BACKGROUND:Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE:To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI).METHODS:Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm~2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION:The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia rnyocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance (P＜0.01).The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.

BACKGROUND: Coronary occlusion and balloon occlusion are two major methods in preparing acute myocardium infarction models. The pigs were expensive and the modeis will periorm further study,therefore,it is necessary to prepave a model with advantage of short time consuming, few trauma, and high survival rate.OBJECTIVE: To establish acute myocardium infarction in miniature pigs induced by coronary occlusion and balloon occlusion,and to compare the differences.DESIGN, TIME AND SETTING: The randomized grouping, contrast observation animal experiment was performed at the heart intervention room of The First Affiliated Hospital of Kun Ming Medical College between May 8~(th) and August 3~(rd), 2009.MATERIALS: A total of 20 Banna miniature pigs, weighing 20-30 kg, irrespective of genders, were purchased from animal department of Kunming Medical College. The animals were equally divided into embolism and occlusion groups.METHODS: In the embolism group, the balloon was implanted into distal end of anterior descending coronary via femoral artery,blocked the forward flow with 202.65 kPa pressure for 1, 2, and 5 minutes, with 60 seconds interval. The same operation was performed in the occlusion group, followed by blocked the forward flow for successive 60 minutes.MAIN OUTCOME MEASURES: Differences of modes established by 2 methods were compared by coronary opacification, ECG,myocardium zymogram, ultrasonic cardiogram and pathology detection.RESULTS: Nine pigs were survived in the embolism group, and the remained 1 pig died of coronary artery rupture. After operation, T wave inversion could be found, without ST stage raise. At day 1 after operation, correlated lead ST stage was raised 0.1-0.2 mV. The operation duration was 11 hours. In the occlusion group, 5 pigs survived, 4 pigs died of ventricular fibrillation,and 1 died without definite cause. The operation cost 24 hours, and the correlated lead ST stage was increased 0.2-0.3 mV postoperatively. Motion abnormality in infarction place was exhibited in both groups; ventricular aneurysm was formed in 3 pigs in the embolism group, and 1 in the occlusion group. Levels of creatine kinase isoenzymes serum troponin T were obviously stepped up and presented dynamic changes. The myocardiolysis was obviously showed in the infarcted areas, but the differences were no obviously in 2 groups.CONCLUSION: Both coronary occlusion and balloon occlusion can induce models of acute myocardium infarction. The coronary occlusion method is superior to balloon occlusion with few trauma, faster postoperative recover and low mortality rates.

Sepsis is one of the most common causes of mortality in the intensive care units (ICUs) with high mortality rates which may be related to the lack of thoroughly understanding of the specific pathophysiological mechanisms.Improved treatment protocols have resulted in most patients got out of the initial hyperinflammatory phase and entered into a protracted immune suppressed phase.Deaths in this immunosuppressive phase are typically due to failure to control the primary infection or the secondary nosocomial infections often with opportunistic pathogens.As the complexity in multiple systems and varied mechanisms involved in the development of disease,the disorder of immune system and inflammation reaction may be one of the main mechanisms,which were mainly characterized by inflammation cytokines storm and immune dysfunction.The mechanism in the later course of disease may include apoptosis and depletion of immune cells,increased suppression of T regulatory cell and increased myeloid-derived suppressor cell,and cellular exhaustion.In this review we focus on the pathophysiologic mechanism of sepsis with immune compromized,monitoring the immune response,the cellular immunoadjuvant therapy,and improving the recognition of sepsis immunosuppression.

Objective To observe the results of melatonin combined with alprostadil in the treatment of patients with acute pancreatitis.Methods Seventy patients with acute pancreatitis were included in the study,14 patients died after conventional treatment were set to group Ⅰ ,28 patients cured after conventional treatment were set to group Ⅱ and 28 cases cured after melatonin combined with alprostadil and conventional treatment were set to group Ⅲ.White blood cell count,blood gas analysis,serum amylase,endotoxin and malondialdehyde (MDA) content was detected at 6 h,48 h and 4 d.Results White blood cell count,serum amylase,endotoxin,MDA content at 6 h,48 h and 4 d in group Ⅰ were higher than those in group Ⅱ ,Ⅲ (P＜0.05).Endotoxin levels reached a maximum in the 4 d [(273.5 ± 20.4) pg/L],and MDA content reached a maximum in the 4 d [(5.12 ± 0.87) μmol/L].White blood cell count,partial pressure of carbon dioxide in artery (PaCO2),serum amylase,endotoxin and MDA content at 48 h,4 d in group Ⅲ were lower than those in group Ⅰ,Ⅱ (P <0.05).Conclusions Melatonin combined with alprostadil not only shows antioxidant,anti-inflammatory,anti-apoptotic effect but also improves the pancreas,lung,small intestine microcirculation,protects the cell membrane and the lysosomal membrane,and prevents effectively the pancreatic digestive enzymes release; also it inhibits intestinal bacterial translocation,reduces the generation of gut-derived endotoxin and pro-inflammatory cytokine release.It can reduce effectively the systemic inflammatory response in acute pancreatitis.

Epilepsy is one of the most common diseases of the central nervous system, affecting tens of millions of people around the world. Most of clinically used antiepileptic drugs are based on ion mechanism to antagonize epileptic seizures, targeted to various ion channels or ion channel receptors. However, with the in-depth research on the pathogenesis of epilepsy, the non-ionic antiepileptic mechanism has increasingly become the key to the control of various intractable epilepsy, and the relevant drugs have gradually achieved clinical transformation. In this paper, non-ionic antiepileptic mechanisms are classified to clinical and preclinical types according to whether clinical transformation has been achieved. The application of non-ionic antiepileptic drugs in refractory epilepsy was mainly introduced, including everolimus, cannabidiol, fenfluramine, padsevonil, medium chain triglyceride modified ketogenic diet, and anakinra. Additionally, some preclinical non-ionic antiepileptic mechanisms such as prostaglandin, adenosine, metabolic glutamate receptor and mitochondrial mechanism are briefly introduced. The authors believe that the current stage of ionic antiepileptic drugs research has reached the bottleneck of transformation and it is difficult to achieve a major breakthrough in the mechanism, but there are broader research prospects in non-ionic antiepileptic mechanisms because a large number of them have not yet been clinically transformed. From a deeper perspective, some non-ionic antiepileptic mechanisms may have been involved in the fundamental mechanism of epileptogenesis, and they may be the prospect for the future treatment of refractory epilepsy.

Objective To research the changes of calcium regulation hormone and bone mineral density (BMD) in type 2 diabetes mellitus (T2DM ) patients and analyze the main impact factors. Methods 117 T2DM patients (T2DM group ,M/F=52/65 ,age 40~79 years) and 63 age‐ and gender‐matched healthy people (NC group) were selected in this study. According to the course of diabetes ,blood glucose control and the value of BMD ,T2DM patients were divided into subgroups :course≤10 years ,and>10 years ;HbA1 c≤8% ,and>8% ;normal BMD ,osteopenia ,and osteoporosis (OP). Serum 25‐hydroxy vitamin D3 [25(OH)D3 ]and Parathormone (PTH) were measured and BMDs of lumbar spine (L1 ~L4 ) , femoral neck ,total hip ,and whole body were evaluated for all the subjects. Result (1)Compared with NC group ,the level of serum 25(OH)D3 and BMDs of femoral neck and total hip decreased significantly in T2DM group[ (35.57 ± 12.30)nmol/L ,(0.848 ± 0.136)g/cm2 ,(0.873 ± 0.150)g/cm2 vs(44.94 ± 17.40) nmol/L ,(0.927 ± 0.173)g/cm2 ,(0.934 ± 0.140)g/cm2 ,respectively ,P<0.01 or P<0.05)]. The level of PTH increased in T2DM group[ (8.50 ± 4.15) vs(5.62 ± 3.93)pmol/L ,P<0.01]. (2)Compared with the group duration of diabetes≤10 years ,BMD of femoral neck and total hip decreased in patients with duration of diabetes>10 years[ (0.814 ± 0.148) ,(0.840 ± 0.157) vs (0.882 ± 0.111) ,(0.908 ± 0.139) g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(10.55 ± 9.09) vs (7.06 ± 3.74)pmol/L , P<0.05)]. 25(OH)D3 and total body BMD have no significant difference(P>0.05). (3)Compared with HbA1c≤8% group ,BMD of femoral neck and total hip in HbA1c> 8% group decreased [(0.830 ± 0.131) ,(0.832 ± 0.161) vs (0.891 ± 0.130) ,(0.949 ± 0.130)g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(9.96±8.80) vs (7.21±3.98)pmol/L ,P<0.05]. 25(OH)D3and total body BMD have no significant difference(P> 0.05). (4)The rates of OP and osteopenia (41.03% ,47.86% ) in T2DM were higher than those in NC group (26.98% ,33.33% ) (χ2 =4.367 ,4.669 ,P<0.05). The duration of diabetes and the levels of HbA1c and PTH were longer or higher in OP group than those with normal BMD or osteopenia (P<0.05). (5)Logistic regression analysis showed that BMD negatively correlated with the duration of diabetes ,HbA1c ,and PTH (β= 0.076 ,0.213 ,0.112 ,respectively ,P< 0.05) ,and positively correlated with 25(OH)D3 (β= -0.043 ,P<0.05). Conclusion The values of BMD decreased and the incidence of OP is higher in T2DM patients ,particularly in patients with longer diabetic duration and poor glycemic control.

Objective To observe the clinical effect of continuous intravenous pumping of octreotide in the treatment of intestinal endotoxemia.Methods Eighty patients with intestinal obstruction and non-surgical treatment were divided into group Ⅰ with 34 cases who received conventional-treatment and group Ⅱ with 46 cases who received conventional-treatment combined with octreotide 24 h continuous intravenous pumping.White blood cell count ( WBC ),diamine oxidase (DAO),D-lactic acid (D-LA) and endotoxin were detected before treatment and at 24 h,48 h,4 d after treatment.Results The content of WBC,DAO,D-LA and endotoxin in two groups all reached peak at 48 h after treatment.The difference of the content of WBC,DAO,D-LA and endotoxin between two groups had no statistical significance at 24 h after treatment (P ＞ 0.05).The content of WBC,DAO,D-LA and endotoxin of group Ⅱ at 48 h and 4 d after treatment were lower than those of group Ⅰ.And the difference at 48 h after treatment had statistical significance[(18.40 ±0.10)× 109/L vs.(20.60 ± 2.36) × 109/L,(6.12 ± 1.02) kU/L vs.(8.02 ± 1.54) kU/L,(2.14 ±0.21) mg/L vs.(3.34 ± 0.04) mg/L,(1.65 ±0.16) kEU/L w.(2.23 ±0.36) kEU/L] (P ＜ 0.01).While the difference at 4 d after treatment had no statistical significance(P＞ 0.05 ).Body temperature at 48 h after treatment,gastrointestinal decompression capacity,anus exhaust time of group Ⅱ were (37.60 + 3.01 )℃,(320.00 ± 76.14) ml/d,(54.00 ± 0.94) h respectively,and they all were superior to those of group Ⅰ[(38.50 ± 2.21 ) ℃,(500.00 ± 80.32) ml/d,(68.00 ± 1.02) h] (P ＜0.01).Conclusions Continuous intravenous pumping of octreotide can effectively protect the intestinal mucosal barrier function,improve intestinal permeability,reduce the trmslocation of intestinal flora,inhibit the incidence and development of enterogenous endotoxemia.And it provides new evidence to support the clinioal application of octreotide in patients with intestinal endotoxemia.

Objective To explore the relationship between the activity of cholinesterase in hemolyzed blood sample and non-hemolyzed blood sample. Methods The activities of cholinesterase in hemolyzed blood samples and non-hernolyzed blood samples from 112 healthy individuals in Ji'nan were determined by the ferric trichloride chro-mometry, and the activities of cholinesterase in hemolyzed blood samples were adjusted by the concentration of ho-moglobulin (Hb) in blood samples. Results Highly significant correlation was found in the activities of cholinesterase between hemolyzed blood samples and non-hemolyzed blood samples (r = 0.728, F

Objective To investigate the regulating effects and mechanism of Laminaria japonica (L.japonica) on serum lipid of hyperlipidemia rats.Methods Forty healthy female Wistar rats were used to establish hyperlipidemia models by feeding fat-rich forage,and the powder of L.japonica was applied as a supplement in forage for test groups.The levels of serum lipid including the triglyceride(TG),total cholesterol(TC),low-density lipoprotein (LDL),high-density lipoprotein(HDL) and the activities of lipoproteinesterase(LPL) and hepatic lipase(HL) were detected by biochemical assay.Results The levels of serum TG and TC in test group decreased significantly than those in pre-treated and model group (P