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 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 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.