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 determine the content of capsaicin in different kinds of dried capsicums.Methods A RP-HPLC method was established.The chromatographic column was DiamonsilTM C18(250 mm ? 4.6 mm,5 ? m) and the column temperature was 30 ℃.The mobile phase consisted of methnol ∶ 0.1 % phosphoric acid aqueous solution(70 ∶ 30) with a flow rate of 1.0 mL? min-1.The detection wavelength was 281 nm.Results A good linearity of capsaicin was in the rang of 0.100 6～ 4.024 0 ? g.The average recovery was 101.18 % and RSD was 1.81 %(n=6).Conclusion The method can be used to determine the content of capsaicin in different kinds of dried capsicums.

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.

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.

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.

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 evaluate the effect for the treatment of severe asthma. Methods The data of 47 patients with severe asthma who were admitted to emergency department were retrospectively anayzed. Results Of total 47 patients ,45 were rescued, with the survival rate of 95.7%. Arterial blood gas was improved after treatment (P < 0.01). Conclusion Appropriate commencement, mode, strategy, and early weaning of mechanical ventilation, combined with the administration of bronchodilators and eorticosteroids are the important way to rescue patients with severe asthma.

AIM:To examine the effects of hypoxia on sodium-hydrogen exchange 1 (NHE1) expression, in-tracellular Ca2+concentration ( [ Ca2+] i ) and calpain activity, and to explore the effect of amiloride on adenosine triphos-phate-binding cassette transporter A1 (ABCA1) degradation and its calpain-related mechanism.METHODS:RAW264.7 cells were exposed to hypoxia for 0 h, 12 h, 24 h and 48 h.The cell viability was measured by MTT assay and the expres-sion of NHE1 at mRNA and protein levels was detected by real-time PCR and Western blot.[ Ca2+] i was analyzed by flow cytometry.Calpain activity was assessed by the method of Suc-LLVY-aminoluciferin.Furthermore, the protein levels of ABCA1 in the RAW264.7 cells exposed to hypoxia for 24 h were determined after 6 h or 12 h treatment with NHE1 inhibi-tor amiloride in the presence of cycloheximide.ABCA1 protein levels and calpain activity were detected after 12 h incuba-tion with calpain inhibitor ALLN or intracellular calcium-chelating agent BAPTA.RESULTS: Hypoxia inhibited the cell viability in a time-dependent manner.Hypoxia up-regulated the mRNA and protein expression of NHE1, and increased [ Ca2+] i and calpain activity.Hypoxia increased the degradation of ABCA1 and amiloride slowed down the ABCA1 degra-dation.ALLN or BAPTA increased ABCA1 protein level and decreased calpain activity.CONCLUSION:NHE1 inhibitor amiloride attenuates the calpain-mediated degradation of ABCA1, indicating that hypoxia-induced NHE1 might, at least in part, participate in the ABCA1 degradation.

Objective To evaluate the value of serum procalcitonin (PCT)on antibiotic use in treatment of community acquired pneumonia (CAP) in outpatient. Methods From November 2006 to February 2008, a total of 127 patients with CAP in outpatient were randomly assigned into two groups:PCT group(n=63)and control group(n =64). PCT levels of all patients were measured after study admission. On the base of similarly normal treatment, the control group received antibiotics according to the attending physicians and the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level ≥ 0. 25 μg/L and was discouraged with PCT level < 0.25 μg/L. Clinical efficacy, rate of antibiotics use, duration courses and costs of antibiotics were observed. Results Clinical efficacy of the PCT group was similar with the control group (92.1% vs 87.5%, P >0.05) ;rate and costs of antibiotics use was lower, antibiotic duration of the PCT group was shorter than that ofthecontroigroup(P<0.05,P<0.001,P<0.001).Conclusion PCT could be used in treatment of CAP for antibiotic use in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.

Objective To evaluate the impact of depression on 5-year survival rate of elderly patients with chronic obstructive pulmonary disease (COPD).Methods From January 2002 to June 2004, a total of 401 elderly inpatients with COPD were enrolled.They were assigned into two groups according to their HAD-D scores: depression group (HAD-D scores≥8) and non-depression group (HAD-D scores<8).The follow-up time was 5 years.Results The 5-year survival rate was lower in depression group than in non-depression group (log-rank test, χ~2 = 6.94, P<0.01).Depression was independently associated with mortality in elderly patients with COPD (HR: 1.84, 95% CI: 1.08 to 3.11).Conclusions Depression in elderly COPD patients is associated with poor 5-year survival rate, and it is an independent influencing factor of 5-year mortality.