Objective To study the protective effect of Mailuoning on ischemia/reperfusion injury in extremities. Methods The experimental models of ischemia/reperfusion injury in extremities were produced in 20 healthy adult rabbits, which were randomly divided into control group and Mailuoning group (10 rabbits each). Normal saline and Mailuoning injection were infused intravenously into ear margin of rabbits in the control group and Mailuoning group respectively just before blood reperfusion. At preischemia, two hours post ischemia, one hour post reperfusion and four hours post reperfusion, blood sample was collected from the femoral veins respectively for measurements of aspartate aminotransferase (AST), lactic dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA) and superoxide dismutase (SOD). Meanwhile, the tibialis anterior muscles were harvested for examination of the microstructure and the ultrastructure by using optical microscope and electron microscope. Results The contents of AST, LDH, CK, MDA increased significantly ( P

Objective To evaluate the efficacy of different doses of dezocine for decreasing the minimum alveolar concentration (MAC) of desflurane.Methods ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-70 yr,undergoing elective lower abdominal surgery performed under general anesthesia,were divided into 4 groups:control group (group C)and different doses of dezocine groups (D1,D2 and D3 groups).Before induction of anesthesia,in D1,D2 and D3 groups,dezocine 0.050,0.075 and 0.100 mg/kg were intravenously infused,respectively,while in group C,the equal volume of normal saline was given instead of dezocine.The adverse reactions were observed.Propofol 3 mg/kg was given for induction of anesthesia 15 min later until patient' s consciousness and spontaneous respiration disappeared.Laryngeal mask airway was inserted and the patients were mechanically ventilated.Up-and-down sequential allocation was used to determine the MAC of desflurane during maintenance of anesthesia.The end-tidal concentration of desflurane was set at 8.0％ and maintained at this level for at least 5 min before skin incision in the first patient.Each time the concentration of desflurane increased/decreased in the next patient depending on whether or not the body movement developed.The ratio between the two successive concentrations was 0.9.The point between the positive response and negative response served as a cross-over point.After at least 7 independent cross-over points were observed in each group,the experiment was stopped.The MAC and 95 ％ confidence interval of desflurane were calculated.Results No adverse reactions developed in each group.The MAC of desflurane was significantly lower in D1-3 groups than in group C,in groups D2.3 than in group D1,and in group D3 than in group D2.Conclusion Dezocine 0.100 mg/kg injected intravenously at 15 min before induction of anesthesia provides a better efficacy for decreasing the MAC of desflurane in the patients.

Pain is the most fearful symptom in cancer patients.The cancer patients suffered refractory pain with the progress of cancer.Not all cancer patients could obtain adequate pain relief by the mefhod of three-step pain relief ladder of WHO.With the reseach and recognition of the mechanisms,the pain can be effectively controlled by the right technique at the right time.It is summarized in this artical about the central and peripheral mechanism and the treatment progress of the terminal cancer pain.

BACKGROUND: Bone marrow mesenchymal stem cells(MSCs) have been investigated initially. Because both fat tissue and bone marrow are tissues originated from mesoderm, so whether MSCs could be obtained from fat tissue as well, which also have multi-lineage differentiation potential?OBJECTIVE:To investigate the basic biological characteristics of adipose MSC and its differentiation into osteoblast under given culture condition for the exploration of its feasibility as seed cell in bone tissue engineering.DESIGN: A randomized and controlled study based on cells.SETTING: Department of Orthopaedics of an Affiliated Hospital of a university.MATERIALS: The study was conducted in the Department of Orthopaedics of the Third Hospital of Peking University. Adipose MSC extracted from the fat tissue of Lewis rats was used as subject.METHODS: Adipose MSCs were obtained from inguinal fat pads of Lewis rat after digestion, which were induced into adipocytes and osteoblasts with adipose and osteogenesis induced culture mediums. The differentiations were examined with cytochemical staining, immuncytochemical staining and Western blotting.MAIN OUTCOME MEASURES: Morphological and biological characteristic of adipose MSCs, and the specific mark of osteoblast after induction.RESULTS: Adipose MSCs were obtained from rat adipose tissue culture,which appeared fibroblast-likely in the culture in vitro, and could stably proliferate and passage in vitro. Primary adipose MSCs could differentiate into adipocytes spontaneously, and passaged cells could form fat drop under the reaction of insulin and dexamethasone, and then differentiate towards adipocytes after the expression of peroxidase proliferation activated receptor ?(PPAR-?) enhanced. There was significant difference between induction group and control group in alkaline phosphatase(ALP) activity detection under the induction of dexamethasone, ascorbic acid, and ?-sodium glycerophosphate(P ＜ 0.01) . Calcium node appeared in yon Kossa staining. Result of osteopontin (OPN) immunocytochemcial staining was positive,and OPN expression was detected by Western blotting after induction.CONCLUSION: MSCs with multi-lineage potential can be obtained from rat adipose tissue, and differentiate into adipocytes and osteoblasts after inductions. Therefore, adipose MSCs can possibly be served as one of optimal seed cells for bone tissue engineering.

Scutellarin is the main effective constituent of breviscapine, a flavonoid mixture isolated from the dried whole plant of Erigeron breviscapus (Vant.) Hand-Mazz, and valsartan is used as an antihypertensive drug. These two drugs have already been clinically used together to treat diabetic nephropathy (DN) in China, and the combined medications showed some enhanced protection against DN. The aim of this study is to investigate the potential pharmacokinetic interaction between scutellarin and valsartan in rats. Breviscapine injection (20 mg x kg(-1), i.v.) and valsartan (15 mg x kg-, i.g.), either alone or together were given to 18 male Sprague-Dawley rats. Concentrations of scutellarin and valsartan were quantified by HPLC, and pharmacokinetic parameters were calculated by non-compartmental methods. We found that the pharmacokinetic parameters of scutellarin altered significantly after co-administration of oral valsartan. The plasma clearance (CL(p)) and the bile clearance (CL(b)) of scutellarin were reduced significantly in the presence of valsartan. After oral administration of valsartan with or without intravenous scutellarin, however, the pharmacokinetic parameters of valsartan were comparable. In conclusion, our data suggests that the concurrent use of valsartan reduces the biliary excretion of scutellarin, and this may be due to the inhibitory effect of valsartan on the biliary excretion of scutellarin mediated by Mrp2 (Multidrug resistance-associated protein 2).

Objective To evaluate the effectiveness and predictive value of high-resolution manometry(HRM) for POEM in treating achalasia. Methods A total of 84 achalasia patients categorized into subtypes by HRM, who also underwent POEM, were enrolled in our study. Eckardt score, Barium esophagogram and HRM were performed before, 6 months and 1 year after POEM. Results POEM was successfully performed in all 84 patients. No perforation occurred in any patient. The Eckardt scores and esophageal diameter after POEM significantly reduced compared with those before(P<0. 05). The 4s-IRP decreased from 33. 4±9. 0 mmHg (1 mmHg =0. 133 kPa) to 14. 6±3. 8 mmHg six months after POEM (P<0. 05) and to 16. 4±3. 9 mmHg one year after POEM (VS preoperate, P<0. 05). The LESP before treatment was 41. 8±15. 4 mmHg, decreasing to 18. 4±7. 1 mmHg six months after POEM (P<0. 05) and 20. 7±7. 6 mmHg one year after POEM (VS preoperate, P <0. 05) . When categorizing patients into 3 subtypes by HRM, 4s-IRP of type II showed the most dramatic decrease six months after POEM(62. 8%), followed by typeⅠ(53. 5%), while type III had the least decrease(41. 8%). The mean decreasing rate of LESP in type III was 42. 3% six months after POEM, followed by typeⅠ(55. 3%) , while type II showed the highest rate(57. 8%). Conclusion POEM is a safe treatment for achalasia and has significant short-term efficacy with Type II responding best to POEM. HRM plays a vital role in typing AC and predicting the effectiveness of POEM and can be useful in selecting an appropriate treatment.

Objective To determine whether pyloric measurements with ultrasound, that muscle thickness and channel of pyloric, correlated with weight and age in patients with hypertrophic pyloric stenosis (HPS). Methods A retrospective analysis was conducted on 111 cases diagnosed with HPS by operation from 2008 to 2012. Pearson correlation and linear regression analyses were used to determine if there were sta?tistically signiifcant associations between these combinations of factors:age and pyloric muscle thickness, weight and pyloric muscle thickness, age and pyloric length, and weight and pyloric length. Results Patients’mean age was 39.1 d (8-92 days). Their mean weight was 4.3 kg (2.2-7.9 kg). Mean pyloric muscle thickness was 4.8 mm (2-4.6 mm), and mean pyloric length was 17.5 mm (12-23.5 mm). Pearson correlation coefifcient analysis showed a signiifcant correlation between age and muscle thickness (r=0.6, P<0.001) as well as weight and muscle thickness (r=0.486, P<0.001). No signiifcant correlation was found be?tween pyloric length and age or weight. Linear regression analysis demonstrated similar results. Conclusions In patients with HPS, pyloric muscle thickness was directly related to age and weight. Smaller and younger infants with suspected diagnosis of HPS should be followed up even though the minimum diagnostic criterion for muscle thickness or length was not found on ultrasound.

Objective To investigate the clinical significance and biological role of G-protein coupled receptor 49(GPR49) expression in pancreatic carcinoma.Methods GPR49 expression in tumor and adjacent normal tissues of 77 patients with pancreatic cancer was compared by tissue microarray and immunohistochemistry.And then, the GPR49 expression levels in the tumor tissues of patients with different pathological grades and clinical stages were analyzed.GPR49 positive pancreatic cancer cell line CFPAC-1 was taken as cellular model.CFPAC-1 cells were stimulated with roof plate-specific spondin(RSPO)1, the ligand of GPR49, in vitro.The effect of RSPO1 on CFPAC-1 cells proliferation was evaluated with cell counting.The effect of RSPO1 on the expression of membrane molecular CD44 in CFPAC-1 cells was detected by flow cytometry.CFPAC-1 cells incubated with RSPO1 were subcutaneously implanted into nude mice.And then, the time of tumor formation and tumor size were observed.T test and single factor analysis of variance were performed for statistical analysis.Results GPR49 was widely expressed in all 77 pancreatic cancer tissues.By immunohistochemistry, the score of GPR49 expression in pancreatic cancer tissues was 9.0±2.4, which was higher than that of adjacent normal tissues (5.7±2.4), and the difference was statistically significant (t=8.995, P<0.01).There was no correlation between GPR49 expression and tumor sizes, pathological grades, lymph node metastasis, and clinical stages (all P>0.05).The results of experiments in vitro indicated that RSPO1 could promote CFPAC-1 cells proliferation and up-regulate CD44 expression in CFPAC-1 cells.Experiments in vivo demonstrated that after 30 days the tumor volume of mice implanted with RSPO1-pretreated CFPAC-1 cells was (606.0±188.0) mm3, which was larger than that of PBS-pretreated group ((364.2±83.7) mm3), and the difference was statistically significant (t=2.616, P=0.031).Conclusion GPR49 is widely expressed in pancreatic cancer cells and RSPO1/GPR49 pathway has play a role in promoting the proliferation of pancreatic cancer cells, which might be a potential target for interfering pancreatic cancer.

Objective To observe the effects of different quantities of cake-separated moxibustion on blood cells and immunoglobulin in immunosuppressive rabbits; To study the possible mechanism of quantity-effect difference. Methods Immunosuppressive rabbit model was established by intraperitoneal injection of cyclophosphamide. Rabbits were randomly divided into blank group, model group, cake-separated moxibustion 3 Zhuang group, 5 Zhuang group, 7 Zhuang group.Liuwei Dihuang Decoction was used to make herbal-cake, and was put on Shenque (RN8), Guanyuan (RN4), and other acupoints, once for every other day, 10 times in total. Venous blood was taken on the next day after finishing treatment, and the contents of blood cells series and IgG, IgM, complement C3 and complement C4 were detected.Results Compared with blank group, the levels of WBC, NEU, RBC, HGB, HCT, PLT, IgG, IgM, and complement C3 of model group significantly decreased, while the levels of LYM and MONO significantly increased (P<0.01). Compared with model group, the increase of HCT and IgM in the cake-separated moxibustion 3 Zhuang group was not significant, the levels of WBC, NEU, RBC, HGB, HCT, PLT, IgG, IgM, and complement C3 in all treatment groups significantly increased, and LYM and MONO significantly decreased (P<0.01). Compared with cake-separated moxibustion 3 Zhuang group, the levels of WBC, IgG, and complement C3 of cake-separated moxibustion 5 Zhuang group significantly increased, and the levels of WBC, HGB and complement C3 of cake-separated moxibustion 7 Zhuang group significantly increased (P<0.01).Conclusion Cake-separated moxibustion can improve the immune function under immunosuppressive state induced by cyclophosphamide, and different quantities have differences in efficacy.

BACKGROUND:The technique of vacuum sealing drainage, initialy used for better wound healing, has been widely applied to al kinds of refractory wounds. OBJECTIVE:To summarize the research progress in vacuum sealing drainage for treatment of severe soft tissue injury. METHODS: An electronic retrieve was performed in Wanfang database, VIP database and PubMed database from January 1989 to August 2014 was performed for papers regarding the vacuum sealing drainage technology with the key words of “vacuum sealing drainage technology; injury; gentamicin; hyperbaric oxygen; nerve growth factor; chymotrypsin” in Chinese or English. Finaly 48 articles were involved in the final analysis according to the inclusion criteria. RESULTS AND CONCLUSION:Vacuum sealing drainage is a highly effective treatment technique to promote wound healing which can promote wound blood circulation, reduce sweling, inhibit bacterial growth, stimulate growth of granulation tissue by mechanical stress, inhibit cel apoptosis, thereby helping wound healing. Compared to conventional open-dressings, vacuum sealing drainage has a faster wound healing speed, lower infection rate, and fewer dressing change frequency. With recent advances in medicine, vacuum sealing drainagetechnology cannot be simply used for treatment of skin soft tissue damage, but in combination with gentamicin, hyperbaric oxygen, nerve growth factor and chymotrypsin to achieve better therapeutic effects.