Objective To investigate the effect of dexmedetomidine combined bhutto butorphanol in cesarean section postoperative patient-controlled intravenous analgesia.Methods 80 cases of cesarean section pregnant women from January 2013 to August 2015 in zhejiang greentown cardiovascular hospital were selected and randomly divided into the control group and the observation group,40 cases in each group,all patients were treated with endotracheal intubation inhalation anesthesia,postoperative PCIA.The observation group was treated with 300μg dexmedetomidine combined with butorphanol 10mg bhutto,the control group using 200μg dexmedetomidine combined with butorphanol 10mg bhutto,comparison of the effect of analgesia in two groups of patients.Results The visual analogue scale(VAS)score of the T0,T1,T2,T3,T4,T5 time nodes in the observation group was compared with that of the control group,the difference was not statistically significant.The Ramesay scores of the T0,T1,T2,T3,T4,T5 time nodes in the observation group were compared with those in the control group,the difference was not statistically significant.Conclusion Dexmedetomidine combination of bhutto butorphanol in cesarean section after controlled intravenous analgesia to achieve satisfactory analgesic effect.

Objective:To observe the clinical efficacy of Chinese medical gargle on gingivitis of the patients wearing fixed appliance. Methods:60 gingivitis patients with fixed orthodontic treatment were randomly divided into chlorhexidine gargle group( CG group) and Chinese medical gargle group(CMG group)(n=30). Gingival index(GI) and sulcus bleeding index(SBI) in all patients were tested, then the patients were treated by scaling and curettage, and guided to use gargling with corresponding gargle 3 times a day for 14 d. GI and SBI were tested after 7 and 14 days respectively. Data were analysed. Results:After 7 d treatment, GI and SBI were decreased( P<0. 05) and there was no obvious difference between the 2 groups(P<0. 05). After 14 d treatment GI and SBI in CMG group de-creased more than those in CG group(P<0. 05). Conclusion:Chinese medical gargle is effective in the treatment of gingivitis of the patients during fixed orthodontic treatment.

Objective To investigate the effects of N-acetylcysteine (NAC) on the expression of cardiac adiponectin and its receptors in streptozotocin-induced diabetic rats. Methods Thirty-two male Wistar rats were randomly divided into four groups, with 8 in each: untreated control group (C group), NAC-treatment group (CT group), diabetic untreated group (D group) and diabetic NAC-treatment group (DT group). After 8 weeks, plasma glucose and insulin, and cardiomyocyte cross sectional area were measured. Cardiac protein expression of adiponectin receptor 1 and 2 (adipoR1 and adipoR2), AMP-activated protein kinase ? (AMPK?), phosphorylation of AMP-activated protein kinase ?-subunits and glucose transporter 4 (GluT4) were determined by Western blotting. Plasma and myocardial adiponectin levels were measured by radioimmunoassay. Plasma and myocardial free 15-F2t-isoprostane levels were assayed by enzyme immunoassay. Results Compared with C group, the ratio of ventricular weight to body weight and cardiomyocyte cross-sectional area, plasma and levels of free 15-F2t-isoprostane in myocardium and the protein expression of myocardial adipoR1 increased significantly in diabetic rats (D group) (P

Objective To assess the efficacy and safety of urinary kallidinogenase combined with sodium ozagrel for cerebral infarction (CI), and provide references for clinical rational drug use. Methods Retrieved from Cochrane library, PubMed, CBM, FMJS, VIP, Wangfang database and CNKI ( published until January 2015), randomized controlled trails (RCT)about urinary kallidinogenase combined with sodium ozagrel for treatment of CI were included,then methodological quality were evaluated and statistical analysis of those studies were carried out by Rev Man 5.3.4 software. Results 19 RCTs were included,involving 1 747 patients. Results of Meta-analysis showed that urinary kallidinogenase combined with sodium ozagrel could significantly improve total effective rate[RR= 1.18, 95%CI(1.13, 1.23), Z= 7.97, P<0.000 01], cure rate[RR = 1.42, 95%CI(1.23, 1.64), Z= 4.86, P<0.000 1], neurological deficit scores[MD= -4.40, 95%CI(-5.36, -3.43), Z= 8.90,P<0. 000 01] and activity of daily living scores[MD = 19.14, 95%CI(17.39, 20.90), Z = 21.36, P<0.000 01]. Conclusion Urinary kallidinogenase combined with sodium ozagrel was effective in the treatment of CI, and no significant adverse reactions were observed. The combination therapy was worthy of clinical application.

Jervine, a novel steroidal alkaloid from Veratrum nigrum L., exhibits both antitumor effect and potential toxicity. The aim of study was to characterize the pharmacokinetic behaviors and enterohepatic circu-lation of jervine in rats. A rapid and simple ultra-high performance liquid chromatography-tandem mass spectrometric method was developed and validated for quantification of jervine and alpinetin (internal standard) in rat plasma. After extraction from rat plasma by a simple protein-precipitation method, the analyte was separated on a C18 column (2.1 mm × 50 mm, 1.7μm) using water with 0.1％formic acid and acetonitrile as the mobile phase delivered at a flow rate of 0.4 mL/min. Jervine and alpinetin were determined in the positive mode with multiple reaction monitoring (MRM) of the ion transitions at m/z 426.3→108.8 and m/z 271.0→166.9, respectively. Molecular docking method was used to investigate the binding of jervine to p-glycoprotein and dehydroepiandrosterone sulfotransferase. The method was well validated within acceptance limits including specificity, matrix effect, recovery, precision, accuracy, and stability, and was successfully applied to the pharmacokinetic study of jervine after oral and intravenous administration to rats. Jervine presented a small volume of distribution, fast absorption, high oral bioavailability, and enterohepatic circulation. The enterohepatic circulation was first observed in veratrum alkaloids, and was further investigated by molecular docking studies, which was related to the binding of jervine to p-glycoprotein and dehydroepiandrosterone sulfotransferase. The pharmacokinetic properties and enterohepatic circulation of jervine in rats provided a significant basis for the drug-drug interaction and toxicity study in the future.

OBJECTIVETo prepare the gel of Chinese medicine catechu,study its release mechanism in vitro and observe the anti-inflammatory activity in rats.

METHODUsing the amount of catechin and epicatechin in dry extract as major evaluation factors, orthogonal experiment was carried out to investigate four influential factors of the ethanol concentration, ratio of raw material to solvent, ultrasonic time and extraction temperature. The catechu gel was prepared by using carbomer-940 as the gel base, and triethanomine as neutralizer. The experiments on drug-releasing profiles in vitro and the phamacodynamics studies on the anti-inflammatory in rats were carried out, respectively.

RESULTThe optimum condition of extraction from catechu was as follows, the concentration of ethanol, ratio of raw material to solvent, ultrasonic time, and extraction temperature were 50% , 1: 12, 35 min and 60 degrees C, respectively. The formulation of catechu gel was carbomer-9 400.5 g, glycerol 5.0 g, the extracts of catechu 50.0 mL, and triethanomine 0.5 mL The gel was semitransparent and stable. The drugs released quickly. The catechu gel reduced the paw edema considerably in dose-dependent manner compared to carrageenan-induced rat.

CONCLUSIONThe formulation of the catechu gel is reasonable, and it shows remarkable anti-inflammatory activity. It is worth doing further research.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; chemistry ; pharmacology ; Areca ; chemistry ; Catechin ; chemistry ; pharmacology ; Chemistry, Pharmaceutical ; Edema ; drug therapy ; Gels ; Male ; Phytotherapy ; Plant Extracts ; chemistry ; pharmacology ; Plants, Medicinal ; chemistry ; Rats ; Solid Phase Extraction ; methods ; Temperature

Objective To investigate the clinical-pathological features, treatment and prognosis of thrombotic thrombocytopenic purpura in patients with lupus nephritis (LN). Methods A retrospective ana-lysis was carried out based on the clinical-pathological data for the treatment and prognosis of eight patients with LN related TIP. All patients had thrombocytopenia and hemolytic anemia, neurological symptoms and renal dysfunction. Six patients had fever. Results All 8 patients had sudden-onset of rapid progressive glomeurlonephritis (RPGN), one patient with continuous gross hematuria, the pathological features of these patients revealed TMA lesions. Immune suppressive therapy was initiated and blood purification therapy were applied in seven patients. Three cases had plasmapheresis and (or) immunoabsorption. One case was lost during follow-up, the other seven patients were followed with period at one year. One patient died, three patients went into peritoneal dialysis in which one of them was changed to hemodialysis finally. The other three patients had stable renal function. Conclusion The LN patients with TTP had severe clinical-patho-logical changes, rapid progressive and poor outcome, so we should diagnose and treat these patients as early as possible.

Objective To evaluate the robustness of body mass index (BMI) adapted tube current selection method for obtaining consistent image quality in MSCT coronary artery imaging Methods Initially one hundred patients in the control group ( C group) underwent cardiac scans using GE 64-row VCT with standard scan protocol (640 mA, 120 kV, 0.35 see, body bewtie, C2 filter). Noise measurement was obtained for each patient using the average of three consecutive slices in the ascending aorta with ROI of 10 mm×10 mm to establish the relationship between BMI, desired image noise (IN) and required mA. An excel table was established to predict the required mA to achieve a desired IN for each patient with different BMI. A second group of one hundred cardiac patients (L group) was scanned with BMI-aclapted mA from the table to evaluate the practicability of this method. BMI, IN, CT dose index(CTDI),effective dose (ED) were all recorded. Results For the control group of 100 patients, the mean values and standard deviations of image quality score (IQS), BMI, IN and ED were 3.71±0.54, 25.08±2.63, 24.56±5.03 and (17.63±1.68 ) mSv (with range of 15-22 msy). Regression analysis indicated linear relationship between BMI and image noise with fixed mA. Using the relationship between tube current and image noise and noise ratio between large bowtie and cardiac bowtie, the following equation for the required tube current Xma to achieve present image noise of Ins for patient with certain BMI value when using cardiac bowtie could be then obtained: Xma = Fma×( k1 x BMI + c1 )/Ina]2, where Fma = 640 mA, k1 = 1. 033, c1 = - 3.2, Ins = 27 in the study. (2) For the patients in L group, the mean values and standard deviations of IQS, BMI, and IN were 3.69±0.53, 25.07±2.91, and 26.61±3.44, respectively. The average tube current used was (469.95±113.45) mA, depending on patient's BMI values. The average effectively dose was(9.08±2.25) mSv. There was no statistically difference between the two groups in image quality( F= 0.068,P=0.794). Conclusions In 64-MSCT cardiac imaging, the use of BMI dependent tube current selection method, in conjunction with dose reduction techniques, can provide individualized scan protocol to obtain consistent image quality across patient population and to optimize dose delivery to patients.

Objective To investigate the safety of gastrointestinal endoscopy in elderly patients undergoing intravenous anesthesia .Methods 130 patients undergoing gastrointestinal endoscopy were selected .The patients were divided into the elderly group ( A group):65 to 75 years old,65 cases,and young group ( B group):30 to 65 years old,65 cases.The vital signs ( including heart rate, blood pressure, blood oxygen saturation ), anesthesia time, consciousness recovery time,dosage, patients 'experience and adverse reaction were analyzed in the same group of fentanyl combined with propofol intravenous anesthesia .Results (1)Intravenous anesthesia,the blood pressure,heart rate of the two groups decreased in varying degrees ,compared between before examination and during examination in the two groups,there were no statistically significant differences in A group (t=0.11,0.67,0.73,all P>0.05),and there were no statistically significant differences in B group (t =0.27,0.83,1.82,all P>0.05).In the surgery, 1 case of heart rate dropped to 50 times/min below in A group and B group;In A group,1 case of SBP decreased by 30％ of baseline blood pressure before examination ,and B group did not show 30％reduction in SBP before reaching baseline blood pressure .Intravenous anesthesia had greater impact on SpO 2 in elderly patients , and with age increased,the incidence increased, after symptomatic treatment, SpO2 immediately rebounded, and successfully completed the inspection.(2)In A group,the anesthesia time was (16.75 ±5.76)min,the conscious recovery time was (3.51 ±0.69)min,the propofol dosage was (72.43 ±19.58)mg.In B group,the anesthesia time was (15.96 ± 6.58)min,conscious recovery time was (2.98 ±0.71)min,the propofol dosage was (71.67 ±20.49)mg,there were no statistically significant differences between the two groups (t=1.85,1.57,1.96,all P>0.05),but the amount of A group was more than that of B group,indicated that with age increased,the dosage decreased.(3)The patients of the two groups underwent intravenous anesthesia under the gastrointestinal endoscopy could achieve satisfactory anesthesia sedative effect ,and safe to complete the examination .And no bleeding ,perforation and even death and other serious adverse consequences were observed .Conclusion In the strict control of indications and close observation , elderly patients undergoing anesthesia under the gastrointestinal endoscopy is safe ,comfortable and feasible .

The activity of the NK cells in patients with preeclampsia was studied to investigate the pathogenesis of preeclampsia. By using MTT and 51Cr releasing technique, the proliferation and killing ability of the NK cells in maternal and umbilical blood from preeclampsia patients (n = 18) and normal third trimester pregnant women (n = 18) were detected. The NK-92 cell line was as the positive control. The results showed that the NK cell counts of umbilical blood in preeclampsia patients and normal third trimester pregnant women were significantly greater than those of maternal blood (both P<0.05). Compared with that in normal third trimester pregnant women, the proliferative ability of the NK cells in preeclampsia patients was apparently increased (P<0.05). Compared with that in maternal blood, the proliferative ability of the NK cells in umbilical blood from both preeclampsia patients and normal third trimester pregnant women was dramatically increased. The killing ability of the NK cells in preeclampsia patients was significantly higher than that in normal third trimester pregnant women (P <0.05). It was suggested that both number and function of the NK cells in preeclampsia women were increased, and that in umbilical blood was greater than that in maternal blood, speculating that the function of the NK cells may affect the maintenance of the maternal and fetal immune tolerance during pregnancy.
Cytotoxicity, Immunologic/*immunology ; Fetal Blood/cytology ; Immune Tolerance ; Killer Cells, Natural/*immunology ; Killer Cells, Natural/pathology ; Pre-Eclampsia/blood ; Pre-Eclampsia/*immunology ; Pregnancy Trimester, Third