Objective To assess the effects of hypothermia induced by 4 ℃ normal saline (NS) on biochemical function, enzymology and morphology of liver in swine after the success of cardiopulmonary resuscitation (CPR) for cardiac arrest(CA). Method The swine were resuscitated with standard CPR 4 minutes after ventricular fibrillation(VF) ,and the survived swine were randomly(random number) divided into two groups. In hypothermia(LT) group (n = 5), swine were treated with continuous infusion of 4 ℃ NS at the speed of 1.33 mL/(kg·min) for 22 min, and then slow the speed to 10 mL/(kg·h) for 4 h. In normothermia (NT) group ( n= 5) swine were treated with the infusion of NS with room temperature instead of cryogenic NS at the same speed as the LT group. The hemodynamics and the changes of blood gas were monitored until 4 h after restoration of spontaneous circulation (ROSC), and blood samples were taken to detect serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) before VFand 10 min, 2 h and 4 h after ROSC. All swine were sacrificed 24 hours after ROSC, and their liver tissues were taken away for detecting Na+ -K + -ATP enzyme and Ca2+ -ATP enzyme as well as the histological changes under both light and electron microscopy. ResultsThe heart rate, MAP, cardiac output(CO) and coronary perfusion pressure(CPP) of swine were stable in LT group ( P ＞ 0.05). The AST, ALT and LDH increased in both groups but less in LT group. The hepatic ATP enzyme activity was much higher in LT group ( P ＜ 0.05). Compared with the NT group, there were less cellularedema,necrosis or inflammatory cells infiltration, and better morphosis of mitochondria of livers found in swine of LT group. Conclusions The continuous administration of 4 ℃ NS after ROSC could quickly lower the core body temperature, and it could keep hemodynamics and oxygen metabolisms stable, protecting the biochemical function,enzymology and morphology of liver in swine after CPR.

This article summarizes 32 cases of the SCI patients suffered from bladder stones.Respects relating to causes,characteristic,diagnosis,treatment and prevention of bladder stones after SCI are discussed in the article.In order to decrease or avoid complication of indwelling urethral catheter,the patients with neuropathic bladder dysfunction are treated by intermittent catheterization.If it is necessary for SCI patients to indwell urethral catheter,we must strengthen management of the catheter and renew a catheter in time(once a week).

Objective To evaluate the therapeutic effect of implantation of artificial urinary sphincter (AUS) for treatment of patients with trauma-induced genuine stress incontinence. Methods Two patients (1 male and 1 female) with genuine stress incontinence due to urethral rupture underwent implantation of AUS device (AMS 800).In the male case,the cuff of the AUS device was used to wrap the bulbar urethra.The reservoir was placed into the retropubic space.The controllable pump was implanted into the right scrotum. In the female case,the cuff was used to wrap the neck of bladder.The reservoir was placed into the retropubic space. The pump was implanted into the right subcutaneous labium majus.The literature was reviewed to show the indication,efficacy,complication and durability of implantation of AUS device. Results After operation the male patient was followed up for 17 months,and he achieved complete continence.The female was followed up for 14 months,and she had significant improvement in continence with changing 1 or 2 small pads every day.There were no infection, erosion, urethral atrophy and mechanical failure during follow-up.The review of the literature showed that in patients with implantation of AUS the mean of continence rate was 85.5%;the incidence rates of infection,erosion,urethral atrophy and mechanical failure were 6.1%,7.5%,6.1% and 16.7%,respectively. Conclusions The implantation of AUS is an effective,reliable method for patients with trauma-induced genuine stress incontinence.

Objective To investigate the clinical efficacy of off-pump coronary artery bypass grafting (OPCABG) comparing with the conventional coronary artery bypass grafting (CCABG) for treating the patients with coronary heart disease (CHD) and its impact on brain natriuretic peptide (BNP).Methods One hundred and twenty-two patients undergoing elective coronary artery bypass grafting were divided into CCABG group and OPCABG group according to the surgical method.The operative condition and postoperative clinical data,postoperative complications and death of the two groups were observed.The level of BNP was detected before surgery,immediately after surgery,postoperative 6,24,72 h and 1 week.Results The operative time,postoperative mechanical ventilation time,ICU monitoring time,24 h after drainage and blood transfusion,hospital stay in OPCABG group was(210.08 ± 60.02) min,(9.01 ± 2.57) h,(32.08 ±9.17) h,(343.43 ± 98.12) ml,(341.75 ±97.64) ml,(9.70 ±2.77) d,significantly lower than those in CCABG group [(309.38 ± 88.39) min,( 15.25 ±4.36) h,(45.14 ± 12.90) h,(530.24 ± 151.50) ml,(752.90 ± 215.11 ) ml,( 15.44 ± 4.41 ) d] ( P ＜ 0.05 ).The incidence of postoperative complication of OPCABG group and CCABG group was 15.9％(10/63) and 47.5％(28/59),there was significant difference ( χ2 =14.172,P ＜ 0.01).The mortality rate of OPCABG group and CCABG group was 1.6％(1/63) and 8.5％(5/59),there was no significant difference ( x2 =3.091,P ＞ 0.05 ).The level of BNP in CCABG group before surgery,immediately after surgery,postoperative 6 h was (104.54 ±29.87),(114.74 ±32.36),( 129.10 ± 36.15 ) ng/L,and in OPCABG group was ( 103.46 ± 29.56 ),( 109.49 ± 31.28 ),( 126.42 ± 36.12 )ng/L respectively,there was no significant difference (P ＞ 0.05).The level of BNP in CCABG group postoperative 24,72 h and 1 week [(335.57 ± 95.83 ),(429.98 ± 122.85 ),(350.92 ± 100.26) ng/L] were significantly higher than those in OPCABG group [(241.22 ± 68.92 ),( 317.49 ± 90.71 ),(256.86 ± 73.39)ng/L] (P ＜ 0.05).The levels of BNP in both groups postoperative 24,72 h and 1 week were significantly higher than those before surgery (P＜ 0.05).Conclusion The OPCABG surgery is safe and effective,and has certain advantages for maintenance of cardiac function.

Objective: To Study the effects and feasibility of life quality list for idiopathic pulmonary fibrosis(IPF) patients.Methods: Applying the self-made life quality evaluating list,life qualities of 36 cases of IPF patients were analyzed and compared before and after the intervention of traditional Chinese medicine.Results: The evaluating list of life quality is available for IPF patients.Conclusion: The evaluation of life quality is an available method for the observations of clinical therapeutic effect and health status on IPF patients and it is worth further investigation.

【Objective】To investigate the therapeutic effect of Turbidity-resolving and Stasis-removing Prescription(TSP) for the treatment of nonalcoholic fatty liver disease(NFLD).【Methods】One hundred and thirteen NFLD patients were randomized into groups A and B according to their consulting order.Group A(N=61) received oral use of TSP 100 mL,bid,and group B(N=52) received oral use of ursodesoxycholic acid(UDCA) 150 mg,tid.The treatment lasted 2 months.【Results】The total effective rate was 85.2% in group A,superior to 51.9% in group B (P

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by inflammatory demyelinating lesions and axonal degeneration in optic nerve and spinal cord. It has high relapse rate and high disability rate. In recent years, as the studies on mechanisms of NMOSD, related immune therapy strategies have been developed rapidly. These immunologic interventions are collectively called the disease modifying therapy, which are helpful in improving the course and outcome of the disease. In this review, the latest treatment progress in NMOSD is summarized to guide clinical choice and application of the medication.

ObjectiveTo observe the effect of urethral stent implantation on detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.Methods13 patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction were treated with the operation of the urethral stent implantation. Voiding function, renal function, residual urine volume and hytronephrosis were examined before and after the operation to evaluate the effect of this procedure.ResultsAfter operation, 7 patients normally emptied their bladders and 6 patients had urinary incontinence. Urethral stents were removed from 2 patients in this group due to the irritation symptoms, the second implantation was performed in a patient due to the voiding difficulty. The renal function of patients after the operation had a non-significant improvement, but the residual urine volume and hytronephrosis improved significantly.Conclusion Urethral stent implantation can decrease residual urine volume and hytronephrosis in patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.

Clinical data of 23 elderly patients with rectal cancer undergoing trans-sphincteric local resection(TSLR, Mason's operation)were retrospectively analyzed. All the 23 patients were followed-up for three to seven years after operation, 18 with normal or good fecal continence(78%), five just in fair condition(22%)and none in fecal incontinence. Three-year survival was 83 percent(19/23)and 5-year survival was 78 percent(18/23)for them. It is suggested that TSLR is a safe, feasible and effective treatment for middle and low rectal cancer in the elderly with a long term survival and satisfactory quality of life.

Objective In order to extrapolate the respiratory dysfunction of patients in early stage of acute organophosphorus pesticide poisoning (AOPP),transpulmonary thermodilution technique was used in swine models of severe acute dichlorvos poisoning (SADP) to evaluate respiratory function.Methods Twenty healthy female swine were randomly divided into dichlorvos ( n =7 ),atropine ( n =7 ) and control (n =6) groups.In the dichlorvos group,the swine were administered with 80％ emulsified dichlorvos (100mg/kg) via the gastric tube toinduce SADP.In the atropine group,swinewere administered with dichlorvos,and 0.5h later,atropine was injected to obtain and maintain atropinization.The swine of control group were administered with saline solution instead.Arterial and venous blood samples were collected 0,0.5,1,2,4 and 6 hours after modeling for blood gas analysis and detecting acetylcholinesterase levels.Both extravascular lung water index (EVLWI) and pulmonary vascular permeability index ( PVPI ) were measured by using PiCCO (pulse indicator continuous cardiac output ). At the termination of the experiment,the animals were sacrificed and the lung wet/dry weight ratio was determined and histopathological changes of lung tissue were also observed under microscope.Results In the dichlorvos group,EVLWI and PVPI were substantially increased from 0.5 h to 6 h after modeling but PaO2/FiO2 decreased from 0-6 h after modeling.In the atropine group,EVLWI and PVPI increased initially,but then they decreased 1 h afterwards and PaO2/FiO2 was also gradually decreased from 0-1 h.In both dichlorvos group and atropine group,the EVLWI was negatively correlated with PO2/FiO2 and positively correlated with PVPI.Compared with the control group,the lung wet/dry weight ratio increased markedly in the dichlorvos group and mildly increased in the atropine group.Meanwhile,the histopathological changes of lung tissue were obvious in the dichlorvos group and mild in the atropine group.Conclusions SADP swine experienced substantial changes in respiratory function. EVLWI was a reliable and valuable indicator for evaluating respiratory function in the early stage of AOPP.