Objective:To investigate the effects of two different routes of nutrition support on the treatment of severe pneumonia in elderly patients.Methods:From January 2015 to January 2016,84 elderly patients with severe pneumonia in our hospital were randomly divided into two groups,42 patients in each group.The enteral nutrition (EN) group was treated with nasogastric feeding and another group was defined as combined treatment group.After 4 weeks of treatment,the nutritional status of two groups of patients was compared.The incidence of complications during treatment were documented.Results:After treatment,the hemoglobin was (111.34 ± 20.33) g/L,and the albumin was (23.33 ± 5.09) g/L in the EN group.The hemoglobin was (132.13 ±24.39) g/L,and the albumin was (35.43 ±9.12)g/L.There was significant difference between the two groups (P ＜ 0.05).The cure rates of the two groups were 92.86％ and 95.24％,respectively,and there was no significant difference (P ＞ 0.05).Conclusion:For elderly patients with severe pneumonia,the combination of enteral and parenteral nutrition is more likely to improve the nutritional index,and has a lower incidence of adverse events.

Objective To observe the expression of triggering receptor-1 on myeloid cells (TREM-1) of mice with acute lung injury (ALI) in oder to find out its regularity and significance in inflammatory response of or-ganisms. Method Thirty BALB/C mice were randomly(random number) divided into normal control group (n =6) and ALl group (n = 24). The models of ALI were made with intraperitonal injection of lipopolysaccharide (LPS) in dose of 10 mg/kg. Specimens from peripheral blood and lung tissue were collected 6 h, 12 h, 24 h and 48 h after LPS injected. The fluorescent real-time quantitative reverse transcriptiun-polymerase chain (RT-PCR) was used to detect TREM-1 mRNA, and ELISA was employed for detection of TREM-1 protein and TNF-α protein, and HE staining was made doe the pathological Smith lung score under light microscope. Analysis of variance was used for comparison of TREM-1 mRNA, TNF-α and Smith lung injury score between two groups. Spearman corre-lation analysis was made to find out the relationship among these three variables. Results The expressions of TREM-1 mRNA in lung tissue of ALI mice 6 h, 12 h, 24 h, and 48 hours after injection of LPS were 6.61±0.08,34.71±0.83, 61.85±14.05 and 56.46±8.89, respectively which were higher than that in control group (1.00±0.00, P = 0.017, 0.009, 0.002 and 0.003, respectively). The expressions of TREM-1 mRNA in blood were 14.01±3.24, 47.07±0.98, 8.18±0.43 and 8.06±0.05, respectively which were higher than that in normal control group (1.00±0.00, P = 0.010, 0.004, 0.011 and 0.011, respectively). The expression of TREM-1 rnRNA in tissue began to increase 6 hours after modeling and reached its peak 24 hours later, and expres-sion of TREM-1 mRNA in blood reached its peak after 12 hours. The levels of TREM-1 protein in lung tissue of ALl mice 6 h,12 h,24 h and 48 hours after LPS injected were 997.8±114.62, 1579.70±45.92, 1123.9±108.2 and 429.8±89.96 pg/mL, respectively which were higher than that of mice in control group (279.22±4.62 pg/mL, P = 0.024, 0.007, 0.011 and 0.04, respectively). The level of TREM- 1 protein reached the peak 12 hours after LPS injected, but it had no significant correlation with the expression of TREM-1 mRNA (P =0.14). The levels of TNF-α protein in lung tissue of ALI mice 6 h, 12 h, 24 h and 48 hours after LPS injection were 313.16±39.50, 491.91±96.65, 388.48±29.84 and 282.5±52.76 pg/mL, respectively which were sig-nificantly higher than that of mice in control group (256.6±28.31 pg,/mL, P = 0.037, 0.019, 0.032 and 0.043, respectively). The TNF-α concentration was positively correlated with TREM-1 levels in lung tissue and with Smith pathological score (r = 0.795, P = 0.001: r = 0.499, P = 0.034), but not with the expression of TREM-1 mRNA (P = 0.176). Conclusions The expression of TREM-1 mRNA in lung tissue of mice with ALI is elevated, and the expression of TREM-1 mRNA is related to the level of TNF-α and the severity of the ALI in in-flammatory responses in lung. The expressions of TREM- 1 gene are not consistent with the levels of TREM- 1 pro-tein, suggesting another new functional proteins involved in immune regulation.

Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with bra-chial plexus block under ultrasound-guided ,to assess its effectiveness and security ,so as to determine the optimum dosage of anes-thetic for elderly patients with brachial plexus block .Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group in this study .These patients were randomly divided into four groups on average ,narcosis was conducted in each group with ultrasound-guided :group A with 30 mL of 0 .250%ropivacaine ,group B with 30 mL of 0 .375% ropivacaine ,group C with 30 mL of 0 .500% ropivacaine ,group D with 30 mL of 0 .750% ropivacaine .The onset time of sensory block ,motor block level ,duration of analgesia and adverse reactions were observed and recorded .Results With the increase of concentration of ropivacaine ,the onset time of narcotize became shorter(P< 0 .05) and duration of analgesia became longer(P < 0 .05) .There were no significant difference in the effects of brachial plexus block (P>0 .05) .There was no complications occurred in four groups after narcosis .Conclusion Concentration of ropivacaine more than 0 .375% can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound .

Objective To explore the clinical value of Glucosamine hydrochloride tablets(GH)alone and combination with Xianlinggubao capsules(XLGB)for treatment patients with knee osteoarthritis(KOA).Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function (HSS)score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment (P >0.05 ).After treatment,pain,stiffness,physical function scores and total scores were (10.2 ±1.4)points,(3.5 ±1.6)points, (40.5 ±5.0)points and (56.4 ±6.7)points in the observation group,those were (14.8 ±2.6)points,(6.2 ±2.3)points, (52.2 ±6.8)points and (73.3 ±4.5)points in the control group,the differences were statistically significant (t =7.631,4.721,6.791,10.26,all P <0.01).The onset time,HSS score at 3 months and 6 months after treatment in the observation group were (6.0 ±2.2)d,(68.2 ±6.4)points and (84.3 ±6.2)points,while those were (9.8 ± 2.8)d,(58.5 ±3.9)points and (72.8 ±5.4)points in the control group,the differences were statistically significant (t =5.228,6.341,6.852,all P <0.01 ).The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group (t =3.880,2.668,all P <0.05).After treatment,the total effective rate of the observation group was 93.8%(45 /48),while that was 77.1%(37 /48)in the control group,the difference was statistically significant (χ2 =5.352,P <0.05).Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.

Objective To investigate the influence of blood arsenic concentration change on hepatic and renal function of rats administered with different toxic dosages of realgar by applying the linear mixed-effects model.Methods SD rats were given gastric gavage of realgar at the single dose of 3.738g/kg,1.869 g/kg and 0.935 g/kg respectively.After administration,the concentration of blood arsenic,the activities of urine alkaline phosphatase(AKP),N-acetyl-beta-D-glucosaminidase(NAG),serum glutamic oxaloacetic transaminase(GOT) and glutamate-pyruvate transaminase(GPT) activities,serum creatinine(Cr) level,and blood urea nitrogen(BUN) content were detected in different groups at different time points.The detection results were analyzed with the linear mixed-effects model.Results The changes of urine AKP and NAG activities,serum BUN content and serum GOT activity were presented in a dose-dependent manner,and had linear correlation with arsenic concentration.Conclusion In the dose range of 0.935 to 3.738 g/kg,realgar can cause the hepatic damage and the injury of tubular epithelial cells of kidney,but has not affected the renal excretion.

BACKGROUND: With the rapid development of tissue engineering, a single biological scaffold material is hard to meet the needs of tissue engineering. Therefore, composite scaffolds with excellent performance will be obtained by combining two or more kinds of materials.OBJECTIVE: To detect the adherence and proliferation of dental pulp stem cells on the Chitosan-fibrin composite scaffold.METHODS: Dental pulp stem cells were isolated and extracted from C57 neonatal rats through modified enzyme-digestion method, and subcultured to the third generation, followed by adipogenic and osteogenic induction in vitro. Then, induced cells were identified. The chitosan-fibrinogen composite scaffold was prepared, and the pore size and porosity were determined. The chitosan-fibrin composite scaffold was co-cultured with passage 3 dental pulp stem cells to observe the cell proliferation by MTT assay, and the morphology of the composite scaffold, cell adhesion,proliferation and extracellular matrix secretion were observed under scanning electron microscope. In addition, the cells were inoculated directly on the bottom of culture plate as controls.RESULTS AND CONCLUSION: The dental pulp stem cells were successfully isolated and cultivated, and positive for osteogenic and adipogenic differentiation. The pore size and porosity of the composite scaffold was (105.32±22.10) μm and (87.714±1.276)%, respectively. The S-shaped proliferation curve in the experimental group was similar with that in the control group; the proliferation rate in the experimental group was significantly higher than that in the control group after 4-8 days of culture (P < 0.05). At the 2nd day after co-culture, the cells adhered tightly and grew well onto the composite scaffold; at the 4th day, enlarged cells began to proliferate obviously with abundant extracellular matrix; the surface and pores of the scaffold were full of cells at the 6th day. These results indicate that the chitosan-fibrin composite scaffold is suitable for the adhesion and proliferation of dental pulp stem cells.

Objective To determine the content of six heavy metal elements of arsenicum(As),mercury(Hg),cuprum(Cu),plumbum(Pb),cadmium(Cd) and chromium(Cr) in Rhizoma Curcumae Longae.Methods Samples were digested with microwave digestion system,and the contents of Cu,Pb,Cd and Cr were determined by graphite furnace atomic absorption spectrometry(GFAAS);the contents of As and Hg were determined by atomic fluorescence spectrometry(AFS),and the reproducibility and recovery of the method were also examined.Results As and Hg contents in most of the products were below the limit.Only Cu,Pb and Cd contents exceed the limit.The recovery was 86.3 %～113.4 %and RSD was 10.4 %.Conclusions The method is simple and accurate,and can be used for the determination of heavy metal in Chinese herbs.

Objective To study the pharmacokinetics of arsenic from Realgar in rats and tissue distribution after single dose and multiple dose of oral administration.Methods Rats were orally administrated with single dose(75 mg?kg~(-1)) and multiple dose (75 mg?kg~(-1)?d~(-1),one dose per day,15 continuous days) of Realgar respectively.Arsenic concen- trations in serum and arsenic contents in organs and tissues were determined by atomic spectrophotofluorimetry alter mi- crowave digestion pretreatment.PK Solutions 2.0~(TM) software was used to process experimental data.Results Half-life of absorption,distribution and elimination of arsenic in rat serum were 4.30,12.59 and 22.70 hours respectively after single dose administration.Arsenic concentration reached to maximum concentration (46.0?g?L~(-1)) at 3 hours after ad- ministration,and then decreased.Twelve hours after administration arsenic concentration increased to the second peak concentration (42.0?g?L~(-1)).When Realgar was orally administrated in a fixed close and at a fixed interval,arsenic concentration maintained a steady state from the 7th day after the first administration,and the half-life of elimination was 43.61 h.Arsenic could be detected in the main organs and tissues of rats after administration of a single dose.The ar- senic was most accumulated in the spleen,hair,lung and suprarenal gland organs,and kidney,heart,liver,bladder and skin came next.Brain,testis,muscle and tibia had the least amount of arsenic.After 15 continuous days of admin- istration,arsenic contents in kidney and bladder tissues increased appreciably besides suprarenal gland,lung,hair and spleen.After 2 weeks of discontinuation,arsenic contents in organs and tissues decreased by 21.1%～69.5 % except for heart.Conclusion Small amount of soluble arsenic in Realgar was absorbed in blood circulation.Absorption,distri- bution and elimination of arsenic from Realgar proceed slowly in rats after single dose of oral administration.Multiple dose of oral administration prolongs the elimination of arsenic.Arsenic distributes widely in rats organs and tissues.It is the first reported that high arsenic accumulation is found in the suprarenal gland,indicating that the suprarenal gland is prob- ably one of the target organs of Realgar.

Objective To investigate the effect of renal sympathetic denervation (RSD) on the activity of renalase in dogs with chronic heart failure (CHF).Methods After induced by abdominal aorta constriction,dogs were divided into three groups according to whether they underwent double renal artery ablation:2 dogs in control group,2 dogs in sham-operated group (no renal artery ablation),and 5 dogs in RSD group (renal artery ablation).Plasma noradrenaline (NE),B-type natriuretic peptide (BNP),and renalase were determined in 5 dogs with RSD (RSD group),2 control dogs (control group),and 2 shamoperated dogs (sham-operated group).Results NE,BNP and heart rate were significantly higher and renalase was lower in CHF group than those in control group (all P ＜ 0.05).Compared to the control dogs with CHF,the levels of renalase were significantly increased in 6 weeks after RSD [(1 948.78 ±49.19) ng/ml vs (1 847.35 ±20.72)ng/ml,P =0.029],and NE [(166.30 ±7.68)pg/ml vs (181.29 ±8.57)pg/ml],and BNP [(75.10 ± 5.58)lμg/ml vs (89.79 ± 2.04) μg/ml] were decreased in 8 weeks after RSD (all P ＜ 0.05).An decreased trend of the levels of renalase was observed in 8 weeks than in 6 weeks in CHF dogs after RSD,without significant difference (P ＞ 0.05).Conclusions The activity of renalase in dogs with CHF can be affected by RSD.

Aim To investigate the release feature of ginsenoside Rd solid lipid nanoparticles (Rd-SLN) in vitro,and to clarify the difference in absorption of Rd-SLN from varied rat intestinal segments and pharmacokinetic properties in vivo. Methods Dialysis method was used to determine ginsenoside Rd release rate from nanoparticles in vitro. Perfusion method was used to study the intestinal absorption of Rd-SLN in rat. HPLC assay was established to determine the concentration of ginsenoside Rd in plasma. After intragastric administration,the concentrations of drug in rat blood at different time points were recorded to investigate the absorption and pharmacokinetics of Rd-SLN. Results The release of ginsenoside Rd from Rd-SLN was slowed down and presented the property of sustained release. There was no significant difference between the absorption rate of Rd-SLN and control solution in duodenum and jejunum. However,it was obviously different in ileum and colon. Comparing with other intestinal segments,significantly higher percentage of Rd-SLN was absorbed in colon. In Rd-SLN group,the concentration of ginsenoside Rd in blood was maintained,and the Cmax,MRT,AUMC,and AUC were all increased. Conclusions Rd-SLN possesses sustained-release effect. The colon is the preferable absorption site for Rd-SLN in intestinal tract. Rd-SLN can enhance the oral bioavailability of ginsenoside Rd.