Most pelvic fractures were commonly seen in polytrauma caused by violent forces,and often complicated with hemorrhagic shock,with mortality being 25%～39%.Anti-shock and control of bleeding are th e philosophy of treatment of this critical condition.Since 1985,hundred s of pelvic fracture victims have bee n sal-vaged in my hospital by VIP procedure which means ventilation(V),infusion(I),and pulsation(P).First,V was to establish an airway,then I was to manage hypovolumic shock,and fin ally,P was to improve the impaired heart function to maintain normal hemodynamics and tissue perfusion.It was necessary for antishock therapy to infuse rapidly and sufficiently in o rder to gain diluted blood.Pneumatic antishock garment,angiography an d em-bolism,and retroperitoneal tampon aded bleeding could control most hem orrhage associated with pelvic fractures.[

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

OBJECTIVE:To observe the efficacy and safety of eprosartan in the treatment of hypertensive patients with coro-nary heart disease. METHODS:160 hypertensive patients with coronary heart disease randomly divided into observation group and control group. All patients were given aspirin,nitroglycerin,low molecular weight heparin,statins and other conventional treat-ment;control group was additioanlly given 50 mg Losartan potassium tablet,orally,once a day. Observation group was additional-ly given 600 mg Eprosartan tablet,orally,once a day. The treatment course for both groups was 6 months. Clinical efficacy,sit-ting systolic blood pressure and diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase(AST),urea (UREA),creatinine(Cr),uric acid(UA),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C),the Mini-Mental status (MMSE) scale and activities of daily living (ADL) scale scores before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:There was no signifi-cant difference in the total effective rate between 2 groups(P>0.05). After treatment,the sitting systolic blood pressure and diastol-ic blood pressure,MMSE and ADL scale scores in 2 groups were significantly lower than before,and sitting systolic blood pres-sure in observation group was lower than control group,the differences were statistically significant(P<0.05),and there were no significant differences in sitting diastolic blood pressure,MMSE and ADL scale scores between 2 groups(P>0.05),and no signifi-cant differences in ALT,AST,UREA,Cr,UA,TC,TG,HDL-C and LDL-C between 2 groups before and after treatment(P>0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Eprosartan can effectively reduce sitting systol-ic blood pressure in hypertensive patients with coronary heart disease,and improve cognitive function,with good safety.

OBJECTIVE:To study the effects and mechanism of propranolol on the myocardial abnormal electrophysiology sta-tion in diabetic model rats. METHODS:SD rats were randomly divided into normal control(normal saline)group,diabetic(nor-mal saline)group,PD98059(ERK inhibitor,10 mg/kg)group and propranolol low-dose,medium-dose and high-dose(1,20,50 mg/kg)groups,with 8 rats in each group. Except for normal control group,rats were given alloxan(20 mg/kg)intravenously via tail vein to induce diabetic model. They were given relevant medicine intragastrically,once a day,for consecutive 42 days. The car-diac index,electrocardiogram and action potential durations (APD) of rats were analyzed;the expression of TNF-α,IL-2,IL-6 and IL-10 protein in serum were detected,and the expression of Ras,Raf,ERK kinase(MEK)and ERK1/2 in myocardial tissue were detected. RESULTS:Compared with normal control group,cardiac index increased in diabetes group;heart rate decreased;QT interval and APD were prolonged;the relative expression of TNF-α,IL-2,IL-6,IL-10,Ras,Raf,MEK and ERK1/2 protein increased (P<0.01). Compared with diabetes group,cardiac index decreased in propranolol medium-dose and high-dose groups and PD98059 group,heart rate increased,QT interval and APD were shortened;the relative expression of TNF-α,IL-2,IL-6, IL-10,Ras,Raf,MEK and ERK1/2 protein decreased(P<0.05 or P<0.01). CONCLUSIONS:Propranolol can improve myocar-dial abnormal electrophysiology station of diabetic model rats by down-regulating inflammatory reactions in serum and inhibiting the activation of MEK/ERK signaling pathway.

Objective To discuss and to compare the curative effects of interventional embolization with different embolic agents in treating giant hepatic cavernous hemangiomas. Methods From 2008 to 2010, a total of 30 cases with clinically proved hepatic cavernous hemangioma were treated with interventional embolization. According to the embolic agents used , the patients were divided into pingyangmycin-lipiodol emulsion mixed with sodium alginate microspheres group(PLE+KMG, group A, n=15) and pingyangmycin-lipiodol emulsion group (PLE, group B, n=15). CT scanning was performed one, 3, 6, 12 months after the treatment to evaluate the curative effect. Results The technical success rate was 100%in both groups. The mean PLE dose used in group A and B was (10.9 ± 5.2) ml and (11.4 ± 4.9) ml respectively, the difference between the two groups was not significant (P > 0.05). CT reexamination performed one, 3, 6 months after the treatment showed that a reduction in tumor volume over 50%in group A was seen in 9, 11 and 14 cases respectively, while in group B it was 0, 3 and 5 cases respectively (P <0.05). One week after the procedure, the degree of pain in patients of group A was more severe than that in patients of group B, the difference between the two groups was statistically significant (P < 0.05). Slight abnormal hepatic function was seen in some patients of both groups, which presented mainly as an elevation of aminotransferase, which returned to normal after symptomatic medication. Follow-up with questionnaire indicted that patients of group A were more satisfied with the treatment than the patients of group B. Conclusion Transhepatic infusion of pingyangmycin-lipiodol emulsion is a safe and effective treatment for giant cavernous hemangioma of the liver. Combination use of pingyangmycin-lipiodol emulsion and sodium alginate microspheres can obviously reduce the tumor size mainly in the first and the third month after the treatment, besides it produces instant clinical effect although the pain is more severe than in patients treated with pure pingyangmycin-lipiodol emulsion.

Objective To observe the efficacy and safety of Shuxuetong injection with edaravone in treatment of acute cerebral infarction.Methods 70 patients of acute cerebral infarction were ramdonly divided into two groups:treatment group was done with Shuxuetong injection and edaravone,and the control group was treated by xiangdan.Two groups were treated with routine therapy.ESS and ADL content change in two groups were assessed at different point before treatment and two weeks after treatment.Results The scores of ESS of two groups increased after treatment(P

OBJECTIVE To investigate the induc-ing factors of Bell’s palsy. METHODS From Febru-ary to May 2005, 262 outpatients of Bell’s palsy were surveyed for 9 inducing factors. RESULTS The mean age of onset was 39?17 years old. The ratio of male to female and of left to right were 48:52. Forty-eight patients denied all inducing factors, while 214 pa-tients (81.7 %) had at least one factor. Cold was found in 53.5 % of the patients, fatigue in 22.5 %, viral infec-tion in 18.7 %, recurrence in 11.8 %, psychological stress in 11.5 %, family history in 7.6 %, puerperal period in 1.5 %, and molar infection of the affected side in 1.5 %. CONCLUSION Bell’s palsy is likely to be a set of disease. Most of patients with Bell’s palsy had inducing factors. Avoid these factors may reduce the incidence of Bell’s palsy. Further investigate will fractionize Bell’s palsy to several diseases includ-ing true idiopathic peripheral facial paralysis and some definite diseases.

Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group (group A, n=10), epinephrine group (group B, n=6) and epinephrine plus adenosine group (group C, n=6). After a 3-min asphyxia without intervention, cardiopulmonary resuscitation (CPR) was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine (200 times/min). Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine (bolus of 90?g/kg) respectively, and in group C epinephrine (bolus of 90?g/kg) plus 70?g/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B (P

Objective To detect the osteopontin(OPN)expression in renal tissue of rats with fluorosis and low calcium diet,and study the role of OPN in renal injury of fluorosis.Methods Forty-eight aged 1 month Wistar rats,80-120 g,were randomly divided into 4 groups by 2×2 factorial design(the number of female and male in each group was equal):the control group,high-flluoride group,low-calcium group and low-calcium with high-fluoride group.All rats of the fluorosis groups were fed with feed containing corn exposed to coal-burning from endemic fluorosis areas with high fluoride(100 mg/kg,corn),the other two groups were fed with feed containing coru from nonendemic fluorosis areas(fluoride 5 mg/kg,corn).After 16 weeks,the rats were killed.The change of teeth was examined,and the incidence rate of dental fluorosis was calculated.The expressions of both protein and mRNA of OPN in rat renal tissue were determined by RT-PCR and immunohistochemistry after four-month experimentation.Results The growth of teeth was very well in the control group and the low-calcium group.The two high-fluoride groups showed evident dental fluorosis(100%).The results of immunohistochemistry showed that the OPN protein was localized in renal tubule cytoplasm.The OPN-positive cells from renal tissue were lightly and scatteredly stained in control and low-calcium groups.The OPN-positive cells had deeper color in high-fluoride group and low-calcium with high-fluoride group,widely distributed in the renal tubular epithelial cells.The protein expression of OPN in the two groups exposed to fluoride(168.64±13.21,169.26±8.92)was significantly higher than those of the corresponding control group(145.78±10.26,all P<0.01)and low-calcium group(149.60±16.84,all P<0.01).The mRNA expression of OPN in the two groups exposed to fluoride(1.89±0.37,1.94±0.22)was significantly higher than those of the corresponding control group(1.32±0.26,all P<0.05)and low-calcium group(1.30±0.186,P<0.05),respectively.High fluoride influenced the expression of protein and mRNA of OPN(F=13.821,4.24,all P<0.05).Low calcium did not affect the expression of protein and mRNA of OPN(F=2.164,0.58,all P>0.05).However,high fluoride and low calcium had a cross interaction on the expression of protein and mRNA of OPN(F=6.257,432,all P<0.05).Conclusions Over-dose fluoride enhances the expression of OPN.The higher expression observed in the cases exposed to high fluoride concentration is associated with serious renal injury.OPN may he a potential marker for renal injury in fluorosis.Moreover,over-dose fluoride and low calcium make the renal injury worse,indicating low calcium plays an important part in renal injury by fluoride.