Abstract:Objective To explore the mechanism by which enterovirus 71 (EV71) crossing the blood-brain barrier (BBB). Methods BBB models were established by human brain microvascular endothelial cells (HBMECs) in vitro and were randomly assigned to control and EV71-infected groups. The cytotoxic effect of EV71 on HBMECs was examined by morphological observation, immunoflurescence, transmission electron microscope and real-time PCR. In addition, the cytoskeletal alterations in HBMECs were observed by laser confocal method. Results EV71 infection could lead to cytopathic changes of HBMECs. Immunofluorescent staining confirmed the presence of EV71 antigen (red fluorescence) and 20-30 nm EV71 particles in EV71-infected HBMECs, but not in mock infected cells. Viral replication in HBMECs was shown by real-time PCR in a time-dependent manner (P<0.01). EV71 infected cell lost the normal morphology and polarity, with disarranged actin filaments. Conclusion For the first time we prove that EV71 can infect HBMECs and can replicate in the cells, and can induce cytoskeleton changes in some HBMECs.

Abstract:Objective To observe the influence of U75302, blocker of leukotriene B4 receptor 1, on immune function in septic mice, so as to explore the implication of blocking leukotriene B4 receptor 1 for treatment of sepsis. Methods Experimental sepsis model was induced by cecal ligation and puncture (CLP). A total of 18 male C57BL/6 mice were randomly divided into sham group (n=6), CLP group (n=6) and CLP + U75302 intraperitoneal injection group (n=6). The peripheral blood cytokine tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) levels, peritoneal lavage fluid Gr-1⁺ cell count and thymus T lymphocytes apoptosis were detected in mice of three groups 24 h after surgery. Results Compared with the CLP group, CLP + U75302 intraperitoneal injection group had significantly reduced blood TNF-α level (by 43%, P<0.05), significantly increased IL-10 level (by 88%, P<0.05), signficantly decreased Gr-1⁺ cell counts in peritoneal lavage fluid (P<0.05), and significantly decreased apoptosis of thymus T lymphocytes (P<0.01). Conclusion Blocking leukotriene B4 receptor 1 with U75302 may decrease peripheral TNF-α level, increase IL-10 level, and improve cellular immunity, which may be involved in inflammation of sepsis.

Abstract:Objective To investigate the secondary prevention in acute coronary syndrome patients receiving percutaneous coronary intervention (PCI) during hospitalization and after discharge from Changhai Hospital. Methods The clinical data of patients with acute coronary syndrome undergoing PCI in Changhai Hospital from Jan 1^st. 2009 to Dec 31^st. 2011 were collected. The status of secondary prevention and drug therapies was analyzed at 1 month, six months and 1 year after discharge. Results A total of 238 patients with acute coronary syndrome receiving PCI were included in the present study. Smoking patients were forced to quit during hospitalization; the application rates of aspirin, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin Ⅱ receptor blockers (ARB), β-blockers and statins among patients were 96.6%, 73.1%, 68.9% and 92.4%, respectively. At 1 month, 6 months and 1 year after discharge, the application rates of aspirin among the patients were 98.3%, 95.8% and 94.1%; of ACEI/ARB were 72.3%, 69.7% and 63.4%; of β-blockers were 68.1%, 62.2% and 52.1%; and of statins were 91.6%, 88.7% and 83.6%, respectively. At 1 month, six months and 1 year after discharge, the non-smoking rates were 86.4%,77.9% and 78.6% in male patients and 100%, 98.8% and 98.8% in female patients, respectively; the control rates of blood pressure were 93.3%, 95.4% and 94.3% and those of blood glucose were 98.3%, 96.2% and 97.5%, respectively. Conclusion The secondary prevention is satisfactory during hospitalization in acute coronary syndrome patients undergoing PCI, but the situation gradually worsened after discharge; therefore efforts should be made to strengthen the follow-up and health education of the patients so as to reinforce secondary prevention for coronary heart disease.

Abstract:Objective To study the efficacy of postoperative early enteral nutrition (EN) therapy with long peptide mixture in gastric cancer patients receiving distal subtotal gastrectomy. Methods A total of 70 patients with gastric cancer were randomly divided into experimental group (n=35) and control group (n=35) after distal subtotal gastrectomy. The experimental group received early enteral nutrition with long peptide mixture postoperatively (NEN group) and the control group received early enteral nutrition with glucose saline postoperatively (GEN group). Results There were no significant differences in the recovery time of intestinal peristalsis or ventilation time between the two groups after treatment. Significant differences were found between the two groups regarding the symptoms of diarrhea and vomiting (P=0.048, P=0.000). The hospitalization time and total cost of hospitalization were not significantly different between the two groups. The level of prealbumin in the experimental group was significantly higher than those in the control group on the fourth and seventh days after operation (P=0.000,P=0.000); moreover, compared with the control group, the experimental group had significantly higher IgG level on the fourth day and seventh day after operation (P=0.000 6, P=0.000 8), and IgM level was significantly higher than that in the control group on the seventh day after operation (P=0.000 1). Conclusion Postoperative early enteral nutrition with long peptide mixture can induce obvious gastrointestinal irritation symptoms in gastric cancer patients receiving distal subtotal gastrectomy, but it does not greatly increase the hospitalization time or cost, and can rapidly improve the nutrition and immune state of patients.

Abstract:Objective To explore the relationship between urinary albumin-to-creatinine ratio (UACR) and blood pressure of young migrant builders in Shanghai. Methods A total of 3 195 builders (age ranged from 18 to 50) were selected from migrant builders of Shanghai Construction Group Co., Ltd. by using random cluster sampling method. They were subjected to questionnaire interview, physical examination, and biochemical tests, including UACR, renal function, serum uric acid, serum lipid, and serum glucose. The participants were divided into 4 groups (Ⅰ, Ⅱ, Ⅲ, and Ⅳ)according to the levels of UACR, and the ordinal multinomial logistic regression model was employed to determine the relationship between UACR levels and blood pressure grouping (normal, pre-hypertension, and hypertension). Results Among the 3 195 builders, 3 112 (97.4%) finished interview. The UACR (median [Q1-Q3]) levels and high-UACR ratio for the normal, pre-hypertension and hypertension groups were 0.8 (0.6-1.2) mg/mmol, 0.9 (0.7-1.4) mg/mmol, and 1.0 (0.8-1.7) mg/mmol, and 6.8%, 8.0%, and 15.6%, respectively, with significant differences for both UACR levels and high-UARC ratios (P<0.05) among the 3 blood pressure groups. According to the 25%, 50%, and 75% quartiles of UACR values, builders were classified into 4 groups. After adjustment of the other factors such as age, the average systolic pressures of the Ⅰ, Ⅱ, Ⅲ, and Ⅳ UACR groups were (126.8±13.3), (127.9±14.2), (129.9±14.4 ), and(134.2±19.0) mmHg (1 mmHg=0.133 kPa), and the average diastolic pressures of the 4 groups were (77.6±9.7), (78.8±9.2), (79.2±10.4), and (81.8±12.5) mmHg, respectively. UACR was positively correlated with both the average systolic pressures and diastolic pressures (P<0.05). Logistic regression analysis showed that, after adjusting the factors such as age, body mass index, total cholesterol, and low density lipoprotein cholesterol, the odds ratio (OR) and 95% confidence interval (95%CI) of pre-hypertension and/or hypertension, compared with Ⅰ group, were 0.98 (0.80-1.20), 1.29 (1.05-1.58), and 1.86 (1.52-2.28) for Ⅱ,Ⅲ,and Ⅳ groups, respectively. Conclusion The UACR is positively correlated with pre-hypertension and hypertension among young migrant builders in Shanghai.

Abstract:Objective To assess the impact of atrial fibrillation (AF) on the early outcomes of patients undergoing aortic valve replacement (AVR). Methods The clinical data of 961 adult patients who underwent AVR in Department of Cardiothoracic Surgery, Changhai Hospital between Jan. 2000 and Dec. 2011 were retrospectively analyzed. The patients with pre-operative AF were assigned to AF group (n=54) and the rest to non-AF group (n=907). Pre-, intra-, and post-operative findings were compared to assess the impact of AF on early outcomes. Possible risk factors affecting the early mortality were identified using logistic regression analysis. Results AF patients compared with non-AF patients had an elder age(P<0.001), higher NYHA functional classification Ⅳ(P=0.039), lower left ventricular ejection fraction(P=0.017), and higher proportion of pulmonary hypertension(P<0.001). Accordingly, the post-operative early mortality, mechanical ventilation time, and incidences of low cardiac output syndrome, cardiac arrest/ventricular fibrillation, and acute renal failure were significantly higher in the AF group than those in the non-AF group (P<0.05). Logistic regression analysis showed that age, NYHA functional classification Ⅳ, AF and cardiopulmonary bypass time>120 min were independent risk factors for early mortality. Conclusion AF has a negative impact on the early outcomes of patients undergoing AVR. AF patients have higher post-operative early mortality and more related complications compared with non-AF patients.

Abstract:Objective To explore the relationship between blood lipids and the severity of coronary artery disease. Methods A total of 4 751 patients with chest pain were divided into two groups according to the results of coronary angiography: coronary artery disease group (n=3 402 stenosis in one main branch stenosis≥50%) and control group (stenosis<50%, n=1 349). According to the number of coronary artery stenosis, the coronary artery disease group was divided into three subgroups (group 1: 1 branch stenosis; group 2: 2 branch stenosis;and group 3: 3 or more than 3 branch stenosis).The serum total cholesterol (TC),triglycefides (TG),high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were determined and LDL-C/HDL-C was calculated.The relationship between lipids and the severity of coronary artery stenosis was analyzed by Spearman correlation analysis, and the risk factors of coronary artery disease were analyzed by multiple-stepwise logistic regression analysis. Results The levels of TG, TC, LDL-C and the ratio of LDL-C/HDL-C in the coronary artery disease group were significantly lower than those in the control group (P<0.01). LDL-C/HDL-C ratio increased with the increase of diseased branches in the disease group (P<0.001), and the number of diseased branches was positively correlated with the ratio of LDL-C/HDL-C (R=0.25, P<0.01). Logistic multiple regression analysis showed that high LDL-C/HDL-C level was an independent risk factor for coronary heart disease. Conclusion LDL-C/HDL-C ratio is an independent risk factor for coronary heart disease and it is positively correlated with the severity of coronary artery lesions.

Abstract:Objective To investigate the protective effect of zinc supplementation during pregnancy against mercury toxicity to mothers and newborns and the possible mechanism. Methods According to the maternal blood mercury levels at middle and late pregnancy, 90 pregnant women were equally divided into a case group (blood mercury≥5.8 μg/L at middle and late pregnancy), a treatment group (blood mercury≥5.8 μg/L at middle pregnancy, daily supplementation of 10.6 mg zinc till delivery), and a control group (normal blood mercury level at middle and late pregnancy). The levels of maternal blood mercury and zinc, and pregnancy outcome were observed in the three groups. The expression of apoptosis-associated protein Bcl-2 and Bax in the placenta tissue was detected by Western blotting analysis, and the apoptosis rate of cells in placenta tissue was detected by TUNEL assay in each group. Results The maternal blood mercury level at late pregnancy in the treatment group ([3.42±0.52] μg/L) was significantly lower than that in the case group ([6.16±0.32] μg/L, P<0.05) and that at middle pregnancy ([6.15±0.26 ] μg/L, P<0.05) in the treatment group; the blood zinc level in the treatment group ([671.34±44.65] μg/L) was significantly higher than that in the case group ([483.25±62.20] μg/L, P<0.05) and that at middle pregnancy ([480.73±60.64] μg/L, P<0.05) in the treatment group. The incidence rates of premature labour, premature rupture of membranes (PROM), and small for gestational age (SGA) in the case group were significantly higher than those in the treatment group (P<0.05). The apoptosis rate of cells in the placenta of the case group ([35.20±4.96]%) was significantly higher than those of the treatment group ([13.47±2.43]%) and the control group ([13.27±2.21]%, P<0.05). The expression level of Bax protein in the placenta of the case group (3 110.38±136.09) was significantly higher than those in the treatment group (2 015.76±177.63) and the control group (2 009.90±152.61, P<0.05).The expression level of Bcl-2 protein in the placenta of the case group (2 055.97±280.82) was significantly lower than that in the treatment group (5 187.93±247.89) and the control group (5 308.83±259.97, P<0.05). Conclusion Zinc supplementation during pregnancy has protective effect against mercury toxicity to mothers and newborns, which might be associated with up-regulation of Bcl-2 protein and down-regulation of Bax protein and the subsequent inhibition of cell apoptosis.

Abstract:Objective To silence polβ gene by RNAi technique and to observe its effects on the drug-resistance of esophageal carcinoma cells to cisplatin (cDDP). Methods We constructed recombinant lentivirus containing siRNA targeting polβ genes. The two lentiviral vectors containing siRNA targeting the polβ gene were designated as pRNAT-U6.2/Lenti-polβ1 and pRNAT-U6.2/Lenti-polβ2, and the negative control vector as pRNAT-U6.2/Lenti-polβC; they were used to infect EC9706/cDDP cells, which was resistant to cDDP. The expression of polβ was then examined by RT-PCR, Western blotting and immunofluorescence. MTT was used to observe the inhibitory effect of cDDP; the IC₅₀ of cDDP and resistance index (RI) were calculated. Results Both pRNAT-U6.2/Lenti-polβ1 and pRNAT-U6.2/Lenti-polβ2 down-regulated polβ at mRNA and protein levels, with the effect of former being more prominent. Cisplatin inhibited EC9706/cDDP cell proliferation in a dose-dependent manner. The IC₅₀ values of cDDP in cells infected with pRNAT-U6.2/Lenti-polβ1, pRNAT-U6.2/Lenti-polβC and untreated EC9706/cDDP were 55.71 μg/mL, 62.41 μg/mL, and 63.11 μg/mL, respectively, with the first one being significantly different from the latter two (P<0.05); and the corresponding RI values were 13.9, 15.5, and 15.7, respectively, also with the first one being significantly different from the latter two(P<0.05). Results It is suggested that polβ expression is associated with cDDP resistance in EC9706/cDDP, and silencing polβ by RNAi can partly reverse the drug resistance of EC9706/cDDP to cDDP.

Abstract:Objective To investigate the effects of carvacrol on proliferation, apoptosis and invasion of human prostate cancer cells in vitro, and to explore the role of mitogen-activated protein kinase (MAPK) signaling pathway in the related mechanism. Methods Prostate cancer cells DU145 were treated with (carvacrol group) or without (negative control group) 80 μmol/L carvacrol for 24 or 48 hours. CCK-8 assay and cell growth curve were used to detect the proliferation of DU145 cells on day 0, 1, 2, 3, 4 and 5. Cell apoptosis and invasion were assessed by FACS method and transwell assay, respetively. RT-PCR and Western blotting analysis were used to detect the expression of matrix metalloproteinase 9 (MMP-9) and its inhibitor TIMP-1. Expressions of poly(ADP)-ribose polymerase (PARP), caspase-9, and activation of extracellular signal-regulated kinase (ERK) and p38 were also detected by Western blotting analysis. Results Compared with negative control group, cell viability was inhibited in the carvacrol group and cell proliferation was decreased significantly on the third day of treatment(P<0.05, P<0.01). Apoptosis rate of DU145 cells was significantly increased (P<0.05) and the invasion capability of DU145 cells was significantly decreased in the carvacrol group (P<0.01). Expressions of TIMP-1 and caspase-9 were increased in the carvacrol group, with fragmented PRAP, activated p38 signaling pathway, and inhibited MMP-2 activity of ERK signaling pathway. Conclusion Carvacrol can inhibit cell growth, invasion and induce apoptosis of DU145 cells, which involves MAPK signaling pathway.

Abstract:Objective To compare the hemostatic efficacies and exothermic reactions between mesoporous and microporous materials with similar components but different specific surface areas and pore sizes, so as to lay a foundation for developing new first-aid hemostat with mesoporous materials. Methods Totally 15 male pigs were made into femoral artery fatal hemorrhage models and were randomly divided into three average groups (group A, group B and group C). Their hemostatic efficacies and exothermic reactions on the tissues were compared between the three groups (group A was treated with hemostatic mesoporous material HW, group B with microporous material ZSM-5, and group C with standard gauze as control). Results The hemostatic time periods of group A and B were (49.50±3.27) s and (59.50±2.42) s, respectively (P<0.05); standard gauze in group C had failed hemostatic effect. The highest local temperature rose to (42.0± 1.58) ℃in group A, (46.4±1.14)℃ in group B, and (36.8±0.84)℃ in group C, with significant difference found between different groups (P<0.05). Histological test showed that the tissue damage caused by exothermic reaction of mesoporous material HW was slighter than that of microporous material ZSM-5. Conclusion Compared to mesoporous material HW, the microporous material ZSM-5 has more rapid hemostatic efficacies and slighter exothermic reaction, and ZSM-5 is a promising carrier for next generation first-aid hemostatic study.

Abstract:Objective To compare the clinical outcomes of two percutaneous tracheostomy methods, the guide wire dilating forceps (GWDF) and the single step dilational tracheostomy (SSDT), in patients having received cardiac surgery. Methods Totally 60 patients, who underwent mid-sternal thoracotomy from October 2011 to August 2013 and had tracheostomy indications, were included in the present study. The patients were equally divided into GWDF group and SSDT group. The operation time, times of dilation, blood loss, and postoperative complications were compared between the two groups. Results The operation time of tracheostomy in the SSDT group was significantly shorter than that in the GWDF group ([6.5±2.2] min vs [9.3±3.1] min,P=0.02). The times of dilation of the SSDT group was significantly less than that of the GWDF group (1.10±0.05 vs 1.53±0.22, P=0.001); the blood loss was also significantly less than that of the GWDF group (P=0.000). The overall complication rate of the SSDT group was significantly lower than that of the GWDF group (P=0.000). Conclusion SSDT, compared to the GWDF, has the advantages of simple manipulation, short operation time, less trauma, and less complication, and it can be used as the first choice for severe patients after cardiac sugery.

Abstract:Objective To explore the changes of plasma coupling factor 6 (CF6) in children with large atrial septal defect and different degrees of pulmonary hypertension. Methods A total of 160 patients with large atrial septal defect and different degrees of pulmonary hypertension from January 2010 to August 2012 were retrospectively analyzed. The age of the patients ranged from 4 to 16 (mean 9.7±2.1) months old, and the weight ranged from 3.5 to 8.3 (mean 6.9±2.1) kg. The participants were divided into three groups: atrial septal defect without pulmonary artery hypertension (control group, n=41); atrial septal defect with pulmonary artery hypertension, but not to a severe degree (A group, n=76); and atrial septal defect with severe pulmonary artery hypertension (B group, n=43). The plasma CF6 levels were determined and compared by radioimmunoassay between different groups; the relation of CF6 levels with degree of pulmonary artery hypertension was analyzed. Results The plasma CF6 level was (198.5±43.7) pg/mL in the control group, (167.7±89.8) pg/mL in A group, and (304.4±80.7) pg/mL in B group, showing no significant difference between control group and A group (P>0.05), but with that in B group being significantly higher than those of control group and A group (P<0.01). We also found that the ratio of systolic pulmonary artery pressure to systolic blood pressure was positively correlated with plasma level of CF6 in atrial septal defect children with severe pulmonary artery hypertension (r=0.781, P<0.01). Conclusion The plasma CF6 level is obviously increased in children with large atrial septal defect and severe pulmonary artery hypertension. CF6 may be one of the reasons for severe pulmonary artery hypertension.

Abstract:Despite chemotherapy regimens for advanced gastric cancer keep emerging, the patients still have poor prognosis. Molecular targeted therapy is another important direction for the treatment of advanced gastric cancer. Various drugs for molecular targeted therapy have been developed targeting epidermal growth factor receptor (EGFR), human epidermal growth factor receptor-2 (HER-2), vascular endothelial growth factor (VEGF) and its receptor (VEGFR), and cyclooxygenase-2 (COX-2); a number of Ⅱ/Ⅲ clinical trial have been completed or being conducted. The aim of this review is to summarize the recent progress on molecular targeted therapy for gastric cancer.

Abstract:War trauma accompanied by multidrug-resistant infection pose a severe challenge for military medical services. Due to the wide application of antibiotics, war trauma complicated by multi-drug resistant infection is becoming a troublesome problem. This paper summarized the commonly-seen war-related bacteria and the corresponding revolution of drug resistance. The details of detection, treatment, and prevention measures of multi-drug resistant bacteria in war trauma were reviewed, and the risk factors of multi-drug resistance in warfare condition was also discussed.

Abstract:Objective To assess the safety and effectiveness of self-made side hole balloon for treating no-reflow following percutaneous coronary intervention(PCI). Methods Twenty-three patients diagnosed with no-reflow during PCI from Jan. 2012 to Jan. 2013 were enrolled. Residual stenosis, thrombosis,dissection, and spasm of coronary artery were excluded. The mean age of the 23 patients was (62.0±13.8) years old. Of the 23 patients 14 had ST segment elevation myocardial infarction (STEMI), and 9 underwent elective PCI. There were 11 cases with no-reflow in the left anterior descending branch, 8 in the right coronary artery and 4 in the circumflex branch. The drugs (nitroglycerin and tirofiban) were selectively injected into the vessel using self-made side hole balloons. The thrombolysis in myocardial infarction (TIMI) grade before and after procedure,ST segment resolution (STR),ST-T changes for 24 and 72 hours and complications (perforation, dissection,and thrombosis of coronary artery) were observed postoperatively. Patients were followed up by ECG and echocardiogram at 1 month after PCI. Incidence of major adverse cardiovascular events (MACEs) and cardiac function were observed 6 months after PCI. Results After intracoronary administration of drug therapy, TIMI grade-1 flow was found in 3 patients, TIMI grade-2 flow in 5 patients and TIMI grade-3 flow in 15 patients. In patients with STEMI, complete resolution (≥70%) was found in 8 patients,partial resolution (30%-69%) in 4, and no resolution (<30%) in 2. One of the 2 patients with ventricular electrical storm was treated with temporary cardiac pacing and drug therapy and recovered within 1 week; the other one with pericardial tamponade who was treated with emergency surgery repair died. In 9 patients undergoing selected PCI,transient ST segment changes were noted in 3 patients which recovered within 1 week after conservative treatment; with no perforation, dissection,or thrombosis of coronary artery. One month after discharge, echocardiogram of the 22 patients showed a mean left ventricular ejection fraction (LÜEF) of (50.6±14.3)% and a fractional shortening in the short axis view of 0.36±0.04, and ECG showed non-specific changes of ST-T in 6 patients. In 4 patients with STEMI, culprit artery showed TIMI grade-3 by angiography performed during PCI for non-culprit vessel 1 month after primary PCI. At 6 months after primary PCI, there was no MACE; 18 patients were in New York Heart Association Class Ⅰ and 4 in Class Ⅱ. Conclusion Self-made side hole balloon is a safe, economical, effective and convenient method for intracoronary administration of nitroglycerin and tirofiban in treating no-flow during PCI, but the result still needs further verification.

Abstract:Objective To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral posterior canal involved. Methods The clinical data of BPPV patients, who were diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012, were retrospectively analyzed. The patients had bilateral torsional upbeating geotropic nystagmus as showed by Dix-Hallpike test. The diagnosis and treatment strategies were summarized. Results Twenty patients presented bilateral torsional upbeating geotropic nystagmus in Dix-Hallpike test; further investigation by lean and bow test showed that six patients manifested with vertical upbeating nystagmus in lean test and no nystagmus was found in the bow test; then they were diagnosed as having bilateral posterior canal BPPV and were treated by bilateral particle repositioning maneuver. Whereas the torsional upbeating nystagmus remained in the other 14 patients in both lean and bow test, but the torsional direction of nystagmus was reversed, so these patients were diagnosed as having unilateral horizontal canal BPPV and their symptoms disappeared after treated by unilateral Barbecue maneuver. Conclusion Diagnosis of bilateral posterior canal BPPV should not be hastily made in patients showing bilateral torsional upbeating geotropic nystagmus in Dix-Hallpike test unless unilateral horizontal canal BPPV is ruled out.

Abstract:Objective To compare the efficacies of esmolol and urapidial in improving brain beat during microvascular decompression surgery for hemifacial spasm. Methods A total of 226 patients scheduled for microvascular decompression surgery received general anesthesia with controlled blood pressure,with the mean arterial blood pressure (MAP) being 55-65 mmHg (1 mmHg=0.133 kPa) and the bispectral index being 40-60. Thirty-two of the 226 patients who developed brain beat were randomly assigned to 3 groups: group A (esmolol, n=11), B (urapidial, n=11) and C (isotonic NaCl, n=10), receiving intravenous injection of esmolol 10 mg, urapidial 5 mg and isotonic NaCl 2 mL, respectively. The heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) at T0 (before injection),T1(1 min after injection), T2 (5 min after injection), T3 (10 min after injection), T4 (30 min after injection), operating time under microscope, and improvement of brain beat were observed. Results There were no significant differences in HR, MAP or CO at T0 time between the three groups. HR and CO were significantly decreased in group A compared with those in group C at all time points(P<0.01); MAP values were similar between group A and group C. HR, MAP and CO were similar at different time points in group C. The improvement rate of group A was significantly higher than those of group B and group C(P<0.01). The operating time under microscope in group A was (18±4) min, which was significantly shorter than those in group B ([28±6] min) and group C ([29±5] min). Conclusion Esmolol can notably improve the brain beat during microvascular decompression surgery for hemifacial spasm.

Abstract:Objective To observe the effect of electroacupuncture (EA) intervention on the expression of Rho-associated kinase 1(ROCK1) and Rho-associated kinase 2 (ROCK2) in rat peri-infarct cortex after middle cerebral artery occlusion (MCAO), so as to study the underlying mechanism by which EA improves cerebral ischemia. Methods Totally 40 male Sprague Dawley (SD) rats were equally randomized into four groups, control group, sham-operation group, model group and EA group. MACO in the model group and EA group was successfully established by an improved Longa procedure. EA was given 90 min after resuscitation for the EA group, once a day for 14 days. The modified neurological severity scores (mNSS) of rats in each group were determined on the 1^st day, 3^rd day, 7^th day and the 14^th day after operation. Immunohistochemistry and Western blotting analysis were used to detect the expression of ROCK1 and ROCK2 in the brain 14 d after operation. Results Neural dysfunction was not observed in the control group and sham-operation group. The values of mNSS were significantly different between model group and EA group at 7 d, 14 d after operation (P<0.05). Both immunohistochemical staining and Western blotting analysis indicated that the expression levels of ROCK1 and ROCK2 were up-regulated in model group, while those in EA group were significantly less than those in the model group (P<0.05). Conclusion The expression of ROCK1 and ROCK2 is up-regulated in rat cortex after focal cerebral infarction, and the up-regulation can be prevented by EA intervention, which might be one of the mechanisms by which EA promotes the recovery of neurological dysfunction after cerebral infarction.

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Abstract:Objective To observe the distribution of serum thrombospondin-1. platelet total and platelet parameters in children with Kawasaki disease and children in the control group, to explore deeply the law of changes of platelets，and relation between TSP-1 and changes of platelets, its potential mechanisms. Methods Serum TSP-1 were measured by Enzyme-linked immunosorbent assay, PLT and platelet parameters were measured by Automatic Hematology Analyzer in 32 cases of KD inpatients of pediatric department during September 1 st, 2011 and December 31st, 2012, 30 cases of children in similar ages in the control group were measured the same indicators during the same period，relative data were analyzed. Results (1) Serum TSP-1 was highest in acute phase and decreased little by little; PLT reached the peak in sub-acute phase; The activity of platelet reached the strongest level in acute children with KD and decreased then. (2) There was no correlation between the level of serum TSP-1 and PLT in acute, sub-acute and convalescent phase. Conclusions (1) The level of serum TSP-1 is related to the activity of the platelet, it can be used as an indicator to evaluate the extent to which the activity of platelet reaches. The activity of platelet reaches the strongest in acute children with KD.（2）Inhibition to thrombocytosis is unclear in children with KD, it needs more deep investigation.

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