Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

For probing into therapeutic effect, action, and proper and effective administration way of Jiang Ni Fu Sheng Liquid for treatment of acute cerebral hemorrhage, 150 cases were assigned at random to two groups to receive different therapies. Integral of hyponeuria, change of disturbance of consciousness, change of blood pressure, CT and clinical therapeutic effect were observed before and after treatment in the two groups. Results showed that the therapeutic effect in the treated group was obviously superior to that in the control group, with a markedly effective rate of 51. 1% and an effective rate of 90. 0%. It is suggested that Jiang Ni Fu Sheng Liquid has the action of relieving disturbance of consciousness, promoting recovery of nervous function, keeping stability of blood pressure, accelerating absorption of cerebral hemorrage, alleviating cerebral edema and hemorrhage of digestive tract, and so on.

OBJECTIVE To analyze the prophylactic application of antibiotics during perioperative period in surgical department and provide the scientific basis for management and rational application of antibiotics.METHODS The rational use of antibiotics during perioperative period was evaluated based on antibiotics selection,usage,dosage,the first time of application,treatment course,and the percentage of antibiotic application for cleaning operation.RESULTS All of surgical operations were used antibiotics.As for the first time of application,the use rate of thirty minutes before operation was 4.1%,but nothing used before operation was 73.2%.The treatment period after operation within 3 days was 8.1%.Among all kinds of used antibiotics,the third generation of cephalosporin accounted for 49%,and quinolones for 25%.CONCLUSIONS There are still some problems about prophylactic application of antibiotics during perioperative period in surgical department in our hospital.It is necessary to standardize application of antibiotics during perioperative period.

BACKGROUND: +Gz-induced acute dysencephalia and its protection is one of the significant topics in Aero-medical researches. Its pathological mechanism, however, is still unclear and protective measures should be developed further. OBJECTIVE: To observe the expression of inducible nitricoxide synthase (iNOS) in brain tissue after +Gz exposure and to analyze the protective effects of danshen and basic fibroblast growth factor (bFGF) on repeated +Gz exposure-induced brain injury. DESIGN: Randomized controlled animal study. SETTING: Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA from April to August 2000. A total of 20 healthy SD rats of clean grade were divided into 5 groups according to randomly digital table, including control group, +Gz exposure group, bFGF group, danshen group and saline group with 4 in each group.METHODS: All rats were fixed on rotatory arm of centrifugal apparatus,and their heads were towards core of the apparatus. Except the rats in control group, the value of +Gz exposure was +14 Gz, and the growth rate was 1.5 G/s. The exposure at peak value lasted for 45 s. +Gz exposure was done for three times, and the interval was 30 minutes. Rats in the control group were also treated with the same +Gz exposing procedure, but the G value was +1 Gz. Rats in bFGF group and danshen group were intraperitoneally injected with 100 μg/kg of bFGF and/or 15 g/kg of danshen solution, respectively, at 30 minutes before centrifugation and immediateness after centrifugation; moreover, rats in saline group were injected with the same volume of saline. Six hours after exposure, rats were cut off their heads to obtain the brains which were maintained in liquid nitrogen for RNA extraction. The expression of iNOS mRNA in brain tissues of the rats in each group was detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and calculated on the basis of ratio between iNOS and glyceraldehyde-3-phosphate dehydrognase.MAIN OUTCOME MEASURES:Expressed level of iNOS mRNA in brain tissue of rats.RESULTS: Expression of iNOS mRNA in brain tissue was higher in repeated +Gz exposure group than that in control group (0.452 ±0.014,0.065±0.008, P ＜ 0.01); however, that was lower in bFGF group and dan-shen group than that in +Gz exposure group (0.196±0.010, 0.183±0.011,0.452±0.014, P ＜ 0.01).CONCLUSION: Repeated +Gz exposure can increase the expression of iNOS mRNA, this plays an important role in cerebral injury induced by repeated +Gz exposure. Moreover, bFGF and danshen have protective effects on cerebral injury induced by +Gz exposure.

Objective To investigate the value of CD5 molecule-like protein(CD5L) and partial pressure of CO2 in arterial blood(PaCO2) in predicting the survival of patients with severe asthma and mechanical ventilation.Methods From Jan.2013 to Jan.2016,a total of 38 patients with severe asthma and mechanical ventilation were enrolled.Acute Physiology and Chronic Health EvaluationⅡ(APACHE II)were used to assess the severity.Enzyme linked immunosorbent assay was used to detect serum levels of CD5L at admission and 6 h after treatment.PaCO2 were also detected.Pearson correlation analysis was used to analyze the correlation between APACHEⅡ score and CD5L and PaCO2 levels.Receiver operation characteristic(ROC) curve was used to evaluate the value of CD5L and PaCO2 in predicting the survival of patients.Results APACHEⅡscores of survival patients were significantly higher than dead patients(P<0.05).CD5L level of survival patients after treatment was significantly lower than dead patients,while PaCO2 level was significantly higher(P<0.05).APACHEⅡ score was negatively correlated with serum CD5L level(r=-0.347,P<0.05),while positively correlated with PaCO2 level(r=0.573,P<0.05).ROC curve analysis showed that serum CD5L and PaCO2 were with predictive value for prediction the survival of patients,with sensitivity of 93.33%,specificity of 75.00%,accuracy of 89.47%,positive predictive value of 93.33%,and negative predictive value of 75.00% for CD5L,and those for PaCO2 were 90.00%,87.50%,89.47%,97.42% and 70.00%.Conclusion With the decreasing of CD5L level and increasing of PaCO2 level,severity of disease in patients with severe asthma and mechanical ventilation could be more serious condition,indicating poor prognosis.CD5L and PaCO2 could be with fine predictive value of survival of patients with severe asthma and mechanical ventilation.

Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.

Objective To investigate the possible effects and underlying mechanisms of desferroxamine (DFO) preconditioning against hypoxia in neurons. Methods Cortical neurons were cultured in DFO under ischemia condition of oxygen-glucose deprivation (OGD). Cell viability was determined by cell counting kit-8 (CCK-8) method; apoptotic cell ratio was examined with Hoechst 33342 staining; the morphological change was observed. Middle cerebral artery was occluded with or without DFO administration to establish the cerebral ischemia rat model. Infarct sizes were examined by TIC staining, and the neurological severity score was evaluated. Meanwhile immunofluorescent staining was employed to detect the protein synthesis of hypoxia inducible factor-1 (HIF-1) and erythropoietin (EPO), RT-PCR was performed to detect the mRNA expression of HIF-1 and EPO as well Results Neuronal viability kept in 49% (OGD group was 25%, t =8. 544, P<0. 05), the rate of apoptosis was 38% (OGD group was 30%, t = 4. 409, P <0.05 ) after administration of DFO (post-DFO) , the morphology of neurons improved. In the model of focal cerebral ischenfia of 30 mg/kg group, neurological severity score was reduced, the percentage of brain infarct decreased 8.5% (t=4.649, P<0.05) 3 days post-DFO(vs control). In the 100 mg/kg group, neurological severity score was 7.44 ±0.39 (t=2.903, P<0.05 ) ,5.60±0.47 (t=10.143, P < 0.01 ) ,6.97 ±0.73 (t=3.142, P<0.05 ), the percentage of brain infarct decreased 12. 0% (t=5.056, P<0.05), 32.3% (t =10.993, P<0.01), 10.6% (t =4.385, P<0.05)2,3 and7 days post-DFO(vs control), respectively. Immunofluorescent staining found synthesis of HIF-1α and EPO in cultured cortex neurons after DFO pretreated; HIF-1α and EPO were upregulated in the neurons of rat brain after DFO pretreated. The mRNA of HIF-1α and EPO upregulated in vivo and in vitro. Conclusion DFO preconditioning can protect the brain against ischemic damage, which is related to the protective effect on neurons. The mechanism of DFO preconditioning may be involved in the expression of HIF-1α and EPO in vivo and in vitro.

To study the effect of Feiyanning Decoction (FYN), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) activated by tumor necrosis factor-α (TNF-α) in human lung adenocarcinoma epithelial cell line (A549).