OBJECTIVE: To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction, and to explore the rational period of conservative therapy before operation. METHODS: Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed. The etiology of the obstruction was categorized, and the correlation of mortality and time interval between conservative therapy and operation was analyzed. RESULTS: There were 705 patients with acute intestinal obstruction included. There were 71.1% of the obstruction lesions located on the small bowel, and 82.6% of the patients experienced simple obstruction. The most frequent cause was adhesions (62.0%), and next was neoplasms (23.7%). There were 57.6% of the patients underwent the surgical treatment. The overall mortality rate was 1.6%, and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively. The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation, and the death might occur 24 hours after strangulation. CONCLUSION: The epidemiological transition to adhesive obstruction still exists in China, and it is similar to that in Western countries. In our experience, near half of the patients with simple obstruction may achieve palliation by conservative therapy. Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction, or strangulation disease within the first 24 hours.

OBJECTIVE:To provide basis and thinking for the development of medicines for treating depression. METHODS:Rats with adaptive feeding for 7 d were randomly divided into normal group,depression group and treatment group(citalopram hy-drobromide 1 mg/kg),8 in each group. Rats in depression group and treatment groups randomly received once low-density stimula-tion in a day [catching tail stimulation(1 min),frequent flashing stimulation(120 times/min,12 h),noise stimulation(4 h),ice water swimming stimulation(1 h),hot water stimulation(45 ℃,1 h),electric shocking foot(10 Hz,1 mA,each time interval of 100 ms,100 times),no food and no water(24 h)] for 21 d to reduce stress depression model. Body mass of rats in 0,7 d of adaptive feeding and 7,14,21 d of stress were respectively weighed,and horizontal activity and vertical activity frequencies in open field test were detected. After stress,rats were intragastrically administrated related medicines for 30 d,then 5-hydroxytrypta-mine (5-HT) and tryptophan hydroxylase (TPH) expressions in brain,liver,kidney tissues were determined. RESULTS:Com-pared with normal group,the increasing trend of body mass in depression group and treatment group slowed down from the 14 d of stress(P<0.05). The horizontal activity frequencies in depression group and treatment group in 14,21 d of stress slowed more ob-viously than the previous time point (P<0.05 or P<0.01);vertical activity frequencies in 21 d of stress slowed more obviously than the previous time point (P<0.05 or P<0.01). After 30 d of administration,horizontal activity and vertical activity frequen-cies in treatment group were increased more obviously than the previous time point (P<0.01). Compared with depression group,brain tissue of rats,indicating that TPH can be used as a target for depression treatment.

BACKGROUND: The occurrence and severity of acute high-altitude disease(AHAD) are determined by the speed entering the highland, the altitude of highland and seasons. The association between obesity and AHAD has not been fully investigated.OBJECTIVE: To investigate the association between obesity and acute high-altitude in people exposed rapidly to the highland.DESIGN: Comparative observation.SETTING: Department of Cardiology, General Hospital of Chinese PLA and Department of Cardiology, Tibetan General Hospital of Chinese PLA.PARTICIPANTS: The experiment was conducted at the Department of Cardiology, General Hospital of Tibetan Military Area Command of Chinese PLA in August 2006. Totally 82 Henan subjects aged 28-45 years were selected from the male workers constructing the Qinghai-Tibet Railway and their managers with acute high-altitude exposure. They had never been to the highland before, and all agreed to the detection.METHODS: ①Every subject completed the AHAD self-report questionnaire at sea level and 12 hours and 24 hours after ascending high-altitude. The items in the questionnaire included symptoms of headache, gastrointestinal symptoms,fatigue or weakness, dizziness, and insomnia. Each symptom was graded from 0-3 with 0 as no symptoms, 1 as mild symptoms, 2 as moderate symptoms, and 3 as severe symptoms and a total score of 15. A score of 4 or more could by identified as AHAD. ②The height and body mass were measured to calculate the body mass (BMI). Those with BMI≥28 kg/m2 served as the obesity group [n =39, mean age (35±8) years], and those with BMI of 18.5-23.9 kg/m2 as the normal body mass group [n =43, mean age (35±8) years]. ③Arterial blood was taken to evaluate arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. ④The measurement data was compared by t test.MAIN OUTCOME MEASURES: BMI, vital capacity of lungs, SO2, PaO2 and PaCO2 levels of obese and normal people.RESULTS: Totally 39 obese people and 43 normal people were involved in the result analysis. ①AHAD score: No symptom was reported at sea level in all participants (scored 0), but the AHAD scores in the obesity group were significantly higher than those in normal group 12-hour and 24-hour after ascending high-altitude. ②Blood gas analysis:At sea level, there were no statistical differences in the levels of SO2, PaO2, and PaCO2 between two groups (P ＞ 0.05).But 24 hours after ascending high-altitude, SO2 and PaO2 of the obesity group were much lower than in the normal group (P＜ 0.01), and PaCO2 was significantly higher than in the normal group (P＜ 0.01).CONCLUSION: Obese men are more vulnerable to high-altitude hypoxia than people with normal body mass. Obesity is an important risk factor for the development of acute high-altitude disease.

The effects of ultrafine grinding on the dissolution rates of the effective components in Sanjie Zhentong capsule (SZC) were studied in this experiment. Fine and ultrafine powder of SZC intermediates were made by ordinary grinding and ultrafine grinding technology, and then granulated by wet granulation. SZC were prepared by fine powder, ultrafine powder and ultrafine granules, respectively. With resveratrol and loureirin B as investigated indexes, dissolution rates of the four intermediates in SZC were determined by cup method and HPLC. The dissolution rates of resveratrol in SZC prepared by fine powder, ultrafine powder and ultrafine granules were 26.11%, 63.27%, 67.49%, respectively; and the dissolution rates of loureirin B were 7.160%, 20.29%, 23.05%, respectively. The dissolution rate of resveratrol and loureirin B in SZC prepared by ultrafine granules was the best. D90 size of ultrafine grinding was 13.221 μm and could improve the dissolution rates of resveratrol and loureirin B in SZC.
Capsules ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Particle Size ; Silicones ; chemistry ; Solubility ; Technology, Pharmaceutical ; methods

BACKGROUND:Dysphagia is one of common early complications after anterior cervical fusion. Medium and severe dysphagia often causes serious influence on the patients. A variety of factors have been shown to have a correlation with the postoperative dysphagia, but specific mechanism is stil unclear. OBJECTIVE:To explore the risk factors for dysphagia after single-level anterior cervical fusion. METHODS:From January 2011 to June 2013, data of 44 patients with dysphagia and 213 patients without dysphagia after single-level anterior cervical fusion were compared. The baseline data (age, gender, ethnicity, body mass index, smoking history, drinking history, hypertension, diabetes, course length, and type of cervical spondylosis) and perioperative data (intraoperative blood loss, internal fixation, the location of the operated level, operation time, and the side of operation approach) between two groups were compared by Logistic regression analysis to determine risk factors for postoperative dysphagia.RESULTS AND CONCLUSION:A total of 257 patients were included with a fol ow-up for 6 to 24 months postoperatively and 44 of them suffered from dysphagia after single-level anterior cervical fusion. The overal prevalence for postoperative dysphagia was 17.1%. Univariate analysis indicated that age, gender, the location of the operated level, and course length were associated with postoperative dysphagia. Logistic regression analysis of multivariate analysis demonstrated that independent predictors for postoperative dysphagia included gender (female), age (>60 years), the location of the operated level (C 4-5 , C 5-6 ), and course length (>12 months). Clinicians should give appropriate recognition and take corresponding measures to avoid it.

Objective To explore the feasibility of low-tube-voltage and low-concentration contrast agent applied to coronary computed tomography angiography (CTA) in the overweight patients. Methods Totally 83 overweight patients with suspected coronary heart disease who underwent coronary artery angiography were randomly assigned into two groups. Group A used 100 kVp and ioversol-320 mg/ml, and Group B received 120 kVp and iopamidol-370 mg/ml. Both the groups went through prospectively ECG-gated scanning. The two groups were compared on the image quality, radiation dose, iodine intake and coronary artery segments scores. Results The effective radiation dose and iodine intake in Group A were significantly lower than those in Group B (P<0.05). Group A had the coronary artery CT value and image noise lower significantly than Group B (P<0.05). No significant differences in signal to noise ratio, contrast to noise ratio and coronary artery segments scores were observed between the two groups (P>0.05). Conclusion For coronary artery CTA in the overweight patients, low-tube-voltage and low-concentration contrast agent still preserves the image quality, as well as significantly reduces the radiation dose and iodine intake.

Objective To explore the change of serum insulin-like growth factor-2 (IGF-2) and its relationship with clinical characteristics in patients with schizophrenia. Methods Fifty-one schizophrenic patients were recruited in the present study and 50 healthy volunteers served as controls. The serum IGF-2 level was measured using enzyme linked immunosorbent assay (ELISA). Positive and Negative Syndrome Scale (PANSS) was used to evaluate the psychotic symp?toms of patients. Trail Making Test-A (TMTA), Digit-Symbol Coding Test (DSCT), Continuous Performance Test (CPT) and Stroop Color-Word Test (SCWT) were used to evaluate the cognitive function of both groups. Results There were sig?nificant differences in the results of TMTA, DSCT, CPT and SCWT between patient and control groups. The serum levels of IGF-2 were significantly lower in patients than that in controls [(202.7±40.7) ng/mL vs. (365.9±65.5) ng/mL, P<0.01]. The levels of serum IGF-2 were not significantly different between first-episode and recurrent schizophrenic patients (P>0.05). Furthermore, significant correlations were found between the serum IGF-2 level and the negative symptom sub?scale of PANSS (r=-0.397, P=0.004), CPT score (r=0.378, P=0.006), SCWT-word number (r=0.289, P=0.040), SC? WT-color number (r=0.327, P=0.019) and SCWT-word/color number (r=0.386, P=0.005) in schizophrenic patients. Con?clusion The serum IGF-2 levels of patients with schizophrenia are significantly lower than that of healthy controls, and the IGF-2 level is associated with the severity of negative symptoms and cognitive impairments in patients, indicating that serum IGF-2 might be an indicator of the severity of schizophrenia.

Objective To explore the mechanism of deep brain stimulation(DBS)therapy to Parkinson's disease(PD).Methods We produced hemi-parkinsonian rat model with stereotaxically injecting 6-OHDA to right medial forebrain bundle(MFB)and stimulated ipsilateral subthalamu nucleus (STN)with platinum electrodes chronically to investigate the influence of DBS to the expression of Calbindin-28,synaptophysin and tyrosine dioxydase(TH)in Striatum by Western blot.In addition,slices of bilateral PD rats after DBS were stained to observe the expression of Calbindin-28 and synaptophysin in substantia nigra by Immunohistochemistry.Results High frequency stimulation impaired the rotational frequency 31% of unilateral PD rats triggered by apomophine;Long-term DBS increased the expression of TH in innocent striatum of unilateral PD rats 78.6%?9.5%,since the ipsilateral striatum(lesion side) was TH depleted by 6-OHDA insults;Calbindin-28 expression in ipsilateral striatum of hemi-PD rats raised up 75.4%?15.0% and long-term DBS reduced the effect by 43.0%?7.1%,meanwhile Calbindin-28 positive neurons in substantia nigra compacta in sham,PD and DBS rats were 74.5?10.2,75.7?15.6, 33.1?7.8.However,Synaptophysin expression in substantia nigra and striatum kept stable even after long- term DBS.Conclusions Consistent to the treatment to PD patients,DBS to STN alleviated the motor disorder of PD rats,the treatment might be based on regulating the expression of Calbindin-28 and TH.

Objective To observe the therapeutic effect of the sacral nerve stimulation (SNS)on the neurogenic bladder. Methods SNS was used to treat 94 patients with neurogenic bladder. The ICI-Q-SF scores, voiding diary (including urinary incontinence times, urinal pad test, urination times,nocturia times and urinary volume) and urine dynamics test (including bladder volume, pressure of detrusor, maximum urinary flow rate, average urinary flow rate, pressure of bladder neck, maximal urethral pressure, functional urethral length and residual urine volume) were observed before and 1 week after SNS. And the data was analyzed statistically. Results The ICI-Q-SF scores were 17.2±1.8 before the treatment of SNS and 8.3±1.6 after SNS (P＜0.05). The urinary incontinence times, urination times and nocturia times were significantly decreased (P＜0.05) compared with those before treatment. The weight of urinal pads was lessened significantly (P＜0.05), while the urinary volumes were increased significantly (P＜0.05). The bladder volume, the maximum urinary flow rate and the average urinary flow rate were increased significantly (P＜0.05) while the residual urine volumes were decreased significantly (P＜0.05). There were no differences in pressure of detrusor, pressure of bladder neck, maximal urethral pressure and functional urethral length (P＞0.05). No complication occurred in our study and total effective rate was 75.5%. Conclusions The therapeutic effect of SNS on the neurogenic bladder is sure, and the symptom of the neurogenic bladder is well improved with few complications. It should be widely used.

BACKGROUND: Recently, it is thought that endothelial function is a new independent risk factor of atherosclerotic disease. However, the differences in endothelial function between Tibetan and Han nationality populations have not been fully investigated.OBJ ECTIVE: To investigate the differences in endothelial function between Tibetan and Han nationality population.DESIGN: Controlled analysis.SETTING: Department of Cardiology, General Hospital; Department of Cardiology, Tibet General Hospital of Chinese PLA.PARTICIPANTS: Totally 272 Tibetan male subjects, aged (43±9) years, were enrolled in this study to stand for Tibetan nationality populations. All of them were native residents in Lhasa city. And 580 Qinghai-Tibetan railway constructers with Han nationality, aged (42±11) years, were enrolled in this study to stand for Han nationality populations. All of them were male subjects from Sichuan province and lived in Lhasa city for at least 1 year. All the participants received regular physical examination between February and May 2006 in the General Hospital of Tibet Military Area Command of Chinese PLA. All the subjects lived in the same high-altitude area (the altitude of Lhasa is 3 658 m). Informed consents were obtained from all the participants.METHODS: ①Height, body mass, waist circumference, hip circumference, systolic blood pressure(SBP) and diastolic blood pressure (DBP) were measured. Body mass index (BMI) was measured as body mass/height2. ② Measurement of brachial artery flow-mediated dilation (FMD): All the participants, who were in the fasting state, were examined in supine position following 20-minute rest. The room temperature was about 20 ℃. In the right arm, a sphygmomanometer cuff was positioned 5 cm below the antecubital fossa. A 10-MHz transducer (Vivid 7, GE Corporation, USA) was used to image the right brachial artery. After obtaining the baseline imaging, the blood pressure cuff was inflated 50 mm Hg (1 mm Hg=0.133 kPa) above the participant's SBP to occlude the brachial artery for 4 minutes. The brachial artery was then imaged during cuff inflation and 2 minutes after cuff release. After the cuff was released and reactive hyperaemia occurred, that was, flow in the brachial artery increased to accommodate the dilated resistance vessels in the forearm. In order to ensure the reliability of the data, the cuff placement and image record were performed by two designated performers. Computer-assisted analysis software was used to calculate brachial artery diameters. The absolute and relative changes of brachial artery FMD were automatically calculated out with the attached software of Vivid 7 ultrasonic diagnosis instrument. ③Biochemical study: The biochemical parameters were obtained after an overnight fasting for 12 hours. Venous blood was sampled for the measurement of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C). ④ Analysis of variance was used to evaluate the measurement data. Chi-square statistic was used to compare enumeration data.MAIN OUTCOME MEASURES: Comparison of change in BMI, waist-hip ratio, blood pressure, blood lipid, baseline brachial diameter and brachial diameter between 2 groups.RESULTS: Totally 272 Tibetan nationality populations and 583 Han nationality populations participated in the final analysis. ① Brachial artery FMD: The baseline brachial artery diameter of Tibetan nationality populations was significantly larger than that of Han nationality population [(4.28±0.06) mm vs. (4.03±0.04) mm, t =71.915 6, P ＜0.01]; The absolute and relative changes of brachial artery of Tibetan nationality populations were significantly smaller than those of Han nationality populations, respectively [(0.124±0.005) mm vs. (0.141±0.006) mm; (2.934±0.204)% vs.(3.587±0.152)%, t = 40.582 0,52.173 2, P ＜ 0.01]. ②Physical study results: BMI and waist-hip ratio of Tibetan nationality populations were significantly larger than those of Han nationality populations [(30.1±2.5) kg/m2 vs. (26.5±3.4) kg/m2, 0.92±0.07 vs. 0.88±0.05, t =15.595 1, 9.525 4, P ＜ 0.01]. ③TG and LDL-C levels of Tibetan nationality population were (2.31±1.31) mmol/L and (3.49±0.91) mmol/L, respectively, which were significantly higler than those of Han nationality population [(1.97±1.44) mmol/L and (3.07±0.86) mmol/L, t =3.420 0, 6.522 3, P ＜ 0.01].CONCLUSION: ① Brachial artery FMD of Tibetan nationality population is poorer than that of Han nationality population,I.e. Poor vascular reactivity. ② Tibetan nationality populations have severe abdominal obesity and higher level of blood lipid as compared with Han nationality populations.