Objective To investigate the safety and therapeutic effect of intra-carotid infusion with cold sa line in rats with acute focal cerebral ischemia-reperfusion injury.Methods 60 rats were randomly divided into six groups:sham operated group,normal infusion group,stroke group,local hypothermic group,local normothermic group,and systemic infusion group.Brain infarct volume and cerebral water content were analyzed 48 h after ischemia.Neurological deficits were assessed using the mNSS 24 h and 48 h after infarction.Results In the local hypothermic group,brain temperature was reduced to 33 to 34 ℃ within 5 to 10 minutes,and this significantly low temperature maintained to nearly 60 minutes after infusion continued.Physiological variables were not significantly different among each time point (P ＞ 0.05).No significant morphological abnormality was found in brain sections stained with TTC and HE.Animals receiving local cold infusion significantly decreased infarct volume and brain water content compared to stroke group (P ＜ 0.05).Both 24 h and 48 h mNSS in local hypothermic group was significantly lower than those in other groups (P ＜ 0.05).Conclusions Intra-carotid infusion with cold saline can quickly and effectively reduce brain temperature and is a relatively safe cooling method.Local hypothermia significantly reduced brain infarct volume,decreased brain water content and improved neurological functional outcomes after brain ischemia.

Objective To investigate the correlation between the prognosis and the early lactate clearance in patients with postcardiac surgery undergoing cardiopulmonary bypass.Methods The clinical data of 73 patients who underwent postcardiotomy undergoing cardiopulmonary bypass in SuBei Hospital of Jiangsu Provience,from March 2006 to February 2010,were prospectively collected and analyzed.The collection data including:( 1 ) Preoperative factors:including gender,age,diagnosis preoperative,NYHA grade,APACHE Ⅱ score and left ventricular end-diastolic diameter.(2) Operative factors:operation time,block aorta time.(3)Postoperation factors:hemorrhage volume,mechanical ventilation time,and factors of hemodynamics and oxygen metabolism at 6 hour postoperative:heart rate(HR),central venous pressure(CVP),pulmonary capilary wedged pressure( PCWP),cardiac output index( CI),arterial blood lactic acid,6 h lactate clearance,partial pressure of oxygen( PO2 ),mixed venous oxygen saturation ( SvO2 ),oxygen delivery index ( DO2I),oxygen consume index (VO2I),oxygen extraction ratio(O2ext).Patients were divided into survival group,control group,high level of lactate clearance group( lactate clearance rate ＞ 30％ ) and low level of lactate clearance group.Firstly,the data analyzed with process of single variable analysis and some parameters,which showed the significant difference,were sorted out from two groups.Then these parameters were put to the Logistic regression analysis.Consequently,the independent risk factors of death of postcardiac surgery could be found.Results The mortality in high lactate clearance group ( 4.55％ [ 2/44 ] ) was significantly less than the low lactate group (34.48％ [ 10/29] ) ( x2 =11.889,P ＜0.01 ).The single variable analysis had shown that there were significant difference on APACHE Ⅱ score ( [ 16.9 ± 2.9 ] vs [ 19.2 ± 2.6 ],t =2.537 ),left ventricular end-diastolic diameter( [ 53.9 ± 5.6 ] mm vs [ 63.8 ± 4.6 ] mm,t =5.847 ),block aorta time ( [ 101.2 ± 34.2 ] min vs [ 122.7 ±22.7 ] min,t =2.078 ),hemorrhage volume( [464.0 ± 158.8 ] ml vs [ 603.2 ± 159.5 ] ml,t =2.773 ),mechanical ventilation time( [ 22.6 ± 5.1 ] h vs [ 28.8 ± 5.2 ] h,t =3.857 ),arterial blood lactic acid ( [ 3.5 ±1.3 ] mmol/L vs [5.1 ± 1.5 ] mmol/L,t =3.912),lactate clearance ( [38.8 ± 17.4]％ vs [ 14.6 ±9.7]％,t =4.846),and SvO2( [69.1 ±4.2]％ vs [59.2 ±6.9]％,t =5.847) (P＜0.05 or P ＜0.001)between survival group and control group.Multiple regression analysis showed that lactate clearance and left ventricular enddiastolic diameter were the two independent risk factors of death,and the odds ratio(OR) were 7.773 (95％ CI 1.364-44.306,P ＜0.05) and 15.186(95％ CI 2.758-83.162,P ＜0.01).Conclusion Early lactate clearance rate can be used as an important indicator to evaluate the prognosis of patients with postcardiac surgery undergoing cardiopulmonary bypass.

Objective To study the change of levels of IL-6,IL-17,IL-23,IL-8,TNF-α and IFN-γ and their clinical significance on children with different types of Henoch-Schonlein purpura (HSP) Methods The blood specimens of 180 children with HSP as disease group and 30 health children as normal group were collected respectively.Disease group included 30 children at acute stage and 30 at convalescence stage of primary abdominal type,30 at acute stage and 30 at convalescence stage of primary non-abdominal type,30 at acute stage of secondary abdominal type,and 30 at acute stage of secondary non-abdominal type.The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-α and IFN-γ in the two groups were measured by ELISA method for comparison and analysis.Results The plasma levels of IL-6,IL-8,IL-17,IL-23 and TNF-α in disease group were higher than those in the normal group (P＜0.05).Those levels in the children at acute stage and of primary group were also found to be higher than those at convalescence stage (P＜0.05) and of secondary group (P＜0.05) respectively.Comparison of IL-6,IL-8,IL-17,IL-23 and TNF-α between abdominal type and the non-abdominal type had no significant difference (P＞0.05).The plasma level of IFN-γ in disease group was lower than those in normal group (P＜0.05).The levels of IFN-γ in the children at acute stage and of primary group were lower than those at convalescence stage (P ＜0.05) and of the secondary group (P ＜0.05) Comparison of IFN-γ between abdominal type and non-abdominal type had no significant difference (P＞0.05) Conclusions The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-o,IFN-γ show obvious changes in children with HSP,which suggests that the changes of cytokines are associated with the pathogenesis and prognosis of Henoch-Schonlein purpura.

With the intensification of global aging trends,the health needs of the elderly are becoming increasingly prom-inent.As one of the main forces in implementing the Healthy China strategy,medical and health institutions play a crucial role in building a scientific,systematic,and targeted health popularization system to improve the health status of the elderly and delay the aging process.However,medical institutions face numerous challenges in constructing a health popularization system for the elderly.Based on the perspective of aging,this article focuses on the hot and difficult issues encountered by the elderly when see-king medical treatment,pays attention to the blind spots and hot issues in elderly health,explores the importance and construction methods of health popularization systems for the elderly in medical and health institutions,in order to enhance the health aware-ness of the elderly,promote health behavior changes,and ultimately improve the health status and quality of life of the elderly.

OBJECTIVETo compare the neuroprotective effects of intracarotid cold saline infusion (ICSI), ice cap and systemic cooling in rats with early cerebral ischemia.

METHODSSD rats were randomly divided into model group, ice cap group, systemic cooling group and ICSI group (n=13). Cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 2 h. In the 3 hypothermic groups, the target temperature of 33-34 degrees celsius; was achieved and maintained for 20 min. In each group, the neurological scores were recorded at 48 h after the reperfusion, and the brains were removed for measuring the infarct size using 2,3,5-triphenyltetrazolium chloride staining. The brain water contents and serum levels of neuron-specific enolase (NSE), S100β and matrix metalloproteinase 9 (MMP9) were also measured.

RESULTSCompared with the model group, the ice cap, systemic cooling and ICSI groups all showed significantly reduced infarct size by 27.4% (P<0.05), 47.6% (P<0.01) and 61.6% (P<0.01), respectively. The systemic cooling and ICSI groups, but not the ice cap group, had significantly lower brain water contents than the model group (P<0.05). Among the 3 hypothermic methods, only ICSI significantly improved the neurological scores (P<0.05) and reduced serum NSE and S100β levels (P<0.05).

CONCLUSIONOf the 3 hypothermic groups, ICSI has the best neuroprotective effects, and systemic cooling produces better effect than ice cap in rats with ischemic stroke.

Animals ; Brain Ischemia ; therapy ; Cryotherapy ; methods ; Hypothermia, Induced ; methods ; Infusions, Intra-Arterial ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Sodium Chloride ; administration & dosage