The neurogenic pulmonary edema (NPE) was produced consistently in rabbits by raising intracranial pressure (ICP) with an infusion of anticoagulat rabbit blood into subarachnoid space of the bilateral parietal regions. When ICP increased from 60mmHg to 140 mmHg, There was a rapid decrease in blood flow volume of the bilateral internal carotid arteries (ICABFV). At the same time, the frequency of cervical sympathetic discharge and the concentrations of plasma noradrenaline and adrenaline increased acutly accompanied by a rapid elevation of systemic arterial pressure (SAP). There was a decline in SAP and a further decrease in ICABFV and the animal died as ICP was sustained at 140mmHg for 5-20min. Autopsy revealed severe hemorrhagic pulmonary edema and the left ventricular and atrial enlargement. In the period of ICP rising, the NPE was prevented if SAP was kept at the baseline levels by withdrawing blood from femoral artery, The results suggest that decreased cerebral blood supply due to ICP rising is responsible for the massive sympathetic discharge and catecholamine release which contribute to SAP elevtion and left ventricular overload, the NPE is mediated by hemodynamic mechanism.

BACKGROUND:Cardiopulmonary exercise test plays a significant role in the evaluation of cardiopulmonary function, but it is limited by expensive equipments and professional personnel, and moreover, the subjects need to bear the maximal exercise intensity. As a result, it is extremely urgent to find a submaximal exercise test characterized by simple operation, low cost and easy to be popularized and used. OBJECTIVE:To compare the maximal oxygen uptake in cardiopulmonary exercise test and 6-minute stair climbing and descending test. METHODS:Sixty-seven volunteers were recruited to undergo the cardiopulmonary exercise test using the Bruce protocol, and then, the maximal oxygen uptake was detected. After that, al the participants were subjected to 6-minute stair climbing and descending test, folowed by determination of the maximal oxygen uptake. RESULTS AND CONCLUSION:The maximal oxygen uptake in the cardiopulmonary exercise test was significantly higher than that in the 6-minute stair climbing and descending test (P < 0.01), and there was a highly positive correlation and consistency between the maximal oxygen uptakes in the two tests (r=0.911,P < 0.01). Therefore, 6-minute stair climbing and descending test can be used to detect the maximal oxygen uptake, which may become an effective method for evaluating cardiopulmonary function.

Objective To evaluate the efficacy and safety of alemtuzumab in renal transplant recipients treated with induction therapy. Methods Eighty-nine cadaveric renal transplant recipients in our department were randomly divided into experimental group (n = 43) treated with alemtuzumab induction, 15 mg i. v. and control group (n = 46). Main immunosuppressive therapy regimen consisted of steroids, tacrolimus or cyclosporine and mycophenolate mofetil in all recipients. Post-transplant kidney function, acute rejection,infection, DGF, graft survival, lymphocyte counts were recorded within 1 year. ATP values in CD4+ T cells after transplantation was determined by using Cylex ImmuKnow assay. Results There was significant difference in the incidence of biopsy-proven acute rejection, but no significant difference was found in ImmuKnow ATP values during 6 months after transplantation and lymphocyte counts during 3 months, graft survival and the incidence of infections between the two groups. Conclusion Induction therapy with alemtuzumab appeared to be effective in the prevention of acute rejection.

BACKGROUND:It has a variety of treatments for equinovarus in spastic cerebral palsy, including physical therapy, orthotic therapy, systemic anti-spasticity drug therapy, local intramuscular injection of botulinum toxin type A and a variety of surgical operations. These treatments aim at different severity of deformities and different age in children patients, and each has its own merits. OBJECTIVE:To investigate the therapeutic effect of Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat equinovarus in spastic cerebral palsy. METHODS: Twenty-two children with spastic cerebral palsy combined with equinovarus were colected from 2012 to 2014, and then these children were subject to Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition. Postoperative plaster external fixation was done for 6 weeks, and then rehabilitation training was given. RESULTS AND CONCLUSION:Al the 22 patients were folowed for an average of 1-2 years, and then were evaluated according to the degree of patient’s satisfaction and the degree of foot deformity. Satisfactory results were obtained from al the patients. Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat spastic cerebral palsy combined with equinovarus is a good method, and it is characterized as good appearance of the ankle and favorable foot function.

Objective To explore the curative effect of colonoscopy combined with laparoscope in the treatment of colonic polyps.Methods The clinical data of 48 cases with colonic polyps were retrospectively analyzed.According to the operation pattern,the patients were divided into observation group(23 cases)and control group(25 cases).The observation group received colonoscopy combined with laparoscopy for radical surgery of colon polyps,the control group used the traditional open surgery to remove polyps.The operation time,bleeding volume, exhaust and defecation time,hospital days and cost as well as postoperative complications were observed.Results The two groups were successfully completed surgery.The operative time,bleeding volume of the observation group were (78.3 ±8.2)min and (1 3.1 ±4.5)mL respectively,which of the control group were (1 1 5.5 ±1 0.1 )min, (63.6 ±1 8.1 )mL,the differences between the two groups were statistically significant(t =1 3.93,1 3.01 ,all P <0.05).The anal exhaust time and defecation time of the observation group were (25.1 ±6.5)h and (42.5 ±7.6)h, which were significantly shorter than those of the control group[(36.6 ±8.1 )h,(82.3 ±1 1 .5)h],the differences were statistically significant(t =5.39,1 4.01 ,all P <0.05).The hospitalization time,hospital costs of the observation group were (5.5 ±0.6)d,(1 3 842.5 ±875.5)yuan,which of the control group were (8.2 ±1 .5)d,(1 8 992.5 ± 1 001 .5)yuan,the differences between the two groups were statistically significant(t =8.05,1 8.89,all P <0.05). Pulmonary infection in 1 case,anastomotic fistula in 2 cases,1 case of intestinal obstruction in the observation group, and in the control group,pulmonary infection occurred in 2 cases,2 cases of intestinal obstruction,the postoperative complications between the two groups had no statistically significant difference(P >0.05).Conclusion For simple colonoscopy treatment difficulties of colon polyps,colonoscopy,laparoscopy combined treatment is minimally invasive and can improve the safety,strictly control surgical indications,can give full play to the double mirror combined advantage.

Objective To determine the length of warm ischemic (WI) tolerance in bronchial graft from non-heart-beating donors. Methods Forty-eight rats were randomly divided into 4 groups (each group having 12 rats) according to different WI durations including WI-0 min (group A), WI-30 min (group B), WI-45 min (group C) and WI-60 min (group D). In each group, the tracheae from 6 rats were respectively imbedded in greater omentum of other 6 rats, and 14 days later, the transplanted tracheae were taken from recipients to evaluate epithelial thickness and regeneration. Results Epithelial thickness and the degree of epithelial regeneration had no significant difference (P >0. 05) between the syngeneic control group and the WI-30 minutes group. All of the grafts with WI duration of 45 min were viable, but the epithelium was significantly thinner than that in the syngeneic control group (P<0. 05). However all of the grafts with WI duration of 60 min showed lower viability rate. Conclusion The time limits of tolerance to WI of tracheal grafts from NHBDs may be 45 min.

Objective　To explore the effect of nordihydroguaiaretic acid (NDGA) on the expressions of vascular endothelial growth factor (VEGF) and its receptor, kinase-inserted domain containing receptor(KDR) and the possible mechanism. Methods　The expression of VEGF in human malignant glioma cell line SHG-44 and that of KDR in human umbilical vein endothelial cell (HUVEC) line ECV-304 were observed 1～3 d after NDGA treatment with immunohistochemistry, in situ hybridization and image analysis. Results　The expression of VEGF was declined at protein or mRNA levels in SHG-44 cells after treated with 100 μmol/L NDGA for 1 to 3 d. The expression of KDR in endothelial cells with 100 μmol/L NDGA treatment for 1 to 3 d was decreased too, in a more obvious way compared with the decline of VEGF expression in SHG-44 cells. Conclusion　The results suggest that NDGA inhibits the expression of VEGF in glioma cells as well as that of VEGF receptor KDR in endothelial cells, which may be the important molecular mechanism of anti-angiogenesis of NDGA.

Objective　To investigate the changes and their significance of bcl-2 and c-myc in nordihydroguaiaretic acid (NDGA)-induced apoptosis of human malignant glioma cell line SHG-44. Methods　The apoptosis of SHG-44 cells was observed with light and electron microscopy and TUNEL method. The expression of bcl-2 and c-myc gene was measured with immunohistochemistry, in situ hybridization and image analysis. Results ① The SHG-44 cell apoptosis was induced by NDGA at a concentration lower than 200 μmol/L in a time-dependent manner. ② The expressions of bcl-2 and c-myc gene in SHG-44 cells were decreased after the treatment of 100 μmol/L NDGA with the elapse of time, indicating a close association with cell apoptosis. ③ The expressions of bcl-2 and c-myc mRNA in SHG-44 cells were decreased after the treatment with 100μmol/L NDGA, which was apparently consistent with the immunohistochemical results. Conclusion　The NDGA-induced apoptosis in human malignant glioma cells might be related with the down-regulated expressions of bcl-2 and c-myc gene. The exact mechanism needs further research.

Objective　To investigate roles of cyclin-dependent kinase 4 (CDK4) in nordihydroguaiaretic acid (NDGA)-induced inhibitory effect on proliferation of human malignant glioma cells. Methods　The techniques of cell culture, cell counts, flow cytometry, immunoprecipitation, immunohistochemistry and image analysis were employed in this study. Results　①A concentration-dependent inhibition of proliferation was demonstrated in the SHG-44 cells incubated for 24 hours in the presence of NDGA, and cell proliferation was blocked in the G1→S phase. ②The activity of CDK4 was decreased apparently in the SHG-44 cells treated for 24 hours with 10 to 200 μmol/L NDGA in a concentration-dependent way. ③The expression of CDK4 gene was downregulated in the cells after NDGA treatment. Conclusion　CDK4 plays an important role in NDGA-induced inhibition of glioma cell proliferation.

Objective To analyze the multi-component,multi-target and multi-pathway mechanism of peony leaf in the treatment of cervical cancer based on network pharmacology. Methods The possible active components and targets in peony leaf were screened and predicted by pharmacological database and analysis platform of traditional Chinese medicine system,and the related targets of cervical cancer diseases were ob-tained by searching Therapeutic Target Database and others. The potential targets for the disease regulation were screened according to the active components of peony leaves entering blood,then the key target names and the pathways involved in the treatment of peony leaf were selected according to the network topological characteristic parameters. Then,the enrichment analysis was carried out by using ClueGO software plug-in. Results There were 194 target sites for 11 blood entry components in peony leaves. Finally,171 signal pathways were ob-tained,and 21 key pathways related to cervical cancer were obtained after the wide pathway was excluded,such as estrogen signaling pathway,neurotrophin signaling pathway and so on. Conclusion Peony leaves may play a vital role in the treatment of cervical cancer by acting on inflammatory,metabolic,immunological,endocrine and cell cycle related protein targets and pathways.