The mortality of septic shock has been reported high.Glucosteroid is widely used in patients with septic shock as one of the assistant therapies of septic shock.However the applied patients,the using time,the duration and the dose of glucosteroid remain controversial.Recently it is recommended using small dose in septic shock according to results of large scale clinical trials.We will review the studies of glucosteroid in septic shock in recent years here.

The mechanism of carcinoma occurrence is of multiform. One of the scheduled multi modality treatment is hyperthermia. Result of research indicates that hyperthermia can kills the tumor cells by affecting carcinogens, tumor suppressors and immunity. This review presents the current knowledge of hyperthermia on mechanism of therapeutic effects and the application in the treatment.

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Objective To improve the diagnostic accuracy by analyzing the computed tomography ( CT) characteristic performance of mucoepidermoid carcinoma of the lung. Methods CT findings 15 cases proved by pathology of mucoepidermoid carcinoma of the lung were retrospectively analyzed,and CT characteristic performance were studied by reviewing the literatures. Results The mucoepidermoid carcino-ma were located in right bronchial of 8 cases,left bronchial of 6 cases,peripheral part of the lung of 1 case. Calcification was seen in 7 mas-ses. Most masses density was not homogeneous at plain scanning. Venous phase have significantly enhanced compared with arterial phase. Ten cases showed obstructive pneumonia and atelectasis,3 cases with mediastinal lymph node metastases. Conclusion Multiple mucoepidermoid carcinoma of the lung grows extension of the long axis of bronchial,calcification be seen in most of patients. The enhanced mode of the lesions appeared as continuous progressive enhancement,some were illustrated with post obstructive pneumonia or atelectasis,CT have a certain value of diagnosis and diffenertial diagnosis.

Objective To observe the effects of compound lidocaine cream on patients with tracheotomy during recovery from general anesthesia.Methods Fifty-four patients scheduled for radical oral cancer resection and tracheotomy under general anesthesia were randomly allocated into two groups:control group (group C,27 patients) and compound lidocaine cream group (group L,27 patients).Compound lidocaine cream was uniformly smeared on the airway segment of tracheotomy tube in group L,and no drug was coated on tracheotomy tube in group C.Hemodynamic parameters before induction (To),at the end of surgery(T1),at the moment of awake(T2) and 1 min after awake(T3),respiration recovery time,awake time,time spent in the postanesthetic care unit (PACU),coughing,and agitation after surgery were monitored.Results There were no difference in the operation time,sevoflurane inhale time,respiration recovery time and awake time between two groups (P ＞ 0.05).The time spent in the PACU in group L was less than that in group C [(27.3 ± 6.9)min vs.(34.9 ± 6.6) min] (P ＜ 0.05).The HR and MAP of T3 in group C were significantly higher than those ofT0 [(113.5 ± 18.0) bpm vs.(82.2 ± 13.1) bpm,(112.7 ± 15.7) mmHg (1 mmHg =0.133 kPa) vs.(87.5 ± 12.7) mmHg] (P ＜ 0.01).The HR and MAP of T3 in group L were lower than those in group C [(92.6 ± 12.8) bpm vs.(113.5 ± 18.0) bpm,(98.3 ± 13.5) mmHg vs.(112.7 ± 15.7) mmHg] (P ＜ 0.01 or P ＜ 0.05).Degree of coughing in group L was lower than that in group C (Z =-2.409,P ＜ 0.05).Degree of agitation in group L was lower than that in group C (Z =-2.013,P ＜ 0.05).Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream can effectively alleviate hemodynamics fluctuations,coughing and agitation after tracheotomy during recovery for general anesthesia.

Objective To evaluate the effects of ischemic postconditioning on nuclear factor kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) expression during lung ischemia-reperfusion (I/R) injury in a dog model of cardiopulmonary bypass (CPB), and further investigate the pulmonary protection induced by ischemic postconditioning and the underlying mechanism.Methods Twelve adult mongrel dogs of both sexes, weighing 12-15 kg, were randomly divided into either CPB group or ischemic postconditioning group (IPO group) using a random number table, with 6 dogs in each group.CPB was established after the chest was opened in dogs anesthetized with pentobarbital sodium.Ischemic postconditioning was induced by 2 cycles of 5 min reperfusion followed by 5 min ischemia immediately after occlusion of the left pulmonary artery was released in group IPO.Before CPB (T1), before occlusion of the artery was released (T2) , and at 2 h after termination of CPB, lung specimens were obtained for examination of pathological changes which were scored (with light microscope) and for determination of the expression of NFκB and ICAM-1 (using Western blot) and wet/dry lung weight ratio (W/D ratio) in left lung tissues.Blood samples were collected from femoral arteries at T1 and T3 for blood gas analysis, and oxygenation index (OI), respiration index (RI) and dynamic lung compliance (Cdyn) were calculated.Results OI and Cdyn were significantly decreased, and RI was increased at T3 , and W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were increased at T2,3 than at T1 in the two groups.W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were significantly higher at T3 than at T2 in the two groups.Compared with group CPB, OI and Cdyn were significantly increased, and R1, W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were decreased at T3 in group IPO.Conclusion Ischemic postconditioning up-regulates the expression of ICAM-1 through inhibiting NF-κB activity, thus reducing lung I/R injury induced by CPB and improving the lung function in dogs.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

AIM: To find out characteristic UV spectum of Isatis Root Granules for identification. METHODS:Spectral correlation coefficient was calculated and compared between Isatis Root Granules and Radix Isatidis. Correl function from the Ms-Excel were applied for spectral calculation of three commodities. RESULTS: Spectral correlation coefficient was good between Isatis Root Ganules and Radix Isatidis. CONCLUSION: Fingerprint of Isatis Root can identificate whether granules contained isatis or not and its content.

[Summary] Serum cystatin C levels were measured by microparticle enhanced turbidimetry in 114 type 2diabetic patients without retinopathy (group A) and 105 type 2 diabetic patients with retinopathy (group B),as well as 47 normal healthy individuals as controls (group NC).The results showed that the serum cystatin C level of group B was much higher than those of group NC and group A (P＜0.05).However,there was no difference in serum cystatin C level between group NC and group A.Multivariate logistic regression analysis revealed that serum levels of cystatin C and cholesterol,and systemic blood pressure were independent risk factors of diabetic retinopathy in type 2 diabetic patients (all P＜0.05),suggesting that detection of serum cystatin C level may play an important role in early diagnosis and prevention of diabetic retinopathy.