Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

Henoch-Schnlein purpura(HSP) is a common autoimmune small vessel vasculitis that primarily affects children.Although the pathogenesis of HSP is unknown,there are tantalizing clues on the immune abnormalities mediated by IgA,which mainly affects the vessels of the skin,gastrointestinal tract and kidneys.The reasons of deposition maybe involve in the increases of serum IgA,the abnormalities of IgA-specific autoantibodies,structures and acceptors of IgA1,complements,and so on,which mediates the abnormal expressions of adhesion molecules and cytokines.

Congenital heart disease often lost the opportunity of radical sureryfor secondary pulmonary hypertension.pulmonary hypertension is pathologicallycharacterizzed by pulmonary vascular remodeling,including the vascular smooth musclecell' s proliferation,migration and extracelluar matrix deposition,Recently,someresearchers have found that connective tissue growth factor can bind with somesurface receptors of vascular smooth muscle cells,causing some biological behaviorchanges such as proliferation,migration and extracellular matrix abnormaldeposition,and activating crresponding gene expression through this signaltransduction pathway.Pulmonary vascular remodeling may be one of the molecularpathogenesis in pulmonary hypertension.

Objective To draw up a satisfaction rating scale utilized by outpatients in general hospitals,for the quality evaluation of the out-patient service.Methods Outpatients at four municipal general hospitals in Hangzhou City were as the subjects.The validity and reliability of the rating scale were estimated.Results The response rate to items was 98.82% ,and valid rate reached 96.8% ,the internal consistency coefficient was in the range of 0.76 to 0.87.The composition of the scale conforms well to the management practice,the relativity inside the factor was stronger than the relativity among the factors,which supported the contents validity.Factor analysis results demonstrated that both the factor loads and structures were consistent with the structures of the rating scale,which supported the structure validity.Conclusion All of validity indexes of the rating scale meet the requirements of psychometrics.This scale is practicable to estimate the satisfaction of outpatients to the service they received,and provides valuable evidence to estimate the quality of hospital therapeutic services.

Digital subtraction angiography has long been recognized as a gold standard for detecting cerebrovascular lesions.With the development of CT techniques,CT angiography(CTA)has been widely used in intracranial and extracranial vascular evaluation.This article reviews the development of CTA technique and its application in the diagnosis of cerebrovascular lesions.

OBJECTIVE: To evaluate three therapeutic schemes for sudden deafness with cost-effectiveness analysis for guiding rational use of drugs. METHODS:Using pharmacoeconomic cost-effectiveness analysis to evaluate 61 patients with 62ears of sudden deafness treated by Salvia Miltiorrhiza(groups A), Salvia Miltiorrhiza and cerebroprotein hydrolysate(groups B) or cerebroprotein hydrolysate(groups C) . RESULTS: The effective rates of three groups were 73.9%, 75.0% and 80.0% respectively without significant difference among them(P ＞ 0.05) . The average drug costs for one patient in three groups were 617.89 yuan, 2 651.29 yuan and 2 647.99 yuan respectively. The costs for 1% increase of effective rate in three groups were 8.36 yuan, 35.35 yuan and 33.10 yuan respectively. CONCLUSION: Salvia Miltiorrhiza scheme is the most rational one for sudden deafness.

Anti-neutrophil cytoplasmic antibodies( ANCA)-associated vasculitis ( AAV) has various clinical symptoms, thus various treatment schemes were used in clinics.To date, there has been no validated diagnostic criteria or treatment guideline for AAV.There are three aspects to be considered when assessing the treatment with AAV patients:staging of disease, distinction between disease activity and chronic damages, and quality of life ( QOL) .This review focuses on the latest classification of vasculitis, the rela-tion between disease stages and its severity, the importance of distinguishing active diseases from permanent damages, the therapeutic choices and the management of complications.

Objective To investigate the effect of Xinmailong injection combined with Qiliqiangxin capsule on serum BNP , NF-kappa B and cystatin C in the treatment of chronic heart failure in the elderly .Methods 78 cases of elderly patients with chronic heart failure were selected and randomly divided into two groups according to the random number table, 39 cases in each group.All patients received basic treatment, the control group received standard treatment, and the study group received more with Xinmailong injection combined with Qiliqiangxin capsule,and levels of serum B-type natriuretic peptide(BNP), cystatin C(CysC) and NF-κB were compared, left ventricular function and 6 min walking test were detected and the clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of serum BNP, CysC and NF-κB in 2 groups decreased(P<0.01), left ventricular ejection fraction(LVEF) increased(P<0.05), left ventricular end-systolic volume(LVESV) reduced(P<0.05), 6 min walking distance increased(P<0.01), scores of symptom decreased(P<0.01), compared with the control group, levels of serum BNP, CysC and NF-κB in study group were lower, LVEF were higher ( P<0.05 ) , levels of LVEDV and LVESV were lower ( P<0.05 ) , scores of 6 min walking distance were higher(P<0.01), scores of symptom were lower (P<0.01), the effective rate was higher(P<0.05).Conclusion Xinmailong injection combined with Qiliqiangxin capsule in the treatment of chronic heart failure in the elderly was effective , and it can improve left ventricular function, the possible mechanism related to the decrease of BNP, CysC and NF-κB levels.