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.

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.

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.[

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.

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 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 explore the effect of multifunctional rehabilitation wheelchair on early rehabilitation of elderly patients after anesthesia recovery with hip fracture surgery.Methods Toally 34 elderly inpatients with hip fracture surgery treated with regular function exerciser between November 2013 to October 2014 were assigned as the control group and another 34 elderly inpatients with hip fracture surgery during November 2014 and November 2015 as the observation group.The control group was treated with routine nursing and early on-bed rehabilitation exercise and the latter with early off-bed exercises on a muhifunctional wheelchair.The two groups were compared in terms of hip function and daily life activities ability before surgery and 14 d after operation.Result The Harris hip function cores and activities of daily living scores of the observation group after surgery were significantly higher than those of the control group (P ＜0.05).Conclusion Multifunctional rehabilitation wheelchair can be effective in the improvement of the hip function and daily life activities for the elderly patients with hip fracture surgery.

Objectives To study the role of IL-17 and IL-23 in non-Hodgkin lymphoma (NHL) by detecting the expression levels of IL-17 and IL-23 in peripheral blood of B-cell non-Hodgkin lymphoma patients treated by RCHOP.Methods T wenty-five patients with B-cell NHL who achieved remission after 6 to 8 cycles of R-CHOP as a NHL group,20 healthy volunteers were recruited as a normal control group.RT-PCR was used to detect the expression levels of IL-17 mRNA and IL-23mRNA in NHL patients and health volunteers.Results The expression level of IL-17mRNA andIL-23 mRNAin the patients with NHL before therapy and the patients with NHL who achieved remission was lower than that in the normal control group (P＜0.05).The expression level of IL-17mRNA andIL-23mRNA in the patients with NHL who achieved remission was higher than that in the patients with NHL before therapy (P=0.001,P＜0.05).Conclusion IL-17 and IL-23mRNA expressions are higher after treated with R-CHOP.The expression levels of IL-17 mRNA and IL-23 mRNA in NHL patients are related with prognosis and efficacy.

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.