Objective To reduce the hypokalemia caused by inner environment imbalance effectively in order to lower the death rate and improve the prognosis for patients with severe cranial injury.Methods Seventy-five patients with severe cranial injury who had hypokalemia were studied retrospoctively from October 10th,2003 to July 30th,2006.Results The waves of electrocardiogram and changes of illness condition was closely observed,the volume:of intake and output and kalium outcome was accurately recorded.Kalium was supplemented as early as possible.the amount was adjusted by the use of dehydratins agents and biochemical kalium.Only timely and effective monitoring and treatment could complications be reduced or prevented.Conclusions Severe cranial injury is one of the most severe trauma,timely monitoring and nursing measures are key point for rectification of hypokalemia for patients with severe cranial injury.

Objective:To develop an HPLC-DAD method for the simultaneous determination of seven alkaloid constitutents, so-phoranholN-oxide, oxymatrine, sophoridine, oxysophocarpine, sophoranol, matrine and sophocarpine in Sophora flavescens Ait. Meth-ods:The chromatographic separation was performed on an Agilent Zorbax C18 column (150 mm × 4. 6 mm, 5μm) with 10 mmol·L-1 NH4Ac(0.1% ammonia, pH=9.0)(A)-acetonitrile-methanol(1 ∶22) containing 20 mmol·L-1NH4Ac(B) as the mobile phase with gradient elution at the flow rate of 1 ml·min-1 . The detection wavelength was set at 220 nm,and the column temperature was maintained at 30 ℃. Results: SophoranholN-oxide, oxymatrine, sophoridine, oxysoph-ocarpine, sophoranol, matrine and sopho-carpine was linear within the range of 0.093-1.860 μg(r =0.999 6) , 0.530-10.600 μg (r =0.999 7), 0.062-1.240 μg (r =0. 999 8), 0. 281-5. 620 μg (r=0. 999 9), 0. 026-0. 520 μg (r=0. 999 8) ,0. 036-0. 720 μg (r=0. 999 7) and 0. 032-0. 640 μg (r=0. 999 6), respectively. The average recovery was 97. 5%, 98. 2%, 99. 0%, 99. 4%, 99. 2%, 98. 2% and 98. 7%, and RSD was 1. 18%, 0. 92%, 1. 43%, 1. 04%, 0. 81%, 0. 43% and 0. 88%(n =6), respectively. Conclusion:The method is convenient, accurate and reproducible in the quality control of multicomponents in Sophora flavescens Ait.

Functional magnetic resonance imaging(fMRI) has been widely applied in many fields,such as neurology,psychology,etc.Recently it has also been used to study the visceral hypersensitivity of the gut.This review gives an overview of the basic principle of fMRI and its application in the visceral sensitivity of esophagus and rectum.

Objective To study the protective effect of nalmefene hydrochloride on lung ischemia-reperfusion injury and its mechanism.Methods 40 rats were randomly divided into model group,high dose of nalmefene group,low dose nalmefene group and sham operation group equally(n =10).The lung ischemia-reperfusion model was established by occlusion of the left pulmonary hilum.The intravenous injection of nalmefene (20,10 μg·kg-1) was applied at 10 minutes before occlusion of the left pulmonary hilum in the high dose of nalmefene group and the low dose of nalmefene group,respectively.The sham operation group without occlusion of the left pulmonary hilum was not given any treatment.At 2 h after reperfusion,all rats were detected arterial blood gas value and then sacrificed.The specimens from the upper lobe of the left lung tissue were preserved to observe pulmonary lesions,detect the ratio of wet / dry weight and the expressions of β-endorphin and interleukin(IL)-17.Results Compared with the model group,the value of PCO2,the degree of pulmonary lesions,the ratio of wet / dry weight and the expressions of β-endorphin and IL-17 in lung tissue were significantly decreased (P ＜ 0.01),while the value of PO2 was significantly increased (P ＜ 0.01) in the low dose of nalmefene group.Compared with the low dose of nalmefene group,thevalue of PCO2,the degree of pulmonary lesions,the ratio of wet/dry weight and the expressions of β-endorphin and IL-17 in lung tissue were significantly decreased (P ＜ 0.01),while the value of PO2was significantly increased (P ＜ 0.01) in the high dose of nalmefene group.Conclusion Nalmefene hydrochloride may prevent lung ischemia-reperfusion injury in a dose dependent manner by reducing the production of β-endorphin and inhibiting the expression of IL-17 in lung tissue.

lschemic postconditioning(IPo)is a way that after long ischemia on liver graft,animals are given one or several brief reperfusion-ischemia before persistent reperfusion to improve the hepatic tolerance and relieve the ischemie reperfusion injury.It has been proved an effective and controlled method to attenuate the ischemic reperfusion injury.Protective mechanism of ischemic postconditioning on hepatic graft is related with protecting sinus hepaticus endotheliocyte and hepatic microcirculation,relieving hepatic cells injury and inflammatory reaction induced by oxygen free radicals,relieving calcium ovedoad in hepatic cells and mitochondria,regulating apoptosis genes,transforming ion channels condition in mitochondria.This article will makes a brief review on protective mechanism ofhepatic ischemic posteanditioning.

Objective To investigate the combination appr oach used to treat the complex acetab ular fractures.Methods Form January 1998to August 2001,31c ases of acetabular fractures were tr eated through combination of Kocher-Langenbeck a nd ilioinguinal approaches.26case s of them resulted from traffic injur ies,and 5from fall injuries.The average interval from injure to operation wa s 17.6days.The average blood loss wa s1890ml.The average operative duration was 252minutes.According to the classification of Letournel and Jud et,associated fracture types accounte d for 27cases,and simple type 4cases.They were fixed by the reconstructi ve plates and /or plates +lag screws.Results The average follow-up was 20.2month s.According to criteria of Matta,of the 20cases who underwent a natomic reduction,10were satisfac tory while 1unsatisfactory.21case s had excellent and good clinic results,8fair,2poor.Conclusion Because of the advantages of excelle nt ex-posure,convenient reduction,rigid fixation and lower heterotopic ossification,the combination approach is good to treat the complex acetabular fractu res involved the two columns.[

OBJECTIVE:To study the effects of carbamylated erythropoietin(CEPO)on cardiovascular microcirculation in rats with diabetes mellitus. METHODS:Rats were randomly divided into blank control group,model group,CEPO low-dose,medi-um-dose and high-dose groups(500,1 000,2 000 u/kg)with 12 in each group. The rats in the last 4 groups were reduced diabetes mellitus model. All rats were given relevant medicine intragastrically twice a week,coronary microcirculation endothelial cells were separated after consecutive 4 weeks. Enzyme-linked immunosorbent assay was conducted to detect levels of peripheral serum prosta-cyclin (PGI2),vasoconstrictor endothelin-1 (ET-1),angiotensin Ⅱ(AngⅡ) and von Willebrand factor (vWF) of rats in each group;in vitro CCK 8 test was used to detect endothelial cell activity(OD value);real-time quantitative polymerase chain reaction was adopted to detect proliferation-related genes(Ki67,p16),poptosis-related genes(Bad,Bax),and expressions of protein vas-cular endothelial growth factor(VEGF)and AngⅠ. RESULTS:Compared with blank control group,levels of PGI2,ET-1,AngⅡand vWF in serum in model group increased;OD value deceased;Ki67,p16,Bax and VEGF expression decreased;the difference was statistically significant (P<0.05). Compared with model group,levels of PGI2,ET-1,AngⅡ and vWF in serum in CEPO low-dose,medium-dose and high-dose groups increased;OD value increased;Ki67,p16 and VEGF expression increased;expres-sions of Bad and Bax decreased;the difference was statistically significant(P<0.05). The others had no significant difference(P>0.05). CONCLUSIONS:CEPO maybe improve the coronary microcirculation function by upregulating VEGF expression in coro-nary microcirculation endothelial cells and promoting endothelial cells’regeneration.

Objective To investigate the role of Toll-like receptor4 (TLR4) activation in spinal cord in a rat model of persistent postoperative pain evoked by skin/muscle incision and retraction(SMIR).Methods Ninetysix male SD rats weighing 200-250 g were randomly divided into 4 groups(n =24 each):group sham operation; group SMIR; group SMIR + IT scramble siRNA and group SMIR + IT TLR4siRNA.The rat model of persistent postoperative pain evoked by SMIR was established according to the method described by Flatters.The TLR4 siRNA were administered intrathecally for 7 days starting from 1 day beforc surgcry.Pain behavior was assessed by paw mechanical withdraw threshold (MWT) to Electronic von Frey Anesthesiometer stimulation at 1 day before and 1,3,7,12,and 22 days after operation.Four animals were sacrificed at each time point in each group for detection of the expression of TLR4 protein in the spinal cord by Western blot analysis.Results Compared to group sham group,MWT was significantly descreased at 3,7,12,and 22 days after operation,while the expression of TLR4 protein in the spinal cord were significantly increased at 3,7,12 days after operation in group SMIR and group SMIR + IT scramble siRNA ; IT TLR4siRNA significantly attenuated the hyperalgesia induced by SMIR and descreased the expression of TLR4 protein at 3,7,12 days after operation in group SMIR + IT TLR4siRNA.Conclusion TLR4 activation in spinal cord plays an important role in the development of SMIR-evoked persistent postoperative pain in rats.

Objective To evaluate the role of p38 mitogen-activated protein kinase (p38MAPK) in the spinal cord in the development of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) and the relationship with Toll-like receptor 4 (TLR4).Methods One hundred and twenty male SpragueDawley rats,weighing 200-250 g,aged 2 months,in which intrathecal catheters were successfully implanted,were randomly divided into 5 groups (n =24 each) using a random number table:sham operation group (group S),SMIR group,SMIR + dimethyl sulfoxide (DMSO) group (group DMSO),SMIR + p38MAPK inhibitor SB203580 group (group SB203580) and SMIR + TLR4 small interference RNA (siRNA) group (group TLR4siRNA).The rats were anesthetized with intraperitoneal chloral hydrate 400 mg/kg.The skin and superficial muscle of the medial thigh were incised and a small pair of retractors inserted.This tissue was retracted for 1 h causing potential stretch of the saphenous nerve.2％ DMSO 10 μl and SB203580 5 μg were injected intrathecally at 30 min before operation and 1-12 days after operation in DMSO and SB203580 groups,respectively.TLR4siRNA 2 μg was administered intrathecally at 1 day before operation and 1-12 days after operation once a day in group TLR4siRNA.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 day before operation and 1,3,7,12 and 22 days after operation.Four rats in each group were sacrificed after measurement of MWT at each time point,and the L4-6 segments of the spinal cord were obtained for detection of the expression of phosphorylated p38MAPK (p-p38MAPK) by Western blot analysis.Results Compared with group S,MWT was significantly decreased after operation,and the expression of p-p38MAPK was up-regulated after operation in SMIR and DMSO groups.Compared with group SMIR,MWT was significantly increased after operation,and the expression of p-p38MAPK was down-regulated after operation in SB203580 and TLR4siRNA groups,and no significant changes in MWT and p-p38MAPK expression were found at each time point in group DMSO.Conclusion TLR4-triggered activation of p38MAPK in spinal cord is involved in the development of SMIR-evoked persistent postoperative pain in rats.

Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.