AIM:Sodium aescinate can protect the vessel wall while clearing free radical in body.This study was designed to approach the protective effects of preconditioning with sodium aescinate on ischemia/reperfusion injury of the limbs induced by tourniquet.METHODS:Forty patients undergoing elective lower limb operation were selected from the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2006 to February 2007.They were randomly divided into 2 groups:20 in treated group received sodium aescinate(5 mg/100 mL) by intervenous drop infusion,while 20 cases in control group received equal dose of Sodium Chloride at 30 minutes before fastening tourniquet.Blood samples(4 mL) were obtained before fastening tourniquet and at 5,10,20 minutes after release of tourniquet to measure superoxide dismutase(SOD),malondialdehyde(MDA),lactic acid(Lac) and nitrogen monoxidum(NO).Meanwhile the blood pressure and heart rate were recorded in two groups.RESULTS:All of 40 patients were involved in the result analysis.①In the control group,diastolic blood pressure after 5 and 10 minutes of release was significantly less than that before(P

Headache is a common complaint in children and adolescents.While the majority of headaches are self-limited and benign,headaches occasionally herald a life-threatening illness such as meningitis,intracranial hemorrhage,brain tumor or hydrocephalus.The primary objective of the emergency department pediatrician is to diagnose and manage any acute life-threatening cause of headache.For the non-emergency headache,the goal is to relieve the pain and the associated symptoms.

It has been demonstrated that the combination of abnomal expression of gastrin with its receptor can promote cell proliferation and inhibit apoptosis in colorectal neoplasms via signal transduction pathways,which is related with the abnormal expression of miRNA.Researches show that there are multiple intersections between the molecule mechanisms of miRNA and the signaling pathway of gastrin in promoting colorectal cancer cell proliferation.It may exist a gastrin-miRNA-target gene signaling transduction pathway.Knowing the mechanism of the signaling pathway and controlling the related factors will open another avenue for the gene targeted therapy of colorectal neoplasms.

ObjectiveTo compare the efficacy between needling peri-ocular points plus abducens oculi and needling peri-ocular points alone in treating abducens paralysis, for evaluating the effectiveness and advantage of needling peri-ocular points plus abducens oculi.MethodFollowing the random number table, 86 patients with postnatal unilateral abducens oculi were divided into two groups: 43 cases in the control group were intervened by conventional acupuncture at peri-ocular points including bilateral Taiyang (EX-HN5), Cuanzhu (BL2), Fengchi (GB20), Hegu (LI4) and Waiguan (TE5), plus Baihui (GV20), Sizhukong (TE23) and Tongziliao (GB1) on the affected side; 43 cases in the treatment group were intervened by acupuncture at peri-ocular points and abducens oculi, i.e. to puncture the abducens oculi (1~3 mm behind the attached point of the extrarectus to eyeball) in addition to the treatment given to the control group. After 3 treatment courses, the total effective rate, average recovery time and improvement of strabismus angle were observed.ResultThe total effective rate was 93.0% in the treatment group, significantly higher than 81.4%in the control group (P<0.05); of the 28 cured patients in the treatment group, the average recovery time was (34.51±7.91)d, versus (41.88±7.87)d in the 22cured patients in the control group, and the difference was statistically significant (P<0.01). There was a significant difference in comparing the improvement of strabismus angle between the two groups (P<0.01); after treatment, the strabismus angle was (11.23±6.32)° in the treatment group versus (14.14±6.85)° in the control group, and the difference was statistically significant (P<0.05).ConclusionNeedling peri-ocular points and abducens oculi can improve the strabismus angle, shorten treatment duration and reduce patient’s sufferings in treating postnatal abducens paralysis, significantly superior to conventional acupuncture at peri-ocular points.

Objective To investigate the effects of preconditioning with extract of Ginkgo Biloba (EGB) on the tourniquet-induced ischemia-reperfusion (I/R) injury to the limb. Methods Forty ASA Ⅰ or Ⅱ patients aged 17-64 yr weighing 46-72 kg undergoing lower limb operation under combined spinal-epidural anesthesia (CSEA) were randomly divided into 2 groups (n = 20 each) : group A control and group B EGB. CSEA was performed at L2,3 or L3,4 interspace. The height of sensory block was kept below T10. Group B received EGB 0.3 mg/kg in 100 ml normal saline (NS) injected over 20 min via an intravenous line in the forearm as soon as the tourniquet was inflated while control group received plain NS 100 ml without EGB. Venous blood samples were obtained before tourniquet was inflated (To baseline) and at 5, 10, 20 min after tourniquet was released (T_1 , T_2, T_3) for measurement of blood lactate and MDA concentrations and SOD activity. BP (SP, DP) and HR were continuously monitored and recorded at the above time points. Results In control group DP and SOD activity were significantly decreased while blood lactate and MDA concentrations were significantly increased after tourniquet release as compared with the baseline values before tourniquet was inflated. In EGB group there was no significant change in DP, blood lactate and MDA concentrations and SOD activity after tourniquet was released as compared with the baseline. Conclusion Pretreatment with EGB can protect against tourniquet-induced I/R injury to the limb.

Objective To establish the quality standards for Shufeng Zhike Extract;To improve the controll ability of the extract and ensure medicine efficacy. Methods To establish a HPLC method for simultaneous differentiation of Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizomaet Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurum in Shufeng Zhike Extract. Phenomenex Kintex C18 column (4.6 mm×100 mm, 2.6 μm) was used. Acetonitrile-0.05%phosphoric acid was as the mobile phase in gradient elution (0–25 min, 10%acetonitrile; 25–26 min, 10%→14% acetonitrile; 26–35 min, 14% acetonitrile; 35–36 min, 14%→34% acetonitrile;36–55 min, 34%acetonitrile) at flow rate of 0.8 mL/min, and column temperature was 40 ℃. The detection wavelength was 250 nm. To establish a HPLC method for simultaneous determination of Paeoniflorin and Prim-O-glucosylcimifugin in Shufeng Zhike Extract, Phenomenex Luna C18 column (4.6 mm×150 mm, 5 μm) was used; acetonitrile-0.05%phosphoric acid (12:88) was as the mobile phase at flow rate of 1 mL/min; column temperature was 40 ℃; the detection wavelength was 250 nm. Results The chromatographic peak separation with HPLC method for simultaneous differentiate of Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizoma et Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurumin in Shufeng Zhike Extract was clear and negative control had no interference. The linear range of Paeoniflorin was 0.035 93–2.514 8 μg (r=0.999 5), and the average recovery was 100.54%(n=6). The linear range of Prim-O-glucosylcimifugin was 0.006 7–0.67 μg (r=0.999 5), and the average recovery was 100.39%(n=6). Conclusion The established quality standards are simple, reliable, and accurate. It can rapidly identificate Paeoniae Radix Alba, Saposhnikoviae Radix, Polygoni Cuspidati Rhizomaet Radix, Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Bupleurum, and suitable for rapid determination of Paeoniflorin and Prim-O-glucosylcimifugin, which can provide the basis for the quality inspection of Shufeng Zhike Extract.

Objective: To analyze and evaluate of the long-term follow-up data of 152 patients with inoperable malignant biliary obstruction who underwent percutaneous placement of metallic stents. Me-thods: From 2000 through 2006, 152 consecutive patients with malignant biliary obstruction were treated with PTCD or placement of metallic stents. The causes of obstruction were bile duct carcinoma (n=35),pancreatic carcinoma (n=32), hepatocellular carcinoma and metastatic (n=61), lymphadenopathy in the hepatoduodenal ligament (n=24). We used 86 stents: 31 Cook Zilver Stents,25 Sinus Superflex Stents,12 Wall Stents,3 Sinus-s Iliaca Stents,3 ZA-S Bliary Design Stents,5 Smart Stents and 7 other stents. Every three months we followed up all patients except those who died. Patient survival and stent patency rates were estimated by life-table analysis. The Kaplan-Meier method (log-rank test) was used to compare the patency and survival rates among different groups. And the COX regression model was established to compare the relative risks. Results: The overall median length of patency of all stents was 314 days. The median length of survival for the entire patient group was 215 days. The survival rate was 79.1%,51.7% and 26.8% after 3, 6, and 9 months, respectively. Six patients developed recurrent jaundice or cholangitis. The patients with hepatic hilar obstruction group indicated worse prognosis (P≤0.05). Conclusion: Metallic stents showed a favorable patency rate with regard to patient survival. In patients with hilar obstruction, the clinical prognosis was worse than that in patients with common bile duct (CBD) obstruction. We believe that the placement of metallic stents is the procedure of choice for palliation of malignant biliary obstruction.

The celiac ganglia from 9 mature guinea pigs of both sexes were fixed in a mixture of 2％ glutaraldehyde and 2.5％ depolymerized paraformaldehyde. The SIF cells in cryostat sections were discerned out through their eatecholamine fluorescence induced by the fixative. These cells were processed through routine procedures for electron microscopy after or without incubation for acid phosphatase (AcP). The ultrastructure and AcP activity of these cells were observed under an H-600 electron microscope.The SIF cells were found to be present in clusters adjecent to fenestrated capillaries. The exocytosis of vesicular granules of SIF cells were seen on the surface of their cell membrane facing the capillaries. In addition, some dark SIF cells which were more osmiophilic and rich in mitochondria were discovered in this ganglion. These ultrastructural features of the SIF cells indicate that they may perform functions of an endocrine and/or paracrine nature.After one. hour incubation in a Gomori-typed medium at 37℃, some granules. besides the typical lysosomes display the AcP activity. Although the nature of the AcP-positive granules hasn't been elucidated a speculation is laid on that the presence of the enzyme on these granules may play a role of regulation in replacing the intragranular contents.

Monoamine oxidase and thiamine pyrophosphatase activities were demonstrated ultracytochemically in the celiac ganglion and adrenal medulla of the guinea pig by Shannon's and Novikoff's method respectively. Monoamine oxidase activity was found frequently on the nuclear evelope, and ocassionally in mitochondrial outer compartment and cell membrane of the small intensely fluorescent (SIF) cells of the ganglion. Similar Iocalizations were also observed in chromaffin cells of the adrenal medulla. In pricipal neurons of the ganglion, a large amount of products of the monoamine oxidase reaction were found on the endoplasmic reticulium in addition to the nuclear envelope and mitochondrial membranes. Abundant thiaminepyrophosphatase activity was seen at the tran-face of the Golgi complex in the pricipal neurons, in contrast to which, both SIF cells and chromaffin cells exhibited little thiamine pyrophosphatase activity. The results suggested that catecholamine metabolism and the mode of functional activity in the SIF cells were different from those in the pricipal neurons but similar to those in the chromaffin cells of adrenal medulla.

Objective To evaluate the academic level and the popularity of Chinese Journal of Orthopaedics from the point view of citation. Methods According to the information of Chinese Medical Citation Index (CMCI), the amount and distribution of the original articles in Chinese Journal of Orthopaedics cited by the journals included by CMCI were statistically analyzed. The data analyzed included the percentage of cited articles, the number of citation of a single article, authors of most cited articles, geological regions of cited articles, years of citation, citing journals and self citing rate. Results The percentage of cited papers (749 articles, 4213 times) in all published 1184 articles in Chinese Journal of Orthopaedics from 2000 to 2004 were 76.43%, 75.20%, 71.49%, 57.46% and 30.19%, with an average of 63.26%. The original articles cited by other researchers were 7.86, 6.54, 5.48, 2.98 and 1.78, with an average of 5.62. The highest one was citated by 68 times. The most frequently cited authors were from 30 provinces of China and the city Beijing, Shanghai and Tianjin were the three topest cities among other cities in the naion. There were 461 citing journals, and there was 191 items self citsted, self-citing rate is 0.045. Conclusion Chinese Journal of Orthopaedics has published high quality articles. It has been become one of the most important information resource for orthopaedic researchers and one of the most important medical journals in China.