Cerebral smal vessel disease (CSVD) refers to various diseases of brain perforating arterioles, capilaries and venules caused syndrome of clinical, cognitive and pathological manifestation. It is not only the main cause of stroke, but also causes cognitive impairment and dementia. Its pathogenesis is not fuly understood. Many studies have confirmed that endothelial dysfunction plays an important role in the pathogenesis of CSVD. This article review s the relationship between endothelial dysfunction and CSVD in order to provide new ideas for etiology, pathogenesis, and clinical prevention and treatment of CSVD.

Objective:To observe the change of serum and urinary nitric oxide (NO) and the relation between NO and blood pressure in chronic glomerulonephritis (CGN) patients at pre-uremic phase.Methods:The levels of serum and urinary NO - 3/NO - 2 were measured in 92 cases of CGN at pre-uremic phase and 31 normal subjects by chemical colorimetry.Results:The levels of serum and urinary NO - 3/NO - 2 in CGN patients at pre-uremic phase were significantly lower than those in the control group.The levels of serum and urinary NO - 3/NO - 2 of the hypertension group were significantly lower than those of the normal blood pressure group and the control group;furthermore,the levels of urinary NO - 3/NO - 2 of the normal blood pressure group were significantly lower than those of the control group.There was significantly inverse correlation between the levels of serum NO - 3/NO - 2 and mean arterial pressure (MAP),and also there was significantly inverse correlation between the levels of urinary NO - 3/NO - 2 and MAP.Conclusion:In CGN patients at pre-uremic phase,hypertension may be related to the insufficiency of NO.

Objective:To observe the effect of Astragalus membranaceus on serum NO in patients with chronic glomerulonephritis at pre-renal failure phase.Methods:The levels of serum NO 3 -/NO 2 - that can indirectly reflect serum nitric oxide were measured in 92 cases of chronic glomerulonephritis (CGN) at pre-renal failure phase and 31 normal subjects by chemical colorimetry.Renal function,serum NO and urinary protein of patients were examined before and after treatment with or without Astragalus membranaceus.Results:1.The levels of serum NO 3 -/NO 2 - in patients were significantly lower than those in the control group,with the lesions of renal function aggravating,the levels of serum NO 3 -/NO 2 - decreasing gradually.2.Astragalus membranaceus could remarkably increase serum NO 3 -/NO 2 - and decrease urinary protein.Conclusion:In patients with chronic glomerulonephritis at pre-renal failure phase,NO is insufficiednt.Astragalus membranaceus may contribute to the synthesis of NO and the decrease in urinary protein excretion.

Objective:To study the clinical features of serious opioid overdoses and effects of naloxone.Methods:32 cases of serious opioid overdose were involved.All patients were treated with naloxone,the change in consciousness and respiration,cure rate and the interval time,during which naloxone takes effect were observed.Results:Abnormal mental status,substantially decreased respiration,miotic pupils,and hypotension,even the apnea and cardiac arrest were found to be clinical characteristics.Naloxone could quickly reverse the respiratory depression,abnormal mental status,and hypotension.The cure rate was 90.6%.Conclusion:Effects of naloxone on serious opioid overdoses is confirmed,which is worthy of being widely used in clinic.

Objective:To study the influence of hematocrit on the consistency between blood glucose meters and automatic biochemical analyzer for testing blood glucose of peripheral blood and venous blood.Methods: 200 cases of diabetic and non-diabetic patients were selected in our hospital from January 2013 to September 2015, in which 124 cases were diabetics and 76 cases were non-diabetics. All the selected patients were treated with venous blood and peripheral blood glucose testing by the SIEMENS ADVIA1800 full automatic biochemical analyzer and three brand of blood glucose meters (Reiter GM300, Arkray GT-1920, Johnson & Johnson One Touch), comparing their consistency.Results: The hematocrit range was 35.1~51.6%, accounted for 91.0%(182), 25.0~35.0% of patients accounted for 9.0%(18), and average hematocrit was (42.3±4.2). When hematocrit was 35.1~51.6%, the correlation of automatic biochemical analyzer and Reiter GM300 blood glucose meter was high and stable, followed by Arkray GT-1920 and Johnson &Johnson One Touch. When hematocrit was 25.0~35.0%, the correlation of automatic biochemical analyzer and three blood glucose meters were high than hematocrit was 35.1~51.6%. There was no significant difference between SIEMENS ADVIA1800 automatic biochemical analyzer and Reiter GM300 about monitoring the blood glucose results, but there were significant differences between Johnson and Johnson One Touch and Arkray GT-1920.Conclusion: The automatic biochemical analyzer and three blood glucose meters have good correlation. When hematocrit is greater than 35%, the correlation is lower; when hematocrit is less than 35%, the correlation increases.

ObjectiveTo investigate the correlation between microalbuminuria (MA) and vascular dementia (VaD).MethodsThe patients with VaD and the age-and sex-matched controls were enrolled.The urinary albumin/creatinine ratio (UACR) was detected, and MA was defined as UACR 30-300 mg/g.The demographic and clinical data in both groups were compared, and multivariate logistic regression analysis was used to investigate the correlation between MA and VaD.ResultsA total of 45 patients with VaD and 58 inpatient controls without dementia during the same time period were enrolled.There were significant differences in age (82.36±7.68 years vs.78.57±9.46 years;t=-2.183, P=0.031), years of education (10.84±3.59 years vs.13.41±2.03 years;t=4.590, P<0.001), systolic blood pressure (137.11±14.31 mmHg vs.128.57±16.90 mmHg, 1 mmHg=0.133 kPa;t=-2.717, P=0.008), fasting glucose (5.75±1.01 mmol/L vs.5.22±1.25 mmol/L;t=2.344, P=0.021), glycosylated hemoglobin (6.35%±1.10% vs.6.00%±0.66%;t=1.950, P=0.05), and the proportions of hyperlipidemia (64.4% vs.39.7%;χ2=6.229, P=0.013), and positive MA (82.2% vs.25.9%, χ2=32.199, P<0.001) between the VaD group and the control group.Multivariate logistic regression analysis showed that hyperlipidemia (odds ratio [OR] 5.169, 95% confidence interval [CI] 1.243-21.494;P=0.024), fasting glucose (OR 3.090, 95% CI 1.317-7.247;P=0.009), glycosylated hemoglobin (OR 3.951, 95% CI 1.017-8.608;P=0.047) and MA (OR 7.220, 95% CI 1.912-27.266;P=0.004) were all independently correlated with VaD.Conclusions MA was closely associated with the occurrence of VaD.MA, fasting glucose, glycosylated hemoglobin, and hyperlipidemia were the independent risk factors for VaD.

OBJECTIVE:To analyze the risk factors,pathogens and drug sensitivity test of ventilator-associated pneumonia (VAP) in ICU. METHODS:A case-control study was conducted to analyze the clinical data of 190 patients receiving mechanical ventilatory support in ICU. RESULTS:The incidence of VAP in our hospital was 48.4%;elderly patients(>65 years),duration of mechanical ventilation(>5 d),use of corticosteroids,antacid drugs,indwelling stomach tube,and combined use of antibiotics were the risk factors of VAP;among the 162 pathogens,39 were Gram-positive bacteria(24.07%),102 were Gram-negative bacte-ria (62.96%),21 were fungi (12.96%);multi-drug resistance existed in most pathogens. CONCLUSIONS:A variety of factors are closely associated with the incidence of VAP;the main pathogens of VAP are Gram-negative bacteria;the phenomenon of multi-drug resistance is common. Some measures are adopted to decrease the incidence of VAP,such as strengthen monitoring of el-derly patients,to improve their immunity;use hormonal drugs reasonably;shorten the course of mechanical ventilation as much as possible,and plan ventilator removal;elevate the head of the bed and clean the oral for patients receiving gastric canal implantation and enteral nutrition;clean hands in accordance with asepsis principle strictly,and use antibacterials reasonalbly.

AIM: To establish a HSP90 highly expressing cell line and study the effect of high level of HSP90 on cell stress response. METHODS: The recombined plasimid pSmycHSP, which contains the full length DNA coding for human HSP90?, was introduced into mouse fibroblast cell line NIH-3T3 by electroporation after being subcloned, purified and identified by limited enzyme digestion. Screened by G418, the positive clones were selected and identified by immunofluorescence, immunocytochemistry and Western-blotting. NIH-3T3 cells transfected with empty plasmid served as control, hyperthermia(44 ℃, 20 min, 40 min)was used to simulate oxidative stress. The activity of lactate dehydrogenase (LDH) in supernatant and damage of DNA were detected by automatic biochemistry analyzer and flow cytometer separately to analyze the effect of high-level HSP90 on cell membrane and DNA injuries under stress condition. RESULTS: The rising level of HSP90 was shown by immunofluorescence, immunocytochemistry and Western-blotting in HSP90 overexpressing cell line. There was no difference in the leakage of LDH between HSP90 overexpressing cell line and control, but the damage of DNA was more severe at 44 ℃for 20 min in HSP90 overexpressing cell line than control. Compared with control, the above indices were relieved at 44 ℃ for 40 min in HSP90 overexpressing cell line. CONCLUSION: The NIH-3T3 derived cell line, which stably expressed high level of HSP90, was established. The effect of high-level HSP90 on cells is complex at different intensity of stress, and the protection may be shown at more severe stress circumstance.

OBJECTIVE:To establish a HPLC method for determination of the content of ephedrine hydrochloride in compound Baifu pellicle.METHODS:A XTerra RP 18 column was used.The mobile phase was methanol-1%ammonium acetate solution(40∶60).The detection wavelength was215nm.The column temperature was30℃.The flow rate was0.6ml/min.RESULTS:There was good linearity of ephedrine hydrochloride in the range of0.1034?g～4.136?g(r=0.9994,n=3). The average recovery was101.29%(RSD=2.34%,n=6).CONCLUSION:This method is simple,accurate and repeatable,and can be used for quality control of compound Baifu pellicle.

OBJECTIVE:To establish a RP-HPLC method for content determination of Dexamethasone Sodium Phos-phate in Compound Baifu Pellicles.METHODS:A X-Terra RP 18 column was used,the mobile phase was Methanol-0.34%KH 2 PO 4 solution-triethylamine(52∶48∶0.2),detecting wavelength was242nm and the flow rate was0.7ml/min.RE-SULTS:Dexamethasone Sodium Phosphate was in the good linear range when the sample size was between0.0403?g～2.016?g(r=0.9999,n=3).The average recovery rate was99.85%(RSD=3.00%,n=6).CONCLUSIONS:The established method is convenient,accurate,replicable,which can be applied to quality control of Compound Baifu Pellicles.