Objective:To analysis clinical curative effect of laparoscopic radical prostatectomy bladder cancer and influence on serum levels of ferritin (SF),soluble interleukin-2 receptor (SIL-2 R) and rumor specific growth factor (TSGF).Methods:98 cases of bladder cancer who were treated in our hospital from August 2012 to February 2016 were selected and randomly divided into the control group 0=49) and the research group (n=49).The patients in the control group were treated with open radical radical cystectomy,while the patients in the research group were treated with laparoscopic radical cystectomy.Then the operation time,intraoperative blood loss,anal exhaust time,hospitalization,the lymph node cleaning,the serum levels of SF,SIL-2R,TSGF,white blood cells and cortisol,the complications and recurrence rate in the two groups were observed and compared.Results:The operation time of research group was longer than that of the control group,while the intraoperative blood loss,the hospitalization and the anal exhaust time were less than those of the control group,and the differences were statistically significant (P＜0.05).There was no statistically significant difference about the numbers of the lymph node and the recurrence rate between two groups (P＜0.05).After treatment,the serum levels of SF,SIL-2R and TSGF in the two groups decreased,while there was no statistically significant difference between the two groups (P＞0.05);After treatment,the white blood cell count and cortisol rise in the two groups increased,while the research group was lower than that of the control group (P＜0.05).Conclusion:LRC and ORC clinical efficacy similar,both of which can reduce the serum levels of SF,SIL-2R and TSGF of patients with laparoscopic radical prostatectomy bladder cancer.

Objective To explore the effects of sedationand hemodynamics on different ages patients with the same concentration of dexmedetomidine under general anesthesia.Methods A total of 264 patients (ASAⅠ-Ⅱ)with orthopaedic surgery under general anesthesia in our hospital from April 2013 to May 2015 were divided into 3 groups by age,the young group (group Y,n =76),middle age group (group M, n =107),and old age group (group O,n =81 ).Fifteen minutes before anesthesia,patients were infused dexmedetomidine with 1 μg/kg, maintain the concentration of 0.5 μg·kg-1 ·h-1 and stop at 30 minutes before surgery finished.The SBP、DBP、BIS、HR before anesthesia (T1),pump injection start(T2),tracheal intubation(T3),1 minute after intubation(T4),5 minutes after skin incision(T5),endotracheal ex-tubation(T6)were observed.The dosage of propofoland remifentanil in anesthesia,duration from stop infusion to endotracheal extubation, Ramsay score and adverse reactions 5 minutes after PACU also need to be recorded.Results The level of SBP and DBP were significantly increased at T2,T3 in all groups.Compared with group O,both group Y and group M increased significantly,the difference was statistically significant(P <0.05).The level of SBP and DBP were significantly decreased at T5 in all groups,the difference was statistically significant (P <0.05).There was no significant difference in 3 groups at T4-T6(P >0.05).Compared with T1,the level of HR and BIS were signifi-cantly decreased at T2-T5,the difference was statistically significant(P <0.05).The dosage of propofol and remifentanil in group Y and group Mwas more than that of group O.The extubation time was significantly shorter and the Ramsay score was significantly less than those of the group O,the difference was statistical significance(P <0.05).SAS scores among the three groups was not significant difference (P >0.05). There was no significant difference in the total adverse reaction between group Y and group M(P >0.05),but it was significantly lower than that of group O(P <0.05).Conclusion Dexmedetomidine has good sedative effect in all groups,but older group have more adverse reac-tions and wake up time is extended.The concentratiuon of dexmedetomidine should be adjusted according to the age of patients.

Objective To investigate influence of dexmedetomidine on postoperative cognitive function in elder patients after hip re-placement surgery under spinal anesthesia. Methods Forty elderly patients with ASAⅠ~Ⅲ,undergoing hip replacement with spinal anesth-sia,were randomly divided into dexmedetomidine group( group A) and normal saline group( group B) ,with 20 patients in each group. Dexme-detomidine was given with 1 μg/kg after anesthesia and followed with 0. 5 μg·kg-1 ·h-1 in group A. The equal volume of normal saline was infused in group B. Cognitive function was evaluated before anesthesia,3 and 7 days after surgery by mini-mental state examination( MMSE) . The intraoperative concentration of TNF-α,IL-6,MDA were detected at the time of before surgery(T0),end of surgery(T1),3 days after sur-gery(T2),7 days after suegery. Results There was no significant difference in MMSE score before anesthesia between the two groups (P>0. 05). The difference of MMSE score at postoperative 3 days between two groups was statistical significance (P<0. 05). The MMSE score recovered normal in both groups 7 days later. There was no significant difference of TNF-α,IL-6,MDA concentration at T0 between two groups(P>0. 05). Compared with T0,the concentration of TNF-α,IL-6,MDA at T1,T2 in group B increased,the difference was significant. And the concentration of IL-6 at T1 in group A decreased,compared with that at T0,the difference was significant(P<0. 05). The concentra-tion of TNF-α,IL-6 at T1,T2 and MDA at T2 in group A were lower than those in group B,the difference was significant. (P<0. 05). Con-clusion Dexmedetomidine can decreased the concentration of TNF-α,IL-6,MDA,and improve the postoperative cognitive dysfunction of eld-erly patients who finished the hip replacement surgery under spinal anesthesia.

Objective To analyze the clinical experience of double lumen endobronchial tube intubation in 41 cases of whole lung lavage .Methods Forty‐one patients with whole lung lavage in our hospital from February 2010 to February 2015 were retro‐spectively analyzed .The effect of bronchoscopy and auscultation location method were explored after double‐lumen endobronchial intubation in whole‐lung lavage .Results Among 41 cases ,39 cases were successfully located by using the auscultation location ,and other 2 cases were successfully positioned by using the bronchoscopy position after repeatedly auscultation location method resulting in lung isolation failure .The catheter depth in 19 cases was adjusted after using bronchoscopy ,and then double lung was isolated well and lavage was successfully conducted .Conclusion The prerequisite for success of whole lung lavage is accurate position of double‐lumen endobronchial tube .Bronchoscopy look positioning has become the gold standard of double‐lumen endobronchial tube position .

Objective To compare and analyze the clinical application of lumbar plexus combined with sciatic nerve block and spinal anesthesia for elderly patients with knee joint surgery.Methods A total of 77 elderly patients with ASAⅠ ~Ⅲ undergoing single knee re-placement surgery were randomly divided into combined group which recieved lumbar plexus combined with sciatic nerve block and spinal an-esthesia group.The baseline values,blood pressure and heart rate at multiple time points,the block area and duration,the volume of intraoper-ative fluid,and other indexes of adverse reaction were observed.Results The MAP,SBP and DBP in the spinal anesthesia group after the op-eration have changed significantly at the time of T1,T2 and T3.The operating of anesthesia in the combined group was shorter than that of spi-nal anesthesia group.The rate of adverse reactions in combined group was significantly lower than that inspinal anesthesia group.Conclusion The spinal anesthesia can be satisfied for operation requirements,but it will cause the unstable circulation and varied adverse reactions.Lum-bar plexus combined with sciatic nerve block is safe and effective with less adverse reactions,less disturbance of hemodynamics,which is much better for the old or the patients with coagulation abnormalities combined heart and lung disease.

Objective To evaluate the efficiency of dezocine combined with sufentanil on postoertive analgesia for spinal deformity sur-gery.Methods Divided the 90 patients who were admitted into our hospital from January 2013 to September 2015 into three groups by ran-dom single blind method,namely the dezocine group,the sufentanil group and the combined group,with 30 cases in each group.All the pa-tients underwnet propofol and sevoflurane static absorption compound anesthesia,and they were given continuous intravenous analgesia with different drugs after the surgery.Their visual analogue scale (VAS)score,sedation scale (SS)score,adverse reaction,total PCIA times,ef-fective PCIA times,respiratory rate and arterial blood gas were measured at 2,6,24,48 hours after operation.Results The VAS score of the combined group was lower than that of the dezocine group (P <0.05).The combined group was significantly superior to the dezocine group and the sufentanil group in SS score and adverse reactions.At 24 and 48 hours after surgery,SaO2 and PaO2 in the combined group were higher than those in sufentanil group (P <0.05).PaCO2 in the combined group was lower than that in the dezocine group and the sufentanil group(P <0.05).Conclusion Dezocine combined with sufentanil is a more efficiency way with less adverse reaction on postoperative anal-gesia for spinal deformity surgery,and it is an ideal way of analgesia.

Objective To construct the recombinant adenovirus vector containing ubiquinol-cytochrome C reductase core protein 1(UQCRC1) and to investigate the protective role of UQCRC1 against hypoxia/reoxygenation injury in H9c2 cardiac myocytes . Methods UQCRC1 gene was obtained from the cDNA library by PCR ,then was double-digested with restriction endonucleases SalⅠand XbaⅠand inserted into pAd Track-CMV .The identified plasmid of pAd Track-UQCRC1 was transfected into BJ 5183 contai-ning pAdEasy-1 .After screening the positive clone ,the plasmid was transfect into 293T cells with liposome to integrate and package the recombinant adenovirus .Finally ,these adenoviruses were transfected into H9c2 cardiac myocytes .The expressions of green fluo-rescence protein(GFP) ,UQCRC1 gene and protein were observed by RT-PCR and Western blot analysis .The cell viability and the LDH release were detect .Results The recombinant adenovirus-UQCRC1 was constructed successfully .The overexpression of UQCRC1 increased the cell viability(P<0 .05) and decreased the LDH release(P<0 .05) from H9C2 cardiac myocytes after suf-fering hypoxia/reoxygenation injury .Conclusion UQCRC1 has the protective effect on hypoxia/reoxygenation injury in H9c2 car-diac myocytes ,and the construction of recombinant adenovirus vector will lay the foundation for further studying the role of UQCRC1 in cardioprotection .

Objective To establish a method to isolate,culture and identify cardiomyocytes from neonatal mouse,estimate the cardiomyocytes survival rate,and identify the purity of cardiomyocytes.Methods Neonatal C5 7 mouse heart(within 3 days)was di-gested using trypsin and collagenase.Cardiomyocytes survival rate was estimated by trypan blue staining,and cardiomyocytes purity was identified byα-actin immunofluorescence staining.Results Mouse cardiomyocytes could be successfully isolated and cultured using neonatal mouse within 3 days.Trypan blue staining showed cardiomyocytes survival rate was>95%,and cardiomyocytes pu-rity was more than 95% demonstrated byα-actin immunofluorescence staining.Conclusion Under the strict experimental condi-tions,mouse cardiomyocytes can be successfully isolated and cultured with high survival rate and high purity.

Objective To aims Study cardioprotection of different postconditioning algorithm,and investigate the role of MAPK pathway in the process.Methods Sixty SD rats were randomly (random number) divided into 5 groups,sham operation group,reperfusion/injury group (I/R group),gradual decreased reperfusion in postconditioning (GDR,30/10-25/15-15/25-10/30s of reperfusion/re occlusion) group,routine reperfusion in postconditioning (ER,4 cycles of 20/20s of reperfusion/reocclusion) group,and gradual increased reperfusion in postconditioning (GIR,10/30-15/25-25/15-30/10s of reperfusion/re-occlusion) group.Acute myocardial infarction and ischemic postconditioning models were established in the rats.Six hours after reperfusion,3 rats of each group were sacrificed and myocardial tissue were taken out to measure the level of phosphorylation of extracellular signal regulated protein kinase (P-ERK),Phosphorylation of stress-activated protein kinase (stress activated protein kinase,P-JNK),phosphorylation of p38 MAPK (P-p38),tumor necrosis factor-α (TNF-o),cysteine and aspartic protease-8 (Caspase-8) in myocardial tissue and the expression of cytochrome C in the cytosol using Western Blot method.Twenty-four hours after reperfusion all the remaining rats were to measure hemodynamic variables and level of myocardial enzyme,and myocardial tissue were taken out to determine myocardial apoptosis.A one-way analysis of variance (ANOVA) was used,and q tests were employed to determine differences in individual variables existed between groups.Results All three postconditioning modalities were found to provide cardioprotection (P ＜ 0.05) compared with I/R without preconditioning.The GIR provided the best cardioprotection effect,followed by ER and then GDR.Apoptotic index and serum marker levels were reduced far more in GIR than those in ER (P ＜ 0.05).The enhanced cardioprotection provided by GIR was accompanied by significantly increased levels of P-ERK1/2 [(1.82 ± 0.22) vs.(1.54±0.32),P＜0.05],and lower levels of P-p38 [(0.82±0.26) vs.(1.63 ± 0.24)],P-JNK [(0.76±0.28) vs.(1.33±0.21),TNF-o [(0.62±0.20) vs.(1.00±0.12)],Caspase-8 [(0.61 ±0.21) vs.(1.00±0.30)],Cyt-c [(0.66±0.16) vs.(1.68±0.22)] in the cytoplasm (P ＜ 0.05,all compared with ER).In addition,all the variables measured here were significantly improved in the GIR group relative to the GDR group (P ＜ 0.05).Conclusions The method of gradual increased reperfusion in postconditioning could attenuate reperfusion injury more significantly than routine algorithm whereby MAPK pathway played an important role in the process.

AIM: To determine the effect of exogenous phosphocreatine (PCr) at different concentrations on transient outward potassium (Ito) current in rat ischemic ventricular mid-myocardial (M) cells and to explore the antiarrhythmia mechanism in the treatment of ischemic heart disease. METHODS: M cells were isolated enzymatically from left ventricular mid-myocardium of rats. Peak Ito current was recorded by patch-clamp technique in the whole-cell configuration when M cells were superfused with normal Tyrode solution,simple ischemic solution,and simulated ischemic solution containing PCr at concentrations of 5,10,20 and 30 mmol/L for 10 min. RESULTS: Peak Ito current density of M cells superfused with simple simulated ischemic solution was significantly reduced by (76.1±6.3)% (P<0.05) compared with M cells superfused with Tyrode solution. Ischemic solution containing 5,10,20 and 30 mmol/L PCr reduced peak Ito current density by (57.1±9.6)% (P<0.05),(40.3±10.3)% (P<0.05),(34.3±9.6)% (P<0.05) and (32.1±10.6)% (P<0.05),respectively. There was statistical difference among ischemic solution without PCr and containing PCr at concentrations of 5 and 10 mmol/L groups (P<0.05). No statistical difference among groups of 10,20 and 30 mmol/L PCr was observed (P>0.05). CONCLUSION: PCr reverses the inhibition of Ito current under ischemic condition in M cells,which may be the mechanism responsible for arrhythmia prevention in ischemic heart disease. PCr at concentrations of 0～10 mmol/L exerts significant dose-effect relationship.