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To relationship between ambulatory 24h blood pressure parameters and left ventricular hyper‐trophy in patients with essential hypertension .Methods :A total of 106 EH patients (EH group) and 50 healthy vol‐unteers (healthy control group) were selected from our hospital ,and all subjects received 24h ambulatory blood pres‐sure monitoring .According to clinical condition ,EH patients were divided into stage I group (n＝43) ,stage II and III group (n＝63) ;according to left ventricular mass index (LVMI) ,they were divided into no left ventricular hy‐pertrophy (NLVH) group (n＝ 56 ) and LVH group (n＝ 50 ) ,blood pressure load and blood pressure variability (BPV) indexes were compared among above groups .Results : Compared with stage I group ,there were significant rise in percentages of 24hSBP load ≥ 25% (20. 93% vs.77.78%) , 24h mean SBP (24hmSBP )≥ 130mmHg (30.23% vs.73.02%) and 24hSBP standard deviation (24hSSD)≥11.9 (16. 27% vs.82. 54%) in stage II and III group , P＝0. 001 all.Compared with healthy control group ,there were significant rise in daytime mean DBP (dm‐DBP) ,nighttime mean DBP (nmDBP) ,24hSBP load ,24hDBP load and nighttime SBP (nSBP) load in NLVH group and LVH group , P＜0.05 or ＜0.01 ;compared with NLVH group ,there were significant rise in 24hmSBP ,night‐time mean SBP (nmSBP) ,daytime SBP (dSBP) load ,24hSSD and daytime SBP standard deviation (dSSD) in LVH group , P＜ 0.05 or ＜ 0.01 ; compared with stage I group , there were significant rise in 24hmSBP , nmSBP , 24hSBPload ,nSBP load ,24hSSD ,dSSD and nighttime SBP standard deviation (nSSD) in stage II and III group , P＜0.05 or ＜0.01. Conclusion : The 24h blood pressure parameters is closely associated with left ventricular hyper‐trophy in patients with essential hypertension .Reducing 24h ambulatory blood pressure load and variability can re‐duce risk of left ventricular hypertrophy .
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Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting (PONV) in patients undergoing thyroidectomy.Methods One hundred patients (39 males and 61 females,ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal-antiemetic therapy group (group M).Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M,which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P<0.05).The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P<0.05).Conclusion The multimodal-antiemetic therapy: prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.
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Objective To evaluate the role of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in mild head hypothermia-induced reduction of global cerebral ischemiareperfusion (I/R) injury in rats.Methods Sixty male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 5 groups (n=12 each) using a random number table:sham operation group (group S),group I/R,mild hypothermia + I/R group (group H),mild hypothermia + I/R + solvent control group (group DM),and mild hypothermia + I/R + PI3K inhibitor LY294002 group (group LY).Global cerebral I/R was induced by modified four-vessel occlusion method described by Pulsinelli.In H group,when the hippocampal temperature was decreased to 33℃ using nasopharyngeal cooling,the bilateral common carotid arteries were occluded for 15 min followed by reperfusion,and hippocampal hypothermia was maintained at 32.5-33.5 ℃ for 1 h.In DM and LY groups,DMSO and LY294002 5 μl were injected into the left ventricle,respectively,and 20 min later the other procedures were similar to those previously described in group H.At 8 h of reperfusion,6 rats were sacrificed,and hippocampal specimens were obtained to detect the expression of pFoxO3a,Bcl-2 and Bax (by immuno-histochemistry).The expression of phosphor-Akt (p-Akt) was determined by Western blot.Results Compared with group S,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated in I/R,H and DM groups,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/Bax was increased in H and DM groups,and the ratio of Bcl-2/Bax was decreased in I/R and LY groups.Compared with group I/R,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/ Bax was increased in H and DM groups.Compared with H and DM groups,the expression of p-Akt,pFoxO3a and Bcl-2 was down-regulated,the expression of Bax was up-regulated,and the ratio of Bcl-2/ Bax was decreased in group LY.Conclusion PI3K/Akt signaling pathway is involved in reduction of global cerebral I/R injury by mild head hypothermia in rats.