Atropine has been an effective drug antagonizing M-like symptoms induced by severe acute organophosphate pesticide poisoning (AOPP), which could relieve bronchospasm, inhibit glandular secretion, and prevent pulmonary edema. In the rescue of severe AOPP, a hypo-dose of atropine is difficult to effectively block the effect of acetylcholine, and overdose plays great risk of atropine poisoning. When the patient's condition improves, the rebound often occurs in the process of withdrawal. Medical workers at home and abroad have conducted a lot of study to explore the personalized judgment of atropinization and optimal treatment of atropine for severe AOPP, including the initial bolus of atropine,the sustained infusion for the treatment of pulmonary edema, the maintenance dose, extenuation and withdrawal of atropine for the prevention of its overdose. Related researches in recent years were reviewed to provide the clinical reference.

OBJECTIVE:To optimize the preparation technology of Angelica sinensis powder and conduct screening for the op-timal particle size thereof. METHODS:With the contents of volatile oil and ferulic acid as the indexes,screening was conducted for the optimal drying temperature,dry welding time and particle size of the crude drug A. sinensis,and the stabilities of the A. si-nensis powder with different particle sizes which was packed by simulating that sold in the market were investigated. The verifica-tion tests on the preparation technology were conducted. RESULTS:The optimal conditions for preparing the crude drug A. sinensis were as follows as drying temperature of 60-70℃,drying for 4.5-5 hours and being crushed into moderate-sized powder;the stabil-ity of the moderate-sized powder which was packed by simulating that sold in the market was the best. In the verification tests on the preparation technology,the average content of the volatile oil was 0.46 ml/g,with RSD of 0.034%(n=3);the average con-tent of the ferulic acid was 0.123 μg/ml,with RSD of 0.026%(n=3). CONCLUSIONS:The optimized technology is stable and feasible,and the stability of the moderate-sized A. sinensis powder is the best.

Objective To investigate the effects of glycosaminoglycans (HGAG) on the immune function of peripheral blood cells from patients with pulmonary tuberculosis.Methods Peripheral blood monouclear cells (PBMC) were isolated from peripheral blood of 40 healthy people (healthy group) and 30 tuberculosis patients (tuberculosis group) and cocultured with HGAG in vitro for 24 hours.Flow cytometry was used to detect the expression of CD45RA and CD45RO,as well as the expression of CD1a and CD83.Results The results showed that the expression of CD45RA and CD45RO in the tuberculosis group was the most significant (P ＜ 0.05) at the concentration of 50 μg/m coculturing with HGAG.The expression of CD45RA and CD45RO were most obvious in the healthy group at the concentration of 10 μg/ml and 50 μg/ml respectively (P ＜0.001).The difference of CD45RA between the two groups was no significant (P ＞0.05),while the difference of CD45RO was statistically significant (P ＜ 0.01) before co-culturing.The expression of CD45RA and CD45RO at 10 μg/ml and 50 μg/ml after co-culturing with HGAG were statistically significant (P ＜ 0.05).There was no statistical difference in CD1a and CD83 in healthy group before and after co-culturing (P ＞ 0.05),while there was statistically difference (P ＜ 0.05) before and after culturing in tuberculosis group.Before co-culturing,there was no significant difference in the expression of CD1a between the healthy group and the tuberculosis group (P ＞ 0.05),but CD83 expression was statistically different (P ＜ 0.001).After co-culturing,there were no significant differences in CD1a and CD83 expression between healthy and healthy groups (P ＞ 0.05).Conclusions HGAG can down-regulate the expression of CD45RA and up-regulate the expression of CD45RO in a certain concentration range,and promote the maturation of dendritic cells (DC) in tuberculosis patients and regulate the cellular immunity of patients with pulmonary tuberculosis in vitro.

The fatality rate of traumatic cardiac arrest (TCA) is extremely high, and it is very different from that of non-traumatic cardiac arrest (NTCA) in resuscitation strategy. Only when the standard resuscitation process is combined with rapid treatment of various reversible causes can the mortality rate of patients be decreased. In this paper, the key factors leading to TCA are reviewed, such as hypovolemic shock, asphyxia, tension pneumothorax, pericardial tamponade, crush syndrome, craniocerebral injury, cerebral hernia, and the control measures are elaborated respectively, so as to provide references for clinical treatment of patients with severe trauma, and reduce TCA incidence and mortality.

Brain edema could be secondary to cerebral lesion caused by a variety of reasons, severe cases may result in brain herniation or even death. Accurate real-time monitoring of cerebral edema, rational application of dehydrating drugs, and timely treatment of cerebral edema were very important for patients. However, there were defects in the monitoring methods commonly used in clinical practice. Noninvasive brain-edema monitoring was a new method, which can quantify the degree of brain edema by electromagnetic disturbance and directly reflect the state of brain edema. This article reviews the application of noninvasive brain-edema monitoring in the treatment of in critically ill patients with traumatic brain injury.