Objective To investigate the clinical values of dexmedetomidine in general anesthetic for laparo-scopic cholecystectomy.Methods One hundred patients admitted to our center with cholelithes were prospectively studied.According to the principle of completely random digital table,all patients were randomly signed to dexmedeto-midine group or control group.The primary outcomes were hemodynamic changes and postoperative complications. Results There was no significant differences at t0,t1,t2,t3,t4 and t5 in mean arterial pressure (P >0.05).There was no significant difference in heart rate at t0 (P =0.503),however,compared with the control group,patients in the dexmedetomidine group got a significant reduction in t1,t2,t3,t4 and t5 in heart rate(all P <0.05).Compared with the control group,the operation time of the dexmedetomidine group was significantly shorten[(1 18.52 ±15.42)min vs.(127.24 ±19.14)min,t = -5.673,P =0.021 ],the rate of movement of the center of the operation was significantly decreased (36% vs.64%,χ2 =7.840,P <0.001),the incidence rate decreased significantly (0% vs. 10%,χ2 =5.263,P =0.022).There was no difference between the two groups in intra -operative bleeding volume, hypertension,hypotension,tachycardia,postoperative drainage volume,postoperative bleeding,infection and vomiting (all P >0.05 ).Conclusion Dexmedetomidine contributed to maintaining the hemodynamic stable in general anesthetic for laparoscopic cholecystectomy,and reducing the rate of shivering.

Cardiac biomarkers of sensitive and specific are very important to the early diagnosis of cardiovascular diseases,such as cardiac troponin (high sensitivity),myoglobin,heart-fatty acid-binding protein,ischemia modified albumin,B-type natriuretic peptide and N-terminal-pro-B-type natriuretic peptide.They also play an important role in risk stratification and prognosis evaluation,but improvement is still needed.Biomarker of high sensitivity and specificity,convenient detection control is still required in clinical application.

Ostial lesions present many challenges for percutaneous coronary intervention (PCI). Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wire technique and focused-force angioplasty.

During the last fifty-year medical treatments have made great advances in the treatment of heart failure(HF).The current applicatin of treatment improves the life quality of patients with HF,and reduces their clinical envents and mortality.But the patients with refractory heart failure(RHF) have poor prognosis.This article reviews and analyzes the advances in the therapies for patients with RHF.

Objective: To establish a method for the determination of norcantharidin in norcantharidin in situ gel .Methods:An optimal HPLC method was set up and an Agilent ZORBAX SB-C18 column (150 mm ×4.6 mm, 5μm) was adopted.The mobile phase was acetonitrile-phosphate buffer solution(1∶9, adjusting pH to 3.1 with phosphorjc acid).The flow rate was 0.8 ml· min-1 and the column temperature was 25℃.The detection wavelength was set at 210 nm and the injection volume was 20μl.Results:Norcanthari-din had a good linear relationship within the range of 0.02-1.00 mg· ml-1 (r=0.999 9).The average recovery was 97.5%and RSD was 0.98%(n=9).Conclusion:The method is accurate, simple and reproducible, which can be used for the determination of nor-cantharidin in norcantharidin in situ gel .

Objective To analysis the correlation between coronary atherosclerosis and levels of glycated hemoglobin (HbA1c) and endothelin(ET ) ,furthermore to explore the clinical significance of the two indexes in the department of cardiology .Methods 572 inpatients were divided into four groups according to the blood glucose level and coronary angiography results :negative control group with 40 patients ,simplex DM group with 50 patients ,simplex CHD group with 262 patients ,CHD+DM group with 220 pa-tients .The HbA1c and ET levels in the four groups were monitored ,and the correlations between the two indexes and coronary ath-erosclerosis were analysed by Logistic regression analyses .Results HbA1c level :control group and CHD group < DM group 0 .05) .ET level :control group < CHD group and DM group < CHD+DM group .No significant differences were observed between CHD group and DM group(P>0 .05) .After adjusted the potential risk factors such as age ,sex ,body mass index ,smoking ,the history of hypertension and blood glucose levels with binomial Logistic regression analysis the content of ET was relevant to the onset of CHD ,however HbA1c not .Conclusion ET has obviously correlation with coronary atherosclerosis ,however the simplex DM may cause false posi-tive interferences .Combined determination of HbA1c and ET is beneficial in the preliminary diagnosis of CHD and DM .

0.05).However,major vascular complications occurred only in the femoral group(3.9%).Conclusion Transradial LM PCI is as fast and successful as the femoral approach and results in fewer vascular complications.

Objective To investigate the character and differentiation diagnosis of coronary artery fistula in aged.Methods Clinical symptom, sign and laboratory examination were analyzed in 8 aged patients with coronary artery fistula. Results Myocardial ischemia is the main manifestation of agedness coronary artery fistula, and should be discriminated with coronary artery disease. Conclusion If myocardial ischemia symptom aggravates with age in patient with long-term angina, coronary angiogram is the most dependable method.

Objective To investigate the significance of three electrocardiographic indexes in predicting the myocardial infarct related artery (IRA) in inferior wall of acute myocardial infarction (IAMI) Methods One hundred and twenty patients with IAMI were studied Results (1) IRA was related to right coronary artery (RCA) in 98 (81 7%) case, left circumflex branch (LCX) in 22 (18 3%) cases (2) ST segment depression in lead Ⅰ identified RCA occlusion with a sensitivity of 77 6%, specificity of 90 9% in patient with IAMI, but isoelectric or elevated ST segment in lead Ⅰ identified LCX occlusion with a sensitivity of 90 9%, specificity of 77 6% (3) About QRS wave of lead aVL, S/R≥1/3 identified RCA occlusion with a higher sensitivity of 93 9% and a lower specificity of 63 6% (4) When IRA was RCA, ST segment elevated amplitude Ⅲ≥Ⅱ identified as a diagnostic index no matter the location of occlusion Conclusion Three electrocardiographic indexes have significant value in predicting the infarct related artery in inferior wall acute myocardial infarction

Objective To evaluate the clinical effect of pneumatic lithotripsy under ureterorenoscope in the treatment of ureteral calculi. Methods One hundred and eighty-nine cases of ureteral calculi were treated by ureterorenoscopic pneumatic lithotripsy between November 1999 and February 2003. Results Lithotripsy was performed successfully on one session in 183 cases,with a success rate of 96.8% (183 of 189).Conversions to open surgery were required in the remaining 6 cases because of unsuccessful entry of the ureterorenoscope (ureteral perforation in 1 case).Follow-up period ranged from 10 days to 3 months (mean, 1.3 months). Stones were entirely expelled in 182 cases of the 183 cases (99.4%) within 2 months after the procedures. Conclusions With minimal invasion and pain, this procedure is safe and effective for ureteral calculi, being probably the treatment of first choice.