Role of three drugs in traumatic proliferative vitreoretinopathy in rabbits / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of triamcinolone acetonide(TA), artesunate(ART), and luteolin(LU)on the prevention and treatment of traumatic proliferative vitreoretinopathy(TPVR). <p>METHODS: Forty-eight cyanotic blue rabbits were selected to prepare TPVR animal models by making a penetrating eye injury and intravitreal injection of 0.3mL platelet-rich plasma, and were randomly divided into four groups(<i>n</i>=12), in which the vitreous cavity of the control group was injected with 0.1mL saline; The vitreous cavity of the TA group was injected with 0.1mL(1mg/mL)triamcinolone acetonide; The vitreous cavity of the ART group was injected with 0.1mL(20μg/mL)artesunate; 0.1mL(10μg/mL)luteolin was injected into the vitreous cavity of the LU group. The vitreous and retinal proliferation were observed by fundus photography and ocular ultrasound at 1, 2, 3 and 4wk postoperatively. The expression levels of α-SMA and VIM protein in the vitreous fluid of each group of rabbit eyes were detected by Western Blot at 28d postoperatively, and the retinal tissue structure of each group was observed by retinal HE staining. <p>RESULTS: At 28d postoperatively, the TPVR grading of rabbit eyes in the TA, ART and LU groups were significantly lower than that in the control group(<i>P</i><0.05), and the TPVR grading of rabbit eyes in the TA group was significantly lower than that in the ART and LU groups(<i>P</i><0.05). The expression levels of α-SMA and VIM proteins in the vitreous fluid of the rabbit eyes in the TA, ART and LU groups were significantly lower than those in the control group at 28d after surgery(<i>P</i><0.01). The results of HE staining showed that the arrangement of retinal layers in rabbit eyesin the control group were disordered, severely distorted or locally broken, the structure of each layer were unclear, the anterior membrane was obviously thickened, and the retina was obviously detached; The arrangement of retinal layersin rabbit eyes in the LU group were slightly distorted, inflammatory exudation was visible in front of the retina, and the retina was superficially detached; The structure of retina in rabbit eyes in the ART group were clear, with mild edema and superficial detachment; The structure of retinal layers in rabbit eyes in the TA group were clear, the arrangement was still neat, the retinal folds were locally visible, and there was no retinal detachment.<p>CONCLUSION: Intravitreal injection of triamcinolone acetonide, artesunate and luteolin were all effective in preventing and treating traumatic TPVR, among which triamcinolone acetonide has the most obvious effect.

Splenic tyrosine kinase promotes pulmonary angiogenesis in rats with hepatopulmonary syndrome / 生理学报

The present paper was aimed to study the role of spleen tyrosine kinase (Syk) in angiogenesis in hepatopulmonary syndrome (HPS) and the underlying mechanism. Sprague Dawley (SD) rats were randomly divided into three groups: sham operation group (sham group), common bile duct ligation (CBDL) 5-week group (5W group) and R788 intervention group (R788 group). HPS model was established by CBDL. Rats in R788 group were intraperitoneally injected with R788 (20 mg/kg) once daily to week 5 after CBDL operation. The protein expression levels and distribution of Syk, p-Erk1/2, and p-Akt in lung tissue were detected by Western blot and immunohistochemistry. Immunofluorescence staining was used to observe the location of Syk expression and the number of angiogenesis in lung tissue. The results showed that, compared with sham group, 5W group exhibited up-regulated protein expression level of Syk, increased phosphorylation levels of Erk1/2 and Akt, and increased number of pulmonary microvessels. Compared with 5W group, R788 group exhibited down-regulated protein expression level of Syk, decreased phosphorylation levels of Erk1/2 and Akt, and decreased number of pulmonary microvessels. These results suggest that Syk may promote pulmonary angiogenesis in HPS model rats by activating downstream Erk1/2 and Akt signaling pathways, which provides a theoretical basis and potential drug therapeutic targets for the clinical treatment of HPS.

Clinical significance of MDM2 protein expression and gene amplification in atypical lipomatous tumour/well-differentiated liposarcoma / 临床与实验病理学杂志

Purpose This study was to investigate the clinical significance of MDM2 protein expression and gene amplification in atypical lipomatous tumour/well-differentiated liposarcoma (ALT/WDL).Methods MDM2 protein expression and gene amplification were detected by immunohistochemistry of EliVision two-step method and fluorescence in situ hybridization (FISH) in 58 cases of ALT/WDL.Results Immunohistochemical staining showed that the positive rate of MDM2 was 79.3％,MDM2 gene amplification rate by FISH assay was 96.5％.There was statistically significant differences between immunohistochemistry and FISH (P ＜ 0.05).Conclusion MDM2 protein expression and MDM2 gene amplification provide the basis for diagnosis of ALT/WDL.However,a positive rate of MDM2 by immunohistochemistry is nearly 80％,so we recommand to carry out immunohistochemical MDM2 protein detection in most conditions without FISH which can help in the diagnosis of most cases of ALT/WDL.

High-risk factors for quality of general movements in infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the high-risk factors for the quality of general movements (GMs), which has a predictive value for brain dysfunction in infants.</p><p><b>METHODS</b>A total of 618 infants in the stage of writhing movements and 539 infants in the stage of fidgety movements were selected separately for the evaluation of GMs. The high-risk factors for the quality of GMs in infants were analyzed by ANOVA, chi-square test, and multivariate logistic regression.</p><p><b>RESULTS</b>Multivariate logistic regression analysis showed that the factors significantly associated with the quality of GMs in the stage of writhing movements were gestational age (OR=0.762, P<0.001), birth weight (OR=0.264, P<0.001), severe asphyxia (OR=2.445, P=0.012), and intrauterine distress (OR=4.865, P<0.001); the factors significantly associated with the quality of GMs in the stage of fidget movements were gestational age (OR=0.786, P=0.003), birth weight (OR=0.217, P<0.001), severe asphyxia (OR=3.765, P=0.001), and hyperbilirubinemia (OR=2.640, P=0.028).</p><p><b>CONCLUSIONS</b>Low gestational age, low birth weight, severe asphyxia, hyperbilirubinemia and intrauterine distress are high-risk factors for abnormal GMs in infants, and early screening and intervention should be performed to reduce the incidence of abnormal nervous system sequelae.</p>

Alkaloids of Nitraria sibirica Pall. decrease hypertension and albuminuria in angiotensin II-salt hypertension / 中国天然药物

In traditional Chinese medicine, Nitraria sibirica Pall. (Nitrariaceae) is used to treat hypertension. This study determined the effects of the total alkaloids of the leaves of Nitraria sibirica (NSTA) on blood pressure and albuminuria in mice treated with angiotensin II and a high-salt diet (ANG/HS). Adult mice were divided into three groups: control; infused with angiotensin II and fed a diet containing 4% NaCl (ANG/HS; and ANG/HS plus injection of NSTA (1 mg·kg(-1)·d(-1), i.p.). After treatment of these regimens, daily water and food intake, kidney weight, blood pressure, urinary albumin excretion, renal concentrations of inflammatory markers, including soluble intercellular adhesion molecule-1 (sICAM-1) and monocyte chemoattractant protein-1 (MCP-1), and the expression of renal fibrosis markers were determined. Compared to the control group, the ANG/HS group had higher blood pressure and urinary albumin excretion. Treatment with NSTA in ANG/HS mice for three weeks significantly reduced blood pressure and urinary albumin excretion. ANG/HS treatment caused elevated levels of sICAM-1 and MCP-1, as well as increased fibrosis markers. Concurrent treatment with ANG/HS and NSTA attenuated the levels and expression of renal inflammatory and fibrosis markers. Treatment with NSTA effectively reduces hypertension-induced albuminuria through the reduction of renal inflammatory and fibrosis markers.

Effects of N2 O on the content of FHb and ICAM-1 in HIFU treatment patients / 重庆医学

Objective To observe the effect of nitrous oxide (N2O) on the content of serum free hemoglobin ,and intercellular adhesion molecule‐1 (ICAM‐1) of patients with HIFU Therapy ,and investigate its action of tissue damage mechanism .Methods 50 patients with primary liver cancer undergoing HIFU surgery (ASA Ⅰ - Ⅱ class) were randomly divided into control group (group C) and experimental group(group N) ,25 patients of each group .General anesthesia method was used in both two groups , group C was by total intravenous anesthesia ,group N was adopted intravenous‐inhalation anesthesia .both two groups was adopted the same anesthesia induction method .anesthesia maintain of group N was joined N2 O on the basis of group C .both two groups were draw blood from the radial artery at the points of before anesthesia (T1 ) ,before operation (T2 ) ,1 h (T3 ) ,2 h (T4 ) ,3 h (T5 ) after intraoperative ,and 24 h after operation (T6 ) ,peroxidase reaction test and double antibody sandwich ELISA method were a‐dopted to detect the content of Fhb value and ICAM‐1 ;ultrasonography system of HIFU therapeutic instrument was used to meas‐ure the abdominal wall thickness of patients before and after operation .Results The content of FHb and ICAM‐1 in serum were significantly increased after operation than before with the anesthesia time (P<0 .05);compared with group C ,group N increased obviously at the same point in time (P<0 .05);preoperative and postoperative abdominal wall thickness value of group N was in‐creased significantly (P< 0 .05) .Conclusion It may be connected with N2 O enhanced ultrasound cavitation effect that the body produces more FHb and ICAM‐1 of group N in HIFU treatment ,and induces abdominal wall skin markedly swollen .

Application of problem-based learning in clinical anesthesiology demonstration for clinical un-dergraduates / 中华医学教育探索杂志

Objective To explore the effect of applying problem-based learning(PBL)in clin-ical anesthesiology demonstration for clinical undergraduates. Methods Eighty-nine 2009 clinical undergraduates were divided into two groups:experimental group and control group. Students in ex-perimental group received PBL while those in control group received traditional teaching. The effect was evaluated according to the results of case examination and investigation table. The results were analyzed by X2 test. Results Most students (42/45) answered questions correctly in experimental group while only 30 of 44 students(30/44)did in control group(P<0.05). Concerning the results of investigation,PBL had more advantages than traditional teaching method in the following 5 aspects:self-studying ability(86.7%,39/45),clinical thinking ability(73.3%,33/45),information seeking ability (75.6%,34/45),expressing ability (82.2%,37/45),communicating between students (75.6%, 34/45)(P<0.05). Conclusions PBL has evident advantages in anesthesiology clinical demonstration. It can inspire students,cultivate abilities,enhance critical thinking and finally improve teaching effect.

Effects of propofol on lipopolysaccharide-induced brain injury in rats / 中华麻醉学杂志

Objective To investigate the effects of propofol on lipopolysaccharide (LPS)-induced brain injury in rats.Methods Fifty-four pathogen-free SD rats of both sexes, aged 6 weeks, weighing 200-250 g, were randomly divided into 3 groups: control group (group C, n = 6) ; LPS group (group L, n = 24) ; propofol group (group P, n = 24) . Brain injury was produced by injection of LPS 1 mg/kg via the left internal carotid artery in L and P groups. Propofol 100 mg/kg was injected intraperitonealry immediately after the LPS administration in group P, while the equal volume of normal saline was given instead of propofol in group L. The equal volume of normal saline was given instead of LPS and propofol in group C. Six rats in each group were sacrificed and the brain tissues were immediately removed at 24 h after intraperitoneal administration in group C, and at 6, 24, 48 and 72 h after intraperitoneal administration in L and P groups for determination of brain water content, high-mobility group box 1 ( HMGB1) expression and NF-κB activity, and microscopic examination. Results The brain water content and NF-kB activity were significantly increased, and HMGB1 expression was up-regulated in group L as compared to group C (P ＜ 0.05) . The brain water content, expression of HMGB1 and NF-kB activity were significantly lower in group P than in group L ( P ＜ 0.05) . The microscopic examination showed that brain injury was attenuated in group P compared with group L. The brain water content was positively correlated with the HMGB1 expression and NF- κB activity (r = 0.692 and 0.769 respectively, P ＜ 0.05). Conclusion Propofol can reduce the LPS- induced brain injury by reducing inflammatory response of the brain tissues.

Effect of penehyclidine pretreatment on Toll-like receptor 4 mRNA expression in the lung following acute lung injury induced by hemorrhagic shock in rats / 中华麻醉学杂志

Objective To investigate the effect of penehyclidine (PHCD) pretreatment on Toll-like receptor 4 (TLR4) mRNA expression in the lung following acute lung injury (ALI) induced by hemorrhagic shock in rats. Methods Forty healthy SD rats of both sexes weighing 200-250 g were randomly divided into 5 groups( n = 8 each): group Ⅰ sham operation (group S); group Ⅱ ALI (group ALI); group Ⅲ, Ⅴ, PHCD 0.3,1.0, 3.0 mg/kg were given iv respectively at 30 min before hemorrhagic shock (P1-3). Hemorrhagic shock was induced by exsanguinations. MAP was maintained at 35-45 mm Hg for 60 min. The animals were killed at 4 h after resuscitation. Their lungs were removed for microscopic examination, W/D lung weight ratio and determination of TLR4 mRNA expression in the lung tissue (by RT-PCR). NF-κB p65 protein expression in the lung tissue was determined (by immuno-histochemical staining). Results Hemorrhagic shock significantly increased TLR4 mRNA and NF-κB p65 protein expression in the lung tissue and W/D lung weight ratio. Pretreatment with PHCD 1.0 or 3.0 mg/kg significantly inhibited hemorrhagic shock-induced increase in TLR4 mRNA and NF-κB p65 protein expression in the lung and W/D lung weight ratio. The lung injury was significantly ameliorated in group P2,3 as compared to group ALI. Conclusion PHCD pretreatment can attenuate ALI induced by hemorrhagic shock through down-regulation of TLR4 mRNA expression and decreasing NF-κB activity in the lung.

Effect of penehyclidine hydrochloride pretreatment on activity of NF-κB in lung tissue following acute lung injury induced by hemorrhagic shock in rats / 中华麻醉学杂志

Objective To investigate the effect of pretreatment with penehychidine hydrochloride(PHCD) on NF-κB activity in the lung tissue following acute lung injury(ALI)induced by hemorrhagic shock in rats.Methods Twenty-four Wistar rats of both sexes weighing 200-250 g were randomly divided into 3 groups (n=8 each):group Ⅰ sham operation (group S);group Ⅱ ALI and group Ⅲ PHCD.The animals were anesthetized with intraperitoneal chloral hydrate 350 mg/kg.Hemorrhagic shock was produced in group Ⅱ and Ⅲ.Right carotid artery was cannulated for BP monitoring.Left femoral artery was cannulated for blood letting.MAP was reduced to 35-45 mm Hg within 10 min and maintained for 1 h in group ALI and PHCD(group Ⅱ andⅢ).The animals were then resuscitated with blood and normal saline.PHCD 2 mg/kg was given iv immediately before blood-letting in group PHCD.Blood samples were obtained from artery at 6 h after hemorrhagic shock wag induced for blood gas analysis and from right auricle for determination of plasma TNF-α concentration by ELISA.The lungs were then harvested for microscopic examination and determination of the expression of NF-κB p65 by immuno-histochemistry and W/D lung weight ratio.Results The plasma TNF-α concentration and expression of NF-κB p65 in the lung tissue were significantly increased in group ALI and PHCD as compared with group S and were significantly lower in group PHCD than in group ALI.There was less damage to the lung tissue in group PHCD than in group ALI.Conclusion PHCD pretreatment can attenuate ALl induced by hemorrhagic shock by inhibiting NF-κB activity.

Effect of Shenfu infusion on myocardial KATP channel in rats after ischemia/reperfusion / 中国组织工程研究

BACKGROUND: KATP channel regulates the response of cells to hypoxia and ischemia, mediates and is involved in the protection for cells or tissue organs. Our previous research confirms that Shenfu injection has good protective effect on myocardial ischemia/reperfusion injury in rats. There have been no reports on whether this protective effect is related to KATP channel in WeiPu deriodical database, WanFang database and Medline database until October 2005.OBJECTIVE: To observe the protective effect of Shenfu injection on myocardial ischemia/reperfusion injury in rats, and analyze its correlation with KATP channel.DESIGN: Completely randomized grouping design, randomized controlled trial.SETTING: Department of Anesthesiology, Second Hospital Affiliated to Dalian Medical University; Department of Anesthesiology, Second Hospital Affiliated to Chongqing Medical University.MATERIALS: Twenty-four adult SD rats of clean grade, of either gender, weighing 240 to 320 g, were employed in this trial. Shenfu injection (Sanjiu Medical & Pharmaceutical, Co., Ltd., Batch No. 031002) and glibenclamide (National Institute for the Control of Pharmaceutical and Biological Products) were employed.METHODS: This trial was carried out in the Laboratory of Anesthesiology, Second Hospital Affiliated to Chongqing Medical University from April to December 2004. Myocardial ischemia/reperfusion injury models were employed. Twenty-four rats were randomized into 4 groups, with 6 in each group: sham-operation group [putting through thread, but without ligation of left anterior descending coronary artery, 8 mL/kg normal saline, intravenous injection (i.v.)], ischemia/reperfusion group (8 mL/kg normal saline, i.v.), Shenfu injection group (8 mL/kg Shenfu injection, i.v.) and Shenfu injection + glibenclamide group (0.33 mg/kg glibenclamide and 8 mL/kg Shenfu injection, i.v.). Administration in each group was conducted 15 minutes before ligation except for that in sham-operation group (immediately after putting through thread). About 6 mL blood was taken from cardiac apex. Left ventricular anterior wall was divided into 3 parts, and then which were used for homogenate, electron microscope observation and immunohistochemical detection separatety. The superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, expressions of tumor necrosis factor-α(TNF-α) and interleukin 6 (IL-6)and plasm cTnl level in myocardial tissue were detected. Ultra-structural changes of myocardial tissue were observed.MAIN OUTCOME MEASURES: SOD activity, MDA level, expressions of TNF-α and IL-6, plasm cTnI level and ultra-structural changes of myocardial tissue. RESULTS: All the 24 rats were involved in the result analysis, without deletion. ① Compared with sham-operation group,SOD activity in myocardial tissue in ischemia/reperfusion group was decreased, while the expressions of TNF-α and IL-6 were increased, with statistical difference (P ＜ 0.01). MDA level in the ischemia/reperfusion group was higher than that in the sham-operation group (P ＜ 0.01); Compared with ischemia/reperfusion group, SOD activity was increased, MDA level and expressions of TNF-α and IL-6 were all decreased in Shenfu injection group(P ＜ 0.01); There were no significant differences in above-mentioned indexes between Shenfu injection group and Shenfu injection + glibenclamide group (P ＞0.05). ②Compared with sham-operation group, the plasm cTnl level in the ischemia/reperfusion group and Shenfu injection+ glibenclamide group was significantly increased (P ＜ 0.01); Compared with ischemia/reperfusion group, plasm cTnl level in the Shenfu injection group was significantly decreased in Shenfu injection group (P ＜ 0.01); There were no signifi cant differences in plasm cTnl level between Shenfu injection group and Shenfu injection + glibenclamide group. ③ In the sham-operation group, the ultrastructure of myocardial cells was basically normal and mitochondrium swelled a little; In the ischemia/reperfusion group, karyolysis appeared, mitochondrium swelled obviously and considerable neutrophils infil trated; In the Shenfu injection group, myofilament of myocardial cells dissolved, mitochondrium swelled and nuclear mem brane was integrity; In the Shenfu injection + glibenclamide group, mitochondrium obviously swelled, myofilament present ed focus dissolving, sarcoplasmic reticulum expanded a little and allochromacy assembled in the edge of cells. CONCLUSION: Glibenclamide suppresses myocardial KATP channel, but does not eliminate the protective effect of Shenfu injection on myocardial ischemia/reperfusion injury. KTAP channel does not play an important role in the protection of Shenfu injection for myocardial ischemia/reperfusion injury.

Practice and reflection of multimedia teaching / 中华医学教育探索杂志

Compared with the traditional teaching methods,multimedia teaching has specific advantages and has been widely used. Meanwhile,the defects in multimedia teaching must be attached great importance to. This paper focuses on some problems widely existing in the multimedia teaching and sets forth several proposals of promotion in the use of multimedia teaching.

Effect of Shenfu parenteral injection on the expressions of Bcl-2, Bax and c-Fos proteins in ischemia reperfusion myocardium of rats / 中国组织工程研究

BACKGROUND: It has been confirmed that Shenfu parenteral injection can ameliorate and treat various shocks, heart failure, myocardial ischemia and supraventricular/ventricular arrhythmia, and it also has a good protective effect on myocardial ischemia/reperfusion injury in rats.OBJECTIVE: To observe the effects of Shenfu parenteral injection on the protein expressions of myocardial apoptosis-related genes of Bcl-2, Bax and c-Fos in rats with acute ischemia/reperfusion injury.DESIGN: A complete randomized grouping design, controlled experiment.SETTING: Department of Anesthesiology, the Second Affiliated Hospital,Chongqing University of Medical Sciences.MATERIALS: The experiments were carried out in the Staff Room of Anesthesiology, the Second Affiliated Hospital, Chongqing University of Medical Sciences from April to December in 2004. Thirty-five healthy adult Wistar rats were provided by the experimental animaI center of Daping Hospital, Third Military Medical University of Chinese PLA. Shenfu parenteral injection was the TCM formula of Shenfu Tang, which is for recuperating depleted yang and rescuing the patient from collapse, and its main components are ginsenoside and aconitum alkaloid. It was the product of Yaan Sanjiu Pharmaceutical Co., Ltd., 10 mL/piece, the batch number was 030110.METHODS: In vivo models of myocardial ischemia/reperfusion injury were used. The 35 rats were divided into 5 groups according to the number of random number table, with 7 rats in each group: ① Sham-operated group: The rats were treated with only insertion of thread without ligation, followed by intravenous injection of saline (8 mL/kg), and then observed for 120 minutes. ② Shenfu parenteral injection 30-minute group: The rats were treated with intravenous injection of Shenfu parenteral injection (8 mL/kg) at 15 minutes before ligation, and then the left coronary artery anterior descending branch was ligated for 40 minutes and reperfused for 30 minutes. ③ Shenfu parenteral injection 120-minute group: The rats were reperfused for 120 minutes, and the others were the same as those in the Shenfu parenteral injection 30-minute group. ④ Saline 30-minute control group: The rats were treated with intravenous injection of saline (8 mL/kg) at 15 minutes before ligation, and then the left coronary artery anterior descending branch was ligated for 40 minutes and reperfused for 30 minutes. ⑤ Saline 120-minute control group: The rats were reperfused for 120 minutes, and the others were the same as those in the saline 30-minute control group. The expressions of Bcl-2, Bax and c-Fos proteins in myocardial tissues were detected with immunohistochemical method.MAIN OUTCOME MEASURES: The expressions of Bcl-2, Bax and cFos proteins in myocardial tissues of rats in each group were observed.RESULTS: All the 35 rats were involved in the analysis of results without deletion. ①As compared with the sham-operated group, the expressions of Bcl-2, Bax or c-Fos protein in myocardium were significantly increased(P ＜ 0.01), but the Bcl-2/Bax ratios were significantly decreased (P ＜0.01) in the saline 30 and 120-minute groups. ② As compared with corresponding saline groups, the expressions of Bcl-2 protein in the Shenfu parenteral injection 30 and 120-minute groups were significantly increased (P ＜ 0.01), the expressions of Bax and c-Fos proteins were remarkably decreased (P ＜ 0.01), and the Bcl-2/Bax ratios were significantly increased (P ＜ 0.01).CONCLUSION: Protective effect of Shenfu parenteral injection on ischemia/reperfusion myocardium may be correlated with its promotion of Bcl-2 protein expression, restrain to Bax and c-Fos protein expressions, and increase of Bcl-2/Bax ratio, and it restrains the apoptosis of myocardial cells.

The safety of application of combined spinal and epidural anesthesia to hip surgery on the elderly / 重庆医科大学学报

Objective: To observe the effect and safety of application of combined spinal and epidural anesthesia to hip surgery on the elderly.Methods: 47 patients aged over 70 years underwent hip surgery;All patients were given combined spinal and epidural anesthesia with 7.5mg~10mg of 0.5% bupivacaine(1~1.4ml of 0.75% bupivacaine was attenuated with 0.5~1ml of cerebrospinal fluid;density: 1.010).The time to anesthesia?sensory block levels and the effect of analgesia and muscle relaxation were recorded;BP?HR and SPO2 were monitored.Results: Foot febrile and lower limb numbness appeared in 40 patients immediately after drug administration;foot febrile appeared in 7 patients 3min after drug administration.There were 3 patients at the highest sensory block levels(T6)?40 patients at T10~12 and 7 patients at T7~9.Combined spinal and epidural anesthesia could provide 100% satisfactory analgesia and muscle relaxation during operation.BP and HR had no obvious variation after anesthesia.Conclusion: The application of combined spinal and epidural anesthesia has the advantage of low-dosage?fast-acting?consummate analgesia?satisfactory muscle relaxation and small interference with recirculating and respiratory system;etc,and so it is safe and effective for hip surgery on the elderly.