ObjectiveTo summarize the treatment of simple renal cysts experience,the advantages and disadvantages of the two surgical options. MethodsRetrospective analysis of 15 cases of renal cysts after general anesthesia in patients with laparoscopic cyst decompression in the clinical data and 21 cases of renal cysts underwent open surgery in patients with clinical data,comparative analysis of advantages and disadvantages of both types of surgery were conducted. ResultsIn this study,14 patients with laparoscopic surgery were successful,1 patient converted to open surgery,laparoscopic surgery in patients with blood loss,postoperative complications and time of staying hospital after operation postoperative hospital stay were significantly less than group of open surgery. ConclusionThe laparoscopic renal cyst decortication was a safe and effective treatment for simple renal cysts,compared to traditional open surgery in patients with trauma,less bleeding postoperative pain,rapid recovery,shorter hospital staying and so on.

Objective To observe blood glucose values and serum insulin levels at different times after acupoint injection of insulin with PVP as a sustained release agent and analyze the correlation between them in SD Rats.Methods One hundred and forty-four male SD rats were randomized into groups A (acupoint injection of insulin alone), B (acupoint injection of sustained-release insulin) and C (control). At one hour after every group received an oral gavage of 40% glucose solution (2.2 g/kg), groups A and B were given point Zusanli injection and group C was not treated. In the three groups of rats, blood glucose values and serum insulin levels were measured at six time points: 0.5, 3, 6, 8, 10 and 24 hours after acupoint injection (in group C at the corresponding time points). In every group, the reaction of Point Zusanli region to the stimulation was observed by optical microscopy in at three time points: 3, 10 and 24 hours after acupoint injection.Results The glucose-lowering rate reached its peak at 3 hours after acupoint injection and then declined in groups A and B. The hypoglycemic effect tended to be stable at 6 hours after acupoint injection in group A and at 10 hours after acupoint injection in group B. The hypoglycemic effect was better in group B than in group A at 6 and 8 hours after acupoint injection (P<0.01). In group A, serum insulin reached its peak at 3 hours and tended to be stable at 6 hours after acupoint injection (P<0.05). Serum insulin levels were significantly lower in group B than in group A at four time pints: 0.5, 3, 6 and 8 hours after acupoint injection (P<0.05). An analysis of the correlation between rat serum insulin levels and the glucose-lowering rate showed a significant positive correlation in group A (P<0.01) and a low positive correlation in group B (P<0.05). In groups A and B of rats, clear stripes and complete structure of muscle fibers were seen with no obvious degeneration, necrosis and inflammatory reaction around point Zusanli at three time points: 3, 8 and 24 hours after acupoint injection; there were no obvious pathological changes compared with group C.Conclusions PVP as a sustained release agent can slow down the absorption rate of insulin in rat point Zusanli region. Meanwhile, it prolongs the continuous time of the hypoglycemic effect of insulin. There is a low correlation between serum insulin levels and the hypoglycemic effect, suggesting that acupoint injection with a sustained release agent can prolong the effect of acupoint injection of medicine.

Objective To observe the inhibition of amikacin in vitro on platelet aggregation and blood coagulation tests, and to study its effects on hemostasis and the related mechanisms.Methods Plateletrich plasma and platelet-poor plasma from donors were mixed with different concentration of amikacin, which was divided into four groups:0 mg/L, 30 mg/L, 91 mg/L and 910 mg/L group.The maximial ratio of platelet aggregation induced by ADP were measured with Platelet Aggregation Analyzer.The expression levels of P-selectin, GP Ⅱ b/Ⅲ a and Fg-R were determined with Flow Cytometer.The PT, APTT, TT and Fg of platelet-poor plasma were detected with Blood Coagulation Analyzer. The four concentration of amikacin mentioned above and two anticoagulants (62.5 U/ml of sodium heparin and 109 mmol/L of sodium citrate)were interacted with fresh whole blood, in which the blood CT and plasma Ca2+ were detected. Blood samples were collected from 10 patients with acute lower respiratory tract infection before and 30 minutes after routine amikcin treatment respectively.The maximial ratio of platelet aggregation, the expression levels of P-selectin, GPⅡ b/Ⅲa and Fg-R induced by ADP were measured; while PT, APTT, CT and plasma Ca2+ were determined.Results At 30 mg/L of amikacin group, the maximal ratios of platelet aggregation (65.8±3.9)%, the expression levels of P-selectin (9.2 ± 1.0)% and Fg-R (12.6 ± 1.7)% were statistically lower than those [(88.0 ±4.6%, (16.1 ± 1.3)% and (31.0 ±2.5)%]at 0 mg/L of amikacin group ( t = 9.442,8.432,9.993,P ＜ 0.01 ).At 30 mg/L of amikacin group, the APTT (80.5 ±6.8) s and CT ( 857 ± 66) s were significantly higher than those [(33.0 ± 3.6) s and (447 ± 35 ) s] at 0 mg/L of amikacin group ( t = 11.312, 13.211, P ＜ 0.01 ). There was a negative correlation between amikacin concentration and maximial ratio of platelet aggregation ( r = - 0.832, P ＜ 0.05 ), but a positive correlation between amikacin concentration and inhibitory rates of platelet aggregation ( r = 0.939, P ＜0.05) was observed, as well as APTT (r ＞0.870, P＜0.05).At 30 mg/L, 91 mg/L, and 910 mg/L of amikacin groups, the P-selectin and Fg-R expression were remarkably inhibited with a dose-dependent manner, the CT was notably enhanced [Fwithin subjects =21.44, 26.24, ( ＞29.81 ), P ＜0.01].At 0 mg/L,30 mg/L, 91 mg/L and 910 mg/L of amikacin groups, the PT values were ( 14.7 ± 1.9) s, ( 15.2 ± 1.7) s,(15.6±1.5) s and (22.1 ±2.1) s, respectively (F=8.21,P＜0.05), but there was no markeddifference for the levels of GP Ⅱ b/Ⅲ a, TT, Fg and plasma Ca2+ among the four groups ( P ＞ 0.05 ).After 30 minutes of amikacin treatment, the maximial ratio of platelet aggregation (51.6 ± 10.1)%, the expression levels of P-selectin (6.8 ± 1.8) % and Fg-R ( 20.1 ± 5.8 ) % were significantly lower than those [(66.8 ± 11.4)%, ( 10.9 ±3.1 )% and (28.5 ±7.4)%] before amikacin treatment, but APTT (49.8 ±5.9) s and CT (660 ±59) s were remarkably higher than those [(26.9 ±3.8) s and (410 ±45) s] before amikacin treatment, respectively ( t = 5.456,8.875,7.423,10.012,11.322, P ＜ 0.01 ), while the GP Ⅱ b/Ⅲ a expression, PT and Ca2+ concentration had no significant changes ( P ＞ 0.05).Conclusions There are inhibitory effects of amikacin on platelet aggregation mainly through the inhibition of both fibrinogen receptor activation and secretion reaction of activated platelet. Amikacin may also inhibit pathway of coagulation system factor to prevent blood coagulation.Therefore, risk of hemorrhage may be investigated in the patients with amikacin for anti-infection treatment.

Objective To evaluate impacts of acute hypervolemic hemodilution (AHH) and intra-operative cell salvage (ICS) with 6％ volume fraction of hydroxyethyl starch (HES) on hemodynamics,blood saving efficiency and renal function of orthopedic surgery patients.Methods A total of 58 patients from orthopedic surgery were involved and randomly divided into AHH + ICS group (30 cases) and control group (28 cases).Changes of hemodynamic indices (HR,MAP and CVP) and renal function indices (BUN,BCr,UCr and ALB) in both groups were compared before operation (T0),immediately after operation (T1) and at postoperative 4 hours (T2),1 day (T3) and 2 days (T4).CCr was counted and intraoperative blood conservation was observed at each time point as well.Results HR,MAP and CVP of the two groups had no significant differences.Both groups showed some drop of HR (P ＜ 0.05),but an increase of MAP and CVP at T1-T4 (P ＜ 0.05),in contrast with levels at TO.BUN,BCr and ALB also showed insignificant differences between groups or within group at each time point.CCr in the control group showed no significant difference at each time point.On the contrary,CCr in the AHH + ICS group had a fall at T1-T4 and was declined to the lowest level at T2.CCr in the AHH + ICS group showed a recovery at T3-T4 and its level at T4 was still lower than that at TO,with no significant difference.CCr in the two groups showed insignificant difference at TO,but its level in the AHH + ICS group was lower than that in the control group at T1-T4,at T2 in particular (P ＜0.01).Moreover,CCr in the two groups was still significantly different at T4 (P ＜ 0.05).Renal function indices of the two groups were all within normal range at each time point.Intraoperative blood loss and unrine volume of the two groups had no significant differences,but intraoperative fluid requirement,allogenic blood transfusion volume and transfusion rate of AHH + ICS group were notably lower than those of control group (P ＜ 0.05 or P ＜0.01).Conclusions AHH plus ICS using HES are safe,effective and promising integrated blood conservation measures,which significantly reduces intraoperative allogenic blood transfusion volume and transfusion rate and has few impacts on fundamental vital signs and renal function.However,prolonged use of large dose of HES may do harm to renal function and therefore should be carefully considered in treatment of patients with severe renal dysfunction.

Objective To observe the in vitro inhibitory effects of brucea javanica oil on human washed platelet and explore the possible mechanism.Methods Human washed platelets were mixed withdifferent concentration of brucea javanica oil which were divided into four groups[untreated control group,negative control group,9.0% of brucea javanica oil group,and 22.5%of brueea javanica oil group].The maximal ratio of platelet aggregation induced by adenosine liphosphate(ADP),arachidonic acid(AA),collagen,and thrombin,respectively,was measured with platelet aggregation analyzer.The expressions of fibrinogen receptor(FIB-R)and P-selectin(CD_(62p))on external membrane of activated platelet were determinated with flow cytometry.The F-actin of cytoskeletal structure in activated platelet was detected by SDS-PAGE.Results At 9.0% of brucea javanica oil,the maximal ratio of platelet aggregation[(57.7±4.0)%,(62.2±3.9)%,(66.9±5.0)%and(71.8±5.1)%]induced by ADP,AA,collagen,and thrombin,was significantly lower than that[(75.3±4.1)%,(79.3±4.8)%,(80.6±5.4)%,(84.1±6.2)%]at negative control(0% of brucea javanica oil)(P<0.01),but makedly higher than that[(39.2±3.5)%,(45.8±3.4)%,(51.2±3.9)%and(56.7±4.8%)]at 22.5%,respectively(P<0.01).The inhibitory rate of platelet aggregation(47.9%,42.2%,36.5%and 32.6%)at 22.5%of brucea javanica oil was notably higher than that(23.4%,21.6%,17.0%and 14.6%)at 9.0%,respectively(P<0.001).There was a negative correlation between brucea javanica oil concentration and the aggregation ratio of platelet stimulated by the four agonists,respectively(r=-0.952,-0.961,-0.970,-0.975,P<0.001).At 9.0% of brucea javanica oil,the expression levels of FIB-R[(64.7±4.0)%]and CD_(62p) [(3.91±0.21)%] of platelet activated by ADP were significantly lower than that[(85.5±4.6)%and (5.05±0.27)%]at negative control,but remarkably higher than that[(36.2±3.9)%and(2.34±0.15)%]at 22.5%,respectively(P<0.01).There was a much higher inhibitory rate of platelet aggregation(57.7%)at 22.5%than that(24.3%)at 9.0%(P<0.01).The ratios(1.68±0.10 and 1.77±0.12)of F-actin photodensity at 22.5%and 9.0%to that in blank control were significantly lower than that(2.22±0.15)at negative control(P<0.01)but there was no statistical difference between the ratios in the group of 9.0%and 22.5%brucea javanica(P>0.05).Conclusions brucea javanica oil has special inhibitory effect on activated platelet and thrombosis in a dose-dependent manner.The mechanism is to inhibit the expression of fibrinogen receptor on external membrane of activated platelet,which is also related to the inhibition of F-actin and secretion of platelet.

Acute respiratory distress syndrome (ARDS) is a serious disease with high mortality, which is characterized by non-cardiogenic pulmonary edema and hypoxemia. In recent years, the development of supportive therapy has reduced the mortality to some extent, however, the high cost of treatment, side effects and the high mortality of moderate and severe ARDS limit its efficacy. So it is necessary to strengthen the research on specific drugs. The core pathological changes of ARDS are the uncontrolled inflammatory response and the impairment of pulmonary vascular endothelium and alveolar epithelial barrier function. Therefore, regulating the intensity of inflammatory response and promoting the endothelial and epithelial barrier have become two key factors in the current drug treatment of ARDS. This article summarizes the pathogenesis of ARDS and the related preclinical drug therapy of ARDS in recent years from two aspects: the uncontrolled inflammatory response and the destruction of alveolar epithelial and pulmonary vascular endothelial barrier, in order to provide reference for the later treatment of ARDS.

A new kind of biosensor for immunology was developed by ultrasonic technique and LB membrane. A double delay-line resonator was made by using ST-cut quartz crystal with working frequency of 149.7 MHz. Then a layer of LB membrane was covered on it. When anti-IgM antibody of various concentrations was added to it, the sensor can be used to detect IgM antigen. The biosensor was highly sensitive, small and light. The experimental results showed that the working frequency change of the sensor was proportional to the concentration of antibody with its dilution ratio between 1:10000 and 1:100. It was also first observed that the frequency curve of the sensor resulting from the reaction of IgM antigen and antibody undulated in the experiment.

A new kind of biosensor for immunology was developed by ultrasonic technique and LB membrane. A double delay-line resonator was made by using ST-cut quartz crystal with working frequency of 149.7 MHz. Then a layer of LB membrane was covered on it. When anti-IgM antibody of various concentrations was added to it, the sensor can be used to detect IgM antigen. The biosensor was highly sensitive, small and light. The experimental results showed that the working frequency change of the sensor was proportional to the concentration of antibody with its dilution ratio between 1:10000 and 1:100. It was also first observed that the frequency curve of the sensor resulting from the reaction of IgM antigen and antibody undulated in the experiment.

Objective To assess the prevalence of metabolic syndrome (MS) and explore the associated risk factors with MS among 35 ～ 80 years elderly people in Changsha.Methods The survey used by cluster random sampling method (from October to December,2008 ) was carried out by the Physical Examination Center of the Second Xiangya Hospital,Changsha.All subjects aged from 35 to 80 years old had the questionnaires,physical examination,and biochemical measurements.MS was defined by IDF 2005.Results The prevalence of MS was 24.3％ among elderly people in Changsha.The prevalence of MS in male and female was 27.9％ and 19.3％,respectively; which in male was significantly higher than in females ( P ＜0.01).According to census of 2000 in Changsha,the age-adjusted rate of MS was 24.4％ among elderly people,27.8％ in male and 21.9％ in female,respectively.The metabolic abnormalities and the prevalence rate of MS were different in gender and age.Except the essential component of the central obesity in the 194 cases of MS patients,there are 80 cases include other two kinds of metabolic abnormalities,accounting for 41.2％,most of them with elevated blood pressure + sugar metabolism disorders; the most common three kinds of metabolic abnormalities of the 78 cases,accounting for 40.2％ of the people with MS,most of them with high TG + elevated blood pressure + sugar metabolism disorders; With 4 kinds of metabolic abnormalities of 36 patients,accounting for 18.6％ of the MS patients.Increasing age,male,overweight and (or) obesity,high LDL-C hematic disease,high uric acid hematic disease,diabetes were all the risk factors of the elderly people in Changsha city.Conclusions Elderly people in Changsha have a relatively high prevalence of MS,especially for male.The prevalence of MS is considerably high in Changsha,which may continue to rising with the social economic development and population aging.There is an urgent need to take actions to reduce the burden of MS.

10.3969/j.issn.1007-3969.2013.04.011