Objective To investigate the effects of ketamine preconditioning on the expression of induced nitric oxide synthase(iNOS)mRNA after myocardial ischemia-reperfusion injury induced by cardiopulmonary bypass(CPB)in patients with congenital heart disease(CHD).Methods Thirty-six patients with atrial or ventrieular septal defect were randomly allocated to 3 groups(n=12):control group and ketamine preconditioning group(K1 group,K2 group).Ketamine 0.5 mg/kg and 1.0 mg/kg,were injected at the time of sternum splitted,aorta intubated and before 5 minutes of aorta clamped off intravenously.Collected the myocardium at the time of superior vena cava intubated(T1),30 minutes after aorta clamped on(T2)and 30 minutes after aorta clamped off(T3).Detected the value of iNOS mRNA in myocardium by one-step real time fluorescence quantitative RT-PCR.Results The levels of iNOS mRNA were significantly increased at T2 and T3 as compared with T1 in the three groups,and were significantly lower both in K1 group(2.33±0.31,3.76±0.61)and K2 group(1.92±0.12,3.12±0.39)than those in control group(2.85±0.48,4.49±0.86)(P＜0.01 or ＜0.05).Furthermore,they were lower in K2 group than those in K1 group(P＜0.05).Conclusion Ketamine can significantly decrease iNOS mRNA in myocardium,and decrease the plasma marker of cardiac muscle injury,it shows dose dependent.

Objective To investignte the effects of ambroxol on lung injury in children undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Thirty-six ASA Ⅱ or Ⅲ children of both sexes aged≤8 yr,weighing≤25 kg undergoing repair of ventricular septal defect (VSD) under CPB were randomly divided into 3 groups (n=12 each):I control group (C);II low dose ambroxol group (2.25 mg/kg) (A,) and III moderate dose ambroxol group (4.50 mg/kg) (A2).Ambrexol was diluted with normal saline 10 ml and infused slowly after skin incision in group A1 and A2.In group C equal volume of normal saline(10 ml) was infused instead of ambroxol.Blood samples were taken from radial artery before skin incision,at 20 rain of CPB,20 rain after aortic unclamping,2 h and 6 h after temtination of CPB and 12 h after operation for determination of plasma MDA concentration and SOD activity and blood gas analysis.Respiratory index (RI) and pulmonary compliance (CL)were calculated.Results The plasma MDA concentration and RI were significantly lower while plasma SOD activity was significantly higher in group A2 than in group C and A1·CL was significantly higher in group A2 than in group C.Conclusion Ambroxol 4.50 mg/kg can attenuate lung injury in children undergoing cardiac surgery with CPB by decreasing lipid peroxidation.

OBJECTIVE:To study the effects of podophyllotoxin derivative QW-83 on human cervical cancer HeLa cell apopto-sis and its mechanism. METHODS:After treated with 0(negative control),0.01,0.1,1 and 10 μmol/L QW-83 and positive drug etoposide(VP-16)for 48 h,proliferation inhibition rate and IC50 of HeLa cell were determined by MTT assay. The morphological changes of HeLa cell were observed by Hochest 33342 staining after treated with QW-83 [0(negative control),2.5,5,10μmol/L] for 48 h;flow cytometry was used to detect apoptosis rate;semi quantitative RT-PCR was adopted to detect the expression of apop-tosis related gene P53,Bax,Casepase-3,Casepase-8,Casepase-9 and Bcl-2 mRNA. RESULTS:Compared with negative control, 1,10 μmol/L VP-16 and QW-83 had obvious proliferation inhibition effect on HeLa cells (P<0.05 or P<0.01),and IC50 were (5.11±0.43)μmol/L and(4.96±0.54)μmol/L. Hochest 33342 staining results showed QW-83 could obviously induce cells apopto-sis and nuclear pyknosis. Flow cytometry showed QW-83 could increase apoptosis rate in concentration-dependent manner,being 16.89%-62.56%. RT-PCR showed mRNA expression of P53,Bax,Caspase-3,Casepase-8 and Casepase-9,Bcl-2/Bax increased, while mRNA expression of Bcl-2 decreased after treated with QW-83(P<0.05). CONCLUSIONS:Podophyllotoxin derivative QW-83 can induce HeLa cell apoptosis,and its mechanism may be associated with regulate mRNA expression of apoptosis related gene.

ObjectiveTo observe the effect of acupuncture on rat model with damp-heat syndrome.MethodsThe combined use of high fat diet,damp-heat environment and infection of bacillus coli was adopted to establish rat models with damp-heat syndrome.A 10-day acupuncture treatment was given to the models.Results Changes can be found in both symptoms and signs of the model rat,which were held to meet the features of damp-heat syndrome.Moreover,abnormity can be found in the expression of the whole blood viscosity [(2.95 ±0.18)、(3.31±0.20)、(9.52±0.53)]mPa ? s,the expression of SOD and MDA of the blood serum and the skin [(4.21 ± 0.3)、(8.51 ± 0.42)]mPa ? s and [( 1.35 ± 0.16)、(1.26 ± 0.20)]mPa ? s.under high,medium and low shear rate.And improvements can be found in the expression of the whole blood viscosity [(2.70± 0.15)、(2.98 ±0.27)、(8.93 ± 0.80)]mPa ? s,the expression of SOD and MDA of the blood serum and the skin [(4.52 ± 0.26)、(7.00 - 0.62)]mPa ? s,[( 1.49 ± 0.12)、( 1.05 ± 0.24)]mPa ? s under high,medium and low shear rate.Conclusion Acupuncture at Yinlingquan (SP9) and Neiting (ST44) can improve the high blood viscosity situation of rat model with damp-heat syndrome,and enhance the ability of the body to eliminate hyperoxide as well.

Objective To investigate the effects of ulinastatin on serum concentrations of advanced oxidation protein products and C-reactive protein in patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-two patients with MODS were randomly divided into ulinastatin group(n=36) and control group(n=36).The serum concentrations of advanced oxidation protein products and C-reactive protein in two groups were determined before therapy and after 3d,5d and 7d of therapy.Acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ)for patients were recorded before therapy and after 3d,5d,7d of therapy.Mortality within 28d was also compared between the two groups.The serum concentrations of advanced oxidation protein products and C-reactive protein in 36 healthy volunteers were detected as normal control.Results The concentrations of AOPP and CRP in patients with MODS before therapy were significantly higher than those obtained from healthy volunteers(P<0.05), whereas no obvions difference was found between the two groups.However,the levels of AOPP and CRP in patients with MODS were significantly decreased after 3d,5d,7d of therapy.Compared with control group,AOPP concentrations and CRP levels were markedly attenuated and APACHE Ⅲ scores decreased significantly in ulinastatin group(P<0.05).The mortality in ulinastatin group was also improved more significantly than that in control group(P<0.05).Conclusion Ulinastatin can decrease the concentrations of serum AOPP and CRP in patients with MODS,so as to alleviate the damage resulting from oxidative stress and inflammation,contributing to improve the outcome in patients with MODS.

In this study,we summarized airway management of a series of patients with inhalation injury caused by smoke from smoke pot based on grade classification,which were:establishment of a special team for these classified patients,classifying the patients into four sub-groups including extremely severe,severe,moderate and mild,establishment of a program for trachea management and relevant measures on these classified sub-groups.Key points of management on extremely severe patients were as follows:protective isolation,mechanical ventilation,nursing of extracorporeal membrane oxygenation and pneumothorax and mediastinal emphysema,prevention of tracheo-esophgeal fistula,nursing cooperation of fiberoptic bronchoscopy.Key points of management on severe patients were as follows:disinfection and isolation,rational oxygen therapy,sputum elimination management,observation of illness status,preparation of emergency treatment,prevention and nursing of complications.Key points of management on moderate patients were as follows:ventilation,oxygen uptake,aerosol inhalation,sputum elimination guidance,respiratory function training.For mild patients,there was no special management except ventilation,aerosol inhalation and regular pulmonary function examination.One patient died due to multiple organ failure complicated with massive hemoptysis,four patients recovered with airway scar proliferation and lung fibrosis,and fifty-five patients fully recovered.

Objective To evaluate the effects of dexmedetomidine on lung ischemia-reperfusion (I/R) injury in rats.Methods Ninety-six healthy SPF male Wistar rats,weighing 250-350 g,aged 8-12 weeks,were randomly divided into 4 groups (n =24 each):sham operation group (S group),I/R group,low dose dexmedetomidine group (DL group) and high dose dexmedetomidine group (DH group).In DL and DH groups,dexmedetomidine 100 and 500 μg· kg-1 · d-1 were injected intraperitoneally once a day for 2 consecutive days,while the equal volume of normal saline was given in S and I/R groups.Lung·I/R was induced by clamping the left hilum of lung for 45 min followed by reperfusion at 30 min after administration on 2nd day.At 45 min of ischemia,and 60 and 120 min of reperfusion,6 rats were sacrificed,and lungswere removed for determination of TNF-α (tumor necrosis factor-a) content and myeloperoxidase (MPO) activity in lung tissues.The percentage of damaged alveolar in lung tissues was detected at 120 min of reperfusion.Another 6 rats were lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of the total protein concentrations.Results Compared with S group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly increased in I/R,DL and DH groups.Compared with I/R group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly decreased in DL and DH groups.Conclusion Dexmedetomidine can alleviate the lung I/R injury in rats,and the mechanism is related to inhibiton of the inflammatory responses.

Objective To investigate the effect of telephone follow-ups on medication compliance of elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods One hundred and sixty elderly patients with coronary heart disease undergoing PCI were randomly divided into control group(n=79)and experimental group(n=81).Conventional treatment with medication and telephone follow-ups per six months were administered to patients in control group after discharging from the hospital.Besides the same treatment as in the control group,8 telephone follow-ups were made within 12 months from discharging and additional follow-ups were performed if their medication compliance was poor.The two groups were compared in terms of medication compliance 12 months since discharging,and cardiovascular adverse events,readmission rates and restenosis rates within 1 year. Results The medication compliance in the experimental group was significantly better than that in the control group.The rates of cardiovascular adverse events,readmission and restenosis within 1 year were all significantly lower than those of control group(all P<0.05).Conclusion Telephone follow-ups can improve medication compliance of elderly patients with coronary heart diseases after PCI and thereby enhance the curative effects.

Objective To discover the excision repair cross-complementing 1 (ERCC1) expression in non-small cell lung cancer (NSCLC) patients and explore the prognostic value of ERCC1 .Methods The ERCC1 mRNA expressions in NSCLC was tested from 85 tumor tissues and 34 adjacent tissue samples from patients who were after the surgery were used by semi-quantitative RT-PCR .The data of clinical features and progression-free survival (PFS) and overall survival (OS) were linked to ERCC1 expression by retrospective analysis .Results In 85 patients ,the ERCC1 negative ones had a significantly longer survival than the ERCC1 posi-tive expression ones (PFS ,P=0 .001;OS ,P=0 .001) .During the multivariate analysis ,ERCC1was found to be a significant factor in PFS and OS (P=0 .018 and P=0 .027) .Conclusion NSCLC patients who were undertaken platinum-based adjuvant chemother-apy after surgery could use the detection of ERCC1 mRNA as a determinant factor for the prognosis predicting of individualized treatment .

Objective To study the changes and management of systemic and pulmonary hemodynamics during anhepatic period in patients undergoing orthotopic liver transplantation without veno-venous bypass.Methods Sixty-eight patients with end-stage liver disease undergoing orthotopic liver transplantation were enrolled in this research. Monitoring and recoding CVP, MAP, CI, HR, MPAP, PAWP PVR, SVR at different time points: preincision, before anhepatic, 5, 30 min of anhepatic, 5, 30, 60 min of neohepatic,ending of operation, 12 h and 24 h after operation. All the patients were divided into three groups according CVP during anhepatic period: group A(CVP <4 mmHg) ,group B(4 mm Hg≤CVP≤6 mmHg) ,group C (CVP>6 mmHg). Besides, calculating the concentration of dopamine, norepinephrine ,epinephrine and the volume of urine during of operation. Results There were different changes during different operation periods. During anhepatic period, HR, PVR and SVR increased, while CVP, CI, MAP, PAP, PAWP decreased(P<0.05). At early neohepatic period, HR decreased and CVP,PAWP, MPAP,CI,PVR SVR increased ,At the beginning of neohepatic period, MAP dacreased or increased quickly, and became steadily after 5 min. Among the three groups, the changes of hemodynamics in group B was slightest,and the concentration of dopamine, norepinephrine and epinephrine was smallest (P< 0.05 ). Conclusions The systemic and pulmonary emodynamics fluctuated sharply during anhepatic and early neohepatic period. It is important and useful to manage CVP 4 -6 mmHg, MABP ≥ 60 mmHg by infusing liquid and vasoconstrictors,such as dopamine, norepinephrine or epinephrine during anhepatic period.