This paper recommends the quantitative determination of endotoxin in PVC disposable transfusion set by limulus test for the first time in our country. The data obtained can act as reference material for eontroling the quality of the transfusion set. The p-nitroaniline staining combined with spectrophotometry was used in this study. The precision, sensitivty and repetition rate of this method were satisfactory. We conclude that this method is an ideal one for quantitatively determining endotoxin in PVC transfusion set.

One hundred patients were diagnosed with cervicalspondylotic radiculopathy definitely by symptoms, signs and X-ray examination. The therapeutic method was acupuncture of Jiaji(Ex-B 2) on the affected segment and the upper and lower vertebrae close together. After the arrival of qi, the needles were connected to acupuncture therapeutic instrument. Meanwhile, the numb, heavy and uncomfortable area on the shoulder and upper limb, where something like cord could be touched, was selected as Ashi point. The needle was inserted perpendicularly into the skin on the place that the cord was most obvious and inserted obliquely and deeply along the cord. After 3-4 courses of treatment, 90 cases got marked effectiveness and 10 cases got effectiveness.

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in patients undergoing lumbar surgery in prone position.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 45-90 kg,scheduled for lumbar surgery in prone position,were randomly divided into 2 groups (n =30 each) using a random number table:pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V).Anesthesia was induced with dexamethasone 10 mg,etomidate 0.3 mg/kg,sufentanil 0.4 μg/kg,and rocuronium 0.6 mg/kg and maintained with propofol 2-4 mg· kg-1 · h-1,remifentanil 6-10 μg· kg-1 · h-1 and vecuronium 0.08 mg· kg-1 · h-1.The i-gel laryngeal mask airways were inserted after induction and the patients were mechanically ventilated.A gastric tube was inserted through the drain tube of i-gel.The maximum inspiratory pressure was adjusted to reach the tidal volume (VT) of 8 ml/kg in group P and the VT was set at 8 ml/kg in group V.PTrCO2 was maintained at 30-40 mm Hg.The mean airway pressure (Pmean) and peak airway pressure (Peak) were recorded immediately after insertion of i-geal (T0),immediately after the patients were turned to prone position (T1),immediately before skin incision (T2),30 min after the beginning of surgery (T3),immediately after the end of surgery (T4) and immediately after the patients were turned to supine position (T5).While dynamic lung compliance (Cdyn) was calculated.Arterial blood samples were taken at the same time points for blood gas analysis.Oxygenation index (OI) and respiratory index (RI) were calculated.Results Compared with group V,Pmoan and Ppeak were significantly decreased at T0-5,Cdyn and OI were increased,and RI was decreased at T1-4 in group P (P ＜ 0.05).Conclusion Compared with volumecontrolled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy and reduce prone position-induced effect on respiratory function in patients undergoing lumbar surgery.

Objective To investigate the treatment of proximal femoral nail antirotation (PFNA) in pertrochanteric hip fractures with unstable lateral-wall.Methods Thirty-two cases were included from the April 2009 to May 2011.Recorded operation period,blood loss volume,and complications and evaluated the effect of the methods.Arrange referral at 6 weeks,3 months,6 months,12 months respectively after operation,to check limb function and conventional camera hips,lateral X-ray film.Postoperative functional evaluation using the Harris hip score.Measure the last follow-up neck shaft angle and compare with postoperative's.Results The average operation period was (60-190) min,average was (80 ± 5) min ; blood loss volume was (90-250)ml,average was (120 ± 9) ml ; Average hospital periods was (15 ± 7) days; weight loading time was (6.3 ± 1.2)weeks after surgery and average time of union of fracture was 3.6 months.All patients obtained union of fracture without complications such as varus,internal fixation cutting out.Conclusion PFNA was proved to be an effective way for treating unstable lateral-wall of pertrochanteric hip fractures due to its advantages of stable fixation,minor trauma,less complications.

Objective To investigate the effects of radix salvia miltiorrhizae on the apoptosis of hepatoeytes during cold preservation and reperfusion injury in rat donor liver. Methods Forty male SD rats were divided into experimental group, control group and sham operation group. The rat model of liver transplantation was established according to the Kamada method. The grafts were preserved in lactated Ringer's solution with radix salvia miltiorrhizae in experimental group and in lactated Ringer's solution in control group for 5 hours, then they were transplanted orthotopically. Six hours after transplantation, the recipients were sacrificed, and the serum ALT and AST were detected by automatic biochemistry analyzer, the hepatocyte apoptosis by TUNEL, the expression of Bcl-2 and FasL protein by flow cytometry. The histopathological changes of the liver grafts were observed under light microscope. Results The levels of ALT and AST in the experimental group were significantly lower than those in the control group after reperfusion. Compared with that in the control group, the apoptosis index of the hepatoeyte was signifieandy decreased in the experimental group ( F = 133.802, P <0.05 ), while the level of Bel-2 protein expression was increased ( F = 91.063, P < 0.01 ). No statistical difference upon FasL protein expression was detected between the 2 groups( F = 1.329, P >0.05). The histopathological injury of the liver grafts in the experimental group was significantly slighter than that in the control group. Conclusions Radix salvia mihiorrhizae inhibits the apoptosis of hepatocytes by increasing the Bcl-2 protein expression during cold preservation and reperfusion injury, so it has a protective effect on the liver graft against ischemia reperfusion injury.

Objective To investigate clinical value of procalcitonin (PCT ) in guiding treatment of infection in elderly patients with heart failure .Methods A total of 120 cases of elderly patients with heart failure and infection were divided into control group (50 cases) ,receiving conventional anti-infection treatment ,and observation group(70 cases) ,receiving adjusted anti-infection treat-ment based on serum PCT levels .Treatment efficiency ,cost of treatment ,hospitalization duration and other indicators were com -pared between the two groups .Results Effective rate of observation group was 78 .57% ,which was not significantly different with the 78 .00% of control group ( P > 0 .05) .Cost of treatment ,hospitalization duration ,application time of antibiotics ,antibacterial drug costs ,superinfection and mortality were significantly different between the two groups (P< 0 .05) .After treatment ,levels of e-rythrocyte sedimentation rate ,C-reaction protein ,white blood cells and neutrophil in the two groups were significantly improved (P< 0 .05) .After treatment ,C-reaction protein level of observation group was lower than control group (P < 0 .05) .Conclusion PCT based anti-infection treatment could help shorten the treatment time ,reducing treatment costs and improving outcomes ,and might be worthy of clinical application .

Objective To study the effect of chemically synthesized Nogo-66 receptor ( NgR ) specific small interfering RNA ( siRNA) on nerve regeneration and function of newborn rats after hypoxic-ischemic brain damage ( HIBD) . Methods A total of 50 HIBD newborn rats were set up. They were randomly assigned OR allocated into siNgR group ( n=20 ) , normal saline ( NS ) group ( n=20 ) and HIBD group ( n=10 ) . The rats of siNgR group were given intraventricular injection of siNgR and transfection reagents ( 10μl ); the rats of NS group were given intraventricular injection of NS and transfection reagents (10μl);and the rats of HIBD group had no intervention. In addition to these three groups, there is another group, sham-operated group ( n=10 ) . The rats of sham-operated group were sham-operated ( common carotid artery was isolated but not ligated) and did not receive hypoxia-ischemia processing and intraventricular injection. Utilize water maze experiment to analyze the rats' escape time. The levels of NgR and GAP-43 protein in rats' brains were measured by immunohistochemistry and image analysis. Results RT-PCR gel electrophoresis results showed that the NgR cDNA stripe of siNgR group was not obvious, but the stripe of NS group was clear. At the same time, the GAPHD cDNA bands of the above two groups were both clear. There were more NgR positive immune reaction products ( brown particles) in NS group than in siNgR group. The number of GAP-43 positive cells by immunohistochemistry in sham-operated group, HIBD group, NS group and siNgR group was (33. 24±1. 32), (20. 14±1. 24), (18. 73±1. 41) and (28. 06±1. 78), respectively. The number of sham-operated group and siNgR group was greater than HIBD group and NS group ( P＜0. 05 ) . There was no statistical significant difference for the number of GAP-43 positive cells between sham-operated group and siNgR group ( P＞0. 05 ) . Water maze experiment results showed that the newborn rats ' average escape time ( s ) of HIBD group ( 58. 1 ± 10. 3,47. 2±10. 1, 42. 5±7. 6) was obviously longer than sham-operated group (34. 2±5. 6, 25. 7±6. 2, 21. 2±8. 1), and the difference was statistically significant (P＜0. 05). However, the average escape time of siNgR group (37. 5±9. 8, 29. 1±9. 8, 27. 2±9. 3) was obviously shorter than HIBD group and NS group (60. 7±5. 2, 49. 1±9. 9, 45. 3±9. 3), (P＜0. 05). Conclusions Chemically synthesized specific siRNA had the potential to interference the expression of NgR in the brain of newborn rats, and to a certain extent, could promote the nerve regeneration and neural functional recovery of rats.

Objective To compare the clinical outcomes between proximal femoral nail antirotation (PFNA) combined with risedronate sodium and isolated PFNA for the treatment of intertrochanteric fractures in elderly patients.Methods Clinical data of 62 elderly patients with intertrochanteric fracture from January 2011 to April 2013 were prospectively studied.Patients were randomly divided into two treatment groups:risedronate sodium group (the combined PFNA and risedronate) and control group (isolated PFNA).According to AO classification,32 patients in risedronate sodium group (15 males and 17 females,with an average age of 78 years) were divided into type A1 (n=10),type A2 (n=18) and type A3 (n=4).30 patients in control group (13 males and 17 females,with an average age of 77.5 years) were divided into type A1 (n=9),type A2 (n=16) and type A3 (n=5).Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry before and 1 year after operation.The hip joint function was assessed by Harris hip score.Complications and subsequent fragility fractures were evaluated postoperatively.Results 60 patients (30 patients in risedronate sodium group and 30 patients in control group) were followed up for at least one year.All fractures were healed at 6 months after surgery.No significant difference was found between the two groups in BMD in contra-lateral hip before treatment [(-2.58±0.41)kg/m2 vs.(-2.56±0.36)kg/m2,P＞0.05].BMD in contra-lateral hip had significant difference between the risedronate sodium and control groups one year after surgery [(-0.66±0.37)kg/m2 vs.(-1.13 ±0.28)kg/m2,P=0.000].There was no significant difference between the two groups in Harris hip score (P=0.238).During the follow-up,no patient in risedronate group suffered from subsequent fragility fracture after surgery,while lumbar compression fracture occurred in 1 case,distal radius fracture occurred in 1 case,the contralateral hip fractures occurred in 2 cases,postoperatively.Conclusions PFNA treatment combined with risedronate sodium can effectively improve BMD and reduce the risk for refracture,and has a good effect on intertrochanteric fracture in elderly patients.

Objective To study the role of bcl 2 gene expression in human prostate. Methods The level of bcl 2 gene mRNA expression were investigated by in situ hybridization in 11 cases of fetal prostates, 27 cases of adult (specimens obtained from autopsy)and 60 cases of hyperplastic prostates. Results In fetal prostates, positive signals were detected in all epithelial cells of the prostate buds, while in adult and hyperplastic specimens, positive signals were predominantly concentrated to the basal cell layer of the epithelium, with little involvement of the secretory epithelial cells. The expression in hyperplastic prostates was significantly higher than in normal ones and that of the basal epithelial cells was significantly higher than the secretory ones in both the normal prostates and the hyperplastic ones. Conclusions Bcl 2 gene may play an important role in regulating the apoptosis of the basal cells while if plays a secondary role in the secretory cells of the prostate.

Objective To report 44 cases of meta-superior position anorectal malformation in different age therapied by posterior sagittal anorectoplasty(PSARP) operation, and to discuss possibility of one-stage anorectoplasty via posterior sagittal approach in neonate. Methods The clinical data of 44 cases meta-superior position anorectal malformation,which were treated by PSARP,were studied retrospectively. Results Of 44 cases, 15 were treated by colon stoma in neonate, then PSARP was executed after 3～7 months. And the rest 29 cases (9 in neonate and 20 in 2 months～9 years) were operated with one-stage anorectoplasty via posterior sagittal approach. Among 21 children followed from post-operration 6 months to 5 years, 18 cases of defecation clinical score were fineness. Conclusion The curative effects of PSARP in neonate to meta-superior position anorectal malformation is satisfactory. If the neonate is in good condition, one-stage anorectoplasty via posterior sagittal approach could be executed in infant, and favourable defecate function could be remain.