Objective: To explore the pathogenesis of multiple organ dysfunction syndrome (MODS) with respect to the balance of Th1/Th2. Methods: Eighteen healthy male minipigs, weighing 22-30 kg, were randomly divided into two groups: MODS group and control group. Double-hit method including hemorrhagic shock and endotoxiemia was used to establish the porcine MODS model. The peripheral vein blood samples were collected at different time-points (before bloodletting, before endotoxin injection, 1 h, 24 h,48 h and 72 h after endotoxin injection) in the two groups. The spleen samples were collected after death of the animals. Plasma levels of IFN-γ and IL-4 were detected by enzyme-linked immunosorbent assay (ELISA). Real-time PCR was used to detect the expression of IFN-γ, IL-4, T-bet and GATA-3 mRNA (The latter 2 were the key transcription factors associated with Th1/Th2 response) in the spleen samples. Results: The plasma levels of IFN-γ and IL-4 quickly reached the peak values 1 h after the endotoxin injection, then the level of IFN-γ decreased quickly. The ratio of IFN-γ/IL-4 was significantly lower than the baseline value 72 h after endotoxin injection(P = 0.000). The ratio of IFN-γ/IL-4 mRNA in MODS group was obviously lower than that in the control group (P = 0.020); the ratio of T-bet/GATA-3 was also lower in MODS group (P = 0.038). Conclusion: The shift from Th1 to Th2 occurs in the progress of MODS.

Objective To report the medium-term follow-up results for deep venous thrombosis(DVT) after total knee arthroplasty(TKA).Methods Between July 2003 and March 2004,55 patients(63 knees)who had had TKA were followed up for DVT.In follow-ups 1 to 2 weeks after TKA,their clinic symptoms,Doppler ultrasonograms and venograms were analyzed.In the following out-patient follow-ups done at every six months,we observed their clinic symptoms and Doppler uhrasonograms for the operated lower extremity.Venography was done only for those who had severe DVT symptoms.Results The venography one week after TKA conformed that DVT occurred in 34 patients(41 knees,61.8%).Two weeks after operation,DVT vanished in 12 cases,but deterio- rated to the proximal part in two cases.The follow-ups averaged 36.6 months(range,32 to 40 months).The results at five time points showed that the incidence of DVT did no decrease with lapse of time(P＞0.05).Conclusion No matter whether DVT occurs in the perioperative period,incidence of DVT in the medium term varies little.

Aim To further investigate the protective effect and mechanisms of total paeony glycoside (TPG) on apoptosis in experimental myocardial ischemic rats.Methods The myocardial ischemic model of rats was established by subcutaneous injection of isoprenaline (ISO), and early apoptosis rate of myocardial cells and the expression of apoptosis related genes Bax, Bcl-2 and proteins in myocardial tissues were analyzed and contrasted among five groups, including normal control, ISO injury, TPG prevention and treatment, TPG treatment and positive control.Results Compared with ISO injury group, all of indexes had improved in various degrees in TPG prevention and treatment group and TPG treatment group, such as the decrease of early apoptosis rate,expression of Bax gene and protein, the increase of Bcl-2 gene and protein and the ratio of Bcl-2 protein/Bax protein.Conclusion TPG has protective effect on apoptosis in ischemic myocardium induced by ISO.The pharmacological mechanism may relate to the activation of the Bcl-2 gene and protein expression, the inhibition of Bax gene and protein expression, as well as the increase of Bcl-2/Bax ratio.

Objective:To investigate the in vivo absorption kinetics of caffeine at different intestine segments in rats.Methods: The rat intestine was cannulated for in situ recirculation.The absorption kinetics of caffeine,including the absorption segments of intestine,drug concentration and pH value,were investigated in all the rats under light anesthesia.Ultraviolet light spectrometry and high-performance liquid chromatography were used to determine the concentrations of phenol red and caffeine,respectively.Results: The absorption rate constants(Ka) of caffeine in the small intestine at the concentrations of 2.5,5,10 and 25 mg?L-1 were 0.252,0.247,0.304 and 0.232 h-1,respectively.The Ka values at pH of 7.8,6.8,and 5.4 were 0.267,0.274 and 0.247 h-1,respectively.The Ka values in the duodenum,jejunum,ileum,and colon were 0.112,0.099,0.095 and 0.069 5 h-1,respectively.Conclusion: Concentration and pH value have no obvious effect on the absorption kinetics of caffeine.Caffeine can be better absorbed in the duodenum,jejunum and ileum than in the colon.The absorption of caffeine in the intestine is a first-order process through passive diffusion mechanism.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cluster Analysis ; Diagnosis, Differential ; Female ; Humans ; Liver Diseases ; classification ; epidemiology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Yang Deficiency ; classification ; epidemiology ; Yin Deficiency ; classification ; epidemiology

Objective To observe the postoperative changes of diplopia and eyeball movement disorder in patients with orbital fracture. Methods The clinical data of 62 patients with reconstructive surgeries for orbital fracture were retrorespectively analyzed.The position,range of fracture and incarceration of extraocular muscles were determined by CT scanning.The eyeball movement and diplopia were examined and recorded pre-operation,3,6 and 12 months after operation,respectively. Results Among the 62 cases,23 were simple orbital wall fracture and the other 39 were complex orbital fracture.Eighteen of the patients with simple orbital wall fracture had diplopia and 19 had eyeball movement disorder of Ⅰ degree or Ⅱ degree before operation.Twelve months after operation,5 had diplopia ofⅠ degree or Ⅱ degree,and 5 had eyeball movement disorder of Ⅰ degree.For those with complex orbital fracture,36 had diplopia and 38 had eyeball movement disorder.Twelve months after operation,29 had diplopia(III degree diplopia in 6) and 22 had eye movement disorder.Among the 12 patients with complex orbital fracture who received operation within 3 weeks after trauma, only one had III degree diplopia,while 5 of the 23 with complex orbital fractures repaired 3 months after trauma had III degree diplopia. Conclusion Surgical management can effectively improve diplopia and eyeball movement disorder resulted from orbital fracture.Earlier treatment is superior to later treatment in regard with the effect of surgical intervention.

Background Cystoid macular edema (CME) is a manifestation secondary to multiple fundus diseases and often leads to the decline of visual acuity.Optical coherence tomography (OCT) is a common diagnostic method for CME,but it can not reflect the metabolism information of retinal pigment epithelium (RPE).Shortwave autofluorescence (SW-AF)may find the abnormality of macula,but its clinical value remains to be confirmed.Objective This study was to investigate the value of SW-AF in the diagnosis of CME.Methods One hundred and eighty-nine eyes of 140 patients who have the relative diseases to CME or received intraocular surgery were included from May 2010 to August 2011 in Lihuili Hospital of Ningbo city.SW-AF,infrared autofluorescence (IRAF),fundus fluorescein angiography (FFA) and OCT were performed in all the eyes under the informed consent of each patient.The sensitivity,specificity and other indicators in diagnostic test of SW-AF for CME were evaluated and compared with OCT.Results SW-AF had certain accuracy in diagnosis of CME with the sensitivity 78.29％,specificity 96.67％,Youden index 0.75,positive predictive value 98.06％,negative predictive value 67.44％.The area under curve (AUC) of SW-AF for the diagnosis of CME was 0.875 with the 95％ confidence interval (CI) 0.823-0.926 (P＜0.001).Compared with OCT,the differences of SW-AF and IR-AF in the diagnosis for CME was statistically significant(x2 =22.53,91.35,both at P＜0.001),and agreement coefficients of diagnosis result between SW-AF、IR-AF or FFA and OCT were 0.67,0.12 and 0.85.Conclusions SW-AF can be used as a new rapid,non-invasive,ancillary technique in diagnosis of CME with certain accuracy,and the diagnostic agreement of SW-AF with OCT is lower than FFA but is higher than IR-AF.

0.05) for the index of renal function(Cr-s,UA,UREA).The patients treated by general low protein diet had worse nutrition state and worse compliance than those before treatment.Better nutrition state and better compliance were found in personal diet group.Conclusion: The personal diet model should be used to the patients basing on the different conditions.

Objective To compare the analgesic efficacy and safety of the sole local anesthetic ropivacaine with the combination of both local anesthetic ropivacaine and opioidergic analgesic sufen-tanil given epidurally on the labor pain control.Methods After institutional review board approval and patient consent,a total of 481 nulliparas requesting epidural labor analgesia were randomized into two groups:a sole local anesthetic group (0.125% ropivacaine,group R)and a combination of local anesthetic and opioidergic analgesic group (0.125% ropivacaine+0.3 μg/ml sufentanil,group RS). Analgesic efficacy was measured using numerical rating scale (NRS)of pain and maternal visual ana-logue scale (VAS)analgesia satisfaction with regard to the first and the second stage of labor.Anal-gesic safety was measured with the Bromage scale of maternal safety and epidural labor analgesia re-lated side effects,as well as fetal safety including Apgar scoring and umbilical cord artery blood gas a-nalysis.Results A total of 346 participants completed the study,with 1 64 and 182 women in each group R and RS,respectively.The median NRS pain score during the first stage of labor was signifi-cantly lower in the combination group (2.2,IQR:1.8-2.7 )comparing to the sole local analgesic group (2.4,IQR:2-2.8)(P <0.001).No significant difference was observed in NRS pain score dur-ing the second stage of labor.Patients in both groups were rated the same VAS satisfaction of analge-sia.Patients in the sole local analgesic group experienced fewer side effects than those in the combina-tion group (37.7% versus 47.2%,P =0.082).The incidence of 1-min Apgar≤7 was lower in the sole local analgesic group 2 (1.2%) than the combination group 10 (5.5%) (P < 0.05 ). Conclusion The sole local anesthetic ropivacaine produces a comparable labor analgesic effect as the combination of both local anesthetic ropivacaine and opioidergic analgesic sufentanil but the former has less maternal side effects,and less incidence of lower 1-min Apgar scoring.

Automobile Driving ; China ; Humans ; Seat Belts ; utilization