Objective To observe the clinical effects of different doses of Xuebijing injection in the treatment of sepsis. Methods Eighty patients with sepsis from First Center Clinical College of Tianjin Medical University were selected and randomly divided into four groups:the control group,Xuebijing small,middle and large dose groups(each, 20 patients). All patients in the four groups were given Western medicine conventional treatment,whereas in the Xuebijing small,middle and large dose groups,additionally they were intravenously dripped with Xuebijing injection 50 mL, 2 times a day,100 mL,2 times a day and 100 mL,4 times daily respectively. The patients' vital signs,blood routine, interleukin-18(IL-18),procalcitonin(PCT)and C- reactive protein(CRP)were detected before treatment(0 d)and 3,7 and 14 days after Xuebijing injection,28-day and 60-day death rate were observed. Results With prolonged treatment,the body temperature,heart rate(HR),respiratory rate(RR),white blood cell count(WBC),IL-18,PCT, CRP levels were all decreased in each group(all P<0.05),and on 14 days they reached the valley;when compared with middle,small dose Xuebijing groups and control group,in the Xuebijing large dose group they were decreased the most significantly over the same period〔temperature (℃):36.22±0.55 vs. 36.55±0.99, 36.87±1.05, 36.93±1.07,HR(beats/min):82.11±8.99 vs. 93.45±10.02,109.02±11.44,113.13±10.34,RR(breaths/min):15.48±6.45 vs. 17.33±6.94,20.35±7.19,22.34±6.67,WBC(×109/L):5.35±1.37 vs. 8.35±2.98,10.54±3.22, 13.33±4.78,IL-18(ng/L):107.36±55.89 vs. 136.55±80.19,177.78±102.32,193.93±98.07,PCT(μg/L):0.33±0.19 vs. 0.66±0.22,1.62±0.44,2.78±0.34,CRP(mg/L):15.40±1.37 vs. 48.34±8.98,100.45±30.67, 131.92±49.53〕,the differences all being statistically significant(all P<0.05). The 28-day and 60-day death rate in Xuebijing large dose group were significantly lower than those in control group,Xuebijing small,middle dose groups (28-day:25% vs. 40%,40%,45%;60-day:30% vs. 45%,40%,50%). Conclusion The time for onset of therapeutic effect in large dose Xuebijing group is short,and reduce the levels of inflammatory mediators significantly, and improve the prognosis of patients with sepsis,therefore it can be used clinically.

Objective:To investigate the effect of methycobal on peripheral nerve regeneration.Methods:Thirty Wistar rats were divided into normal group(N),model group(M)and methycobal group(B).Each group contained 10 rats.The model of rat with sciatic nerve half injury was made by clamp.Rats were fed with methycobal in B group,and same dose of normal saline was fed in N and M groups.The nerve tissue(silver nitrate stain)and gastrocnemius tissue(HE stain)were obtained to observe the morphologic index,functional index(sciatic nerve function index,differential value of hind legs tensile force,gastrocnemius wet weight index)after 14 days.Results:There were nerve fiber sparseness,disposition disorder,and decrease of gastrocnemius cross section area,sciatic nerve function index,and differential value of hind legs tensile force,gastrocnemius wet weight index diminutu in M group compared with those of N group(P ＜ 0.01).There were more nerve fiber,normal gastrocnemius cross section area,and higher sciatic nerve function index and gastrocnemius wet weight index in B group compared with those of M group(P＜ 0.01),whereas which were also different compared with those of N group(P＜ 0.01).Conclusion:Methycobal can promote the axon growth,postpone sarcous anaiosis of denervation,and enhance functional recovery of peripheral nerve injury.

Objective To investigate the expression of IFN-? and IL-18 in patients with progressive psoriasis and its clinical significance. Methods Twenty cases of psoriasis vulgaris, 19 cases of erythroder-mic psoriasis and 10 oases of pustular psoriasis were studied. Sandwich ELISA was used to detect the plasma level of IFN-? and IL-18, or supernatant level of IFN-? and IL-18 in PBMC culture under the stimula-tion of staphylococcal enterotoxin B (SEB). Results The plasma level of IFN-? in patients with psoriasis vulgaris, erythrodermic psoriasis and pustular psoriasis was higher than that in healthy control. The plasma level of IL-18 in progressive psoriasis vulgaris was higher than that in healthy control. The supernatant level of IFN-? and IL-18 in PBMC culture in progressive psoriasis vulgaris were higher than that in normal control, with a positive correlation between IFN-? level and IL-18 level (r = 0.55, P

Objective To explore the correlation between adipocyte factors(adiponectin and visfatin)and fetus intrauterine growth.Methods Enzyme immunoassay was used to measure the adiponeetin and visfatin levels in maternal and umbilical serum from 14 women with fetal growth restriction (FGR group),14 women with maerosomia(macrosomia group)and 14 normal pregnant women(control group).The correlations of cord serum adiponectin and visfatin with matemal serum adiponectin and visfatin were analyzed.Results (1)Serum visfatin levels in FGR mothers[(41.4±5.5)]μg/L were significantly higher than that in control women[(34.7±4.9)μg/L and macrosomia mothers[(37.3±4.4)μg/L;P<0.01,P<0.05].Serum adiponectin levels in maerosomia mothers [(4.1±1.3)mg/L]were significantly lower than that in control women [(6.6±1.5)mg/L]and FGR mothers[(6.4±1.3)mg/L;P<0.01].(2)Serum visfatinin levels in FGR babies[(58.1±7.6)μg/L] were significantly increased than that in control newborns[(42.6±7.8)μg/L]and macrosomia babies[(48.5±9.1)μg/L;P<0.01,P<0.05].Serum adiponeetin levels in macrosomia babies[(6.5±1.3)mg/L]were significantly decreased than that in control newborns[(7.7±1.5)mg/L]and FGR babies[(7.7±1.0)mg/L;P<0.05,P<0.05].(3)Maternal serum visfatin levels were positively correlated with umbilical serum visfatin levels(r=0.720.P<0.01).Umbilical serum adiponectin levels were higher than that in maternal serum,but there were no relationship between them(r=0.301,P>0.05).Conclusion The changes of visfatin and adiponeetin levels may be related to the oceurrenee of FGR and fetal macrosomia.

Objective To evaluate pulmonary protection of dexmedetomidine under general anesthesia in the patients with sepsis.Methods Fifty patients with sepsis,aged 50-64 yr,weighing 50-75 kg,of ASA physical status Ⅲ or Ⅳ,were randomly divided into 2 groups (n =25 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium,and maintained with infusion of remifentanil and propofol and intermittent iv boluses of cisatracurium.The patients were endotracheally intubated and mechanically ventilated.In group D,dexmedetomidine 1.0 μg/kg was infused over 10 min,followed by infusion at 0.4 μg · kg-1 · h-1 for 2 h before induction of anesthesia.While the equal volume of normal saline was given in group C.BIS value was maintained at 40-60.Immediately before skin incision,at 2 h after beginning of skin incision,and at 24 h after operation,arterial and venous blood samples were taken for blood gas analysis and for determination of the concentrations of serum procalitonin,interleukin-6 and tumor necrosis factor-alpha.Oxygenation index was calculated.Results Compared with group C,oxygenation index was significantly increased,the concentrations of serum procalitonin,tumor necrosis factor-alpha and interleukin-6 were decreased,and the rate of improvement of pulmonary function was increased in group D.Conclusion Dexmedetomidine (infusion at 0.4 pg · kg-1 · h 1 for 2 h after infusion of 1.0 μg/kg) before induction of anesthesia provides pulmonary protection under general anesthesia in the patients with sepsis.

Objective To investigate the effect of dexmedetomidine on inflammatory response during the perioperative period in patients with acute craniocerebral trauma.Methods Seventy ASA Ⅰ-Ⅳ patients of both sexes,aged 20-68 yr,with craniocerebral trauma,who required decompressive craniectomy within the next 24 h,were randomly divided into 2 groups (n =35 each) ∶ control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with fentanyl,propofol and cisatracurium and maintained with remifentanil,sevoflurane and propofol and intermittent iv boluses of cisatracurium.In group D,dexmedetomidine 1 μg/kg was infused over 10 min,followed by infusion at 0.4 μg· kg-1 · h-1 for 2 h.Venous blood samples were taken before induction of anesthesia (baseline),2 h after the beginning of operation,at the end of operation and at 24 h after operation (T1-T4) to determine the concentrations of serum neurone specific enolase (NSE),interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α).Results Compared with group C,the concentrations of serum NSE,IL-6 and TNF-α were significantly decreased in group D (P ＜ 0.05).The concentrations of serum NSE,IL-6 and TNF-αwere significantly higher at T2 and T3,and the concentration of serum TNF-α was significantly lower at T4 than at T1 in group C (P ＜ 0.05).The concentrations of serum NSE and IL-6 were significantly higher at T2 and T3 and lower at T4 and the concentration of serum TNF-α was significantly higher at T3 and T4 than at T1 in group D (P ＜0.05).Conclusion Dexmedetomidine protects the brain against acute craniocerebral trauma by inhibiting systemic inflammatory response during the perioperative period.

Objective : To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians. Methods: Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. Results: All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P<0.05). The mean angulation changes of the long axes of the canines were 17.5°. There was no significant difference in the depth of periodontal measurement and buccal crown height measurement between T1 and T3 (P>0.05). Conclusion The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.