n=4), hepatic cellular carcinoma(n=1), recurrent varicose vein bleeding(n=1), and renal failure(n=1). The other patients remained asymptomatic and shunt patency. Conclusions PTIPS is both safe and effective for the treatment of symptomatic portal hypertension caused by chronic portal vein occlusion and cavernous transformation.The technical success rate is high,and the short-term curative effect is satisfied.

Objective:To investigate the correlation between subclinical hypothyroidism(SCH)and the degree of coronary artery stenosis in patients with coronary heart disease.Methods:From March 2018 to September 2019, 138 patients undergoing coronary angiography in our hospital were randomly selected and their serum thyroxine(FT4)and high-sensitivity thyroid stimulating hormone(sTSH)levels were measured.Based on the levels of FT4 and sTSH, patients were divided into the SCH group and the normal group.Combined with coronary angiography results, the correlation between the SCH and the number of coronary lesions were analyzed.Results:Patients in the SCH group were associated with significantly higher levels of cholesterol(TC)[(5.83±1.27)mmol/L vs.(5.02±1.22)mmol/L, t=3.746, P=0.000], triglyceride(TG)[(3.29±1.74)mmol/L vs.(2.17±1.68)mmol/L, t=3.769, P=0.000], low-density lipoprotein cholesterol(LDL-C)[(3.81±1.02)mmol/L vs.(3.24±1.08)mmol/L, t=3.092, P=0.001], and high-density lipoprotein cholesterol(HDL-C)[(1.13±0.27)mmol/L vs.(1.02±0.25)mmol/L, t=2.4459, P=0.008]than those in the normal group.There were significant differences in sTSH levels between patients with multivessel, double vessel or single vessel disease when grouped by the number of coronary lesions, and between those with severe, moderate or mild coronary artery stenosis when grouped by disease severity(all P<0.05). Multiple regression analysis showed that SCH, TC, and LDL-C were factors affecting the number of coronary lesions( P<0.05). Conclusions:SCH is an important factor that causes the occurrence and progression of coronary artery stenosis in patients with coronary heart disease, mainly by affecting lipid metabolism.

Objective:To observe any effect of transcranial direct current stimulation (tDCS) on learning, memory ability and the morphology of neurons in the hippocampus and cortex of rats with cognitive impairment, and also to seek any correlation between the rats′ behavior and the thickness of the granular layer in the CA1 region of the hippocampus.Methods:Thirty Sprague-Dawley rats were randomly divided into an observation group, a model group and a control group, each of 10. Cognitive impairment was induced in the observation and model groups by intraperitoneal injection of scopolamine, while the control group was injected with saline solution over the same period of time. After successful modeling, the observation group was given tDCS, while the model and control groups were connected with electrodes but not given any electrical stimulation. After 16 consecutive days of treatment, behavioral changes of each group were quantified using a shuttle box and a Morris water maze. On the 30th day after the mode-ling, the brains were collected to observe any changes in the morphology of the hippocampal and cortical neurons. The thickness of the hippocampal granular layer was also measured.Results:In the observation group the average rate of electrical impulses after the intervention [(60.5±6.67)/min] was significantly less than in the model group [(145.8±19.31)/min], while the time to find a platform was significantly shorter. The rats of the observation group also crossed the D quadrant of the platform significantly more quickly than the model group, on average. Compared with the control group, the granular layer in the CA1 region of the hippocampus [(93.47±1.07)μm] was significantly thinner on average than in the model group but compared with the model group, the observation group had significantly thicker layers [95.17±1.49)μm] on average. The thickness was negatively correlated with the number of shocks and the time to find the platform, but positively correlated with the number of crossings of the platform in the D quadrant.Conclusions:The degree of impairment generated by intraperitoneal injection of scopolamine correlates with the thickness of the CA1 granular layer of the hippocampus, at least in rats. tDCS can improve the learning and memory of such rats. Its mechanism may be related to promoting structural recovery of hippocampal cortical neurons and increasing the thickness of the granular layer.