Objective To investigate the effects of dexmedetomidine preconditioning on nitric oxide (NO)/endothelin (ET)-1 imbalance and remote lung injury induced by lower limb ischemia-reperfusion (LIR). Methods Sixty patients who scheduled for unilateral lower extremity surgery matched American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ, were randomized into two groups:control group (R group, n=30) and dexmedetomidine preconditioning group (PD group, n=30). Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups. In group PD, dexmedetomidine intravenous infusion was started at a dose of 0.125 mL/kg (4 mg/L) for 10 minutes before using tourniquet, whereas group R received an equivalent volume of normal saline. Artery blood gas analysis, respiratory index and oxygenation index were measured, and NO, ET-1, interleukin-8 (IL-8) and malondialdehyde (MDA) concentrations were determined from plasma samples 10 minutes before tourniquet inflation (T0), 15 minutes (T1), 2 h (T2), 6 h (T3) and 24 h (T4) after tourniquet deflation. Results Compared with T0, RI was higher at T3 in group R and OI was lower at T2-4 (P＜0.01). There were no significant differences in RI and OI of group PD between different time points (P＞0.05). In R and PD groups, ET-1, IL-8 and MDA concentrations were increased, while NO level and NO/ET-1 ratio were significantly decreased after tourniquet deflation (P＜0.05). Compared with group R, RI was lower and OI was higher at T3 in group PD (P＜0.01). The levels of ET-1, IL-8, MDA, NO and NO/ET-1 ratio were significantly different after tourniquet deflation between group PD and group R (P＜0.05). In group R, there was positive correlation between ET-1 and IL-8 levels with RI, and negative correlation between ET-1 and IL-8 levels with OI (P＜0.01). There was positive correlation between NO level, NO/ET-1 ratio and RI level (P＜0.01). Conclusion Lung function impairment induced by tourniquet application could be attenuated by dexmedetomidine preconditioning based on protecting endothelial cells and inhibiting lipid peroxidation.

All previous literatures about Chinese herbal medicines show distinctive traditional Chinese medicine (TCM) flavors. Compendium of Materia Medica is an influential book in TCM history. The TCM flavor theory and flavor standardization principle in this book has important significance for modern TCM flavor standardization. Compendium of Materia Medica pays attention to the flavor theory, explain the relations between the flavor of medicine and its therapeutic effects by means of Neo-Confucianism of the Song and Ming Dynasties. However,the book has not reflected and further developed the systemic theory, which originated in the Jin and Yuan dynasty. In Compendium of Materia Medica , flavor are standardized just by tasting medicines, instead of deducing flavors. Therefore, medicine tasting should be adopted as the major method to standardize the flavor of medicine.
Materia Medica ; standards ; Medicine, Chinese Traditional ; Reference Standards ; Taste

BACKGROUND: Cigarette smoking has been recognized as one of the high risk factors in carcinogenesis of lung cancer. Early diagnosis of lung cancer may be of clinical therapy value.OBJECTIVE: To explore the mutation of K-ras oncogene in bronchoalveolar lavage fluid(BALF) in order to reveal its relationship with cigarette smoking in lung cancer patients.DESIGN: Randomized controlled trial based on the patients.SETTING: Department of Toxicology, College of Radiology and Public Health of a university, and Department of Respiratory Medicine of a university hospital.PARTICIPANTS: The out-patients and inpatients in the Second Affiliated Hospital of Soochow University between June 1999 and September 2001 were included. The patients were confirmed to have lung cancer or innocuous diseases by fiber bronchoscopy through bronchoalveolar lavage(BAL) and cytological or pathological examination.METHODS: BALF samples were obtained from 37 smoking patients with lung cancer and 25 nonsmoking patients with lung cancer, and 20 with benign pulmonary diseases in the Second Affiliated Hospital of Soochow University. They were detected for K-ras codon 12 mutations using polymerase chain reaction with restriction fragment length polymorphism(PCR-RFLP).MAIN OUTCOME MEASURES: Codon 12 mutations of K-ras gene.RESULTS: K-ras mutation in patients with lung cancer was found to have an average frequency of 36% (22/62)but no K-ras gene mutation was detected in patients with benign pulmonary diseases. The mutation frequency in heavy smokers(69% ) was higher than that in moderate smokers(31%), mild smokers (25%) and nonsmokers (20%). The mutation was related to age and history of smoking, but not to sex and TNM classification.CONCLUSION: Cigarette smoking may be correlated with the mutation of K-ras gene. Early detection of K-ras mutation in BALF may be of clinical value, which helps the identification and diagnosis of smoking-related lung cancer.

Objective To investigate the correlation of spiral CT(SCT)features with pathology, microvessel density(MVD)、expression of vascular endothelial growth factor(VEGF)、matrix metalloproteinase-2(MMP-2)in colorectal carcinoma.Methods Forty patients with colorectal carcinoma confirmed by operation were examined by SCT.The resected tumor specimens were immunohistochemically stained for the expression of VEGF,MMP-2 and the calculation of MVD.Results The accuracy of SCT in depicting the pericolic and wall infiltration was 92.5%.The metastasis rates of colorectal cancer with pericolic infiltration and wall infiltration were 75.0% and 33.3%,respectively,the differences were statistically significant between the two groups(P

Public Health ; methods ; Systems Analysis

Background Diabetic cataract is one of the major ocular complications in diabetes mellitus,including cortical cataract,nuclear cataract,subcapsular cataract and mixed cataract,and different cataractogenesis may be associated with lens epithelial cells (LECs).Subcapsular cataract is one of diabetic cataracts.Studying the biological behavior of LECs in subcapsular cataract is crucial for prevention and treatment.Objective This study was to investigate the effects of Src-family tyrosine kinases (SFKs) on apoptosis and epithelial-mesenchymal transition (EMT) of human LECs cultured by high glucose.Methods Human LECs (HLE-B3) were cultured for 24 hours with DMEM containing 5.5 mmol/L glucose (normal control group),DMEM containing 35.5 mmol/L glucose (high glucose group) and DMEM containing 35.5 mmol/L glucose + 10 μmol/L PP1,a specific inhibitor of SFKs (PP1 group).In 3,6,12 and 24 hours after culture,the apoptosis of human LECs was detected by flow cytometry assay;morphological change of human LECs was observed under the inverted microscope,and the expressions of the markers of EMT,E-cadherin and a-smooth muscle actin (α-SMA),in the cells were detected by immnofluorescence staining.In addition,the alternations of p-Src418 (active c-Src),bcl-xl,survivin,caspase-3,E-cadherin and α-SMA proteins were assayed by Western blot analysis.Results An elevated expression level of p-Src418 was found in LECs in the high glucose group and peaked 6 hours after cultured.The expressions of p-Src418(grey levels) were 0.125 ±0.036 in the high glucose group,and which was significantly higher than 0.042±0.011 in the normal control group and 0.035 ± 0.018 in the PP1 group,respectively (both at P＜0.01).No remarkable differences were seen in the apoptotic rates between the high glucose group and normal control group in 6,12 and 24 hours after culture (all at P＞0.05).The apoptotic rates of human LECs were(6.433±2.084)％,(10.333±2.610)％ and (8.033±2.967)％ in the PP1 group,which were higher than (3.233 ± 1.320) ％,(3.533 ± 1.159) ％,(5.733 ±0.230) ％ in the high glucose group and (3.133±1.170)％,(2.833±0.751)％,(3.333±1.201)％ in the normal control group (all at P＜0.05),however,there were significant differences in the apoptosis between the high glucose group and the normal control group (all at P＞0.05).In 6 hours and 12 hours after cell culture,the expression levels of bcl-xl and survivin (grey values) in human LECs were significantly declined,but the expression of caspase-3 was increased in the PP1 group compared with the the high glucose group and the normal control group (all at P＜0.05).The LECs showed slender in shape 24 hours after culture in the high glucose group,but the cell shape was close to the normal in the PP1 group.Western blot and immunofluorescence assay revealed that the expression of E-cadherin in human LECs was significantly reduced and that of α-SMA was significantly increased 6 hours after culture in the high glucose group compared with the PP1 group and the normal control group (all at P＜0.05).Conclusions High glucose activates c-Src kinase of LECs in high glucose environment and therefore induces EMT and inhibits apoptosis.However,PP1 impedes the biological process of EMT and apoptosis of LECs to maintain the epithelial characteristics even under the stress of high glucose.

Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

Objective To determine the optimum dose of dexmedetomidine for lumbar plexus combined with sciatic nerve block when mixed with ropivacaine.Methods Eighty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-63 yr,weighing 47-83 kg,scheduled for elective ankle joint surgery,were randomly divided into 4 groups (n =20 each) using a random number table:ropivacaine group (group R) and different doses of dexmedetomidine mixed with ropivacaine groups (RD1-3 groups).Lumbar plexus block was performed by using psoas-compartment approach guided by a nerve stimulator.0.5％ ropivacaine 20 ml was injected in group R.0.5％ ropivacaine 20 ml containing dexmedetomidine 1.0,1.5 and 2.0 μg/kg was injected in RD1 3 groups,respectively.Labat's sciatic nerve block was performed,and 10 ml of the corresponding drug was injected in each group.The onset time and duration of sensory and motor blockade,and side effects such as cardiovascular events and excessive sedation were recorded.Results There was no significant difference in the onset time and duration of sensory and motor blockade between the four groups.The duration of sensory and motor blockade was significantly longer in RD1-3 groups than in group R,in RD2 and RD3 groups than in group RD1,and in RD3 group than in RD2 group.The incidence of over-sedation and bradycardia was significantly higher in RD3 group than in RD1.2 groups.Conclusion The optimum dose of dexmedetomidine is 1.5 μg/kg for lumbar plexus combined with sciatic nerve block when mixed with ropivacaine.

Objective To study clinical signiifcance of single tidal breathing testing in bronchiolitis. Methods Infants with bronchiolitis at ifrst wheezing (bronchiolitis group, n=756), and 115 infants with bronchopneumonia (bronchopneumonia group) hospitalized were enrolled. Tidal breathing parameters were analyzed in two groups. Bronchiolitis group was divided according to percentiles of the fraction of exhaled time at peak tidal expiratory lfow to total expiratory time (TPTEF/TE). The episodes of recurrent wheezing of infants below the 20th or above the 80th percentile of TPTEF/TE were followed up by phone calls within 1 year after discharge from the hospital. Results There were signiifcant differences in TPTEF/TE, VPEF/VE, Ti, Ti/Te, TEF75 and TEF50 between bronchiolitis group and bronchopneumonia group. The recurrent wheezing rate of infants with bronchiolitis below the 20th percentile of TPTEF/TE was signiifcantly higher than that above the 80th percentile of TPTEF/TE (37.5%vs 11.3%). Conclusions There is the greater possibility of recurrent wheezing in the infants with the more serious airway obstruction relfected by single tidal breathing testing in bronchiolitis.

As the integration of human parasitology and medical microbiology curriculum, pathogen biology, although constructed and developed about 20-years, didn't realize the true integration of the two disciplines. Beyond that, it was also faced with numerous difficulties such severe compression of human par-asitology class, lack of teaching materials to achieve the true meaning of integration, difficulty to cultivate teachers and so on. The organ-system based learning (OBL) curriculum model may provide new strategies for the dilemma, to be resolved through the following channels: Rearranging the curriculum and teaching materials based on the classification of pathogenic organism parasitic or invasive organs; Corresponding training in microbiology and parasitology teaching by teachers continuous realization, while highlighting the professional teaching level of highly qualified teachers in both courses.