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Objective To study the effect of combined atorvastatin and ezetimibe pretreatment on perioperative hs-CRP after elective PCI.Methods One hundred and fifty-six patients with typical chronic stable angina pectoris were randomly divided into atorvastatin treatment group (n=78) and combined atorvastatin and ezetimibe treatment group (n=78).Their serum hs-CRP,TC and LDL-C level was measured before PCI,at hours 8,24,48 and on day 7 after PCI.Results In comparision with pre-operation,the serum TC and LDL-C levels were significantly lower in two groups (P＜0.01) and in combined atorvastatin and ezetimibe treatment group than in atorvastatin treatment group on day 7 after PCI (P＜0.05).The serum hs-CRP level was significantly higher in two groups at 8 h after PCI than before PCI,reached its peak at 24 h after PCI,continued to increase at 48 h after PCI (P＜0.01),no significant difference was found between the two groups on day 7 after PCI (P＞0.05).The average serum hs-CRP level was lower in combined atorvastatin and ezetimibe treatment group than in atorvastatin treatment group at hours 8,24 and 48 after PCI (P＜0.05) with no significant change found between the two groups on day 7 after PCI (P＞0.05).Conclusion The effect of combined atorvastatin and ezetimibe pretreatment is better than that of atorvastatin alone on perioperative acute inflammatory reactions after PCI.
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Objective To investigate the relationship between cardiac vagus nerves and changes of connexins(Cx)and intracellular gap junction(GJ)distribution pattern in superior vena cava(SVC)myosleeve in dog with atrial fibrillation(AF).Methods Twenty four hybrid dogs were divided into sham operation group(Sham group,n=8),SVC-AO fat pad removed group(RM group,n=8)and SVC-AO fat pad reserved group(RS group,n=8).In RM group and RS group,right atrial pacing was performed at a frequency of 500～650/min for 6 weeks to establish AF model.AF was induced by programmed stimulation or burst stimulation of atrial pacing.The expression and distribution of Cx40 and Cx43 in the SVC myosleeve tissue in three groups were analyzed by immunofluorescence staining.Transmission electron microscopy was used to observe the uhrastructural organization of gap junction(GJ).Results The rate of inducing sustained AF(＞ 15 min)in RS group was significantly higher than that in RM group (P ＜ 0.01).The expression of Cx40 and Cx43 in the SVC myosleeve in sham group and RS group were significantly higher than that in RM group(P ＜ 0.05).Furthermore,the expression of Cx40 and Cx43 in RS group were obviously higher than that in sham group(P ＜0.05).The ratio of end-to-end to side-to-side in RS group was lower than that in Sham group and RM group.Comparing with RM group,the channel of GJ became shorter and wider in RS group(P ＜0.05).Sarcomere was dissolved and mitochondrion showed vacuole degeneration in RS group.Conclusion The remodeling of Cx40 and Gx43 in SVC myosleeve tissue may be mediated by vagus nerves.It is conducive to the maintenance and stability of AF.However,this effect can be weakened by removing SVC-AO fat pad of canine.
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[Objective]To investigate the diagnosis and treatment of lumbosacral nerve roots anomalies. [Method]Etiological factors,typing,diagnosis and treatment of lumbosacral nerve roots anomalies confirmed by operation were analyzed.Operative treatment included wide laminectomy(n=8),hemilaminectomy(n=8) and enlargement fenestration(n=9).[Result]The presenting symptoms of lumbosacral nerve roots anomalies often resulted from lumbar disc herniation or spinal canal stenosis.The typs of lumbosacral nerve roots anomalies included conjoined nerve roots(n=10),closely adjacent roots(n=8),thickening of nerve roots(n=2),caudal origin roots(n=2),division of nerve roots(n=1),double nerve roots(n=1),and anastomosis of nerve roots(n=1).The levels of nerve roots anomalies were L4 in 1,L5 in 14,and S1 in 10.Only 5 cases were diagnosed preoperatively by myelography,CT or MRI.The others were found at operation.All patients were followed up for more than 2 years.Postoperatively,the results were rated as excellent in 12,good in 8,and fair in 4.One patient had residual radiating pain in the lower lims and weakness in dorsiflexion of the foot. [Conclusion] Radicular symptoms of lumbosacral nerve roots anomalies are changeable.The preoperative diagnosis is difficult to establish by myelography,CT or MRI(axial and sagittal plane).It is necessary to heighten the sensitivity of diagnostic modalities.It may improve the surgical outcomes to expose sufficiently,to explore the nerve roots carefully and to decompress thoroughly.
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Objective To discuss the results and characteristics of surgical treatments through anterior or posterior approach for thoracolumbar burst fractures. Methods The retrospective review included 43 cases with an average age of 30.4 years from September, 1999 to November, 2004. The surgical approach was chosen according to conditions of the injury. 17 cases received an anterior approach operation. The Frankel scale was used for assessment of nerve function. 3 cases were rated as Grade A, 12 as Grade B, 19 as Grade C, and 9 as Grade D before surgery. Results The mean follow-up period was 36.7 months. There were no severe postoperative complications, such as deterioration of nerve function. All the cases showed notable improvement. Except in 3 cases of complete paraplegia, the improvement was 1.6 and 1.3 Frankel grades respectively for the anterior and posterior approach operations. Conclusions The anterior and posterior approaches are different in advantages and characteristics. The surgery through anterior approach provides more decompression and better maintenance of sagittal plane alignment.