Peroxisome proliferation-activated receptor-γ (PPAR-γ) is a ligand-activated transcription factor belonging to the nuclear hormone receptor superfamily and participates in the regulation of various metabolic pathways as well as inflammatory responses. PPAR-γ ligands significantly improve myocardial functional recovery and prevent ischemia-reperfusion induced injury. Given the increasing understanding of the cardioprotective effects of PPAR-γ ligands, we know today that the therapeutic effects of PPAR-γ ligands reach far beyond their use as insulin-sensitizers, as many of these agents exert beneficial effects in the conditions associated with ischemia-reperfusion and inflammation.

Peroxisome proliferation-activated receptor-? (PPAR-?) is a ligand-activated transcription factor belonging to the nuclear hormone receptor superfamily and participates in the regulation of various metabolic pathways as well as inflammatory responses. PPAR-? ligands significantly improve myocardial functional recovery and prevent ischemia-reperfusion induced injury. Given the increasing understanding of the cardioprotective effects of PPAR-? ligands,we know today that the therapeutic effects of PPAR-? ligands reach far beyond their use as insulin-sensitizers,as many of these agents exert beneficial effects in the conditions associated with ischemia-reperfusion and inflammation.

Objective To compare the clinical effects of combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve versus spinal-epidural analgesia in total hip replacement. Methods Fifty cases of total hip replacement were randomly divided into two groups. Patients in group A received combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve,while patients in group B received spinal-epidural analgesia. Results There were no significant differences in preoperative HR, SBP,DBP and SpO2 between the groups(P > 0. 05). Compared with pre-anesthesia data,HR,SBP,DBP in group A were significantly lower during the anesthesia(P < 0. 05). In group B,there were no significant changes in HR,SBP,DBP and SpO2 during the anesthesia( P > 0. 05). Patients′ heart rate in group A showed significant changes compared with that in group B. The differences in HR,SBP and DBP between group A and B at the same time points were significant(P < 0. 05). Superior rate of anesthesia in group B is higher than that in group A(P < 0. 05). Conclusion Combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve has limited influence on the circulatory and respiratory systems,which can be used for total hip replacement.

Objective To analyze the changes of serum amyloid A (SAA) ,C reactive protein (CRP) ,procalcitonin(PCT) and trypsin activated peptide(TAP) in the patients with acute pancreatitis (AP) ,and to evaluate the above 4 indexes combined detection in the diagnosis and treatment of AP .Methods The levels of SAA ,CRP ,PCT and TAP were detected in 21 cases of severe AP (SAP) and 49 cases of mild AP(MAP) .The detection results were compared with those in the healthy control group (n=50) .Re‐sults The levels of SAA ,CRP ,PCT and TAP had statistical differences between the patients with acute stage of SAP and MAP groups with the healthy control group(P<0 .01);the levels of SAA ,CRP ,PCT and TAP in the SPA group were significantly high‐er than those in the MAP group with statistical difference(P<0 .01) .The diagnostic efficiency of 4‐index combined detection was higher than that of single index detection .Conclusion The combined detection of SAA ,CRP ,PCT and TAP is conducive to early diagnosis and disease condition judgement of AP ,and has an important significance to the diagnosis and treatment of SAP .

Objective To evaluate the long term curative effects of radiotherapy combined with photodynamic therapy on the advanced esophageal cancer.Methods From Oct 1991 to Dec 1992, 60 patients with advanced esophageal cancer were randomly divided into two groups, 30 patients received conventional radiotherapy alone (CRT), the other 30 cases received radiotherapy combined with photodynamic therapy (PRT). After PRT the total dose of 40Gy,for 4 weeks the hematoporphyrin derivate(HpD) was given using 5mg/kg body intravenously and after 48 and 72 hours,the location of lesion were irradiation by 630-nm red light with 400～500mW/cm 2. Laser irradiation was given for 15 minutes to each part of tumor.Results The 5,10-year survival rates were 16 7% ,10 0% respetively;for CRT group and 29 9%, 16 7% respectively; for PRT group, The difference was significant (P

0 05).The survival rate of 1,2,3-year of SG and CRG respectively were 72 58%,51 61% and 37 10%,and 58 10%,32 26% and 20 97%.There was significant difference in the survival rate of 2,3-year between two groups(P

OBJECTIVE:To investigate the effects of rosuvastatin combined with berberine hydrochloride on related indexes in patients with acute cerebral infarction.METHODS:Medical information of 120 patients diagnosed as acute ischemic cerebral infarction were analyzed retrospectively,and they divided into observation group (65 cases) and control group (55 cases) according to route of administration.Both groups were given routine treatment;control group was additionally given Rosuvastatin calcium tablets 10 mg orally before bedtime,once a day;observation group was additionally given Berberine hydrochloride tablets 0.3 g orally,3 times a day,on the basis of control group.Treatment courses of 2 groups lasted for 14 d.The levels of TC,TG,LDL-C,HDL-C,hs-CRP,ox-LDL,NIHSS score,ADL score,TPA,IMT,Crouse score,the number of unstable plaque and ADR were observed and compared between 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).After treatment,the serum levels ofTC,TG,LDL-C,hs-CRP and ox-LDL in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After treatment,NIHSS score of 2 groups were significantly lower than before,and ADL score,HDL-C levels were significantly higher than before,with statistical significance (P＜0.05);there was no statistical significance between 2 groups (P＞0.05).After treatment,there was no statistical significance in IMT,Crouse score and the number of unstable plaque in control group compared to before treatment (P＞0.05),but in observation group were significantly lower than before treatment,and also lower than control group at corresponding period,with statistical significance (P＜0.05).There was no statistical significance in TPA between 2 groups before and after treatment(P＞0.05).There was no statistical significance in the indcidence of ADR between 2 groups during treatment(P＞0.05).CONCLUSIONS:Based on routine treatment,rosuvastatin combined with berberine hydrochloride could effectively reduce blood lipid levels in patients with acute cerebral infarction,stabilize or reverse atherosclerotic plaque,and reduce inflammation and oxidative stress with good safety.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

Objective:To analyze the adverse drug reactions(ADR)and clinical application of thalidomide to provide useful reference for rational medication in clinics. Methods:The case reports and literatures from foreign countries on the clinical medication of thalidomide were analyzed and summarized. Results:The ADR of thalidomide included gastrointestinal reaction, hematotoxicity,cadiovascular toxicity,neurotoxicity,skin lesion,pulmonary embolism and so on. Its new medication methods were widely used in clinics. Conclusion:Clinicians and pharmacists should pay more attention to the medication risks and rational use of thalidomide in order to assure the safety and effectiveness of clinical drug use.

Objective:To analyze the reasons of early failure of the PHILOS in proximal humerus frac-tures.Methods:From Nov.2010 to Nov.2014,there were 117 patients with humerus fractures treated with PHILOS locking plate in Department of Orthopaedics,Xuanwu Hospital.All of the patients were treated with the plate by open reduction internal fixation,and we analyzed these cases retrospectively. After the operation,we removed the drainage tube within 48 h,and the patients were allowed to do the passive motion 3 days after the surgery if the X-Ray showed the plate and screws were reliable.Eight ca-ses failed within 4 weeks after the operation.We analyzed the reasons of the failure.Results:The rate of the failed cases was 6.83%(8 /117).The average age was 72.4(66 -82)years.In the 8 failed cases, 3 were on the right side,and the other 5 on the left side.As for the reason of the fractures,2 cases were because of car accidents,and the other 6 because of daily life injury.According to the Neer classifica-tion,3 cases were 2-part fractures,and the other 5 3-part fractures.Three cases were total failure,and the other 5 partial failure.All the 8 failed cases failed within 4 weeks after the operation,of which 1 was on the sixth day after surgery,the other 7 2 to 4 weeks after the surgery.The 3 totally failed cases were treated by removing the screws and plates,the other 5 by conservative methods.All of the cases were malunion at the end.Conclusion:The early failure of the PHILOS locking plate in proximal humerus fractures is related to the bad reduction during the operation,the loss of medial cortex support,the limi-tation of screw length,the osteoporosis and the improper rehabilitation after operation.It is very important to do good preoperative plan for a surgeon.During the operation,we should try our best in the fracture reduction,use the appropriate plate and screws,and then pay attention to the rehabilitation after the operation.After all of this,the rate of failure may be decreased.