Objective The purpose of this study was to investigate the effects of cardiopulmonary bypass(CPB) on monocyte HLA DR expression and immune function Methods Sixteen ASA Ⅱ Ⅳ patients [mean age (38 5?5 1)yr,mean body weight (42 9?10 2kg)] of both sexes (male 7,female 9) with rheumatic value disease undergoing mitral value replacement (11 patients) and mitral value and aortic value replacement (5 patients) with moderate hypothermic CPB were enrolled in this study Another ten patients undergoing lung lobectomy were used as control group Patients suffering from infection, immuno deficiency or receiving corticosteroid or immunoregulatory drugs were excluded Premedication included intramusallar midazolam 0 1mg?kg -1 and morphine 0 1mg?kg -1 Anesthesia was induced with intravenous midazolam 0 15mg?kg -1 , fentanyl 8?g/kg and vecuronium 0 1mg?kg -1 and maintained with isoflurane inhalation (0 8%～1 2%) and intermittent boluses of fentanyl and vecuronium The total dose of fentanyl was (18 3?3 2)?g/kg in CPB group and (9 6?1 3)?g/kg in control group CPB time was (74 2?22 5) min and aortic clamping time (57 5?19 2) min Blood samples were taken from CVP line before and 5 min after induction of anesthesia, before and after CPB and on the 1st, 3rd and 5th postoperative day for determination monocyte count and percentage of HLA DR + monocytes Results The number of monocytes decreased at the end of surgery but greatly increased on the postoperative days The percentage of HLA DR + monocytes also decreased at the end of surgery and decreased further on the 1st postoperative day but started increasing on the 3rd postoperative day In two patients who developed infection the percentage of HLA DR + monoeytes was lower than the average percentage of HLA DR + monocytes of the other 14 CPB patients In control group the percentage of HLA DR + monocytes also decreased significantly after operation but there was no significant change in the number of monocytes However there was a significant difference in monoeyte HLA DR expression between the two groups Conclusions The changes in monocyte HLA DR expression and monocyte count may be induced by impaired immune response after CPB and dynamic monitoring of monocyte HLA DR expression may help to predict complication of infection after CPB

Objective To investigate the gradient changes of bilateral cerebral hemisphere pressure after lateral hemisphere injury and observe their effects on craniotomy. Methods Twenty-four patients with cerebral contusion and subdural intracerebral hematoma were included in this study. All patients received brain parenehyma pressure (BPP) monitoring by introducing optic fibro sensor into each cerebral hemisphere via the frontal lobe. All patients underwent surgical craniotomy for evacuation of space occupying lesions such as cerebral hemisphere contusion, subdural and/or intracerebral hematoma.Preoperative and postoperative BPP data at different time points were recorded and analyzed. Results Preoperative BPP value of the injured hemispheres was significantly higher than that of the other hemisphere (P ＜ 0. 01 ). There was no significant statistical difference upon BPP value at 0, 24 and 48 hours after operation between both hemispheres ( P ＞ 0.05 ). The postoperative BPP value of bilateral hemispheres was lower than the preoperative one. Conclusions BPP monitoring sensors should be introduced into the injured hemisphere so that the valuable information can be timely showed. When the cerebral hemisphere has lesions after brain injury, such lesion becomes the source of elevated intracranial pressure and can result in bilateral hemisphere pressure gradient. Craniotomy can not only effectively lower the intracranial pressure, but also eliminate the BPP gradient, which contritbutes to reposition of the oppressed brain tissue.

0.05). Postoperative cataract incidence was higher in the patients without IOL implantation than that in the patients with IOL implantation. Postoperative cataract appeared 6 months after operation in the patients without IOL implantation, while it appeared 14 months after operation in the patients with IOL implantation. There was no significant difference in the postoperative complications between group A and group B. Conclusions Combined surgery is effective and safe for the selected patients of primary retinal detachment accompanied with cataract.

OBJECTIVETo observe the efficacy and safety of acupuncture therapy on moderate and severe allergic rhinitis via the comparison evaluation of western medicine.

METHODSSixty cases of moderate and severe allergic rhinitis were divided into an acupuncture group (30 cases) and a western medicine group (30 cases). In the acupuncture group, the main acupoints included Yingxiang (LI 20), Shangxing (GV 23), Fengchi (GB 20), Quchi (LI 11), Xuehai (SP 10), Feishu (BL 13), Geshu (BL 17), Pishu (BL 20), etc. The supplementary points were selected according to syndrome differentiation. In the western medicine group, budesonide nasal spray and cetirizine tablets were prescribed. All the cases were treated for 8 weeks in the two groups. Separately, before treatment, in 4 weeks and 8 weeks of treatment, the scores of clinical symptoms and physical signs were observed and the clinical efficacy and safety were compared between the two groups.

RESULTSIn 4 weeks and 8 weeks of treatment, the scores of symptoms such as sneezing, nasal discharge, nasal obstruction, nasal itching, eye itching and turbinate hypertrophy, the score of physical signs and total score were all reduced apparently as compared with those before treatment (all P<0. 05). The differences were not significant between the acupuncture group and the western medicine group (all P>0. 05). The total effective rates were 90. 0% (27/30) and 93. 4% (28/30) in the acupuncture group after 4 and 8 weeks of treatment, and were 76. 6% (23/30) and 80. 0% (24/30) in the western medicine group separately, without significant difference in comparison (all P>0. 05).

CONCLUSIONAcupuncture achieves the similar efficacy on moderate and severe allergic rhinitis as western medicine. It is the safe therapy and has no apparent adverse reactions.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; physiopathology ; therapy ; Sneezing ; Treatment Outcome ; Young Adult

BACKGROUND:To dynamicaly monitor the varying levels of inflammatory factors in the gingival crevicular fluid is helpful to assess the early effect of orthodontic tooth movement. Myeloperoxidase, soluble intercelular adhesion molecule-1, pentraxin 3 are proven to be closely related to inflammation, but it is unclear about the levels of these three kinds of inflammatory factors as wel as association of these three kinds of inflammatory factors with orthodontic tooth. OBJECTIVE:To detect the expression levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid during maxilary canine distal movement and to assess their correlation with periodontal disease, canine movement distance and orthodontic force. METHODS:Twenty-one orthodontic patients were enroled and assigned into 150 g (n=12) or 100 g (n=9) groups according to orthodontic force. The gingival crevicular fluid samples of orthodontic patients were colected before and at 4, 12, 24 hours, 7, 14 days after maxilary canine distal movement. Levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid were measured and analyzed using ELISA assay. RESULTS AND CONCLUSION: During the distal movement of maxilary canine, under orthodontic force, the level of myeloperoxidase was peaked at 4 hours and then decreased, while the expression level of soluble intercelular adhesion molecule-1 was peaked at 12 hours, and then decreased. Both myeloperoxidase and soluble intercelular adhesion molecule-1 levels returned to normal at 7 days under orthodontic force. The expression level of pentraxin-3 was increased significantly under orthodontic force, peaked at 24 hours, and then decreased gradualy to the normal level at 7 days. In addition, the expression levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid were significantly higher under 150 g force than under 100 g force. These findings indicate that detecting varying levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid is useful to assess the efficiency of orthodontic treatment and prevent adverse reactions.

Objective To understand the epidemiological characteristic of committing suicide and to provide the scientific evidence for prevention and crisis intervention.Method A descriptive epidemiological method was employed to analyze the data of 153 individuals of committing suicide successfully saved by doctors of Emergency Department of Gongli Hospital,Pudong New Area,Shanghai.Results Female suicide committers were predominent over male ones,in the ratio 4.6 to 1.Most of the suicide committers were adolescents who had only received junior high school education.The major social support system of the suicide attempters was family support.The majority,of the suicide committers tried to kill themselves by drug ingestion such as hypnotice, sedatives and pesticides,and most of them haven't resorted to psychological counseling.Conclusions It is necessary to pay more attention to the psychological education of adolescents,and popularize the knowledge of psychological counseling in rural areas where are lack of psychological sense among pelple.Emergency department of general hospital which saves suicide committers is playing an important role in suicide prevention and crisis intervention.

AlM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens (lOL) implantation with a 1. 8mm or 3. 0mm clear corneal incision on total root mean square ( RMS ) value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film.
METHODS:ln a prospective study, 156 age- related patients ( 196 eyes ) were randomly distributed into two groups. 1. 8mm-group comprised 94 eyes that had a silicone lOL inserted through a 1. 8mm sutureless clear corneal incision, while, 3. 0mm- group comprised 102 eyes through a 3. 0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively.
RESULTS:ln both groups, postoperatively at 1wk,there were statistically significant differences ( P<0. 05 ) in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film, while, there were statistically minimal differences ( P< 0. 05 ) between 1. 8mm-group and 3. 0mm-group at 1mo, but were not statistically significantly different ( P > 0. 05 ) between two groups at 3mo postoperative.
CONCLUSlON:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3. 0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1. 8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.

AIM: To investigate the variations of heme oxygenase-1/carbon monoxide system in lung ischemia-reperfusion injury and effects of puerarin on the system.METHODS: The unilateral lung ischemia-reperfusion model was replicated in vivo.Rabbits were randomly divided into three groups(n=10 in each): control group,ischemia-reperfusion(I-R) group and puerarin group.The blood specimens collected at times before ischemia,ischemia 1 h,reperfusion 1 h,3 h and 5 h were tested for the contents of carboxyhemoglobin(COHb) and cyclic guanosine monophosphate(cGMP).The lung tissues sampled at 5 h after reperfusion were assayed for wet/dry weight ratio(W/T),the injured alveoli rate(IAR) and the activity of HO-1.The changes of ultrastructure were observed under electron microscope.The tissue slides were also stained by immunohistochemistry(IHC) and in situ hybridization(ISH) to detect the expression of HO-1.RESULTS: The plasma content of COHb and cGMP in I-R and puerarin group increased in a time-dependent manner after I-R compared with control group,but the increment in puerarin group was higher than that in I-R group(P

Objective To investigate the effects of glutamine (Gln) on proliferation and survival of small cell lung cancer H446 cells, and further to explore the potential mechanism. Methods The proliferation of H446 cells was detected at different time points (0, 24, 48, 72 and 96 h) by CCK-8 assay in Gln (+) group and Gln (-) group, and an optimal time was selected. Under the optimal time, Annexin V-FITC/PI staining, CellTiter-Glo? assay kit and flow cytometer were used to detect cell survival, cellular adenosine triphosphate (ATP) and reactive oxygen species (ROS) levels. Gln (-) group was used as the control group, under the condition of Gln deficiency, cellular ATP, cell proliferation and survival were detected after adding oxaloacetic acid (OAA) or dimethyl-α-ketoglutarate (DM-αKG). Gln (-) group was used as the control group, cellular ROS, cell proliferation, colony and survival were detected after treated with ROS scavenger N- acetyl cysteine (NAC). With different concentrations (0, 2, 5, 10 μmol/L) of glutaminase inhibitor BPTES, the optimal concentration was selected through the colony assay. The cellular ATP and ROS levels and cell proliferation were detected under the optimal concentration. H446 cells were treated with bis-2-(5-phenylacetamido-1,2,4-thiadiazol-2-yl) ethyl sulfide (BPTES), ROS inducer hydrogen peroxide (H2O2) or the combination of them, and cell survival ratio was compared between two groups. Results The proliferation levels of H446 cells at 24, 48, which were decreased most significantly in 72 h in Gln (-) group. When 72 h was used as the optimal time, the cell survival ratio and ATP level were decreased, and the ROS level was increased, in Gln (-) group compared with those of Gln (+) group (P<0.05). There was a higher survival ratio in H446 cells in Gln (-)+OAA group and Gln (-)+DM-αKG group than that of Gln (-) group (P<0.05), but there were no significant differences in cell proliferation and ATP levels between Gln (-) group, Gln (-)+OAA group and Gln (-)+DM-αKG group. The ROS level was reduced, the cell proliferation, colony level and survival ratio were increased in Gln (-)+NAC group compared with those of Gln (-) group (P<0.05). Cloning assay showed that 10μmol/L was the optional concentration. Under this concentration, the proliferation and ATP level were decreased in Gln(+)+BPTES group (P<0.05), and cellular ROS level was up-regulated compared with Gln(+) group. The survival ratio was significantly lower in BPTES+H 2O2 group compared with BPTES (+) group or H2O2 (+) group. Conclusion Glutamine deficiency inhibits the proliferation and survival ratio of H446 cells through enhancing ROS level. BPTES and H2O2 show synergistically inhibitory effect on the survival of H446 cells.