Object To investigate the effects of Congsheng Capsule (CSC) on free radical change after cerebral ischemia reperfusion, and analyze the mechanisms of CSC anti cerebral ischemia action. Methods Bilateral carotid artery occlusion and reperfusion combined with tail bleeding hypotension were employed in this study. Changes in free radicals were observed by means of spectro photometry. Results CSC 1, 3, 9 g/kg could enhance SOD activity, reduce the MDA content, and decrease NOS activity and NO content. Conclusion The protective effects of CSC on cerebral ischemia may be mediated by its anti free radical and NO damage.

Object To investigate the profective effects of Congsheng Capsule (CSC) on cultured cerebral cortical neurons after cerebral ischemia reperfusion in order to study the anticerebral ischemia effect of CSC. Methods Drug containing serum was used to study the protective effect of CSC on neurons damaged during hypo glucos and hypoxia (3 h)/reoxygenation (0, 3, 6, 18 h), the demage to neurons was reflected by the increase in activity of lactate dehydrogenase (LDH) released from cells into culture medium and the changes of apoptosic cells which were studied by flow cytometry. Results The serum preparation of CSC (2, 4, 8 g/kg) attenuated neuronal damage during hypo glucos and hypoxia (3 h)/reoxygenation (0, 3, 6, 18 h) by decreased LDH and changes in apoptosic cell numbers. Conclusion CSC has protective effects on cerebral ischemic damage.

Objective To investigate the effects of continuous hemofihration on gastrointestinal dysfunction for treating patients with intra-abdominal hypertension.Methods A total of 37 patients were divided into two groups randomly (random number),namely control group (n =17) and continuous blood filtration (CBF) group (n =20).The patients of control group were treated with routine treatment,and the patients of CBF group were given CBF for 72 hours in addition to the routine treatment.The intra-abdominal pressure (IAP),gastrointestinal (GI) symptoms,and SOFA score were documented at 0 hour,24 hours,72 hours and 7 days after treatment.Results The MAP of patients in the CBF group was not significantly changed (P =0.218),while the IAP was decreased significantly (P =0.001) and the abdominal perfusion pressure (APP) increased significantly after CBF (P =0.036).Compared with the control group,there were more than 2 GI symptoms markedly relieved after CBF for 24 hours (P =0.049).The SOFA score of CBF group decreased significantly (P =0.037).There were no differences in 28-day and 60-day mortality between two groups.Conclusions The CBF can decrease IAP,increase APP,improve splanchnic blood circulation,and ameliorate gastrointestinal dysfunction.But CBF does not reduce the mortality in comparison with routine treatment.

Objective To investigate the effects of ginkgolide B on neuronal cell apoptosis,superoxide dismutase activity,malondialdehyde,interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum of rats with intracerebral hemorrhage in order to explore the role of ginkgolide B in suppressing the neuronal cell apoptosis.Methods A total of 175 male Wistar rats were randomly (random number)divided into sham operation group,intracerebral hemorrhage group,as well as low,medium and high dose treatment groups.The rat model of intracerebral hemorrhage was made with infusion of autologous whole blood to caudate nucleus in the right basal ganglia region.Ginkgolide B in dose of 5 mg/kg,10 mg/kg and 20 mg/kg was given to rats in the low,middle and high dose treatment groups by intraperitoneal injection once a day for 5 days after intracerebral hemorrhage.The rats with intracerebral hemorrhage in the sham operation groups received intraperitoneal administration of 1 mL saline.Animals were sacrificed by decapitation 2,6,12,24,48,72 h and 5 days after intracerebral hemorrhage.Brains were taken and blood samples were collected.Neuronal cell apoptosis was measured by using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL),and superoxide dismutase activity in serum was determined by using xanthine oxidase method,and serum malondialdehyde level was detected by using thiobarbituric acid reactive substance assay,and interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum were assayed with enzyme linked immunosorbent assay(ELISA).Statistical analysis was carried out by using one-way analysis of variance and least-significant difference test.Results As 2 h,6 h,12 h,24 h,48 h,72 h,and 5 days after intracerebral hemorrhage,the differences in the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels between the low dose treatment group and intracerebral hemorrhage group were not significant statistically(P ＞0.05).As 12 h,24 h,72 h,and 5 days after intracerebral hemorrhage,the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels in the medium dose and high dose treatment groups were significantly statistically lower than those in the intracerebral hemorrhage group(P ＜ 0.05),but these differences in above biomarkers were not significant statistically among these three groups 2 and 6 hours after intracerebral hemorrhage(P ＞ 0.05).Conclusions Ginkgolide B may lessen neuronal cell apoptosis by means of inhibition of free radical production and inflammatory reactions after intracerebral hemorrhage.

AIM To explore whether plasma vasoactive substances and neutrophil infiltration make different contribution in cerebral ischemia-reperfusion injury and protective effect of triacetylshikimic acid(TSA). METHODSThe rat models of ischemia 90 min and reperfusion 3-48 h were prepared with middle cerebral artery occlusion. TSA 50-200 mg·kg-1 were given (ig) immediately and 60 min again after the onset of ische- mia. Serotonin and thromboxane B2 (TXB2) concentrations in plasma were detected by fluorescence spectrophotometry and radioimmunoassay respectively. Myeloperoxidase(MPO) activity in brain tissue was quantified by chemical analysis. RESULTS At 3-24 h after reperfusion, the concentrations of plasmic serotonin, TXB2, and brain MPO activity increased obviously in a time-dependent manner. At 48 h after reperfusion, the concentrations of serotonin and TXB2 decreased to the same level of sham. Nevertheless, brain MPO activity remained more elevated than the contralateral cortex. At 24 h after reperfusion, TSA (100 and 200 mg·kg-1) was shown to possess the ability to inhibit the increased plasmic serotonin, TXB2 concentrations, and brain MPO activity induced by focal cerebral ischemia-reperfusion. CONCLUSION Vasoactive substances in plasma and MPO activity in brain tissue show different time courses during focal cerebral ischemia-reperfusion and make different contribution to brain damage. TSA is effective to protect the ischemic brain tissue from ischemia-reperfusion injury.

Taking global minimum essential requirements(GMER)as standard,school of basic medical science in Wuhan University paid more attention to the cultivation of students' professional skills, innovation ability and communication ability. ‘Response to injury’integrated course was carried out. Based on the immunology,this course involves pathology and pathophysiology and explores the mecha-nism of the diseases' diagnosis and treatment. It took small classes,bilingual education,literature read-ing ,experiments and discussions in various forms . This reform aimed to improve the immunology , pathology and pathophysiology teaching and make our medical education meet the process of globalization.

Objective A new type adsorbent for removal of bacterial ET was prepared by immobilizing L-serine covalently onto polyvinylidene difluoride membrane (PVDF-Ser) to study the effect of hemoperfusion on sepsis induced lung injuries in a pig model. Method Endotoxemia were induced in thirteen pigs by injecting endotoxin (1 μg/(kg·h) ) intravenously for 2 h. One hour later, the pigs were treated with absorber of PVDF-Ser volumn (group hemoperfusion) or empty adsorber (group control) for 2 h. Extravascular lung water indexed to body weight and alveolar capillary permeability, levels of serum endotoxin, tumor necrosis factor-α, interleukin-6, malondialdehyde, glutathione, myeloperoxidase activity, and lung histological changes and myeloperoxidase immunohistochemical analysis were measured. Results Hemoperfusion treatment with PVDF-Ser volumn significantly improved extravascular lung water, pulmonary alveolar capillary permeability and lung injuries ( P ＜ 0. 05). In addition, hemoperfusion attenuated both serum and pulmonary cytokines, and decreased lung malondialdehyde and myeloperoxidase levels ( P ＜ 0. 05). Conclusions Hemoperfusion with the adsorber of PVDF-Ser volumn effectively reduced inflammatory responses and improved lung injuries and oxidative stress in endotoxemia. It has a high potential of clinical application for treatment of patients with severe sepsis.

BACKGROUND:At present, many researches have shown that tacrolimus has protecting effect on peripheral nerves,however,whether tacrolimus has a similar effect on central neural system has not been known yet.OBJECTIVE:To investigate the effect of tacrolimus on neural behaviors and memory by observing the neural behaviors and detecting the expression of synaptophysin in cortex,hippocampus and basipodite.DESIGN:Parallel and before and post contrast study.SETTING:Department of neurosurgery, affiliated hospital of the two medical universities.MATERIALS:The experiment was carried out in the Laboratory of Department Neurosurgery,Shanghai Changzheng Hospital in November 2002.Twenty-four qualified Sprague-Dawley rats supplied by Shanghai Experimental Animal Center of medical institution of Fudan University,with body mass of 180-220 g,were randomly divided into three groups:control, injury and treatment,with 8 rats in each group.INTERVENTIONS:Anesthesia was induced by administration of sodium pentobarbital(with the concentration of 20 g/L,40 mg/kg) twenty-four hours before the operation.The coup energy was 151.95-172.21 kPa that was equal to medium injury. The control rats did not receive the coup. Tacrolimus was given to the treatment group in the dosage of 1 mg/kg body weight by intraperitoneal injection at 5 minutes post trauma. The drug was given once physiological saline. Before and post trauma (on the third and seventh day)all rats Accepted Beam Walking Test,Beam Balance Test and Memory Test,respectively. One week after trauma,all rats' heads was removed and the brain was taken out within seconds.The hippocampus,cortex and basipodite of the traumatic hemisphere were kept in methanal with the concentration of 4 percent. Immunohistochemistry and image analysis system were used to study the expression of synaptophysin in cortex,hippocampus and basipodite of the traumatic hemisphere.MAIN OUTCOME MEASURES: ①The performance records of neural behaviors and memory of the three groups. ②Results of the expression of synaptophysin in cortex, hippocampus and basipodite of the three groups.③Apoptotic cellscalculation of synaptophysin in cortex,hippocampus and basipodite.RESULTS:Totally 24 rats entered the final analysis. ①On the third day and the seventh day,the scores recorded in Walking Test and Balance Test of the treatment group were less than those in the injury group[Walking Test: (7.5±2.5) s,(5.5±2.1) s,(10.5±2.5) s,(8.2±2.5) s. Balance Test:(3.4±0.5)score,(2.5±0.2) score,(5.7±0.2) score,(5.0±0.5) score,P ＜ 0.05-0.01].But the scores recorded in memory test of the treatment group were still more than those in the control group,memory test[(4.9±1.7) s,(6.2±2.3) s,(4.0±1.5) s,(4.4±2.6) s,P ＜ 0.05-0.01]. ②The expression of synaptophysin in cortex,hippocampus and basipodite in the treatment group was still more than that in the injury group(140.36±3.87, 45.52±2.16,31.67±2.35,96.25±2.85,24.35±2.47,20.49±2.08,P ＜ 0.01);The expression of synaptophysin control group was especially more than that in treatment group (162.24±3.52,50.58±2.31,42.69±2.53, P ＜ 0.01).Apoptotic cells calculation of cortex,hippoeampus and basipodite in treatment group was far less than those in injury group,(10.37±2.12)%,(18.39±2.87)%, (12.78±2.45)%,(21.14±4.85)%,(38.57±3.78)%, (21.18±4.59)%,P ＜ 0.01].And apoptotic cells calculation in injury group was more than those in control group [(3.85±2.56)%,(4.96±2.15)%, (3.52±2.17)%,P ＜ 0.01].CONCLUSION:Tacrolimus can facilitate the expression of synaptophysin,refrain from calcineurin involving in the process of transcription-dependent and nontranscription-dependent apoptosis,and can also contribute to the recovery of memory and neural behaviors post trauma.

Objective To evaluate the predictive performance of diaphragm thickening fraction ( DTF) assessed by ultrasound in the feasibility of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Forty-three patients with COPD were enrolled for prospective study.All patients were ventilated mechanically for more than 48 hours and were expected to be weaned when they met clinical criteria in the intensive care unit from February 2015 to August 2015.Patients received a spontaneous breathing trial under pressure support for 1 h.At the end of spontaneous breathing trial, the right hemi-diaphragm was visualized in the zone of apposition using a 6-13 MHz linear ultrasound probe. Diaphragm thickness was recorded at end-inspiration (DTei) and end-expiration (DTee), and the DTF was calculated as percentage from the following formula:(DTei -DTee) /DTee.Also the rapid shallow breathing index ( RSBI ) was calculated.Patients meeting weaning criteria were extubated.Weaning successfully was defined as spontaneous breathing for >48 h without any form of ventilation support.Results Twenty-five patients were weaned successfully and failure of weaning was found in 18 patients.A significant differences in DTF ( 39.66 ±13.22 )%vs.( 23.84 ±8.85 )%, P <0.05 and RSBI ( 62.74 ±26.05 ) vs.( 98.89 ± 35.44) , P <0.05 were observed between patients with successful weaning and patients with failure.The sensitivity and specificity of DTF≥30 % for successful weaning were 84% and 83.88 %, respectively.The area under the receiver operating characteristic curve was 0.872 ( 95 % CI: 0.759-0.985 ) for DTF.By comparison, when RSBI was ≤105, there was a sensitivity of 92 %, and a specificity of 38.89 % for determining successful weaning.The area under the receiver operating characteristic curve was 0.804 ( 95 %CI: 0.669-0.940) for RSBI. Conclusions This study shows that in a cohort of COPD patients, the assessment of DTF using diaphragm ultrasound may be useful to predict success weaning or failure during spontaneous breathing trial.

Objective To analyze the clinical characteristics and coagulation parameters of the infants with placental abruption . Methods Analysis was made on clinical and laboratory indexes of the hospitalized children of the NICU of Bayi Clinical Medical College of South Medical University ,enrolled from August 2012 to January 2013 ,including 60 infants with placental abruption as observation group and 60 infants without placental abruption as the control group .Results From clinical manifestations and lab date ,significant differences were found in gestational age ,polyembryony ,premature rupture of membrane ,birth weight ,intrauterine growth retardation ,motherhood gestational hypertension ,mother gestational diabetes mellitus ,asphyxia ,APTT ,D-dimer on admis-sion between the observation group and control group (P<0 .05) .Conclusion Placental abruption is the result of placental insuffi-ciency ,which may cause coagulation disorder and thus show the pathological state of high condensation in infants .