This study was designed to determine the protective effect of scopolamine and catalase on the arterial endothelial cells during reoxygenation. The culture of endothelial cells from bovine aorta subjected to ischemia for 2 hours and reoxygenation for 30 minutes was used as a model for inves-tigaion. In the experimental group, scopolamine was added to the arterial endothelial cells culture medium, Hanks solution containing no sugar or oxygen; or in the control group no medicine was added to the ordinary Hanks solution. The alteration of glutathione ( GSH ) and malondialdehyde (MDA) of endothelial cells, and nitric oxide (NO) and lac-tate dehydrogenase (LDH) in the supernatant fluid were determined. The results demonstrated the following changes: (1) GSH in the control group significant reduction from the preischemia value 44. 5 + 2.45 to postischemia and reoxy genation value 35.08 + 5.72ug/mg protein, vs the post-ischemia and reoxygenatior value of 46. 67+3.20ug/ mg protein (scopolamine) and 43.38+2.98ug/mg protein (catalase). The differences between the GSH changes of control group and medicine treated group are statistically significant (P

[Objective]To investigate the morphological changes of the roof of the subacromial bursa and the extent of involvement of the subacromial bursa after rotator cuff tear.[Method]For the experimental group,the roof of the subacromial bursa was obtained from patients with rotator cuff tear both at the tear site and 2.5 to 3.0 cm distal to the tear site during surgery of rotator cuff repair.For the control group,the roof of the subacromial bursa was obtained during surgery of recurrent shoulder dislocation or humeral shaft fracture at the exposure site.The specimens were processed for histological staining,immunohistochemical analysis and for transmission electron microscopy.The number of cells were quantitated by counting cells with blue-stained nucleus in the subacromial bursa using a computer image analysis system.[Result]The number of cells increased significantly in the roof of the subacromial bursa obtained from both sites,the tear site and the distal site,in the patients with rotator cuff tear,compared with the normal bursa(P

Objective To investigate the effect of adenosine on pulmonary injury after extracorporeal circulation. Methods Twelve mongrel dogs were randomly divided into two groups, the test group and control group. The model of extracorporeal circulation was established. In the test group and control group, adenosine(50μg/kg*min) and normal saline were infused before extracorporeal circulation respectively. Hemodynamics, right cardiac function and arterial blood gas were assessed. Lung water and malondialdehyde content were assessed. Histological evaluation was also made. Results　There were no differences between the two groups with respect to heart rate, mean systemic artery pressure, left atrial pressure, and central venous pressure. In the test group, pulmonary vascular resistance was lower and right cardiac function improved remarkably; arterial oxygen pressure (PaO2) was also higher, less lung water was observed and the malondialdehyde content in the pulmonary tissue was lower (P＜0.05,P＜0.01). Histological evaluation of the test group revealed normal pulmonary architecture without abundant intra-alveolar neutrophils. Conclusion Adenosine can attenuate ischemia-reperfusion lung injury and right cardiac insufficiency caused by extracorporeal circulation. At a proper dose, there was no significant effect on systemic hemodynamics.

Objective To evaluate segmental resection of involved portal vein (PV) in the surgical treatment of advanced pancreatic carcinoma (PC). MethodsIn our 22 advanced PC patients involving PV and/or superior mesenteric vein (SMV) extended pancreaticoduodenectomy or distal pancreatectomy plus extensive regional lymph node clearance were performed and cancer involved PV and/or SMV segment were resected enbloc. Results Among 22 cases, 6 underwent wedge resection and repairment of PV or SMV. Eight underwent segmental resection of PV or SMV followed by end-to-end anastomosis in 5,autotransplantation of great saphenous vein in 2, mesocaval shunt in one. The mean operation time was 7 5?h, the average blood transfusion was 600?ml, and there was no mortality in all cases. All 22 patients were followed up with a postoperative survival of 6 mos in one, 12 mos in 3, 18 mos in 6 cases, 24 mos in 8 and 36 mos in 4 cases. ConclusionsIt is rationale to resect the advanced PC en bloc with the cancer involved segment of PV and/or SMV in terms of low morbidity and long postoperative survival.

Objective To investigate the clinical effect of perioperative electroacupuncture intervention on postoperative delirium (POD) in hip replacement surgery patients.Method One hundred and twenty-eight patients who would undergo hip replacement surgery were randomly allocated to treatment and control groups, 64 cases each. The treatment group received perioperative electroacupuncture and the control group, routine preoperative preparation and postoperative treatment. Serum S100β protein concentration was measured in the two groups of patients at one day before, the end of and one day after surgery. The incidences of POD were compared between the two groups at one, two and three days after surgery.Result There was a statistically significant difference in the incidence of POD between at one day after surgery and recovery from anesthesia in the two groups (P<0.01). In the treatment group, the incidence of POD was significantly lower at two and three days than at one day after surgery (bothP<0.05) and at three days than at two days after surgery (bothP<0.05). There was a statistically significant difference in the incidence of POD between the treatment and control groups at different time points (recovery from anesthesia, and one, two and three days after surgery) (P<0.01). In the treatment group, there was a statistically significant difference in S100β protein concentration between at one day after and the end of surgery (P<0.05). There was a statistically significant difference in S100β protein concentration between the treatment and control groups at the end of and one day after surgery (P<0.05).Conclusions Perioperative electroacupuncture treatment can effectively decrease postoperative incidence of delirium and its duration in hip replacement surgery patients.

In order to study the influence of high temperature and high humidity on the vital signs after craniocerebral missile wound(CMW), CMW was produced in 32 cats according to the method of Carey. Then they were placed in a cabin with respective environmental temperature and humidity of 25℃ and 50%,35℃ and 85%,38℃ and 90% or 40℃ and 95%(as group A, B, C, D).The vital signs and mortality rate were recorded. There were little changes in group A, a slow elevation in group B, but obvious changes in groups C and D. There was no death in groups A and B in 8 hours. All cats in group C died in 5 hours, and also in 2 5 hours in group D. The results suggested that an environment of high temperature and high humidity was detrimental to survival of cats inflicted with CMW, and measures should be taken to alleviate these detimental effects in the treatment of CMW.

BACKGROUND:Crainocerebral missile wound (CMW) is the common severe trauma of war. Environmental factor is the important factor that aggravates the development of sickness and threatens the life of the sick and wounded at early stage. The study on basic theory and treatment of CMW under hyperthermia and high-humidity is the major task in military medicine.OBJECTIVE: To observe the characters of bacterial growth in wound cavity and peripheral tissue after CMW in cats under hyperthermia and high-humidity so as to provide the reference data to the tissue repair and its functional recovery in CMW.DESIGN: Randomized controlled experiment.SETTING: Surgery Department of Neurology in Zhujiang Hospital affiliated to Southern Medical University(First Military Medical University).MATERIALS: The experiment was performed in Department of Tropical Medicine and Hygiene in Southern Medical University from April to May 2003. In the experiment, 24 hybrid cats were employed, of clean grade, of either sex, body-weighted (2.5±0.2) kg, provided from Experimental Animal Center of Southern Medical University. The animals were randomized into 4 groups, named the control at common temperature (5 cats), common temperature group (8 cats), hyperthermia and high-humidity group (8 cats) and blank control (3 cats).METHODS: After weighted, the cat was injected abdominally with 30 g/L pentobarbitol sodium solution at 30 mg/kg. After successful establishment of craniocerebral blindgut wound model, in common temperature group, the cats were placed in simulated climatic cabin at 25 ℃ and 50% relevant humidity for 6 hours and in hyperthermia and high-humidity group, the cats were placed in the hyperthermia and high-humidity environment for 6 hours. With biopsy, the fragmented brain tissue in wound tract and the brain tissue on the wall of wound tract far from 0-5 mm and 5-10 mm were collected and preparedinto successively natural solution and homogenate, and counting was done in 24 hours of bacterial culture to calculate bacterial content in wound cavity and peripheral tissue. In blank control, the cats were sacrificed with anesthesia and the material was collected directly, the rest steps were same as the control at common temperature.MAIN OUTCOME MEASURES: Bacterial content in wound cavity and peripheral tissue in each group.RESULTS: Totally 23 animals were employed in outcome analysis. Bacterial contents in same regions were different remarkably in different groups (F=171.423, P=0.000). It was indicated in paired comparison that significant difference happens between the control at common temperature, common temperature group and hyperthermia and high-humidity group and blank control successively (P ＜ 0.01). The difference was not significant in the comparison among the control at common temperature, common temperature group and hyperthermia and high-humidity group (P ＞ 0.05). Bacterial contents at different distances from the wound cavity were different remarkably in each group (F=14.865, P = 0.000).CONCLUSION: Hyperthermia and high-humidity does not impact significantly the bacterial growth of CMW in 6 hours and bacterial reproduction has not entered high-rate increasing stage yet, due to which, it is still safe for debridement repair.

Objective: To observe the clinical efficacy of combined tuina manipulations with Qi Zheng Qing Peng paste for herniation of the lumbar intervertebral disc. Method: All 568 cases were randomly allocated into an observation group (189 cases), control Ⅰ group (187 cases) and control Ⅱ group (192 cases). Combined tuina with Qi Zheng Qing Peng paste, combined tuina with diclofenac diethylamine emulsions and tuina alone were adopted in the above three groups respectively. The efficacies in the three groups were compared after 4 weeks of treatment. Results: The total effective rates in the observation group, control Ⅰ group and control Ⅱ group were 89.9%, 86.6% and 84.9% respectively, showing a significant difference (P ＜0.05) . Conclusion: Combined tuina manipulations with Qi Zheng Qing Peng paste works well for herniation of the lumbar intervertebral disc.

Objective To investigate the mechanisms of both levofloxacin and ciprofloxacin resistance in clinical strains of Pseudomonas aeruginosa isolated from our hosptial.Methods Twenty P .aeruginosa isolates resistant to both levofloxacin and ciprofloxacin as tested by VITEK-2 Compact were collected.Agar dilution method was used to confirm their minimum inhibito-ry concentrations (MICs)of levofloxacin and ciprofloxacin.DNA gyrase (gyrA and gyrB )and topoisomerase IV (parC and parE)were analyzed by PCR amplification.The expression of efflux systems were analyzed by real-time RT-PCR.Results The MIC results were consistent between Agar dilution method and Vitek-2 Compact system.DNA gyrase (gyrA and gyrB )se-quencing analysis showed that the mutations were mainly frame-shifting mutation characteristic of base (C)insertion at position 941 in gyrA gene,deletion of base (A)at position 1588 in gyrB gene,and insertion of base (T)at position 1543 in gyrB gene.Insertion of base (C)at position 1895 in parE gene was identified in 3 strains.Overexpression of MexAB-OprM and MexCD-OprJ was detected by real-time RT-PCR.Conclusions The insertion and/or deletion of bases in DNA gyrase (gyrA and gyrB)genes and overproduction of MexAB-OprM and MexCD-OprJ efflux systems may contribute to the resistance to both ciprofloxacin and levofloxacin in clinical isolates of P .aeruginosa.

objective: To observe the variations of stress magnitude in the cervical vertebra exerted by vertical traction force from various angles and different points. Methods: The cervical vertebra model was produced by using elastic material of light (polycarbonate) and silica rubber(1:1). By calculating the arithmetical progression of interference fringe. The author judged the stress magnitude in the posterior edge of the C4-7 vertebral bodies when different kinds of pulling force acted on. Result: The interference pattern was seen clearly on the screen while the force acted on the model. When the pulling force acted on C1 or C2, the force was acting at an angle of 150the maximum of the stress presented in C4-5 and when the force acted at an angle of 25° the maximum stress presented in C5-6 and C6-7. Conclusion: The stress distributed upon the posterior edge of the vertebral joints is closely related to the points that the force aced on and the direction of the force． Appropriate points and direction of the pull should be selected according to the change of the lesion joints when manual manipulation is used for the treatment of cervical vertebral disease.