Objective To study the changes of vascular endothelial functional status and cytokine TNF-α in patients with multiple organ dysfunction syndrome (MODS).Methods Plasma levels of tissue plasminogen activator (t-Pa), plasminogen activator inhibitor-1 (PAI-1 ), circulating endothelial cell (CEC) and serum levels of endothelin (ET-1), tumor necrosis factor- ( (TNF-α), nitric oxide (NO) were determined serially dynamically in patients with MODS and those without MODS (non-MODS). At the same time Marshall scores were evaluated.Results Blood levels of TNF-α, ET-1, PAI-1, CEC, and Marshall scores were significantly higher in MODS and succumbed (those who died) groups than those in non-MODS and survied (those who lived) groups (P ＜ 0.05), but blood levels of NO and t-Pa were significantly lower ( P ＜ 0.05).Conclusion TNF-α played an important role in the progression of MODS. The increase of ET-1, PAI-1, CEC and the decrease of NO and t-Pa indicated endothelial dysfunction in MODS. Marshall scoring system for MODS was a sensitive parameter in evaluating the patients with MODS.

OBJECTIVE: To evaluate the current situation and trend of narcotic drug use in our hospital where the authors work in order to provide the reference for scientific management and rational use of these drugs. METHODS: The yearly amount of narcotic drugs administered in the whole hospital, the yearly amount in the separate departments, as well as drug expenditures and ratios between January 2002 and November 2005 were added up and analyzed statistically. RESULTS: The amount of bucinnazine use dominated in the first. The amount of morphine for oral use was increasing year by year. The amount of fentangl transdernal patch use was also bigger and increasing rapidly. However, the amount of pethidine and morphine for injection use was decreasing. CONCLUSION:Analgetics for oral and transdermal use will be the main categories of analgetics in the future.

AIM To study if cholecystokinin octapeptide (CCK-8) alter cardiovascular functions by its direct inhibitory effect on carotid sinus baroreceptor (CSB) activity. METHODS The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized male rats with perfused isolated carotid sinus. RESULTS ① CCK-8 0.1, 0.5 and 1.0 μmol·L-1 shifted FCCB to the right and downward, with a marked decrease in peak slope and peak integral value of carotid sinus nerve discharge in a concentration-dependent manner, indicating the inhibitory effect of CCK-8 on CSB activity. ② Pretreatment with proglumide (100 μmol·L-1), a nonselective CCK receptor antagonist, or Bay K8644 (0.5 μmol·L-1), an agonist of calcium channel, partially attenuated the inhibitory effect of CCK-8 (0.5 μmol·L-1) on CSB activity. Pretreatment with L-NAME (100 μmol·L-1), an inhibitor of NO synthase, did not affect the inhibitory action of CCK-8. CONCLUSION CCK-8 inhibits CSB activity, which may be mediated by activating CCK receptors in the carotid sinus area and thereby resulting in an inhibition of stretch-sensitive channels and decrease in Ca2+ influx.

Objective To study the behavioural changes and biological effects of selective adenosine A2A receptor antagonist (CSC) in a rat model of levodopa(L-DOPA) -induced dyskinesia (LID).Methods The hemi-parkinsonian rat model was produced by stereotaxically injecting 6-OHDA to the right medial forebrain bundle. Rats were randomly divided into 4 treatment groups with a random number generating program to receive intraperitoneal injections twice daily for 21 days (n = 10): saline, L-DOPA at 25 mg/kg with benserazide at 6. 25 mg/kg, CSC at 2. 5 mg/kg alone and CSC at 2.5 mg/kg with L-DOPA at 25 mg/kg plus benserazide at 6. 25 mg/kg. Forepaw adjusting steps, abnormal involuntary movements (AIM) and rotational response duration were observed on 2, 9, 11,18 and 21 d. After sacrifice, the expression of adenosine A2A R and mGluR5 was observed by Western blot. Results Co-administration of LDOPA with CSC significantly increased the forelimb adjusting steps of parkinsonian rats during 21 days of treatment when compared to L-DOPA alone. CSC treatment alone increased the forelimb adjusting steps significantly. Co-administration of L-DOPA with CSC ( ( 11 ± 5 ) score) significantly decreased the AIM scores of limb and orolingual muscles when compared to L-DOPA alone (( 17 ± 4) score; t = 2. 44, P ＜0. 05). The subchronic L-DOPA treatment upregulated the striatal expression of adenosine A2A R and mGluR5. However, co-administration of L-DOPA with CSC reversed the shortening of the rotational motor response duration induced by L-DOPA administration during the period of the treatment and attenuated the LDOPA-induced upregulation of adenosine A2A R and mGluR5 expressions. Conclusions CSC improves motor function in a hemi-parkinson rat model, potentiates the antiparkinsonian effects with L-DOPA and partly attenuates LID. Co-administration of L-DOPA with CSC reverses the L-DOPA-induced upregulated expression of A2A R and mGluR5, indicating the involvement of both A2A R and mGluR5 in the onset and progression of LID. Adenosine A2AR antagonists may be promising drugs for treatment of LID.

Objective To observe the feasibility and safety of self-made extended endobronchial tube applicated in one-lung ventilation for radical resection of esophageal cancer.Methods 80 patients were randomly divided into two groups:self-made extended endobronchial tube group (group A) and double-lumen endobronchial tube group (group B).The degree of lung collapse,systolic blood pressure,diastolic blood pressure,heart rate,airway pressure (Paw),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation (SaO2) were monitored.The time for insertion,rate of successfully intubation for single time,incidence of postoperative hoarseness and sore throat were recorded.Results There were no significant differences in degree of lung collapse,systolic blood pressure,diastolic blood pressure and heart rate,SaO2 in the two groups(all P＞0.05).The comparison of the time for insertion between the two groups:(1.5±0.4)min vs.(2.6±0.8)min(t=4.78,P＜0.05);rates of successfully intubation for single time:95.0％ vs.80.0％(χ2=5.19,P＜0.05).The comparison of Paw between the two groups:T1:(17.3±1.1)cmH2O vs.(22.5±0.9)cmH2O,t=4.613,P＜0.05;T2:(17.9±0.5)cmH2O vs.(23.6±1.4)cmH2O(t=5.438,P＜0.05);T3:(18.1±0.8)cmH2O vs.(24.6±1.2)cmH2O(t=3.741,P＜0.05).The comparison of blood gas during one-lung ventilation between the two groups:PaO2(281.5±53.4)mmHg vs.(187.6±48.8)mmHg(t=5.28,P＜0.05);SaO2(98.1±6.3)％ vs.(94.5±5.7)％(t=3.46,P＜0.05);PaCO2(31.2±3.6)mmHg vs.(37.6±4.1)mmHg(t=6.32,P＜0.05).The comparison of incidence of postoperative hoarseness:1case vs.6cases(χ2=5.91,P＜0.05);The comparison of incidence of sore throat:4cases vs.13cases(χ2=6.13,P＜0.05).Conclusion Single-lung ventilation has achieved via either the double lumen tube or the self-made extended endobronchial tube.However,the self-made extended endobronchial tube is recommended for single-lung ventilation because of the advantages of its easy intubation and position,full oxygenation,low Paw,less incidence of postoperative hoarseness and sore throat.Self-made extended endobronchial tube can be used as a one-lung ventilation method in its indications.

It analyzed the definition, mechanism, characteristics of Mirror Visual Feedback and summarized the application of mirror visual feedback in recovering upper limb function after stroke patients at home and abroad, so as to provide evidences for the further research in China.

Objective To investigate the clinical value of neutrophil-lymphocyte ratio (NLR) in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods A total of 128 newly diagnosed T2DM female patients were randomly recruited from the Zhujiang Hospital of Southern Medical University from March to September 2015. According to the physiological state, the patients were divided into menopausal group (n=66) and non-menopausal group (n=62). Fifty-six healthy females were chosen as the control group. The values of blood pressure, blood lipid, fasting plasma glucose (FPG), fasting insulin (FINS) and white blood count (WBC), neutrophil count, percentage of neutrophils,lymphocytes count, and percentage of lymphocytes were detected and compared between three groups. The NLR and the HOMA insulin resistance index (HOMA-IR) were calculated. Results Age, systolic blood pressure (SBP), triglyceride (TG), FINS, percentage of neutrophil, NLR, HOMA-IR were significantly higher in menopause group than those of control group and non-menopause group (P<0.05). There were no significant differences in diastolic blood pressure (DBP) and FPG between menopause group and non-menopause group, but both were significantly higher than those of control group (P < 0.05). There were no significant differences in total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), WBC and HbA1c between three groups (P>0.05). There was no linear correlation between NLR and HOMA-IR (rs=0.015, P > 0.05), HbA1c (r=0.030, P > 0.05). Conclusion NLR is of a certain significance in the assessment of inflammatory status and IR levels in postmenopausal women with T2DM, which may be related to the changes of autonomic nervous system.

Objective To investigate the clinical value of low-dose decitabine (DAC) in elderly patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) patients with intermediate-or high-risk. Methods Low-dose DAC (10 mg/d, 7 days) combined with CAG regimen were given to 19 elderly patients with AML and intermediate- or high-risk MDS patients. The efficacy and adverse reactions were evaluated after a course of treatment, and the patients were followed up for survival. Results After a course of treatment, 8 patients achieved complete remission (CR), 7 patients achieved partial remission (PR). After 4 courses of treatment, 68.4 % (13/19) of patients achieved CR, the overall response rate reached 78.9% (15/19). Fewer side effects were seen associated with chemotherapy. After 42 months of follow-up, there were 12 survival cases, the median survival time was 13.5 months (3-42 months). Conclusion Low-dose DAC combined with CAG regimen have a better efficacy, higher safety, and lower economic burden for elderly AML patients and intermediate- or high-risk MDS patients, which is beneficial to greatly improve patients' compliance.

Objective To evaluate the condition of oxidative stress and immunosuppression in early stage of severe sepsis,and investigate the correlation between them. Methods A prospective random control study in-cluded patients group(n=51)and control group(n=31). The concentration of serum superoxide dismutase was measured by enzyme linked immunosorbent assay(ELISA),CD4+CD25+Treg% was measured by flow cytometry , respectively. The difference between two groups was compared and the correlation between parameters in patients group was evaluated. Results The concentration of serum SOD was lower than control group (P < 0.01). CD4+CD25+Treg% significantly high,compared to the control group(P < 0.01). There was no strong correlation be-tween parameters in patients group. Conclusion Oxidative stress and immunosuppression are exist in the early stage of severe sepsis.