Objective To investigate the effect of sevoflurane postconditioning on the myocardial oxidative stress injury in patients undergoing heart valve replacement with cardiopulmonary bypass (CPB) . Methods Thirty ASA Ⅱ or Ⅲ and NYHA class Ⅱ or ID patients, aged 30-59 yr, weighing 42-62 kg, scheduled for cardiac valve replacement with CPB, were randomly divided into 2 groups ( n = 15 each) : control group (group C) and sevoflurane postconditioning group (group S) . Anesthesia was induced with iv injection of midazolam 0.05-0.08 mg/kg, fentanyl 3-6 μg/kg, vecuronium 0.10-0.15 mg/kg and etomidate 0.1-0.2 mg/kg. The patients were tracheal intu- bated and mechanically ventilated. Anesthesia was maintained with intermittent iv boluses of fentanyl and midazolam and continuous infusion of atracurium and propofol. In group S, 2% sevoflurane was given over 15 min via the cardiopulmonary bypass machine immediately after aortic unclamping. Blood samples from the internal jugular vein were collected immediately before skin incision (T1 ) and at 30 min, 3 h and 24 h after aortic unclamping (T2-4 ) for measurement of the plasma malondialdehyde level. Myocardial tissues were taken from the left auricle before operation and after termination of CPB for determination of α-glutathione-S-transferase expression by Western blot. Results The plasma malondialdehyde concentration was significantly lower at T2, 3, while a-glutathione-S-transferase expression in myocardial tissues higher after termination of CPB in group S than in group C ( P ＜ 0.05) . Conclusion Sevoflurane postconditioning can enhance the antioxidant capacity and attenuate the myocardial oxidative stress injury in patients undergoing cardiac valve replacement with CPB, which may be helpful to reduce myocardial ischemia-reperfusion injury.

To evaluate the efficacy of HbA1C in diagnosing diabetes in subjects with primary hypertension.The results demonstrated that the area under the reciever operating characteristic ( ROC ) curve was 0.895,with corresponding sensitivity of 85.4％,and specificity of 82.2％,when the optimal cutpoint of HbA1C in diagnosing diabetes was 6.0％.Our study suggested that HbA1C ≥6.0％ can be used efficiently in diagnosing diabetes in patients with primary hypertension.

Objective To evaluate the effects of limited fluid resuscitation on systemic inflammatory responses in rats with traumatic hemorrhagic shock through comparing with unlimited fluid resuscitation.Methods Sixty pathogen-free male Sprague-Dawley rats,aged 2-3 months,weighing 250-290 g,were randomly divided into 6 groups (n =10 each) using a random number table:sham operation group (group S),no fluid resuscitation group (group NF),unlimited fluid resuscitation group (group ULF),limited crystalloid fluid resuscitation group (group LR),and limited colloid fluid resuscitation groups (group LSG and group LHES).Traumatic uncontrolled hemorrhagic shock was induced by withdrawal of blood from the femoral artery at 2.5 mL/100 g over a 20-minute period,followed by tail amputation at 10 min after the end of blood withdrawal.At 10 min after the end of blood withdrawal,fluid resuscitation was performed.Lactated Ringer's solution (ULF and LR groups),4 ％ succinylated gelatin (group LSG),or 6 ％ hydroxyethyl starch 130/0.4 (group LHES) was infused intravenously.The initial infusion rate was 2 ml · kg-1 · min-1.The target MAP was maintained at 50 mm Hg in rats with limited fluid resuscitation,while at 80 mm Hg in rats with unlimited fluid resuscitation.After 60 min of fluid resuscitation,bleeding in the tail was stopped by ligation and fluid infusion was replaced with blood resuscitation.After 60 min of blood resuscitation,180 main of observation was started.At 10 min after catheterization of the femoral artery and vein (T0),10 min after the end of blood withdrawal (T1),the end of fluid resuscitation (T2),the end of blood resuscitation (T3),and the end of observation (T4),arterial blood samples were collected to measure hematocrit (Hct)and concentrations of plasma tumor necrosis factor-alpha (TNF-α),interleukin (IL)-6,and IL-10.Blood samples were collected from the femoral artery at T2 for determination of the expression of Toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88) and activity of nuclear factor-kappaB (NF-κB) in monocytes.The amount of blood loss from the tail and volume of fluid infused were also recorded.Another 120 Sprague-Dawley rats were randomly divided into 6 groups (n =20 each) and resuscitation was performed according to the method previously described.The rats were observed for 72 h survival rate.Results Compared with group S,Hct was significantly decreased,the concentrations of plasma TNF-α,IL-6,and IL-10 and activity of NF-κB were increased,and the expression of TLR4,and MyD88 in monocytes was up-regulated in the other groups (P ＜ 0.05).Compared with group NF,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly increased,and the concentration of plasma IL-10 and Hct were decreased,and the expression of TLR4 and MyD88 in monocytes was up-regulated in ULF,LR and LSG groups,and the concentrations of plasma TNF-α and IL-6 were significantly increased,the concentration of plasma IL-10 and Hct were decreased in group LHES (P ＜ 0.05).Compared with group ULF,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly decreased,the concentration of plasma IL-10 and Hct were increased,the survival rate was higher,the expression of TLR4 and MyD88 in monocytes was down-regulated,and the amount of blood loss from the tail was decreased and the volume of fluid infused was reduced in LSG,LHES and LR groups (P ＜ 0.05).Compared with group LR,the concentrations of plasma TNF-α and IL-6 and NF-κB activity were significantly decreased and the expression of TLR4 and MyD88 in monocytes was down-regulated (P ＜ 0.05),and no significant change was found in the concentration of plasma IL-10 in group LHES (P ＞ 0.05),and the volume of fluid infused was reduced and the survival rate was increased (P ＜ 0.05),and no significant change was found in the amount of blood loss from the tail in LSG and LH-ES groups (P ＞ 0.05).Conclusion Compared with unlimited fluid resuscitation,limited fluid resuscitation exerts less effect on systemic inflammatory responses in rats with traumatic hemorrhagic shock,especially when resuscitation with 6％ hydroxyethyl starch 130/0.4 is performed,and inhibition of TLR4/NF-κB signaling pathway is involved in the mechanism.

Objective To investigate the efficacy and safety of lauromacrogol foam sclerosant in the treatment of peripheral venous malformations.Methods 21 patients with peripheral venous malformations were treated with foam sclerotherapy.The sclerosing foam was produced by Tessari's method using 1％ lauromacrogol.When necessary,the injections were repeated at an interval of four weeks,and this process contained 3 to 5 injections.Therapeutic outcomes and safety were established by evaluating size of lesion,symptom,duration of treatment and side-effects of treatment before and after treatment.Results 21 patients were followed up for 3 to 18 months.10 cases showed markedly shrinked or even disappeared of treated malformations,9 cases showed a reduction in size over 50 ％,and 2 cases showed a reduction in size less 50 ％.Local swelling occurred in almost per session,pyrexia in 5 patients,which resolved spontaneously within several days to 1 week.No major complication occurred.Conclusions Foam sclerotherapy using lauromacrogol seems to be a safe and effective therapeutic method for peripheral venous malformations.

Objective· To investigate the clinical features of macrophage activation syndrome (MAS) associated with adult-onset Still's disease (AOSD),and provide the basis for clinical diagnosis and treatment of the disease.Methods· The clinical data of 42 patients with AOSD,including 14 patients with AOSD-induced MAS (the MAS group) and 28 AOSD patients paired by age and sex (the non-MAS group),diagnosed in Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine from October 2013 to June 2016 were collected and then retrospectively analyzed.Results· There was no significant difference in age,sex and duration of AOSD between two groups.The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in MAS group were higher than those in non-MAS group,while the level of FDP is lower.Glucocorticoids were used in all 42 patients,and the dosage of glucocorticoids was significantly higher in MAS group than non-MAS group.Only 1 patient with AOSD-induced MAS received MTX,the percentage of patients receiving MTX was significantly lower in MAS group than non-MAS group.Five patients with AOSD-induced MAS received IVIG,the percentage of patients receiving IVIG was significantly higher in MAS group than non-MAS group.Two patients with AOSD-induced MAS received VP-16.Conclusion · The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in patients with AOSD-induced MAS were higher than patients without MAS,while the level of FDP was lower.Early diagnosis and active treatment is the key point to improve clinical outcome.

Objective To built up the ERP model,measure mode and P300 potential reference standard in mice with vascular dementia(VD),and characterize the P300 potential in mice with VD.Methods Fortyeight mice were randomly divided into a normal group.sham operation group and a VD group.The mice in the Vd group were subject to repetitive ischemia and reperfusion by using the ligation of bilateral common carotid arteries so as to establish the VD model.The behavioral abnormalities were investigated by step-down test and water maze test.The N2 and P3 components of P300 potentials were also recorded.Results It was shown that the learning and memory abilities as reflected by the step down test and water maze test scores were decrease in mice in the VD group when compared with those in the normal group and sham operation group(P<0.05).The N2 and P3 latencies significantly prolonged(P<0.01)and P3 amplitudes decreased(P<0.05)in VD group as well.Conclusions In VD mice,there is a significant prolongation of the P300 potential latency and a significant decrease of learning and memory abilities.Recordings of P300 from unanesthetized mice could be an objective,non-invasive,quantitative and valuable electrophysiological method for studying the cognitive function of VD mice.

AIMTo establish a method for screening active substance with scavenging effects on superoxide anion in vitro by designed superoxide dismutase biosensor.

METHODSThe enzyme sensor was built by connecting the immobilized CuZnSOD with optical oxygen sensor through a special way. Superoxide anions were generated by auto-oxidation of pyrogallol. The auto-oxidation speed was examined before and after adding samples into the system, and the Vit C having the scavenging radical activities was served as a positive control.

RESULTSThe limit of biosensor detection was 7.0 U in activity, and lifetime of the immobilized enzyme in the reaction-cell was above 2 weeks. The scavenging effects on superoxide radicals of fifteen active substance were studied in vitro by the sensor, and some of them presented scavenging activities.

CONCLUSIONThe signal from biosensor is stable, easy to be determined, and the kinetic information on scavenging superoxide radicals could be obtained directly. The biosensor system can be used for screening drugs simply and rapidly.

Ascorbic Acid ; metabolism ; Benzaldehydes ; metabolism ; Biosensing Techniques ; Caffeic Acids ; metabolism ; Enzymes, Immobilized ; metabolism ; Free Radical Scavengers ; metabolism ; Pyrogallol ; metabolism ; Superoxide Dismutase ; metabolism

Objective To investigate the clinical epidemiological features of femoral neck frac-tures. Methods The clinical data of patients with femoral neck fractures admitted to Third Affiliated Hospital of Hebei Medical University from 2003 to 2007 were retrospectively analyzed. All patients were divided into children group (age < 16 years) , adult group (age ranged from 16 to 60 years) and older group (>60 years). The types of the femoral neck fractures included 31-B1, 31-B2 and 31-B3 according to AO classification. The gender, age, fracture type and injury causes were analyzed. Results A total of 2 064 patients (971 males and 1 093 females) with femoral neck fractures were involved in the study.There were 356, 381, 397, 454 and 476 patients respectively in 2003, 2004, 2005, 2006 and 2007.There were 74 patients (3.59%) in the children group, 979 (47.43%) in the adult group and 1 011 (48.98%) in the older group. There were 960 patients (46. 51%) with type 31-B1 fractures, 860 (41. 67%) with type 31-B2 fractures and 244 (11. 82%) with 31-B3 fractures. Conclusions Form 2003 to 2007, the incidence of femoral neck fracture shows a trend of increase, with the highest incidence in the old persons. The male patients with femoral neck fractures are more than female patients in adult group, while the female patients with femoral neck fractures are less than male patients in older group.The dominant fractures type according to AO classification are type 31-B2 fractures in children and adult groups, but type 31-B1 fractures in older group.

After consulting literature, following the original meaning of the paper about slow-rapid reinforcing-reducing method in Huangdi's Internal Classic, in combination with explanation of later ages, and comprehension and clinical experience of the authors, it is put forward that the slow-rapid reinforcing-reducing method in Huangdi's Internal Classic is not single manipulation method, but it is a guiding principle for reinforcing-reducing manipulation, it includes many manipulation methods and they were listed, and all of the reinforcing-reducing methods of later ages are developed from these. In the teaching material Acupuncture and Moxibustion Sciences they are included in single reinforcing-reducing method, reducing extension and intension of this definition. The relative description in the teaching material only is slow-rapid reinforcing-reducing method of narrow sense, but the manipulations can be divided into qi-carrying manipulating needle type and three-one pushing-pulling type.
Acupuncture Therapy ; methods ; Humans ; Medicine, Chinese Traditional

OBJECTIVETo assess the efficacy of quick meridian needling therapy plus scalp acupuncture on infantile cerebral palsy (CP).

METHODSOne hundred and forty-seven cases of CP were randomly divided into a quick meridian needling therapy plus scalp acupuncture group (group A), a conventional acupuncture group (group B) and a scalp acupuncture group (group C), 49 cases in each one. In group A, quick needling was applied to the Conception Vessel, Governor Vessel, Hand-Yangming, Hand-Jueyin, Foot-Yangming and Foot-Taiyin meridians distributed on four limbs and trunk. One pricking point was 10 mm far from the other one. In scalp acupuncture, motor area, equilibrium area, sensory area, tremor-control area, foot-motor-sensory area, speech No. 2 area, speech No. 3 area, Baihui (GV 20), Sishencong (EX-HN 1), etc. were selected. The needles were stimulated with rotating manipulation and remained for 30-60 min. In group B, the conventional acupuncture was adopted mainly at Dazhui (GV 14), Shenzhu (GV 12), Fengfu (GV 16) and others. In group C, the scalp acupuncture was used and the points selected were same as those in group A for scalp acupuncture treatment. The scores of Gross Motor Function Measure (GMFM) were observed before and after treatment for children. The clinical efficacy of each group was evaluated. By follow-up for 12 months, the condition of independent walking was observed.

RESULTSThe total effective rate in group A was 79.6% (39/49), which was superior to that of group B [49.0% (24/49)] and group C [51.0% (25/ 49)] respectively (both P < 0.05). After treatment, GMFM scores of children were all improved significantly in 3 groups (P < 0.001, P < 0.05), of which, the improvement extent in group A was superior to that of other two groups (both P < 0.05). It was found after follow-up for 1 year that 31 cases could walk independently in group A, which was more than group B (17 cases) and group C (16 cases).

CONCLUSIONThe quick meridian needling therapy plus scalp acupuncture can improve significantly limb motor function of children with cerebral palsy and its therapeutic effect is superior to conventional acupuncture and simple scalp acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Meridians ; Scalp ; physiopathology ; Treatment Outcome