This study was undertaken to compare the effects of acute hemodilution (AH) induced separately by three solutions on blood properties and hemodynamics. Sixty-six patients, ASA grade Ⅰ to Ⅱ, aged 18 to 54 years, having open heart surgery with fentanyl-pancuronium anesthesia, were acted as subjects. During the induction of AH, blood 10-12ml?kg~(-1) was drawn from internal jugular vein in each subject, as Ringer's lactated injection (RL) at equivalent volume was infused intravenously, afterwards, all subjects were randomly allocated to being intravenously infused with RL at a dose of two times as many as the blood volume drawn (BVD) (group RL), Haemaccel 35 (R35) (group H35) or hydroxyethyl starch (Hes) (group Hes) at a dose equal to BVD, respectively. All patients were observed for 30 mins following the status of AH. The results showed that plasma colloid osmotic pressure was descended markedly in these three groups, but more significantly in group RL immediately after induction of AH, and was kept at low level in group H35 and RL and continued to decrease in group Hes during AH. The hemodynamic values of these three groups were within normal range during whole procedures. Prothrombin time and activated partial thrombin time were prolonged in each group, but within normal range. No anaphylactic reactions occured in all subjects. It is suggested that H35 can be applied more safe to acute moderate hemodilution in clinical anesthesia.

Objective To observe the effect of Huanglian Jiedu Decoction ( HJD) for the treatment of dyslipidemia, thus to provide evidence for the prevention and treatment of dyslipidemia with traditional Chinese medicine. Methods A total of 80 dyslipidemia patients were randomized into HJD group ( 50 cases) and simvastatin group ( 30 cases) . After treatment for 4 weeks, blood lipid levels, metabolic parameters and alanine aminotransferase (ALT) levels were detected. Results (1) After treatment, HJD group and simvastatin group both had lower total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol levels (P<0.01 compared with those before treatment), and HJD group had higher high density lipoprotein cholesterol than that before treatment ( P<0.05), but the differences of TC, TG, low and high density lipoprotein cholesterol were insignificant between the two groups ( P>0.05). ( 2) After treatment, uric acid was reduced in HJD group ( P<0.05) , but fasting blood glucose only showed a decreasing trend and the other metabolic parameters stayed unchanged ( P>0.05). The inter-group comparison showed that HJD had lower blood glucose level than simvastatin group, and the difference had statisticall significance ( P<0.05). ( 3) During the treatment, the patients showed good compliance, and had no obvious hepatic or renal damage. Conclusion HJD could reduce TC, TG and low density lipoprotein cholesterol, and increase high density lipoprotein cholesterol of dyslipidemia patients, the effect being similar to simvastatin. HJD could also significantly reduce uric acid of dyslipidemia patients, showing good safety.

AIM: To study and evaluate the changes of two main kinds of voltage-gated K+ currents in human atrial fibrillation (AF) and to discuss the role of these changes in the atrial electrical remodeling (AER) caused by AF. METHODS: Specimens of human atrial appendage were obtained from 36 RHD patients (18 with chronic AF and 18 without AF). Single atrial myocytes were acutely dissociated by tissue chunk enzymatic digestion. I_~to1 and I_~Kur in the two groups were measured respectively with the patch-clamp technique in a whole-cell configuration and the I-V curves were compared. RESULTS: I_~to1 and I_~Kur amplitudes in AF groups were significantly reduced and the current densities of both I_~to1 and I_~Kur in AF patients were lower than those in NAF patients. CONCLUSION: The reduction of I_~to1 and I_~Kur may be related to changes in atrial conduction, refractory period and may constitute two main parts of the major mechanisms in the AER of chronic AF. Whether exists a relation between changes of the above K+ currents and that of other ionic currents and the AF initiation and perpetuation deserves further investigation. [

Objective To evaluate the role of ATP-sensitive potassium (KATP) channel in spinal dorsal horn neurons in hyperalgesia after thoracotomy in rats.Methods Twenty-eight Sprague-Dawley rats,aged 7-9 weeks,weighing 250-350 g,in which intrathecal catheters were successfully implanted without complications on 14th day after chronic post-thoracotomy pain was induced,were randomly divided into 4 groups (n =7 each):control group,the solvent dimethyl sulfoxide (DMSO) group,KATP channel opener pinacidil group (group P) and KATP channel blocker glibenclamide group (group G).10％ DMSO 10 μl,pinacidil 10 μg/10 μl and glibenclamide 50μg/10μ1 were injected intrathecally in groups DMSO,P and G at 5 day after the intrathecal catheter was implanted,respectively.Paw withdrawal threshold to von Frey filament stimulation was measured before intrathecal administration and at 10,30 and 60 min after intrathecal administration and the acetone test was performed.Coldinduced pain threshold was measured.Results There was no significant difference in paw withdrawal threshold to yon Frey filament stimulation at each time point among the four groups (P ＞ 0.05).Compared with C and DMSO groups,cold-induced pain threshold was significantly increased in group P and decreased in group G (P ＜ 0.05).There was no significant difference in cold-induced pain threshold between C and DMSO groups (P ＞ 0.05).Conclusion KATP channel in spinal dorsal horn neurons is involved in the maintenance of hyperalgesia after thoracotomy in rats.

BACKGROUND:Percutaneous vertebroplasty and kyphoplasty are both effective in the treatment of osteoporotic vertebral compression fractures, but different in the distribution and dispersion of bone cement. ＜br> OBJECTIVE:To analyze the factors affecting the bone cement dispersion within the vertebral body in treatment of osteoporotic vertebral compression fracture with vertebroplasty or kyphoplasty. ＜br> METHODS:A total of 41 patients with osteoporotic vertebral compression fractures were included, and divided into three groups:group A (22 cases receiving high viscosity bone cement vertebroplasty treatment), group B (5 cases receiving high viscosity bone cement kyphoplasty), group C (14 cases receiving low viscosity bone cement vertebroplasty treatment). The groups A and C were divided into subgroups according to bone cement injection volume, time from fracture to operation, preoperative degree of vertebral compression. The distribution and dispersion of bone cement in the vertebra were reconstructed by the CT three-dimensional imaging and volume rendering analysis. ＜br> RESULTS AND CONCLUSION:In the three groups, after operation, relative dispersion area and relative dispersion volume in the vertebrae had no obvious difference, and the bone cement could al diffuse to upper and lower lamina cross the vertebral midline. There was no significant difference in bone cement diffusion coefficient among the three groups. In a certain range, the bone cement injection volume and bone cement dispersion volume was positively correlated. In groups A and C, bone cement diffusion coefficient decreased with the increasing of bone cement injection volume, time from fracture to operation, and the compression degree of the fractured vertebrae, but showed no significant correlation with bone cement viscosity.

BACKGROUND:Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but postoperative change of stress in the fractured vertebrae and adjacent vertebrae can lead to new fractures. OBJECTIVE:To analyze the stress changes of the fractured and adjacent vertebrae with different bone cement injection volume by three-dimensional finite element method. METHODS:One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. The osteoporotic vertebral compression fracture model in L2-L4 segments was established after assignment. Bone cement of 1, 2, 4, 6 mL was injected into the L3 vertebrae respectively and distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on L2 surface with an additional moment of 50 N·m. The lower surface free degree of L4 was restrainted. The L2-L4 forward flexion, extension, right flexion and axial rotation on the right side were stimulated to compare the stress changes of fractured vertebrae and adjacent vertebrae before and after the bone cement injection with different volume. RESULTS AND CONCLUSION:The stresses of fractured and adjacent vertebrae after the bone cement injection were significantly increased; meanwhile, the stresses of fractured and adjacent vertebrae increased with the increase of bone cement injection volume, which may be one of the factors leading to the compression fractures of adjacent vertebrae.

We investigated the common diseases in patients from village clinics and compared them to those of the general population in rural areas of Jiangsu Province.We found that the treatment rates of chronic diseases such as hypertension and diabetes mellitus were quite low.Village clinics should play a more active role in health record management,healthcare education,and management of chronic diseases for the farmers.

BACKGROUND:Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but bone cement injection can cause the change of stress in the fractured vertebrae and adjacent vertebrae after surgery, leading to new fractures.
OBJECTIVE: To analyze the stress changes of the fractured vertebrae and adjacent vertebrae after vertebroplasty with different elastic modulus bone cement by a three-dimensional finite element method.
METHODS: One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. An osteoporotic vertebral compression fracture model in L2-4 segments was established after assignment. Bone cement (4 mL) with different elastic moduli (8 000, 4 000, 2 000 and 1 000 MPa) injected into the L3 segment distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on the L2 surface with an additional bending moment of 50 N?m. The lower surface free degree of L4 was restrained. The L2-4 forward flexion, posterior extension, right flexion and axial rotation on the right side were stimulated. The stress changes of the fractured vertebrae and the upper and lower adjacent vertebrae before and after bone cement injection with different elastic moduli were compared.
RESULTS AND CONCLUSION:The stress of the fractured vertebrae and adjacent vertebrae were significantly increased compared with that before operation. With the increase of elastic modulus, the stress of the fractured vertebrae increased, but there were no changes in the stress of adjacent vertebrae. These findings indicate that the elastic modulus of bone cement may be a method to reduce new fractures of the fractured and adjacent vertebrae after bone cement injection.

Objective:To study the clinical efficacy of acupuncture at Zusanli (ST 36)combined with Traditional Chinese Medicine (TCM) enema in the treatment of gastroparesis syndrome after gastrointestinal tumor operation.Methods:A total of 96 patients with gastroparesis syndrome after gastrointestinal tumor surgery in our hospital from June 2016 to May 2021, who met the inclusion criteria, were randomly divided into three groups by random drawing, with 32 in each group. The control group took mosapride citrate tablets orally, the TCM enema group added TCM enema on the basis of the control group, and the combined group added acupuncture Zusanli (ST 36)on the basis of the TCM enema group. All three groups were treated continuously for 4 weeks. The main syndromes were scored before and after treatment. The levels of serum gastrin (GAS), motilin (MTL) and somatostatin (SS) were detected by radioimmunoassay. The gastric electrophysiological parameters (waveform response area, waveform frequency and average amplitude) were detected by intelligent dual channel gastrointestinal electrograph, the adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.9% (31/32) in the combined group, 81.3% (26/32) in the TCM enema group and 68.8% (22/32) in the control group. There was significant difference among the three groups ( χ2=8.72, P=0.013). The scores of abdominal fullness and distention, fatigue, belching acid reflux, dry mouth and bitter mouth in the combined group were significantly lower than those in the TCM enema group and the control group ( F values were 16.39, 13.21, 11.28 and 10.23, respectively, P<0.001). After treatment, the levels of GAS [(140.62±15.19) ng/L vs. (128.79±14.34) ng/L, (115.98±12.40) ng/L, F=21.09], MTL [(268.66±28.21) ng/L vs. (245.89±25.24) ng/L, (230.78±22.43) ng/L, F=30.29] and SS [(70.58±8.17) ng/L vs. (65.50±7.76) ng/L, (59.73±7.05) ng/L, F=33.19] in the combined group were significantly higher than those in the TCM enema group and the control group ( P<0.01). The waveform response area [(172.62±17.14) μV/s vs. (158.56± 15.32) μV/s, (145.48±14.13) μV/s, F=20.24], waveform frequency [(3.86±0.61) cpm vs. (3.29±0.50) cpm, (3.01±0.63) cpm, F=13.17] and average amplitude [(86.51±8.98) μV vs. (75.70±7.93) μV, (68.65±7.46) μV, F=28.11] were significantly higher than those in TCM enema group and control group ( P<0.01). During the treatment period, the incidence of adverse reactions was 18.8% (6/32) in the combined group, 15.6% (5/32) in the TCM enema group and 12.5% (4/32) in the control group. There was no significant difference between the three groups ( χ2=0.47, P=0.789). Conclusion:Acupuncture at Zusanli (ST 36) combined with TCM enema can improve the TCM syndrome scores, gastrointestinal hormone level and gastric electrophysiological parameters of patients with gastroparesis syndrome after gastrointestinal tumor operation, improve the curative effect with safety.

Objective:To analyze the clinical characteristics and treatment of patients with serious interstitial lung diseases (SILD).Methods:The clinical data of 43 patients with SILD hospitalized in the respiratory intensive care unit of the Characteristic Medical Center of The Chinese People's Armed Police Force from January 2010 to December 2020 were retrospectively reviewed. According to the prognosis, the patients were divided into the death group and non-death group.Results:The included 43 patients include 31 cases of acute exacerbation of idiopathic interstitial pneumonia (AE-IIP), 18 cases of usual interstitial pneumonia (UIP) and 16 cases of nonspecific interstitial pneumonia (NSIP), in which 40% were aggravated due to co-infection and 33 patients were dead. The results showed that there was no significant difference between death and non-death patients in age, gender, smoking, hospitalization time, duration, clinical symptoms and signs, blood T lymphocyte subsets, co-infection, mechanical ventilation and glucocorticoid dose (all P>0.05), and there were significant differences in arterial partial pressure of oxygen to the fraction of inspired oxygen (PaO 2/FiO 2) and arterial partial pressure of carbon dioxide (PaCO 2) (all P<0.05). The PaO 2/FiO 2 level in the dead patients was lower, who often accompanied by type Ⅱ respiratory failure. Conclusions:AE-IIP was more common in patients with SILD, and most of their chest images were consistent with UIP and NSIP. Pulmonary infection is a common cause of acute exacerbation of SILD, and type II respiratory failure in the progress of the disease is a sign of poor prognosis.