Objective To study the neuroprotective effect of sevoflurane on controlled hypotension in patients with coronary heart disease undergoing craniocerebral surgery. Methods Twenty-six patients with coronary heart disease undergoing craniocerebral surgery were randomly divided into two groups,receiving either inhaled 2%-5%sevoflurane plus intravenous sodium nitroprusside (treatment group,n=13) or intravenous sodium nitroprusside 3-8 μg·kg-1 alone (contorl group,n=13) for blood pressure control. The hemodynamic changes were recorded during the operation. Patient satisfaction with surgeons and the duration hospital stay after surgery were recorded. The levels of cardiac troponin I (TNI),creatine kinase-MB (CK-MBM),neuron specific enolase ( NSE) and S100 calcium binding proteinβ( S-100βprotein) in serum were detected at one day pre-operation,the end of the operation,and one day post-operation. Results The duration of hospital stay after surgery was significantly shortened in treatment group [(20. 3±3. 8) versus (23. 9±4. 6) d,P<0. 05) compared with control group. The average heart rate significantly decreased, patient satisfaction significantly increased, and serum levels of NSE and S-100β protein one day post-operation significantly decreased as compared to control group (all P<0. 05). Compared with the day before operation,serum levels of NSE and S-100βprotein in the two groups increased significantly at the end of surgery (P<0. 05),and the levels of TNI,CK-MBM,NSE and S-100βsignificantly elevated one day post-operation (P<0. 05). Compared with the end of operation,serum levels of NSE and S-100βin contorl group incarcerated remarkably (P<0. 05) Conclusion Sevoflurane plays an important neuroprotective role,as evidenced by improving patients' satisfaction,reducing hospital stay after surgery,and maintaining the balance of myocardial oxygen delivery and consumption in craniocerebral surgery patients with coronary heart disease during controlled hypotension. However,it can not prevent postoperative myocardial injury in these patients.

Objective To investigate roles of superoxide dismutase-1(SOD1),phosphatidylinositol 3-kinase (PI3K) /serine/ threonine protein kinase (AKT) signal transduction pathway in protection of propofol on spinal cord ischemic reperfusion injury (SCIRI) in rabbit model before and after ischemia. Methods Sixty Japanese male rabbits were randomly divided into 3 groups (n=20),namely sham-operation group (Group S),ischemia-reperfusion group (Group I/ R) and ischemia-reperfusion group with propofol treatment (Group P). Abdominal aorta of the rabbits in group I/ R and group P were blocked by clamp for 40 min and then the clamp was removed. Propofol (30 mg·kg-1 ) was intravenously infused 10 min before blocking the aorta and at the time of reperfusion. Normal saline was intravenously infused at the same time points in the other two groups. Four rabbits of each group were randomly executed 1,2,3,5,7 days after surgery. Spinal cord tissues at L3-L4 levles were harvested. Bioactivity of SOD1 was detected by ELISA and mRNA expression levels of SOD1,PI3K and AKT were detected by RT-PCR. Results On the 1st day after the surgery,the bioactivity of SOD1 increased significantly in Group I/ R and Group P as compared with that in Group S (P<0. 05). On the 2nd day,compared with Group S,the bioactivity of SOD1 increased significantly in Group P (P<0. 05),but there was no change in Group I/ R (P>0. 05). On the 3rd,the 5th and the 7th day,compared with Group S,the bioactivity of SOD1 decreased significantly in Group I/ R (P<0. 05),but there was no change in Group P (P>0. 05). Linear regression analysis indicated that there was a positive correlation between the changes of SOD1 activity and the mRNA expression of SOD1,PI3K and AKT respectively in spinal cord tissues. Conclusion Pre- and post-ischemic conditioning with propofol shows potent protective effects against SCIRI in the rabbit model. The mechanisms may be related to increased expression of SOD1 in the spinal cord tissues by activating PI3K/ AKT signal transduction pathway.

ObjectiveTo investigate the method of establishing damaged endometrial stromal cells (ESC) model in vitro.Methods ( 1 ) From June to December 2011 ESC from normal endometrim at proliferation phase ( n =8 ) and secretory phase ( n =8 ) were isolated,cultured and identified in vitro.( 2 ) ESC was treated with different concentrations of mifepristone or withdrawal of mifepristone at different time point.The proliferation inhibition percent was measured by cell counting kit-8 ( CCK-8 ). ( 3 ) 0 μmol/L (control group)and 60 μmol/L(experimental group) concentration of mifepristone was added into ESC for 48 hours,then withdrew of mifepristone,continued to be cultured for 48 hours.The morphological changes were observed and apoptosis of ESC in different menstrual cycle were detected by flow cytometry.The mRNA and protein level of vascular endothelial growth factor ( VEGF),caspase-3,8,and 9 were determined by one-step quantitative real-time PCR (Q-PCR) and western blot.Results( 1 ) ESC from 16 specimens of endometrium were all isolated and cultured successfully. (2) The proliferation inhibition rate of ESC was correlated with concentration and duration of mifepristone positively. The proliferation of ESC could be recovered at a range of time after withdrawal of mifepristone.However,when the concentration of mifepristone was 100 μmol/L,the growth of ESC recovered very hardly. (3) The damaged ESC spacing increased,the spindle shape and vacuolization in the cytoplasm were observed in experimental group; the rate of apoptosis of these damaged cells was significantly increased compared with control groups,which were (52 ± 12)％ vs.( 13 ± 5 ) ％ at the proliferative phase and (53 ± 6) ％ vs.( 32 ± 3 ) ％ at the secretory phase ( all P ＜0.05).The relative mRNA level of VEGF was 0.52± 0.12 in experimental group and 1.00 ± 0.17 in control group at proliferation phase (P ＜0.05).And the relative mRNA level of VEGF was 0.19 ±0.03 in experimental group and 0.81 ±0.07 in control group at secretory phase (P ＜ 0.05).The relative level of VEGF protein in the experimental group were both decreased 1.98 and 2.79 folds at the proliferation phase and the secretory phase when compared with those in control group,respectively ( P ＜ 0.05 ).While the relative levels of caspase-3,8,9 mRNA were 5.62 ± 0.65,5.41 ± 0.53,7.22 ± 0.51 in the experimental group and 1.00 ± 0.44,1.00 ± 0.21,1.00 ± 0.32 in control group at the proliferative phase.In the mean time,the relative levels of caspase-3,8,9 mRNA were 10.22 ± 0.72,25.3 ± 1.72,9.48 ± 1.89 in experimental group and 1.42 ± 0.14,1.14 ± 0.28,1.16 ± 0.12 in control group at the secretory phase,respectively (P ＜ 0.05).Compared with the control group,the levels of caspase protein in the experimental group were increased 2.04 and 1.60 folds in caspase-3,4.23 and 1.49 folds in caspase-8,2.65 and 3.5 folds in caspase-9 at the proliferative phase and at the secretory phase,respectively (P ＜ 0.05 ).ConclusionThe damaged model of ESC can be established after 48 hours by the withdrawal of 60 μmol/L mifepristone in treatment of ESC for 48 hours.

Objective To explore the association of NH2-terminal pro-B-type natriuretic peptide ( NT-proBNP) with the risk of type 2 diabetes.Methods One hundred and twenty-six impaired glucose regulation( IGR) participants from Diabetic Identification Center of Tianjin Metabolic Diseases Hospital were included.NT-proBNP was measured in plasma samples collected from participants at baseline condition.Results At baseline, NT-proBNP was inversely associated with body mass index, waist circumference, fasting glucose, insulin and low-density lipoprotein-cholesterol( LDL-C) levels.During a follow-up of 2 years, 51 participants reported a new diagnosis of diabetes from OGTT.Baseline quartiles of NT-proBNP were inversely associated with diabetes risk, even after multivariable adjustment.Theadjustedrelativerisksfordiabeteswere1.0(reference),0.83(95%CI0.74-0.96),0.78(95%CI 0.68-0.90), 0.74 (95%CI 0.64-0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline NT-proBNP, respectively ( P<0.01 ) .Conclus ion In IGRpopulation , lowlevels of NT-proBNP were associated with a significantly increased risk of type 2 diabetes.

Objective:To explore therapeutic effects of sodium nitroprusside (SNP) combined verapamil on no-reflow during percutaneous coronary intervention (PCI).Methods: A total of 106 patients, who suffered from no-reflow during PCI in our department from Jan 2011 to Dec 2013, were selected.According to random number table method, patients were divided into SNP group (n=55, received SNP based on routine treatment) and combined treatment group (n=51, received verapamil based on SNP group).Cardiac troponin I (cTnI) level before and 16h~18h after PCI, cardiac function indexes after 12-month follow-up, incidence of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before PCI, there were significant rise in cTnI level in both groups on 16~18h after PCI, P=0.001 both;compared with SNP group, there were significant reductions in cTnI level [(1.31±0.44)μg/L vs.(0.11±0.02)μg/L] and percentage of cTnI>0.10μg/L (94.5% vs.54.9%) in combined treatment group, P=0.001 both.Compared with SNP group after 12 months, there was significant rise in left ventricular ejection fraction [(62.29±3.06)% vs.(65.65±3.94)%], and significant reductions in left ventricular end-diastolic dimension[(50.24±3.73)mm vs.(47.60±4.72)mm] and left ventricular end-systolic dimension [(33.29±2.11)mm vs.(31.00±4.33)mm] in combined treatment group, P<0.05 all.There were no significant adverse reactions during hospitalization and follow-up in both groups.Conclusion: When no-reflow occurs during PCI, intracoronary injection of SNP combined verapamil can improve cardiac function, and its safety is good, which is worth extending.

Objective To investigate the effects of remote ischemic preconditioning(RIPC)on the expression of brain-derived neurotrophic factor(BDNF),Serine/threonine protein kinase Cε(PKCε)in spinal cord tissues and change in mRNA content after spinal cord ischemic reperfusion injury(SCIRI). Methods A total of 36 cases of Japanese white rabbits were randomly divided into sham(group S),is-chemic reperfusion injury(group IR)and group IR+ RIPC(12 rabbits in each group).Each group was further divided into two sub-groups according to time points after reperfusion(2 and 5 days),six rabbits of each group were sacrificed at each time point.In group S,abdominal aorta were only separated and ex-posed and were not camped.In group IR and group IR+RIPC,the abdominal aorta were camped for 30 min,and the SCIRI models were established.In group IR+RIPC,RIPC was performed 1 h before aortic calmping.Hind-limb neurological function of each group was evaluated using Tarlov Scale at 2,5 d after surgery,then rabbits were sacrificed,and L4-L6 spinal cord segments were taken.Pathological change in spinal cord tissues were observed,the protein and mRNA expression of BDNF and PKCε were detected by Western blotting analysis and PT-PCR.Results In comparison with group IR,hind-limb neurologic func-tion scores at the same time point were significantly higher(P<0.05),and the protein and mRNA expres-sion of BDNF and PKCε were significant increased in group IR+RIPC(P<0.05).Conclusion RIPC has an important role in prevention and treatment of SCIRI in rabbits.The mechanisms may be that RIPC activates the PKCε/PKC signaling pathway and up-regulates the expression of BDNF and PKCε in spinal cord tissues after spinal cord injury.

Objective:To compare the clinical effects of dexmedetomidine assisted lumbar plexus nerve block and propofol-remifentanil general anesthesia in the patients aged over 70 years undergoing total hip replacement. Methods:Totally 58 patients(≥70 years old) with selective total hip replacement were divided into dexmedetomidine assisted lumbar plexus nerve block group(group A,28 cases) and propofol-remifentanil general anesthesia group (group B,30 cases) according to the time order of operation. The perioperative stability of respiratory and circulatory,postoperative recovery,anesthesia complications in 24 h after the surgery and anes-thesia satisfaction were evaluated and compared between the groups. Results:The vital signs of group A during the operation had no significant difference among each time point(P>0.05). There was statistical signification in blood pressure and heart rate before and after the anesthesia induction and the tracheal intubation in group B(P<0.05). Perioperative cardiovascular drug use in group B was significantly more than that in group A(P<0.01). Totally 20 cases in group A were directly sent back to the ward after the operation, another 8 cases was in anesthesia recovery room for 0.5~1-hour observation. Totally 12 cases with postoperative controlled breathing in group B were directly sent back to the intensive care unit,another 7 cases pulled out the endotracheal tube and were sent back to the intensive care unit and another 11 cases were observed in anesthesia recovery room for 1-2 h. The occurrence of postoperative cognitive dysfunction in group B was significantly higher than that in group A(P<0.05),while the anesthesia satisfaction was extremely lower than that in group A(P<0.01). Conclusion:For the patients aged over 70 years undergoing total hip replacement,dexmedetomidine at moderate dose assisted lumbar plexus nerve block is more ideal anesthesia.

Ureteral calculi after lingual mucosal ureteral reconstruction are rare. In this paper, we reported a case of a male patient who had undergone robotic-assisted laparoscopic lingual mucosal right ureteroplasty. Calculi were found in the right reconstructed ureteral segment 4 months after surgery. Then the patient underwent transurethral ureteroscopic holmium laser lithotripsy combined with a stone retrieval basket, and postoperative urological CT showed no residual calculi in the right ureter. No recurrence of right ureteral calculi or complications were observed during 20 months of follow-up.

so higher in diabetic patients 4 h after the meal (all P<0. 05). Positive correlation existed between serum triglycerides and white blood cell counting, neutrophils, and high-sensitivity C-reactive protein(r were between 0.268 and 0.548, all P<0.05).

Objective To expand the application of EOS in orthopedic diagnosis and treatment by comparing EOS and CT in the measurement of tibial tubercle-trochlear groove(TT-TG)distance of patellar dislocation.Methods The clinical and complete imaging data(EOS and CT)of 35 cases of patellar dislocation(dislocation group)and 35 cases of non-patellar dislocation(non-dislocation group)were analyzed retrospectively.Results The age difference between the dislocation group and the non-dislocation group was statistically significant(P＜0.05).The TT-TG distance was measured by EOS in the dislocation group(20.19±1.05)mm and the non-dislocation group(13.33±1.17)mm,and the difference between the two groups was statistically significant(P＜0.05).The TT-TG distance was measured by CT in the dislocation group(21.51±1.11)mm and the non-dislocation group(14.21±1.11)mm,and the difference between the two groups was statistically significant(P＜0.05).Bland-Altman plot showed that only three cases were outside the 95％confidence interval.Conclusion Accurate TT-TG distance can be obtained by using EOS system in imaging evaluation of patients with patellar dislocation,which provides a new measurement method for diagnosis and treatment evaluation of patellar dislocation.