Objective To study the effect of papaverine on vasospasm caused by PICC intubation with B-mode ultrasonography. Method Three mg papaverine were injected into the median cubital vein for at least 2 minutes in 15 patients with vasospasm. Results The vasospasm in the 15 patients was relieved 36~270 s seconds after injection. The followed intubation was all successful. There was no abnormality in their liver function and heart rate, or abnormal bleeding, or other serious complications. Conclusion Papaverine can relieve vasospasm caused by PICC intubation, so it can allow another intubation. It also can avoid delayed intubation reduce patients′pain and cost and reduce psychological pressure of the nursing practitioner.

Objective To evaluate the usefulness of imging techniques in diagnosis of corticosteroid-induced avascular necrosis of the femoral head(ANFH).Methods Twenty seven patients with avascular necrosis of the femoral head due to long-term corticosteriod treatment were analysed retrospectively.There were 16 femal and 11 male,ranged in age from 20 to 46 years(mean age 35.6 years).The course of disease was 1～5 years.The administration of corticoid orally was 60～25 mg/d taken on 6 months to 5 years.ANFH was appeared 3 months to 2 years after the administration of corticoid.The imaging examinations included radiography in 20 cases,MRI in 15 cases,both radiography and MRI in 10 cases and CT in 8 cases.8 cases were confirmed by operation and pathology.Results 7 femoral heads in 6 cases with early-ANFH were diagnosed by X-ray,21 femoral heads in 15 cases with early-ANFH were diagnosed by MRI and 11 femoral heads in 7 cases were by CT,19 femoral heads showed a typical “line sign”on MRI.Conclusion The “line sign” on MRI is regarded as the characteristic finding in early-ANFH.MRI is the most sensitive method in the early-diagnosis of the corticosteroid-induced ANFH and it can provide important evidence for clinical management.

Rhynchophylla is a Chinese herb commonly used in clinical practice. It's also the primary herb of some famous Chinese herbal compound such as Tianma Gouteng decoction, and Lingyang Gouteng decoction. According the record from many previous materia medica literatures, rhynchophylla should be added later during decoction. Pharmaceutical research showed that rhynchophylla alkaloids were not stable. Which has resulted in many problems in the research and its application. For example, there was not a quantitative determination method in "Chinese Pharmacopoeia" of past and present versions, which seriously impacted its quality control and product application. Firstly, records from previous materia medica literatures and "Chinese Pharmacopoeia" were systematically sorted based on the chemical stability of rhynchophylla. Secondly, pharmaceutical research including chemical compositions and their stability, pharmacological effects, extraction process and quality analysis, was reviewed after reference of literatures published at home and abroad in recent decades. Positive reference and evidence for further research and development of rhynchophylla will be provided in the article.
Animals ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Quality Control ; Uncaria ; chemistry

Objective To evaluate the effect of aminophylline on monophasic action potential (MAP) during remifentanil-induced negative chronotropic effect in the isolated rabbit hearts.Methods Eighteen healthy adult rabbits,weighing 2.0-2.5 kg,wereused in the study.Their hearts were excised and retrogradely perfused in a Langendorff apparatus.After 15 min of stabilization with K-H solution,the isolated hearts were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),remifentanil group (R group),and remifentanil + aminophylline group (RA group).Group C was perfused with 37 ℃ K-H solution for 60 min.Group R was perfused with K-H solution containing remifentanil 12 ng/ml for 60 min.Group RA was perfused with K-H solution containing remifentanil 12 ng/ml and aminophylline 30 μg/ml for 60 min.At 15 min of stabilization and 15,30 and 60 min of perfusion,HR and MAP in the myardium of left ventricle were recorded:MAP duration at 90％ and 50％ repolarization (MAPD90,MAPD50) was calculated.The early after depolarization,delay after depolarization and arrhythmia were recorded.Results Compared with group C,HR was significantly decreased at 15,30 and 60 min of perfusion,and MAPD50 and MAPD90 were prolonged in goup R,and HR was increased in group RA.HR was significantly higher,and MAPD50 and MAPD90 were shorter in RA group than in group R.No early after depolarization,delay after depolarization or arrhythmia developed in each group.Conclusion Aminophylline antagonizes remifentanil-induced negative chronotropic effect through shortening monophasic action potential duration in the myocardium of left ventricle of the isolated rabbit hearts.

Objective:To acquire potential HBsAb sequences,we have analyzed the BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml,which could provide a data basis for follow-up study.Methods:Genomic DNA of pe-ripheral blood mononuclear cells was extracted from samples with HBsAb titer higher than 10 000 mU/ml.We have adopted Illumina Solexa high-throughput sequencing technology of the Adaptive Biotechnologies ImmunoSEQ platform to acquire sequence data.IMGT/High V-QUEST was used to preliminary analyze our sequence data,including usage of IGHV,IGHJ and IGHD gene subgroups,IGHV-J matching,distribution of CDR3 amino acid (AA) length and usage of total CDR3 AA.And these sequences were compared with the HBsAb sequences from NCBI database.Results:Experimental samples have highly selected gene subgroups IGHV3,IGHV4,IGHJ4, IGHJ6,IGHD3,IGHD6,and IGHV3-J4 pairing,IGHV3-J6 pairing.The AA length distributions of CDR3 region were normal distribution with the length of 14/15 AA as the midline.In the regard to amino acid usage in CDR3 region, each sample prior used Alanine, Tyrosine,Glycine,Alanine,Aspartic acid and Serine.The amino acid usages of 107,108,109,113,114 positions were diversified but 105,106,115,116,117 positions taking conservative amino acids usages.We have found 48 unique sequences that have same IGHV, IGHJ and CDR3 AA length with the HBsAb sequences from NCBI database.Conclusion:There were almost the same characteristics of BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml.The 48 unique sequences provided a solid data basis for the follow-up study.

AIM:To study the effect of remifentanil on monophasic action potential and transmural dispersion of repolarization (TDR) in the 3-layer myocardium of isolated rabbit hearts .METHODS:Adult rabbits (n=18, 2.0 ~2.5 kg) were used to isolate the hearts for preparing Langendorff perfusion model .The hearts were randomly divided into 3 groups after perfusion with K-H solution for 15 min: the perfusion in control group ( C group ) continued for 60 min; the hearts in remifentanil group ( R group ) were perfused with 12 μg/L remifentanil K-H solution for 60 min; the hearts in remifentanil+aminophylline group ( RA group ) were given 60-min perfusion of 12 μg/L K-H remifentanil +30 mg/L aminophylline .The HR and 3 layers of myocardial monophasic action potential ( MAP) in the left ventricular anterior wall were recorded at time points after balanced infusion for 15 min ( T0 ) , and continued perfusion for 15 min ( T1 ) , 30 min ( T2 ) and 60 min ( T3 ) .The monophasic action potential duration of repolarization at 90%( MAPD90 ) and the transmural dispersion of repolarization (TDR) were calculated.The early afterdepolarization, delay afterdepolarization and arrhythmia were also observed.RESULTS:In R group, slower HR and prolonger MAPD90 and TDR at T1 ~T3 were observed as com-pared with those at T0(P<0.05).R group showed slower HR and longer MAPD 90 and TDR than C group and RA group (P<0.05).CONCLUSION:Remifentanil slows the HR, extends the MAPD90 and increases the TDR, thus being prone to induce reentry.Aminophylline makes HR faster and MAPD90 shorter, thereby reducing the TDR.

Adolescent ; Humans ; Leukemia, Myeloid, Acute ; etiology ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology

Objective To investigate the association of expressions of cyclooxygenase-2(COX-2),matrix metanoproteinases-9(MMp-9)and Ki67 with occurrence,infiltration and metastasis of gastric cancer.Methods Fifty-eight surgically obtained and pathologically performed cancerous tissues were collected between Jan.2003 and Dec.2005.Among them,37 were males and 21 were females with mean age of 58.2 years(ranged from 31 to 76 years).Fifty-eight paracancerous tissues(5-6 cm apart form the cancer)were taken as controls.The expressions of COX-2,MMP-9 and Ki67 in cancerous or paracancerous tissues were examined by immunohistochemistry.Results The expressions of COX-2 and MMP-9 in cancerous tissues(82.76%and 68.9%,respectively)were higher than those in controls(37.93%and 24.14%,respectively,P＜0.01).The expressions of COX-2 and MMP-9 were not associated with sex,age,location and size of gastric cancer(P＞0.05),but were correlated with the depth of lymph node infiltration.metastasis and TNM stage(P＜0.05).The expression of MMP-9 was also associated with the degree of differentiation of gastric cancer(P＜0.05).There was a correlation between COX-2 and MMp-9 expressions in gastric cancer tissues(P＜0.05,C=0.359).The expression of Ki67 in tissues with positive expressions of COX-2 and MMp-9 was higher than that in negative ones(P＜0.O 1).Conclusion The COX-2,MMP-9 and Ki67 play important roles in metastasis and infiltration,which promote occurrence and development of gastric cancer.

Objective To determine the level of adiponectin (APN) in serum and induced sputum of patients with chronic obstructive pulmonary disease both during acute exacerbation (AECOPD) and silent stage, and investigate APN' s role as a marker of inflammation in the pathogenesis of COPD. Method From October 2008 to October 2009,30 male AECOPD patients in the emergency department, 30 male silent COPD patients in the department of respiratory diseases and 30 healthy nonsmoking male volunteers were included. All subjects' serum and induced sputum were collected, and they were all of normal weight(BMI range of 18.5～ 24.9 kg/m2). Patients were excluded if they suffered from severe bronchial asthma, bronchiectasis or autoimmune disease. The number of cells in induced sputum was counted and the cell type was classified. The concentrations of APN, IL-8, IL-6 and TNF-α in both serum and sputum were measured by using ELISA, and their pulmonary function was tested. The different groups were compared among them by using the t -tests, ANOVA analysis or nonparametric analysis, the relation between variables was assessed by using the Pearson or Spearman correlation test. Results The concentrations of APN in both serum and induced sputum of AECOPD patients were significantly higher than those in the silent COPD patients and the control subjects ( P ＜ 0.01 ). The concentrations of APN in the silent COPD patients were significantly higher than those in the control subjects ( P ＜ 0. 01 ). There were significant relationships between the concentrations of APN in serum and induced sputum and the levels of IL-8 and TNF-α in AECOPD patients ( r = 0.739, 0. 734,0.852 and 0. 857, respectively, P ＜ 0. 05) and in silent COPD patients ( r = 0.751,0.659, 0.707 and 0.867, respectively, P ＜0.05). There was significant relation betweenship between APN and neutrophil in induced sputum of AECOPD patients (r = 0.439, P ＜ 0.05). Conclusions APN was involved in the process of systemic and airway inflammation of COPD, and it was related with IL-8 and TNF-α. APN can be used as a new inflammation marker for COPD.

Objective To evaluate the value of serum procalcitonin (PCT) in antibiotics used for the treatment of acute exacerbation of asthma. Method From February 2007 to July 2009, a total of 158 patients with asthma were randomly (random number) assigned to PCT group ( n = 77) or to control group ( n = 81 ). The PCT levels of all patients were measured. On the bases of routine treatment, the employment of antibiotics in control group was determined by the guidebook, and patients in the PCT group were treated with antibiotics guided by the levels of serum PCT. The antibiotics treatment was employed as PCT level ＞0.25 ng/mL, and was not employed as PCT level ＜ 0.25 ng/mL. The rates of antibioties employment were observed. Results The rate of antibiotics employment in PCT group (45.4%) was lower than that of the control group (77.8%) (x2 = 17.15,P =0.000). Conclusions PCT could be used safely as guidance of antibiotics employment for the treatment of patients with acute exacerbation of asthma, leading to appropriate use of antibiotcs.