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.

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.

Based on the investigation and analysis of industry dynamics of health maintenance Applications (APP) of Traditional Chinese Medicine (TCM),the paper designs and develops health maintenance APP of TCM,and describes its architecture,operating principle,functions,innovativeness,applicability scope,etc.

Objective To investigate the effects of urotensin Ⅱ/urotensin Ⅱreceptor ( UⅡ/UT) system on the expression of inflammatory signal molecules p 38 mitogen-activated protein kinase ( p38 MAPK) and nuclear factor-κB ( NF-κB ) in lipopolysaccharide ( LPS )-stimulated Kupffer cells ( KCs ) . Methods Rat KCs were isolated and purified by means of in situ perfusion and density gradient centrifuga-tion.The isolated cells were randomly divided into six treatment groups including group 1:UⅡ(-) urantide (-)LPS(-), group 2:UⅡ(+)urantide(-)LPS(-), group 3: UⅡ(-)urantide(+)LPS(-), group 4:UⅡ(-)urantide(-)LPS(+), group 5:UⅡ(+) urantide(-) LPS(+) and group 6:UⅡ(-)urantide(+) LPS(+) .Western blot assay was performed to detect p 38 MAPK/p-p38 MAPK protein and NF-κB p65 sub-unit.The DNA-binding activity of NF-κB was tested by electrophoretic mobility shift assay (EMSA).Re-sults There was no significant difference with the expression of p 38 MAPK protein in KCs among the six groups (P>0.05).The expression of p65 protein and p-p38 MAPK and the DNA-binding activity of NF-κB were significantly enhanced in LPS-stimulated KCs from groups 4, 5 and 6 in comparison with those in group 1 (P<0.01).No significant differences with the levels of p65 protein and phosphor-p38 MAPK and the DNA-binding activity of NF-κB were observed between UⅡ/urantide-treated cells ( group 2 or group 3) and untreated cells (group 1) (all P>0.05), but that were decreased in group 6 than those in group 4 (all P<0.01).Conclusion UⅡ/UT system participated in the activation of p38 MAPK and NF-κB signaling pathways in LPS-stimulated primary Kupffer cells .

Objective To summarize the common types and clinical characteristics of ureter disease;which can increase manipulation difficulties and adverse events during rigid ureteroscopic procedures. Methods From Jan 2001 to Dec 2010,our team performed 317 rigid ureteroscopic Drocedures for ureteroscopic examination or treatment;including 60 difficult procedures(34 male and 26 female).The mean age of the patients was 37 years (range,18 to 71).The ureteral diseases were classifted into five types according to the pathological characteristics:Type Ⅰ calculous stenosis,Type Ⅱ neoplastic stenosis;Type Ⅲ non-congenital stenosis,Type Ⅳ congenital stenosis,Type Ⅴ expansion of tortuous ureters.The operative time,complications,and conversion to open surgery were evaluated,and the therapeutic methods were analyzed. Results Of the 60 difficuhly-manipulated procedures,the mean manipulated time was 75 min (range,31 to 200).Intra-operative complications occurred in 9 procedures,including 4 cases of mucosal bleeding,2 cases of submucosaI false passage and 3 cases of ureteral perforation.Eleven procedures were converted to open surgery. In five procedures only a double J tube was inserted for drainage due to the difficulty of entering the ureter.Fiftyfive patients were followed up for 17 months (range,3 to 110);48 patients were cured,5 patients improved and 2 patients were unchanged. Conclusions The five types of ureteral disease can increase operative difficulties and risks of rigid ureteroscopic procedures.We should be cautious during surgery and should stop manipulation or convert to other surgeries if necessary.

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

The purpose of this study is to evaluate the effect of oligomeric grape seed proanthocyanidins (GSP) on isoproterenol (ISO)-induced cardiac remodeling in rats. ISO was given subcutaneously (5 mg x kg(-1), sc, 7 days) to induce cardiac remodeling in rats. Therapeutic groups were given GSP (50, 100, and 150 mg x kg(-1)) after ISO treatment. After 2 weeks intervention, heart rate (HR), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), rate of rise of left ventricular pressure (+/- dp/dt(max)) were examined. The myocardial hypertrophy index was expressed as heart weight/body weight (HW/BW) and left ventricle weight/body weight (LVW/BW), the histological changes were investigated by HE and Van Gieson stain. SOD activity and MDA content in serum, contents of hydroxyproline (Hyp) in the left ventricular tissue were assayed by xanthinoxidase method, thiobarbituric acid (TBA) method and alkaline hydrolysis method, respectively. After the onset of ISO-treatment, GSP therapy potently improved cardiac function, inhibited myocardial hypertrophy, improved cardiac pathology change, decreased the myocardial cross-section area (CSA), collagen volume fraction (CVF) and perivascular circumferential collagen area (PVCA), reduced the content of Hyp in the left ventricular tissue, inhibited the decrease of SOD activity and increase of MDA content in serum. GSP possess protective effect against ISO induced cardiac remodeling in rats, this may be related to reducing the oxidative stress and improving antioxidant capacity.

BACKGROUND: Direct anterior minimum invasive surgery (DAMIS) total hip arthroplasty has been considered as the total hip arthroplasty that is most consistent with the minimally invasive standards. In theory, there is a low incidence of complications in the DAMIS total hip arthroplasty. However, because minimally invasive surgery demands high surgery skills, the incidence rate of complications is high in the early period of its learning curve. Lateral decubitus position DAMIS was considered to provide a better perspective, so that, the incidence of surgical complications may be reduced. OBJECTIVE: To explore the feasibility of lateral decubitus position DAMIS for total hip arthroplasty. METHODS: Totally 62 cases from the Department of Orthopedics, First Affiliated Hospital of Gannan Medical University between April 2013 and April 2016 were retrospectively analyzed, and randomly assigned to two groups: lateral decubitus position group (n=31) and supine position group (n=31). Incision length, operative time, intraoperative blood loss, acetabular cup angle, hospital stay, Harris scores, Visual Analogue Scale score, and SF-36 score were compared between the two groups. Complications at postoperative 1 year were recorded. RESULTS AND CONCLUSION: (1) Operative time was longer and intraoperative blood loss was more in the lateral decubitus position group than in the supine position group (P < 0.05). There were no statistically significant differences in incision length and hospital stay between the two groups (P > 0.05). (2) There were no significant differences in the incidence of postoperative complications between the two groups (P >0.05). (3) There were no significant differences in the anteversion and abduction angles of acetabular cup between the two groups (P > 0.05). (4) There were no significant differences in Harris hip score, Visual Analogue Scale score, and SF-36 the quality of life scores between the two groups before surgery and 1 year after surgery (P > 0.05). (5) In conclusion, DAMIS total hip arthroplasty can abandon special traction bed when patients are in lateral decubitus position. The short-term effects are the same with supine DAMIS total hip arthroplasty.

Objective To describe the MRI features and pathologic findings of biliary cystadenocarcinoma(BCAC)and to assess the diagnostic value of MRI in those tumors.Methods Five cases of BCAC were collected.All cases were proved by pathology.Non-enhanced and multiphase-enhanced MRI were performed in all cases.MRCP were performed in two cases.The MRI features of the five cases were reviewed retrospectively and correlated with pathologic findings.Results Histological evidence demonstrated five cases of BCAC.Four cases were solitary,whereas the other case was multifocal.All cases were solid and cystic lesions.Two cases were unilocular,whereas the other three cases were multilocular. Multiple mural nodules and irregular thickening cystic walls were presented in all cases.The cystic parts of the lesions were homogeneous in signal intensity and showed no enhancement after contrast administration in the five BCAC.Septa were present in three BCAC with multilocular cyst.On MRCP the bile duct dilatation was found in two BCAC.Conclusion MRI can reveal the characteristic findings of BCAC and accurate preoperative diagnosis can be made.

Objective To describe the US, CT, and MR imaging findings and diagnosis of hepatic adenomas. Methods The comprehensive imaging features in 6 patients with 6 hepatic adenomas confirmed pathologically were reviewed retrospectively and correlated with pathologic findings. Results One case was diagnosed correctly, four cases were mistaken for hepatocellular carcinomas (HCC), and one case was mistaken for focal nodular hyperplasia. US: six lesions were hypoechoic with hypohalo in four lesions, and there was low velocity arterial and venous flow within the six lesions. CT: six lesions were hypodense with pseudocapsule in four lesions, and the four lesions showed slight enhancement during arterial and portal venous phases, and one lesion showed moderate enhancement during arterial phase and slight enhancement during portal venous phase. MRI: six lesions had heterogeneously high signal intensity on T 1WI and T 2WI, and the high intensity on T 1WI remained unchanged after using fat saturation. Two lesions showed strong enhancement during arterial phase and slight enhancement during portal venous and delayed phases, and three lesions showed slight enhancement during arterial, portal venous, and delayed phases. Pseudocapsule detected in six lesions showed slight enhancement on portal venous or delayed phases. Conclusion The comprehensive imaging findings of hepatic adenomas were nonspecific. The presence of pseudocapsule, heterogeneous high signal intensity on T 1WI, and the high intensity remained unchanged after using fat saturation may help make a correct diagnosis of hepatic adenoma.