Fresh healthy human erythrocytes were treated by four kinds of bile acid solution (DOC, GDC, C-Na and GC-Na) at physiological and pathological concentrations of human serum level. The more hydrophobic bile acids (DOC and GDC) significantly affected lipid components of erythrocyte. membranes and morphology at concentration of 0.5 mmol/L and 1.0 mmol/L. To the extent of he-molysis DOC and GDC were more hemolytic than C-Na and GC-Na. Additionally the erthrocytes from patients with biliary obstruction were also studied. The results suggest that the more hydropho-bicity of bile acid, the more erythrocyte damage. The hydrophobicity was associated with the structure of bile acid molecules.

Objective To investigate the relationship of diabetic nephropathy with serum endothelin-1(ET-1) and C-reactive protein(CRP). Methods Levels of blood pressure, glucose, lipid, creatinine,ET-1,CRP and urinary albumin excretion(UAER) were measured and calculated in 86 patients with type 2 diabetes mellitus(T2DM)and 30 healthy subjects. Results Serum ET-1 and CRP were significantly higher in T2DM than in control(P<0.05，P<0.01).Serum ET-1 and CRP were increased with increment of serum creatinine and UAER(P<0.05，P<0.01). Conclusions Serum ET-1 and CRP may be involved in the development and progression of diabetic nephropathy.

Objective]To summarize professor and national physician master Guo Chengjie asarum clinical application experience, to do good to the practitioners. [Methods] Through analyzing Guo Lao clinical experience of the medicinal nature of the composition and toxicity of understanding, to adapt to the conditions and the usage and dosage of the original understanding, analyse and summarize the experience of clinical application of asarum. [Results] Professor Guo Chengjie applies asarum poliomyelitis to cold organs and blockage for the treatment of diseases such as lung;Drug compatibility exalts development, and expands the application in the mammary gland disease by asarum;On the dosage of asarum characteristics and decoction methods give unique insights;Guo Lao especially emphasizes the importance of dialectical medication. [Conclusion] Pro. Guo's application experience and innovation, asarum clinical curative effect is good, is worth using for reference.

OBJECTIVE:To optimize the extraction technology of total volatile oil from Cinnamomum cassia Presl. and Cyper-us rotundus L. in Hegan lipi granules. METHODS:With the extraction rate of total volatile oil as the index,Box-Behnken response surface method was applied to investigate the effects of water amount,soaking time for medicinal materials and extraction time by distillation on the amount of the extracted volatile oil and optimize the extraction technology of total volatile oil from C. cassia Pre-sl. and C. rotundus L. in Hegan lipi granules,and verification tests were conducted. RESULTS:The relevant coefficient of the es-tablished quadratic polynomial regression model of 3 variable factors was 0.970 5. The optimal extraction technology was as follows as 5 times as much as the amount of medicinal materials of water,soaking time of 2.5 h,extraction time of 6.0 h. Verification tests showed the extraction rate of total volatile oil was 1.65%,with a deviation rate lower than 2% compared to the predicted value of 1.67%. CONCLUSIONS:The established model is reliable with good predictability. The optimal technology can be used for the ex-traction of total volatile oil from C. cassia Presl. and C. rotundus L. in Hegan lipi granules.

The exposure of lead in environment has caused a major public health problem all over the globe.Because of rapid industrialization and constant existence of lead in environment,it is necessary to screen,monitor and intervene in the content of lead of human body during a long time.The toxical and harmful influence of lead on human body,especially on children are expounded.The content index of lead in the body set by international and national standards as well as its evaluation basis are included.The most frequently used testing method of blood lead is also described: atomic absorption spectrometry and its operative process.

OBJECTIVE: Embryonic Stem Cell (ES) are characterized by totipotency and normal karyotype and provide the theoretical base in the following fields: embryonic developmeut of mammalian, cell differentiation, expres sion of exogenous genes and utilization of Ess to develop animal model for human inherited diseases. The identification of ES therefore is very important to research and utilize ES.DATA SOURCES: The relevant articles to embryonic stem cell between January 1980 and December 2003 were computer searched for in Medline with the key words "embryonic stem cell, embryo, Alkaline phosphatase,Oct-4"in English. Similarly, the relevant articles to embryonic stem cell between January 1980 and December 2003 were computer searched for in China Journal Full-text Database (CJFD) with the key word "embryonic stem cell" in Chinese.STUDY SELECTION: The articles were browsed firstly. The inclusion criteria were for those articles about the identification of embryonic stem cells. The exclusion criteria were for those about repetitive studies, reviews and other similar articles.DATA EXTRACTION: 16 articles about the identification of embryonic stem cells were collected. Then, the full-texts of the articles were looked through.DATA SYNTHESIS: The selected data were summarized in the following order: ①Preliminary identification of Ess based on morphology and growth;②Immunological valuation; ③Chromosome related identification; ④Identi fication of totipotency and pluripotency.CONCLUSION: The identification of embryonic stem cells is not the result of only one identifying method, but a process of identification. During this process of comprehensive identification, it is recommend to conduct AKP test firstly, karyotype analysis secondly, then examination of surface markers and finally identification of Ess totipotency when Ess are sufficient, takingcare to repeat every identification.

Objective To study the expression of Toll-like receptor 4(TLR4) in peripheral blood mononuclear cell (PBMCs) and serum interleukin-6(IL-6) in wheezing children under 5 years of age.Methods A total of 224 wheezing children under 5 years of age were divided into API(asthma predictive index)-positive (n=116) and API-negative groups (n=108).Serum level of IL-6 and TLR4 expression on CD14+ monocytes were measured after wheezing was stable for one month.TLR4 expression on CD14+ monoeytes was quantified via flow-cytometry.Serum level of IL-6 was detected by ELISA.Results Serum level of IL-6 and TLR4 expression on CD14+ monocytes of API-positive group were higher than API-negative group [LR4(％):34.9±10.0 vs.30.2± 8.8;IL-6(ng/L):46.4±15.1 vs.40.5±13.6].There was a significant positive correlation between the expression of TLR4 and the content of serum IL-6 in two groups of wheezing children(P＜0.05).Conclusion TLR4 may play a role in the pathogenesis of asthma through promoting the expression of IL-6.TLR4 may be a index to predicting asthma in wheezing children.

Objective To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods Two hurdred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluated. x2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test(2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint,precise test of fourfold table is used to compare normal group with patient groups. Results ( 1 ) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters( ＜ 15 years) and 180 adults( ≥ 15 years). The median and P95% of |VBLADI| were 0.850 mm,2.450 mm in the young ( ＜ 15 years) and 0.700 mm,2.051 mm in the adult(≥15 years),there were 2 and 10 volunteers whose |VBLADI| ≥P95% in the young and in the adult respectively. There was no correlation between VBLADI( -2.146 to 2.114 mm,Median 0.000 mm) and LA(22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300° ), VLRA ( - 11.643°to 8.623 °, median 0.000 ° ) respectively in normal people ( r = - 0.030, - 0.005,0.026, P ＞ 0.05 ). ( 2 ) In the study with 32 patients including 25 youngsters( ＜ 15 years) and 7 adults( ≥ 15 years). Seventeen of 32 had atlanto-axial lateral subdislocation (AALSD),in 16 youngsters( ＜ 15 years), the median of the |VBLADI| was 3.350 mm and 14 cases |VBLADI| ≥2.450 mm;1 adult patient(≥ 15 years) had |VBLADI| ≥ 2.051 mm; 7 of 32 patients had atlanto-axial rotatory dislocation (AARD) including 4 youngsters |VBLADI| ＜2.450 mm,median 1.200 mm,3 adults |VBLADI| ＜2.051 mm,all of the 7 patients with AARD had unilateral parasol LADI in neutral position;8 of 32 patients had atlanto-axial complicated dislocation(AACD) including 5 youngsters |VBLADI| ≥2.450 mm,3 adults |VBLADI| ≥2.051 mm. There are more cases whose |VBLADI| ≥P95% in group AALSD and group AACD than in abnormal group( P<0.01 ), but there is no difference between group AARD and normal group( P = 0.738 ).Conclusion The imaging finding of "asymmetry of bilateral LADI" may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis.

Objective To explore the effects of high-dose ambroxol hydrochloride (Mucosolvan) on pulmonary protection and anti-inflammatory in traumatic brain injury patients treated by mild hypothermia.Methods From June 2008 to June 2012,40 elderly traumatic brain injury patients aged 60-70 years treated by mild hypothermia in our hospital were selected.Patients were randomly divided into two groups:low-dose ambroxol hydrochloride group and high dose ambroxol hydrochloride (n=20,each).Patients in low-dose ambroxol hydrochloride group were treated with ambroxol 30 mg plus saline infusion,3 times/day; while patients in high-dose ambroxol hydrochloride group were treated with ambroxol 300mg plus saline infusion,3 times/day; both groups were treated for 7 days.The changes of characteristic and quantity of sputum,PaO2and PaO2/FiO2,and serum TNF α level were analyzed at day 1,3,7.Duration of mechanical ventilation,tracheotomy proportion,and mortality were compared between the two groups 3 months after treatment.Results At day 3-7 after the intervention,the sputum got thinner and less,and more easy to suck in highdose group than in low-dose group (thin sputum proportion:75％ vs.40％,P =0.025; clean proportion by once suction:65％ vs.25％,P=0.011).The improvement of PaO2,PaO2/FiO2 were more significant in high dose group than in low dose group (PaO2 ∶ 3d,(92.3±12.3) mm Hg vs.(83.3±15.2) mm Hg,P=0.046;7d,(95.9±12.5) mm Hgvs.(87.1±11.7) mm Hg,P=0.028;PaO2/FiO2∶3d,(290.8± 15.8) mmHgvs.(221.8± 16.4) mm Hg,P=0.000;7d,(296.3±16.9)mm Hg vs.(238.4±15.0) mm Hg,P=0.000).Serum concentrations of TNF α was lower in highdose group than in low dose group [3d,(54.1± 4.9) ng/L vs.(71.4± 5.6) ng/L,P=0.000;7d,(35.1± 2.7) ng/L vs.(63.3±4.3) ng/L,P 0.000].Duration of mechanical ventilation was shorter and tracheotomy proportion was lower in high dose group than in low dose group [(116.8±18.7) hrsvs.(178.4±35.5) hrs,P=0.000; 25％ vs.60％,P=0.025].There was no significant difference in mortality between groups 3 months after treatment.Conclusions The application of high dose ambroxol can improve respiratory function,decrease duration of mechanical ventilation and tracheostomy proportion,and reduce the systemic inflammatory response in elderly traumatic brain injury patients treated by mild hypothermia,but without long-term survival benefit.

Objective To investigate the prognostic value of fever burden in traumatic brain injury (TBI) patients.Methods A retrospective analysis of 355 TBI patients admitted to the emergency department and intensive care unit from November 2010 to October 2012 was performed,and the Glasgow outcome scale (GOS) was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group (4 to 5) and poor outcome group (1 to 3).Relevant clinical findings were studied by statistical description,logistic regression analysis,Spearman correlation analysis and ROC curve analysis.Results Fever burden level was continuously increased with the decrease of GOS from score 5 to 2,except for score 1 of GOS,which was corresponding to a significant lower fever burden.There were significant differences in age,pupil reactivity,Glasgow coma scale (GCS) and fever burden between two groups (P ＜ 0.05).Compared to the good outcome group,the poor outcome group was featured with more advanced average age (P =0.000),poorer pupil reactivity (P =0.000),lower GCS score (P =0.000) and higher fever burden level (P =0.000).Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and fever burden level (OR 1.166,95％ CI:1.117-1.217) were associatedwith poor outcome.The fever burden level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of fever burden level was 1.098 (95％ CI:1.031-1.169,P =0.003).ROC curve analysis showed the respective AUC for fever burden was 0.713 (95％ CI:0.663-0.760).The relevant analysis revealed a significant negative correlation between the fever burden and the GOS score (r =-0.376,95％ CI:-0.462--0.283,P =0.000).Conclusions Fever burden can be considered as an independent predictor of poor outcome of patients with TBI.The TBI patients with early onset of high levels of fever burden will have increased poor outcome risk.