BACKGROUND: The present study aims to investigate whether mannitol facilitates central nervous system (CNS) entry of vancomycin and alleviates methicillin-resistant Staphylococcus aureus (MRSA) intracranial infection. METHODS: Blood-brain barrier (BBB) permeability was assessed by measuring the concentration of sodium fluorescein (NaF) in the brain tissues of rats and fluorescein isothiocyanate-dextran (FITC-dextran) in a single-cell layer model. Neutrophil infiltration in the brain tissue, inflammatory cytokine levels in the serum, neurological function, and 7-day survival rates were used to evaluate therapeutic effects of mannitol and vancomycin in MRSA-infected rats. Syndecan-1 and filamentous actin (F-actin) levels were measured, and the relationship between F-actin and the endothelial glycocalyx layer (EGL) was explored via the depolymerization agent cytochalasin D and the polymerization agent jasplakinolide. RESULTS: Following mannitol administration, the NaF and vancomycin concentrations in the brain tissue increased rapidly within 5 min and remained stable for 30 min, indicating that mannitol increased BBB permeability for 30 min. In vitro, mannitol treatment led to significantly greater FITC-dextran permeation through a single-cell layer compared to controls. In the MRSA intracranial infection model, rats treated with mannitol and vancomycin simultaneously presented less inflammation, improved neurological function, and increased 7-day survival rate compared to rats treated with vancomycin and mannitol at 10-hour intervals. Further experiments revealed that mannitol decreased the expression of syndecan-1 in brain tissues, which was confirmed by in vitro experiments showing that mannitol significantly decreased syndecan-1 via F-actin depolymerization. CONCLUSION: Mannitol may enhance the therapeutic efficacy of vancomycin against intracranial MRSA infection by decreasing the endothelial glycocalyx of the BBB via F-actin depolymerization.

Acute traumatic coagulopathy (ATC) is one of coagulopathy induced by severe trauma in the early phase of trauma.It is always with high morbidity,mortality and multiple organ failure.Early diagnosis and treatment is the main content of trauma surgery in the department of emergency and the key to reduce mortality.Thrombelastography (TEG) can comprehensively assess the different stages of coagulation,early diagnose disturbance of blood coagulation and guide the goal-directed therapy with low complications,mortality and medical costs.TEG has been widely used in the operation of cardiac surgery,liver transplantation and trauma surgery to monitor coagulation and guide therapy.This paper mainly reviews the clinical value of thrombelastography in diagnosis and treatment of acute traumatic coagulopathy.

Asialoglycoprotein receptor(ASGPR),also called galactose receptor,is predominantly expressed on the sinusoidal surface of mammalian hepatocytes and is involved in many physiological functions.For many years ASGPR has been applied for targeting hepatocytes in drug and gene delivery and for functional mapping of the liver,and considerable progress has been made.ASGPR-mediated liver-targeted drug delivery mainly involved anti-tumor drugs and cholesterol-lowering drugs,etc.Liver-targeted gene delivery was often seen in antisense drugs.The research of hepatic imaging mainly involved the evaluation of liver function and identification between hepatocellular carcinoma and hepatic metastasis of tumors.In addition,researchers have also extended its applications to some new fields,such as three-dimension culture of hepatocytes,hepatocytes screening,and hepatocytes transplantation.New achievements in studies of ASGPR-mediated liver targeting are reviewed in this article.

ObjectiveTo evaluate two "up and down stair" methods used by hemiplegic patients.Methods40 cases with hemiplegia were randomly divided into two groups with 20 cases in each group. Patients in the group A went upstairs with health leg and downstairs with affected leg, while, patients in the group B upstairs with affected leg, downstairs with health leg, and then up and down stairs with health and affected leg alternated. Effects of two training menthods were compared.ResultsEach of two training methods had its advantage and disadvantage, but motor function and mobile ability of patients in the group B were better than patients in the group A (P<0.05).ConclusionHemiplegic patients Should choose different training method of up and down stairs according to his status, and not always choose the method of going upstairs with health leg and downstairs with affected leg.

OBJECTIVE:To know the utilizatior of Shenfu injection(SFI)in our hospital,and provide reference for ratio-nal use of SFI. METHODS:In respective study,patients received SFI from the Hospital Information System(HIS)in surgery department in our hospital from Jan. 2013 to Dec. 2014 were analyzed statistically in aspects of general situation,indications, usage and dosage,course of treatment,drug combination,etc. And the incidence of ADR/ADE was monitored. RESULTS:The 1 247 surgery inpatients used SFI distributed in thyroid and galactophore department(634 cases),comprehensive minimal-ly invasive department (292 cases),gastrointestinal surgery department (250 cases),urology department (64 cases) and car-diothoracic surgery department(7 cases),including 466 male and 781 female,the ratio of male to female was 1∶1.68,aver-age age was 58.50 years;it mainly used in perioperative medication (78.11%) and treated for tumors (11.23%),treatment course concentrated on 2-7 d(71.45%),dosage mainly was 100 ml(70.01%);combination medication were mainly pantopra-zole sodium,Fructus bruceae injection,Xueshuantong for injection(lyophilized),etc. The nonstandard phenomenon was exist-ed in indications,dosage,solvent selection,medication frequency,drug combination,etc. There were no obvious ADR/ADE related to SFI. CONCLUSIONS:More attention must be paid to the irrational use of SFI in surgery clinic of our hospital,the safety of traditional Chinese medicine injection in clinical use should be correctly understood,achieve dialectical therapy and rational drug use.

ABSTRACT:Objective To investigate CA125 and ALDH1 levels in diagnosis and postoperative follow‐up of endometriosis (EMs) .Methods Serum CA125 and ALDH1 levels were tested by enzyme‐linked immunosorbent assay (ELISA) in 105 patients with EMs and 100 healthy subjects who came to our hospital between January 2011 and June 2013 .Results The preoperative serum CA125 and ALDH1 levels of EMs patients were significantly higher than those in the control group ( P<0 .05) .Serum ALDH1 levels in stages I and II of EMs were significantly higher than those in the control group (P<0 .05) ,but there was no difference in serum CA125 level between the two groups ( P>0 .05) .Taking CA125≥35 U/mL and ALDH1≥2 .0 pg/mL as the boundary values ,the specificity , sensitivity ,positive predictive value and negative predictive value of serum CA 125 combined with ALDH1 for diagnosis of EMs were 87 .1% ,91 .6% ,84 .6% and 89 .3% ,respectively .One month after operation ,serum CA125 and ALDH1 levels of EMs patients were decreased significantly (P<0 .05) ,but they were still higher than those in the control group ( P<0 .05) .Six months after operation ,their serum CA125 and ALDH1 levels did not differ from those in the control group (P>0 .05) .Relapse occurred in 1 patient 1 year after treatment and in 6 patients 2 years after treatment ;all these patients had a higher serum ALDH1 level than the control group ,but only 2 of them had a higher serum CA125 level .Conclusion The combined detection of serum CA125 and ALDH1 has a higher sensitivity in diagnosis of EMs .Serum ALDH1 level increases in stages Ⅰ and Ⅱ and recurrent patients and can become a better serum marker for early diagnosis and detection of the recurrence of EMs in patients .

Objective To investigate the changes and significance of I?B kinase-?(I?K-?) in the lung tissues of rabbits with hemorrhagic shock.Methods The expressions of I?K-? and NF-?B in the lung tissues and the concentration of tumor necrosis factor-?(TNF-?) in the plasma were measured by in situ hybridization(ISH),immunohitochemistry and enzyme linked immune adsorbent analysis(ELISA), respectively. And the pathological changes were examined with light microscope in lung tissues.Results In hemorrhagic shock group,the expressions of I?K-?(0 1685?0 0164)and NF-?B( 0 1469?0 0083)in lung tissues , the level of TNF-?(636 72?100 23) in the plasma were obviously higher than those of normal group [I?K-?(0 0427?0 0241),NF-?B(0 0358?0 0048),TNF-?(199 51?35 69)ng/L](all P

Objective To investigate the preventive mechanism of Anisodamine (654-2) on multiple organ dysfunction syndrome (MODS) of rabbits. Methods Rabbit model of MODS induced by hemorrhagic shock and endotoxin was used in this study. Twenty-four rabbits were randomly divided into the control group (C group) , hemorrhagic shock plus endotoxin group (M group) and 654-2 treatment group (T group). The expression of IKK-? of pulmonary alveolar macrophage (PAM) and kuffer cell(KC), the NF-?B activity of nuclear protein extracted from PAM and KC and the concentration of tumor necrosis factor-? (TNF-?) in the culture supernatant were measured by in situ hybridization (ISH), electrophoretic mobility shift assay (EMSA) and enzyme linked immune absorbent analysis(ELISA), respectively. Then the blood air, biochemical and pathological changes in visceral organs were examined in each groups. Results In PAM and KC of M group, The expression of IKK-? mRNA [(0 15?0 03);(0 17?0 04)], the activity of NF-?B [(1 49?0 30);(1 72?0 36)] and the secretion level of TNF-? [( 279 74?25 91);(300 05?30 86)ng/L] were significantly higher than those of control group (P

Objective To investigate the significance of I?B kinase-?(IKK-?) and the protective effect of Ligustrazini(Lig) in acute lung injury(ALI) induced by hemorrhagic shock(HS) in rabbits. Methods Thirty rabbits were randomly divided into three groups: HS plus endotoxin group(n=10), Lig treatment group(n=10) and the normal group(n=10). In situ hybridization and immunohitochemistry combined with in situ quantitative analysis were used to detect the distribution and relative contents of IKK-? and NF-?B in lung tissues. The plasma concentration of tumor necrosis factor-?(TNF-?) was measured by ELISA. Morphological change of the lung was observed by light microscopy. Results Compared with the normal group, the expression levels of IKK-?(0.223?0.080), NF-?B(0.162?0.021), and TNF-?(809.33?201.6) were obviously increased in HS plus endotoxin group(P

Objective To study the possible protective mechanisms of Anisodamine against liver injury induced by hemorrhage shock(HS). Methods In this study, we established animal models induced by HS and endotoxin, observed the expressions of NF-?B mRNA and heat shock protein 70(HSP 70) mRNA by In-situ hybridization (ISH) in liver kupffercells(KC) and studied the pathologic changes of the liver tissue by microscope. Results After stimulus of HS and injection of endotoxin, the mRNA expressions of HSP70 and NF-?B in KC were (0.1565?0.0260) and (0.1659?0.0103),respectively, and significantly higher than those in the control group (0.0328?0.0201; 0.0256?0.0043)(P