Objective To evaluate the influences of laryngeal mask airway(LMA) combined with epidural anesthesia on hemodynamics in hypertensive patients.Methods 72 gynecological patients with stage Ⅰ to Ⅱ hypertension were randomly divided into four groups(n=18 for each):general anesthesia with tracheal intubation(group G) or LMA(group L),combination of epidural anesthesia and general anesthesia with tracheal intubation(group GE) or LMA(group LE).BP,HR,ECG,SpO2 were monitored in different time.Intraoperative awareness,the time of extubation or LMA removal and anesthetic dosages were recorded.Results During insertion of the tube or LMA,SBP,DBP,HR were significantly higher than those before anesthesia in group G and GE(P

Objective To analyze the imaging characteristics of thoracic LDRD(Low-dose directly Digital Radiographic Device) and its artifacts.Methods 188 patients were performed with LDRD and common thoracic X-ray film respectively in our hospital during two weeks.Results Among the 188 cases,1.60%(3/188) showed thoracic motion artifacts.46.8%(88/188) appeared as tentorial prominence along left heart edge and 2.6%(5/188) along the right one.1 artifact was in aorta-pulmonary artery window(0.53%).Conclusion(1)Less than 0.5 should be taken as reference in podoid enlargement diagnosis.(2)Pseudomorph from heart motion may result from cardio-phase,cardiac contraction,heart rate,arrhythmia,local abnormal pulse of left heart edge,different enlarged velocity of cardiac cavity during heart beat,etc.(3)The motion artifacts in thoracic LDRD has no important influence in clinical diagnosis and therapy.

Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio (NLR) in patients with gastrointestinal stromal tumors (GIST).Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013.According to the exclusion criteria,79 cases were enrolled.Preoperative neutrophil and lymphocyte count was collected and NLR was calculated.According to the receiver operating characteristic (ROC) curve of NLR,GIST patients were divided into low NLR group (NLR ＜ 2.30) and high NLR group (NLR ≥ 2.30).Clinic-pathological features and five year disease free survival (DFS) were compared between the two groups.Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group (respectively,x2 =9.517,12.411,all P ＜ 0.05).Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78％ and 32％ (x2 =18.749,P =0.000).By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs (RR:3.516,95％CI:1.453-8.506,P=0.005).Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.

Objective To evaluate Chinese tinnitus handicap questionnaire (T HQ ) reliability and validity through clinical use and analysis .Methods A total of 230 tinnitus patients who were seen at our ENT clinic with tinnitus lasting longer than 3 months were administered with the THQ ,THI ,tinnitus questionnaire ,pure tone au‐diogram and tinnitus matching .Assessed THQ’s reliability and validity ,the relationship between THQ and its re‐lated factors .Results In the 206 tinnitus patients ,the Cronbach’sαwas 0 .93 ,split -half reliability was 0 .91 ,test-retest reliability was 0 .96 .In the 171 tinnitus patients ,the THI correlation coefficient was 0 .745 .The THQ scores were highly correlated with the hearing loss level of the worse ear .The age ,sex ,side ,complications ,dura‐tion and tinnitus matching were not correlated with THQ scores .Conclusion THQ Chinese version has good relia‐bility and validity .It is worthy of clinical application .

This study investigated the effects and molecular mechanisms of genistein in improving insulin resistance induced by free fatty acids (FFAs) in HepG2 hepatocytes. A model of insulin resistance in HepG2 cells was established by adding palmitic acid (0.5 mmol/L) to the culture medium and the cells were treated by genistein. Glucose consumption of HepG2 cells was determined by glucose oxidase method. The levels of c-jun N-terminal kinase (JNK) phosphorylation, insulin receptor substrate-1 (IRS-1) Ser307 phosphorylation, JNK, IRS-1, phosphatidylinositol-3-kinase p85 (PI-3K p85) and glucose transporter 1 (GLUT1) proteins were detected by Western blotting. The results showed that after the treatment with palmitic acid for 24 h, the insulin-stimulated glucose transport in HepG2 cells was inhibited, and the glucose consumption was substantially reduced. Meanwhile, the expressions of IRS-1, PI-3K p85 protein and GLUT1 were obviously reduced, while the levels of JNK phosphorylation and IRS-1 Ser307 phosphorylation and the expression of JNK protein were significantly increased, as compared with cells of normal control. However, the aforementioned indices, which indicated the existence of insulin resistance, were reversed by genistein at 1-4 μmol/L in a dose-dependent manner. It was concluded that insulin resistance induced by FFAs in HepG2 hepatocytes could be improved by genistein. Genistein might reverse FFAs-induced insulin resistance in HepG2 cells by targeting JNK.

The effects of Cinnamon granules on pharmacokinetics of berberine in Rhizoma Coptidis granules in healthy male volunteers, and the compatibility mechanism of Jiao-Tai-Wan (JTW) composed of Rhizoma Coptidis granules and Cinnamon granules were investigated. The concentration of berberine in plasma of healthy male volunteers was determined directly by high performance liquid chromatography (HPLC) after an oral administration of Rhizoma Coptidis granules alone or combined with Cinnamon granules (JTW). The plasma concentration-time curves of berberine were plotted. The data were analyzed with Drug and Statistics (DAS) 2.0 pharmacokinetic program (Chinese Pharmacology Society) to obtain the main pharmacokinetic parameters. The results showed that the plasma concentration-time curve of berberine was described by a two-compartment model. The C(max), T(max), t(1/2) and CLz/F of berberine in Rhizoma Coptidis granules were 360.883 μg/L, 2.0 h, 3.882 h, 119.320 L·h(-1)·kg(-1) respectively, and those of berberine in JTW were 396.124 μg/L, 1.5 h, 4.727 h, 57.709 L·h(-1)·kg(-1) respectively. It was suggested that Rhizoma Coptidis granules combined with Cinnamon granules could increase the plasma concentration of berberine, promote berberine absorption and lengthen the detention time of berberine in healthy male volunteers.

OBJECTIVETo determine and analyze plasma ammonia concentration difference of the portal vein system and ramifications of rabbits and consequently guide selection of the portal vein in transjugular intrahepatic portosystemic shunt (TIPS) so that reduce shunt-induced hepatic encephalopathic incidence. To evaluate clinical significance of transjugular intrahepatic left branch of portal vein portosystemic shunt (TILPS) and to analyse hemodynamics of both branches of the portal vein and to observe long-term results in the prevention of encephalopathy.

METHODSBlood samples in different portal vein branches of rabbits were collected and the plasma ammonia concentration was assayed and compared. The left branch of portal vein was used as the puncture site to perform TILPS and to keep away from the right branch of portal vein blood that contains nutrition and toxin.

RESULTSPlasma ammonia content was superior in the mesenteric vein and higher than the portal vein branch, the splenic vein, and the vena cava. The right portal vein was above the left. Encephalopathy did not occur in all patients within 3 months. Of the 341 patients undergoing TILPS, encephalopathy occurred in only 5 patients (1.47%) and shunt abnormalities in 19 patients (5.57%) verified by venography during overall follow-up period.

CONCLUSIONSSelective left branch of the portal vein portosystemic shunt can decrease encephalopathy obviously and protect liver function.

Adult ; Aged ; Ammonia ; blood ; Animals ; Female ; Follow-Up Studies ; Hepatic Encephalopathy ; blood ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Portal Vein ; surgery ; Portasystemic Shunt, Transjugular Intrahepatic ; adverse effects ; Rabbits ; Treatment Outcome

The effects of Cinnamon granules on pharmacokinetics of berberine in Rhizoma Coptidis granules in healthy male volunteers,and the compatibility mechanism of Jiao-Tai-Wan (JTW) composed of Rhizoma Coptidis granules and Cinnamon granules were investigated.The concentration of berberine in plasma of healthy male volunteers was determined directly by high performance liquid chromatography (HPLC) after an oral administration of Rhizoma Coptidis granules alone or combined with Cinnamon granules (JTW).The plasma concentration-time curves of berberine were plotted.The data were analyzed with Drug and Statistics (DAS) 2.0 pharmacokinetic program (Chinese Pharmacology Society)to obtain the main pharmacokinetic parameters.The results showed that the plasma concentration-time curve of berberine was described by a two-compartment model.The Cmax,Tmax,t1/2 and CLz/F of berberine in Rhizoma Coptidis granules were 360.883 μg/L,2.0 h,3.882 h,119.320 L·h-1·kg-1 respectively,and those of berberine in JTW were 396.124 μg/L,1.5 h,4.727 h,57.709 L·h-1·kg-1 respectively.It was suggested that Rhizoma Coptidis granules combined with Cinnamon granules could increase the plasma concentration of berberine,promote berberine absorption and lengthen the detention time of berberine in healthy male volunteers.

This study investigated the effects and molecular mechanisms of genistein in improving insulin resistance induced by free fatty acids (FFAs) in HepG2 hepatocytes.A model of insulin resistance in HepG2 cells was established by adding palmitic acid (0.5 mmol/L) to the culture medium and the cells were treated by genistein.Glucose consumption of HepG2 cells was determined by glucose oxidase method.The levels of c-jun N-terminal kinase (JNK) phosphorylation,insulin receptor substrate-1 (IRS-1) Ser307 phosphorylation,JNK,IRS-1,phosphatidylinositol-3-kinase p85 (PI-3K p85) and glucose transporter 1 (GLUT1) proteins were detected by Western blotting.The results showed that after the treatment with palmitic acid for 24 h,the insulin-stimulated glucose transport in HepG2 cells was inhibited,and the glucose consumption was substantially reduced.Meanwhile,the expressions of IRS-1,PI-3K p85 protein and GLUT1 were obviously reduced,while the levels of JNK phosphorylation and IRS-1 Ser307 phosphorylation and the expression of JNK protein were significantly increased,as compared with cells of normal control.However,the aforementioned indices,which indicated the existence of insulin resistance,were reversed by genistein at 1-4 μmol/L in a dose-dependent manner.It was concluded that insulin resistance induced by FFAs in HepG2 hepatocytes could be improved by genistein.Genistein might reverse FFAs-induced insulin resistance in HepG2 cells by targeting JNK.

Objective: To evaluate the correlation between type Ⅰ allergic reaction and pathogenesis of Meniere′s disease. Methods: A total of 35 (10 male vs. 25 female) patients aged between 21-66 years diagnosed with Meniere′s disease were recruited to this study, mean age of them was (47.3±13.6) years. The control group consisted of 15 inpatients (5 male vs. 10 female) with pharyngolaryngeal diseases but without otologic and rhinologic abnormity, mean age was 45.4±12.8 years. Allergic prevalence, serous total immunoglobulin E( tIgE ) levels, serous specific immunoglobulin E( sIgE ) levels and subtypes of T lymphocytes were measured and compared in patients with Meniere′s disease and the control group. Severity of vertigo, tinnitus and sensation of fullness were compared between Meniere′s disease patients with or without allergy. Results: Allergic prevalence were significantly different (Pearson chi-square 5.832, P<0.05) between patients with Meniere′s disease and the control group(57.1% vs. 20.0%). Patients with Meniere′s disease report higher level of serous tIgE compared with controls, the difference is statistically significant (Z=168.000, P<0.05). However, positive rates of sIgE of food allergens and inhalant allergens were not significantly different between patients with Meniere′s disease and the control group. Scores of vertiginous severity, dizziness handicap inventory (DHI) and tinnitus handicap inventory (THI) were significantly different between Meniere′s disease patients with or without allergy (P<0.05). Treg and Treg/Th17 levels (Z=26.000) were much higher in Meniere′s disease patients with allergy than in the controls(P<0.05). Conclusions Patients with Meniere′s disease report higher rate of allergy than the control group. Type Ⅰ allergic reaction is thought to be one of the possible reasons that may induce endolymphatic hydrops and lead to Meniere′s disease.