Objective To assess the efficacy and safety of sequential type artificial liver with regional citrate anticoagulation in patients with hepatic failure at high risk of bleeding.Methods Fifteen patients with hepatic failure at high risk of bleeding treated with plasma exchange(PE)plus continuous veno -venous hemofiltration (CVVH)for 4h anticoagulation selected anticoagulant citrate dextrose solution A (ACD -A),blood flow velocity was setted to 100 -120mL/min.In the former,ACD -A solution was delivered pre -filter,with the rate adjusted to maintain a postfilter ionized calcium (iCa2 +)level between 0.35 -0.45mmol/L.Before the extracorporeal blood returned to the patients, 10% calcium gluconate was infused to maintain a systemic iCa2 + level between 0.90 -1.20mmol/L.Hypoxemia and hypocalcemia were correctted before treatment.Acid -base changes,serum sodium,total calcium -ionized calcium ratio were recorded at 2h,4h and 6h during the treatment.Effective therapeutic time (the therapy was completed successfully)also was recorded.Results The total 38 sessions were performed,effective performance was 35 sessions. 3 sessions were stopped because of high transmembrane pressure.Acid -base change,serum sodium had no significant changes.Serum iCa2 + concentration was detected 110 times,16 times were below 0.9mmol/L,the lowest concentration was 0.62mmol/L.Convulsion of the limbs appeared two times because of hypocalcemia.The total calcium -ionized calcium ratio above 2.5 appeared totally 6 times.The events improved after augmented substitution fluid.All events presented in advanced hepatic failure.Conclusion Under closely monitoring and application of preventive measures, regional citrate anticoagulation sequential type artificial liver is safe and efective for patients with hepatic failure at high risk of bleeding.The application in patients with advanced hepatic failure still is cautious.

Aluminum is a common metal element,and its nervous toxicity probably has an effect on the learning and memory mechanism. Long-term potentiation (LTP) is an available electrophysiology-model,cAMP/protein kinase A (PKA) approach is an important signal transduction pathway of nerve cells,and plays an important role in the process of learning and memory mechanism. Aluminum has some adverse effects on learning and memory through influencing some links,such as neurotransmitter,Ca2 + concentration,protein kinase and so on. According to the recent studies in this field,in electrophysiology and biochemistry,the present paper reviewed the effects of aluminum on the learning and memory mechanism,as well as the role of cAMP/PKA approach.

The effects of Panax notoginseng saponins (PNS) and verapamil(Ver)on hemo-dynamics of internal carotid artery and superior mesenteric artery were determined and compared in anesthetized Sprague ~ Dawley strain rats. PNS 30-150 mg ? kg-1 iv was shown to reduce the mean blood pressure, internal carotid arterial resistance and superior mesenteric arterial resistance by 11 % ~19%, 14%~27%,23%~ 39%respectively. Meanwhile, the mesenteric ar-terial blood flow increased.by 16%~51%. Ver showed similar reflects as PNS. The results indicated that the vasodilation effects of PNS and Ver are vascular selective, that is PNS and Ver are more potent in dilating the mesenteric artery than the internal carotid artery.

0.05), the same results were seen in the interferential experiment groups and the positive group. There were no alternating effects between nano red elemental selenium and CCl4. Conclusion In the present paper, nano red elemental selenium does not show an adverse effect on the liver of rats and a protective effect on liver injury induced by CCl4.

By means of DEAE-sephadex A - 50 column chromatography, the venom of Agkistrodon acutus was separated into fifteen fractions. The fraction Ⅱ was rechro-matographed, on sephadex G - 50 column and a single peak was obtained. The polyacrylamide disc gel electrophoresis also showed a single band. The fraction Ⅱ had strong fibrinolytic activity on dog plasma fibrin plate and showed direct fibrinolytic effect on heated fibrin plate. In addition to fibrinolytic activity, the fraction Ⅱ had fibrinogenolytic activity, In vitro and at aconcentration less than 17. 8 mg?L-1,the potency of fibrinolysis was higher than that of fib-rinogenolysis. Local hemorrhage activity which is characteristic for crude venom of Agkistrodon a-cutus was not found when the fraction 1 was injected hyperdermically in rabbit. The ip LD50 value of the purified fraction Ⅱ was determined to be 11. 1 mg ? kg-1 in mice and there was no gross hemorrhage found in the dead animals.

Endothelium-derived hyperpolarizing factor (EDHF) is the third factor released by en-dothelial cell other than NO and PGI2. It relaxes smooth muscle accompanied by a hyperpolarization in the membrane potential. EDHF may be epoxye-icosatrienoic acids (EETs) formed from arachidon-ic acid by the action of cytochrome P450. It is synthesized and/or released by endothelial cell as a result of an cytosolic Ca2+ increase, which is stimulated by the action of acetylcholine or bradykinin on endothelial cell. EDHF is shown to activate Ca2+-activated K+ channels and induce a hyperpolarization in the membrane potential in vascular smooth muscle. The hyperpolarization of the membrane inhibits the opening of voltage-dependentcalcium channels, allows calcium sequestration and removal mechanisms to lower intracellular calcium, and leads smooth muscle to relaxation. In large conducing arteries, EDHF may provide a secondary system to NO, which assumes primary importance in endothelium-dependent relaxation and inhibits the release of EDHF. However, in small resistance arteries, EDHF appears to be a major determinant of vascular calibre, and may be of primary importance in the regulation of vascular resistance.

Objective To investigate the effects of different modes of mechanical ventilation on lung function during open heart surgery in children with pulmonary hypertension (PH). Methods Twenty-four patients with moderate PH aged 3 mon-12 yr 2mon (group M) and twenty-four patients with severe PH aged 3 mon-7yr 9mon (group S) were further divided randomly into 3 subgroups based on the modes of mechanical ventilation used: pressure-controlled ventilation(PCV) only and alveolar pressure (Palveo) was maintained at 0 cm H2O during CPB (group M1/S1 n = 8); PCV + PEEP (2 cm H2O) and Palveo was maintained at 2 cm H2O during CPB (group M2/S2 n = 8); and PCV+ PEEP (4 cm H2O) and Palveo was maintained at 4 cm H2O during CPB (group M3/S3 n=8). The patients were premedicated with atropine 0.01 mg ?kg -1 and midazolam 0. 1 mg?kg-1 . Anesthesia was induced with fentanyl 20?g?kg-1 and vecuronium 0. 1 mg?kg-1 and maintained with vecuronium infusion(70?g?kg-1?h-1 ) and inhalation of N2O-O2 and isoflurane. The children were mechanically ventilated after intubation and the ventilatory parameters were VT = 10-12 ml ?kg-1, F = 20 bpm and I : E = 1: 2. Lungs were lavaged and 2-3 ml of aspirate were taken for determination of surfactant. Total protein (TP), total phospholipid -(TPL), saturated phosphatidylcholine (Sat PC) and respiratory system compliance(Crs) was measured before skin incision( T0 ), before CPB (T,), at the end of CPB ( T2) and at the end of surgery(T3 ) . Results (1) Crs decreased significantly at T2 and T3 as compared with that at T0 and T1 in group M1/S1 and M2/S2 but in group M3/S3 there was no significant difference in Crs between T0, T1 and T2-3. (2) Sat PC/TPL and Sat PC/TP decreased significantly after CPB (T2, T3 ) in group M,/S, and M2/S2 but in group M3/S3 there was no significant difference in Sat PC/TP and Sat PC/TPL between T0-1 and T2-3. Conclusion PEEP 4 cm H2O can effectively prevent postoperative lung function from worsening in children with pulmonary hypertension undergoing open heart surgery with CPB.

Objective To investigate different surgical treatments for femoral intertrochateric fractures. To evaluate the results of treatment of intertrochateric fractures with PFNA. Methods 37 patients with femoral intertrochateric fracture were retrospectively reviewed,of which 12 patients were treated operatively with PFNA,25 patients were treated operatively with DHS. Therapeutic efficacy were compared and analyzed. Results All the patients were followed up for 5-18 months(an average of 11 months). All fractures healed in a mean of 3 months. According to Harris'standard of hip-joint fuction,the outcome was classified into excellent,good and poor. In 25 patients with DHS,the good clinical results was 21 cases. In 12 patients with PFNA, excellent and good clinical result was 11 cases. Conclusion PFNAintemal fixation was an effective method for treating the femoral intertrochateric fractures and better than that by DHS.

Objective To explore the more secure and available methods in replacing traeheostomy tube.Methods Sixty patients with incision of trachea were divided into group A(29 eases)and group B (31 cases)randomly.The new method was used in group A with putting a catheter into the old tracheostomy tube before taking it out,and placing the new tracheostomy tube under the guide of catheter.While the traditional method was used in group B.The heart rate,SpO2,manipulation time,perioperative haemorrhage, and the condition of entering the false passage were recorded.Results The heart rate,SpO2 were no significant difference before and after manipulation in group A,but the heart rate increased and SpO2 decreased in group B(P<0.01 or<0.05).The manipulation time was(50.5±4.2) s in group A,and (84.9±5.3) s in group B(P<0.05).The perioperative haemorrhage >3 ml and the condition of entering the false passage in group A(2 Cases,o cage)were less than those in group B(15 cases.5 cases)(P<0.01 or<0.05).Conclusion The new method in replacing tracheostomy tube which use an input catheter is more security and more availability.

Objective To explore the effect of protein kinase C inhibitor on the level of phosphralated extracellular regulated protein kinases in the spinal trigeminal nucleus of migraine model rats.Methods Healthy adult male SD rats were randomly divided into four groups:normal group (group C),sham operation group (group C),migraine model group(group M),and H-7group(H-7group),with 18 rats in each group.Dural blood flow and the extracellular discharge frequency in the spinal trigeminal nucleus was recorded.ERK1/2 phosphorylation was tested.Results (1) Dural blood flow:compared with group C((3.8± 1.0)％),the dural blood flow in M group ((78.0±4.2) ％)increased obviously(P＜0.01) ; compared with M group((78.0±4.2)％),the dural blood flow in H-7 group((-24.8±4.9) ％) decreased obviously(P＜0.01).(2) The percentage of extracellular discharge frequency change:two hours after treatment,the percentage of extracellula discharge frequency change in group M ((325.9 ±47.3)％)was higher than that in group C((107.3±16.4)％).The percentage of discharge frequency change in group H-7((136.0±26.5)％) was lower than that in group M((325.9±47.3)％).There was no significant difference in the percentage of discharge frequency change between group H-7((136.0±26.5) ％) and group C((107.3 ± 16.4)％).(2) ERK1/2 phosphorylation:the ERK1/2 phosphorylation in group M was higher than that in group C.The ERK1/2 phosphorylation in group H-7 was lower than than that in group C and group M.Conclusion ERK1/2 is a downstream PKC signal path and PKC may have indirect activation of ERK1/2.