OBJECTIVE:To study the in vitro and in vivo metabolism of DX by intestinal bacteria in rats and volunteers and the active components in serum of rat after oral administration of DX 900mg/kg METHODS:To detect DX and its metabolites in stool,urine and serum with TLC and EST-MS RESULTS:In vitro,DX was decomposed easily by rat and human intestinal bacteria,and various metabolites were found With prolongation of metablism,metabolite with molecular weight of 415 3 was shown to be corresponding to diosgenin in rat serum and in urine of rats and volunteers CONCLUSION:The above-mentioned DX was decomposed easily by intestinal bacterias and diosgenin was absorbed into serum after oral administration of DX

Objective To study effect of immediate abundant sucralfate suspension perfusion to prevent upper gastrointestinal hemorrhage on the organophosphorous insecticides toxicosis suffer after washing stomach.Methods Total 83 patients suffering organophosphorous insecticides toxicosis were divided randomly into 2 groups randomly.In the control group,40 samples were given cimetidine 0.4 g by vein injection after stomach washing completely twice one day. Meanwhile,they were taken sucralfate 1.0 g/(4 times day) orally or by nastal feeding,continuing 5 days.In the treatment group,the samples were perfused sucralfate suspension 3.0 g (grind to powder,mixed with warm water 80 ml) by stomach tube after each stomach washing,and given routine treatment to assist (method as the control group).Results In the aspects of recessive hemorrhage,conspicuous hemorrhage and hospitalizing period the treatment group was significant decreased compared with the control group (P＜0.05).However,Analysis of the results showed no significant difference in death rate (P＞0.05).Conclusion Immediate abundant sucralfate suspension perfusion after washing stomach has significant curative effect on preventing upper gastrointestinal hemorrhage and decreasing hospitalizing period.

Objective To explore the impact of lung-protective mechanical ventilation (low tidal volume and optimal positive end-expiratory pressure (PEEP) on cerebral perfusion pressure (CPP) and cerebral oxygen metabolism.Methods Forty patients with severe cerebral injury along with respiratory failure were randomly assigned into two groups:lung-protective ventilation group A and conventional ventilation group B.Group A was planned to prescribe tidal volume 6 ～ 8 mL/kg,initial FiO240％,PEEP gradually increasing from 2 cmH2O to matched with FiO2 elevation,but the FiO2 was kept at permissive lower level.Group B was formulated with tidal volume 8 ～ 12 mL/kg,PEEP stepwise increasing from 0 2 cmH2O to match with FiO2 elevation,but PEEP was kept at permissive lower pressure.The intracranial pressure (ICP),mean arterial pressure (MAP),CPP,arterial and jugular venous blood gas were monitored.Results PEEP (8.2±3.32 cmH2O),ICP (19.7 ±3.6 mmHg),PaCO2 (54±7.3 mmHg),jugular venous carbon dioxide partial pressure (PjV CO2,56.7 ± 9.6 mmHg) in group A were higher than those (5.7±2.3 cmH2O,16.9±3.8 mmHg,41 ±5.2 mmHg,49.8 ±6.9 mmHg) in group B (P＜ 0.05 or P ＜ 0.01).VT,FiO2 in the group A were lower than those in the group B.There were no differences in PaO2/FiO2,jugular venous oxygen saturation (SjVO2),MAP,and CPP between two groups.PaCO2 were significantly correlated with CPP (r =0.368,P =0.019) while there was no correlation with ICP,PaO2,SjVO2,PjVCO2 (all P ＞0.05).CPP (69.7 ± 12.3 mmHg) was higher in case of PaCO2 (46 ～60mmHg) than those (61.5 ±9.1 mmHg) in case of PaCO2 (35 ～45 mmHg).There was correlation between PEEP and ICP (r =0.436,P =0.005).When PEEP was divided into three groups:≤52 cmH2O,6 ～ 102 cmH2O and ＞ 102 cmH2O,ICPs were different one another among three groups.When PEEP ＞ 102 cmH2O,it had a distinguished negative correlation with CPP (r =-0.395,P =0.017),while PEEP ≤ 102 cmH2O,CPP presented decreasing tendency.SjVO2 correlated with PaO2 (r =0.403,P =0.014) and PjVCO2 (r =-0.502,P =0.001) respectively.There were no significant relationships between SjVO2 and CPP,ICP,MAP,PEEP,respectively.Conclusions Lung-protective mechanical ventilation was relatively safer in patients with severe cerebral injury compared with conventional mechanical ventilation.Mild PaCO2 elevation (46 ～ 60 mmHg) combined with higher PEEP (＜ 102 cmH2O) did not decrease CPP.There was no difference in SjVO2 between the two modes of mechanical ventilation,suggesting no changes in cerebral metabolism occurred.

Objective To e xplore the clinical value of adrenomedullin on children with acute heart failure treatment and progno-sis.Methods Selected 58 cases of AHF children,40 patients with pneumonia,40 cases of children with congenital heart disease and 50 healthy children as the object,radioimmunoassay was taken to detected plasma adrenomedullin and endothelin level,and analysed correlation between AMD,ET-1 and cardiac function.Results Pneumonia complicated with heart failure group,congenital heart disease complicated with heart failure group plasma AMD,ET-1 levels were significantly higher than those in the control group, congenital heart disease group and pneumonia group (P<0.05),congenital heart disease group and pneumonia group of plasma AMD,ET-1 levels were significantly higher than those in the control group (P<0.05).Heart failure stage plasma AMD,ET-1 lev-els were significantly higher than those of early stage and recovery period (P<0.05),heart failure early stage plasma AMD,ET-1 levels were significantly higher than those of early heart failure recovery period (P<0.05).There was a significantly negative cor-relation between with AMD,EF-1 levels and CI,LVEF in AHF children (r= -0.614,-0.793,-0.618,-0.547,P<0.05);AMD mutation rate was significantly higher than that of EF-1 (P<0.05).Conclusion Plasma levels of ADM are closely relate with heart function in AHF children,through the determination of plasma ADM level can assessment treatment and the prognosis of children with AHF,and worthy of clinical application.

OBJECTIVE:To establish a method for the quality control of compound angelica injection.METHOD:5main Chinese crude drugs,i.e.angelica,chuanxiong,flos carthami,salvia miltiorrhiz and pueraria in compound angelica injection were identified qualitatively by TLC;The contents of ferulic acid in angelica and chuanxiong were determined by HPLC.RES_ ULTS:The above mentioned5main Chinese crude drugs were detected by TCL.Ferulic acid showed a good linearity in a range of2.829～15.990mg/L(r=0.9996),the average recovery rate was99.34%(RSD=0.94%).CONCLUSION:This method has a good reproducibility and suitable for the quality control of compound angelica injection.

Objective To investigate the thyroid hormone changes and their relationship with the state of severity in critically ill patients. Methods Ninety-two patients with no thyroidal illness syndrome admitted to the ICU from January ,2009 to December,2009 were enrolled in this study. The common situations and the score of acute physiology and chronic health evaluation Ⅱ were assessed on addmission. We measured the thyroid hormone levels on the day after admission and analysed whether thyroid hormone levels were related to disease severity. Results The thyroid hormone levels in septic shock group [TT3 (1.16 ± 0.24) nmol/L, TT4 (68.93 ± 24.11) nmol/L, FT3 (3.76 ± 0.21) prnol/L, FT4 (16.40 ± 2.74) pmol/L, TSH (1.58 ± 1.01) mU/L] were significantly lower than those in non-septic shock [TT3 (1.50 ± 0.25) nmol/L, TT4 (91.70 ± 21.90) nmol/L, FT3 (4.24 ± 0.45) pmol/L, FT4(17.98 ± 3.28) pmol/L, TSH (2.43 ± 2.76) mU/L] (P ＜ 0.05). The serum thyroid hormone levels of free triiodothyronine (FT3) ,free thyroxine (FT4) were related to the score of APACHE Ⅱ in septic shock(P ＜ 0.05).Conclusions The levels of thyroid hormone were significantly lower in critically ill patients than the control group and had positive correlation with the disease severity.

Objective To investigate the effect of fluvastatin on the expressions of caspase-12,CCAAT/enhancer-binding protein homologous protein(CHOP), and c-Jun N-terminal kinases (JNK) in ischemia-reperfusion brain injury in rats.Methods Forty two rats were randomly divided into sham operation group (6 rats), ischemia-reperfusion (I/R) group (18 rats), and fluvastatin (Flu) group (18 rats).The rats of I/R and Flu groups were molded by modified Longa intraluminal thread, then put to death at 2 h occlusion and 24 h reperfusion point.Expressions of caspase-12, CHOP, and JNK were detected with immunohistochemistry and Western blot.Results Immunohistochemistry and Western blot showed that the expressions of caspase-12, CHOP, and JNK were increased at 24 h reperfusion.Compared to I/R group, the expressions of caspase-12 and CHOP in Flu group were decreased significantly (all P ＜0.01);and the expression of JNK had no difference between I/R and Flu groups(P ＞ 0.05).Conclusions The increased expression of caspase-12, CHOP, and JNK showed that endoplasmic reticulum stress was involved in the pathological process of ischemia-reperfusion brain injury.Fluvastatin could inhibit the expression of caspase12 and CHOP, and could delete endoplasmic reticulum stress (ERS) in ischemia-reperfusion brain injury.

Objective To assess cerebrovascular reserve capacity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods One hundred and fourteen patients with OSAHS and 43 normal persons were enrolled in this study.The patients were divided into mild,moderate,severe according to apnea hypopnea index (AHI) and LSaO2 (lowest arterial oxygen saturation).All the patients and normal persons were routinely examined using transcranial Doppler (TCD) and end-tidal carbon dioxide partial pressure(ETCO2) to evaluate cerebrovascular reserve.Hypercapnia was induced by inhaling the CO2 which produced by the patients themselves,and hypocapnia was elicited by voluntary hyperventilation.Results CVR in the severe and moderate OSAHS were significantly lower than that in the control group [ (1.80 ± 1.34) ％/mm Hg and (1.43 ±1.05)％/mm Hg vs (2.93 ±0.93)％/mm Hg,P ＜0.05] when patients in the condition of hypocapnia.And there was no significant difference on CRV between the mild OSAHS group and control group [ (2.53 ±1.83 ) ％/mm Hg vs ( 2.93 ± 0.93 ) ％/mm Hg,P ＞ 0.05 ].When patients in the condition of Hypercapnia,CRV in the severe and moderate OSAHS were also significantly lower than that in the control group [ ( 1.83 ±1.32) ％/mm Hg and (1.08 ± 1.00)％/mm Hg vs (3.32 ± 1.53)％/mm Hg,P ＜ 0.05),AHI was negatively correlated with the cerebrovascular reserve at the condition of hypercapnia and hypocapnia (r=-0.665,-0.721; P ＜ 0.05 ).Conclusion Inhaling CO2 is a effective method for assessing CVR.Cerebrovascular reserve capacity is associated with AHI.Reduced CVR causes hemodynamics change being severe hypoxia in the moderate and severe OSAHS.

Objective To reveal inpatient service utilization and medical burden in disease-caused poor rural families,for policy references.Methods By means of convenience sampling method,face-toface interview was made to inpatients from such families in Miyi County of Sichuan Province,Binhai County of Jiangsu Province and Xingtai County of Hebei Province.Results Totally 453 effective questionnaires were collected,with an effective rate of 96.7％.Respondents feature low income and fund raising capability,while 75.3％ of them pay their inpatient costs out-of-pocket,17.7％ pay with loans from others and 7.1％ pay by financial assistance from relatives;but they tend to go to higher level hospitals and have higher financial burdens for diseases.Conclusions Rural hospitalization resources should be optimized and integrated,levels of the New Rural Cooperative Medical System be improved,the catastrophic health care system be perfected and the health insurance coverage be gradually expanded for the low-income and marginalized population.

Objective To develop a method for determination of the plasma protein binding rate of bisoprolol in human plasma by high performance liquid chromatography ( HPLC) combined with hollow fiber-based liquid-phase microextraction ( HF-LPME) . Methods Method of liquid phase microextraction was optimized. The concentration of bisoprolol in the reconstitute solution was analyzed by HPLC. The mobile phase consisted of water-methanol-acetonitrile-0. 1% phosphoric acid (50:34:6:10). The excitation wavelength was 232 nm and emission wavelength was 300 nm. Through the linear regression equations, the total and free concentrations were obtained, and then the protein binding rate was calculated. Results At low, middle, and high concentration, the protein binding rate of bisoprolol was 31. 2%, 32. 0% and 31. 8%, respectively. Conclusion The proposed method is proven to be simple, fast and reproducible, and is feasible for the determination of plasma protein binding rate of bisoprolol. Bisoprolol moderately binds with plasma protein independent of concentration.