Objective:To evaluate the clinical effects of fasudil hydrochloride on patients with acute cerebral infarction. Methods:100 cases of acute cerebral infarction patients were randomly divided into treatment group(n=50) and control group (n=50). All the cases were given enteric-coated tablets aspirin,ligustrazine hydrochloride injection, piracetam and sodium chlorideand injection and mannitol injection, and so on. Additionally,in the treatment group fasudil hydrochloride injection 30 mg,dissolved in 100 ml 5% glucose or saline were injected intravenously. Results:Basic recovery rate and total effective rate of treatment control were significantly higher(P

In order to observe the pattern of energy expenditure in trauma patients,the REE, substrate oxygenization and nitrogen balance were measured in1 8severely injured patients. REE in posttrauma day1 was1 882? 2 45 kcal/d,1 .1 9of HBBEE,reduced gradually to normal range on posttrauma day 1 0 .REE in single trauma patients decreased more rapidly than that in multiple trauma patients.REE in patients with APACHE ≥ 1 2 was higher than that in patients with APACHE

Objective To investigate the effect of no-tonch harvesting technique in reducing vein graft intimal hyperplasin. A4othods This longitudinal trial compared graft ungiestenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group: 12 rabbits had their veins stripped, distended, and stored in heparinized saline solution. No-touch group: 12 rabbits had veins removed with surrounding tissues, but were not distended, and stored in heparinized blood. The grafts were removed 4 weeks following grafting, and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness, degree of anginstennsis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P< 0.01) compared with those of the conventional group. The proliferating cell nuclear antigen pnsitive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimul hyperpinsin of the vein graft.

Objective To explore the clinical significances of leukocyte (WBC ) ,C‐reactive protein (CRP ) and procalcitonin (PCT) in early diagnosis of bacterial bloodstream infections (BSI) ,in order to provide references for early diagnosis of BSI . Methods The detection results of WBC ,PCT and CRP from 48 cases of patients with positive blood culture(positive blood culture group) and 50 cases of patients with negative blood culture(negative blood culture group) were retrospectively analysed .Then com‐pared the detection results between the two groups ,and between patients with gram‐positive bacteria infection and those with gram‐negative bacteria infection in the positive blood culture group .The diagnostic performance of WBC ,PCT and CRP were determined by drawing the receiver operator characteristic(ROC) curves ,and areas under ROC curves(ACUs) were calculated .The perform‐ance of the three indicators in predicting BSI were evaluated by using the binary logistic regression analysis .Results The levels of PCT and CRP in positive blood culture group was significantly higher than those in negative blood culture group ,had statistically significant differences(P<0 .05) ,while no statistically significant difference was found in WBC count between the two groups(P>0 .05) .In the positive blood culture group ,statistically significant difference was only found in PCT level between patients with gram‐positive bacteria infection and patients with gram‐negative bacteria infection(P<0 .05) .The AUCs of WBC ,PCT and CRP were 0 .579 ,0 .746 and 0 .624 ,respectively .The result of the binary logistic regression analysis showed that only PCT made a unique statistically significant contribution to the model(P=0 .013) for predictive diagnosis of BSI .And the positive predictive rate of joint detection of these three indicators was 71 .4% .Conclusion WBC ,PCT and CRP could be indicators for early diagnosis of BSI ,while PCT and CRP might have much more important significance ,moreover ,PCT could distinguish between gram‐positive bacterial in‐fection and gram‐negative bacteria infection .

To summarize the experiences of optimization of emergency medical care in Nanjing General Hospital.The principles and methods of optimizing emergency medical care were analyzed and summarized.The following methods were used to improve the emergency medical care: Applying modern conceptions of emergency medicine and establishing professional physician teams;Reinforcing the duty of each position and improving the quality of medical care;Modifying the mode and improving the working efficiency;Establishing clinical pathways for disasters and other accidents.The roles of emergency medicine are changed and modernized. Optimization of emergency care and popularization of emergency care skills may improve the quality and efficiency of emergency medical care.

Objective To investigate the effects of different target plasma concentrations of propofol given by TCI on end-tidal isoflurane concentration when the depth of anesthesia was maintained at BIS 50 and evaluate the reliability of electromyography (EMG) as an anesthesia depth monitor. Methods Sixty ASA Ⅰ-Ⅱ patients aged 40-65 yrs weighing 40-85 kg undergoing elective abdominal surgery under general anesthesia were randomly allocated to one of three groups with 20 patients in each group : group Ⅰ isoflurane; group Ⅱ isoflurane + TCI propofol (1 ?g?ml-1) and group Ⅲ isoflurane + TCI propofol (2 ?g?ml-1). The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.05 mg?kg , fentanyl 3 ?g?kg-1 and propofol 0.5-1.0 ?g?kg-1. Tracheal intubation was facilitated with vecuronium 0.12 mg?kg-1. After intubation anesthesia was maintained with isoflurane inhalation alone (group Ⅰ) or isoflurane combined with TCI propofol at a target plasma concentration of 1 ?g?ml-1 ( group Ⅱ) or 2 ?g?ml-1 ( group Ⅲ). MAP, HR, SpO2, PETCO2, BIS, EMG and end-tidal isoflurane concentration were continuously monitored during anesthesia. BIS was maintained at 45-55 after tracheal intubation during maintenance of anesthesia.Results The three groups were comparable with respect to age, sex, body weight, duration of anesthesia and the total amount of fentanyl used during anesthesia. There were no significant differences in MAP, HR and SpO2 among the 3 groups. When BIS was maintained at 50, the end-tidal isoflurane concentration was 0.76?0.03% (group Ⅰ), 0.43? 0.08% (group Ⅱ) and 0.21?0.07% (group Ⅲ) respectively. EMG was maintained at 26-29 during operation. During emergence from anesthesia EMG value increased with BIS value. When the patients opened their eyes at command EMG value was about 40. The correlation between BIS and EMG was poor. Conclusion At the samedepth of anesthesia (BIS = 50) the end-tidal isoflurane concentration was greatly reduced when combined with TCI propofol. EMG value decreases with increasing depth of anesthesia but as an anesthesia depth monitor it still needs improving.

Objective To establish a neuropathic pain model by transection of L4 spinal nerve in rats.Methods Twenty-eight male SD rats weighing 270-310 g were randomly divided into 3 groups: A experimental group (n = 12) received transection of right L4 spinal nerve; B sham operation group ( n = 8) in which right L4 spinal nerve was exposed but not transected and C control group ( n = 8) received no surgery. The paw withdrawal threshold (PWT) to mechanical stimulation was measured by using modified von Frey test. The response to cold stimulation evoked by applying acetone to the plantar region of hindpaw was measured and scored. The threshold to both noxious mechanical and thermal stimuli was measured once a week for 8 weeks. Results In experimental group the pain threshold to mechanical stimuli (von Frey hair stimulation) and cold stimuli (acetone test) on the operated side were significantly decreased after L4 spinal nerve transection as compared to the baseline values before operation and significantly lower than in sham operation and control groups. There was no significant change in the withdrawal response of the hindpaw to mechanical and cold stimuli after surgery on the unoperated side. Conclusion Hyperalgesia to mechanical and cold stimuli develops after L4 spinal nerve transection on the operated side and lasts more than 8 weeks

Hyperlipidemia is one of the most important risk factors of human atherosclerosis and cardiaccerebral vascular disease.The number of hyperlipidemia in China increased year by year and showed a younger trend.The current treatments for hyperlipidemia include drug therapy,physical exercise,diet prevention,liposuction surgery and low-energy laser therapy,etc.Many researches showed that low intensity laser irradiation has a certain curative effect on hyperlipidemia.The aim of this paper is to provide a new idea and method for the future treatment of dyslipidemia by reviewing the anti-hyperlipidemia methods and mechanism of low energy laser irradiation treatment.

Objective To investigate the effect of nicorandil pretreatment on myocardial mitochondria in a rabbit model of myocardial ischemia-reperfusion (I/R). Methods Tirty-two healthy male New Zealand white rabbits weighing 2.0-2.5 kg aged 4 months were randomly allocated into 4 groups ( n = 8 each): Ⅰ group sham operation (group S); Ⅱ group I/R; Ⅲ group nicorandil pretreatment (group N) and Ⅳ group nicorandil + 5 hydroxydecanoic acid (group N + 5-HD). Myocardial I/R was induced by 30 min occlusion of left circumflex coronary artery followed by 120 min reperfusion. In group N and N + 5-HD a bolus of nicorandil 100 μg/kg was given iv at 10 min before myocardial ischemia followed by continuous infusion at 10 μg· kg-1 · min-1 until the beginning of myocardial ischemia. In group Ⅳ a bolus of 5-HD 5 mg/kg was injected iv at 20 min before myocardial ischemia.The animals were sacrificed at the end of 120 min reperfusion. The mitochondrial membrane potential was measured by flow cytometry using JC-1 fluorescence probe as indicator. Bcl-2, Bax and cytochrome c protein expression was determined by immuno-histochemistry. Myocardial ultrastructure was examined with transmission electron microscope. Results Red fluovescence intensity indicating normal live cells was significantly higher, the green fluorescence intensity indicating apoptotic cells was lower and red/green fluorescence intensity ratio was higher; the Bcl-2/Bax ratio was significantly higher and cytochrome c protein expression lower in group N than in group I/R.5-HD administration negated the protective effect of nicorandil pretreatment against myocardial I/R injury. Conclusion Nicorandil stabilizes mitochondrial membrane potential, decreases cytochrome c protein releasing, and suppresses mitochondrial apoptotic signal transduction by opening the mito-KATP channels.

ObjectiveTo explore the sensitivity of cancer stem cells to chemotherapy in human pancreatic carcinoma.MethodsPANC-1 ceils were cultured in an incubator filled with 5％ CO2 at a temperature of 37℃,and were labeled with Hoechst 33342.The SP analysis and sorting were performed using a FACSVantage SE.RT-PCR was performed to detect the expression of human CD133 ABCG2 and Notch1.SP and non-SP cells from the PANC-1 cell line were treated with 5-fluorouracil (5-FU; 1,10,or 100 μg/ml) or gemcitabine (10,100,or 1000μg/ml),and the cell viability was determined using the MTT assay.The sensitivity of sorted tumor cells to chemotherapeutics was determined in NOD/SCID mice model.ResultsSP cells were found to have higher drug-resistance both in vivo and in vitro and higher levels of mRNA expression for CD133,ABCG2 and Notch1,when compared to non-SP ceils.The xenografted tumors derived from injected SP cells and treated with gemcitabine had more CD133± cells than the untreated group.ConclusionsThe SP of PANC-1 pancreatic carcinoma cells are enriched with highly gemcitabine-resistant CSCs and determine the carcinogenesis of the PANC-1 pancreatic carcinoma cells.