Objective To investigate the therapeutic effects of rhein on experimental diabetic nephropathy in rats. Methods Rat model of diabetic mellitus was established by interperitoneal injection of streptozotocin (50 mg/kg) . Renal damages and changes of endothelin (ET) in urine and renal tissues were observed at 12 weeks after the induction of diabetic mellitus and after treatment with rhein (70 mg/kg). Results Compared with the normal rats, at 12 weeks after hyperglycemia, diabetic rats had decreased renal weight/body weight(RW/BW), significantly increased mean glomerular plane area (MGPA), mean glomerular volume (MGV), creatinine clearance rate (Ccr), blood urea nitrogen (BUN), and 24 hour urinary protein excretion (UPE) ( P

Effect of clinical intervention on human body is multistage and multifaceted, involving physiology, psychology, social function and the surrounding resources, etc. Therefore, the range of clinical outcome assessment includes patient, his or her family and care giver. The evaluation of clinical intervention mainly focuses on its effectiveness, safety and health economics. Effects of clinical interventions are measured by comparisons of the outcome of intervention and control groups. Different effect measures come from different comparisons.

Abstract: There are two stages for selecting the clinical intervention outcome variables. One is crude collection and the other is precise collection. The selection methods include brainstorming method, Delphi method, Gordon method, systematic review, systematic analysis method, mathematic model method and so on. Each method has some advantages or disadvantages. When selecting the clinical intervention outcome variables, researchers should make sure the research aim, the representative and the sensitivity of the variables, and select all kinds of recommended methods comprehensively, then decide which method should be used.

Aim To investigate the protective effects of Aplysin on ethanol-induced oxidative damage in rat pri-mary hepatocytes. Methods Rat primary hepatocytes were obtained via the portal vein collagenaseⅣin situ perfusion technique followed by a Percoll density gradi-ent centrifuge. MTT test was used to determine the op-timum dose of Aplysin and ethanol, and detect the cell vitality in primary hepatocytes. Supernatants of primary hepatocytes were harvested to measure AST and LDH level, and the SOD, GSH-PX activities and MDA con-tent in primary hepatocytes were observed. Flow cy-tometry was used to detect the cell apoptosis rate. DNA damage in primary hepatocytes was detected by single-cell gel electrophoresis assay. The level of mitochon-drial membrane potential in primary hepatocytes was tested by fluorogenic probe JC-1 . The CYP2 E1 activity in primary hepatocytes was detected by colorimetry. The proteins of CYP2 E1 were detected by Western blot. Results 300 mmol·L-1 dose of ethanol and 30 mg·L-1 dose of Aplysin were the optimal dosages and were used in the subsequent experiments. Hepatocyte vitality was significantly increased in Aplysin group compared to that in ethanol group, and Aplysin inhibi-ted the release of AST and LDH(P<0. 05). For Apl-ysin treatment group, the activities of hepatocyte SOD and GSH were significantly increased, and MDA was markedly lowered as compared with those in ethanol group( P <0. 05 ) . Aplysin could alleviate hepatocyte apoptosis significantly, and hepatocyte DNA damage rates of Ⅱ ~Ⅲ level and Ⅳ level were significantly lowered in Aplysin treatment group as compared with those in ethanol group, and Aplysin had evident im-provement in alcohol induced mitochondria damage of hepatocyte. Primary hepatocyte activities and protein expression of CYP2 E1 were markedly lowered in Aply-sin treatment group as compared with those in ethanol group(P<0. 05). Conclusion Aplysin has protective effects on liver oxidative damage induced by alcohol of primary cultured rat hepatocytes by blocking CYP2 E1 activation, relieving oxidative stress, and sharpening the oxidation resistance ability.

Objective To develop a simplified bisulfite genomie sequencing(BGS)method for DNA methylation marker scanning.Methods According to modified BGS protocol,the desalt DNA treated with bisulfite were directly used for bisulfite-PCR(BSP)without alkali treatmenL Complement of the bisulfite modification Wag accomplished by a prolonged pre-denaturation stage.After BSP,a second round PCR was performed with a pair of GC tagged primers to adjust the GC content of the amplieon for direct sequencing.To assess this improved protocol,promotor methylation of TNF-α gene in 3T3-L1 cell and androgen receptor(AR)gene in Hela cell was investigated.The real time BSP for Alu was also used to compare the sensitivity of the modified assay with traditional assay.Results Both the hypermethylated TNF-α promotor and hypomethylated AR promotor were successfully sequenced by improved BGS method,and the results were consistent with that of the traditional assay.The conversion rate reached 100%,while the conversion specificity was higher than 93.75%.The sensitivity of improved BGS method inereaged significantly(t=2.978 2,P＜0.05)and showed good reproducibility.Condusion The improved BGS method is simple and sensitive,facilitating more ambitious genomic methyhtion mapping studies.

ObjectiveToexplorethemethodtoestablishanimalmodelofearlyosteonecrosisofthefemoralhead(ONFH)inducedby steroid.Methods20healthymaleBeagleswererandomlydividedintocontrolgroupandexperimentalgroupwith10dogsineachgroup. Theexperimentalgroupwasinjectedlipopolysaccharide10μg/kgandmethylprednisolone20mg/kgfor3daysconsecutively.Thecontrol groupwasinjectednormalsaline.2monthsand4monthsafteradministration,bothgroupswereperformedmagneticresonanceimaging (MRI).5animalsweresacrificedrespectivelyat2monthsand4monthsafteradministrationineachgroup,andbilateralfemoralheadspeci-menswereobtainedtoperformhistologicalexamination.Plasmaprothrombintime(PT),activatedpartialthromboplastintime(APTT),anti-thrombinIII(AT-III)weretestedbeforeand24hafteradministration.ResultsIntheexperimentalgroup,thepathologicalresultsshowed thattherewere4ONFH2monthsand6ONFH4monthsafteradministrationandMRIdidnotshowanyabnormality.Comparedwiththe controlgroup,thePT,APTT,AT-IIIintheexperimentgroupshortenedsignificantlyafteradministration(P<0.001).ConclusionModified steroid-inducedmethodcanestablishtheanimalmodelofearlyONFH.Hypercoagulationandlowfibrinolysismaybethereasonofste-roid-inducedosteonecrosis.

Objective To evaluate the effect of dexmedetomidine on postoperative pain in rats with preoperative sleep deprivation. Methods Fifty healthy adult male Sprague-Dawley rats, aged 12 - 14 weeks, weighing 200-300 g, were divided into 5 groups ( n = 10 each) using a random number table:control group (group C), sleep deprivation group (group SD), incisional pain group (group IP), sleep deprivation plus incisional pain group ( group SD + IP) and sleep deprivation plus incisional pain plus dexmedetomidine group (group SD+IP+DEX). Sleep deprivation was induced by the flower pot technique, and then the incisional pain model was carried out on first day after completion of sleep deprivation. Dexme-detomidine 50 μg∕kg was intraperitoneally injected for 3 consecutive days before establishing the model of in-cisional pain in group SD+IP+DEX, and the equal volume of normal saline was given in the other groups. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal threshold ( TWT) were measured before operation or at 1 day before sleep deprivation and after operation or at 12, 24 and 72 h af-ter sleep deprivation. Blood samples were collected and spinal cord tissues were removed after the end of be-havior test for determination of serum corticosterone concentrations (by enzyme-linked immunosorbent assay and content of 5-hydroxytryptamine (5-HT) in spinal dorsal horns (by high-performance liquid chromatogra-phy). Results Compared with group C, the MWT and TWT were significantly decreased, and the serum corticosterone concentrations and content of 5-HT in spinal dorsal horns were increased in the other 4 groups(P<0. 05). Compared with group IP, the MWT and TWT were significantly decreased, and the serum cor-ticosterone concentrations and content of 5-HT in spinal dorsal horns were increased in group SD+IP, and the MWT and TWT were significantly increased (P<0. 05), and no significant change was found in the ser-um corticosterone concentrations or content of 5-HT in spinal dorsal horns in group SD + IP + DEX ( P >0. 05). Compared with group SD+IP, the MWT and TWT were significantly increased, and the serum cor-ticosterone concentrations and content of 5-HT in spinal dorsal horns were decreased in group SD+IP+DEX (P<0. 05). Conclusion Dexmedetomidine can reduce postoperative pain in rats with preoperative sleep deprivation, and the mechanism may be related to inhibiting stress responses and levels of 5-HT in spinal dorsal horns.

Objective To evaluate the effects of hearing disorder factors on analgesic efficacy of propofol. Methods Ninety?five patients with hearing disorders, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective ear surgery, served as test group(group T). Ninety?five patients with normal hearing function, of Ameri?can Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective non?ear surgery, served as control group(group C). Propofol was given at the initial target plasma concentration of 1.2 μg∕ml. When the target plasma concentration was achieved, 1 min later the concentration was increased in increments of 0.3 μg∕ml. When the patients lost eyelash reflex and had no responses to clapping on the shoulder, bispectral index value and target plasma and effect?site concentrations of propofol, consumption of propofol and time for loss of consciousness were recorded. Re?sults Compared with group C, no significant change was found in bispectral index value at baseline or at loss of consciousness(P>0.05), the target plasma and effect?site concentrations and consumption of propofol were significantly decreased, and the time for loss of consciousness was shortened in group T(P<0.05). The consumption of propofol required at loss of consciousness was gradually reduced with the aggra?vated severity of hearing disorders in group T(P<0.05). Conclusion The analgesic efficacy of propofol is enhanced in the patients with hearing disorders.

Objective To evaluate the efficacy of airway topical anesthesia with combination of su-perior laryngeal nerve block ( SLNB) and thyrocricoid membrane puncture for tracheal intubation in the ped-iatric patients with Pierre Robin Sequence. Methods Thirty-two American Society of Anesthesiologist physical statusⅠorⅡpediatric patients with Pierre Robin Sequence, aged 5-12 months, weighing 5-13 kg, scheduled for elective cleft palate repair under general anesthesia, were divided into 2 groups ( n=16 each) using a random number table method: control group ( group C) and airway topical anesthesia with SLNB-thyrocricoid membrane puncture group ( group ST) . After anesthesia was induced by inhaling sevoflu-rane by mask on admission to the operating room, 2％ lidocaine 0. 5 ml was injected around the bilateral su-perior laryngeal nerve under ultrasound guidance, and then 2％ lidocaine 1 ml was injected via the thyrocri-coid membrane in group ST, and the root of tongue, pharynx and larynx were sprayed with 2％ lidocaine by using a laryngotracheal mucosal atomization device in group C. The pediatric patients were tracheally intuba-ted guided by a video laryngoscope 3 min later. The development of cardiovascular responses, vocal cord activity and body movement was recorded during intubation. The intubation time, success rate of intubationat first attempt and patient′s tolerance to tube were recorded. The occurrence of postoperative hoarseness was also recorded. Results Compared with group C, the incidence of cardiovascular responses, vocal cord activity and body movement was significantly decreased, the intubation time was shortened, the suc-cess rate of intubation at first attempt was increased, and the patient′s tolerance to tube score was decreased in group ST ( P<0. 05) . Conclusion Airway topical anesthesia with combination of SLNB and thyrocricoid membrane puncture can provide better intubation conditions when used for the pediatric patients with Pierre Robin Sequence.

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia (PCIA) in the patients undergoing transcatheter hepatic arterial chemoembolization (TACE).Methods One hundred and twenty patients of both sexes,aged 40-65 yr,weighing 45-80 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective TACE under monitored anesthesia care,were divided into 2 groups (n =60 each) using a random number table:sufentanil group (S group) and dexmedetomidine mixed with sufentanil group (DS group).At 15 min prior to surgery,0.1 μg/kg sufentanil and 5 mg tropisetron were intravenously injected in both groups.In addition,dexmedetomidine 0.6 μg/kg was intravenously infused for 15 min in DS group,while the equal volume of normal saline was given instead in S group.PCIA solution contained sufentanil 2 μg/kg and tropisetron 5 mg in 100 ml of normal saline in S group.PCIA solution contained sufentanil 2 μg/kg,dexmedetomidine 2.μg/kg and tropisetron 5 ng in 100 ml of normal saline in DS group.The PCIA pump was programmed to deliver a 0.5 ml bolus dose with a lockout interval of 15 min and background infusion of 2 ml/h.Observer's Assessment of Alertness/Sedation Scale scores and scores for patient's satisfaction with analgesia were recorded at 30 min and 2,6,12,24 and 48 h after surgery.The pressing times of PCIA,total consumption of sufentanil and requirenent for morphine as rescue analgesics were recorded.The development of requirement for antiemetics,nausea and vomiting,bradycardia,respiratory depression and agitation was also recorded during analgesia.Results Compared with S group,the pressing times of PCIA,total consumption of sufentanil and requirement for morphine were significantly reduced,scores for satisfaction with analgesia were increased,and Observer's Assessment of Alertness/Sedation Scale scores were decreased (P＜0.05),and no significant change was found in the incidence of nausea and vomiting,additional requirement for antiemetics,bradycardia,respiratory depression or agitation in DS group (P＞0.05).Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy than sufentanil alone when used for PCIA in the patients undergoing TACE.