Objective To investigate the effects of dexmedetomidine preconditioning on nitric oxide (NO)/endothelin (ET)-1 imbalance and remote lung injury induced by lower limb ischemia-reperfusion (LIR). Methods Sixty patients who scheduled for unilateral lower extremity surgery matched American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ, were randomized into two groups:control group (R group, n=30) and dexmedetomidine preconditioning group (PD group, n=30). Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups. In group PD, dexmedetomidine intravenous infusion was started at a dose of 0.125 mL/kg (4 mg/L) for 10 minutes before using tourniquet, whereas group R received an equivalent volume of normal saline. Artery blood gas analysis, respiratory index and oxygenation index were measured, and NO, ET-1, interleukin-8 (IL-8) and malondialdehyde (MDA) concentrations were determined from plasma samples 10 minutes before tourniquet inflation (T0), 15 minutes (T1), 2 h (T2), 6 h (T3) and 24 h (T4) after tourniquet deflation. Results Compared with T0, RI was higher at T3 in group R and OI was lower at T2-4 (P＜0.01). There were no significant differences in RI and OI of group PD between different time points (P＞0.05). In R and PD groups, ET-1, IL-8 and MDA concentrations were increased, while NO level and NO/ET-1 ratio were significantly decreased after tourniquet deflation (P＜0.05). Compared with group R, RI was lower and OI was higher at T3 in group PD (P＜0.01). The levels of ET-1, IL-8, MDA, NO and NO/ET-1 ratio were significantly different after tourniquet deflation between group PD and group R (P＜0.05). In group R, there was positive correlation between ET-1 and IL-8 levels with RI, and negative correlation between ET-1 and IL-8 levels with OI (P＜0.01). There was positive correlation between NO level, NO/ET-1 ratio and RI level (P＜0.01). Conclusion Lung function impairment induced by tourniquet application could be attenuated by dexmedetomidine preconditioning based on protecting endothelial cells and inhibiting lipid peroxidation.

Aim To evaluate the effects of aspirin on the expression of inflammatory proteins induced by oxidized low-density lipoprotein(ox-LDL) in human vascular endothelial cells (HUVECs). Methods HUVECs were stimulated with different concentrations of ox-LDL. The expression of inflammatory proteins was detected by Western blot.Intracellular ROS generation was measured by flow cytometry using perexide-sensitive flurscent probe 2′, 7′-dichrofluorescein diacetate(DCFH-DA).Results ① Aspirin inhibited COX-2 expression induced by ox-LDL. Cells were preincubated with 2.5 mmol?L-1, 5 mmol?L-1 of aspirin or without any treatment for 30 min and then stimulated by 0.3 g?L-1 ox-LDL for 16 h, COX-2 expression was reduced by treating of aspirin.COX-2 expression was enhanced after the stimulation with ox-LDL, and aspirin inhibited the increasing.② Aspirin suppressed ICAM-1 expression induced by ox-LDL in HUVECs. ICAM-1 expression was increased by ox-LDL stimulation for 16 h, and aspirin significantly down-regulated the expression. Similar results were obtained by immunofluorescence.③ Aspirin partially reduced ROS production induced by ox-LDL in HUVECs. After stimulation with 0.3 g?L-1 ox-LDL for 16 h, the intracellular level of ROS was increased, however, aspirin failed to fully inhibit the phenomenon.Conclusion Nonsteroidal anti-inflammatory drugs (NSAID) aspirin significantly down-regulated the expression of COX-2 and ICAM-1 induced by ox-LDL.The results suggested that aspirin could reduce the inflammation responses mediated by ox-LDL on HUVECs in atherosclerosis.

Background Stickler syndrome is a genetic connective tissue disorder that affects the ocular,skeletal,orofacial and auditory systems.To determine the gene mutation loci can offer a basis for genetic diagnosis and management of Stickler syndrome.Objective The aim of this study was to research the clinical characteristics of a pedigree with Stickler syndrome and identify the disease-causing gene mutation.Methods This study was approved by Ethic Committee of Peking Union Medical College Hospital.The clinical study and pedigree analysis were performed in one family with Stickler syndrome type Ⅰ (STL Ⅰ).Nine family members were examined with informed consent.The entire coding regions of COL2A1 gene with flanking intronic regions were amplified by PCR and directly sequenced.The detected sequence change was confirmed to be mutationloci by examining whether they existed in normal control individuals.Mutant proteins were predicted with online software.Results There were 4 generations and 11 members in this family,and 2 members died,including 1 patient.Three patients were found in 9living families.Inheritance of this family complicd with an autosomal dominant inheritance mode.All affected individuals showed the consistent phenotypes with STL Ⅰ,including high myopia,membranous vitreous anomaly and surface central flat,short nose,palatoschisis,etc.Mutation screening of COL2A1 gene revealed that the first base of intron 12 was deleted(IVS12+1G del).Nucleotide sequence analysis showed that this mutation led to the functional abnormal of this gene by forming termination cordon in advance.This mutation occurred in all affected individuals,however,no mutation was observed in any unaffected member or 100 normal unrelated individuals.Conclusions This study identifies a novel splice-site mutation(IVS12+ 1G del)in COL2A1 gene in a Chinese STL Ⅰ pedigree.This is the first report on a mutation in a Chinese STL Ⅰ family.

Objective To study the efficacy and safety of polyethylene glycol electrolytes powder (Ⅱ)on bowel preparation in elderly people.Methods A total of 120 elderly patients were divided into two groups,polyethylene glycol electrolytes powder(Ⅱ)group (the experimental group,n =60)and oral colonic salt group (the control group,n =60).The bowel preparation scores,gastrointestinal compliance,patient compliance,and safety of patients were evaluated.Results Bowel preparation scores of the experimental group (7.42 ±1.05)was much better than that of the control group(5.87 ±1.05)(t =8.10,P =0.00). The efficiency rate of bowel preparation of the experimental group was significantly higher than that of the control group(95% VS 65%,χ2 =16.88,P =0.00).Compliance of bowel preparation of the experimental group was much better than that of the control group (χ2 =7.67,P =0.01).There was no significant differ-ence in gastrointestinal compliance between the two groups(χ2 =3.08,P =0.08).No serious adverse events occurred.Conclusion The effect of bowel preparation of elderly patients with polyethylene glycol electro-lytes powder(Ⅱ)is significantly advantageous in drug intestinal tolerance,taste,and safety,which can re-place the traditional method for bowel preparation.

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed

Objective By studying the prescriptions and medicines for treating rheumatoid arthritis (RA) prescribed by modem doctors, we tried to provide new ideas for developing the new medicines for treating rheumatoid arthritis. Methods 340 prescriptions on treating rheumatoid arthritis were collected from core medical periodicals and books published in the recent 20 years. Make a statistical analysis to the medicines in these prescriptions according to TCM etiological and pharmaceutical theories and modern researching foundlings. Results Among all 254 Chinese medicines used for treating RA, 32 medicines belong to worm and vine medicines, being used for 806 times. Conclusion The worm and vine medicines are frequently used in treating RA with good therapeutic effects combined with other kinds of medicines.

OBJECTIVETo explore the optimized rehabilitation program in the treatment of post-stroke hemiplegia at the recovery stage.

METHODSBased on the randomized controlled principle, 60 patients were randomized into an rehabilita tion + massage group (group A) and an rehabilitation + acupuncture group (group B), 30 cases in each one. Bobath sport therapy and functional training were adopted in the two groups. In the group A, the massage therapy was added. The rolling method and palm-rubbing method were used on the affected side, the pressing, kneading and plucking methods were applied to Jianliao (LI 15), Jianzhen (SI 9), Quchi (LI 11), Huantiao (GB 30), Weizhong (BL 40), Chengshan (BL 57), Zusanli (ST 36) and the other acu points; and the nipping method was adopted at the twelve Jing-well points. In the group B, acupuncture was applied to Baihui (BL 20), Jianliao (LI 15), Quchi (LI 11), Shousanli (LI 10), Huantiao (GB 30), Yanglingquan (GB 34), Jiexi (ST 41) and the other acupoints. The treatment was given once a day, 5 treatments a week in the two groups. The efficacy was evaluated in 3 weeks. Fugl-Meyer scale, Barthel index (BI) score, modified Rankin scale and stroke-specific quality of life (SS-QOL) were used to assess the limb motor function, the activity of daily life (ADL), independent activity of life and the quality of life of the patients in the two groups before and after treatment. Based on the total cost and benefit, the health economics evaluation was conducted in the patients of the two groups.

RESULTSThe treatments all improved the limb motor function (group A: 26.00 (22) vs 37.00 (33); group B: 30.50 (21) vs 39.50 (36)), the independent activity of life, ADL (group A: 43.50 +/- 22.25 vs 57.50 +/- 22.25; group B: 52.83 +/- 16.59 vs 66.67 +/- 12.82) and the quality of life (group A: 122.23 +/- 30.00 vs 145.50 +/- 28.14; group B: 132.43 +/- 23.87 vs 151.47 +/- 22.37) in the patients of the two groups. The differences in all the indices were significant statistically before and after treatment in the two groups (all P<0.05). Above indices after treatment were not different obviously between the two groups (all P>0.05). In terms of health economics, the expense was decreased by RMB 688.48 while BI was increased by every 5 score in group A in comparison with the group B.

CONCLUSIONBoth the rehabilitation and massage therapy and the rehabilitation and acupuncture therapy improve the limb motor function and the quality of life in the patients of post-stroke hemiplegia. The therapeutic efficacies are similar between the two therapeutic programs. The program of rehabilitation and massage is more economical in the aspects of ADL improvement, being advantageous at simple operation and low cost.

Acupuncture Therapy ; Aged ; Combined Modality Therapy ; Female ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Male ; Massage ; Middle Aged ; Motor Activity ; Stroke ; complications ; Treatment Outcome

Objective:Thought reviewing the literature of prescription of treating rheumatoid arthritis(RA)to enrich and improve the theory of treating RA and provide the instruction for the clinical practice of treating RA.Methods:340 Prescriptions of treating RA were collected,these prescriptions were analyze according to the theory of traditional Chinese medicine.Results:Principle of treating RA was strengthening healthy qi to eliminate pathogens.Conclution:The traditional therapeutics of RA was plentiful,and provided theory nucleus and reference for treating RA.

Objective To evaluate the role of mitochondrial permeability transition pore (mPTP) in sevoflurane-induced inhibition of apoptosis induced by oxygen-glucose deprivation and restoration (OGD/ R) in rat neurons.Methods Cortical neurons isolated from neonatal Sprague-Dawley rats born within 24 h, were cultured primarily and seeded in 6-well plates (2 ml/well) at a density of 1 × 106 cells/ml.The neurons were randomly divided into 5 groups (n =72 each) using a random number table: control group (group C), OGD/R group (group O), mPTP opener group (group A), mPTP opener + sevoflurane group (group AS) , and sevoflurane group (group Sev).The cells were cultured in normal culture medium in group C, and the cells were subjected to OGD for 90 min followed by restoration of O2-glucose supply for 24 h in the other groups.In A and AS groups, mPTP opener atractyloside 20 μmol/L was added immediately after OGD.In Sev and AS groups, the cells were post-conditioned with 2％ sevoflurane for 1 h immediately after OGD.The neurons were collected at 24 h of OGD in O and A groups, or at 23 h of OGD in Sev and AS groups.Annexin V-FITC/PI double staining was performed to count apoptotic neurons, apoptotic rate was calculated, and cell survival rate was measured using MTT assay.The mitochondrial membrane potential (MMP) was measured by using JC-1 fluorescence probe as indicator.The opening of mPTP was determined through assessing the changes of mitochondrial optical density (△OD540 of mPTP).The expression of pro-apoptotic factors Bid, Bim, Puma protein and mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction and Western blot.Results Compared with group C, apoptotic rate was significantly increased, cell survival rate and MMP were decreased, the opening of mPTP was increased, and the expression of Bid, Bim, Puma protein and mRNA was up-regulated in the other groups.Compared with group O, apoptotic rate was significantly decreased, cell survival rate and MMP were increased, the opening of mPTP was decreased, and the expression of Bid, Bim, Puma protein and mRNA was down-regulated in Sev group.Compared with group Sev, apoptotic rate was significantly increased,cell survival rate and MMP were decreased, the opening of mPTP was increased, and the expression of Bid, Bim, Puma protein and mRNA was up-regulated in A and As groups.Compared with group A, apoptotic rate was significantly decreased, cell survival rate and MMP were increased, the opening of mPTP was decreased, and the expression of Bid, Bim, Puma protein and mRNA was down-regulated in group AS.Conclusion Sevoflurane mitigates OGD/R-induced apoptosis in rat neurons through inhibiting mPTP opening.

Constitution of TCM is based on the study of individual constitution and physical health,and it has also drawn attention from the medical profession in the world.This commentary has reviewed about the development of constitution of TCM over the past few years,summed up the past 30 years,especially analysis the new research fruits during 2005-2006,expounded the important status of Chinese medical constitution in the development of Chinese medicine and the significance in socio-economic sustainable development,and put forward the direction of development and research for Chinese medical constitution.