Objective To investigate the effect of ulinastin on the gastro-intestinal circulation and systemic inflammatory response during open heart surgery with cardiopulmonary bypass( CPB) .Methods Thirty adult patients undergoing valve replacement with mild hypothermic CPB were randomly divided into two groups: ulinastin group (U ,n = 15) and control group (C , n = 15). In ulinastin group patients received ulinastin 6000 IU?kg-1iv after induction of anesthesia and another 6000 IU?kg-1 was added into the priming solution. In control group patients received equal volume of normal saline, instead of ulinastin. The patients were premedicated with morphine 0.2 mg?kg-1 and scopolamine 0.06 mg?kg-1 .Ranitidine 1 mg?kg-1 was given iv before induction of anesthesia. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with fentanyl 50-60?g?kg-1, midazolam, isoflurane and vecuroinum. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg during operation. Gastric intramucosal PCO2 (PiCO2 ) was measured (pHi was calculated) and blood concentrations of TNF-?and IL-6 were determined before CPB (T0), 30 min after aorta was cross-clamped (T1), 60 min after termination of CPB(T2 ) and 6 h after operation (T3 ) .Results The two groups were comparable with regard to age, sex, body weight, ejection fraction, duration of CPB and cross-clamping time. (1) pHi decreased significantly at T1-2 as compared with the baseline value at T0 (P

Aim To explore the protective effect of ac-tive components of Xiaoxuming decoction ( XXMD ) on focal cerebral ischemia/reperfusion injury in rats dur-ing early recovery period .Methods The ischemia and reperfusion of middle cerebral artery model rats were established by nylon wire with 2 hours ischemic time on healthy male SD rats .The models of MCAO were eval-uated by Zea-Longa′s standard score .The model rats were randomly divided into sham operation group , the ischemia/reperfusion model group , the active compo-nents group of Xiaoxuming decoction and the positive group (extract of ginkgo biloba leaves EGb 761).Rats were orally administrated with different drugs 24 h after operation for up to 14 days, once a day.The effect of active components of Xiaoxuming decoction on behavior changes of MCAO rats in different recovery period was evaluated by a series of behavioral assessent methods such as modified neurological severity scores and cor-ner test.The infarct volume was observed by TTC stai-ning.Moreover, the contents of MDA and the activities of GSH-Px, SOD and NOS in the penumbra and core tissues of rat brain were detected by spectrophotometric method.Results Compared with the I/R model group, the active components group of XXMD could significantly alleviate the neurological deficit scores with prolonged administration . The motion function tended to be normal , stayed longer on the balance beam, sensory function gradually restored sensitivity , reduced the radio of turning to the right .Among them , compared with model group , the active components of XXMD could effectively improve the neurological dys-function after five days of administration ( P<0.05, P<0.01).Meanwhile, the active components of Xiaox-uming decoction could significantly reduce the infarct volume percentage in the cerebral tissue on post opera-tion day 5 and 14(P<0.01).In addition, the active components of XXMD could reduce the content of MDA and the activity of NOS , increase the activity of SOD and GSH-Px.Conclusion The active components of XXMD can generate neuroprotective effect in early stage of recovery and may play a major role in regula-ting the level of oxidative stress in rat brain .

Objective To detect cytokeratin in routine pathology negative regional lymph nodes postoperatively in non-small cell lung carcinoma (NSCLC). To investigate the relationship of lymph node micrometastasis in P-TNM stages NSCLC and survival rates. Methods From Jan. 1996 to Dec. 2003, 107 paraffin-embedded specimens of T1-T4N0-N1M0 NSCLC patients were collected. Anti-cytokeratin(CK) an- tibody AE1/AE3 was applied to detect cytokeratin with Envision~(TM) method in routine pathological negative re- gion lymph nodes in NSCLC, and selected negative control, positive control and blank control. The pulmo- nary hilar lymph node micrometastasis was upward regulated with stage pCK-N1, mediastinal lymph node mi- crometastatsis was upward regulated with stage pCK-N2. The result applied to SPSS11.0 software to process. Results The CK positive rate was 29.9% in all the patients. The CK positive rate was 27% (21/78), 30% (7/23), 67% (4/6)in stage p-Ⅰ, p-Ⅱand p-Ⅲ, respectively. All these data showed the tendency by which detectable rate increased and was accompanied by disease progress. Comparing the annual survival rate and median survival time of the non-micrometastasis group with the mierometastasis group in two groups, the survival rate difference was statistically significant. Comparing the annual survival rate and median sur- vival time in pCK-ⅢA stage with p-Ⅰ-Ⅱstage, pCK-ⅢA stage annual survival rate and median survival time was significantly different (P=0.020). Similarly, comparing the survival rate in pCK-ⅡB stage with p-ⅠB stage, pCK-ⅡB stage survival rate was significantly different(P=0.059). Comparing the survival time of pCK-ⅢA stage with p-Ⅲstage, pCK-ⅡB stage, with p-ⅡB stage, euther survival time difference was statistically significant (P=0.838, 0.518). Conclusions The rate of positive cytokeratin increase is ac- companied by the disease progress in NSCLC. Positive cytokeratin has disadvantagious prognosis. It is showed that pCK-N1 may be equal to p-N1 and pCK-N2 which also may be equal to p-N2. Micrometastasis may affect the UICC staging currently in use.

BACKGROUND: There are no effective treatments for spinal cord injury. Transplantation of olfactory ensheathing cells (OECs) has achieved great progress in repairing spinal cord injury. OBJECTIVE: To observe the effect of OECs transplantation on pathological and ultrastructural alterations of spinal cord, and the role in spinal cord injury developing.METHODS: A total of 60 SD rats were randomly divided into blank, model, transplantation and DF12 groups, with 15 animals in each group. The entire vertebral plate of T_(10), and partial vertebral plate of T_9 and T_(11) of blank group were cut open, and gelatin sponge was used for hemostasis. In the model group, the spinal cord was excised. In the transplantation and DF12 groups, OECs and DF12 culture solution were injected following spinal cord excision. The incision was sutured. Two rats from each group were anesthetized 1, 3, 7, 14, 28, 42, and 56 days following injury, and injured areas were observed by light microscopy and electron microscopy. RESULTS AND CONCLUSION: Following spinal cord injury, pathological and ultrastructural changes occurred, such as hemorrhage, edema, degeneration, necrosis, cavitation, gliacyte proliferation and nerve fiber regeneration. OECs transplantation attenuated neuronal and nerve fiber necrosis, relieved degree of pathological reaction, protected injured neurons, prevented gliacyte proliferation and increased nerve fiber regeneration. Results show that OECs transplantation ameliorated pathological reactions and promoted spinal cord injury repair.

Objective To investigate the clinical effects of laryngeal mask airway supreme and endotracheal intubation in patients undergoing laparoscopic cholecystectomy.Methods 90 patients with ASA grade Ⅰ-Ⅱ and normal blood pressure undergoing elective LC were randomly allocated to two groups: laryngeal masks group and tracheal tube group from March 2015 to March 2016.Changes in blood pressure,heart rate and postoperative throat pain degree before and after anesthesia were compared between the two groups.Results The blood pressure and heart rate were significantly increased in the patients than that of tracheal group after catheter insertion,and the blood pressure and heart rate of the patients in laryngeal mask group were not significantly changed.Throat and other complications incidence of the patients in the tracheal tube group was increased significantly after surgery than that in the laryngeal masks group.Conclusion The application of laryngeal mask airway general anesthesia method for the implementation of laparoscopic cholecystectomy has the advantages of easy operation and high safety,and it can help to maintain the stability of cardiovascular function.It is worthy of clinical application.

In spite of the relative success achieved in degree-oriented education program in clinical medicine during its preliminary trial stage, problems remain in regard to its recognition and understanding, administration policy, testing systems and the quality control. To further improve the Effects of the actual teaching, it is of high importance that we further our understanding, strengthen the administration, consolidate the testing system and implement better supervision of the teaching procedures of the program.

?AlM: To analyze the result of ultrasound biomicroscopy ( UBM ) of patients with rhegmatogenous retinal detachment ( RRD ) who need to perform pars plana vitrectomy ( PPV ) to explore the value of clinical application of UBM at preoperation.
?METHODS:Patients who underwent PPV for RRD in our hospital from January to December 2014 were selected. The preoperative results of UBM were recorded and the positive findings of UBM were analyzed, the value of preoperative application of UBM was investigated.
?RESULTS:Totally 356 cases (357 eyes) of patients with RRD were received PPV. All patients were examined by UBM, 122 eyes ( 34. 17%) were positive, 56 eyes were ciliochoroidal detachment, 28 eyes were narrow anterior chamber angle, 6 eyes were chamber angle-closure, 28 eyes were ciliary body cyst, 4 eyes were iris cyst, 11 eyes were anterior proliferative vitreoretinopathy, 1 eye was retinal cyst. There were 12 eyes existing two lesions at the same times. ln this study, patients with choroidal detachment was detected by UBM in 56 eyes, the positive rate was 15. 7%, while 25 eyes was detected by B -ultrasonography, the positive was 7. 0%. The difference was statistical significant(χ2=13. 382, P<0. 05).
?CONCLUSlON: The patients with RRD have underwent PPV for the condition of illness, preoperative UBM can be examined to detect the condition of anterior chamber angle, iris, ciliary and anterior choroid, which is significant for comprehensively understanding the preoperative condition of patients, estimating the difficulty of the operation, and guiding operation and the postoperative follow-up.

OBJECTIVE: To confirm the best content determination method of fluorouracil injection. METHODS: The contents of 95 batches of fluorouracil injection were determined by UV spectrophotometry absorption coefficient method and high performance liquid chromatography (HPLC), respectively. Through investigation of method recoveries, the reasons for difference in the content determination results were further analyzed. RESULTS: The HPLC determination results were slightly higher than those of the UV method (P<0.05), The intervonversion of double alcohol type structure and double ketone type structure of fluorouracil might lead to the lower recovery and determination results of UV method. CONCLUSION: The HPLC method is more accurate and reliable than UV method qualitatively and quantitatively.

Xiamen Cardiovascular Hospital set up the first chest-pain center in Fujian province,and launched the first citywide regional chest pain network in China.Their experiences prove that the first-aid network can effectively integrate ambulances,primary hospitals,general hospitals,and special hospitals for seamless connection between EMS and in-house rescue.These efforts can minimize the mortality and disabilities of myocardial infarction,effectively elevating the myocardial infarction treatment efficiency and capabilities of the region.

[ABSTRACT]OBJECTIVETo study the mRNA expression of glucocorticoid receptor(GR) in peripheral blood mononuclear cells in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and its clinical significance. METHODSReal-time fluorescent quantitative PCR was used to detect GRα mRNA and GRβ mRNA exprssion in PBMC of 30 male patients with moderate to severe OSAHS and 27 healthy male subjects. The relationships between the expression of glucocorticoid receptor mRNA and the apnea hypopnea index, body mass index, neck circumference, waist circumference, the lowest oxygen saturation, the average oxygen saturation, the Epworth sleepiness scale(ESS) score, fasting blood glucose, heart rate and blood pressure were analyzed.RESULTSCompared with the control group, the expression level of GRα mRNA was lower in the OSAHS group(t=2.25,P<0.05) and the expression level of GRβmRNA had no difference between the two groups(t=1.43, P>0.05). We had not found the significant correlation between the expression of GRα mRNA and the clinical parameters above in OSAHS patients.CONCLUSIONThe expression of GRα mRNA in PBMC in moderate to severe OSAHS male patients have a downward trend compared with healthy group, but the mechanism remains unclear.