The pulmonary toxicology after H2S inhalation was studied with bronchoaleveolar lavage (BAL),ultracentrifuge.and optical and electron microscopy in rats.The changes of the activities of lactate dehydrogenase,alkaline phosphatase,acid phosphatase and angiotension converting enzyme in BAL fluid were used as indicators of cellular damages.those of leucocytic count as the indicator of inflammatory response,and those of the concentration of protein and Evans blue as the indicator of the alterations of vascular permeability.In addition,the effects of H2S on lipid peroxidation,natural antioxidative system and energy substances and the changes of phospholipid concentration in BAL fluid were also studied.The results were as follows:(1)Inhalation of H2S exerted a severe cytotoxic effect on the lung tissues resulting in damages on various types of cells and a severe edematogenic effect on lung parenchyma.(2)The development of pulmonary edema in H2S intoxication resulted from a combination of different pathogenic factors.(3)The biochemical changes and their recovery occurred earlier than those of the pathological changes.The effecacy of 6 categories of drugs including 25 medicaments against H2S intoxication was e-valuated in mice,and 10 drugs were found prophylactically effective.The effects of various methe-moglobin-forming substances and some other drugs were also investingated in their treatment for H2S intoxication in rabbitsand dogs.It was concluded that methemoglobin-forming substances could be used as specific antidotes but could not prevent or diminish the lung damages due to H2S inhalation unless they were administered in association with dexamethasone,vitamin E,and anisodamine.Eventually,a postulated scheme of the medical treatment for H2S intoxication was presented.

Objective To study MRI features of solid-pseudopapillary tumors of pancreas(SPTP).Methods MR findings of 3 patients with histopathologically proven SPTP were retrospectively analyzed.Results The mean diameter of these tumors was 4.5cm(3.5～8cm).One tumor was predominantly composed of cystic portions,2 tumors were composed of predominantly solid and some cystic portions.Fibrous septa was seen in cystic area in 1 case.One cystic tumor showed low signal intensities on T1WI and high singal intensities T2WI.The solid portions of mass showed moderate hypointensity on T1WI,and moderate hyperintensity on T2WI,and heterogeneous obvious enhancement on T1WI MRI in 2 cases.Conclusion There are some characteristics in MRI manifestation of SPTP.The disease might be correctly diagnosed combined with the clinical feature,and should be differentiated from nonfunctioning islet cell tumor,mucinous cystadenoma or cystcarcinoma of the pancreas,etc.

The linear regression method of multiwavelength data and orthogonal functions spectropho-tomtry have been used for the determination of sulfamethoxazole and triemethoprim in co-trimo-xazole tablets without any preliminary separation.The methods are simple and rapid.Good results have been obtained. The average recovery of sulfamethoxazole was 99.72-100.5%, with coefficient of variation below 0.48%, and the average recovery of triemethoprim was 99.26-99.46%, with coefficient of variation below 0.83%. The accuracy and precision meet the requirements of analysis of the pharmaceutical preparations

The effects of 4-DMAP and NaNO2 on the hemodynamics of dogs suffering from acute hemorrhage complicated with cyanide poisoning were studied. It was found that the administration of 4-DMAP could brought about an increase of the cardiovascular functions in the experimental animals. Although the increase was temporal and not very impressive, it played an important role to prevent the dogs from developing cardiovascular collapse during the period of observation. On the other hand, the administration of NaNO2 resulted in a transient excitation for 1-2 minutes and then a prolonged and progressive depression of the cardiovascular functions, and all the experimental animals died from cardiovascular failure within 13-19 minutes after NaNO2 injection.The results of this study indicate that 4-DMAP as a therapeutic agent for acute hemorrhage complicated with cyanide poisoning is superior to NaNO2 since the former can produce an excitation of the cardiovascular functions while the latter a progressive depression and eventually a failure of the cardiovascular functions.

The effects of acute hemorrhage complicated with cyanide posisoning on the hemodynamics were studied and compared with those simple cyanide poisoning in 24 dogs.Cyanide poisoning was induced by intravenous injection a lethal dose of NaCN of 2.5mg/kg,Acute hemorrhage was created by bleeding the dogs to an arterial pressure of 9.33 kPa(70mm Hg)within 2 minutes through a cannulated femoral artery.HR,CO,MAP,LVP,LVP (?)dp/bt max,and ECG were recorded.It was found that the excitatory response of cardiovascular functions was observed within 1 minute after cyanide poisoning,then a significant failure of the cardiavascular functions resulted in the rapid death of the animal 7~10 minutes after cyanide administration.In case when cyanide poisoning was complicated with acute hemorrhage,no excitatory response of the cardiovascular functions could be observed.An early cardiovascular collapse occurred which was characterized by a rapid fall of CO,MAP,LVP,LVP(?)dp/dt max as well as arrhythmia.All the dogs in this group died of acute failure of cardiovascular functions 4- 6 minutes after cyanide poisoning.The results of this study suggest that the failure of the cardiovascular functions is the main cause of death in case of acute hemorrhage complicated with cyanide poisoning.

Objective To further explore the blood supply and interventional therapy of adult cavernous hemangiomas of the liver (CHL).Methods Recently some authors reported that a satisfactory effect resulted from transcatheter portal venous embolization was obtained in few cases of CHL with blood supply of portal vein,and raised an objection to the standpoint that CHL was commonly supplied by hepatic artery completely.In order to get a scientific and reasonable explanation for it,this paper reviewed the vascular embryology and histology of the liver,the pathologic features of CHL as well as the relative literature,and combined with the investigation results of blood dynamic changes of CHL that had been performed in 2000～2002 by us.Results CHL was caused by the arrested development of hepatic sinusoids at the embryonic stage.Pathologically,CHL was consisted of a lot of enlarged abnormal sinusoids,which were variant in size and closely related with the hemodynamic changes of CHL (in inverse proportion).The CHL consisted of even and tiny abnormal sinusoids (diameter less than 50 ?m) pathologically usually presented a high flow.During the hepatic artery angiography or CTHA,it was rapidly filled by the arterial blood containing contrast media and frequently showed dense opacification or enhancement.Simultaneously this could result in increased pressure of abnormal sinusoids.When the sinusoidal pressure exceeded that of the connecting portal venules,the arterial blood containing contrast media filled in the abnormal sinusoids could lead to retrograde flow in the portal venules.That was arterial-portal venous shunts (APVS).These appearances described as above could also occur in some CHL with intermediate flow,in which many tiny abnormal sinusoids located in the peripheral area were identified pathologically.On the contrary,the CHL consisted of larger abnormal sinusoids (diameter more than 500 ?m) pathologically usually presented a low flow.During the hepatic artery angiography or CTHA,it was filled very slowly by the arterial blood containing contrast media and was difficult to opacify or enhance.Simultaneously this could result in a low pressure of abnormal sinusoids.When the sinusoidal pressure was lower than that of the connecting portal venules,the portal venous blood containing contrast media could easily flow into the abnormal sinusoids and make it enhanced during the direct or indirect portography (or CTAP).Conclusion CHL is really a congenital venous malformation.All the CHL with high flow and some CHL with intermediate flow are surely supplied by the hepatic artery and drained primarily by the peripheral branches of portal vein.However,in few CHL with marked lower flow,the portal vein should become a primary supply vessel,so a direct or indirect portography (or CTAP) must often be taken to identify the diagnosis.Thereby,the technique of transcatheter embolization of CHL including the aim,indication,approach,and the used sclerotic or embolic drugs,etc,should also be reconsidered in order to improve its therapeutic efficacy.

Objective:To investigate the expression of XIAP and Smac in human non-small-cell lung carcinoma (NSCLC) and the relationship with clinical significance and prognosis. Methods:Immunohistochemical staining was performed to determine the ex-pression of X-linked inhibitor of apoptosis protein (XIAP) and second mitochondria-derived activator of caspase (Smac) in 70 cases of NSCLC and 70 cases of non-cancerous adjacent lung tissues. Results:XIAP is mostly present (59/70) in tumor tissues with 16 high ex-pressions, whereas only five high expressions in non-cancerous adjacent lung tissues are observed (52/70). The statistical difference of these two sets of data is significant (Z=-5.484, P<0.001). Comparatively, Smac is present (63/70) in tumor tissues, which is significant-ly (Z=-5.484, P<0.001) higher than in the non-cancerous adjacent lung tissues (53/70). The expression levels of XIAP and Smac in NSCLC tissues are closely related to the lymph node metastasis at the TNM stages (P<0.05) and not associated to gender, age, size of tumor, and differentiation grades (P>0.05). The Kaplan-Meier analysis results show that survival by XIAP and Smac protein in NSCLC has no significant effect (P>0.05). Conclusion:XIAP and Smac are expressed in NSCLC and noncancerous adjacent lung tissues, and the differences in their expression levels is significant. The deterioration of NSCLC results in apoptosis/anti-apoptotic synchronized with tumor cell proliferation. The expression levels of XIAP and Smac in NSCLC are not related with the prognosis.

Objective To evaluate the efffects of leukocyte-depleted blood transfusion the protection of cardio pulmonary tissue and the reduction of postoperative bacterial infection.Methods Three hundred and forty-four pediatric patients were allocated to one of 3 groups based on transfusing different components of blood during open heart surgery:control group(n=109),routing blood transfusion group(RBT,n=113),leukocyte depleted blood transfusion group (LDBT,n=122). Blood samples were taken before operation,at 6h,and 24h after operation fir determination of creatininee kinase MB( CK MB),aspartate transaminase(AST),lactate dehydrogenase(LDH)and MDA. At the same time,we monitored changes of TPR and RI,and recorded changes of body temperature and days of utilizing antibiotics after operation.Results After operation serum concentrations of CK MB,AST, LDH and MDA significantly increased in all groups as compared to the values before operation,but the values of those in group LDBT were significantly loert than those in group RBT(P0.05).Conclusions Leukocyte depleted blood transfusion can effectively prevent the patients from cardion pulmonary ischemia-reperfusion injury and reduce postoperative bacterial infection in pediatric open heart surgery.

Objective: To study clinical pharmacodynamics and efficacy for endotracheal intubation of rocuronium and succinylcholine at different dosage. Method: Sixty adult patients under general anesthesia according to the different drugs and dosage, were randomly divided into four groups. In groupⅠorⅡ,2 or 3?ED_(95) rocuronium were administrated,and in group Ⅲ and Ⅳ, 2 or 3?ED_(95) succinylcholine were given respectively. The course of depression and recovery of twitch response of the adductor pollicis muscle were recorded, and intubating condition were assessed. Result:The intubation condition was excellent in all patients of group Ⅱ,but only in 20％ of group Ⅲ.The degree of twitch at maximal depression was similar between all groups. The lag time and the time of twitch reaching maximal depression were not significantly different between group Ⅱ,Ⅲ and Ⅳ, which were shorter than those of groupⅠ.The times of twitch recovery to 25％ and 95％ of baseline in groupⅠor Ⅳ were significantly longer than in groupⅠor Ⅲ, respectively. Conclusion: 3?ED_(95) rocuronium has similar onset time to 2 or 3?ED_(95) succinylcholine with the excellent intubation condition,but the clinical effective duration is more longer than that of 2?ED_(95) rocuronium.

Objective To investigate the characteristics of the heart rate variability(HRV) in the elderly bedridden patients. Methods 91 hospitalized patients (age≥60 years ) were divided into three groups according to the function independent measure: independent group (32 cases), partial dependent group (31 cases), dependent group(28 cases). Eight items of HRV were measured, including 24 hour standard deviation of successive normal-to-normal R-R interval(SDNN), total power (TP),standard deviation of all means of 5-minutes R-R interval all over 24 hour(SDANN), low frequency (LF), root mean squared successive difference(MSSD),Edingburgh Index(PNN50), high frequency(HF)and ratio of LF to HF(LF/HF). Results Seven items of HRV of the dependent group and partial dependent group were significantly lower than those of independent group (P0.05). SDNN and FIM were positively correlated (r =0.853, P=0.017). Other factors such as pathogen and the number of concomitant diseases did not affect on HRV in the elderly bedridden patients. Conclusions The HRV in the elderly bedridden patientsdecreased , the changes relatedthe decrease of the activity.