Objective To investigate the effects of minute quantity of endogenous endotoxin originating from the lung on ventilator-induced lung injury in rats. Methods Thirty-two pathogen-free male adult SD rats weighing 370-390 g were randomly divided into 4 groups ( n = 8 each): group I spontaneous breathing (group C) ; group Ⅱ spontaneous breathing + IPS (group CL) ; group IE mechanical ventilation (group M) and group IV mechanical ventilation + LPS (group ML). The animals were anesthetized with intraperitoneal 20% urethane 0.8 ml/100 g. Right common carotid artery and left femoral vein were cannulated for BP monitoring and fluid and drug administration. The animals were tracheostomized. In group CL and ML LPS 100μg /kg was instilled into trachea. In group M and ML the animals were mechanically ventilated (V_T 20 ml/kg, PEEP=0, I = E = 1:1). P_(ET) CO_2 was maintained at 35-45 nun Hg by adjusting respiratory rate. The animals were breathing or ventilated with room air,and ECG, BP, HR and P_(ET)CO_2 were continuously monitored. Blood gases were analyzed at the beginning and 1, 2 and 3 h of experiment. The animals were sacrificed at 3 h of experiment. The lungs were removed for microscopic examination. The pathological changes of the lung were scored (0 = normal,3 = severe change) . Wet/dry lung weight ratio was determined. The left lung was lavaged. The broncho-alveolar lavage fluid (BALF) was collected. WBCs in BALF were counted. Pulmonary albumin permeability (PAP) (BALF protein concentration/plasma protein concentration) was determined. Plasma TNF-a and macrophage inflammatory protein 2 (MIP-2) concentrations were detected with ELISA. The endotoxin receptor CD14 mRNA expression in lung tissue was determined by RT-PCR and the macrophage CD14 expression in BALF was determined by immuno histochemistry in group C and M. Results Wet/dry lung weight ratio and PAP were significantly higher in group ML than in group M and C. WBC count in BALF, the pathological score and plasma MIP-2 concentration were significantly higher in group M and ML than in group C and were significantly higher in group ML than in group M. TNF-a concentration was significantly higher in group CL and ML and was not detected in group C and M. CD14mRNA expression in the lung tissue and CD14 expression in BALF macrophage were significantly higher in group M than in group C. Conclusion Minute amount of endogenous endotoxin from the lung can aggravate ventilator-induced lung injury in rats. Mechanical ventilation with large tidal volume sensitizes the lung to LPS stimulation through up-regulation of CD14 exexpression.

Objective To evaluate the role of gamma-aminobutyric acid A (GABAA) receptor in isoflurane-induced cognitive dysfunction in neonatal rats.Methods Twenty-eight 7-day-old Sprague Dawley rats,weighing 16-18 g,were randomly divided into 4 groups (n =7 each):control group (group Con),securinine group (group See),isoflurane group (group Iso) and securinine + isoflurane group (group Sec + Iso).Normal saline 0.2 ml was injected intraperitoneally in group Con.Specific GABAA receptor antagonist securinine 30 mg/kg was injected intraperitoneally at the corresponding time points in group Sec.Normal saline 0.2 ml was injected intraperitoneally and 1.4％ isoflurane was inhaled for 6 h in group Iso.Securinine 30 mg/kg was injected intraperitoneally at 30 min before isoflurane inhalation and 3 h of inhalation,and 1.4％ isoflurane was inhaled for 6 h in group Sec + Iso.The rats were then sacrificed at 3 weeks after administration,their brains were immediately removed and hippocampal slices were prepared for electrophysiological experiments.The value of population spike amplitude (PSA) and long-term potentiation (LTP) were measured every 5 min.The successful LTP induction was recorded.Results Compared with group Con,the values of PSA and rates of successful LTP induction were significantly decreased in group Iso (P ＜ 0.01),and no significant change was found in the parameters mentioned above in groups Sec and Sec + Iso (P ＞ 0.05).The values of PSA and rates of successful LTP induction were significantly higher in group Sec + Iso than in group Iso (P ＜ 0.01).Conclusion GABAA receptor is involved in isoflurane-induced cognitive dysfunction in the neonatal rats.

Objective To study the expression of P27,c-fos protein in neuron cell after ischemia and reperfusion accompany with the DWI imagings in rat brain.Methods 12 healthy SD rats with MACO were divided into three groups.Group A,ischemia 30 minutes with 60 minutes reperfusion;Group B,ischemia 60 minutes with 60 minutes reperfusion.Group C,ischemia 60 minutes.The DWI imaging was scanned after surgery immediately.The expressions of P27 and c-fos were determined by immunochemistry procedure.Results The P27 protein positive reaction was not detected in all ischemia and reperfusion groups.The c-fos protein positive reaction was observed in the cortex and basal ganglion in all groups.The hyperintense signal was presented the in DWI after fifteen minutes following the ischemia.Conclusions P27 protein is endogenous cyclin dependent kinase inhibitor.There may be the relationship between low expression of P27 protein in rat brain and the programmed cell death in neuron after the ischemia.C-fos protein participates in the neuron cell injury after the ischemia.DWI has good sensitivity to acute cerebral ischemia.

Objective To explore the feasibility of continuous sciatic nerve block via lateral poplit eal approach with single shot femoral nerve block for enhanced recovery after surgery in ankle and foot surgery.Methods Sixty adult patients scheduled for elective ankle and foot surgery were randomly assigned into 2 group (n =30 each):Group A received sciatic nerve block via lateral popliteal approach with a catheter placed and a single shot femoral nerve block under ultrasound guidance followed by patient-controlled postoperative analgesia with 0.2％ ropivacaine through the perineural catheter;Group B received the routine epidural puncture and a catheter placement at L2-3 level followed by postoperative analgesia with 0.2％ ropivacaine through the catheter.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart beat (HR) were recorded before and after anesthesia.The block efficacy,the volume of fluid influsion during operation and the usage of ephedrine were recorded.The pain severity at rest and upon movement with a 0-10 numeric rating scale (NRS,0 =no pain and 10 =worst possible pain),the modified Bromage score of the motor block of the affected extremity,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioid rescue within 48 h after surgery were assessed.The first time of leaving bed after operation,the length of hospital stay and the occurring of complication related to puncture and analgelsia were also recorded.Results SBP and DBP at each time point after anesthesia were higher in group A than those in group B (P ＜ 0.05).The volume of fluid infusion during operation and the occurence of ephedrine use were less in group A than those in group B (P ＜0.05).There was no indifference in terms of the NRS scores at rest and upon movement,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioids rescue (P ＞ 0.05),but the complications such as nausea and vomiting,urinary retention occurred more in group B (P ＜0.05).The modified Bromage score of the motor block at each time point within 24 h after surgery was lower in group B than that in group B (P ＜ 0.05).The first time of leaving bed after operation and the length of hospital stay were shorter in group A than those in group B (P ＜ 0.05).Conclusions Ultrasound-guided continuous sciatic nerve block via lateral popliteal approach with single shot femoral nerve block can provide exact anesthetic effect with minimal interference on haemodynamics and excelent postoperative analgesia with less influence on movement.It's helpful in the ankle and foot surgery to improve the recovery after surgery.

Objective To investigate the improving effects of Shenshao decoction on myocardial structure and function in diabetic cardiomyopathy,and its effect on expression of TLR4/MyD88-dependent pathway signal in diabetic cardiomyopathy.Methods Diabetes mellitus was induced in 8-week-old male Wistar rats by a single intraperitoneal injection of streptozotocin.The changes of plasma myocardial enzyme (CK, LDH) and high sensitive C reactive protein (hsCRP) were measured.Cardiac function was measured by left ventricular intubation.Hematoxylin and eosin staining and electron microscopy were used to observe the changes of myocardial morphology and ultrastructure in rats.Expression of Toll-like receptor 4(TLR4), myeloid differentiation protein 88(MyD88), and nuclear factor-κB P65(NF-κB P65) were tested by immunohistochemistry.Results After 6 weeks of treatment, the left ventricular diastolic and systolic functions were obviously improved;the degrees of myocardial fibers and mitochondrial damage were obviously relieved;the content of CK, LDH and hsCRP decreased (P< 0.05), and hsCPR was positively correlated with CK and LDH (r=0.823,r=0.819,P < 0.05).The expressions of TLR4, MyD88, NF-κB P65 were significantly decreased (P< 0.05).There was no significant difference in the above mentioned indicators between the control group and control+Shenshao decoction group (P> 0.05).Conclusions Shenshao decoction can reduce the myocardial injury in diabetic cardiomyopathy and improve cardiac diastolic and systolic functions.The mechanism may be related to attenuated inflammation by TLR4/MyD88 dependent signaling pathway.

Purpose:To study the clinic characteristic, diagnosis and therapy of hereditary nonpolypoid colorectal cancer.Methods:We analysed the diagnosis, therapy and follow up of hereditary nonpolypoid colorectal cancer in 32 cases from 11 families by studying the tumour site, pathologic results. Results:There were 43 cancer patients having 61 tumours in 11 families, and 32 cases were intestinal cancer with 39 tumours. In these 32 cases, there were 12 hereditary nonpolypoid colorectal cancer (37.5), and 5 cases were intestinal cancer (15.6). We examined the patients and their direct relatives and found 28 people had various cancer, of which 20 cases without any complaint. Conclusions:Hereditary nonpolypoid colorectal cancer is a dominant hereditary disease, with the characteristic of early flare up,prone to upper colon. They are always non contemporary polygeneous cancer or contemporary polygeneous cancer, and prone to take place outside of colon. So it is important not only for patients to be treated and followed up but also for their relatives to be instructed and followed up. We must study the disease history in details. [

Objective To test the reliability and validity of self-management instrument for person with schizophrenia.Methods The instrument was psychometrically tested by using 396 people with schizophrenia among 8 mental health service centers in Beijing.The instrument was test by internal consistency analysis,test-retest reliability,exploratory factor analysis,confirmed factor analysis,known-groups validity.Results The Cronbach α coefficient of instrument was 0.96,Pearson coefficient was 0.791.Factor analysis of the instrument resulted in six factors:medication compliance,medication management,symptom management,maintain daily life and social functioning,manage health recourse and support,and self-efficacy.The six-factor solution accounted for 61.70％ of the total variance.The results also showed that the newly developed instrument was positively correlated with PIH.The results also demonstrated that the instrument could discriminate patients' self-management ability according to their living status,work status,education background,and financial burden.Conclusion The newly developed instrument has adequate psychometric properties and may be useful in intervention program and assessing self-management in individuals with schizophrenia.

Objective To study the factors effecting on flow cytometric sperm chromatin structure assay.Methods The SCSA explores the metachromatic properties of acridine orange (AO) and flow cytometry to monitor the susceptibility of sperm chromatin DNA to acid induced denaturation in situ because of the low pH treatment. Results COMP?t, ?t, SD?t value were different upon on the storage methods (①sperm was preserved in 4℃, ②sperm was cryopreservated after dilution ③sperm was cryopreservated). Results show that the second method above made the least artificial injury to sperm DNA. It did not affect the results if the samples were quickly thawed in a 37℃ water bath and detected immediately and the detect current velocity was lower than 300 cell/sec. The intra -CV was 7 28% and the internal CV was 8 92%. Mean and standard deviations of COMP?t were 8 7?11 0% in 511 healthy men. Because data present right skew distribution, the reference range of COMP?t is

An analysis of the time pattern of outpatients visits to our hospital from 1997 to 2000 led to the discovery of the variation pattern of each outpatient departments workload. This discovery has enabled the managers of the hospital to rationally deploy the manpower and material resources of various departments, make full use of limited resources, readjust the working hours and shifts of different kinds of staff, and work out a flexible system of working hours which is more scientific and more convenient to patients. Implementation of such a system has ensured that prompt delivery of medical service is accessible to patients even at the peak of visiting hours. Hence the reduction of patients time of waiting and the provision of a scientific guarantee for establishing a quality, efficient, low consumption and fast outpatient service system, meeting the medical needs of patients to the maximum and enhancing work efficiency.