Objective To investigate the effects of ketamine preconditioning on the expression of induced nitric oxide synthase(iNOS)mRNA after myocardial ischemia-reperfusion injury induced by cardiopulmonary bypass(CPB)in patients with congenital heart disease(CHD).Methods Thirty-six patients with atrial or ventrieular septal defect were randomly allocated to 3 groups(n=12):control group and ketamine preconditioning group(K1 group,K2 group).Ketamine 0.5 mg/kg and 1.0 mg/kg,were injected at the time of sternum splitted,aorta intubated and before 5 minutes of aorta clamped off intravenously.Collected the myocardium at the time of superior vena cava intubated(T1),30 minutes after aorta clamped on(T2)and 30 minutes after aorta clamped off(T3).Detected the value of iNOS mRNA in myocardium by one-step real time fluorescence quantitative RT-PCR.Results The levels of iNOS mRNA were significantly increased at T2 and T3 as compared with T1 in the three groups,and were significantly lower both in K1 group(2.33±0.31,3.76±0.61)and K2 group(1.92±0.12,3.12±0.39)than those in control group(2.85±0.48,4.49±0.86)(P＜0.01 or ＜0.05).Furthermore,they were lower in K2 group than those in K1 group(P＜0.05).Conclusion Ketamine can significantly decrease iNOS mRNA in myocardium,and decrease the plasma marker of cardiac muscle injury,it shows dose dependent.

Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile (99Tcm-MIBI)tomography and integrated CT in preoperative localization diagnosis of secondary hyperparathyroidism (SHPT).Methods 28 patients with SHPT were selected.15 minutes and 90 minutes (delayed images)after intravenous administration of 99Tcm-MIBI 370 MBq,static anterior planar images of the neck and chest were obtained.99Tcm-MIBI tomography and integrated CT scan were acquired after the delayed imaging.The imaging findings were compared to the pathological results.Results The detection rate of SHPT lesions by 99Tcm-MIBI dua-phase imaging and 99Tcm-MIBI tomography and registration with integrated CT scan was 53.3％ and 70.7％ respectively.The difference had statistical significance(X2 =5.903,P＜0.05).The fusion imaging with integrated CT can provide detailed anatomy data and more information for surgical doctors.Conclusion 99Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of SHPT compared with 99Tcm-MIBI dua-phase imaging,provide more detailed anatomy data,and has high clinical value in preoperative localization and diagnosis of SHPT.

Objective To invetigate the clinical effect of Guyouling Liniment in the treatment of soft tissue contusion.Methods Sixty-three cases of soft tissue contusion in our hospital from October 2012 to January 2014 were selected and divided into the treatment group (n=32)and control group(n=31).The treatment group were treated with Guyouling Liniment and the control group adopted Indomethacin Liniment.The effects were compared between the two groups.Results Twenty-six cases(81.13％) in the treatment group were cured and 30 cases (93.75％) were effective;23 cases(74.19％) in the control group were cured and 27 cases (87.10％) were effective.The clinical effect of the treatment group was better than that of the control group with statistical difference(P＜0.05).Compared with the control group,the pain degree and stasis purple area in the treatment group were significantly alleviated,the difference was statistically significant(P＜0.05).Conclusion Guyouling Liniment has significant effect in the treatment of soft tissue contusion and is worthy of clinical promotion.

Objective To investigate the effect of dendritic cells(DC)pulsed with tumor lysate antigens of K562/A02 co-cultured with cytokine induced killer(CIK)cells on cytotoxicity against multidrug resistant(MDR)leukemia K562/A02 cells with high expression of p-glycoprotein(P-gp).Methods Bone marrow mononuclear cells isolated from healthy adult donors were induced to obtain CIK cells and DC respectively and then CIK were co-cultured with DCs which were pulsed with tumor lysate.The morphologic features were observed with optical microscopy and expressions of markers typical were measured using flow cytometry.The cytotoxicity of three effect cells was measured with MTT assay respectively.Results After pulsing DCs with tumor lysate antigens co-cultured CIK or DC-CIK led to a significant increase of lymphocyte proliferation of both populations.The cytotoxicity of CIK co-culturing with DCs pulsed with tumor lysate antigens to K562/A02 and K562 cells was(42.90?0.67)%、(49.85?0.28)%(63.36?0.46)% and(23.56 ?0.43)%、(26.11?0.34)%、(34.46?0.35)% respectively at an effector-to-target ratio of(5∶1、 10∶1 、20∶1).Conclusion This study indicates that DC pulsed with tumor lysate antigens co-cultured with CIK can improve lymphocyte proliferation and enhance the cytotoxic activity.Especially,it can induce a P-gp specific anti-leukemic immune.

Objective To investigate the protective effects of pretreatment with low-dose ketamine on intestinal mueosa against ischemia-reperfasion injury (I/R) and the underlying mechanism. Methods Forty-eight male SD rats weighing 230-270 g were randomly divided into 6 groups (n = 8 each) : group Ⅰ sham operation (S) ;group Ⅱ ketamine + sham operation (KS);group Ⅲ l/R;group Ⅳ ketamine + I/R (K);groupⅤ ketamine + ZnPPⅨ + I/R (KZ) and group Ⅵ ZnPPⅨ + I/R. Ketaminc 10 mg/kg and/or ZnPPⅨ 5 mg/kg were injected intraperitoneally 30 min before I/R in group Ⅳ, Ⅴ and Ⅵ. Intestinal I/R was produced by clamping of superior mesentery artery for 1 h followed by 6 h reperfusion. The animals were then killed and a segment of small intestine of 2 cm in length at about 10 cm from ileocecal valve was removed for determination of MDA content and SOD activity, HO-1 and iNOS expression and histological examination. The degree of intestinal tissue damage was graded using Chiu's scoring system (0 = normal, 5 = severe damage-exfoliation of villi, disruption of proper lamina, bleeding and ulceration). Results Intestinal MDA content was significantly increased, SOD activity was decreased and HO-1 and iNOS expression was significantly up-regulated by I/R (group Ⅲ) as compared with group Ⅰ and Ⅱ . Ketamine pretreatment significantly attenuated I/R-induced increase in MDA content and decrease in SOD activity and the protective effects of ketamine against I/R were counteracted by concomitant asministration of ZnPPⅨ. Microscopic examination showed that the pathological changes induced by I/R were significantly attenuated by ketamine and the protective effects of ketamine pretreatment against I/R were reversed by ZnPPⅨ in group Ⅴ. Conclusion Low-dose ketamine pretreatment can significantly ameliorate intestinal ischemia-reperfusion injury and up-regulation of intestinal HO-1 expression and down-regulation of iNOS are involved in the mechanism.

0.05) while the active-rosette rate of T lymphocyte was markedly declined(P0.05). Yeast rosette rate of RBC C_3b receptor, as an active index of immunity of RBC, can serve as an indicator of patient's immune fuction and also can be reference for judging treatment effect and prognosis of a disease just as active rosette rate of T lymphocyte can do.

OBJECTIVE:To provide reference for rational use of drugs for gastrointestinal ulcer. METHODS:The drug use for gastrointestinal ulcer in outpatient department of our hospital during 2013-2015 was analyzed retrospectively in respects of drug name,consumption sum,DDDs,DDC,single/multiple diseases prescription,therapeutic efficacy,rationality of presoription,etc. RESULTS:A total of 8 kinds of drugs use for gastrointestinal ulcer in outpatient department of our hospital during 2013-2015, among which the consumption sum and DDDs of Omeprazole capsule and Rabeprazole capsule increased rapidly,and their DDC were the higher others;those of other drugs kept stable. The proportion of acid-inhibitory drugs in single disease prescriptions was lower than in multiple diseases prescriptions,while that of antiacid was higher than in multiple diseases prescriptions,with statisti-cal significance (P<0.05). The total effective rate of patients with gastrointestinal ulcer gradually increased from 77.98% to 82.68% in outpatient department of our hospital during 2013-2015,there was statistical significance between 2015 and 2013(P<0.05);the proportion of irrational prescriptions decreased from 5.01% to 2.12% year by year,with statistical significance among those years (P<0.05). CONCLUSIONS:Omeprazole is the first choice for gastrointestinal ulcer in outpatient department of our hospital with good therapeutic efficacy. There still are some irrational drug use in prescriptions,and clinicians should pay attention to those situations.

Obstetrics and Gynecology Hospital, Capital University of Medical Science, Beijing 100026, ChinaAbstract Objective To observe the change of lipid metabolic parameters, sex hormone and bone mineral density(BMD) in patients with endometriosis before and after oral administration of gestrinone. Methods Fifty-six patients with endometriosis, aged from 20 to 45, were treated with gestrinone 2.5 mg two times a week for 6 months one week after operation. Serum total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C),ApoA_1,ApoB,follicle stimulating hormone (FSH), luteinizing hormone(LH),E_2 and BMD were determined before taking gestrinone, after taking for 6 months and withdrawal for 6 months. Results After administration of gestrinone for 6 months, serum HDL-C and ApoA_1 decreased significantly (P

Objective:To investigate whether ghrelin, a novel endogenous ligand of growth hormone secretagogue receptor ( GHS-R) , was expressed in the thyroid tissues of different thyroid diseases, and its implication. Methods:The paraffin-embedded specimens of thyroid tissues from 2000 to 2004 were obtained from 57 patients with different thyroid diseases, including 5 subacute thyroiditis, 8 Hashimoto' s thyroiditis, 7 hyperthyroidism (Graves disease) , 8 nodular goiter, 5 thyroid adenoma, 3 thyroid lympho-ma, 8 papillary carcinoma, 3 follicular carcinoma, 5 medullary carcinoma and 5 undifferentiated carcinoma cases. The specimens of normal peri-adenoma thyroid tissues served as controls. Immunohistochemi-cal staining was used to detect ghrelin expression. Results:(1) ghrelin expression was undetectable in the thyroid tissues of normal control, subacute thyroiditis, Hashimoto' s thyroiditis and Graves disease. (2) ghrelin expression was also undetected in the tissues of nodular goiter, thyroid adenoma and thyroid lymphoma. (3 ) ghrelin-positive staining was found in the tumor cells of different types of thyroid carcin-moma. Five cases were positive within 8 cases in papillary carcinoma, 2 cases were positive within 3 cases in follicular carcinoma, 3 cases were positive within 5 cases in medullary carcinoma, 3 cases were positive within 5 cases in undifferentiated carcinoma. Conclusion:Ghrelin is expressed in malignant epithelial thyroid neoplasmas, but not in autoimmune or inflammatory thyroid diseases and benign nodular thyroid diseases. The results indicate that ghrelin expression may play an important role in the occurrence and development of thyroid carcinoma.

Objective To investigate the effect of postconditioning with propofol and ischemia on the hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 5 groups of 6 animals each: group I sham operation (group S); groupⅡ I/R; group Ⅲ ischemic postconditioning (group IPC); group Ⅳ propofol postconditioning (group PPC) and group V IPC + PPC. In group Ⅱ-Ⅳ the hepatic arteries and veins of middle and left lobes were occluded for 1 h followed by 4 h reperfusion. Ischemia of the liver was confirmed by the color of the liver turning from red to gray. In group Ⅲ and Ⅴ the livers were subjected to six episodes of 10 s ischemia at 10 s intervals at the end of 1 h ischemia before 4 h reperfusion. In group Ⅳ and V 0.5 % propofol 10 mg/kg was given iv at the end of ischemia followed by propofol infusion at 40 mg·g~(-1) ·h~(-1). Blood samples were taken at the end of 4 h reperfusion for determination of serum ALT activity. Mean-while liver specimens were taken for electron microscopic examination and determination of MDA content and SOD activity. Results I/R significantly increased serum ALT activity and MDA content in the liver and decreased liver SOD activity in group Ⅱ . The I/R-induced changes were significantly attenuated by propofol and/or ischemic postconditioning in group Ⅲ ,Ⅱ and Ⅴ . I/R significantly increased Bel-2 and Bax protein expression in the liver cells. Propofol and/or ischemic postconditioning increased Bel-2 protein expression further but decreased Bax protein expression in group Ⅲ , Ⅳ and Ⅴ as compared with group Ⅱ (group I/R).Electron microscopic examination showed that the pathologic changes induced by I/R were less severe in group Ⅲ, Ⅳ and Ⅴ than in group I/R. Conclusion Postconditioning with propofol and ischemia can reduce the hepatic I/R injury and the mechanism may be related to inhibition of lipid peroxidation and apoptosis, but the efficacy is the same as that of propofol postconditioning alone.