OBJECTIVE:To study the adsorbability of plastic transfusion bottle and infusion set to diazepam. METHODS:With the reference of plastic-bottled 5% glucose injection,HPLC was used to determine the changes of mass concentration of diazepam adding into plastic-bottled 5% glucose injection at different time;disposable plastic infusion set was connected to simulate intrave-nous infusion and determine the changes of mass concentration of diazepam in the liquid effluent at different time. RESULTS:The mass concentration of diazepam in glass infusion bottles group was higher than in plastic transfusion bottles group. The adsorbabili-ties of solutions showed the strongest at the time of 15-20 min. The mass concentration of the effluent liquid from the glass bottle group was about 80% of the original concentration and plastic bottle group was about 67%. As the time went on,the adsorbability was gradually saturated at 60 min and the concentration rose again;the mass concentration of the effluent liquid from the glass bot-tle group returned to 95%of the original concentration at 80 min and the plastic bottle group was about 75%of the original concen-tration. CONCLUSIONS:Both plastic infusion bottle and infusion set have strong adsorbability to diazepam. It is suggested that the dosage of diazepam should be increased by 25% to 33% while plastic-bottled 5% glucose injection is used as solvent for intrave-nous drip.

Objective To investigate the alterations of serological endothelin(ET) in patients with kawasaki disease(KD) and its relation with coronary dilatation(CAD).Methods Serological ET were measured in 50 cases of patients with KD in acute phase as well as subacute phase; 30 cases of patients with acute febrile infection(IC) in infective phases and 30 healthy children(HC).Results 1.ET in subacute phase significantly increased than that in acute phase.2.In both acute and subacute phases of KD, ET significantly elevated higher than that in HC; and ET in subacute phase significantly elevated than that of IC. 3. Fifty-four percentage patients with KD were complicated with CAD. For CAD subgroup, ET had no difference with CAD subgroup in subacute phase.Conclusion ET has still increases in subacute of KD,which indicates the relation with coronary artery lesion.

Objective To explore the clinical features and diagnosis of primary immunodeifciency disease caused byTyk2 gene mutations.Methods Clinical data from the ifrst case in China diagnosed of primary immunodeifciency disease caused by Tyk2 gene mutation were retrospectively analyzed, and related literature was reviewed.Results One year and 3 month old boy suffered with repeated pulmonary infection, chronic otitis media, intractable eczema like rash, repeated skin abscess, HSV infection, intracellular bacterial infection, and remarkedly increased total IgE. It was detected that compound heterozygous mutations of c.2269C>G in No. 16 exon and c.149delC in No. 3 exon inTyk2 gene. Literature searching found other 8 cases (5 males and 3 females) of immune deifciency patients caused byTyk2 gene defects, all of which hadTyk2 gene homozygous mutations and presented with repeated infection of paranasal sinus and lung. In the 8 cases 6 cases were combined with mycobacterium tuverculosis infection, 4 cases had repeated virus infection, 4 cases had meningonecephalitis, 3 cases had intractable eczema like rash, 2 cases had salmonella enteritis, 1 case had remarkedly increased total IgE, one case had elevated eosinophils, 5 cases were born in intermarriage family and 1 case died of meningitis caused by unknown etiology.Conclusions When patients have repeated paranasal sinus infection and lung infection, combined with intracellular bacterial infection (including mycobacterium tuberculosis infection), and repeated virus infection or intractable eczema like rash, with or without increased total IgE, immunodeifciency disease caused by Tyk2 gene defection should be considered. Gene sequence analysis can assist in early diagnosis.

Objective To evaluate the effects of oxycodone combined with incision infiltration with ropivacaine on postoperative outcomes in the patients undergoing laparoscopic cholecystectomy.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 33-64 yr,weighing 45-88 kg,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into 2 groups (n=40 each) using a random number table:patient-controlled intravenous analgesia group (group P) and oxycodone combined with incision infiltration group (group O).In group P,fentanyl 1-2 μg/kg was intravenously infused after cholecystectomy,and patient-controlled intravenous analgesia was performed with sufentanil at the end of surgery.In group O,oxycodone 0.05-0.10 mg/kg was intravenously injected after cholecystectomy,incision infiltration was performed with 0.5％ ropivacaine before suturing,and visual analog scale score was maintained ≤ 3.The emergence time,time to first flatus,time to liquid diet,first ambulation time,length of hospital stay after operation and adverse reactions were recorded.Results Compared with group P,the time to first flatus,time to liquid diet,first ambulation time and length of hospital stay after operation were significantly shortened,the incidence of urinary retention and nausea and vomiting was decreased (P＜0.05),and no significant change was found in the emergence time in group O (P＞0.05).Conclusion Combination of oxycodone and incision infiltration with ropivacaine can promote postoperative outcomes in the patients undergoing laparoscopic cholecystectomy.

OBJECTIVETo evaluate the efficacy and safety of Yigan Fupi Decoction (YFD) in the treatment of irritable bowel syndrome with diarrhea (IBS-D) patients.

METHODSA randomized controlled clinical trail was carried out in patients with IBS-D. All patients were randomly assigned to the treatment group (58 cases, treated with YFD) and the control group (58 cases, treated with Pinaverium Bromide Tablet). The treatment course was 4 weeks for all patients. The total effective rate, the stool property and state, the quality of life (QOL), and TCM syndrome efficacy were assessed by IBS bowel symptom severity scale (IBS-BSS), IBS defecation state questionnaire (IBS-DSQ), IBS quality of life questionnaire (IBS-QOL), and traditional Chinese medicine pattern curative effect scoring system (TCM-PES) before and after treatment.

RESULTSThere was no statistical difference in the total effective rate between the two groups (82.76% vs. 77.59%, P > 0.05). The treatment group was superior in the total IBS-BSS integral to the control group (P < 0.05). The total effective rate of improving the stool property was better in the treatment group than in the control group (81.03% vs. 72.41%, P < 0.05). Besides, the number of days for emergent defecation among 10 days was less in the treatment group than in the control group (P < 0.05). The improvement of the total IBS-QOL integral and the total integral of TCM syndrome were better in the treatment group than in the control group (P < 0.01). The total effective rate of TCM-PES was better in the treatment group than in the control group (84.48% vs. 70.69%, P < 0.05).

CONCLUSIONYFD was effective in the treatment of IBS-D patients of Gan-qi invading Pi syndrome, and could effectively relieve bowel symptoms, improve the stool property and the defecation frequency, elevate their QOL, and attenuate Gan-qi invading Pi syndrome with favorable safety and compliance.

Adult ; Diarrhea ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Irritable Bowel Syndrome ; drug therapy ; Male ; Middle Aged ; Morpholines ; therapeutic use ; Quality of Life ; Treatment Outcome

ObjectiveTo observe protective effects of agmatine (AGM) on inflammatory response and spleen immune function in mice with trauma.Methods Forty-eight adult male C57BL/6 mice were randomly divided into three groups (n= 16 each), including control group, model group (bilateral femoral fracture and removal of 35% of the total blood volume), and AGM group (trauma/hemorrhage & AGM 200 mg/kg). Eight mice in each group were sacrificed at 3 hours and 24 hours, respectively, after modeling, and blood samples and tissue homogenate of spleen and liver were collected. The contents of tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-1β) in serum and liver tissue were determined with enzyme linked immunosorbent assay (ELISA). Serum aspartate transaminase (AST), alanine aminotransferase (ALT) and lactic dehydrogenase (LDH) were determined with automatic biochemistry analyzer. Spleen proliferation response stimulated with concanavalin A (ConA) was evaluated with methyl thiazolyl tetrazolium colourimetry (MTT).γ-interferon (IFN-γ) and IL-2 releases were determined with ELISA.Results Compared with control group, 3 hours after trauma/hemorrhage, the levels of serum TNF-α, IL-6, and IL-1β in model group were significantly elevated [TNF-α (ng/L): 145.38±31.50 vs. 23.06±11.14, IL-6 (ng/L): 496.94±50.76 vs. 47.13±17.47, IL-1β (ng/L): 321.31±43.02 vs. 29.25±16.24,allP< 0.01]. It was found that AGM treatment could alleviate the increase in serum pro-inflammatory mediators induced by trauma/hemorrhage, such as TNF-α (ng/L:111.56±25.47 vs. 145.38±31.50), IL-6 (ng/L: 412.56±44.33 vs. 496.94±50.76), IL-1β (ng/L: 273.38±45.25 vs. 321.31±43.02,P< 0.05 orP< 0.01). Twenty-four hours after trauma/hemorrhage, serum pro-inflammatory mediators were recovered to the levels in control group. There was no significant difference in TNF-α and IL-6 levels at 3 hours after trauma/hemorrhage among groups. Compared with control group, the expressions of liver TNF-α and IL-6 in model group were increased at 24 hours following trauma [TNF-α (ng/mg): 32.93±4.90 vs. 26.58±2.33, IL-6 (ng/mg): 11.20±1.66 vs. 8.38±0.89,bothP< 0.01]. However, AGM inhibited the level of TNF-α (ng/mg:28.92±3.16 vs. 32.93±4.90) and IL-6 (ng/mg: 9.03±1.28 vs. 11.20±1.66) in the liver as induced by trauma/hemorrhage (P< 0.05 andP< 0.01). At 24 hours after modeling, model group and AGM group had distinctly higher serum AST, ALT, LDH levels than those of control group [AST (U/L): 405.9±31.2, 245.7±22.1 vs. 128.2±15.9; ALT (U/L): 92.1±6.3, 51.6±5.0 vs. 30.1±3.2; LDH (U/L): 606.7±36.3, 478.7±25.3 vs. 384.0±16.6, allP< 0.01]. Nevertheless,the increase in serum AST, ALT and LDH was alleviated in AGM group (allP< 0.01). Meantime, trauma/hemorrhage produced a noticeable depression of proliferation of splenic cells and IFN-γ and IL-2 release stimulated with ConA compared with control group [proliferation rate: (40.97±4.13)% vs. (89.99±7.76)%, IFN-γ(ng/L): 91.6±12.3 vs. 353.2±21.5,IL-2 (ng/L): 53.4±6.4 vs. 91.0±12.2,allP< 0.01]. In contrast, AGM notably restored the capacity of proliferation response of splenic cells [proliferation rate: (74.86±5.75)% vs. (40.97±4.13)%, P< 0.01],enhanced the release of IFN-γ and IL-2 stimulated with ConA [IFN-γ (ng/L): 327.8±23.6 vs. 91.6±12.3, IL-2 (ng/L): 74.8±10.4 vs. 53.4±6.4, bothP< 0.01].Conclusion AGM can dramatically alleviate spleen immunosuppression, excessive inflammation and organ damage induced by trauma/hemorrhage.

OBJECTIVETo explore the changes of peripheral blood lymphocyte subsets in patients with acute hydrogen chloride gas poisoning.

METHODSWhen the patients were admitted or on the secondary day, the percentages of total T-cell lymphocyte subsets (CD(3)(+)CD(19)(-)), CD(4)(+)T cells (CD(3)(+)CD(4)(+)), CD(8)(+)T cells (CD(3)(+)CD(8)(+)), B cells (CD(3)(-)CD(19)(+)) and NK cells (CD(3)(-)CD(16)(+)CD(56)(+)), and the ration of CD(4)(+)/CD(8)(+) in 37 cases with acute hydrogen chloride gas poisoning and 49 healthy controls were detected with flow cytometer.

RESULTSThe total T-cell percentage and total CD(4)(+)T cell percentage in 37 cases were significantly lower than those in 47 controls (P < 0.05). The percentages of NK cells and B lymphocytes in 37 cases significantly increased, as compared with controls (P < 0.05). The ration of CD(4)(+)/CD(8)(+) in 37 cases significantly decreased, as compared with controls (P < 0.05).

CONCLUSIONThe lymphocyte subsets in the patients with acute hydrogen chloride gas poisoning changed, which could influence the immune function of patients.

Adolescent ; Adult ; Case-Control Studies ; Female ; Gas Poisoning ; blood ; Humans ; Hydrochloric Acid ; poisoning ; Lymphocyte Count ; Lymphocyte Subsets ; cytology ; Male ; Middle Aged ; Young Adult

ObjectiveTo investigate the effects of edaravone pretreatment on pulmonary inflammatory response during selective lobar blockade in patients undergoing thoracotomy,MethodsSixty ASA Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 50-80 kg,undergoing esophagectomy were randomly divided into 4 groups (n =15 each):the one-lung ventilation group (group OLV),the edaravone pretreatment + one-lung ventilation group (group E + OLV),the Univent tube selective lobar blockade group (group U) and the edaravone pretreatment + Univent tube selective lobar blockade group (group E + U).Padents in groups OLV and U were intubated with the double lumen endobronchial tube and Univent tube,respectively.Edaravone at a dose of 1 mg/kg was infused into patients at 5 min before one-lung ventilation in group E + OLV and before selective lobar blockade in group E + U,respectively.The patients in groups OLV and U received the equal volume of normal saline.The blood samples (5 ml ) were then drawn from the radial artery after anesthesia induction (T0),at 60 min after onelung ventilation (T1),at the end of operation (T2 ) and 120 min after operation (T3) for detecting the plasma concentrations of TNF-α,IL-6 and IL- 10 by enzyme-linked immunosorbent aesay.ResultsCompared with the group OLV and U,the plasma concentrations of TNF-α and IL-6 decreased at T2 and T3 in group E + OLV and group E + U (P ＜ 0.05).CondusionEdaravone pretreatment can reduce pulmonary inflammatory response during selective lobar blockade in patients undergoing thoracotomy.

Objective To investigate the molecular defects of CYPl7A1 gene in a pedigree with two 46,XY patients suffering from 17α-hydroxylase deficiency (17-OHD) and explore the steroid biosynthetic difference in carriers of 17-OHD before and after adrenocorticotrophic hormone (ACTH) test.Methods Clinical data and hormone profiles were collected from the members of the pedigree.CYPl7A1 genotyping was performed in the patients and family members with PCR-direct sequencing.A short ACTH test was evaluated in some cases.Results The CYP17 genes of the patients were proved to hold a homozygous mutation with a base deletion and a base transversion (TAC/AA) in exon 6,which produced a missense mutation of Tyr→ Lvs at codon 329 and changed the open reading frame following this codon.The hormone response of the carriers after ACTH stimulation was abnormal between the patients and normal controls.Conclusion 17-OHD in this family was caused by CYP17A1 mutation (TAC329AA):some hormonal response to ACTH stimulation Was abnormal in carriers.

Objective To study the changes of serum interleukin(IL)-4,IL-12 and correlation with cellular immunity in children with asthma of different stages.Methods Fifty asthmatic children were randomly selected, including 30 cases in attack stage (group A) and 20 cases in remission stage (group R). At the same time, 22 healthy children were studied as normal controls (group N).The levels of IL-12 and IL-4 ,T cells subgroups and erythrocyte immunity were detected.Results 1.Serum IL-12 levels were (24.44? 13.26 ),(42.30?12.65),(44.68?28.28) ng/L in group A, R and N,respectively. There was significant difference in three groups (F=8.92 P