Objective: To systematically review the cardioprotective of sevoflurane in patients undergoing heart surgery under cardiopulmonary bypass,so as to provide evidence for anesthesia decision of cardiac surgery. Methods: Trials about the cardioprotective effect of sevoflurane under CPB were collected through electronic search of Medline, CNKI, and CMBdisk (from the date of database establishment to October 2008); manual search was also conducted. Based on the inclusion and exclusion criteria, fourteen randomized-controlled trials were finally included in the present analysis. The details of the trial design, the characters of the subjects, and the results of the studies were reviewed and analyzed using RevMan 4.2 software. Results: The 14 trials involved 1226 patients, including 616 receiving sevoflurane and 610 receiving total intravenous anesthesia (TIVA). Compared with TIVA, our analysis showed the following results. (1) Cardiac function: sevoflurane significantly increased the postoperative cardio index (CI, P < 0.01) and cardiac output (CO, P < 0.01). (2) Serum cTnI concentration at 24 h postoperation: sevoflurane group was significantly lower than that of TIVA group (P < 0.01). (3) Sevoflurane significantly decreased the period of mechanical ventilation (P < 0.01) and the length of intensive care unit stay (P < 0.01), but the postoperative hospital stay was similar between the two groups. (4) The postoperative usage of inotropic agent was lower in sevoflurane group (P < 0.01). There were no significant differences in the mortality (P = 0.59), the incidence of atrial fibrillation (P = 0.11), and the myocardial infarction rate (P = 0.11) between the two groups. Conclusion: Sevoflurane has cardioprotective effect in patients undergoing heart surgery under CPB.

Liver transplantation is the most effective treatment for patients with advanced liver diseases. Patients undergoing liver transplantation are likely to have severely impaired liver function and poor general condition. Meanwhile, the operation is complicated and needs long time; the hemodynamics fluctuates greatly during operation and many drugs are needed after operation. All the above factors are likely to induce injuries to the heart, brain, lung, etc, and resulting in severe complications and finally leading to the death of patients. Therefore the protection of organs during perioperative period is an important step for liver transplantaion of advanced liver diseases, and it is also a focus of study in the area. This article summarizes the injury mechanism and protection strategy of organs in patients during perioperative period of liver transplantation.

Objective To investigate the effects of different doses of ketamine on spatial cognitive function and the expression of mRNA and protein of N-methyl-D-uspartate (NMDA) receptor subunits NR1 and NR2B in the hippocampus of aged rats.Methods Forty SD rats of both sexes aged 15 months weighing 470-570 g were randomly divided into 4 groups (n=10 each) : one control group (C) and three ketomine groups (K1 ,K2 ,K3).The animals in group K1 ,K2 and K3 received intraperiteneal(IP) ketaminc 10,20 and 100 mg/kg respectively once a day for 3 days,whereas the animals in control group received IP normal saline instead of ketamine.One day after the last drug administration,the animals underwent Morris water maze test 4 times a day for 3 consecutive days.The animals were killed within 1 h after the last test for determination of the expression of NR1 mRNA and NR2B mRNA (using RT-PCR) and protein (using immuno-histochemistry) in the hippocampus.Results The latency period and swimming distance of water maze test were significantly longer on the 2nd and 3rd days in group K3 than in control group.The NR2B mRNA and protein expression was significantly lower in group K3 than in control group.Conclusion Anesthetic dose of ketamine decreases spatial cognitive function and the expression of NR2B mRNA and protein in aged rats whereas subanesthetic doses of ketamine do not.

Atomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit presynaptic noradrenaline transport protein,strengthen noradrenaline's resupination effect,and increases noradrenaline's activity released by synaptic cleft to improve the symptoms of the attention deficit hyperactivity disorder(ADHD)patients.ADHD patients often accompany with other psychological diseases like oppositional defiant disorder,anxiety disorder,which may hinder the diagnosis of ADHD.There is still no accepted effective medicine nowadays.Currently,research on the treatment of the ADHD is more and more popular.Good therapeutic effect of atomoxetine to treat ADHD has been found in resent studies.This article summarized the current management of using atomoxetine to treat ADHD.

Coronary Aneurysm ; complications ; pathology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications

As the active ingredient of traditional Chinese medicine Scutellaria baicalensis Georgi, baicalin has a variety of pharma-cological effects. In recent years, baicalin has made significant achievement in the prevention and treatment of central nervous system diseases, such as ischemic brain injury, hemorrhagic brain injury, Parkinson' s disease and spinal cord injury. Numerous studies showed that baicalin could prevent oxygen free radical injury, inhibit nerve cell apoptosis, inhibit inflammation factor expression, pro-tect the mitochondrial energy metabolism, inhibit thrombin receptor and adjust the balance of excitatory amino acid and inhibitory amino acid. Based on the neuroprotective effect of baicalin, it may be a potential medicine for the treatment of central nervous system disea-ses.

Objective To investigate the cognition of basic doctors on essential drugs in Luo County. Methods The random sampling was used to investigate the basic doctors in Luoping County, and 200 copies questionnaire were distributed. Results The questionnaire response rate was 98%. The survey results indicated that the cognition on essential drugs among basic doctors was poor, but most basic doctors have positive attitudes and behaviors in essential drugs. Conclusion It is necessary to improve the awareness of essential drugs among basic doctors in Luo County.

OBJECTIVE To survey the antibiotic susceptibility of Pseudomonas aeruginosa and medical treatment among the aged patients suffering from underlying disease.METHODS A total of 326 strains of P.aeruginosa were isolated among the aged patients with underlying disease by sputum culture.Drug susceptibility was performed and effective antibiotic treatment was given.RESULTS Amikacin(8.0%),imipenem(12.0%) and piperacillin/tazobactam(16.0%) could be chosen.The symptom of 326 patients was alleviated after clinical treatment,while some sputum samples were found still positive.CONCLUSIONS Combined use of two kinds of medicines may produce better effects in the patients with underlying disease,who infected with P.aeruginosa,but sputum should not be emphasized to converse negative in this case.

Objective To study the diagnostic value of endoscopic ultrasonography (EUS)for benign and malignant bile duct stricture.Methods Data of 51 patients who underwent EUS from January 2007 to March 2015 due to distal biliary stricture were retrospectively studied.And their diagnosis with EUS,IDUS,bile duct cytological brushing and final diagnosis were compared.Results Malignant bile duct stenosis were finally confirmed in 19 cases and benign stenosis were confirmed in 32 cases.The sensitivity (73.7％ VS 57.1％) and positive predictive value (73.7％ VS 57.1％) of EUS for the benign and malignant diagnosis of biliary tract stenosis were significantly higher than that of IDUS (P＜0.05),while their specificity(84.4％ VS 84.2％)and accuracy(80.4％ VS 76.9％)were similar.The sensitivity of EUS was significantly higher than that of bile duct cytological brushing (73.7％ VS 50.0％),while their specificity (84.4％ VS 100.0％)and accuracy(80.4％ VS 81.6％)were similar.EUS findings of hypoechoic mass features had higher diagnostic accuracy for detecting malignant distal bile duct stricture than irregular thickening of the lumen in the distal bile duct (100.0％ VS 64.3％,P＜0.05).Conclusion For patients with lesions of the distal bile duct that CT/MRI could not diagnose,EUS has an important value for the further diagnosis of benign and malignant bile duct stricture.

OBJECTIVETo establish a new evaluation system of curved root canal deviation by the technique of micro-CT.

METHODSCurved simulated root canals were prepared with ProTaper NiTi-hand files by crown-down technique. After root canals were scanned by micro-CT and analyzed by image processing software, the planar area and centers' transportation of each cross-section were compared to evaluate the prepare effect of ProTaper, and a three-dimensional model about it were established.

RESULTSThe same cross-section's area of the root canals which was prepared with ProTaper NiTi-hand files were essentially consistent. With the data analysis of micro-CT, a system of combining planar and three-dimensional index to evaluate the root canal deviation were established. The shapes of root canal before and after prepared with ProTaper showed less deviation, which proved the shaping ability of ProTaper could meet the requirements for clinical use.

CONCLUSIONA three-dimensional root canal central axis model is established using micro-CT. It provides a new method to analyze the shaping ability of the instrumentation after root canal preparation. It will give us a more direct view to analyze the situation of the root canal deviation combining the two-dimensional image and the three-dimensional model.