Objective To investigate the influence of acute hypervolemic hemodilution (AHH) on pharmacodaynamics of cisatracurium in patients undergoing general anesthesia. Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-60 yr scheduled for major abdominal surgery under general anesthesia were randomly allocated into 2 groups (n = 30 each): control group and AHH group. Each group was further divided into 3 subgroups according to the initial dose of cisatracurium (30, 40, 50 μg/kg) . The radial artery and right internal jugular vein were cannulated. BP, HR, CVP, SpO_2, P_(ET) CO_2 and body temperature were continuously monitored. The response of left adductor pollicis muscle to TOF stimulation of ulna nerve was monitored using TOF- Watch~R SX (Organon). Both groups received 10 ml/kg multiple electrolyte solution (plasma-Lyte A) during induction of anesthesia. In group AHH 15 ml/kg 6% hydroxyethyl starch (HES) 130/0.4 solution was infused via internal jugular vein over 30-40 min in addition to plasma-Lyte A. Five minutes after completion of plasma-Lyte A or HES, cisatracurium 30, 40 or SO fig/kg was injected iv in the respective subgroups. After the maximal T_1 block was achieved, the second dose was given to reach a total dose of 100 μg/kg. The onset time, duration of clinical action, total duration of action and recovery index were recorded. The doses for 50% , 90% and 95% T_1 depression (ED_(50), ED_(90), ED_(95)) were calculated by Probit method. Results The ED_(50), ED_(90), ED_(95) of cisatracurium were significantly higher in AHH group than in control group. The onset time of cisatracurium was significantly longer but clinical and total duration of action was significantly shorter in AHH group than in control group. There was no significant difference in recovery index between the two groups. Conclusion AHH can decrease the potency of cisatracurium.

Objective To establish a rabbit model of acute lung injury induced by one-lung ventilation (OLV) .Methods Sixteen New Zealand white rabbits weighing 2.3-2.7 kg were randomly divided into 2 groups (n=8 each):conventional tidal volume(VT) group (group Ⅰ) and high VT group (group Ⅱ).All the rabbits were tracheostomized and a tracheal tube was inserted into the right bronchus for right lung ventilation in the two groups. VT was set at 6 ml/kg in group Ⅰ and at 12 ml/kg in group Ⅱ and the other ventilatory parameters were the same in the two groups (FiO2 50% , RR 40 bpm, I∶E=1∶2). Immediately before OLV(T0) and at 1, 2 and 3 h of OLV (T1-3), peak airway pressure was measured and arterial blood samples were taken for blood gas analysis and oxygenation index (OI) was calculated. The animals were sacrificed at 3 h of OLV and lung tissues obtained for microscopic examination.The lung injury was scored. W/D lung weight ratio was calculated. Bron-choalveolar lavage fluid (BALF) was collected for measurement of protein concentrations and neutrophil counts. Results The peak airway pressure was significantly higher at T1-3 in group Ⅱ and OI was significantly lower at T2,3 in the two groups than those at T0(P＜0.05) .W/D lung weight ratio and lung injury scores of the right lung were significantly lower than those of the left lung in the two groups(P＜0.05).The peak airway pressure was significantly higher at T1-3, OI was significantly lower at T3, and W/D lung weight ratio, protein concentrations and neutrophil counts in BALF and lung injury scores of the right lung were significantly higher in group Ⅱ than in group Ⅰ(P＜0.05). Conclusion OLV with VT of 12 ml/kg for 3 h can successfully establish a rabbit model of acute lung injury.

Objective To evaluate antiangiogenic therapeutics effect with contrast-enhanced gray-scale ultrasound.Methods Kun-min mouse with subcutaneously implanted H22 mice hepatoma were treated with thalidomide or placebo by oral gavage over 7 days, starting at clay 2 post-implantation.Contrast-enhanced gray-scale ultrasound was performed on day 8.The tumor maximum cross-sectional area and non-enhanced area in ultrasound imaging were measured on the ultrasound machine.The percent of non-enhanced area from contrast-enhanced gray-scale ultrasound was calculated.Immediately after imaging, minces were euthanized and tumor tissue removed for fixation in a 10% formalin solution.The section equivalent to ultrasound imaging plane was stained with Hematoxylin and Eosin(HE) to allow for assessment of maximum cross-section area and necrotic area.The percent of necrotic area from HE stained section was calculated.Results The difference of maximum cross-sectional area measured in ultrasound and pathology slice was not significant between control and treated tumors (P >0.05).Ultrasound measurement of the tumor non-enhanced area and the percent of non-enhanced area were significantly larger in treated tumors than in control tumors (P <0.001).The necrotic area and the percent of necrotic area measured from HE stained section were also significantly larger in treated tumors than in control tumors (P < 0.001).The maximum cross-sectional area determined by the two methods was well corrected (r = 0.815, P < 0.001).There was good correlation between the non-enhanced area in contrast-enhanced gray-scale ultrasound and the necrotic area in pathology slides (r = 0.909, P <0.001).The percent of non - enhanced area calculated from ultrasound highly correlated with necrotic area estimated by pathology slides (r = 0.910, P <0.001).Conclusions Contrast-enhanced gray-scale ultrasound can detect the intratumoral necrosis and changes of tumor perfusion caused by antiangiogenic treatment before apparent change in tumor volume.

Objective To evaluate the effect of cisplatin on analgesia with morphine in rats with incisional pain.Methods Forty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 6 groups (n =7 each) using a random number table:normal saline group (group C),normal saline + Pglycoprotein inhibitor LY335979 group (group CL),normal saline + morphine group (group CM),cisplatin group (group S),cisplatin + morphine group (group SM) and cisplatin + morphine + LY335979 group (group SML).Cisplatin 2 mg/kg was injected intraperitoneally once every two days for 5 times in S,SM and SML groups,while the equal volume of normal saline was injected intraperitoneally in C,CL and CM groups.At 2 days after the end of administration,the incisional pain models were established.At 10 min after establishing the model,normal saline 2 ml was injected subcutaneously in C and S groups; LY335979 20 mg/kg was injected via the caudal vein and normal saline 2 ml was injected subcutaneously in group CL; morphine 2 mg/kg was injected subcutaneously in CM and SM groups; LY335979 20 mg/kg was injected via the caudal vein and morphine 2 mg/kg was injected subcutaneously in group SML.Cumulative pain score was used to evaluate analgesia.Results Compared with group C,cumulative pain scores were significantly decreased in group CM,and no significant change was found in cumulative pain scores in CL and S groups.Compared with group CM,cumulative pain scores were significantly increased in group SM,and no significant change was found in cumulative pain scores in group SML.Cumulative pain scores were significantly lower in group SML than in group SM.Conclusion Cisplatin can weaken analgesia induced by morphine in rats with incisional pain through enhancing P-glycoprotein function in the blood-brain barrier.

Turkey is a presidential republic country located in the Eurasian continent, which has a universal health coverage since the health reform in 2003. The leading causes of death in this country are ischemic heart disease, stroke, and lung cancer. Besides, lower respiratory infections, chronic kidney disease, and hypertensive heart disease are the diseases which have a fastest growing rate. Chinese acupuncture was officially recognized by Turkey in 1991 with the promulgation of Acupuncture Treatment Legislation. At present, only trained practitioners and dentist could conduct acupuncture treatment, which was stated in Regulation of Tradition and Complementary Medicine Practice. The application of Turkish acupuncture and moxibustion is still applied in a simplified way that lack of TCM theory. Moreover, Chinese herbal medicine is still not officially recognized and still under control of the Ministry of Agriculture. Therefore, it is suggested to introduce TCM theory in the spread of acupuncture, to promote acupuncture research and clinical practice, to clarify the different standards between the two countries, and to cooperate in Chinese medicine researches, especially those related to the local high incidence and refractory disease so as to promote the development of TCM in Turkey and provide medical services for local residents.

Indonesia is an island country in Southeast Asia. In 2014, Indonesia established the National Health Insurance System (NHIS), and until 2019, the NHIS hadcovered 82% residents. The leading causes of death in Indonesia were stroke, ischemic heart disease, diabetes, tuberculosis and cirrhosis. In 1996, the Indonesian Ministry of Health allowed acupuncturists to enter Indonesian medical institutions to practice acupuncture. After that acupuncture was included in college education as a major course. However, there are still some problems, such as insufficient policy and legislation support of Traditional Chinese Medicine (TCM), imperfect education and talent training system of TCM, and low acceptance of TCM theories. Therefore, it is recommended that the local societies and organizations could actively promote the government’s legislation on TCM; local TCM schools could build a team of excellent teachers, improve teaching quality, and cultivate local TCM talents; strengthen the cooperation and exchanges of traditional medicine between the two countries to promote the spread and development of TCM in Indonesia.

Thailand is a constitutional monarchy located in the central and southern part in Southeast Asia. It mainly implements the civil service insurance plan, the social insurance plan and the "Thai 30" plan, and the government bears the main health expenditures. The Thai traditional and alternative medicine system includes Thai traditional medicine, indigenous medicine and alternative medicine. Traditional Chinese Medicine (TCM) belongs to the category of alternative medicine. Currently, Thai traditional medicine and Chinese acupuncture have been included in medical insurance. With Thailand’s approval of doctors to use Chinese medicine to treat diseases published (Notification No.1 of BE 2543), a series of activities such as the establishment of national TCM center, the certification of TCM doctors, and the set of TCM courses and training have promoted TCM development in Thailand. However, the application of Chinese herbal medicine is restricted by Thai medicine laws; the practical skills of acupuncture and moxibustion is insufficient; and the TCM education is not systematic and complete. Therefore, it is recommended to carry out extensive and continuous publicity in the future to promote policy and legislative support; to strengthen research and development of Chinese patent medicine on popular diseases in Thailand and promote localization; to establish a special practice training center to improve acupuncture clinical operation capacity; to add and refine the content of TCM regarding university education system as well as short-term training; and to encourage cooperation between China and Thailand in talent exchanges and scientific researches, promoting the development of TCM in Thailand.

India is a parliamentary republic country located in South Asian. Its medical and healthcare insurance is paid by the state government and it has the world’s largest "free medical" service system. India has a long history of traditional medicine (TM) represented mainly by Ayurveda, Naturopathy, Yoga etc. As early as the 2nd century BC, Traditional Chinese Medicine (TCM) was introduced to India along with religious exchanges and trade activities. At present, acupuncture has achieved independent legal status in India and there are many acupuncture clinics and associations. However, non-acupuncture TCM treatments lack development in India, but the application of acupuncture lacks of systematic standards.

South Africa is an ethnically and culturally diverse presidential republic country. The medical and health system consists of public and private medical care. AIDS, lower respiratory infections, neonatal diseases, and interpersonal violence and road injuries are the leading causes of adult death. South Africa has rich herbal resources, and a long history of traditional medicine, which is mainly black African traditional medicine. Until the establishment of diplomatic relations between China and South Africa in 1998, the development of TCM was significantly improved, and legislation of TCM was adopted by the government in 2000. Chinese herbal medicine has not yet formed industrial standardization, the TCM application and TCM education are insufficient. Therefore, it is suggested to accelerate the standardization of TCM, to strengthen the TCM education for professional TCM practitioners, and to form a large-scale, industrial and standardized development model. Only in these ways can TCM provide good medical services for residents in South African.

Serbia is a parliamentary republic country in Southeast Europe. It implements a health security system with social insurance as the mainstay and social assistance as a supplement. Ischemic heart disease, stroke and Alzheimer’s disease are the major causes of death, and the mortality rates of cardiomyopathy and chronic kidney disease are increasing. Serbia has relevant legislation on traditional medicine. Acupuncture, as the main form of Traditional Chinese Medicine (TCM), has been introduced to Serbia in an early stage. Acupuncture was recognized as a legal medical method in 2005, and then the corresponding educational institutions of TCM were established soon. However, the limitation of acupuncture treatment application, difficulty in access to Chinese medicine, and undeveloped of TCM education system, all of them restrict the development of TCM in Serbia. It is recommended to improve the development and dissemination of Chinese medicine in Serbia, like to increase the promotion of acupuncture, pay attention to the Chinese medicine for preventive health care, and strengthen TCM education.