Objective To observe the clinical efficacy of Simotang oral liquid combined with compound glutamine enteric capsules in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) belonging to liver depression and spleen deficiency pattern, and to explore its possible mechanism. Methods Sixty patients were randomly divided into two groups. The treatment goup (30 cases) took Simotang oral liquid and compound glutamine enteric capsules, the control group took Cerekinon and Medilac-S. The treatment course was 4 weeks. Clinical symptoms, 5-hydroxytryptamine (5-HT) and substance P (SP) of both groups were evaluated respectively before and after treatment. Recurrence rate and adverse reactions were recorded. Results The total effective rate after treating 1, 2, 4 weeks between the two groups had no significant difference (P>0.05). Four weeks later, in the treatment group, total score of the symptoms, abdominal distension and defecation urgency were apparently lower than that of control group (P<0.05). The levels of 5-HT and SP of the two groups significantly decreased after treatment (P<0.05). The recurrence rate at 4 weeks after drug withdrawal of treatment group and control group was 10.7%(3/28) and 32.1%(9/28) respectively. The difference between the two groups wasn’t significant (P>0.05). Obvious side effects were not found in the two groups. Conclusion Simotang oral liquid combined with compound glutamine enteric capsules has evident therapeutic effect on IBS-D of liver depression and spleen deficiency pattern, especially good at releasing abdominal distension and defecation urgency. The mechanism may be related with decreasing the levels of 5-HT and SP.

Objective To assess the effect of acute hypervolemic hemodilution (AHH) with different hemodiluents on activation of platelets. Method Twenty ASA I-II patients undergoing total hip replacement under general anesthesia were enrolled in this study. They averaged 54 ~ 76 years and 50 ~ 74 kg. The patients were premedicated with intramuscular phenobarbital 2 mg.kg-1 and atropine 0.01 mg. kg-1 . Anesthesia was induced with fentanyl 2ug. kg-1 , dropendol 50 ug. kg-1 , midazolam 40 ug. kg-1 and propofol 1 mg.kg-1. Tracheal intubation was facilitated with vecuronium 0. 1 mg.kg-1 . Anesthesia was maintained with infusion of propofol (2-4mg.kg-1. h-1) and vecuronium (0.06-0.2 mg. kg.h-1) and isoflurane inhalation. Radial artery and right suhelavian vein were eannulated for BP and CVP monitoring. The patients were randomly divided into 2 groups with 10 patients in each group : (A) HES group received hydroxyethyl starch (HES) 25 ml.kg-1 and (B) LR group received Ringer's lactate solution 25 ml.kg-1. In both groups HES or RL solution was infused at a rate of 30 ml-kg-1.h-1 after induetion oi anesthesia. Venous blood samples were taken before induction of anesthesia (T1 ), before AHH (T1 ), 15 min ( T3 ) , 30 min ( T4 ) and 45 min ( T5 ) after the beginning of AHH for determination of the percentage of CD62P and CD63 positive platelet using flow eytometry. ECG, HR, MAP, CVP and urine output were continuously monitored. Small doses of nitroglyeerin were given according to CVP monitoring. Results CD62P expression at T3 , T4 and T5 was significantly higher than that at T, ( P

OBJECTIVE:To provide a method for a scientific and rational formation of hospital drug purchase plan.METHODS:Based on the major factors influencing the drug purchase plans,a moving-average method(mathematical principle)was used to establish computational formula for hospital drug purchase plan model,which was then put into practice.RESULTS:The predicted amount calculated using the computation model could be used to track the actual consumption quantity rapidly;this model could auto-adjust the inventory and dynamically forecast the drug purchase amount.CONCLUSION:The computation model contributes to the scientific and reasonable formation of hospital drug purchase plan thus meeting the needs of majority clinical drugs.

Objective This paper provides an anatomical and theoretic basis for the reverse transposition of proximal ulnar or radial periosteal flap to repair non-union in distal humerus.Methods The origin,course,meanwhile,the outside diameter and length of relevent vessels were measured,on 30 upper limb cadaveric specimens.Results The recurrent interosseous,radial recurrentand the posterior branch of radial collateal arteries,their origin outside diameter and length from the origin to the humerus extermal epicondyle were (1 47?0 2)mm,(65 1?9 5)mm,(2 1?0 3)mm,(63 7?0 8)mm,(1 48?0 22)mm and (104 5?8 9)mm,respectively.Anastomoses pattern existed 3 types: in vicinity of the external epicondyle"Reverse Y"73 3%(22 cases)."Meeting in one point 13 3%(4 cases)"."Arteries networks"13 3%(4 cases).Conclusions It's possible that the reverse transposition of proximal ulnar or radial periostea flap pedicled with recurrent interosseous membrane or radial recurrent vessel for repairing non-union in distal humerus.

Objective To evaluate the effects of dexmedetomidine on the development of perioperative cardiovascular events in elderly patients.Methods Forty-eight patients of both sexes,aged 65-85 yr,with body mass index of 19.5-25.3 kg/m2,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective abdomninal or lower limb surgery under general anesthesia,were divided into 2 groups (n =24 each) using a random number table:general anesthesia group (group G) and dexmedetomidine plus general anesthesia group (group D).In group D,dexmedetomidine was intravenously infused in a loading dose of 0.25 μg/kg over 10 min and then continuously infused at 0.2 μg · kg-1 · h-1 until 30 min before the end of surgery.The equal volume of normal saline was intravenously infused instead in group G.At 1 day before surgery and 1 and 2 days after surgery,dynamic electrocardiogram was used to monitor heart rate variability including standard deviation of normal-to-normal intervals,standard deviation of the average 5-min normal-to-normal intervals,and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals.The development of intraoperative cardiovascular events and requirement for vasoactive drugs were recorded,and the development of cardiovascular events within 2 days after surgery was also recorded.Results Compared with group G,standard deviation of normal-to-normal intervals and standard deviation of the average 5-min normal-to-normal intervals at 1 and 2 days after surgery and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals at 2 days after surgery were significantly increased,the total incidence of intraoperative cardiovascular events and requirement for vasoactive drugs were decreased,and the total incidence of cardiovascular events within 2 days after surgery was decreased in group D (P ＜0.05).Conclusion Dexmedetomidine can reduce the development of perioperative cardiovascular events in elderly patients.

Objective To explore the joints and tendons characteristic features of high frequency ultrasound in asymptomatic hyperuricemia(AH) and to assess its value in AH diagnosis.Methods One hundred asymptomatic individuals with hyperuricemia (AH group) and 75 normouricemic subjects (control group) were examined by high frequency and color Doppler ultrasound.The joints,tendons and soft tissue of the knees,ankles and first metatarsal-phalangeal joints in two groups were examined.The correlations of serum urate(SU) level with double contour sign,bone erosion and articular cavity effusion were analysed.Results Hyperechoic deposition on the sulface of the articular hyaline cartilage (double contour sign) were found in the knees (35),ankles (17) and the first metatarsophalangeal joints (MTPJs,48) from the asymptomatic individuals with hyperuricemia,in contrast to none in the control group (P ＜0.05).Similar results were found in two groups of the bone erosion (30,25,20 vs 4,6,3,P ＜0.05),the effusion (28,36,41 vs 6,8,9,P ＜0.05) and the hyperechoic spots (19,18,22 vs 0,0,0,P ＜0.05).Patellar enthesopathy (4.5％ vs 0.6％,P ＜0.05) as well as achilles enthesopathy(8％ vs 0,P ＜0.05) and achilles tophi (6％ vs 0.6％,P ＜ 0.05) were more frequent in asymptomatic hyperuricemic than that of normouricemic individuals.No correlations between SU concentration and the presence of the double contour sign,the bone erosion and effusion were found (P ＞0.05).Conclusions There were some similar specific sonographic findings of gouty arthritis in the asymptomatic individuals with hyperuricemia.Also,these findings support high frequency ultrasound as a useful tool to detect anatomical damage in the joints,synovial tissue and tendons of asymptomatic individuals with hyperuricemia.

Objective To investigate the mecbanism of safflor injection treating myocardial contusion following thoracic impact.Methods Thirty healthy Japan big-ear rabbits were randomly assigned to the myocardial contusion control group (control group,n =15) and safflor injection group (safflor group,n =15).The rabbits with severe myocardial contusion were induced by BIM-Ⅱ Horizontal Bioimpact Machine.Blood samples were taken from common carotid artery of both groups to measure the levels of plasma thromboxance A2 (TXA2) and prostaglandin I2 ( PGI2 ) at 10 minutes before impact and at t0 minutes,30 minutes,1,3,6,12 and 24 hours after impact.Rabbits were dissected to observe the gross and micropathological changes of the hern at 24 hours after impact.Results The control group showed a distinct falling of plasma PGI2 concentration and a significant increase of plasma TXA2 concentration in the early period after severe myocardial contusion.The morphological observation revealed severe myocardial tissue injury as well.However,the safflor group showed insignificant variation pertaining to the reduction of plasma PGI2 concentration and increase of plasma TXA2 concentration,but obvious alleviation of myocardial tissue injury,as compared with the control group.Meanwhile,the ratio of TXB2 to 6- Ketoprostaglandin Fla (6-Keto-PGFla) in the safflor group was lower than that of the control group (P ＜0.05).Conclusion Safflor injection has therapeutic effect on myocardial contusion by elevating the concentration of plasma PGI2 and decreasing the concentration of plasma TXA2 in the early period after severe myocardial contusion.

Objective To study the expression of programmed death 1(PD-1) on the peripheral T lymphocytes and the serum cytokine levels in different phases of hepatitis B virus (HBV) infection (immune tolerance,immune clearance and non-replicating phases).Methods A total of 105 HBV infected patients in different phases of infection were enrolled in Wuxi No.5 People's Hospital from Apr to Sep 2011,and divided into three groups:the immune tolerance group (35 cases),the immune clearance group (35 cases) and the non-replicating group (35 cases).Meanwhile,20 healthy people were enrolled as controls.The peripheral blood was collected and PD-1 expressions on the surface of T lymphocytes were assessed by flow cytometry.The cytokine levels in different groups were analyzed by enzyme-linked immunosorbent assay (ELISA).The data were analyzed by t test and Pearson correlation analysis.Results The PD-1 expression on surface of CD8+ T lymphocytes of HBV infected patients was (12.35± 3.48)％,which was significantly higher than healthy control group [(4.65±1.21) ％] (t=9.76,P＜0.01).The PD-1 expression on CD4+ T lymphocytes was (4.95±2.87) ％,which was not significantly different from the healthy controls [(4.08±2.14) ％] (t =1.29,P＞0.05).The PD-1 expressions on CD8+ T lymphocytes of patients in the immune tolerance group,the immune clearance group and the non-replicating group were (15.87±3.18)％,(7.69±3.64)％and (10.12±2.84) ％,respectively; that in the immune tolerance group was higher than the immune clearance group (t=10.01,P＜0.01) and that in healthy control group was lower than those in the other 3 groups (t=15.12,3.61 and 8.17,respectively; all P＜0.01).The PD-1 expression on the surface of CD8+ T lymphocytes in chronic HBV infected patients was positively correlated with the serum interleukin-10 (IL-10) level (γ=0.377,P＜0.05),while that was negatively correlated with interferon-γ (IFN-γ) level (r=-0.620,P＜0.05).Conclusions PD-1 is up-regulated on the surface of CD8+ T lymphocytes from chronic HBV infected patients.And PD-1 is negatively correlated with serum IFN-γ levels and positively correlated with serum IL-10 levels.The expression of PD-1 on the surface of CD8+ T lymphocytes influences the balance of helper T cell (Th)1/Th2,which might play a role in the persistence of HBV infection.

In resent years,brain parenchyma and cerebrovascular sonography have received considerable attention.Monitoring of cerebral vessels and their blood flow velocities and pulsation indexes may reflect the intracranial vascular lesions.However,there are a few studies about transcranial color-code duplex sonography (TCCD) in the monitoring of space-occupying stroke.This technology has the non-invasive,convenient,and economical advantages,and can timely provide clinical information.Using TCCD to monitor pace-occupying stroke may play a positive role in prevention of the diseases and prognosis.

Objective To investigate the role of natural killer cells (NK cells) in patients with chronic hepatitis B (CHB). Methods Blood samples and liver biopsies from 108 CHB patients including 43 mild, 28 moderate and 37 severe CHB patients were collected. The levels of interferon (IFN) gamma in liver tissues and peripheral blood were detected by intracellular cytokine staining.The data were analyzed by t test. Results The levels of IFN gamma produced by NK cells in liver tissues and peripheral blood of patients with severe CHB were (8. 12±4. 26) % and (4. 59±2. 95) % ,respectively, which were significantly higher than those in patients with mild CHB [(3. 53±1. 56)%and (2. 26±0.61)%, respectively; t=3. 80 and t = 4. 30, respectively; both P<0. 05] and those in patients with moderate CHB [(4. 59±1. 98)% and (2. 48±1. 05)%, respectively;t=2. 62 and t =3. 28, respectively; both P<0. 05]. While there were no differences of IFN gamma produced by NK cells both in liver tissues and peripheral blood between mild and moderate CHB patients (t=0. 99 and t=1. 27, respectively; both P>0. 05). The levels of IFN gamma produced by NK cells in liver tissues and blood samples in severe phase of severe CHB were (10. 02 ± 4. 15)% and (6. 78 + 2. 91)%, respectively, those in recovery phase were (6. 13±2. 01)% and (3. 13± 1. 52)%, respectively (t = 1. 89 and t=1. 74, respectively; both P<0. 05]. Conclusion NK cells may play a pivotal role in the pathogenesis of severe CHB.