Objective To find ways to reduce vascular crisis of the patients undergoing replantation of severed fingers by pain, adverse analgesics and sleep quality with auricular seeds pressing. Methods 310 digital replantation patients were divided into 2 groups according to admission time. There were 155 cases in the traditional group treated with routine postoperative care ,while 155 cases in the controlled group treated with routine postoperative care plus auricular seeds pressing. Results The scores of pain, adverse analgesics and sleep quality in two groups were statistically significant ( P<0.05). The rate of vascular crisis of the traditional group [18.06%(28/155)] was much more higher than the controlled group [5.16%(8/155)], the difference was significant, χ2=12.571, P < 0.01. Conclusion In digital replantation, auricular seeds pressing was effective to pain relieving, constipation and reduce adverse reactions, and could significantly improve sleeping time and survival rate of the severed fingers.

OBJECTIVE:To study the use and developmental tendency of psychotolytics in hospitals of Guangdong province.METHODS:The psychotolytics used in hospitals of Guangdong province during the period of2000～2004were an-alyzed statistically in respect to consumption sum,DDDs and average daily expense.RESULTS&CONCLUSIONS:Both consumption sum and DDDs of psychotolytics in the past5years increased to a large extent.Benzodiazepine topped the list of anti-anxiety drugs.The consumption of2nd generation antipsychotics increased year by year.On the whole,the consumption of antidepressants increased annually,of which,fluoxetine,flupentixol/melitracen and paroxetine were the most frequently used drugs.However,the consumption of tricyclic antidepressants has a significant reduction.

ObjectiveTo investigate the significance of synchronic heart rate variation(HRV) and blood pressure variation(BPV) in the evaluation of coronary artery disease(CAD).MethodsOne hundred and three patients who received coronary artery angiography were divided by the lesion degree into occlusion group (28 cases with more than 1 complete-occlusion coronary artery),non-occlusion group (45 cases with more than 1 coronary artery stenosis ≥50％ but without complete-occlusion) and control group (30 cases without stenosis ≥50％).Occlusion group and non-occlusion group were divided by lesion location into left anterior descending (LAD) lesion (32 cases),left circumflex ( LCF ) lesion (23 cases ) and right coronary artery(RCA) lesion (18 cases).And these two groups were also divided by lesion branch number into 1 lesion branch (23 cases),2 lesion branches (19 cases) and 3 lesion branches(31 cases).The time domain indexes of HRV were detected and calculated by 24 h dynamic blood pressutre and ECG,including standard deviation of normal number of R-R intervals (SDNN),standard deviation of per 5 min average normal R-R intervals(SDANNind),24 h average of standard deviation of per 5 min normal R-R intervals(SDNNind),root mean square of standard deviation of adjacent normal R-R intervals (rMSSD),and percentage of the difference of adjacent normal R-R intervals ＞ 50 ms (PNN50).And indexes of BPV were detected,including daytime systolic pressure standard deviation (dSSD),daytime diastolic pressure standard deviation (dDSD) and nighttime systolic blood pressure standard deviation (nSSD).The correlations between synchronic HRV and BPV and different coronary artery lesions were analyzed.ResultsSDNN,SDANNind significantly decreased and dSSD obviously increased with the aggravation of coronary stenosis,and there was statistical significance[ ( 115 ± 35 ) ms vs.(98 ± 25 ) ms vs.( 78 ± 28 ) ms,( 100 ± 30) ms vs.( 86 ± 23 ) ms vs.( 70 ± 29 )ms,(14 ± 3) mm Hg (1 mm Hg=0.133 kPa) vs.(20±4) mm Hg vs.(28±2) mm Hg](P＜0.05).rMSSD and PNN50 decreased,dDSD and nSSD increased with the aggravation of coronary artery stenosis,but there was no statistical significance (P＞0.05).SDNN and SDANNind in patients with LAD lesion and LCX lesion were significantly lower than those in control group,and dSSD was obviously higher than that in control group (P ＜ 0.01 or ＜ 0.05 ).SDANNind,rMSSD,PNN50,dDSD and nSSD in patients with LAD lesion and LCX lesion had no significant difference compared with those in control group (P ＞ 0.05 ).SDNN,SDANNind,SDNNind,rMSSD,PNN50,dSSD,dDSD and nSSD in patients with RCA lesion had no statistical significance compared with those in control group ( P ＞ 0.05 ).All the indexes of HRV tended to descend and indexes of BPV trended to raise with the increasing number of coronary artery lesion branches.But only the changes of SDNN,SDANNind,SDNNind,rMSSD,PNN50 and dSSD had statistical significance (P ＜ 0.05).Conclusions The more significantly HRV decreases and dSSD increases in patients with coronary artery disease,the more serious the coronary artery stenosis is and the wider the lesions are.The lesions are commonly located in LAD.It has certain guiding value for the evaluation of coronary artery diseases.

Peroxisome proliferator activated receptor-γ (PPARγ) is a member of the nuclear receptor superfamily of ligand-activated transcription factors that plays a critical role in regulating glucose and lipid homeostasis,and in the processes of tumor cell proliferation,differentiation,apoptosis,invasion and distant metastasis.Studies demonstrate that PPARγexpression is detected in human lung cancer tissues and numerous lung cancer cell lines.Activation of PPARγthrough its ligands impedes significantly a variety of tumor progression,including lung cancer.However,systemic activation of PPARγhas been reported to be protumorigenic in some in vitro systems and in vivo models.

Objective To determine the effect of Nuclear factor-erythroid 2-related factor 2 ( Nrf2 ) on acute hephrotoxicity induced by CCl4 in male rat.Methods 20 male Wistar rats were randomly divided into control group and CCl4 group, 10 rats in each group, another 10 male Wistar rats were transgenic rats microinjection through the carrier, obtained the Nrf2-tk gene integration and specific transgenic rats, as the CCl4 +Nrf2 integration group.The groups was given 1%polysorbate 80 for 4 days,Then the CCl4 and CCl4 +Nrf2 integration group were intraperitoneally injected with a single dose of CCl47.5 mg· kg-1 and were killed 24 h after CCl4 injection.The serum chemical parameters including asparate aminotransferase ( AST) ,alanine aminotransferase ( ALT) and lactate dehydrogenase ( LDH) were measured.Also malonaldehyde ( MDA) ,glutathione ( GSH) ,oxidized glutathione ( GSSG) levels in the liver as well as glutathione ( GSH)/oxidized glutathione ( GSSG ) ratios were detected. Histopathologic changes in the liver were examined. Results F1generation TK transgenic rats in liver and testis and other tissues and organs were not detected the transcription of Nrf2-tk, indicating that Nrf2-tk expression in tissues is specific good.Nrf2 significantly reduced serum AST, ALT and LDH levels in a dose-dependent manner.The results of MDA levels and GSH/GSSG ratios in liver and kidney showed that Nrf2 reduced CCl4-induced hepatic lipid peroxidation,and ameliorated glutathione depletion.The histopathologic results showed that Nrf2 restrained liver and kidney damage induced by CCl4 .Conclusion Nrf2 can effectively protect male rat from acute hepatotoxicity and nephrotoxicity induced by CCl4 .

Objective To investigate neurological recovery effect and mechanisms of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemorrhage.Methods 68 patients with hypertensive cerebral hemorrhage in our hospital were divided into two groups.34 patients of the control group were given conventional western medicine,and 34 patients of the observation group were taken conventional western medicine combined with blood activating and phlegm removing decoction.The clinical outcomes, hematoma volume change and neurological recovery were compared,and analyzed its mechanism of action.Results The effective rate of the observation group(94.12%) was significantly higher than 73.53%of the control group (χ2 =5.31,P<0.05). After 7d,14d,21d treatment,NIHSS scores of the observation group [(12.87 ±1.43) points,(8.55 ±1.11) points and (5.67 ±0.76) points] were significantly lower than those of the control group [(20.43 ±2.57) points, (17.66 ±2.08)points,(14.54 ±1.44)points],and the differences were statistically significant (t=14.99,22.53, 31.76,all P<0.05).After treatment,hematoma volume of the observation group[(6.44 ±0.54)mL]was significant-ly lower than before treatment[(16.30 ±1.90)mL]and after treatment in the control group [(12.11 ±1.44)mL] (t=29.11,21.50,all P<0.05).After treatment,ALD score of the observation group [(66.34 ±5.22)points] was significantly lower than before treatment[(27.53 ±2.20)points]and after treatment in the control group[(47.55 ± 3.33)points],and the differences were statistically significant(t=39.95,17.70,all P<0.05).Conclusion The effect of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemor-rhage is significant,can significantly improve neurologic impairment and daily living skills,has no obvious conflict of interest and high application value,worthy of promotion and application.

Currently we are still unclear in the aspect of etiology and mechanisms,and lack of medical advice based on evidence-based medicine on postural tachycardia syndrome,inappropriate sinus tachycardia and vasovagal syncope.It also prompts clinical research direction of the three special arrhythmia in future.Based on this,it is very necessary to interpret the management consensus of these three types of arrhythmia.

Objective To investigate the similarities and differences of 3 methods for detecting hepatitis B virus S 1(PreS1) ,and select the appropriate method for detecting clinical samples .Methods The PreS1 of the serum samples from chronic hepatitis B pa-tients were tested with enzyme immunoassay analyzer ,time-resolved method and the manual method .To compare the repetition rate ,select PreS1 antigen strongly positive serum and weak positive serum were detected 15 times by three methods ;To compare the explicit rate ,the reaction temperature was raised or lowered by 3 ℃ .Results The positive rate of three methods was 93 .53% , 92 .81% ,92 .81% .Automated ELISA reproducibility CV strong positive CV3 .62% ,weakly positive CV was 13 .42% ,CV of time-resolved method for the 2 kinds of samples were 5 .10% ,7 .92% ,manual methods CV 11 .10% 29 .88% ;changing the reaction incu-bation temperature 3 ℃ ,automatic detection ELISA all specimens S/CO value decreased ,increasing the chance of a false negative . The manual methods and time-resolved detection method for all specimens S/CO values increased ,increasing the chance of a false positive .Conclusion The detection rate and repeatability of automated ELISA were better .The time-resolved method followed and the manual methods were poor .

Objective To investigate the common causes of hypokalemia of inpatients in department of endocrinology.Methods Fifty-nine inpatients with hypokalemia were analyzed retrospectively.Results 84.7％(50/59) of patients with hypokalemia was clearly caused by endocrine diseases,among which 33.9％ (20/59) was diabetes mellitus,25.4％ (15/59) was hyperthyreosis,others were rare endocrine diseases,for example primary hyperaldosteronism and Cushing syndrome,et al.Conclusions Endocrine disease is an important reason of hypokalemia.The doctor should attach importance to the diagnosis and treatment of hypokalemia caused by endocrine disease.

Objective To investigate the effects of Huanglong decoction on mRNA and protein expression levels of intestinal epithelial tight junction protein Claudin-1 and Occludin in rat with sepsis. Methods Fifty-five Wistar rats were randomly divided into sham operation group (n=10), model group (n=15), western medicine treatment group (15 rats) and combined traditional Chinese and western medicine group (n=15). In sepsis model group, cecal ligation with puncture (CLP) was reproduced. In the sham operation group, the steps of operation performed were similar to those in the model group, but without CLP. Normal saline 2 mL was given to sham operation group and model group by gavage;meropenem 50 mg was given to the western medicine treatment group by intra-peritoneal injection; in the combined traditional Chinese and western medicine treatment group, besides meropenem 50 mg was injected intra-peritoneally, 2 mL Huanglong decoction (containing raw herbal medicine 0.68 g/mL) was administered by gavage [ingredients of the decoction: rhubarb 15 g (put into water the latest), Glauber salt 10 g, fructus aurantii immaturus 15 g, mangnoliae officinalis 10 g, ginseng 10 g, Angelica sinensis 20 g, Scutellaria baicalensis 15 g, Radix Glycyrrhizae 10 g, concentrated to a decoction 150 mL], in the four groups, the respective drugs or normal saline were given twice a day. After 4 days, the rats were sacrificed, and a partial ileal tissue close to the ileocecal region about 10 cm in length was taken; and mRNA expression levels of Claudin-1 and Occludin were detected by reverse transcription-polymerase chain reaction (RT-PCR), and protein expression levels of Claudin-1 and Occludin were detected by Western Blot. Results Compared with the sham operation group, the expression levels of Claudin-1 and Occludin mRNA [integrated absorbance (IA) ratio] and protein (gray value ratio) were significantly lowered in model group, western medicine group and combined therapy group (Claudin-1 mRNA: 0.327±0.029, 0.387±0.035, 0.420±0.053 vs. 0.561±0.035, Occludin mRNA: 0.364±0.058, 0.422±0.033, 0.442±0.048 vs. 0.616±0.036, Claudin-1 protein: 0.307±0.015, 0.337±0.017, 0.355±0.027 vs. 0.426±0.017, Occludin protein: 0.326±0.028, 0.355±0.017, 0.366±0.025 vs. 0.455±0.018, P<0.05 or P<0.01). Compared with the model group, the expression levels of Claudin-1 and Occludin mRNA and protein in western medicine group and combined therapy group were significantly higher (P < 0.05 or P < 0.01); the up-regulation was more marked in combined therapy group (all P < 0.05). Conclusion The protective effect of Huanglong decoction on intestinal mucosal barrier in rats with sepsis is possibly related to the up-regulation of expression levels of Claudin-1 and Occludin mRNA and protein.