Objective To study the optimal dose of esmolol for maintaining cardiovascular stability in patients with hypertension during tracheal extubation. Methods In post-anestheisa care unit, hypertensive patients after general anesthesia meeting the extubation criteria were included. Patients were divided into 2 groups according the age: group Ⅰ (>65 years old for the elderly hypertensive, 21 cases), and groupⅡ(≤65 years old for the non-elderly hypertensive, 22 cases). All the patients received esmolol bolus before sputum suction and tube extraction, and the tracheal extubation were extubated 2 minutes after esmolol bolus. The systolic blood pressure, diastolic blood pressure and heart rate were was recorded before tracheal extubation, 2 min after esmolol bolus, at the time of sputum suction extubation, 1 min after tracheal extubation, 3 min after tracheal extubation and 5 min after tracheal extubation. Esmolol dose was determined by the up and down method. Initial dose was 0.5 mg/kg, in accordance with the arithmetic dose (0.2 mg/kg) increasing or decreasing progressively. In negative results (the systolic blood pressure at extubation or 5 min after extubation ≥ 20% of the base, or the systolic blood pressure at sputum suction extubation>180 mmHg, 1 mmHg=0.133 kPa) esmolol dose increased progressively, and in positive results (the systolic blood pressure at extubation or 5 min after extubation<20%of the base) esmolol dose decreased progressively. When the crosspoint (from positive to negative result) reached 6, the study was terminated. Results The median effective doses of esmolol for maintaining cardiovascular stability in groupⅠand groupⅡwere (0.6 ± 0.1) and (0.8 ± 0.1) mg/kg. Conclusions Esmolol can maintain cardiovascular stability in patients with hypertension during tracheal extubation. Median effective dose decreases in older hypertensive patients.

Objective To study the impact of postoperative aerobic exercise on the cardiac function of breast cancer patients during anthracyclines-based chemotherapy. Methods Sixty cases of female breast cancer pa-tients, from June 2014 to December 2015 for anthracyclines-based chemotherapy, were randomly divided into ex-perimental group (n = 30) and control group (n = 30). Four cycles of conventional anthracyclines-based chemotherapy were conducted in control group, while three times of aerobic exercise per week were added in exper-imental group until the end of treatment course apart from conventional treatment. The peak oxygen consumption (VO2max) and maximum heart rate (HRmax) were measured before and after chemotherapy in both groups, ac-companied by ECG monitoring and blood collecting to measure the changes in their N-terminal pro-brain natriuretic peptide (NT-proBNP), serum creatinine (SCr) and kinase isoenzyme (CK-MB). Results No significant differ-ences in various indicators before chemotherapy were reported between two groups (P>0.05). After chemotherapy, VO2 max/kg [(21.9 ± 3.6) vs. (14.5 ± 2.8) mL/(min·kg)], VO2 max [(1 523 ± 186) vs. (911 ± 185) mL/min] and HRmax[(115 ± 15) vs. (129 ± 16) beats/min] in experimental group were significantly improved when com-pared with those in control group; significant differences in hematological levels and ECG changes were also ob-served between two groups. Conclusion Aerobic exercise during chemotherapy can mitigate the cardiotoxicity of anthracyclines to patients, which provides a new idea and therapy to reduce the incidence of clinical cardiovascular events induced by anthracyclines-based chemotherapy.

Objective To study the effects of formaldehyde on the level of microelements in mouse liver and blood and explore the microelements as biomarker in injury induced by formaldehyde.Methods The mice were randomly divided into control,low(1/40LD50),moderate(1/20LD50) and high(1/10LD50) dose groups exposed to formaldehyde by inhalation(n=20),two hours per day for three and six weeks,and than the contents of Cu,Fe,Zn and Mn in mouse liver and blood were measured.Results The contents of Fe,Zn and Mn in liver in high dose group three weeks after exposure and the contents of Fe and Zn in liver in high dose group six weeks after exposure were significantly lower than those in control group(P

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Arrhythmias, Cardiac ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged

Aim To investigate the effect of asiatic acid on apoptosis and autophagy in human glioblastoma T98G cells. Methods MTT colorimetry was employed to assay the cellular proliferating activity. The fluores-cence microscope and Hoechst 33258 staining were used to detect the morphological changes. The cell ap-optosis and autophagy were analyzed by flow cytometry with Annexin-V/7-AAD and MDC staining respective-ly. The expressions of associated proteins were detected by Western blot to analyze the mechanism of apoptosis and autophagy. Results MTT assay showed that the growth of T 9 8 G cells was inhibited by asiatic acid ( IC50 =46. 3 μmol · L-1 ) . Annexin V/7-AAD stai-ning and Western blot revealed that asiatic acid in-duced apoptosis in T98 G cells by reducing the expres-sion of Akt, decreasing the mitochondrial membrane potential, and increasing the expression of Caspase-3. MDC staining and Western blot showed that the per-centage of MDC-positive cells was decreased and the expressions of Beclin-1 , LC3-II and Atgs were inhibi-ted by asiatic acid treatment. 5 μmol·L-1 chloroquine was used to up-regulate the expressions of LC3-Ⅱand Beclin-1 . Asiatic acid-inhibited autophagy was blocked and the total apoptotic rate was reduced remarkably. Conclusion Asiatic acid suppresses T98 G cells pro-liferation by inducing apoptosis and inhibiting cell au-tophagy, and the very role of inhibiting autophagy could promote apoptosis to a certain extent.

PurposeTo evaluate left ventricular function in patients with non-obstructive hypertrophic cardiomyopathy (HCM) by using three-dimensional speckle tracking imaging (3D-STI).Materials and Methods Twenty-eight patients with non-obstructive hypertrophic cardiomyopathy (HCM group) and 30 healthy volunteers (control group) underwent both conventional two-dimensional echocardiography and 3D-STI. Indexes of conventional echocardiography including interventricular septal thickness (IVST), left ventricular posterior wall at end-diastolic thickness (LVPWT), left ventricular diameter, left ventricular volume, end-systolic left ventricular volume, peak velocity of early diastolic mitral valve, peak diastolic of late diastolic mitral valve, outflow tract frequency spectrum of the aortic valve and left ventricular were compared between the two groups to get the pressure difference and velocity time integral of the left ventricular outflow tract. Early and late diastolic peak velocity of mitral annular were calculated and E/A, Ea/Aa, E/Ea were also obtained. 3D-STI indicators including three-dimensional left ventricular ejection fraction (3D-LVEF), sphericity index (SPI) and global area of strain (GAS), global longitudinal train (GLS), global circumferential strain (GCS), global radial strain (GRS) were also compared.Results In HCM group, IVST, LVPWT and E/Ea increased (P<0.01), Ea/Aa and E/A decreased significantly (P<0.01), LVOT-PG and LVOT-VTI increased significantly (P<0.05 orP<0.01). GCS, GAS, GLS and GRS were significant lower in HCM group than those in control group (P<0.01). Local strain values at the level of papillary muscle and apex were decreased, which were significantly decreased at ventricular septum, anterior wall and inferior wall.Conclusion HCM patients have various degree of decreased myocardial contractility. The real time 3D-STI offers a novel way to assess the left ventricular function of patients with HCM.

Objective Evaluate the efficiency of scientific research output of the 54 departments in a hospital,to put forward improvement suggestions based on the evaluation results.Methods Select appropriate indicators of scientific input and output,use the Data Envelopment Analysis method to evaluate and analyze the efficiency.Results According to the analysis of DEA,calculate the values of overall efficiency,technical efficiency,scale efficiency and scale income.Then compare and analyze the relative efficiency of different units scientific output,to identify the relatively superior department a mong the various categories.Conclusions According to the evaluation results,to find out the input surplus and insufficient output of each decision units.Then we will put forward suggestions on hospital resource allocation to optimize the scientific input and output,to improve the competitiveness of the hospital,and to activate the potential of each department's scientific research.

Professor LI Zhi-dao's acupuncture technique at muscle belly and its clinical experiences for the treatment of arthralgia are introduced. From aspects of TCM, anatomical physiology and sports biomechanics, the theory basis of this technique is explained, while its method is elaborated in details from acupoint selection and manipulation combined with classic medical cases. The acupuncture technique at muscle belly is applied at the muscles which already have pathological changes, avoiding re-stimulation on the pain area. It provides new thinking methods and references for acupuncture to treat arthralgia.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Arthralgia ; therapy ; Female ; Humans ; Male ; Middle Aged

BACKGROUND: This study aimed to explore the effects of TNF-α on the expression of IP3R1 mRNA and protein in human mesangial cells (HMCs), and to elucidate the mechanism of TNF-α relating to IP3R1 expression in the occurrence of hepatorenal syndrome (HRS). METHODS: HMCs were stimulated by tumor (TNF-α) with 100 ng/mL for different hours (2, 4, 8, and 24 hours). The expression changes of IP3R1 mRNA and protein were detected by quantitative real-time polymerase chain reaction and immunoblotting. Several inhibitors including D609, U73122, PP1, safingol, rottlerin and non-radioactive protein kinase C (PKC) were used to examine the mechanism of signal transduction of TNF-α-regulated IP3R1 in HMCs. RESULTS: The levels of IP3R1 mRNA at 2 hours after TNF-α exposure were significantly enhanced and peaked at 8 hours in HMCs (P<0.01), then descended at 24 hours (P<0.01). The levels of IP3R1 protein at 4 hours after TNF-α exposure were obviously increased and peaked at 24 hours after TNF-α exposure (P<0.01). Compared to the control group, safingol (PKCα inhibitor) and D609 (phosphatidylcholine-specific phospholipase C inhibitor) significantly blocked the TNF-α-induced expression of IP3R1 mRNA (3.30±0.81 vs. 1.95±0.13,P<0.05; 2.10±0.49,P<0.01) and IP3R1 protein (3.09±0.13 vs. 1.86+0.39,P<0.01; 1.98±0.02,P<0.01). TNF-α promoted PKCα activation with maximal PKCα phosphorylation that occurred 8 hours after stimulation measured by non-radioactive PKC assay, and the effect was markedly attenuated by pretreatment with D609 or safingol. CONCLUSION: TNF-α increased the expression of IP3R1 and this was mediated, at least in part, through the PC-PLC/PKCα signaling pathways in HMCs.

Objective To investigate the changes of C- reactive protein( CRP ) and homocysteine ( Hcy)in the type 2 diabetes with depression,and its clinical significance and potential mechanism. Methods One hundred and twenty-four cases with type 2 diabetes were divided into the depression group(63 cases)and non-depression group( 61 cases ) according to the Self-Rating Depression Scale and verified by Self-Rating Anxiety Scale. The information including age,sex,education degree,body mass index,course of disease and the number of complications were recorded. The levels of CRP,Hcy,fasting plasma glucose( FPG ),glycosylated hemoglobin(HbA1c)and blood lipid were measured. The depression group was divided into mild,medium and heavy group to compared the changes of Hcy and CRP. Results The levels of Hcy,HbA1c and the number of complications in depression group were 11. 5( 8. 6,15. 6 )μmol/L,( 10. 13 ± 2. 17 )%,and 2( 1,3 ) respectively,higher than that of non-depression group(8. 6(7. 4,11. 2)μmol/L,(9. 33 ± 2. 20)%,1(0,2)), while the education degree of depression group((9. 75 ± 3. 36)years)was lower than that of non-depression group((11. 56 ± 3. 73)years),and the differences were significant( t/Z = -3. 537,0. 952,-2. 339,0. 228 respectively;P ﹤0. 05). The levels of Hcy in mild,medium and heavy depression group were(8. 75(7. 45, 10. 45)μmol/L,12. 2(8. 90,14. 40)μmol/L,19. 50(14. 33,28. 03)μmol/L respectively and the difference was significant(F =25. 963,P =0. 000). No significance difference was found in terms of CRP level(2. 35 (1. 10,4. 92)mg/L,3. 25(1. 11,5. 68)mg/L,2. 32(1. 27,5. 41)mg/L;F=0. 194,P=0. 907). There was significant correlation between depression scores and Hcy( r=0. 615,P=0. 000). Conclusion Type 2 diabetes with depression is associated with the level of blood glucose,education degree and the course of disease. Hcy,not CRP is an independent risk factor of type 2 diabetes with depression.