BACKGROUND: Tumor necrosis factor-alpha (TNF-α) in the brain can promote inflammative reaction and thrombosis through inducing the expression of endothelioal adhesion molecule during cerebral ischemic reperfusion.OBJECTIVE: To investigate the good regulation of scalp point through point acupucture with Baihui (GV-20) to Qubin (GB-7) to ischemic cerebral injury, and to inhibition of TNF-α over-expression within the brain as well.DESIGN: A randomized controlled trial.SETTING: Emergency Neurological Department of the Hospital Affiliated to Medical College of Qingdao University.MATERIALS: The experiment was completed from August 2002 to August 2003 at the Institute of Cerebrovascular Disease in Medical College of Qingdao University. A total of 15 healthy female SD rats of clean grade, weighing 230-270 g, provided by Shanghai Experimental Animal Center of Chinese Academy of Sciences, were at random divided as sham operation group,acupuncture group and control group, with 5 rats in each group.for rats in acupuncture group and control groups, the procedur for rats in sham operation group was similar to those in control group, but without obstruction of the middle cerebra artery. After ten minutes ischemia, the rats in acupuncture group were given acupuncture treatment. The hairs in parts correspondent to Baihui (GV-20) and Fengfu (GV-16) points in human were cut down and conventionally sterilized, then a filiform needle in 0.35 mmx40 mm was used to point to point acupucture correspondent to Baihui and Qubin in human to the depth of 0.8 cm. Another needle was used to perpendicularly insert at Fengfu (GV-16) point to the depth of 0.5 cm. A pulse electric machine was applied for 30 minutes, with the positive electrode connecting to Baihui (GV-20) and negative electrode to the Fengfu GV-16), the frequensection and in situ hybridization assay of TNF-α: All rats of every group,after treatment of 2 hours ischemia and 12 hours reperfusion, were deeply anesthetized, quickly given 200 mL normal saline through the catheterized ascending aorta, and continually given 300 mL paraformaldehyde of 40 g/L concentration; then they were decapitated for collecting the brain, the brain was fixed for 1 hour with the same solidification solution. The coronal sec-tion about 7 μm was prepared starting from the part of optic chiasm towards the back. The cytoplasm of TNF-α positive cell was stained brownish yellow, and that of TNF-α negative control cell was not stained. VIDAS-21 image analysing system was used to analyse the image, the result was extissue: After conventional staining with hematoxylin-eosin, the pathological changes of focal areas in both acupuncture group and control group were observed under light microscope.ischemic cerebral tissues in acupuncture group and control group.TNF-α in the cortex and striate body of brain in rats with ischemic reperfusion: Compared with sham operation group, the expressions in acupuncture group and control group were significantly increased (0.302±0.04,0.320±0.02; 0.466±0.08, 0.423±0.02; 0.367±0.03, 0.362±0.02; P ＜ 0.05);compared with acupuncture group, the expression in control group was sigbral tissues: In control group the extent of degeneration and necrosis was more serious, the neuron was degenerative necrosis, the neuroglia cell was in vacuolar degeneration, there was obvious phenomenon of leukocytic aggregation and margination within the vessel, and also leukocytic infiltration around the vessels. In acupuncture group there were only a small nub of neurons being in degenerative degeneration and neuroglia cells in vacuolar degeneration, and less leukocytic aggregation within the vessel.CONCLUSION: The level of TNF-α in the cortex and striate body of brain was increased after ischemic reperfusion. Scalp point through point acupuncture with Baihui (GV-20) to Qubin (GB-7) could markedly inhibit its expression, so that the therapy could effectively check over-expression of inflammatory mediators and their biological effects, hence reducing the inflammatory injury after cerebral ischemia.

Objective To observe the expression of IL-1? and to study the mechanism of acupuncture for focal cerebral ischemia. Methods The ischemia-reperfusion model was established in rats. The immunohistochemistry technique was used to detect the expression of IL-1?in the sham operation group, control group and acupuncture group at 2h, 6h,12h,24h after reperfusion following middle cerebral artery occlusion in rats, TTC staining method was used to observe the infarct volume at 24h after reperfusion. Results The sham operation group showed a baseline expression of IL-1? in cortex and striate body. The cells expressing IL-1? were increased in 2h after reperfusion and peaked at 12h after reperfusion in the control and acupuncture groups. The expression of IL-1? was weaker in acupuncture group as compared to that in the control group at all the time points. Conclusion Acupuncture could downregulate the expression of IL-1?in cortex and striate body and reduce infarct volume. It was indicated in the study that downregulated expression of IL-1? might be one of the mechanisms of acupuncture protecting the brain from ischemic damage.

Vogt-Koyanagi-Harada (VKH)syndrome is an autoimmune disease attacking against pigmented cells, resulting in blindness and usually affecting multiple organs including ears, meninges, hair and skin.Correct diagnosis and immediate treatment in the early stage is vital to visual prognosis.Currently, corticosteroids is first-line drug.In addition, VKH patients refractory to corticosteroids can choose other treatment such as immunosuppressive agents and biological agents.

AIM: To investigate the application value of contrast -enhanced ultrasound ( CEUS) and analysis software for intra-ocular tumor diagnosis.
METHODS:Retrospective analysis for 90 cases (90 eyes) with intra- ocular tumor with CEUS examination, and all cases were confirmed by pathology after surgery or clinical comprehensive diagnosis and follow-up.
RESULTS: Choroidal hemangioma, choroidal melanoma, choroidal metastatic carcinoma had obvious different CEUS enhancement pattern, quantitative analysis indexes of those tumors by imaging analysis software were significantly different (P<0. 05).
CONCLUSION: The CEUS can provide quantitative analysis for intra - ocular tumor with preferable clinical application value.

BACKGROUND: With the extensive development of reperfusion treatment on acute myocardial infarction, myocardial ischemia/reperfusion (I/R) injury cause clinical concern intensively. In recent years, nitric oxide (NO) and endothelin (ET)are hot point of researches. Myocardial protective role of Chinese traditional medicine is highly regarded.OBJECTIVE: To study the change of endothelial function during myocardial I/R injury of rabbits, the effect of shenmai injection (SMI) and mechanism.DESIGN: Randomized controlled animal study.SETTING: The First Hospital Affiliated to China Medical University.MATERIALS: The experiment was carried out in Laboratory Animal Center, Department of Biochemistry and the Second Electron Microscope Room of China Medical University from September 2002 to January 2003. Twenty-one healthy female Japanese white rabbits weighing 1.5-2.5 kg were in this study. SMI was produced by the Three Nine Medicine Industry Co., Ltd., Yaan (batch number: 010110).METHODS: ① Grouping: The animals were randomly divided into three groups, 7 cases of each group. Sham-operation group: Rabbits were gone through thread only and were not ligated coronary artery; I/R group and I/R + SMI group:Coronary artery occlusion was maintained 40 minutes at the ligature was released and reperfusion continued for 40 minutes. ② Administration: Rabbits in I/R group were injected 20 mL saline through ear margin vein (injected one third of saline at 10 minutes before ligature, two thirds of saline when unloosing the ligature). Rabbits in I/R + SMI group were injected with SMI which was diluted with saline to 20 mL (1.5 mL/kg). The method of injection was as same as I/R group.③ Index observation: 4 mL venous blood samples were obtained before ligature, at 40 minutes of ischemia and 40minutes of reperfusion. Half of the blood samples were separated serum to detect NO production (NOP) by nitric acid deacidizing enzyme process; another were separated plasma to detect ET by radiation immunity process. In the experiment ends, NOP and ET of myocardial tissue were detected; total of superoxide dismutase (T-SOD) of myocardial tissue were detected by sulphur purine oxidase process and malondialdehyde (MDA) were detected by thiobarbituric acid development process. Myocardial ultrastructure was observed with transmission electro microscope.MAIN OUTCOME MEASURES: ① Contents of serum NO and plasma ET in each.group before ligature, at 40 minutes of ischemia and 40 minutes of reperfusion; ② contents of NOP, ET, T-SOD and MDA of myocardial tissue; ③ Myocardial ultrastructure.RESULTS: All 21 rabbits were involved in the final analysis. ① Content of serum NOP: Content of serum NOP was lower in I/R group than that in sham-operation group at 40-minute ischemia and 40-minute perfusion (P ＜ 0.01), but was higher in I/R +SMI group than that in I/R group (P＜ 0.01). ② Content of plasma ET: Content of plasma ET was higher in I/R group than that in sham-operation group at 40-minute ischemia and 40-minute perfusion (P ＜ 0.01), but was lower in I/R +SMI group than that in I/R group (P ＜ 0.01). ③ Content of NOP was negative correlation with that of ET 40-minute ischemia and 40-minute perfusion (P ＜ 0.05, P ＜ 0.01). ④ Content of NOP and activity of T-SOD: Those were lower in I/R group than those in sham-operation group at 40-minute perfusion (P ＜ 0.01), but were higher in I/R +SMI group than those in I/R group (P＜ 0.01). ⑤ Contents of ET and MDA: Those were higher in I/R group than those in sham-operation group (P ＜ 0.01), but were lower in I/R +SMI group than those in I/R group (P ＜ 0.01). ⑥ Content of NOP was positive correlation with T-SOD activity (P ＜ 0.05), and negative correlation with content of MDA (P ＜ 0.05). In addition, content of ET was negative correlation with T-SOD activity (P ＜ 0.05), and positive correlation with content of MDA (P ＜ 0.05).CONCLUSION: Myocardial I/R leads to abnormality of vascular endothelial function, and SMI can improve endotheliual function and relieve myocardial I/R injury.

ObjectiveTo observe the expression of mCD14 and human leucocyte antigen (HLA)-DR on peripheral blood mononuclear cell( PBMC ) and cytokine in severe sepsis and its significance.MethodsThirty-five patients with severe sepsis (patients group) and 15 healthy volunteers (control group)were selected in this study.The expression of mCD14,HLA-DR on PBMC,serum tumor necrosis factor (TNF)- α,interleukin(IL)-10,the total score of acute physiology and chronic health evaluation(APACHE Ⅱ )and sepsis-related organ failure assessment (SOFA) score of the patients were measured at the 1st,3rd,5th day after admission.ResultsThe expression of mCD14 and HLA-DR on PBMC,the levels of serum TNF- α and IL-10 were ( 2.61 ± 1.59 )％,( 10.25 ± 5.35 )％,(96.66 ± 45.38) ng/L,( 149.74 ± 77.15 ) ng/L in patients group,(5.57 ± 1.53)％,(59.28 ± 14.76)％,(0.12 ±0.00) ng/L,(5.67 ±2.16) ng/L in control group,there were significant differences between two groups (P ＜ 0.05 or ＜ 0.01 ).In patients group,the mortality of 28 days was 28.6％(10/35).The expression of mCD14 and HLA-DR on PBMC,SOFA score and APACHE Ⅱ at the 1st,3rd day showed no statistical significance between non-survivor patients and survivor patients (P ＞ 0.05 ),but at 5th day the expressions of mCD14 and HLA-DR on PBMC in survivor patients were significantly higher than those in non-survivor patients [ (5.12 ± 2.03 )％ vs.(2.75 ± 0.67 )％; (35.12 ±9.29)％ vs.(13.06 ±5.87) ％](P＜0.01 or ＜ 0.05),SOFA score and APACHE Ⅱ were significantly lower than those in non-survivor patients[ (4.48 ± 1.71 ) scores vs.( 10.70 ± 3.16 ) scores; (9.36 ± 5.57 ) scores vs.(25.60 ± 10.88) scores](P＜ 0.01 ).The levels of serum TNF- α and IL-10 at the 1st,3rd,5th day showed no statistical significance between non-survivor patients and survivor patients(P ＞ 0.05).Conclusions The expressions of mCD14 and HLA-DR on PBMC in severe sepsis show closely related to the outcome.The changes of serum TNF- α and IL- 10 can not reflect the prognosis of severe sepsis in 5 days.

Animals ; Cells, Cultured ; Interleukin-1 ; pharmacology ; Matrix Metalloproteinase 1 ; secretion ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; drug effects ; metabolism ; Platelet-Derived Growth Factor ; pharmacology ; Rabbits

OBJECTIVE To learn the situation of cephalosporins used in our hospital,and offer the scientific guidline base for their clinical use.METHODS Statistics methods were used to analyze dosage,sales volume and DDDS of cephalosporins during 2003-2007.RESULTS The usage of the first generation cephalosporins was reduced year by year,but the third generation of compoands cephalosporins and their oxef cephalosporins occupied the main places.The DDDs of cefoperazone/tazobactam usage ranked second for three years(2005-2007),and at the same period their DDDs consumption got top.CONCLUSIONS The situation of the usage of cephalosporins in our hospital is reasonable basically,but more attention should be payed to the usage of the third cephalosporins and their compounds and oxefs.

Objective To analyze the clinical characteristics and risk factors of prognosis in children with brain trauma.Methods We retrospectively analyzed the clinical data of 125 cases diagnosed as brain trauma in PICU of Shengjing Hospital affiliated to China Medical University from January 2009 to December 2014.The risk factors influencing prognosis were analyzed by using single factor analysis and multiple factors Logistic regression methods.The risk factors included Glasgow coma score (GCS) on admission,blood glucose,lactic acid,prothrombin time,international normalized ratio (INR),serum sodium,serum potassiumin,pulse within 24 hours after admission,gender,age,time for therapy,shock,respiratory failure,cerebral hermia and surgery.Results Eighty-four cases survived and 41 cases died.The fatality rate was 32.8％.T test and chi-square test of risk factors showed that GCS score,blood glucose,blood lactic acid,INR,respiratory failure,shock had a significant influence on the prognosis of brain trauma in children (P ＜ 0.05).Multviariable Logistic regression analysis showed that GCS score,blood glucose,blood lactic acid,respiratory failure were independent risk factors affecting the prognosis of brain trauma (OR =7.434,0.473,0.615,0.000,P ＜ 0.05).Conclusion Pediatric brain trauma has a rapid progress and poor prognosis with high mortality and disability rate.GCS score,blood sugar,blood lactic acid,respiratory failure are independent risk factors for prognosis of brain trauma in children.

OBJECTIVE:To observe the clinical efficacy and safety of Shenmai injection combined with Trimetazidinee tablet in the treatment of hypothyroid heart disease. METHODS:64 patients with hypothyroid heart disease were randomly divided into control group and observation group. Patients in 2 groups were conventional treatment. Based on the treatment,control group was treated with Trimetazidine tablets 20 mg,orally,3 times a day;based on the treatment in control group,observation group was ad-ditionally treated with Shenmai injection 40 ml by intravenous infusion,once a day. The treatment course was 2 months. The clinic data was observed,including clinical efficacy,and T3,T4,TSH,LVEF,LVEDD and LVESD before and after treatment,pericar-dial effusion depth and incidence of adverse reactions. RESULTS:The total effective rate in observation group was significantly higher than control group(P<0.05). After treatment,T3 and T4 in 2 groups were significantly higher than before,TSH and LVESD were significantly lower than before(P<0.05),however,the difference was not statistically significant between 2 groups (P>0.05);LVEF in 2 groups was significantly higher than before,observation group was higher than control group,LVEDD and pericardial effusion depth were significantly lower than before,observation group was lower than control group(P<0.05). There were no obrious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Shenmai injection com-bined with trimetazidinee has better efficacy than only trimetazidinee in the treatment of hypothyroid heart disease,with similar safety.