Objective To explore the relationship between visceral pleura closure of primary spontaneous pneumotho?rax (PSP) using different diameters of drainage tube and the time of implementing closed chest-drain. Methods According to the diameters of tubes for chest drain they used, 214 patients with PSP were divided into standard tube group (136 cases) and fine catheter group (78 cases). Patients in standard tube group who were inserted chest drain for≤1 d,≤3 d,≤6 d,>6 d included 48, 43, 29 and 16 cases respectively while their counterpart in fine catheter group include 24, 23, 17, 14 cases re?spectively. Closed time of crevasse were noted and incidence of preoperative closed pneumothorax converting into open pneu?mothorax, subcutaneous emphysema and prolonged pain after operation were all recorded. Results There is no statistical difference in closing time of crevasse nor in the distribution of various drainage times (proportions of≤6 d and>6 d are low?er than proportions of≤1 d and≤3 d) between standard tube group [(4.76 ±1.65) d] and fine catheter group [(4.54±1.67) d] (t=0.963). However, in both standard tube group and fine catheter group, closing time of crevasse is shorter if drainage time≤6 d or>6 d than if it≤1 d and≤3 d. Closing time of crevasse show negative correlation with period of chest drain in?sertion in both standard tube group and fine catheter group (P<0.05). The rate of converting from close pneumothorax into open pneumothorax were 51.96%(53/102) and 36.21%(21/58) respectively in standard pipe group and fine catheter group. Furthermore, the incidence of subcutaneous emphysema and prolonged pain were all higher than those in standard tube group than those in the fine catheter group (P<0.05). Conclusion Using closed chest drain to treat patients with PSP, di?ameter of the drain tube did not affect closing time of crevasse. But longer insertion period of chest drain can reduce closing time of crevasse.

OBJECTIVE:To investigate the effect of prostaglandin E1 combined with atorvastatin on related indicators in elderly patients with hypertensive nephropathy. METHODS:70 elderly patients with hypertensive nephropathy were randomly divided into control group and observation group. Control group was orally given 10 mg Atorvastatin calcium tablet,once a day;observation group was additionally given 10 μg Prostaglandin E1 injection,adding into 250 ml 0.9% Sodium chloride injection by intravenous infusion,once a day. The treatment course for both groups was 2 weeks. All patients were given quality low-protein,low-salt and low cholesterol diet,depressurization,lipid-lowering and other conventional treatment. Heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),24h urinary protein(TP/24 h),microalbuminuria(mAlb),uri-nary β2-microglobulin (β2-MG),blood urea nitrogen (BUN) before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,HR,SBP,DBP,TG,TC and LDL-C in 2 groups were significantly lower than before,and difference was statistically significant(P<0.05),but there was no significant difference in the above-mentioned in-dicators between 2 groups and HDL-C before and after treatment(P>0.05);Scr,TP/24 h,mAlb,β2-MG and BUN were signifi-cantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on the con-ventional treatment,prostaglandin E1 combined with atorvastatin can effectively improve the HR,blood pressure and blood lipid of elderly patients with hypertensive nephropathy;however,prostaglandin E1 combined with atorvastatin is better than atorvastatin alone in aspect of protecting renal function,with similar safety.

Objective To explore the significance of peptidylarginine deiminase type 4 (PAD4) in the pathogenesis of ANCA-associated vasculitis (AAV) by detecting its level in patients with AAV.Methods Sera from 13 patients with AAV,11 patients with primary chronic kidney disease and 12 healthy controls were collected.Serum PAD4 was detected using commercial ELISA kits.The association between serum PAD4 and BVAS of AAV was further investigated.Results (1) The serum level of PAD4 in patients with AAV in active and remission stages were all higher than that in the healthy controls.The serum level of PAD4 in patients with CKD was not found elevated compared with the normal controls.(2) The serum levels of PAD4 in AAV with renal damage were all significantly higher than that in CKD group no matter in active or remission stage.(3) The serum level of PAD4 in AAV with renal damage in active stage was positively correlated with BVAS (r=0.71,P=0.02).Conclusion PAD4 is involved in the pathogenesis of AAV.

Objective To evaluate the guiding values of different lung compressed forms in the choice of the treat?ment of spontaneous pneumothorax. Methods Based on lung compressed forms on anterior-posterior chest X-ray , a total of 219 spontaneous pneumothorax patients were divided into the periphery shape group (n=127) and irregular shape group (n=92). We observe the relationship between lung compressed form with the times of previous closed thoracic drainage,the cure rate of closed chest drain at the 7th day,length that closed thoracic drainage cure pneumothorax and the incidences of the surgical pleural adhesion. Results We found that the incidence of irregular lung compression in 0, 1 and 2 times of re?ceiving previous drainage were 11.71%(13/111), 57.89%(22/57) and 90.19%(46/51) respectively. Its incidence increased with the times of previous closed chest drain (χ2=96.339, P<0.01). In total, 94 patients (85 of which were cured until the 7th day) and 30 patients (11 of which were cured until the 7th day) were cured using close chest drain in peripheral shape and ir?regular shape group. And the 7th day cure rate is lower in irregular group than that in the peripheral shape. [36.7%(11/30) vs 90.4%(85/94),χ2=37.596, P<0.01]. What’s more, patients in irregular group need longer time to cure pneumothorax than patients in peripheral shape did [d:10.1±4.87 vs 4.00±2.07, t=9.806, P<0.01]. Among the 95 patients who underwent surgi?cal treatment in both groups, the incidence of pleural adhesion is higher in irregular shape group than that in peripheral shape group [91.9%(57/62)vs18.2%(6/33),χ2=52.445, P<0.01]. Conclusion The 7th day cure rate in patients with pe?ripheral shape lung compressed form is higher than patients in irregular lung compressed form using closed chest drain with fewer incidence of pleural adhesion and shorter cure time. Those with irregular lung compression is more appropriate for sur?gical treatment.

Objective To discuss the jointly therapeutic effects of 6％ hydroxyethyl starch 130/0.4 (voluven) and furosemide on acute lung injury induced by paraquat (PQ) in swine.Methods The ALI/ ARDS models were established with 20％ PQ (20 mL) intraperitoneal injection in 18 healthy female piglets and randomly divided into three groups: voluven group (A), furosemide group (B) and voluven + furosemide group (C) (n =6 in each group).The heart rate (HR), mean arterial pressure (MAP), extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), partial pressure of carbon dioxide (PaCO2) and oxygenation index (PaO2/FiO2) among the three groups were carefully measured by PICCO (pulse indicator continuous cardiac output) before modeling (baseline), just aftermodeling (t0), and 2 h (t2), 4 h (t4), 6 h (t6) and 8 h (t8) after trearment.Needle biopsies of lung tissue were made before modeling and at t0 and t8 and prepared for microscopy observation after Hematoxylineosin staining method (HE staning).Repeated measurement data were compared among repeated measures by the ANOVA and the difference between groups was compared by one-wey ANOVA.Results (1) The HR and MAP of all animals increased obviously while the oxygenation index declined significantly at modeling just made (t0) compared to those before modeling (all P ＜ 0.05).At the same time, the HR and MAP of A and B groups were significantly lower than those of C group after treatment (all P ＜ 0.05), while the oxygenation index of A and B were significantly higher (all P ＞ 0.05).(2) The ELWI and PVPI of all animals increased obviously at modeling just made (t0) compared to those before modeling (all P ＜ 0.05).The ELWI and PVPI were decreased after treatment.And at the same time, the ELWI and PVPI of A and B groups were significantly lower than those of C group after treatment (all P ＜ 0.05).(3) The alveolar tissue showed obviously injured changes at modeling just made (t0).The injury was relieved 8h after trearment, which was most markedly in group C.Conclusions With the combination of 6％ hydroxyethyl starch 130/0.4 and furosemide administered, the acute lung injury induced by paraquat poisoning can be effectively relieved, promoting gas exchange, and improve oxygenation.

Objective To study the predictive value of evaluation in oxygen partial pressure[p(O2)] and carbon dioxide partial pressure[p(CO2)] of pleural cavity to the closure of visceral pleura in primary spontaneous pneumothroax (PSP) pa-tients. Methods Seventy-six hospitalized pneumothroax patients were divided into two groups:closed pneumothroax group (n=40) and open pneumothroax group (n=36), according to the radiographic information.To collect the expiratory gas by the device which we designed and produced, to collect the gas in the pleural cavity by thoracentesis. To detect the p(O2)and p(CO2)respectively, and the blood gas analysis of radial artery was done at same time. Results There was significantly low-er value of p(O2)of the gas in the pleural cavity in patients of closed pneumothroax than that of open pneumothroax (P <0.05). The level of p(CO2)was higher in patients of closed pneumothroax than that of open pneumothroax ( P<0.05). There were no significant differences in values of p(O2)and p(CO2)in expiratory gas and the blood gas analysis between two groups (P>0.05). There was significantly higher value of the expiratory gas/the pleural cavity gas p(O2) and a significantly lower value of p(CO2), in closed pneumothroax group than those of open pneumothroax group (P<0.05). Logistic regression analy-sis showed that values of the expiratory gas/the pleural cavity gas p(O2) and p(CO2) were the effective factors for the closure of visceral pleura. ROC curve showed that the areas under ROC curve (AUC) for the expiratory gas/the pleural cavity gas p(O2) and p(CO2) was 0.985 and 0.867, the sensitivities were 92.5% and 77.8%, the specificities were 100%and 85.0%and the reference values were 1.81 and 0.97. Conclusion To utilize the evaluation of gas partial pressure can predict whether the leakage of the visceral pleura is closed.

OBJECTIVETo develop a HPLC method for the determination of plasma concentration of oridonin (ORI) and study the pharmacokinetics of ORI in mice.

METHODBlood was sampled from mice which were injected ORI by 10 mg x kg(-1) at different time intervals, and the concentration of ORI was determined by HPLC. The pharmacokinetic parameters were accessed by 3P97.

RESULTThe calibration curve was linear (r = 0.998 7) within the range of 0.202-20.0 mg x L(-1) for ORI in plasma. The average recoveries were more than 93%. The within-day and between-day precisions were no more than 9%. After i.v. oridonin in mice, the plasma concentration-time course fitted well to two-compartment model. The pharmacokinetic equation was C = 16.192 5e(-0.554 6t) + 5.475 7e(-0.016 3t). The pharmacokinetic parameters were below: t1/2alpha 1.249 9 min, t1/2beta 42.638 4 min, K21 0.152 3 min(-1), K12 0.359 3 min(-1), K10 0.0592 min(-1), AUC 366.035 0 microg x min x mL(-1), CL 0.0273 L x min(-1) x kg(-1), V(c)0.461 5 L x kg(-1).

CONCLUSIONThe method can be used to determine the concentration and to investigate the pharmacokinetics of ORI in mice. ORI was absorbed and distributed very fast in mice. The effect of ORI was rapid. The elimination was the main process.

Objective To observe the effects of treadmill training at different intensities on the expression of p-AKT in rats' gastrocnemius muscles after focal cerebral ischemia,and to investigate whether intensive training is beneficial for the recovery of motor function.Methods Left middle cerebral artery occlusion (MCAO) was induced in 120 male Wistar rats using the intraluminal thread method,and they were divided into an MCAO group (no training),a normal training group (treadmill training once a day for 30 min) and an intensive training group (treadmill training twice a day for 60 min),each of 30 rats.There was also a sham control group with 30 members not given MCAO or training.The four groups were further divided into 3 day,7 day and 14 day subgroups.Five rats randomly selected from each subgroup were sacrificed for hematoxylin-eosin staining after 4％ paraformaldehyde treatment.Neurological function was evaluated using Zausinger scores,and the expression of p-Akt was detected by western blotting.Results No significant differences in Zausinger scores were observed between the intensive training group and the normal training group after 1,3 or 7 days of training.However the average Zausinger score in the intensive training group was significantly higher than in the normal training group after 14 d of treadmill training.After 7 d and 14 d of treadmill training the average cross-sectional area of the gastrocnemius muscles in the sham group was significantly higher than in the other three groups.The average area of the intensive training group was significantly larger than that of the normal training group.The expression of p-Akt in the gastrocnemius was significantly increased in the intensive training group compared with the normal training group in the 7 day and 14 day subgroups.Conclusion Treadmill training can improve the expression of p-Akt in atrophied gastrocnemius muscles caused by MCAO.Intensive training is more effective for the recovery of muscle function.

Objective To investigate mutations of CSMD3 gene in a pedigree of familial cortical myoclonic tremor with epilepsy (FCMTE).Methods Peripheral blood (5 ml) was obtained from FCMTE patients (7 cases),suspected cases,and control individuals.Polymerase chain reaction (PCR) and purification of PCR products for sequencing were used to detect the existence of mutations in 73 exons of gene CSMD3.The resulting products were subjected to agarose gel electrophoresis and gel-imaging system.The PCR amplification products were sequenced.Results The sequencing results of 73 exons were compared with CSMD3gDNA sequence in human GenBank.We neither found any DNA sequence variation nor disease-related mutations.Conclusions The family does not have a mutation in the CSMD3 gene.We need to further find the disease genes and the mutations in this family.