OBJECTIVE:To compare the clinical efficacy and safety of norepinephrine(NE)and dopamine(DE)in the treat-ment of septic shock (SS). METHODS:66 SS patients was retrospectively analyzed and randomly divided into NE group and DE group. DE group was treated with DE with the initial dose of 1 μg/kg per minute by continuous infusion in central venous 48 h, and then increased 1 μg every 2 min to maintain the arterial pressure(MAP)70-80 mm Hg per minute;NE group was treated with NE the initial dose of 0.05 μg/kg per minute by continuous infusion in central venous 48 h,and then increased 0.05 μg/ time every 2 min to maintain the MAP 70-80 mm Hg per minute. At the same time,all patients were given antibiotics,oxygen inhalation,nu-tritional support and other treatment and were given ECG monitoring. The clinic data was observed,including the hemodynamic in-dexes [heart rate(HR),cardiac output index(COI),MAP and systemic vascular resistance index(SVRI)],the tissue oxygenation indexes [lactate clearance rate (LCR) and central venous oxygen saturation (SvO2)] before and 4,8,24 and 48 h after treatment, the morality rate and incidence of adverse reactions. RESULTS:After treatment,HR and COI in NE group were significantly lower than before and DE group in different time points,SVRI was significantly higher than before and DE group,the differences were statistically significant(P<0.05). But there was no significant difference in the MAP between 2 groups in different time points(P>0.05). LCR and SVO2(except for after 4 h treatment)in 2 groups was significantly higher than before in different time points,and NE group was higher than DE group;the difference was statistically significant(P<0.05). There was no significant difference in the morality rate between 2 groups(P>0.05). Incidence of adverse reactions in NE group was significantly lower than DE group, the differences were statistically significant(P<0.05). CONCLUSIONS:Compared with DE,NE can effectively improve the hemo-dynamic indexes and tissue oxygenation indexes in the treatment of SS,with good safety.

Objective To explore the drainage effect of drainage tube with different materials on the basis of a constant nega tive pressure drainage,and its impact on flap survival.Methods The most common clinical used Polyvinyl chloride resin (PVC)pipe,latex tubes,silicone tube drainage tubes,and flaps were compared at different phases of the drainage,to determine the best clinical flap with drainage material.After three groups of flaps were designed,including a constant negative pressure drainage device,without a constant negative pressure drainage system,and drainage alone (no negative pressure) drainage flap,the flap survival was observed at different phase space.Three different drainage drainage ways of the flap and the flap survival area of effect were statistically analyzed.Results The silicone tube drainage was more fully and effectively.Constant negative pressure drainage volume of liquid was up to the flap with drainage to the fullest,the highest rate of skin flap healing,and better healing.Conclusions The constant negative pressure in the drainage of the flap makes drainage more fully,and promotes rapid healing of wounds,while the silicone tube is suitable for flap drainage.

Objective To assess the accuracy and safety of inserting K-wires by a spinal minimally invoive robot system into cattle spines. Methods With a program shown on the screen of a C-arm fluoroscopy system,194 nails were placed ino 17 cattle spines by a spinal minimal invasive robot system which had been developed jointly by Shenyang Institute of Autmation Chinese Academy of Sciences and our institute.Radiation frequency,radiation exposure time,operation time and deviation of drills were recorded and analyzed. Results The mean deviation in the lateral projections by the spinal minimally invasivc robot system was smaller than in the anteroposterior projections.In lateral projection,the deviations within 1 mm,2 mm and 3 mm accounted respectively for 91.6％,99.5％ and 100％.In anteroposterior projection.the deviations within 1 mm,2 mm and 3 mm accounted respecrvely for 71.1％,89.6％ and 94.8％.The mean drilling time,the mean radiation frequency and the mean radiation time per hole by the robot system were respectively 420 seconds (from 330 to 577 seconds),13 times (from 8 to 21 times) and 9 seconds (from 8 to19 seconds).There was a learning curve in mastering the system.Training for a period of time made the accuracy within 2 mm in both lateral and anteropsterior films 95.6％ of the deviations in lateral films and 92.1％ of the deviations in anteroposterior films were less than one mm. Conclusions Operators of the spinal minimally invasive robot system can avoid intraoperative X-ray radiation.The flexibility and accuracy of the system can completely satisfy the clinical needs of spinal surgeons,but there must be a learning curve.

Objective To comfirm the therapeutic effects of copper needle punctured into cavernous hemangioma to explore a more effective and safer method. Methods After local anesthesia, the copper needles were inserted into the cavernous hemangioma with different depth. The needles must be parallel to major nerves and blood vessels. The distance between the two puctured points was 1 to 2cm. The needles were removed after 7 to 9 days. And the copper needles embolism employing exogenous electric current at 3 or 4 5V for 20 to 30 mins, and inserting the needles with the help of high-frequency color doppler ultrasonography, were also performed in this study. Results Forty-eight patients were treated by this method. The follow-up of 1 to 4 years showed that the general effective rate was 100%. Conclusions It is effective, simple and safe method with less complication that copper needle puncturing for the treatment of cavernous hemangioma. Copper needle with electric current is suitable for treating cavernous hemangioma of the face, neck and joints. It is a safer and more effective method that copper needles puncturing for the therapy of cavernous hemangioma under the guidance of the high-frequncy color doppler ultrasonography.

Objective To study the ability of silica nanoparticles as gene carriers for adult human epidermal keratinocytes gene transfection.Methods The silica nanoparticles-DNA conjugated with the enhanced green fluorescence protein plasmid DNA(pEGFP-N_1) was transfected into adult human epidermal keratinocytes.The expression of green fluorescence protein was investigated in transfected keratinocytes by eletromicroscope examine and the efficiency of gene transfection was revealed.Results The silica nanoparticles-DNA complexes can be effectively transfected into adult human epidermal keratinocytes and the efficiency of gene transfection was about 20%～30%.Conclusion The silica nanoparticles can be used as DNA carriers for gene transfection,and can efficiency transfect the pEGFP-N_1 into adult human epidermal keratinocytes.

Objective To further approach the effect of miR-33 to melanoma cells line B16F10 proliferation and apoptosis.Methods Constructing targeted miR-33 over-expression mimics and inhibitor,the same B16F10 cells were divided into five groups,control group,miR-33 mimics group,mimics control group,miR-33 inhibitor group,inhibitor control group,then gene transfer technology was used to transfer corresponding gene into B16F10 cells.The effect of miR-33 on B16F10 cell' s proliferation and apoptosis were analysed.Results The relative miR-33 gene expression of miR-33 mimics group (1773.3±245.83) was higher than that of control group,which had statistical significance (P ＜ 0.01).The gene expression of miR-33 inhibitor group (0.6973±0.1958) was lower than those of control group and inhibitor control group.The cell growth rate of miR-33 mimics group was lower than those of control group and the trend after transfection 48 h (1.1875±0.0502) and 72 h (1.7500±0.0933) was significant (P ＜ 0.05).The cell apoptotic ratio of miR-33 mimics group [(1.8050±0.2050) ％] was higher than that of control group [(1.13000±0.1414) ％] (P ＜ 0.05).Compared with control group the cell proportion ofG1 period in miR-33 mimics group [(62.7000±1.7321) ％]increased,the cell proportion of S period [(23.4000±2.5044) ％] decreased,both of them had statistical significance (both P ＜ 0.05).Conclusion miR-33 over-expression can restrain the proliferation of B16F10 cells line,promote B16F10 cells' apoptosis.

Objective To investigate the expression pattern of Nrf2 in the lung of septic rat and preliminary analysis of the role of Nrf2 in the development of sepsis. Methods Wistar rats were used in this study, it was divided into 4 groups, including normal control group, pure burn group, burn with staphylococcus sepsis group, burn with pseudomonas sepsis group. According to the different time intervals such as 2 hours, 8 hours, and 24 hours, it was divided into three sub-group after injection of bacteria. The expression of Nrf2 in the lung at different time intervals was determined. Results Nrf2 mRNA in the lungs of normal rats was high expression （74.0±7.0）, Nrf2 mRNA in the lungs of pure burns rats obviously down-regulated, respectively as 34.5±1.9,50.4±2.2,32.1±1.4, （t＝5.69～14.63,P＜0.01）. Nrf2 mRNA in burn sepsis caused by Staphylococcus aureus in lung tissue of rats down-regulated expression, respectively as 53.1±5.0,14.4±1.6,48.5±1.9,and reached peak at 8 h（t＝5.59～29.3,P＜0.01）. Pseudomonas aeruginosa burn sepsis didn't induced Nrf2 mRNA in the lung tissue, but it showed a downward trend at 2h（71.0±8.1,P＞0.05）and markedly reduced after 8, 24 h（24.8±2.1,4.1±2.0,t＝21.33,68.1,P＜0.01）.Conclusions The distribution of Nrf2 mainly localized in immune organ, and it directly took part in the post burn immune response.

Objective To investigate the mechanism of HSP70 that inhibits myocardial cell apoptosis in sepsis.Methods Myocardial cells in primary culture were randomly divided into control group,normal serum group,sepsis serum group,transported empty vector group and transported HSP70 group.The myocardial cells in transported HSP70 group have been transported by pcDNA3.1-HSP70 for 36 hours.The myocardial cells in every group have been cultured by respective serum for 2 hours and dyed by Hoechst 33258,and then calculate the rate of myocardial cells apoptosis.Using Western-blot to investigate the effect of overexpression of HSP70 on Caspase-3,8,9's activation and Bid's cracking.Results The rate of myocardial cells apoptosis after dealing in transported HSP70 group [ ( 12.48 ± 2.39 ) ％,( 23.96 ± 3.12 ) ％,( 25.40 ± 3.96) ％ ] is lower than in sepsis serum group [ ( 28.66 ± 2.24 ) ％,( 55.76 ± 5.69 ) ％,( 46.89±8.74)％,t =5.856,5.932,6.027,P ＜0.01,n =3] and lower than in transported empty vector group [(34.25±3.42)％,(50.71±6.38)％,(47.62+5.74)％,t =5.876,5.903,6.122,P ＜0.01,n =3],is higher than in control group,and in normal serum group(3.13％ ～ 6.75％ ,t =6.324,6.578,6.137,5.987,6.032,6.871,P ＜ 0.01,n =3 ).When Caspase-3,8,9 activating,the gray-scale of P11,P20 and P10 in transported HSP70 group( 12.5276 ± 2.1247,9.3481 ± 4.5423,16.1349 ± 6.0641 ) is lighter than that in sepsis serum group ( 27.1324 ± 2.1564,25.5643 ± 4.3018,36.5647 ± 6.7135,t =5.856,5.902,5.891,P ＜ 0.01,n =3 ) and lighter than in transported empty vector group (28.0314 ±2.0367,25.6413 ±4.1356,34.5648 ±5.9473,t =3.861,3.933,4.281,P ＜0.05,n =3),is deeper than in control group(8.0324 ± 1.5234,5.1246 ± 1.3274,2.0314 ±0.6423,t =3.286,3.867,4.031,P＜0.05,n =3) and in normal serum group(8.5649 ± 1.2136,6.0324 ± 1.0214,3.2146 ±0.1325,t =5.898,5.969,6.879,P ＜0.01,n =3).The gray-scale of tBid in transported HSP70 group( 12.0316 ±2.3641 ) is lighter than in sepsis serum group(27.0536 ± 5.3214),t =3.274 ( P ＜ 0.05,n =3 ) and lighter than in transported empty vector group(27.1034 ± 3.6741,t =3.301,P ＜ 0.05,n =3 ),is deeper than in control group ( 6.0347 ± 2.1304,t =5.924,P ＜ 0.01,n =3 ) and in normal serum group ( 7.3121± 1.3021,t =5.871,P ＜ 0.01,n =3 ).Conclusions HSP70 inhibit myocardial cells apoptosis in sepsis by intervened the death receptor pathway and mitochondrial pathway.

Objective To investigate the antibacterial properties and curative effects of a nanosilver-epidermal growth factor (NanoAg-EGF) sustained-release carrier.Methods First,in accordance with former method,sustained-release carrier of NanoAgEGF was prepared,with the design of the NanoAg-EGF group,NanoAg-alone group,EGF-alone group,control groups of normal saline-alone,and benzylpenicillin sodium.Contrasting detection on antibacterial properties of five kinds of common microbes (staphylococcus aureus,escherichia coli,pseudomonas aeruginosa,candida albicans,and streptococcus pneumonia) in each group was used to confirm their antibacterial properties.Then,wound models of diabetic rats were randomly divided into five groups,with the wound treatments by sustained-release cartier of NanoAg-EGF,combined application of NanoAg + EGF,EGF-alone,NanoAg-alone,and normal saline-alone control group,respectively.The observation on the healing situation of each group in different times was used to ensure the curative effect.Results In the antibacterial experiments,it was found that the NanoAg-EGF and NanoAg had strong antibacterial properties.Their antibacterial properties had no significant difference (P ＞ 0.05).The control group,penicillin sodium only had relatively weak antibacterial properties on staphylococcus aureus and streptococcus pneumoniae,with obviously weaker function compared to the NanoAg-EGF and NanoAg groups (P ＜ 0.05).The control groups,EGF-alone and normal saline-alone had no inhibitor function on each kind of pathogenic microorganisms.In the wound healing experiments on diabetic rats,it was found that NanoAgEGF shortened significantly the wound healing time of diabetic rats (P ＜ 0.05).On the 3rd day,the healing rate of each group had no difference (P ＞ 0.05).On the 7th day and 13th day,the healing rates of NanoAg-EGF [(61.71 ± 8.78)％ and (100 ± 2.60) ％] were significantly higher than the other four groups (P ＜ 0.05).Conclusions NanoAg-EGF not only has good antibacterial properties but also can promote rapidly the wound healing of diabetes.

Objective To validate genetic suppression of metastastic capability of highly metastastic melanoma cells by endostatin transfection.Method pcDNA3.1-Endo eukaryotic expression vector contained insulin signal peptide sequence was transfected into highly metastatic mice melanoma cell strain B 16.The expression of endostain was detected by RT-PCR and Western blot experiment,melanoma cells were determined with adhere experiment,in vitro invasion and migration experiment and pulmonary metastasis experiment on C57BL/6 mice.Result Endostatin can obviously inhibit the capability of adherence,in vitro invasion and migration and pulmonary metastasis of melanoma cells.Among them,adhere inhibition ratio was 67.3%,in vitro invasion inhibition ratio was 48.4%,cell migration inhibition ratiowas 52.1%and pulmonary metastasis inhibition ratio was 67.3%.Conclusion Endostatin transfection can obviously inhibit the highly metastatie capability of melanoma cells.