MEDLINE,Ovid,CNKI,and Vip Database were retrieved for articles of diuretics induced hyponatremia.6 retrospective studies,2 prospective studies,and 31 case reports were included.Pearson correlation coefficient of the cumulative dose and serum sodium level was-0.121 (P =0.757).It is suggested that serum sodium level should be closely monitored while administrating diuretics,especially in patients with high-risk of hyponatremia.

To explore the relationship between the activity of polyol pathway and diabetic microangiopathy, the level of red blood cell sorbitol(RBCS)in 106 patients with NIDDMwas determined. The results indicated that the level of RBCS in diabetic patients was significantly increased, and was positively correlated with 24-h urinary albumin excretion rate(UAER)and the degree of diabetic retinopathy(DR). Besides,the value of RBCS in patients with both pro-teinuris and DR or proteinuria was markedly higher as compared with that in patients with either proteinuria or DR,and the concentration of RBCS in the patients with DR of proteinuria was also significantly higher than those wth neither proteinuria nor DR. In addition.it was also found that the value of RBCS gradually elevated with the aggravation of UAERand DR. These findings suggest that the elevation of RBCS level plays an important role in the formation and development of diabetic microangiopathy.

Objective To investigate which subfamily genes of T cell receptor (TCR) V? expand predominantly during the course of experimental allergic neuritis (EAN). Methods Using RT-PCR and in situ hybridization techniques,the expression levels of TCR V? 2,6,8,10,14 in the peripheral blood,lymph nodes,peripheral nerves of group EAN and those of the control group were compared. Results In group EAN,the expression of TCR V? 6?8 mRNA increased at the early phage(41.1?1.1 and 74.4?1.9 vs 25.9?1.5 and 26.1?1.6) and became more significantly at the peak of the disease,and resolved to normal at the recovery phage in the lymph nodes.But they amounted up gradually from the early stage to the peak,and then decreased a little in the infiltrating T-lymphocytes in peripheral nerves,the difference was significant.In addition,the expression of TCR V? 8 was notably higher than that of TCR V? 6 in the levels of mRNA. Conclusion The subfamilies of TCRV? genes which restrict the development of EAN due to recognizing the specific antigens are TCRV? 8 and TCRV? 6. T lymphocytes specifically expressing TCR V?6?8 genes are activated and clonally proliferated in the lymph nodes,and then migrate to the involved peripheral nerves,which might induce a series of immune lesions consequently.

objective To evaluate endoscopic surgery for high risk patients over 70 years old with severe acute cholangitis. Methods From October 1991 to October 2003, 84 high risk patients over 70 years old suffering from severe acute cholangitis were included and divided into laparotomy surgery (ST) and endoscopic surgery (ET) group. Results 80 patients were cured. The care rate was 81.2% in ST group and 91.6% in ET group. The mortality rate was lower in ET compared with ST (9.1% vs 18.8%). The rate of complication was reduced from 37.5% in ST group to 13.9% in ET group. The average duration of drainage was reduced from 49.4 days in ST group to 18.6 days in ET group. The total treatment days were shortened from 46.2 days to 22.8 days comparing ST with ET. Conclusions Endoscopic surgery should be the first choice for the senile and high risk patients with severe acute cholangitis. Endoscopic surgery was convenient, with mininal injury, safe and effective, and period of treatment was shortened, especially for elderly or critically ill patients, as well as those with MODS or previous billiary operations.

Objective To evaluate the efficacy and toxicity of chemotherapy containing paclitaxel in patients with advanced breast cancer.Methods Chemotherapy containing paclitaxel was used in 30 patients with advanced breast cancer.Paclitaxel was administered by iv infusion at a dose of 135*!mg/m 2 in 3-hour every 3～4 weeks for an average of 4 sessions. All patients received premedication of dexamethasone, diphenhydramine and cimetidine to prevent allergic reactions. Results The overall response rate was 43%(13/30),including complete remission(CR) in 3(10%) cases and partial remission(PR) in 10(33%). The average duration of remission was 1.6 months in CR cases and 5 months in PR cases respectively.The major toxicity associated with paclitaxel administration includes neutropenia,myalgia,arthralgia, numbness of hands and feet,alopecia and flushing of face. Conclusion Paclitaxel is an effective agent for treatment of advanced breast cancer and its side effects are tolerable.

Objective To evaluate the anatomic relationships between the portals and radial nerve of three different operations of antrolateral approach elbow arthroscopy.Methods The dissections were pedormed in 10 formalin soaked adult cadaver elbows.The distances from the three different antrolateral portals to the radial nerve in extension and flexion 90° position were measured.The portal A was located at 3 cm distal and 1 cm anterior to the lateral epicondyle;the portal B was located at 2 cm distal and 2 cm anterior to the lateral epicondyle;the portal C,1 cm distal and 1 cm anterior to the lateral epicondyle.Results The nearest distances from the anterolateral portal A,B,and C to the radial nerve in extension position were (2.30 ± 0.95) mm,(3.00 ± 1.56) mm,and (3.60 ± 1.65) mm,with significant differences (F =11.097,P =0.001).Statistical difference in distances from the anterolateral portal to the radial nerve between portal A and C was found (P =0.006).No statistically significant difference was seen between A and B or B and C (PA-B =0.134,PB-c =0.072).The distances from the anterolateral portal A,B,and C to the radial nerve in flexion 90° position were (4.40 ± 2.01) mm,(6.10 ± 1.79) mm,and (7.90 ± 1.85) mm,with significant differences (F =54.775,P =0.000).There were statistically significant difference among the three approaches (PA-B =0.000,PA-c =0.000,PB-c =0.002).The distances increased when the position changed from extension to flexion 90° for portal A (t =-5.161,P =0.001),portal B (t=-8.188,P=0.000),and portal C (t =-10.167,P =0.000).Conclusion The anterolateral portal 1 cm distal and 1 cm anterior to the lateral epicondyle is the safest apporach.

Objective To compare the quality of life before ischemia postconditioning and 6 months after ischemia postconditioning in patients with acute ST segment elevation myocardial infarction,and investigate the related risk factors.Methods One hundred and twenty-nine patients with acute ST segment elevation myocardial infarction were given the ischemie postconditioning.The quality of life was evaluated before ischemia postconditioning and 6 months after ischemia postconditioning by 36-item short-form health survey (SF-36) and seattle angina questionnaire (SAQ).Results In acute ST segment elevation myocardial infarction patients treated with ischemia postconditioning,the scores of SF-36 and SAQ were significantly lower at 6 months after ischemia postconditioning than those before ischemia postconditioning [SF-36:total score of body health (76.4 ± 17.3) scores vs.(56.3 ± 16.8) scores,physiologic function (75.3 ± 18.1) scores vs.(52.4 ± 19.2) scores,physiologic functional authority (75.6 ± 16.5) scores vs.(48.5 ± 20.3) scores,body pain (77.2 ± 15.4) scores vs.(58.7 ± 16.6) scores,total health state (73.6 ± 17.8) scores vs.(50.6 ± 14.7)scores,total score of mental status (77.5 ± 15.3) scores vs.(55.3 ± 17.3) scores,vitality (69.3 ± 18.1)scores vs.(43.2 ± 17.4) scores,society function (70.3 ± 17.5) scores vs.(41.3 ± 14.2)scores,affection functional authority (80.2 ± 17.4)scores vs.(63.5 ± 14.3)scores,mental health (77.6 ± 18.4) scores vs.(55.6 ± 20.1) scores,health change (76.3 ± 17.4) scores vs.(53.4 ± 16.6) scores;SAQ:body limitation of activity (78.46 ± 12.21) scores vs.(35.34 ± 15.33)scores,angina stable state (74.23 ± 8.53) scores vs.(30.12 ± 5.38) scores,angina episode state (72.34 ± 10.33) scores vs.(27.33 ± 9.12) scores,satisfaction degree of treatment (76.42 ± 12.13)scores vs.(30.56 ± 15.57) scores,knowledge of diseases (74.22 ± 9.35)scores vs.(37.25 ± 20.32) scores] (P ＜ 0.05).The results of multiple linear regression equation showed that the older,more severe vascular lesions,and lower total score of body health score before ischemia postconditioning indicated lower total score of body health,and worse quality of life after ischemia postconditioning.Conclusions The quality of life of patients with acute ST segment elevation myocardial infarction after ischemia postconditioning is significantly improved,compared with that before ischemia postconditioning.Advanced age,vascular disease and lower total scores of body health before ischemia postconditioning are independent risk factors of total scores of body health after ischemia postconditioning.

ObjectiveTo investigate the effect of neoadjuvant chemotherapy in locally advanced cervical cancer on cell cycle,proliferation,and evaluate the feasibility of proportion of cell in different phase 　and proliferating cell nuclear antigen(PCNA) as sensitive indices to assess chemotherapeutical sensitivity and therapeutical effect.MethodsForty-nine cases of locally advanced cervical cancer were divided into response group and no-response group according to the clinical efficacy of neoadjuvant chemotherapy.Compared the proportion of cell in different phase and proliferation index of PCNA between two groups.The clinical therapeutic effect was evaluated after 4 weeks in the second neoadjuvant chemotherapy regimen.Results In 49 patients with locally advanced cervical cancer,clinical effective of 39 cases (response group),no effective of 10 cases(no-response group).The S-phase proportion of cell in the pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy of response group[ (21.47 ± 5.21 )％ and(18.32 ±5.07)％] were higher than those of no-response group [ (9.63 ± 2.58)％ and ( 10.14 ± 2.32)％ ] (P ＜ 0.05 ).The proliferation index of PCNA of cervical cancer in the pre-neoadjuvant chemotherapy of response group [ ( 81.67 ± 7.14)％ ] was higher than that of no-response group [ (66.99 ± 2.29 )％ ] (P ＜ 0.05 ).Conclusion The S-phase proportion of cell and proliferation index of PCNA in the pre-neoadjuvant chemotherapy are important indexes to assess chemotherapeutical sensitivity and therapeutical effect.

Objective To explore the effects of wogonin on hyperlipidemia in mice and clarify the molecule mechanism. Methods Thirty mice were evenly divided into three group normal control group,model control group and treatment group. The normal control group was given normal diet,the model control group received high-fat diet,the treatment group received high-fat diet with wogonin (500 mg·kg-1 ). Results The mice developed hyperlipidemia 12 weeks after starting the high-fat diet. The body weight,visceral fat and fat index were increased (P<0. 05). After treatment,these indices were reduced ( P < 0. 01). Wogonin significantly reduced the total cholesterol ( TC),low density lipoprotein ( LDL),high density lipoprotein (HDL),except the triglyceride (TG). Compared to the model control group,the hepatic lipase(HL) and lipoprotein lipase(LPL) activity in the treatment group were recovered (P<0. 05),but HMG-CoA reductase activity was inhibited ( P<0. 01). Mechanistic study suggested that the lipid-lowering effect might be related to the lipid synthesis genes (SREBP-1c,FAS, PPARγ) and the lipid metabolism genes (PPARα,CPT-1). Conclusion Wogonin can prevent hyperlipidemia,which might be related to the regulation of enzyme activity and the changes of lipid synthesis and oxidative metabolism.

A new method was developed for the determination of 11 fat_soluble vitamins ( A, D, E and K) and its derivatives in vitamin tablets by ultra performance convergence chromatography ( UPC2 ) . The mobile phase was the mixture of supercritical CO2 and acetonitrile at a flow rate of 1 mL/min. The separation was carried out on the Waters Acquity UPC2 HSS C18 SB 100 mm × 3. 0 mm i. d. , 1. 8 μm column. The UV detector was set at a wavelength of 284 nm. The limits of detection ( LOD) were 1. 5-2. 0 mg/L, and the calibration linear for VK1 , VK2 , VK3 and VB3 was 3-300 mg/L, linear for VA, VA palmitate, VA formic acid, VE, VE acetate, VD2 and VD3 was 5-300 mg/L, respectively. Its spiked recoveries were 97. 31%-98. 76%, and the relative standard deviations ( RSDs) were 0. 41%-0. 96%. The method is applicable for the determination of fat_soluble vitamins ( A, D, E and K) and Their derivatives in vitamin tablets.