Objective To investigate the fluid resuscitation strategies to craniocerebral injury patients combined with multiple trauma.Methods This retrospective review was made on 124 patients with combined craniocerebal injury (GCS 3-12 points) plus multiple trauma.Based on the fluid resuscitation strategies,63 patients were treated with aggressive fluid resuscitation (AFR),and 61 with limited fluid resuscitation (LFR).A restrictive rehydration principle was performed with intensive hemodynamic monitoring:mean arterial pressure was kept between 70-80 mmHg for 48 hours and central venous pressure between 6-8 cmH2O for 48 hours in LFR group; mean arterial pressure was kept in basic level and central venous pressure between 8-12 cmH2O in AFR group.No significant differences were shown in the rest of treatments.Parameters were compared between groups such as blood pressure,shock index,coagulation function,imaging data,GCS,and GOS at 6 months postinjury.Results Between-group differences were insignificant with regard to mean arterial pressure (MAP),shock indices,ISS,trauma severity indices (TSI),and GCS (P ＞0.05).Blood pressure fluctuation in LFR group was (18.5 ±9.9) mmHg vs (29.4 ± 11.1) mmHg in AFR group (P ＜ 0.01).Eight patients developed intracranial hemorrhage progression in LFR group,with 3 being treated with craniotomy.In comparison,19 patients developed intracranial hemmorrhage progression in AFR group,with 10 being treated with craniotomy (P ＜ 0.01).Improvement in coagulation disorders was better in LFR group than in AFR group.On days 7 after admission,GCS in LFR groups was (9.1 ± 3.6) points vs (7.2 ± 2.3) points in AFR group (P ＜0.05).At 6-month follow-up,results were 34 good and 27 poor in LFR group,better than 23 good and 40 poor in AFR group.Conclusion For moderate to severe craniocerebral injury combined with multiple trauma,LFR is effective to treat coagulation disorders and hemorrhagic shock,reduce the probability of delayed intracranial hemorrhage,and further improve the outcome.

ObjectiveTo evaluate the effect of hydrogen-rich saline given during reperfusion on global cerebral ischeraia-reperfusion (I/R) injury in rats.Methods Seventy-two adult male SD rats,aged 2.0-2.5 months,weighing 260-300 g,were randomly divided into 3 groups (n ＝ 24 each):sham operation group (group S),group I/R and hydrogen-rich saline group (group H).In groups I/R and H cerebral I/R was induced by occlusion of 4 vessels( cauterization of bilateral carotid arteries and 15 min occlusion of bilateral common carotid arteries).In group H intraperitoneal 0.6 mmol/L hydrogen-rich saline 5 ml/kg was injected at 6 h of reperfusion,while equal volume of normal saline was injected instead of hydrogen-rich saline.Eighteen rats of each group were sacririced at 24 h of reperfusion,and then the hippocampi were removed for determination of malondialdehyde (MDA),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6)contents,and nuclear factor-κB (NF-κB) activity and activated caspase-3 expression.Another six rats of each group were sacrificed at 72 h of reperfusion,and then brain tissues were removed for microscopic examination and counting the number of uninjured pyramidal cells in hippocampal CA1 region.ResultsCompared with S group,the contents of MDA,TNF-α,IL-6 and NF-κB activity were significantly increased,activated caspase-3 expression was significantly up-regulated,uninjured pyramidal cells in hippocampal CA1 region were significantly decreased in I/R group( P < 0.05).Hydrogen-rich saline given during reperfusion attenuated the above-mentioned I/R-induced changes( P < 0.05 ).The histologic damage of the hippocampal CA1 region was significantly slighter in group H than group I/R.ConclusionHydrogen-rich saline given during reperfusion can reduce global cerebral I/R injury in rats through inhibition of lipid peroxidation,inflammatory response and apoptosis.

Eight phenolic compounds were isolated from Rhododendron phaeochrysum var. agglutinatum and their sructures were identified as phaeochrysin (1), (2R)-4-(3',4'-dihydroxyphenyl) -2-butanol (2), (-) -rhododendrol (3), rhododendrin (4), (+) -isolariciresinol (5), (-) -lyoniresinol (6), lyoniresinol-9'-O-β-D-xylopyranoside (7), and dihydrodehydrodiconiferyl-3a-O-α-L-rhamnopyranoside (8). Compound 1 is new, and compounds 2, 5-8 were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; Mass Spectrometry ; Molecular Structure ; Phenols ; chemistry ; Rhododendron ; chemistry

The drugs such as sildenafil adulterated in herbal products and dietary supplements may endanger human health. The number of the new modified derivatives is increasing recently. Based on Q-TOF-MS, a new sildenafil analogue was found. It was isolated and purified by preparative liquid chromatography. Its structure was determined by NMR, as 1-[4-propoxy-3-(6, 7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4, 3-d] pyrimidin-5-yl)phenylsulfonyl]-4-methylpiperazine. Compared with sildenafil, the ethoxy group of the benzene ring moiety was moved to the propoxy group, which had not been reported in China. The mass spectrometric behavior pattern of the structure type was summarized, which can greatly accelerate the structural analysis of novel analogues.
Chromatography, High Pressure Liquid ; Dietary Supplements ; analysis ; Drug Contamination ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Piperazines ; chemistry ; isolation & purification ; Sildenafil Citrate ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To compraison the of exposure in the endonasal transsphenoidal approach to the sellar between microscope and endoscope. Methods Ten formalin-fixed, silicone-injected adult cadveric heads were studied. A direct endonasal transsphenoidal approach was performed via the right nostril, pushing aside the nasal septum, then reach the sphenoidal sinus. The approach was performed with the operating microscope first, then with the endoscope. For each step (sellar, suprasellar, parasellar and clival), the operative region afforded by direct microscopic view was measured and then compared with that obtained by using the edndoscope. Results It was found that the endoscope provided greater view than microscope in this approach. Although the microscope provides an adequate view of the midline structures and part of the contralateral parasellar areas; under direct endoscopic vision, the lateral extension could be widened by an additional 6.5 mm on the ipsilateral and 4 mm on the contralateral side. At suprasellar region, the microscope provides could expose the posterior part of, optic nerve and optic chiasma; but could not expose the areas anterior and superior the interspace superior the optic chiasma. Compare with the microscope, the endoscope allowed extension of bone removal and dual opening for an additional 4 mm anteriorly at the sagittal axis and an additional 3.5 mm on the ipsilateral and 4 mm on the contralateral side. At the clivus region, the medial surface of the vertical segment of the ICA and the basilar artery could be partially 7 exposed by the microscope. By the endoscope, it could gain an additional 4 mm on the ipsilateral side and 2.5 mm on the contralateral side in width. Because of the anatomical boundaries of the sphenoid sinus, the anatomincal exposure by the microscope same as the endocope at the sagittal axis. Conclusion The endoscope allows for a panoramic view and permits widening of the operative exposure in all directions. The endoscope is more suitable in the the minimal and expanded endonasal transsphenoial approach.

Objective To study sleeping conditions and relevant factors for insomnia in the elderly people aged 60 years and over in the community of Shanghai,China.Methods A cross-sectional study on sleeping condition by questionnaire was conducted among 2789 elderly people aged 60 years and over during July to October 2005 in seven neighborhood committees of Jing'an District,Shanghai,China,with cluster sampling.Results Totally,2304 elderly people completed the study questionnaire with a response rate of 82.61%.Prevalence of insomnia was 14.84% (342/2304) in the elderly.Logistic regression analysis showed that age increasing (OR=1.02),female (OR=2.20),drinking before sleeping (OR=2.98), room light (OR=3.89),noise (OR=1.95),diabetes (OR=1.82),hypertension (OR=1.49),stroke (OR=1.65),osteoporosis (OR=1.76) and number of afflicted chronic diseases (OR=1.43) all were risk factors for insomnia in the elderly (P

Objective To explore the relationship between genetic variation in PAF-AH V279F and coronary heart disease among Han population in Beijing.Methods A case-control study was held which enrolled 124 patients with coronary heart disease and 103 normal subjects.The genotype of PAF-AH V279F was determined with allele-specific polymerase chain reaction(AS-PCR)method. Results The highest frequency of PAF-AH V279F genetic variation was VV genotype(92.2%),the next was VF genotype(5.8%)and the lowest was FF genotype(2.0%)among the studied Han population in Beijing.In the coronary heart disease group the frequency of 279 V→F carriers was significantly higher than in the control group(19.3% vs.7.8%,P＜0.05)and F allele frequency was also higher(12.1% vs.4.9%,P＜0.01).Among the coronary heart disease group,the V279F variation frequency and the F allele frequency were significantly higher in patients with myocardial infarction than in those without myocardial infarction(27.3% vs.13.0%,17.3% vs.8.0%,both P＜0.05).In multiple logistic regression analysis,the odds ratio(OR)of V279F genetic variation for coronary heart disease was 1.919(95% CI:1.448-2.544,P=0.033).Conclusions The PAF-AH V279F genetic variation may be a novel genetic marker for high risk of coronary heart disease.

Objective To evaluate the effect of hydrogen sulfide combined with mild hypothermia on cerebral ischemia-reperfusion (I/R) injury in rats. Methods Eighty male SD rats, aged 3 months, weighing 250-300 g, were randomly divided into 5 groups ( n = 16 each): sham operation group (group S), cerebral I/R group,mild hypothermia group (group M), sodium hydrosulfide group (group NaHS) and NaHS + mild hypothermia group (group NM). In group I/R, M, NaHS and NM, cerebral I/R was induced by occlusion of 4 vessels (cauterization of bilateral vertebral arteries and 15 min occlusion of bilateral common carotid arteries) followed by reperfusion. In group NaHS and NM, intraperitoneal NaHS 14 μmol/kg was injected immediately after reperfusion, while the equal volume of normal saline was injected in the other three groups. At the same time, the rectal temperature was reduced to 32-33 ℃ within 15 min, lasting for 6 h, in group M and NM, while it was maintained at 36-37 ℃by physical method in other groups. Twelve rats of each group were sacrificed after 6 h of reperfusion, and then the hippocampus was removed for determination of the content of H2 S by using spectrophotometer and the expression of p-CREB and BDNF mRNA by using Western blot and RT-PCR respectively. Four rats in each group were sacririced after 72 h of reperfusion and then the hippocampus was removed for microscopic examination. Results The cerebral I/R injury was attenuated in group M, NaHS and NM compared with group I/R, with the slightest injury in group NM. The H2S content was significantly higher in group I/R, M, NaHS and NM than in group S, and in group NaHS and NM than in group I/R and M. The expression of p-CREB and BNDF mRNA was significantly higher in group I/R, M, NaHS and NM than in group S, and in group M, NaHS and NM than in group I/R. The BDNF mRNA expression was significantly higher in group NM than in group M and NaHS. There was no significant difference in the H2S content and the expression of p-CREB and BNDF mRNA between group NaHS and M.Conclusion Hydrogen sulfide combined with mild hypothermia can attenuate cerebral I/R injury by up-regulating the expression of p-CREB and BDNF mRNA in hippocampus in rats.

Objective To compare different Nrf2 expressions in glioblastoma cell lines and glioma stem cells (GSCs) from xenografts and to study the concentration of Nrf2 in nuclear. Methods GSCs were analyzed by immunofluorescence and different expressions of Nrf2 in glioblastoma cell lines and GSCs from xenografts were detected with real-time RCR and Western. Results GSCs were successfully isolated from xenografts of U251 and U87 cell lines. The percentage of tumor stem cells in total cells was 1.24%, and that was 1.63% in xenografts. Immunofluorescence indicated that Nrf2 was overexpressed in GSCs as compared with that in glioblastoma cell lines. Conclusion Nrf2 may be a potential biomarker and rational therapeutic target for GSCs.

Background and purpose:Suppression of apoptotic signaling pathways is an important factor in tumor cell resistance. Research on cell apoptosis will open up a new way of reversing drug resistance and tumor treatment. This study examined the effects of a novel naphthalimide derivative 8c on multidrug resistant colon cancer HCT116/L-OHP cells and explored the molecular mechanisms underlying the apoptosis induction. Methods: The anti-proliferative effects of 8c were detected by CCK-8 assays and the effects on apoptosis induction were examined by lfow cytometry. The mRNA expression levels of p53, Bax and Bcl-2 were measured by real-time PCR;The protein expressions of p-p53, Bax, Bcl-2 and Cyt-c were detected by Western blot. Results:8c (IC50=8.16 μmol/L) seemed to be more potent than amonaifde (IC50=28.37 μmol/L) against HCT116/L-OHP cells. 8c induced apoptosis on HCT116/L-OHP cell lines through intrinsic or mitochondria dependent pathway. The protein expression of phosphorylation of p53 at Ser-15 was increased, but the mRNA level of p53 did not increase in HCT116/L-OHP cells. Bax protein and mRNA levels were signiifcantly increased, and Bcl-2 protein and mRNA levels were decreased, suggesting an increase of Bax/Bcl-2 ratios. Meanwhile, 8c induced a substantial release of cytochrome c from the mitochondria into the cytosol in HCT116/L-OHP cells. Conclusion: 8c induced cell death signal by inducing the activation p53 phosphorylation which subsequently activated related protein expressions of apoptotic pathway, which may be an important mechanism of 8c on inhibiting proliferation of HCT116/L-OHP resistant cells. All the results suggested that 8c was a potent compound to be developed as an anti-tumor and anti-resistance agent for clinic application in the future.