Objective To demonstrate the carotid artery hemodynamic characteristics in patients with common carotid artery occlusion,and to investigate the value of color Doppler ultrasonography in evaluating it.Methods 30 patients with common carotid artery (CCA) occlusion or severe stenosis (stenosis rate＞70％) were as the patients group,while 30 volunteers with the normal indicators of carotid artery ultrasonography as the control group.In both groups,the examinations of the CCA,the internal carotid artery (ICA),the external carotid artery (ECA) and the vertebral artery (VA) were taken by color Doppler ultrasonography under quiescent conditions.Bilateral carotid ultrasonography studies were performed,which included the peak systolic velocity (PSV),end-diastolic velocity (EDV),mean velocity (MV),and resistance index (RI).Results The peak systolic velocity (PSV),EDV and MV of ICA were obviously lower in case group at affected side than in the control group (P＜0.05 or 0.01).The blood flow of ECA at the affected side was retrograde or bidirectional.PSV,EDV and MV of the external carotid artery (ECA) were obviously higher in the healthy side in patients than in the control group (all P＜0.01).There was a significant difference in blood flow velocity of bilateral vertebral artery (VA) between the patients group and the control group,and the PSV,EDV and MV were obviously higher in the former than in the latter (all P＜0.01).And the RI was different between the two groups (P＜0.05).Conclusions The pressure of ICA is dropped after the common carotid artery occlusion,and then ECA reversely feeds ICA by collateral circulation.The blood flow velocities of bilateral vertebral artery and contralateral ECA are significantly increased to compensate for cerebral blood supply through collateral circulation channels.Color Doppler ultrasonography can reflect this phenomenon more fully and accurately,and provide clinically valuable diagnostic information.

Anniversaries and Special Events ; Education, Medical ; history ; History, 20th Century ; History, 21st Century ; Occupational Medicine ; history

Objective To explore the impact on survivors's health and to determine the risk factors involved in the typhoon in order to investigate the characteristics of traumatic symptoms of casualties in the aftermath of the Saomai Typhoon sweeping over the rural area of Zhejiang province in 2006. Method A cluster sampling study was carried out and a total of 389 survivors were assessed. Data were analyzed by univariate and multivariate Logistic analysis to clarify the characteristics and the risk factors of getting traumatize. Results Of 389, there were 113 (29.1% ) victims suffered from a variety of injuries mainly crush trauma (24.4 % ) and wounded by hard object (23.1% ). Moreover, the combined injuries accounted for 9.2%. The risk factors causing injuries in the residential area were the building collapse, glass fragments from broken windows, flying debris as well as fall from high place. Condclusions Outdoor activity and the crumbled building are the leading causes for injuries during the sweeping of typhoon. Meanwhile, we should make more effort to publicize the precautions against typhoon to the local residents.

Background: It is reported that 30% to 80% schizophrenia patients suffered from hypersalivation when taking clozapine. Some investigations of the use of formulas of traditional Chinese medicine (TCM) to treat clozapine-induced hypersalivation suggested their potential treatment effects. In these formulas, Suoquan Pill (SQP) and Wuling Powder (WLP) were suggested to have therapeutic effects in improving clozapine-induced hypersalivation. Methods and design: A prospective, double-blind, randomized, placebo-controlled study will be conducted to test the therapeutic effects of SQP and WLP in relieving hypersalivation in patients taking clozapine. A total of 45 patients will be enrolled into this study with 15 in each treatment group. Patients will receive medication according to their assigned group. Either SQP 10 g per oral dose twice daily, WLP 10 g per oral dose twice daily or placebo powder 10 g per oral dose twice daily will be prescribed to the patients for 8 weeks. The Drooling Severity Scale, Nocturnal Hypersalivation Rating Scale and sialoscintigraphy will be used as the primary outcome measures; the Clinical Global Impressions Severity, the Positive and Negative Syndrome Scale, the Abnormal Involuntary Movement Scale, the Simpson-Angus Scale and the TCM constitutional scale will be used as the secondary outcome measures Discussion: It is hypothesized that SQP and WLP will have a beneficial effect in controlling clozapine-induced hypersalivation symptoms. It may also improve the life quality of psychotic patients by improving their mental status. Trial registration: ClinicalTrials.gov (Identifier: NCT01045720).

OBJECTIVETo evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.

METHODSFifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.

RESULTSAfter hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).

CONCLUSIONEA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

Acupuncture Analgesia ; methods ; Adolescent ; Adult ; Aged ; Anesthesia, General ; Arteries ; Blood Pressure ; Electroacupuncture ; methods ; Endoscopy ; Female ; Gastric Mucosa ; surgery ; Heart Rate ; Humans ; Hypotension, Controlled ; Interleukin-1 ; Interleukin-6 ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; Young Adult

Objective To investigate the curative effects of dexamethasone in the prevention of delayed encephalopathy after acute carbon monoxide poisoning in the rats.Methods Eighty healthy male Wistar rats were randomly(random number)divided into hyperbaric group(H),dexamethasone group (D),combined treatment group(C)and model control group(M)after carbon monoxide poisoning,twenty rats in each group.Twelve air-modeling rats were selected as normal control group(N).Using eight-arm maze training and testing,the rat's function of cognitive and memory was detected.The serum MBP levels were detected by enzyme-linked immunosorbent assays(ELISA).Magnetic resonance imaging was used for observing the demyelination of the head and the morbidity of delayed encephalopathy.Measured data was analyzed with single factor analysis of variance(one-way ANOVA).Results The result of eight-arm maze showed that there were 6,7,1,1 rats with delayed encephalopathy in groups M,H,C,D,respectively.At 3 days after poisoning,except N group,the serum MBP levels of every groups increased significantly.At 10 days after poisoning,serum MBP levels in groups C and D were significantly decreased,then returned to normal levels at day 18.The serum MBP in groups M and H was higher than normal levels at all the time.Head MRI showed except D group,the rest groups were abnormal signals,which appeared 7 in M group,6in H group and 1 in C group.Conclusions Dexamethasone administrated as soon as possibly after acute carbon monoxide poisoning may reduce the serum MBP levels,prevent demyelination occurs,decrease the pathological damage,eventually play a preventive role in DE.

Objective To analyze results of atopy patch test (APT) with dust mite allergens at different concentrations in patients with atopic dermatitis (AD),and to evaluate the diagnostic value of APT.Methods Totally,85 patients with AD were enrolled into this study.All the patients underwent APT with 5 concentrations (3 000,5 000,7 000,10 000 and 12 000 pnu/g) of dust mite allergens,as well as skin prick test (SPT) with dust mite allergens.Dust mite allergens were obtained from two different manufacturers (group 1 and 2).Enzyme-linked immunosorbent assay (ELISA) was performed to detect allergen-specific immunoglobulin E (SIgE) in sera from these patients.The sensitivity,specificity and positive predictive value of APT,SPT and SIgE assay were compared,and the results of APT were compared among different concentrations of allergens and between allergens from different manufacturers.Results When SIgE assay served as the gold standard,the sensitivity,specificity and positive predictive value in the diagnosis of dust mite allergy were 79.41％,76.12％,and 64.29％ respectively for APT,73.53％,80.95％ and 67.57％ respectively for SPT with group 1 dust mite allergens,and 81.53％,77.78％ and 65.09％ respectively for APT,76.02％,79.85％ and 66.07％ respectively for SPT with group 2 allergens.When SPT was regarded as the gold standard,the sensitivity,specificity and positive predictive value in the diagnosis of dust mite allergy were 78.38％,77.42％,67.44％ respectively for APT,67.57％,84.21％,73.53％ respectively for SIgE assay with group 1 dust mite allergens,79.25％,80.63％ and 69.55％ respectively for APT,61.07％,82.54％ and 77.21％ respectively for SIgE assay with group 2 allergens.There were no significant differences in the sensitivity,specificity or positive predictive value of APT or SPT between the two groups of allergens.The positive rate of APT was 8.24％,22.35％,29.41％,44.71％ and 41.18％ respectively with group 1 allergens at 3 000,5 000,7 000,10 000 and 12 000 pnu/g,and 3.53％,23.53％,31.76％,34.12％ and 35.29％ respectively with group 2 allergens.No significant differences were observed in the positive rate of APT between group 1 and 2 allergens at same concentrations (all P ＞ 0.05),but a significant difference was observed in that between different concentrations of group 1 or 2 allergens (both P＜ 0.05).The positive rate of APT increased with the increase of allergen concentrations,but stopped rising when the concentrations of group 1 and 2 allergens reached 7 000 pnu/g and 5 000 pnu/g respectively.Conclusions The sensitivity of APT is relatively high for the diagnosis of dust mite allergy.The positive rate of APT increased with the increase in allergen concentrations,but stopped rising when the concentrations reached a certain level.

A series of adefovir mono-L-amino acid esters, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs with more potent anti-HBV activity and lower nephrotoxicity were designed and synthesized. Adefovir bis (L-amino acid) ester was used as lead compound, according to pathological and pharmacological findings that non-steroidal anti-inflammatory drugs can effectively inhibit the organic anion transporter 1 (hOAT1)-mediated adefovir phosphonic acid pairs of anion transport across tubular basement membrane thereby reducing the nephrotoxicity of adefovir. Flatten design principle was used to introducing non-steroidal anti-inflammatory drugs structural fragments to design and synthesize target adefovir mixture ester prodrugs. HepG2 2.2.15 cell line was used as in vitro anti-HBV activity evaluation model. Five compounds exhibited antiviral activity, and compound 18 showed the most potent anti-HBV activity and relatively high selective index (EC50 3.92 micromol L(-1), SI 9.97). HK-2 cell line was used as in vitro model to evaluate nephrotoxicity. Results suggested the target compounds have lower cytotoxicity than the positive control. Moreover, by analyzing the primary structure and activity relationship of these compounds, it could suggest that mono-L-amino acid ester, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs strategy has significant potential in the acyclic nucleoside phosphonates prodrug design.

AlM:To investigate the changes of retinal histology and oxidative stress in diabetic retinopathy and its reversal by pyruvate in diabetic rats.
METHODS: Eighty Wistar rats were divided into 3 groups:control group ( 20 rats ) , model group ( 30 rats ) and treatment group ( 30 rats ) . After streptozotocin ( STZ) induced diabetes mellitus in the model group and the treatment group, the treatment group received 2%pyruvate in diet and drinking. The changes of body weight and blood glucose were observed and the changes of glutathione peroxidase ( GSH-PX ) , malonie dialdehyde ( MDA) , and Na+-K+-ATPase levels of retinal tissue and retinal ultrastructure were investigated in three groups at 12wk after occurrence of diabetes.
RESULTS: Compared with control group, the body weight of the model group were significantly decreased, the activities of GSH-PX and ATP in the retina of diabetic rats were significantly lower, the MDA was signigicantly higher and significant changes occurred in retinal ultrastructure. Compared with model group, the blood glucose of the treatment group had no significant changes. However, the activities of GSH and ATP in the retina of diabetic rats were higher, the MDA was lower and the retinal ultrastructure was comparatively mild.
CONCLUSlON:Pyruvate can alleviate oxidatie stress reaction, improve the energy metabolism of retina, and delay the development of retinopathy.

Objective To evaluate the clinical efficacy of standardized house dust mite allergen specific immunotherapy (SIT) for rhinitis and asthma in children. Methods Forty-two children with allergic rhinitis and asthma who received a standardized house dust mite allergen SIT in our hospital were enrolled in our study. The result of allergen skin prick test, serum specific IgE levels (sIgE) of house dust mite and dust mite,pulmonary function and symptom scores were analysed before and at one year after treatment in all children. Results Skin indexes of house dust mite and dust mite, symptom score were significantly decreased at one year after treatment,but the levels of house dust mite and dust mite sIgE,lung function test (FVC,FEVt,MEF25-75) showed no significant differences. Conclusion Children with allergic rhinitis and asthma have significant improvements in their skin sensitivity and clinical symptoms by given SIT for one year,but the impact of SIT on airway inflammation needs further observation.