Objective To synthetical analyse the current status of medication in portal hypertension (PHT) and the direction of development. Methods Papers of treatment of PHT in large quantity of cases and /or by standard clinical test were collected and reviewed. Results Treatment of PHT had been converted from surgery to medication gradually.The effect of medication had increased gradually with drug improvement.Conclusions Medication of portal hypertention is an effective and practicable technique to treat portal hypertention, and it is the research direction in the future.

Objective Orthotopic liver transplantation (OLT) without bypass is technically simpler butimposes additional stress and strain on already compromised ciroulatory function and milieu interieur. The purposeof this study was to investigate the changes in arterial blood concentrations of glucose and lactate during OLTwithout bypass. Methods Eighty patients (66 male, 14 female) aged 12-67 yr weighing 40-130 kg undergoingOLT without veno-venous bypass for terminal liver cirrhosis (40 patients), liver cancer (28 patients), hepato-lenticular degeneration (5 patients), polycystic liver (3 patients) and severe hepatitis (4 patients). Nine patientswere classified as ASA physical status Ⅱ, thirty-nine patients as ASA Ⅲ, thirty patients ASA Ⅳ and two patientsASAV. Anesthesia was induced with midazolam 2 mg, fentanyl 10-15?g?kg~(-1), propofol 1 .0 - 1 .5 mg?kg~(-1) andpancuronium 0. 15 mg?kg~(-1) and maintained with isoflurane inhalation and intermittent i. v. boluses of fentanyl,midazolam and pipecuronium. The patients were mechanically ventilated after intubation, P_(ET) CO_2 was maintained at32-35 mm Hg. No fluid containing glucose was infused during operation. Radial artery and internal jugular veinwere cannulated for BP and CVP monitoring. ECG, MAP, CVP, SpO_2, P_(ET)CO_2, temperature and urine outputwere continuously monitored during operation. Blood samples were taken from artery before anesthesia (T_0 ), beforecross-clamping of portal vein (T_1), 30 and 60 min during anhepatic phase (T_2, T_3), 5 and 30 min afterunclamping of vena cava before the unclamping of portal vein (T_4, T_5 ) and at the end of surgery (T_6 ) fordetermination of blood glucose and lactate concentrations. Blood lactate was determined only in 50 patients whoreceived no lactated but acetated Ringer's solution during operation. In 70 patients blood samples were obtainedfrom hepatic vein after unclamping of portal vein and before the end of exsanguination from the hepatic vein fordetermination of blood glucose and lactate. Results No patient developed hypoglycemia during operation. Bloodglucose increased slightly before cross-clamping of portal vein (T_1) and during anhepatic phase (T_2, T_3) comparedwith the baseline value before anesthesia (T_0 ) (P

Objective To compare the effects of three different crystalloid solutions on arterial blood lactate concentration and acid-base balance during orthotopic liver transplantation (OLT) without veno-venous bypass. Methods Ninety ASA Ⅱ-Ⅳ patients with end-stage liver disease of both sexes (78 males, 12 females) aged 16-67 yrs weighing 45-87 kg undergoing OLT were randomly allocated to one of 3 groups ( n = 30 each): group Ⅰ received normal saline (NS); group Ⅱ received lactated Ringer's solution (LR) and group Ⅲ acetated Ringer's solution (Plasma A, Baxter) (PA). The crystalloid was infused at a rate of 6-8 ml?kg-1?h-1. Colloid, albumin, RBC and whole blood were infused based on BP, CVP and Hb concentration. The arterial pH, BE and lactate concentration were measured before anesthesia (T0 baseline) , before cross-clamping of the portal vein (T1) at 30 min and the end of anhepatic phase (T2,T3) , 5 and 30 min after unclamping of the portal vein (T4,T5) and at the end of surgery (T6). Results There was no significant difference in the amount of crystalloid, colloid and blood products infused during operation among the 3 groups. Arterial pH decreased significantly at T1 (immediately before anhepatic phase) as compared to the baseline value at T0 and the low pH was maintained until the end of operation. BE was significantly decreased during anhepatic phase (at T2 and T3 ) . The blood lactate was increasing during operation and was 3 times that of baseline value at the end of operation. However there was no significant difference in arterial pH, BE and lactate concentration among the 3 groups.Conclusion In OLT without venovenous bypass, blood lactate increases progressively but the lactated Ringer's solution does not have any effect on the blood lactate concentration.

Objective To analyze the difference in changes of upper airway between obstructive sleep apnea syndrome (OSAS) patients and normal population using dynamic radiography under sleeping and awake conditions.Methods 20 normal subjects and 20 OSAS patients underwent the dynamic digital radiography of the upper airway under sleeping and awake conditions.And the dynamic diameter changes of the upper airway at velopharyngeal,oropharynx and hypopharynx levels were measured and recorded.Results The velo-pharyngeal upper airway collapse in normal subjects under sleeping condition was significantly larger than that under awake condition (P <0.014).However no significant differences in the collapse of upper airway at oropharynx and hypopharynx level were observed between sleeping and awake conditions.For the OSAS patients,the upper airway collapses at velopharyngeal,oropharynx and hypopharynx levels under sleeping condition were significantly larger than those under awake condition respectively (P <0.000,P =0.001,P <0.013). During awake state,there were no significant differences in upper airway collapse at velopharyngeal,oropharynx and hypopharynx levels between normal subjects and OSAS patients under awake condition.During sleeping state,the upper airway collapses of OSAS patients were significantly larger than that of normal subjects at velopharyngeal and oropharyngeal levels (P =0.000,P =0.003). However,no significant difference was observed at hypopharynx level.Conclusion The normal upper airway represents obvious col-lapse at velopharyngeal level under sleeping condition.However,the upper airway in OSAS patients at velopharyngeal,oropharynx and hypopharynx level showed significant collapse under sleeping condition compared with that under awake condition.The upper airway of the OSAS patients represents obvious collapse at velopharyngeal and oropharyngeal level under sleeping condition,however no abnormal changes can be observed under awake condition.

Objective To study the effect of Tibet medicine of Herba Lamiophlomis rotata on promoting hemostasis and blood coagulation and to explore its mechanism. Methods High dose(2 g/kg),middle dose(1 g/kg) and low dose (0.5 g/kg) of the aqueous extract from Herba Lamiophlomis rotata(HLRE)were given to mice by gastric gavage for 3 days,and then bleeding time (BT),clotting time(CT) and platelet count(PLC)were determined. Different doses of HLRE(3,1.5,0.75 g/kg)were administered by gastric gavage to rats for 14 days,and then blood samples were collected from common carotid artery for the determination of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time(TT),fibrinogen(FIB),hepatic function and blood lipid indexes. Results Compared to the blank control group,the bleeding time and clotting time were obviously shortened in 2g/kg HLRE and 1g/kg HLRE groups and positive control group,but the difference of PLC was insignificant. PT and APTT values in all of the treatment groups did not differ from those in the blank control group. However, TT values were obviously shortened in 3 g/kg HLRE group,FIB and Albumen(Alb)values increased,the aminotransferase and blood lipid values tended to decrease. Conclusion The aqueous extract from Herba Lamiophlomis rotata has an effect on promoting hemostasis and blood coagulation ,and its mechanisms may be related to the increase of FIB and Alb contents and the shortening of TT value.

BACKGROUND:Valvular interstitial cel s are the main components of the heart valves. Myofibroblasts, as a kind of valvular interstitial cel s, can express alpha-smooth muscle actin and type I col agen fiber, and hold differentiation potential. These cel s cannot only play a support role in the valve structure, but also play a regulatory role in the process of the valve normal physiological and pathological responses.
OBJECTIVE:To obtain a reliable method of separation, primary culture and identification of myofibroblasts laying a foundation for further study on the cardiac valvular calcification.
METHODS:Aortic valve myofibroblas extracted from porcine hearts were primary cultured by trypsin and col agenase combined digestive method, common enzyme-digestion method and tissue-culture method, respectively. The myofibroblast activity and morphology were observed using microscope, and myofibroblasts were identified using light microscope and immunocytochemistrial method.
RESULTS AND CONCLUSION:Myofibroblasts had a higher activity and purity cultured by trypsin combined with col agenase II digestion method. Aortic valve myofibroblasts were positive for alpha-smooth muscle actin and negative for von Wil ebrand factor under fluorescence microscope, suggesting that myofibroblasts were successful y obtained.

Objective To study the pathological changes of acute hemorrhagic necrotizing pancreatitis(AHNP) complicated with acute lung injury(ALI). Method The model of AHNP with ALI was established in rats. The changes of function and structure of pancreas and lung were observed. Results One hour after induction of the model , pancreas showed mild edema and congestion . 12 hours after introduction of the model , the typical pathological changs of AHNP were found . The lung extravascular water volume and levels of PaCO 2 increased significantly, and the PaCO 2 decreased obviously. Morphological examination demonstrated that inflammatory cell , insterstitial edema , intra-alveolar hemorrhage ,desquamate and disintegration occurred in the lungs. Conclusions The pancreatic and pulmonary morphologic changes in this model is similar to the changes in clinical AHNP with ALI , which suggests that the model can be used to study the mechanism of AHNP with ALI and evaluate the effect of drugs for AHNP with ALI.

Objective To investigate the effects of miR-335-5p on the proliferation and apoptosis of osteoblasts which were exposed to high glucose condition, and explore its possible molecular mechanisms. Methods MC3T3-E1 osteoblasts were divided into four groups:control group(5. 5 mmol/L glucose), high glucose group(HG group, 22. 0 mmol/L glucose), agomir-335-5p group(transfected with agomir-335-5p and exposed to 22. 0 mmol/L glucose) , and agomir negative control group( agomir NC group, transfected with agomir negative control and exposed to 22. 0 mmol/L glucose), cultured for 7 days. Cell proliferaton, cell apoptosis, expressions of miR-335-5p and dickkopfhomolog1(DKK1)mRNA,proteinlevelsofDKK1andcysteinylaspartate-specificproteinase-3(caspase-3) were detected using MTT, flow cytometry, quantitative realtime PCR and western blot, respectively. Results Compared with control group, the expression of miR-335-5p mRNA and cell proliferation in HG group were significantly decreased(P<0. 05), while cell apoptosis and the protein levels of DKK1 and caspase-3 were increased significantly(P<0. 05), the expression of DKK1 mRNA did not change (P>0. 05). The miR-335-5p mRNA expression and cell proliferation in agomir-335-5p group were higher than those in HG group and agomir NC group(P<0. 05). However, Cell apoptosis and the protein levels of DKK1 and caspase-3 in agomir-335-5p group were lower than those in HG group(P<0. 05). Conclusion High glucose inhibits the proliferation and induce the apoptosis of MC3T3-E1 osteoblast through decreasing the expression of miR-335-5p and subsequently increasing the DKK1 expression.

OBJECTIVE:To investigate the effects of different operation methods on the residual amount of docetaxel. METH-ODS:60 Docetaxel injections were selected and divided into two groups,i.e. standard operation method was adopted in group A (30 injections),and clinical common operation method was used in group B(30 injections). Docetaxel injections were placed for 5,10 or 15 minutes respectively,and drained. Residual liquid was collected to calculate residual amount. The difference of residual amount,due to preparation method and standing time,were compared between two groups. RESULTS:After placing for 5,10 or 15 min,the volume and amount of residual liquid in group B were significantly higher than in group A(P<0.05). In same group, the volume and amount of residual liquid after placing for 10 and 15 min were all lower than that after placing for 5 min(P<0.05 or P<0.01);the volume and amount of residual liquid after placing for 15 min were lower than that after placing for 10 min(P<0.05). CONCLUSIONS:The standard operation of pharmacy dispensing staff is very important to reduce the residual amount of docetaxel,and guarantee safe,effective and sufficient medication. It is suggested that clinical staff should abide by standard opera-tion method.