Objective To investigate the application of anesthesia methods and clinical experience in treatment of severe traumat-ic shock .Methods 48 severe traumatic shock patients were randomly divided into two groups by different anesthesia treatment ,in-cluding delayed resuscitation group (A group) and routine group (B group) ,24 cases in each group .Results Patients completed operation as expected with stable vital signs in the operation .Patients completely awaked and recovered the spontaneous respiration after 3~4 hours .4 cases in group A (16 .6% ) and 12 cases in group B (50% ) were died .The mortality of group A was significant-ly lower than that of group B (P<0 .05) .Conclusion The appropriate anesthetic managements for the severe traumatic shock pa-tients could maintain the function of each organ ,create favorable conditions for operation ,and improve the survival rate of critical patients .

The clinical medical work is accompanied with high risk .The medical treatment risk exists everywhere at anytime, but the graduate students of the Medical colleges lack the understanding of the hygiene laws. Therefore it is necessary for them to accept the education of hygiene law.

Aim Toexplorewhether1-methylhydan-toin(MH)could inhibit the basal secretion of growth hormone (GH ) and suppress the promoting effect of growth hormone-releasing hormone (GHRH ) in rab-bits.Methods Thirty-sixrabbitswererandomlydi-vided into six experimental groups according to the kind of dosing drugs,namely normal saline group(A), MH group (B ),octreotide group (C ),GHRH group (D),GHRH +MH group(E),GHRH +octreotide group(F),with 6 rabbits in each group.Blood was sampled (1. 0 mL each time)from each rabbit before injecting drugs and 5,15,30,45,60 min after drug administration.Clotting spontaneously,rabbits blood samples were centrifugated for 20 minutes at approxi-mately 1000 ×g and the supernatant was collected. Serum GH concentrations were determined by enzyme linked immunosorbent assay kit(ELISA Kit).Mean-while,the behavior of rabbits in each group after injec-tingdrugswascloselyobserved.Results TheGH level of rabbits in group A at each time point had no significant differences(P>0. 05 ).Group B and group C rabbit GH levels were significantly lower than those of group A (P<0. 05 ),while GH levels in group D were obviously higher than those of group A (P <0. 05 ).Compared with group D,rabbit GH levels in group E and group F decreased markedly(P<0. 05 ). No obvious toxic and side effects had been observed within one week after the experimental rabbits were ad-ministered corresponding drugs by intravenous injec-tion.Conclusions 1-methylhydantoincouldinhibit the basal secretion of GH in rabbits.1-methylhydan-toin could suppress the promoting effect of GHRH in rabbits.

Objective To study effect of etoricoxib on IL-1βand TNF-αin patients with gouty arthritis.Methods 86 patients with gouty arthritis from July 2014 to July 2016 in our hospital were selected, all patients were divided into study group and control group according to the treatment method with 43 cases in each group.The patients in the control group were treated with diclofenac sodium, the patients in the study group were treated with etoricoxib.The clinical symptoms, clinical treatment effects, VAS score, serum IL-1β, TNF-αlevels and adverse reactions were observed and compared between the two groups.Results The VAS score, the joint swelling score and the mobility limitation score of the study group were decreased than before treatment and significantly lower than those of the control group, the difference was statistically significant (P<0.05).The effective rate of the study group (95.35%) was significantly higher than that of the control group (79.07%), the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups were significantly lower than before treatment and the levels of IL-1βand TNF-αin the study groups were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of etoricoxib in treating patients with gouty arthritis is significant, which can effectively relieve the clinical symptoms, inhibit the expression of IL-1βand TNF-α, and the adverse reactions less.

Though lack of definite evidences,closed suction drainage after arthroplasty is routinely employed by the majority of orthopaedic surgeons with the aim of preventing the formation of wound haematoma,reducing delayed wound healing and the risk of deep infection.But the optimal time to remove drains is controversial.The usual time to remove drains is 48~72 h after operation when the volume of drains is less than 50ml within 24 h.But some scholars find that the time of draining more than 24 h increases the risk of wound infection.This paper reviews the literature of draining time,and concludes that the optimal time to remove drains is 24 h after the primary arthroplasty.

Aim To investigate the effects of bradykinin preconditioning on the damage produced by focal cerebral ischemia-reperfusion in rats.Methods Rats were scheduled to undergo middle cerebral artery ischemia-reperfusion by intraluminal suture.Prior to ischemia,bradykinin was pumped into the brain via extra carotid artery and control group was given the same amount of normal saline.The infarct volume、brain water content、permeability of blood brain barrier and histological neuronal changes were evaluated after 2 h ischemia and 24 h reperfusion.Results Compared with other groups, bradykinin preconditioning 15min before ischemia reduced infarct volume、brain edema、permeability of blood brain barrier and histological neuronal damage.Conclusion Bradykinin preconditioning may provide protective effects against cerebral ischemic injury.This protection may be due to the protection of cerebral vasculature and the decrease of infarct volume.

Objective To investigate the effects of apolipoproteinA1 (apoA1) on levels of cholesterol, cholesteryl ester (CE), and expression of ATP-bindiag cassette transporter A1 (ABCA1) in human acute monocytie leukemia cell line (THP-1) macrophage-derived foam cells.Methods The cultured THP-1 cells were induced into foam cells by exposing first to phorbol myristate acetate (PMA, 50 ng/ml) for 48 h, and then to oxidized-low density lipoprotein (ox-LDL, 50μg/ml) for 48 h.Under treatment of apoA1 in different doses (5, 10, 15 and 20 μg/ml) and one simple dose (10 μg/ml) for different time (6, 12 and 24 h), THP-1 macrophage-derived foam cells were incubated to observe the expression of cholesterol and ABCA1.The concentrations of cellular total cholesterol (TC), free cholesterol (FC) and CE were determined by oxidization enzymatic methods.Oil red O dyeing experiment was used to show the cellular lipid droplets in the cells.The expression of ABCA1 was tested by immunofluorescence method.Reverse transcription-polymerase chain reaction was applied to investigate mRNA expression of ABCA1.Results The THP-1 cells turned into typical foam cells after treated with PMA (50 ng/ml) for 48 h, and ox-LDL (50 μg/ml) for 48 h.apoA1 could lower the levels of TC, FC and CE in THP-1 macrophage-derived foam cells in a dose-dependent and a time-dependant manner, apoA1 could increase the expression of ABCA1 protein in THP-1maerophage-derived foam cells without up-regulation of mRNA.Antibody of ABCA1 could up- regulate the expression of ABCA1.Conclusions apoA1 may decrease the levels of cholesterols in THP-1 macrophage-derived foam cells, by promoting the expression of ABCA1 and the reverse cholesterol transport of high density lipoprotein.

Objective To explore the correlation between B lymphocyte activation and CD154 expression and lupus anticoagulants (LAC) in patients with systemic lupus erythematosus (SLE). Methods Sixty newly diagnosed SLE patients (SLE group) and 32 healthy controls (control group) were involved. The expressions of CD27 and CD154 in peripheral blood were determined by flow cytometry, and the positive expression rates were computed. The LAC was determined by activated partial thromboplastin time, and the LAC ratio > 1.20 was positive. Results The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE group were significantly higher than those in control group: 0.047 ± 0.021 vs. 0.035 ± 0.014, 0.387 ± 0.185 vs. 0.214 ± 0.091, 0.191 ± 0.108 vs. 0.101 ± 0.081 and 0.049 ± 0.018 vs. 0.022 ± 0.012, and there were statistical difference (P<0.05 or <0.01). Among patients with SLE, the LAC positive was in 28 cases, and the LAC negative was in 32 cases. The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE patients with LAC positive were significantly higher than those in SLE patients with LAC negative: 0.055 ± 0.023 vs. 0.037 ± 0.014, 0.444 ± 0.179 vs. 0.329 ± 0.123, 0.218 ± 0.101 vs. 0.158 ± 0.044 and 0.058 ± 0.035 vs. 0.020 ± 0.009, and there were statistical differences (P<0.05). Conclusions The B lymphocyte activation and CD154 abnormal expression correlates with generation of LAC in patients with SLE. It provides a basis for the further study on intervening the generation of LAC and reducing the risk of thromboembolism.

Objective To study the Val247Leu and Trp316Ser polymorphisms of β2-glycoprotein Ⅰ(β2GPⅠ) in systemic lupus erythematosus (SLE) patients and their associations with antiphospholipid antibodies and thrombotic complications.Methods We used DNA sequencing to detect the polymorphisms of Val247Leu and Trp316Ser in 378 SLE patients and 240 normal controls.Anti-β2GP Ⅰ antibodies and anticardiolipin (ACA) were tested by enzyme linked immunosorbent assay (ELISA).Lupus-type anticoagulants(LAC) was performed by diluted Russell's Viper Venom Test.Then the patient group was further analyzed according to APLs (Anti-β2GP Ⅰ antibody,LAC and ACA),thrombosis and obstetrical complications using Logistic regression analysis to confirm whether there are associations between β2GPⅠpolymorphism and those factors.Results For Va1247Leu,the predominant genotype was LL in healthy controls which accounted for 57.08％,while it was VL in SLE patients which accounted for 59.5％ (x2=45.01,P=0.000).Frequency of VV genotype was significantly higher in patients with thrombosis,anti-β2GP Ⅰ,ACA and obstetrical complications (OR=6.79,3.75,2.12 and 3.85,respectively;P=0.000,0.001,0.044 and 0.017,respectively).Those patients with VL genotype tended to have positive anti-β2GPI,LAC,ACA,thrombosis and also obstetrical complications (OR=2.95,1.88,2.47,2.97 and 2.74,respectively;P=0.000,0.007,0.000,0.001 and 0.016,respectively) than those negative ones.The predominant genotype of Trp316Ser was TT,then TS.No correlations could be found between Trp316Ser polymorphism and APLs,neither relation to thrombosis complications.Conclusion The polymorphism of Val247Leu is significantly associated with the presence of APLs,thrombosis and obstetrical complications.Both VV and VL genotype are risk factors for the generation of APLs,occurrence of thrombosis and obstetrical complications.The VV genotype is a high risk factor for thrombosis.Trp316Ser polymorphism does not contribute to the APLs production and also have no correlations with thrombotic complication.

Objective To explore the role of Foxp3+ T cells (Tregs) in liver injury induced by chronic intermittent hypoxia. Methods Thirty-two male Wister rats were divided into four groups:control group (A), high-fat diet group (B), intermittent hypoxia group (C), and high-fat diet and intermittent hypoxia group (D). After 4 weeks, blood samples were collected and livers were surgically removed. Using the standard automatic clinical analyzer to test serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL- C), alanina aminotransferase (ALT) and aspartato aminotransferase (AST). The MDA content of liver tissue was measured by colorimetrc method. The levels of TNF-αand IL-1βwere measured by radiommunoassay, and the expression of Foxp3 protein was measured by Western blotting technique. Results Serum levels of TC and LDL-C were significantly higher in B group than those of A, C and D groups, and which were higher in D group than those of A and C groups (P<0.05). There were no significant differences in serum levels of TC and LDL-C between A group and C group. Serum levels of ALT, AST, MDA, TNF-αand IL-1βwere significantly higher in C group than those of A group, and which were significantly higher in D group than those of A, B and C groups (P<0.05). There were no significant differences in these indicators between A group and B group, and between B group and C group. Foxp3 protein expression in liver was significantly lower in D group than that of other groups (P<0.05). Conclusion Foxp3+T regulatory cells involve in the regulation of hepatic injury induced by chronic intermittent hypoxia on the basis of a high-fat diet, and which may play an important role in this process of protective immune response.