Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.

Long non-coding RNAs (lncRNA) play important roles in many biological processes.However,compared with other types of RNAs,limited research has been conducted on lncRNA,mostly concerning its relationship with tumor,and there are much fewer studies on its relationship with atherosclerosis.In this article,we summarized the latest research findings in this field,with an emphasis on the importance of IncRNA in atherosclerosis.The value of lncRNA in targeted therapy of atherosclerotic disorders is also discussed.

Objective: This experiment was designed to study the change of nitric oxide (NO) content in different parts of brain in rats suffering from iodine deficiency(ID) and hypothyroidism since their fetal period. Methods: Iodine deficiency animal model was made and NO content in hippocampus(HPC), cerebellum (CE) and cortex(CO) were measured by using NO test kit. Results: Urinary iodine and serum T 3?T 4 concentrations significantly decreased and learning-memory capacity was impaired in ID rats. NO content was significantly lower in HPC and CE in ID rats than in control rats.(HPC:11.61?2.31/2.3?1 18 ?mol/g Prot;CE:10.77?5.16/4.70?1.95 ?mol/g Prot).No difference was found in cortex. Conclusion: Iodine deficiency and hypothyroidism since fetal period could affect NO level in rat brain. Different parts of brain have different sensitivity to ID and hypothyroidism.The changes of NO content in hippocampus may contribute to the learning-memory impairment in ID rats.

Reversed phase high performance liquid chromatography with diode array detector was employed for simultaneous determination of five main index components and specific chromatograms analysis in Xiaochaihu granules with a linear gradient elution of acetonitrile-water (containing 0.1% phosphoric acid) as mobile phase. The results showed that five main index components (baicalin, baicalein, wogonoside, wogonin, enoxolone) were separated well under the analytical condition. The linear ranges of five components were 0.518 - 16.576, 0.069 - 2.197, 0.167 - 5.333, 0.009 - 0.297 and 0.006 - 0.270 mg x g(-1), respectively. The correlation coefficients were 0.999 9, and the average recoveries ranged from 95% to 105%. Twelve common peaks were selected as the specific chromatograms of Xiaochaihu granules with baicalin as the reference peak. There were good similarities between the reference and the ten batches of samples. The similarity coefficients were no less than 0.9. The analytical method established is highly sensitive with strong specificity and it can be used efficiently in the quality control of Xiaochaihu granules.

ObjectiveTo observe the effect of irbesartan and triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area.MethodsFifty patients with diabetic nephropathy (24-hour urine protein excretion over 1.0 g and serum creatinine level below 265.2 μmol/L) at high altitude area were randomly divided into two groups,the control group were treated with irbesartan 150 mg/d for three months,and the treatment group received irbesartan 150 mg/d combined with triptolide 40 mg/d for three months.24-hour urine protein concentration,arterial pressure,liver function and renal function were measured before and after the treatment.Results After three months' treatment,the levels of 24-hour urine protein and arterial pressure were significantly lower in both control and treatment group (P ＜ 0.01 ).Twenty-four hour urine protein in treatment group were reduced from ( 8.34 ± 1.29) g before treatment to (6.42 ± 0.95 ) g after treatment ( t =5.994,P ＜ 0.001 ).Twenty four-hour urine protein in control group were reduced from (8.57 ± 0.53 )g before treatment to (7.10 ± 0.79 )g after treatment( t =7.730,P ＜ 0.001 ).Systolic pressure in treatment group were reduced from ( 152.04 ± 18.80)mm Hg before treatment to ( 131.24 ± 10.56)mm Hg after treatment(t =4.817,P ＜ 0.001 ) ; Diastolic pressure in treatment group was reduced from (93.60 ± 11.36 )mm Hg before treatment to ( 82.68 ± 7.30) mm Hg after treatment ( t =4.053,P ＜ 0.001 ).Systolic pressure in control group were reduced from ( 151.20 ± 10.17 ) mm Hg before treatment to ( 130.00 ± 10.10 ) mm Hg after treatment(t =7.396,P ＜ 0.001 );Diastolic pressure in treatment group were reduced from (92.76 ± 7.03 )mm Hg before treatment to (84.20 ± 7.56)mmHg after treatment (t =4.147,P ＜ 0.01 ).No statistic differences were observed in liver function and renal function before and after the treatment ( P ＞ 0.01 ).Conclusion Irbesartan and triptolide combination can reduce 24-hour urine protein to a certain extent and donot adversely affect liver function and renal function in patients with diabetic nephropathy at high altitude area

Objective To analyze the risk factors for the external hydrocephalus (EH) after traumatic brain injury in the infants. Methods The clinical data of 178 cases of infants and young children with traumatic brain injury from March 2004 to April 2009 were retrospectively analyzed. Univariate and logistic regression analysis were performed to identify the clinical risk factors for EH after traumatic brain injury. Results By univariate regression analysis, age, GCS score after trauma, coma duration, brain contusion, subarachnoid hemorrhage and epilepsy were risk factors for external hydrocephalus in the infants and young children (Ps < 0.05). Gender,traumatic wet lung and usage of mannitol were less relevant to EH (Ps >0. 05). The incidence of EH after traumatic brain injury in the infants and young children was 14% (25/178 ). Age ( OR = 0.5743 ) , coma duration after trauma (OR =3.0628) ,subarachnoid hemorrhage (OR =3.7093),brain contusion(OR = 4.7892) and post-trauma epilepsy (OR =2. 9976) were risk factors for EH (Ps < 0. 05). Conclusion Younger than 2 years old, low GCS score, long coma duration, brain contusion, subarachnoid hemorrhage and epilepsy would increase the risk of EH after traumatic brain injury in the infants and young children. This study provides information for the prevention of EH after traumatic brain injury in the infants and young children.

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.

BACKGROUND:Currently, surgical implant fixation is mainly applied for spinal tuberculosis. How to choose implant materials, however, is stil under discussion.OBJECTIVE:To compare the biocompatibility and mechanical properties of titanium al oy and stainless steel for rabbit spinal tuberculosis. METHODS:Thirty rabbits were chosen to prepare spinal tuberculosis models. Then, the rabbits were equivalently randomized into two groups, which underwent implant fixation with stainless steel or titanium al oy, respectively. At 30 days after implantation, biocompatibility and biomechanical properties of the two materials in the repaired region of spine were observed and detected, respectively. RESULTS AND CONCLUSION:In view of the biocompatibility, infection and immunological rejection could not been found in the titanium al oy group;in contrast, infection appeared in three rabbits of the stainless steel group. Flexion, extension and lateral bending displacements under the spinal loading in the titanium al oy group were significantly less than those in the stainless steel group (P<0.05);axial pul-out strength in the titanium al oy group was significantly higher than that in the stainless steel group (P<0.05);flexion, extension, lateral bending and axial compression in the titanium al oy group were significantly greater than those in the stainless steel group (P<0.05). In conclusion, titanium al oy material has good biocompatibility that can be used to restore and maintain the spinal stability.

BACKGROUND:Although the traditional surgical treatment can improve the symptoms of patients with senile osteoporotic vertebral fracture, the treatment easily produces bone graft fusion failure and pseudoarticulation formation and affects clinical effects. OBJECTIVE:To investigate biomechanical properties of anterior cervical pedicle screw and the effects on osteoporotic vertebral stability. METHODS:A total of 16 fresh cadaver cervical specimens contained 64 motion segments (C3-4, C4-5, C5-6 and C6-7). The 64 segments by the way of implantation were randomly divided into ordinary anterior locking screw fixation group and lower anterior vertebral pedicle screw system group (32 segments per group). The mechanical properties were determined on the biomechanical testing machine for each group. RESULTS AND CONCLUSION:(1) Biomechanics:Compared with the ordinary anterior locking screw fixation group, the maximum pul-out strength, screw path length, postoperative vertebral column height, the maximum surface strain, strain maximum and the range of maximum values were increased in the lower anterior vertebral pedicle screw system group (P<0.05). (2) Results suggest that compared with the ordinary anterior locking screw fixation group, lower cervical anterior pedicle screw required larger extraction force and was more stable for osteoporotic vertebrae.