Objective To investigate the effect of propofol on the heme oxygenase-1(HO-1)expression in rats with H_2O_2-mediated damage to cultured cardiac myocytes.Methods Primary cultured new-born rat cardiac myocytes were divided into 8 groups:control,H_2O_2 group,low dose propofol (LP) group,middle dose propofol(MP)group,high dose propofol(HP)group,LP +ZnPP Ⅸ group.MP+ZnPP Ⅸ group and HP+ZnPP Ⅸ group.The cells in all groups were incubated for 6 h.The concentration of malondialdehyde(MDA),activity of superoxid dismuase(SOD),mitochondria and Caspase-3,and the expression of HO-1 were determined.Results As compared with H_2O_2 group,the HO-1 expression,and the activity of SOD and mitochondria were significantly increased(P<0.05,P<0.01),and activity of Caspase-3 and concentration of MDA was decreased(P<0.05)in MP and HP groups.As compared with LP,MP and HP groups respectively.the HO-1 expression and SOD activity were significantly decreased and the concentration of MDA increased in LP+ZnPP IX,MP+ZnPP Ⅸ and HP+ZnPP Ⅸ groups(P<0.05,P<0.01),while Caspase-3 activity was significantly increased in MP+ZnPP IX and HP+ZnPP IX(P<0.05,P<0.01).Conclusion Propofol can protect cardiac myocytes against H_2O_2-mediated cytotoxicity in a dose-dependent manner,and increase the HO-1 expression,which may partly mediate cytoprotective effects of propofol.

[Objective] To discuss the cure effect of acupoints application combined with TCM decoctions and auricular point buried-bean on pernicious vomiting. [Method] Choose 65 such cases from April 2011 to March 2012 as control group and another 65 from Nov. 2011 to Sep. 2013 as treatment group. The control one take oral y TCM decoction combined with auricular point buried-bean, the treatment one added with TCM acupoints applica-tion;observe the result after 1 course. [Result] In treatment group, 46 cases were cured, 18 better, 1 was not cured, the total effective rate 98.5%;in con-trol one, they were respectively 40,11,14 and 78.4%; the comparison of them had difference of statistical meaning.[Conclusion] The acupoint application combined with TCM decoction and auricular point buried-bean has obvious cure effect on pernicious vomiting.

Objective To discuss clinical effect and feasibility of laparoscopic pelvic lymphadendenectomy assisted radical vaginal hysterectomy (LARVH) in the treatment of cervical cancer. Methods Laparoscopic pelvic lymphadendenectomy assisted radical vaginal hysteretomy was performed in 38 patients with cervical cancer. The operative quality and postoperative recovery effects were analyzed. Results All 38 patients were successfully performed with LARVH and no complications. The radical vaginal hysteretomy were performed in all of patients, 21.4±2.2 pelvic lymph nodes were removed. The average duration of surgery was (240±25.6) min and the average hemorrhage was (340±40.2) ml. There were 7 patients who needed blood transfusion during operation. After operation, the mean time for passage of gas by anus was (2±0.26) days, and the mean recovery time of bladder function was (10.5±1.3) days. Patients were discharged after (9.2±1.1) days on average. 38 patients had no complication. Conclusions For the treatment of uterine neoplasm, LARVH decreased operative damage with more short recovery time, same operative extent as laparotomy. It is an ideal way to treat uterine neoplasm currently.

Objective To investigate the association between polymorphism of TNFα-308 and mutations of HBV C region in patients with chronic HBV infection. Methods Ninety-five patients with chronic HBV infection were recruited in the study. The single nucleotide polymorphism(SNP) of TNFα-308 Was determined by restriction fragment length polymorphism(RFLP). Mutations of nt1762/1764, nt1896, nt1899, nt1862, as60, aa87 and as97 in HBV C region were detected by direct sequencing after PCR amplification. Mutations of the above points among different genotypes were compared by Fisher's exget test. Results Three different genotypes G/G(63/95, 66.3%), G/A(28/95, 29.5%) and A/A(4/95, 4.2%) were found in TNFα-308 site. The rates of mutations of aa87 and aa97 points in patients with G/G, G/A and A/A genotype were 39.3%(24/61), 11.5%(3/26) and 50.0% (2/4), respectively(F=7.658, P<0.05);while the mutation rates of nt1762/1764, nt1896, nt1864, nt1899 and aa60 were of no statistical significance among different genotypes(F=0.669, 1.542, 1.123, 2.420 and 0.966, P>0.05). Conclusion Compared with G/G genotype, antigenicity of HBV may be more stable in patients with TNFα-308 G/A genotype, which is beneficial to HBV clearance.

Objectives To evaluate the effects of hypertonic-hyperoncotic solution (HHS) on cardiac function and extravascular lung water in children after open-heart surgery for congenital cardiac disease. Methods 50 children with congenital cardiac disease were randomly assigned to 2 groups. The HHS group received HHS (7.5% sodium chloride with 6% hydroxyethyl-stareh 200 kDa). The ISS group received isotonic saline solution (ISS 0.9% sodium chloride). Cardiac index (CI), extravascular lung water index (ELWI), stroke volume index (SVI), mean arterial pressure (MAP), and systemic vascular resistance index (SVRI) were measured. Immediately after sur-gery, patients were loaded either with HHS or with ISS (4 ml/kg). Sodium concentration, osmolality, thrombocyte count(TC), fibrinogen, and arterial blood gases were detected before operation, immediately after loading, 15 minutes, 1,4, 12, and 24 hours after the end of vol-ume loading. Hemodynamic parameters were recorded at the same time. The total amount of dobutamine required was documented. Results In HHS group, MAP, SVI and CI increased, and SVRI decreased significantly after the administration of HHS, compared with ISS group and before administration(P<0.01 or 0.05). Both CVP and HR were unchanged in both groups. In HHS group, ELWI decreased signifi-cantly, compared with before volume administration. But ELWI increased directly and remained elevated for 60 minutes after the administra-tion of ISS. Sodium concentration increased immediately after infusion of HHS. The postoperative need for infused dobutamine in the patients in HHS group was decreased, compared with ISS group (P<0.05). All patients left the hospital in a clinically sufficient state. Condu-sions A single infusion of HHS after cardiac surgery is safe. After cardiopuimonary bypass surgery, the administration of HHS increased CI by elevating SVI in combination with a decreased SVRI. ELWI significantly decreased, which suggest that HHS effectively counteracts, the capillary leakage.

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

Current undergraduate education in traditional Chinese Medicine combines classroom teaching with a small number of practical courses, which has showed its limitations of increasingly bad medical environment and employment situation. Nanjing University of Chinese Medicine explored new ways and means of medical education in recent years. Therefore, reforming based on the integration of clinical teaching pattern for TCM Bachelor has been carried out step by step. It meant that classroom teaching and clinical practice were fully integrated by moving classroom in the affiliated hospitals. It has been proved to work. With the experiences of the development, we have successfully explored a mature mean for the integration clinical teaching pattern. Here, we discussed the codes of such practice in order to strive to maximize the effectiveness of such practice.

Objective To investigate the expression of interleukin 18 (IL-18) in liver tissues of patients with chronic hepatitis B (CHB) and its clinical significance.Methods Totally 172 CHB patients admitted in the Second Affiliated Hospital of Anhui Medical University from January 2012 to December 2012 were enrolled.The tissue specimens were obtained by liver biopsy from all patients,and 22 normal liver specimens were also collected as controls.Liver function,serum markers of HBV and HBV DNA load were measured and liver inflammation grades and fibrosis stages were assessed.Immunohistochemical method was used to detect the expression of IL-18 in liver tissues.Spearman rank correlation was used to analyze the correlations between IL-18 expression and the above indicators.Results IL-18 was mainly expressed in cytoplasm of liver cells.It was positive or strong positive in liver cells of healthy people,but weakly positive in liver cells of CHB patients.The difference of IL-18 expression between CHB patients and healthy people was of statistical significance (x2 =42.124,P ＜ 0.05).In CHB patients,the expression of IL-18 was gradually enhanced with the increasing of ALT,inflammation grades and fibrosis stages (r =0.182,0.173 and 0.068,P ＜0.05),but it was not correlated with HBV DNA load and HBeAg (r =-0.05 and 0.041,P ＞0.05).Conclusion In CHB patients,the expression of IL-18 may be involved in liver injury and fibrosis formation.

Object To optimize the best extraction of the total saponins in the root of Ophiopogon japonicus (Thunb.) Ker-Gawl. (RO). Methods The extract condition of total saponins in RO was observed by orthogonal design with ophiopogonis D as index. Results The optimum extract condition of RO was established. The more effective way was to smash RO to 5-10 mesh and extract total saponins in RO with ten times amount of 80% alcohol thrice by refluxing, one hour each time. Conclusion The total saponins in RO could be fully extracted in this condition.

Objective To solve the caducity question of Dendrobium officinale during the tissue-culture process. Methods Added the different concentration of 0.1 and 2 mg/L AgNO3 into the PLB proliferation medium, buds proliferation medium, and rooting medium separately. The quantity of the ethylene production was to be determined and the situation of the tube seedling growth was to be observed. ResultsAgNO3 can suppress the production of the ethylene, enhance the multiplication speed of PLB and split-up efficiency the clump of bud, and obviously promote the seedling′s growth. It showed that the survival ratio of transplant could enhance as many as two times and display the merit of caducity-resistant. ConclusionAgNO3(1 mg/L) can be taken as the caducity-resistant reagent of D. officinale during the tissue-culture processing.