Objective To explore the administration of Dexmedetomidine combined with remifentanil for sedation and analgesia of ICU patients with hypertensive cerebral hemorrhage after operation.Methods A total of 60 patients with hypertensive cerebral hemorrhage treated with hematoma removal under craniotomy were selected from May 2013 to June 2015.The patients were randomly (random number) divided into the Dexmedetomidine combined with remifentanil group (D + R, n =30), and Midazolam combined with remifentanil group (M + R, n =30).The blood pressure, respiration rate, oxygen saturation, heart rate, ICP (intracranial pressure), Ramsay sedation scores, and IL-1, and TNF-α levels were recorded after sedation and analgesia in ICU, and 6 h, 24 h, 48 h after operation (T0-T3).Results Compared with M +R group, the MAP, RR, HR, ICP, IL-1β, TNF-α, rate of reoperation for check bleeding, and mortality were significantly decreased in D + R group (P ＜ 0.05), and Ramsay sedation score was significantly increased at the same time (P ＜ 0.05) without excessive sedation and analgesia noticed.Conclusions Dexmedetomidine combined with remifentanil exhibits significant benefit in many respects including control of great fluctuations of blood pressure and intracranial pressure after craniotomy, reduce the production and release of inflammatory mediators, reduce the occurrence of rebleeding after operation.It shows good controllability and safety, it is an optimal method producing sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage after operation.

To explore the velocity difference between specifications and categories of liquid with the same pressure infusion bag in order to widen the specification range of the liquid for pressure infusion. Pressure infu-sion experiments were performed with three specifications of normal saline of 100, 250 and 500 ml to compare the veloci-ties of different specifications of liquid, and with 500 ml normal saline, (5%, 10% and 50%) glucose injection, 5% glu-cose and sodium chloride injection, 5% sodium bicarbonate injection, 10% fructose injection, 706 plasma substitute, 20%mannitol injection and etc to make clear the velocities of different categories of liquid. With the same pressure, there were no significant differences between the velocities of three specifications of liquid, and between those of cate-gories of liquid with the same specification and concentration; the difference was significant between the same category of liquid with different concentrations, and the velocity showed a negative correlation with the concentration. The pressure infusion bag is compatible with 100, 250 and 500 ml liquid, and the velocity may be constant in case some specification of liquid is replaced by another one. The velocity has to be regulated in case the concentration or category of the liquid changes, when the pressure infusion is performed.

Objective To evaluate the effects of static magnetic fields (SMFs) of different intensity and exposure duration on the proliferation and apoptosis of human umbilical cord endothelial cells (HUVECs),and their release of nitric oxide (NO),6-keto-prostacyclin 1α (6-keto-PGF1α) and endothelin (ET-1).Methods Cultured HUVECs were exposed to a SMF at 5,22,86 or 135 mT for 8,12 or 24 hours.Their proliferation and apoptosis were monitored by flow cytometry (FCM).The medium was collected to test its NO content by optical density.ET-1 and 6-keto-PGF1α were measured by radioimmunization.Results ( 1 ) The proliferation of HUVECs increased when the cells were exposed to a SMF at 5 mT for 8 h,but a SMF at 135 mT for 12 h or 24 h inhibited the proliferation of HUVECs.(2)An SMF had no effect on apoptosis of HUVECs.(3)An SMF at 5 mT for 8 h increased the release of NO and 6-keto-PGF1 a,but the release of NO and 6-keto-PGF1 a decreased when the SMF intensity was 135 mT or the cells were exposed to an SMF for 12 h or 24 h.(4) An SMF at 5 mT or 22 mT for 8 h did not effect the release of ET-1.An SMF at 86 mT or 135 mT increased the release of ET-1.Compared with a control group,an SMF at 5 mT for 12 or 24 h did not affect the release of ET1,but at 22,80 or 135 mT,the release of ET-1 decreased significantly.Conclusions Exposure to a low intensity SMF for a short duration could improve the proliferation of HUVECs and increase the release of vasoactive factors,but if HUVECs are exposed to a strong SMF or exposed for a long duration,the proliferation and the release of vasoactive factors is decreased.

AIM: To investigate the protective effects of ulinastatin on the rats with paraquat-induced acute lung injury and its mechanisms .METHODS:The Wistar rats ( n=108 ) were randomly divided into control group , pa-raquat group and ulinastatin group .The rats in paraquat group and ulinastatin group were given paraquat by gavage , while the rats in control group were given sterile saline by gavage .The rats in ulinastatin group were also given ulinastatin treat-ment.The serum levels of MDA, SOD, IL-6, IL-10 and TNF-αwere measured after 1 d, 3 d, 7 d, 14 d, 21 d and 28 d. The expression levels of p 38 MAPK, MMP-2 and TIMP-1 in the lung were also measured .RESULTS:The levels of SOD in 1 d, 3 d and 7 d in paraquat group and ulinastatin group were significantly lower than those in control group ( P<0.01).The level of SOD in ulinastatin group was significantly higher than that in paraquat group (P<0.05).The levels of MDA, IL-6, IL-10 and TNF-αin 1 d, 3 d and 7 d in paraquat group and ulinastatin group increased compared with con-trol group (P<0.01), and those in ulinastatin group were significantly lower than those in paraquat group (P<0.05). The levels of p38 MAPK and TIMP-1 in 1 d, 3 d, 7 d, 14 d, 21 d and 28 d in paraquat group and ulinastatin group were higher than those in control group (P<0.01), and those in ulinastatin group was significantly lower than those in paraquat group ( P<0.05) .The level of MMP-2 in 1 d, 3 d, 7 d, 14 d and 21 d in paraquat group and ulinastatin group increased compared with control group (P<0.01), and that in ulinastatin group was significantly lower than that in paraquat group (P<0.05).CONCLUSION:Ulinastatin protects the lung tissues of rats from paraquat-induced acute lung injury by in-hibiting p38 MAPK signaling pathway and ameliorating inflammatory and oxidative responses .

Objective To observe blood gas analysis of internal carotid artery and internal jugular vein to calculate the cerebral extraction of oxygen, and to investigate the relationship between oxyhemoglobin in internal jugular vein, cerebral extraction of oxygen, and the prognosis of patients with head injury. Method Seventy patients with acute severe head injury in ICU of Taizhou People Hospital were studied, and another 80 patients with mild head injury were enrolled as controls. Twenty-four hours after first aid such as keeping airway open and circulatory and ventilation support, and emergency craniotomy, the blood samples from internal carotid artery and internal jugular vein were collected for blood gas analysis including SaO2, PaO2, SjvO2, PJVO2 > PaCO2, PJVCO2, SaO2-SjvO2, Pa-jvCCO2, CaO2-CjvO2 and Ca-jvO2/CaCO2 (CEO2, cerebral oxygen extraction). Results There were significant differences in SjvO2, PjvO2, Sa-jvO2, Pa-jvO2 Ca-jvO2 and CEO2 between two groups. Conclusions The SjvO2 and CEO2 represent the cerebral oxygen uptake and oxygen consumption precisely, and they can be used to predict the outcome of patients with severe craniocerebral trauma commendabiy.

Objective To study the protective effect of lipoic acid (LA) on H9c2 cardiomyocytes hypoxia/reoxygenation injury model, and explore its relevant mechanism. Methods Eight strains of H9c2 cardiomyocytes, passaged after cultured to a full view, were divided into 3 groups:normoxia group, hypoxia/reoxygenation group and LA group. The cell survival rate, lactate dehydrogenase (LDH) activity, malondialdehyde (MDA) and heme oxygenase-1 (HO-1) levels were detected and compared. Results The cell survival rates of H9c2 cardiomyocytes in hypoxia/reoxygenation group and LA group were significantly lower than those in normoxia group:(52.86 ± 6.39)％, (69.25 ± 7.63)％vs. (92.31 ± 7.82)％, while the cell survival rate of H9c2 cardiomyocytes in LA group was significantly higher than that in hypoxia/reoxygenation group, and there were statistical differences (P<0.01). The LDH activity and MDA in hypoxia/reoxygenation group and LA group were significantly higher than those in normoxia group:(286.37 ± 27.49), (209.72 ± 25.63) U/L vs. (126.32 ± 18.94) U/L, and (1.72 ± 0.06), (1.13 ± 0.07)μmol/L vs. (0.68 ± 0.06) μmol/L, while those data in LA group were significantly lower than those in hypoxia/reoxygenation group, and there were statistical differences (P<0.01). The HO-1 in hypoxia/reoxygenation group and LA group were significantly higher than that in normoxia group:(213.71 ± 18.94)％, (367.26 ± 23.07)％vs. (87.92 ± 19.23)％, and HO-1 in LA group was significantly higher than that in hypoxia/reoxygenation group, and there were statistical differences (P<0.01). Conclusions The LA plays a protective role on myocardial cell with hypoxia/reoxygenation injurythough increasing the level of HO-1 against oxidative stress.

Objective To investigate whether an innovative intake duct driven from nasobiliary tube via nose improved the success rate of oronasal conversion and shorten the operation time.Methods 118 patients with routine nose bile duct drainage under ERCP examination were randomly divided into magnetic group and thread group. Patients in magnetic group were using a self-made nasal biliary drainage tube derived via nasal catheter traction and nasal catheter, one end of the magnet will be equipped with high performance through mouth to mouth pharynx, smooth delivery nose bile duct. While patients in thread group adopts godet from pharynx posterior wall drawing pulled stomach tube or catheter again, then ifx the nose bile duct.Results The success rate was signiifcantly higher in magnetic group than thread group, with less stimulation of pharynx, and less complications.Conclusion Self-made intake duct derived magnetic catheter was simple and less stimulation, avoid oral mucosa damage, reduced the suffering of patients, shortened operation time and improved the operation efifciency with high success rate.

Objective To investigate the influence of gestational vitamin A(VA) deficiency on lipid synthesis in offspring liver tissue by using the rat model of gestational vitamin A deficiency.Methods The rat model of gestational VA deficiency was established and divided into the normal AV,VA deficiency and VA deficiency and supplement (VAD) groups.The offspring blood lipid levels were detected.The mRNA expression changes of lipid synthesis molecule ACC1,FAS and SREBP1 in liver were detected;the lipid droplet deposition situation after HE staining in offspring liver tissue section was observed.Results The HDL-C level of the VAD group was significantly lower than that of the VA normal group(VAN group and VAS group,P＜0.05),and the difference between the VAN group and VAS group had no statistical difference(P＞0.05).The TG level had statistically significant difference among the three groups(P＜0.05).The ACC1,FAS and SREBP1 mRNA expression levels in the VAD group were significantly increased.The liver in the VAD group appeared more lipid droplet deposit with partial lipid droplet vacuoles in cytoplasm;while the liver cells in the VAS and VAN groups showed the regular arrangement without obvious lipid droplet deposit.Conclusion Gestational VA deficiency may induce the abnormal activation of liver lipid synthesis pathway in rat offspring and causes lipid metabolic disturbance.

Objective To establish an HPLC method for simultaneous separation and determination of chlorogenic acid, quercetin and kaempferol inPyrrosia lingua (Thumb.) Farwell. Methods The separation was performed on Phenomenex C18 column (250 mm×4.6 mm, 5μm) with the mobile phase of methanol-acetic acid (pH=3.0) solution and gradient elution. Flow rate was 1.0 mL/min;the UV detection wavelength was 254 nm;column temperature was 35℃.Results The calibration curves for chlorogenic acid, quercetin, and kaempferol were in good linearity in the range of 0.000 24-3.00μg (r=0.999 9), 0.000 16-2.00μg (r=0.999 9), and 0.000 16-2.00μg (r=0.999 9), respectively. The limits of detection (S/N=3) were 3.29, 0.43 and 0.33 ng/mL, respectively. The average recovery rates were 97.73%, 98.07% and 96.92%, respectively. ConclusionThe method is simple, precise and sensitive. It provides scientific proof for separation and determination of chlorogenic acid, quercetin and kaempferol inPyrrosia lingua (Thumb.) Farwell.

[Summary] Four patients with hyperthyroid-associated exophthalmos, myxedema, acropachy ( EMA ) syndrome, including three male patients and one female patient were diagnosed with Graves′diseases and treated by 131 I therapy. Complaints of thyrotoxicosis were presented at the onset. Tibia myxedema and acropathy appeared, and eye symptoms aggravated in two patients after anti-thyroid drug therapy and 131 I therapy. Four cases were all given clobetasol propionate, miconazole nitrate, neomycin sulfate and urea cream alone or in combination with compound betamethasone local injection treatment, and three cases were given low-dose oral prednisone treatment. Complaints of tibia myxedema and eye symptoms were significantly improved after the treatment. Therefore, we should be wary of the occurrence of hyperthyroid-associated EMA syndrome after 131 I therapy. Corticosteroid might be the effective therapy for myxedema and eye symptoms of EMA syndrome.