BACKGROUND: In the researches of Ginkgo Biloba Extract(GBE) in the treatment of cerebra ischemia, because of the application of generally anaesthesia medication that may induce the alteration of cerebral temperature, the accuracy of the results may be affected.OBJECTIVE: To investigate the impact of domestic GBE on antioxidase and lipid peroxide of cerebral ischemic reperfusion tissue as well as the water content of ischemic brain tissue under normothermia.DESIGN: A randomised controlled trial.SETTING and MATERIALS: Study was conducted in the Tongji Medical University of Huazhong Science and Technology University. A total of 24 Wistar rats with a mass from 250 g to 300 g were randomly allocated into sham-operation group ( n = 8 ), cerebral ischemia control group ( n = 8) and cerebral ischemia GBE treatment group( n = 8) . The animal model of normothermia rat with left middle cerebral artery ischemia for 2 hours and reperfusion for 2 hours was prepared with the reference of Nagasawa method in the animals of control group and treatment group for contrast study.INTERVENTIONS: The cerebral temperature of the rats was reflected by the temperature of the temporal muscle. The temperature-measuring probe was embedded into the deep part of the left temporal muscle closed to osseous ectoblast. The temperature was continuously monitored by semiconductor oxide temperature sensor. The temperature of the head was heated with 60 W filament lamp and adjusted by automatic double-controlling craniocerebral cooling instrument to maintain the cerebral temperature at normothermia level of 36.5 ℃ - 37 ℃. The normothermia cerebral ischemic reperfusion injury rat model was established according to the design. GBE injection was injected respectively into abdominal cavity in the rats of cerebral ischemia GBE treatment group at the following time point: 12 hours, 8 hours and 4 hours before operation, immediately after cerebral ischemia and immediately after reperfusion, with 3 mL each time and 5 times in total. Same times and dose of normal saline was injected into the abdominal cavity in the rats of both control group and sham-operation groups.MAIN OUTCOME MEASURES: Superoxide dismutase (SOD), glutathione peroxidase(GSH-Px), reduced glutathione(GSH), malondialdehyde(MDA)and water contents in the cerebral ischemic tissue.RESULTS: The levels of SOD, GSH-Px and GSH in cerebral ischemia control group were(73.35 ± 12. 86) NU/mg, (167.37 ±54.34) μkat/g and (196. 84 ± 22.75) μg/g respectively, which significantly lower than that (96. 02± 16. 83) NU/mg, (338.57±84.02) μkat/g and(337.51± 34. 89) μg/g of sham-operation group( P ＜ 0. 01 or P ＜ 0.05) . The SOD, GSH-Px and GSH levels of cerebral isehemia GBE treatment group were (87.24± 15.03) NU/mg, (316. 56 ±93.52) μkat/g and(263.16±28.54) μg/g, which significantly higher than that of cerebral ischemia control group(P ＜ 0.01 or P ＜ 0.05) .The MDA level of cerebra ischemia control group was (308.34 ± 26.81 ) nmol/g, which significantly higher than that(101.46 ± 10.97) nmol/g of sham-operation group( P ＜ 0.01 ) .The MDA level of cerebral ischemia GBE treatment group was(125.86± 13.90) nmol/g, which was significantly lower than that of sham-operation group ( P ＜ 0.01 ) . The water content of cerebral ischemia control group was(80. 45 ± 0.44)%, which was significantly higher than that (78.20 ± 0. 25 ) % of sham-operation group ( P ＜ 0.01 ) . The water content of cerebral ischemia GBE treatment group was(79.63 ± 0.46) %, which was significantly lower than that of cerebral ischemia control group( P ＜ 0.05).CONCLUSION: Domestic GBE can inhibit the excessive production of free radicals and the lipid peroxidation during cerebral ischemia and reduce cerebral oedema and the destruction of blood-brain barrier to protect cerebral ischemic tissues under cerebral normothermia.

Objective To compare the results between laparoscopic repair and surgical procedures in perforation of duodenal ulcer. Methods Fifteen p atients were operated on perforation of duodenal were by laparoscopic repair, an d thirty patients performed open repair or partial gastrectomy at the same peri od were chosen as control groups. Results The operating time in laparoscopic group and other two surgical groups were 59 min, 84 min and 204 min; postoperati ve requirement of analgesic was 7％(1/15), 73％(11/15) and 80％(12/15) in three groups respectively. The recovery time of gastrointestinal function was 25 h, 56 h, and 72 h. the mean time of hospitalization was 6 d, 8 d and 10 d. The differ ences among groups were significant (P

Objective To reseach the effects of diazepam under different cerebral temperature on the concentration of glutamate(Glu), ?-aminobutyric acid (GABA), superoxide dismutase (SOD), glutathione peroxidase(GSH-PX) and malonaldehyde(MDA) in cerebral ischemia tissue of rat. Methods The modle of cerebral middle artery occlusion reperfusion of rats was established to induce the target cerebral temperatue.The concentration of Glu, GABA, SOD, GSH-PX and MDA were detected in mild hyperthermia, ordinary temperature and subhypothermia groups respectively. Results (1)Compared with the sham-operation group under normal temperature,the concentration of Glu, MDA had increased obviously in the control group of focal cerebral ischemia and the group using diazepam under normal temperature (all P0.05),but the concentration of GABA had increased markedly in the groups of normal temperature using diazepam (P0.05).(3)Compared with the control group using diazepam under normal temperature,the concentration of Glu and MDA increased obviuosly(all P0.05).The concentration of Glu and MDA in the groups of hypothermia using diazepam was lower markedly (P

Objective To study the relationship between hyperthermia secondary to extensive cerebral infarction and short-term prognosis.Methods 208 extensive cerebral infarction cases were divided into two groups: the fever group(T≥37.5℃, n=82) and non-fever group(T

Objective To explore the correlation of TCM syndrome patterns of chronic pharyngitis(CP)with etiological factors.Methods A questionnaire investigation was carried out in 102 CP patients,of which 30 were differentiated as lung-kidney yin deficiency,30 as spleen-stomach deficiency,30 as phlegm coagulation and blood stasis,and 12 as spleen-kidney yang deficiency.The dietary hobbies,living and working environment,systemic diseases and living habits of the patients were recorded.Meanwhile,parameters of the pharyngeal microorganism and immunology were detected.Results The results of nonparametric test showed significant difference between the age and the mean disease course of the four syndrome patterns(P0.05). There existed significant difference between indulging in spicy food,indulging in cold and raw food,and staying up at night in the four syndromes (P0.05).The distribution of the four syndromes was different in the population with medical history of tonsillitis,dental caries,chronic cough,chronic gastritis and chronic colitis(P0.05).Conclusion The syndrome patterns of chronic pharyngitis are correlated with age,disease course,dietary habits of indulging in spicy food and cold-raw food,living habit of staying up at night,systemic disease or disease of organs around the throat,but are not correlated with sex,household registration,job,working and living environment,indulging in frying food,hobbies of smoking and drinking,living habits,emotional factors,throat swab culture results and immune parameters.

Purpose: To evaluate the effect of radiotherapy and to detect the prognostic factors for residual and recurrent foci after surgery of thyroid gland cancers. Materials and Methods: 109 patients with residual or recurrent foci of thyroid cancers after surgery were treated with radiotherapy. Results:The overall 5-,10-, 15-, 20- and 25- year survival rates were 93.6%, 91.7% , 88.7%, 87.6% and 87.6% and the 5-, 10-, 15-, 20- and 25- year survival rates with no evidence of disease were 90.8%, 89.8% ,85.6%, 84.1% and 84.1%, respectively. The clinical stage was the main factor and patient's age at diagnosis, patient's sex, histopathological types and radiation dose were also the prognostic factors. Conclusion:Radiotherapy is beneficial to residual and recurrent foci after surgery of thyroid cancer. The optimum radiation dose is 45～65 Gy.

Objective To compare the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients using differentanesthetic methods.Methods Ninety-three ASA Ⅱ or Ⅲ patients,aged ≥ 65 yr,weighing 45-67 kg,scheduled for artificial femoral head replacement,were randomly divided into 2 groups:general anesthesia (group G,n =47) and combined spinal-epidural anesthesia group (group S-E,n =46).In group G,anesthesia was induced with iv injection of midazolam 0.1 mg/kg,propofol 2 mg/kg,fentanyl 3-5μg/kg,and vecuronium 0.1 mg/kg,and maintained with continuous infusion of propofol 2-3 mg· kg-1 · h-1,intermittent iv boluses of fentanyl 1 μg/kg and vecuronium 0.04 mg/kg and inhalation of 1.5％-2.0％ isoflurane.In group S-E,hyperbaric 0.5 ％ ropivacaine 2 ml was injected into the subarachnoid space over 20 s,the patients were kept in the original position for 15 min,the level of anesthesia was simultaneously adjusted to below T8 on the operated side,and 0.5 ％ ropivacaine 3-5 ml was injected into the epidural space when needed during operation.Cognitive function was assessed by mini-mental state examination at 24 h before anesthesia and 24 and 72 h after operation.Venous blood samples were collected for determination of plasma amyloid-beta levels by ELISA.Results Compared with group G,the incidence of POCD at 24 h after operation and level of plasma amyloid-beta were significantly decreased in group S-E (P ＜ 0.05).Conclusion Elderly patients are more likely to develop POCD under general anesthesia than under combined spinal-epidural anesthesia.

Minimally Invasive Surgical Procedures ; Philosophy, Medical

Objective To evaluate the feasibility of virtual touch tissue quantification (VTQ) for the assessment of renal allograft.Methods A total of 72 kidney recipients were examined with conventional ultrasound and VTQ after transpantation.Biopsies were performed in 34 patients,20 patients were with acute rejection (AR),14 with chronic allograft nephropathy (CAN),38 patients as control group.The peak systolic velocity (PSV) and resistance index(RI) were measured on main,infrarenal and arcuate arteries with conventional ultrasound and shear wave velocity (SWV) of the renal cortex was obtained by VTQ.All the data were compared among three groups.Results There were no significant differences of PSV between two groups.An increased RI was presented in the CAN group(P ＜0.05).The mean SWV was (2.67 ± 0.27) m/s,(2.90 ± 0.31)m/s and (2.28 ± 0.24)m/s for AR,CAN and normal group,respectively.There were significant differences of SWV among the three groups (P ＜ 0.05).Conclusions VTQ technique could provide a new method for the assessment of transplanted kidney.

Objective To evaluate the application of health education in patients with cholecystectomy. Methods From October 2009 to July 2010, 93 patients in our hospital with cholecystectomy were randomly divided into the control group (45 cases) and the observation group(48 cases). The control group was given routine nursing care, the observation group received perioperative health education in addition to the routine nursing care, then compared the nursing effect of two groups. Results In the observation group, the patients' knowledge and awareness rate of their own disease was 95.8%, and the control group was 80.0%, the difference was statistically significant between two groups. The recovery of gastrointestinal function in the observation group was significantly better than the control group, the difference was statistically significant between two groups. Conclusions Health education can enable patients with cholecystectomy correct understanding of their disease, eliminate negative emotions, and help the recovery of gastrointestinal function in patients, which is worthy of attention.