Objective To investigate the clinical effect of butylphthalide combined with naloxone in the treatment of elderly patients with cerebral hemorrhage.Methods A total of one hundred and thirty elderly patients with cerebral hemorrhage were selected in North China University of Science and Technology Affiliated Hospital from December 2012 to December 2014,and were randomly divided into two groups,each group 65 cases.Naloxone was used in the control group,while the observation group adopted butylphthalide combined with naloxone in its treatment.The curative effects were compared between two groups.Results After treatment,homocysteine,C reactive protein,hypoxia inducible factor,neurological function defect score were all significantly decreased in two groups (P<0.05).Homocysteine,C reactive protein,hypoxia inducible factor and neurological function defect score in the observation group were much lower than those of the control group ((10.2±1.3) μmol/L vs.(14.0±1.8) μmol/L,(3.9±1.1) mg/L vs.(6.9±1.4) mg/L,(51.6±10.3) pg/ml vs.(82.5±17.6) pg/ml,(3.7±1.0) points vs.(4.4±0.9) points,t=7.134,10.692,9.078,4.892,P<0.05).The total effective rate in the observation group was significantly higher than that of the control group (98.5% vs.89.2%,χ2=4.795,P<0.05).Compared the complications in two groups,the differences were not statistically significant (P>0.05).Conclusion Butylphthalide combined with naloxone is effective in the treatment of elderly patients with cerebral hemorrhage,which can significantly improve their clinical signs and neurological function.

Objective To investigate clinical value of right ventricular morphology in children with congenital heart disease associated pulmonary hypertension. Methods From October 2014 to October 2017, 37 children with congenital heart disease without associated pulmonary hypertension ( resting pulmonary systolic pressure ≤30 mmHg,1 mmHg＝0. 133 kPa) were selected as group A. Thirty-seven children with congenital heart disease and associated pulmonary hypertension (resting pulmonary systolic pressure＞30 m) . were in group B,and 37 healthy children were in control group. Echocardiography was performed to compare the results of right ventricular morphology and systolic function in three groups. Results ( 1 ) Right ventricular morphology indexes:right atrium upper and lower diameter((56. 8±4. 0) mm),right atrium left and right diameter((49. 2± 3. 3) mm),right ventricle basal segment inner diameter(( 43. 7± 2. 5) mm), right ventricle medial diameter((41. 7±3. 9) mm),right ventricle long axis distance((73. 4±6. 2) mm), sternum sidelines right ventricular outflow tract proximal end diameter((37. 8± 2. 4) mm),short axis view right ventricular outflow tract distal internal diameter (( 33. 6 ± 2. 1) mm),main pulmonary artery internal diameter((30. 5± 2. 5) mm), right ventricle end diastolic area (( 31. 6 ± 1. 8) cm2 ), right ventricle end systolic area((19. 0± 2. 7) cm2 ) in group B were higher than those in group A((46. 2± 3. 1) mm,( 40. 4 ±2. 8) mm,(34. 6±2. 2) mm,(32. 5±2. 6) mm,(65. 1±4. 7) mm,(30. 2±2. 0) mm,( 29. 4±1. 8) mm, (23. 0±1. 6) mm,(22. 5±1. 1) cm2,(11. 6±1. 2) cm2)and control group((45. 3±2. 6) mm,(39. 5±1. 7) mm,(34. 0±1. 9) mm,(31. 8± 2. 0) mm,(63. 2± 3. 8) mm,( 29. 6± 1. 7) mm,(28. 9± 1. 5) mm,(22. 4 ±1. 4) mm,(22. 1±1. 0) cm2,(11. 3±0. 9) cm2),( F＝140. 26,147. 47,223. 08,130. 46,43. 56,183. 33, 74. 71,209. 94,587. 99,221. 34, all P＜0. 01 ) . ( 2) Right ventricle contractile function indexes : right ventricular area change rate((40. 1±1. 6)%),three tricuspid ring systolic displacement((2. 2±0. 2) cm), tricuspid valve peak systolic flow velocity((13. 8±0. 9) cm／s)in group B were lower than those in group A ((46. 3±1. 7)%,(2. 5±0. 3) cm,(16. 7±1. 2) cm／s)and control group((46. 8±1. 5)%,(2. 6±0. 3) cm, (17. 2±1. 4) cm／s),the difference was statistically significant(F＝200. 81,21. 86,88. 85,all P＜0. 01 ) . Conclusion Children with congenital heart disease associated pulmonary hypertension have right ventricle morphological changes and right ventricular systolic function decreasing. Right ventricular morphological examination has important clinical value.

Objective:To evaluate the role of the AMP-activated protein kinase (AMPK)-silent information regulator 1 (SIRT1)-nuclear factor-κB (NF-κB) signaling pathway in reduction of brain injury by panax notoginseng saponins (PNS) in mechanically ventilated rats.Methods:Seventy-two SPF-grade male Sprague-Dawley rats, aged 10 weeks, weighing 357-377 g, were divided into 6 groups ( n=12 each) by a random number table method: sham operation group, model group, PNS low dose group, PNS medium dose group, PNS high dose group, and PNS high dose+ compound C group. PNS 12.5, 25 and 50 mg/kg were intraperitoneally injected in PNS low dose group, PNS medium dose group and PNS high dose group, respectively. In PNS high dose+ compound C group, PNS 50 mg/kg was intraperitoneally injected, and 10 min later compound C 0.2 mg/kg was injected via the tail vein. Normal saline 10 ml/kg was intraperitoneally injected in sham operation group and model group. Drugs or normal saline was injected at 30 min before mechanical ventilation in each group. Mechanical ventilation model: The animals were mechanically ventilated for 6 h, with ventilation frequency 40 times/min, tidal volume 40 ml/kg in model group; The animals were mechanically ventilated for 6 h, with tidal volume 10 ml/kg in sham operation group. Morris water maze test was used to detect the learning and memory function of rats, the concentrations of serum interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α) and dopamine (DA) were detected by enzyme-linked immunosorbent assay, the neuronal counts in the hippocampal CA1 region were determined by Nissl staining, and the expression of P2Y1 purine receptor (P2Y1R), dysbindin-1 and AMPK in hippocampal CA1 region was detected by Western blot. The phosphorylated SIRT1 (p-SIRT1) to SIRT1 ratio and phosphorylated NF-κB p65 (p-NF-κB p65) to NF-κB ratio in hippocampal CA1 region was calculated. Results:Compared with sham operation group, the escape latency was significantly prolonged, the number of crossing the original platform quadrant was reduced, the time of staying at the target platform quadrant was shortened, the serum concentrations of IL-1β, IL-6 and TNF-α were increased, the serum DA concentration was decreased, the nerve count in hippocampal CA1 region was decreased, the expression of P2Y1R and dysbindin-1 was up-regulated, the expression of AMPK was down-regulated, the p-SIRT1/SIRT1 ratio was decreased, and the p-NF-κB p65/NF-κB p65 ratio was increased in model group ( P<0.05). Compared with model group, the escape latency was significantly shortened, the number of crossing the original platform quadrant was increased, the time of staying at the target platform quadrant was prolonged, the serum concentrations of IL-1β, IL-6 and TNF-α were decreased, the serum DA concentration was increased, the nerve count in hippocampal CA1 region was increased, the expression of P2Y1R and dysbindin-1 was down-regulated, the expression of AMPK was up-regulated, the p-SIRT1/SIRT1 ratio was increased, and the p-NF-κB p65/NF-κB p65 ratio was decreased in PNS low dose group, PNS medium dose group and PNS high dose group ( P<0.05). Compared with PNS high dose group, the escape latency was significantly prolonged, the number of crossing the original platform quadrant was reduced, the time of staying at the target platform quadrant was shortened, the serum concentrations of IL-1β, IL-6 and TNF-α were increased, the serum DA concentration was decreased, the nerve count in hippocampal CA1 region was decreased, the expression of P2Y1R and dysbindin-1 was up-regulated, the expression of AMPK was down-regulated, the p-SIRT1/SIRT1 ratio was decreased, and the p-NF-κB p65/NF-κB p65 ratio was increased in PNS high dose+ compound C group ( P<0.05). Conclusions:The mechanism by which PNS reduces brain injury may be related to activation of the AMPK-SIRT1-NF-κB signaling pathway in mechanically ventilated rats.