Objective To study the influence of intraoperative use of saline and balanced salt solution on postoperative nerve function recovery in patients with brain trauma.Methods Totally 120 patients were randomly divided into the saline group and the balanced salt solu-tion group,and the postoperative nerve function recovery of the two groups were observed.Results The level of pH and HCO3 -24 hours af-ter operation in the saline group were lower than those in the balanced salt solution group (P <0.05),while the level of Cl - in the saline group was higer than that in the balanced salt solution group (P <0.05).The intracranial pressure and preoperative Glasgow coma score (GCS)of the two groups had no statistical significance (P =0.94).And the Glasgow coma score at 336 hours and 672 hours after opreation of the two groups were of statistical significance (P =0.00,P =0.03).The mortality of the saline group and the balanced solution group 28days after surgery were 15% and 10% respectively,and there was no significant difference between the two groups (P =0.58).Conclusion Saline resuscitation during surgery would lead to hyperchloremic acidosis as well as worse nerve function.However,the perfusion of balanced salt solution during the operation is more favorable to the recovery of neurological function.

Objective To study the clinical efficacy and safety of clopidogrel combined with aspirin in doub-le loading dosage and ordinary dosage in the treatment of acute non -cardiac cerebral infarction.Methods A total of 110 patients with acute non -cardiac infarction were equally assigned into two groups,each group had 55 patients.The patients in group A were treated with clopidogrel 300mg and aspirin 300mg on the 1st day,and followed by clopidogrel 75mg and aspirin 100mg every day.Patients in group B were treated with clopdogrel 75mg and aspirin 100mg every day.Clinical efficacy and safety were evaluated in one week,NIHSS scores were evaluated,and adverse effects were recorded during treatment.Results After one week treatment,the deteriorate rates of group A and B were 12.7%, 18.2%.Compared with group B,group A had lower cerebral infarction deteriorate rate,but there was no statistically significant difference(P =0.429).After seven days treatment,the NIHSS score of A group had improved[(4.42 ± 3.34)points vs.(3.15 ±2.58)points],the difference was statistically significant(t =3.713,P <0.01 ),which in group B had no significant improvement[(4.16 ±2.76)points vs.(3.80 ±3.15)points,t =1.209,P =0.232].After seven days treatment,the NIHSS score improvement of group A was (1.27 ±2.54)points,which of group B was (0.36 ±2.23)points,the difference was statistically significant(t =1.994,P =0.049).No severe adverse effects occurred in both two groups.Conclusion Using clopidogrel combined with aspirin in double loading dosage may effectively attenuate stroke process and improve prognosis than ordinary dosage.Using clopidogrel combined with aspirin had no severe adverse effects in short -term treatment of acute non -cardiac cerebral infarction.

Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.

Objective To observe the effect of Huoluojiangu Capsule(HJC) on anti-inflammatory experiment.Methods The anti-inflammatory experimental models were established in three kinds of rats with pleuritis,the swellen sole of the foot and the PGE_2 content in inflammatory tissues,respectively.Results The swollen reaction in the sole of foot in rats induced by egg white was lessoned with the treatment of low,middle and high dosage of HJC.Compared with the blank control group,the treatment is effective in low dosage group and evidently effective in groups of middle and high dosage after 30 min(P0.05),respectively.Compared with the blank control group,the effect of HJC on the PGE_2 content in the inflammatory tissues of middle and high dosage groups was significant(P

Objective To investigate the value of the expression of Adenosine Triphosphate (ATP) binding cassette transporter A1 (ABCA1),peroxisome proliferator activated receptor γ(PPARγ) and sterol regulato-ry element binding protein (SREBP),adiponectin (ADPN) and liver X recepto α(LXRα) in type 2 diabetic pa-tients.Methods 71 patients with type 2 diabetes received in the hospital from June 2015 to June 2017 were se-lected as the observation group,and 60 healthy persons who underwent the health assessment from June 2015 to June 2017 were selected as the control group.Peripheral venous blood was collected from patients with an empty stomach in the morning,serum was isolated and serum human ADPN content were measured by radio-immunoassay.The levels of serum ABCA1,PPAR γ,SREBP and LXR α were measured by Enzyme linked im-munosorbent assay.Results The serum levels of ABCA1 and ADPN in the observation group were lower than those in the control group,while serum PPARγ SREBP and LXRα levels were higher than those in the control group (P< 0.05);the diagnostic sensitivity and specificity of ABCA 1+ PPARγ+ SREBP+ ADPN + LXRα were higher than those of single detection of ABCA1,PPARγ,SREBP,ADPN and LXRα.Conclusion The levels of ABCA1 and ADPN decreased in patients with type 2 diabetes,while the levels of PPAR γ,SREBP and LXR α was increased.The five joint diagnosis of ABCA1+ PPAR γ+SREBP+ADPN+LXR α has high sensitivity and specificity.It was of important clinical value and worth further application.