Objective To study the effect of papaverine on vasospasm caused by PICC intubation with B-mode ultrasonography. Method Three mg papaverine were injected into the median cubital vein for at least 2 minutes in 15 patients with vasospasm. Results The vasospasm in the 15 patients was relieved 36~270 s seconds after injection. The followed intubation was all successful. There was no abnormality in their liver function and heart rate, or abnormal bleeding, or other serious complications. Conclusion Papaverine can relieve vasospasm caused by PICC intubation, so it can allow another intubation. It also can avoid delayed intubation reduce patients′pain and cost and reduce psychological pressure of the nursing practitioner.

Objective To evaluate the usefulness of imging techniques in diagnosis of corticosteroid-induced avascular necrosis of the femoral head(ANFH).Methods Twenty seven patients with avascular necrosis of the femoral head due to long-term corticosteriod treatment were analysed retrospectively.There were 16 femal and 11 male,ranged in age from 20 to 46 years(mean age 35.6 years).The course of disease was 1～5 years.The administration of corticoid orally was 60～25 mg/d taken on 6 months to 5 years.ANFH was appeared 3 months to 2 years after the administration of corticoid.The imaging examinations included radiography in 20 cases,MRI in 15 cases,both radiography and MRI in 10 cases and CT in 8 cases.8 cases were confirmed by operation and pathology.Results 7 femoral heads in 6 cases with early-ANFH were diagnosed by X-ray,21 femoral heads in 15 cases with early-ANFH were diagnosed by MRI and 11 femoral heads in 7 cases were by CT,19 femoral heads showed a typical “line sign”on MRI.Conclusion The “line sign” on MRI is regarded as the characteristic finding in early-ANFH.MRI is the most sensitive method in the early-diagnosis of the corticosteroid-induced ANFH and it can provide important evidence for clinical management.

Adolescent ; Humans ; Leukemia, Myeloid, Acute ; etiology ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology

The effect of pioglitazone on the expression of genes relative to differentiation and function of primary brown adipose tissue cells was detected for the new treatment of obesity and type 2 diabetes.The results showed that pioglitazone promoted the differentiation and function of brown adipocytes( P＜0.05 ).

Objective To discuss the value of Visfatin in severity evaluation in patients with severe pneumonia via observation on the variations of the plasma level of Visfatin. Method Seventy subjects including 40 patients with severe pneumonia ( group A) and 30 patients with non-severe pneumonia (group B) admitted to the ICU of emergency department and general wards from June 2009 to June 2010, were enrolled in this prospective study, and another 30 healthy individuals from physical examinees were included as subjects in control group (group C). Patients with severe diseases of heart, brain and kidney, cancers, autoimmune disease, or under special treatment in latest one month were excluded. For the subjects of all three groups, the plasma levels of Visfatin, IL-6, IL-8 and TNF-α were measured by using ELISA, while the level of CRP was assayed by using immunoturbidimetry, and the routine blood test was performed as well. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ) were carried out in patients with pneumonia. Comparisons between groups were made by t-tests, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson correlation coefficient or Spearman rank correlation test. Results The plasma level of Visfatin in patients with severe pneumonia (group A) was significantly higher than that in patients with non-severe pneumonia (group B) and in the control subjects (group C) (P < 0. 01) , and the level of Visfatin in pneumonia ( group B) and in control group (group C) , and that in group B was significantly higher than that in the controls (group C) (P <0. 01). In group A, the plasma level of Visfatin was positively correlated with CRP, TNF-α, APACHE Ⅱ and PMN% (rha =0. 653, r = 0.554, r = 0.558, r= 0.484, P <0. 05), while negatively correlated with PaO2 and PaO2/FiO2 ( rha = -0.422, r= -0.543, P <0. 05). Conclusions Visfatin may be involved in the systemic inflammation response in severe pneumonia as a pro-inflammatory cytokine which is valuable in assessing the severity of pneumonia.

Rhynchophylla is a Chinese herb commonly used in clinical practice. It's also the primary herb of some famous Chinese herbal compound such as Tianma Gouteng decoction, and Lingyang Gouteng decoction. According the record from many previous materia medica literatures, rhynchophylla should be added later during decoction. Pharmaceutical research showed that rhynchophylla alkaloids were not stable. Which has resulted in many problems in the research and its application. For example, there was not a quantitative determination method in "Chinese Pharmacopoeia" of past and present versions, which seriously impacted its quality control and product application. Firstly, records from previous materia medica literatures and "Chinese Pharmacopoeia" were systematically sorted based on the chemical stability of rhynchophylla. Secondly, pharmaceutical research including chemical compositions and their stability, pharmacological effects, extraction process and quality analysis, was reviewed after reference of literatures published at home and abroad in recent decades. Positive reference and evidence for further research and development of rhynchophylla will be provided in the article.
Animals ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Quality Control ; Uncaria ; chemistry

Objective To investigate the association of expressions of cyclooxygenase-2(COX-2),matrix metanoproteinases-9(MMp-9)and Ki67 with occurrence,infiltration and metastasis of gastric cancer.Methods Fifty-eight surgically obtained and pathologically performed cancerous tissues were collected between Jan.2003 and Dec.2005.Among them,37 were males and 21 were females with mean age of 58.2 years(ranged from 31 to 76 years).Fifty-eight paracancerous tissues(5-6 cm apart form the cancer)were taken as controls.The expressions of COX-2,MMP-9 and Ki67 in cancerous or paracancerous tissues were examined by immunohistochemistry.Results The expressions of COX-2 and MMP-9 in cancerous tissues(82.76%and 68.9%,respectively)were higher than those in controls(37.93%and 24.14%,respectively,P＜0.01).The expressions of COX-2 and MMP-9 were not associated with sex,age,location and size of gastric cancer(P＞0.05),but were correlated with the depth of lymph node infiltration.metastasis and TNM stage(P＜0.05).The expression of MMP-9 was also associated with the degree of differentiation of gastric cancer(P＜0.05).There was a correlation between COX-2 and MMp-9 expressions in gastric cancer tissues(P＜0.05,C=0.359).The expression of Ki67 in tissues with positive expressions of COX-2 and MMp-9 was higher than that in negative ones(P＜0.O 1).Conclusion The COX-2,MMP-9 and Ki67 play important roles in metastasis and infiltration,which promote occurrence and development of gastric cancer.

Objective To evaluate the effect for the treatment of severe asthma. Methods The data of 47 patients with severe asthma who were admitted to emergency department were retrospectively anayzed. Results Of total 47 patients ,45 were rescued, with the survival rate of 95.7%. Arterial blood gas was improved after treatment (P < 0.01). Conclusion Appropriate commencement, mode, strategy, and early weaning of mechanical ventilation, combined with the administration of bronchodilators and eorticosteroids are the important way to rescue patients with severe asthma.

Objective To determine the level of adiponectin (APN) in serum and induced sputum of patients with chronic obstructive pulmonary disease both during acute exacerbation (AECOPD) and silent stage, and investigate APN' s role as a marker of inflammation in the pathogenesis of COPD. Method From October 2008 to October 2009,30 male AECOPD patients in the emergency department, 30 male silent COPD patients in the department of respiratory diseases and 30 healthy nonsmoking male volunteers were included. All subjects' serum and induced sputum were collected, and they were all of normal weight(BMI range of 18.5～ 24.9 kg/m2). Patients were excluded if they suffered from severe bronchial asthma, bronchiectasis or autoimmune disease. The number of cells in induced sputum was counted and the cell type was classified. The concentrations of APN, IL-8, IL-6 and TNF-α in both serum and sputum were measured by using ELISA, and their pulmonary function was tested. The different groups were compared among them by using the t -tests, ANOVA analysis or nonparametric analysis, the relation between variables was assessed by using the Pearson or Spearman correlation test. Results The concentrations of APN in both serum and induced sputum of AECOPD patients were significantly higher than those in the silent COPD patients and the control subjects ( P ＜ 0.01 ). The concentrations of APN in the silent COPD patients were significantly higher than those in the control subjects ( P ＜ 0. 01 ). There were significant relationships between the concentrations of APN in serum and induced sputum and the levels of IL-8 and TNF-α in AECOPD patients ( r = 0.739, 0. 734,0.852 and 0. 857, respectively, P ＜ 0. 05) and in silent COPD patients ( r = 0.751,0.659, 0.707 and 0.867, respectively, P ＜0.05). There was significant relation betweenship between APN and neutrophil in induced sputum of AECOPD patients (r = 0.439, P ＜ 0.05). Conclusions APN was involved in the process of systemic and airway inflammation of COPD, and it was related with IL-8 and TNF-α. APN can be used as a new inflammation marker for COPD.

Objective To evaluate the value of serum procalcitonin (PCT) in antibiotics used for the treatment of acute exacerbation of asthma. Method From February 2007 to July 2009, a total of 158 patients with asthma were randomly (random number) assigned to PCT group ( n = 77) or to control group ( n = 81 ). The PCT levels of all patients were measured. On the bases of routine treatment, the employment of antibiotics in control group was determined by the guidebook, and patients in the PCT group were treated with antibiotics guided by the levels of serum PCT. The antibiotics treatment was employed as PCT level ＞0.25 ng/mL, and was not employed as PCT level ＜ 0.25 ng/mL. The rates of antibioties employment were observed. Results The rate of antibiotics employment in PCT group (45.4%) was lower than that of the control group (77.8%) (x2 = 17.15,P =0.000). Conclusions PCT could be used safely as guidance of antibiotics employment for the treatment of patients with acute exacerbation of asthma, leading to appropriate use of antibiotcs.