Object To investigate the effects of Congsheng Capsule (CSC) on free radical change after cerebral ischemia reperfusion, and analyze the mechanisms of CSC anti cerebral ischemia action. Methods Bilateral carotid artery occlusion and reperfusion combined with tail bleeding hypotension were employed in this study. Changes in free radicals were observed by means of spectro photometry. Results CSC 1, 3, 9 g/kg could enhance SOD activity, reduce the MDA content, and decrease NOS activity and NO content. Conclusion The protective effects of CSC on cerebral ischemia may be mediated by its anti free radical and NO damage.

Object To investigate the profective effects of Congsheng Capsule (CSC) on cultured cerebral cortical neurons after cerebral ischemia reperfusion in order to study the anticerebral ischemia effect of CSC. Methods Drug containing serum was used to study the protective effect of CSC on neurons damaged during hypo glucos and hypoxia (3 h)/reoxygenation (0, 3, 6, 18 h), the demage to neurons was reflected by the increase in activity of lactate dehydrogenase (LDH) released from cells into culture medium and the changes of apoptosic cells which were studied by flow cytometry. Results The serum preparation of CSC (2, 4, 8 g/kg) attenuated neuronal damage during hypo glucos and hypoxia (3 h)/reoxygenation (0, 3, 6, 18 h) by decreased LDH and changes in apoptosic cell numbers. Conclusion CSC has protective effects on cerebral ischemic damage.

Objective To investigate the effects of continuous hemofihration on gastrointestinal dysfunction for treating patients with intra-abdominal hypertension.Methods A total of 37 patients were divided into two groups randomly (random number),namely control group (n =17) and continuous blood filtration (CBF) group (n =20).The patients of control group were treated with routine treatment,and the patients of CBF group were given CBF for 72 hours in addition to the routine treatment.The intra-abdominal pressure (IAP),gastrointestinal (GI) symptoms,and SOFA score were documented at 0 hour,24 hours,72 hours and 7 days after treatment.Results The MAP of patients in the CBF group was not significantly changed (P =0.218),while the IAP was decreased significantly (P =0.001) and the abdominal perfusion pressure (APP) increased significantly after CBF (P =0.036).Compared with the control group,there were more than 2 GI symptoms markedly relieved after CBF for 24 hours (P =0.049).The SOFA score of CBF group decreased significantly (P =0.037).There were no differences in 28-day and 60-day mortality between two groups.Conclusions The CBF can decrease IAP,increase APP,improve splanchnic blood circulation,and ameliorate gastrointestinal dysfunction.But CBF does not reduce the mortality in comparison with routine treatment.

Objective A new type adsorbent for removal of bacterial ET was prepared by immobilizing L-serine covalently onto polyvinylidene difluoride membrane (PVDF-Ser) to study the effect of hemoperfusion on sepsis induced lung injuries in a pig model. Method Endotoxemia were induced in thirteen pigs by injecting endotoxin (1 μg/(kg·h) ) intravenously for 2 h. One hour later, the pigs were treated with absorber of PVDF-Ser volumn (group hemoperfusion) or empty adsorber (group control) for 2 h. Extravascular lung water indexed to body weight and alveolar capillary permeability, levels of serum endotoxin, tumor necrosis factor-α, interleukin-6, malondialdehyde, glutathione, myeloperoxidase activity, and lung histological changes and myeloperoxidase immunohistochemical analysis were measured. Results Hemoperfusion treatment with PVDF-Ser volumn significantly improved extravascular lung water, pulmonary alveolar capillary permeability and lung injuries ( P ＜ 0. 05). In addition, hemoperfusion attenuated both serum and pulmonary cytokines, and decreased lung malondialdehyde and myeloperoxidase levels ( P ＜ 0. 05). Conclusions Hemoperfusion with the adsorber of PVDF-Ser volumn effectively reduced inflammatory responses and improved lung injuries and oxidative stress in endotoxemia. It has a high potential of clinical application for treatment of patients with severe sepsis.

OBJECTIVE:To construct the database of“The Time and Age Limit in the Use of Common Orally Adminis-tered Drugs”in order to guide the rational drug use in patients.METHODS:The frequently used instructions of common orally administered drugs in the hospital where the authors worked were collected,and then were classified and listed according to the elements in“The Time and Age Limit in the Use of Common Orally Administered Drugs”,and further summarized according to the basic knowledge in drug administration.RESULTS:Ante cibum drugs accounted for22.2%,post cibum drugs11.7%,either ante cibum or post cibumor or unmarked drugs59.4%,bedtime drugs6.7%,wholly swallowed drugs12.2%,chewed drugs1.7%,children restricted drugs32.2%,and the drugs taken once daily with the set time accounted for13.9%.CONCL_ USION:The construction of“The Time and Age Limit in the Use of Common Orally Administered Drugs”database can guide patients to use medicine rationally.

Objective To evaluate the indications and surgical procedure of bronchial-pulmonary arterial sleeve resection for patients with centrally located non-small cell lung cancer (NSCLC),and to prevent complications. Methods From October 1987 to December 2004, 96 cases of central NSCLC were treated with bronchial-pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. Results The complication rate was 19.8%(19/96), the mortality rate in 30-day postoperation was 3.1%(3/96), the overall 1, 3, 5 year survival rates were 82.6%(76/91), 57.8%(37/64) and 39.1%(18/46) respectively. Conclusion Bronchial-pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve the quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.

Objective To evaluate the predictive performance of diaphragm thickening fraction ( DTF) assessed by ultrasound in the feasibility of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Forty-three patients with COPD were enrolled for prospective study.All patients were ventilated mechanically for more than 48 hours and were expected to be weaned when they met clinical criteria in the intensive care unit from February 2015 to August 2015.Patients received a spontaneous breathing trial under pressure support for 1 h.At the end of spontaneous breathing trial, the right hemi-diaphragm was visualized in the zone of apposition using a 6-13 MHz linear ultrasound probe. Diaphragm thickness was recorded at end-inspiration (DTei) and end-expiration (DTee), and the DTF was calculated as percentage from the following formula:(DTei -DTee) /DTee.Also the rapid shallow breathing index ( RSBI ) was calculated.Patients meeting weaning criteria were extubated.Weaning successfully was defined as spontaneous breathing for >48 h without any form of ventilation support.Results Twenty-five patients were weaned successfully and failure of weaning was found in 18 patients.A significant differences in DTF ( 39.66 ±13.22 )%vs.( 23.84 ±8.85 )%, P <0.05 and RSBI ( 62.74 ±26.05 ) vs.( 98.89 ± 35.44) , P <0.05 were observed between patients with successful weaning and patients with failure.The sensitivity and specificity of DTF≥30 % for successful weaning were 84% and 83.88 %, respectively.The area under the receiver operating characteristic curve was 0.872 ( 95 % CI: 0.759-0.985 ) for DTF.By comparison, when RSBI was ≤105, there was a sensitivity of 92 %, and a specificity of 38.89 % for determining successful weaning.The area under the receiver operating characteristic curve was 0.804 ( 95 %CI: 0.669-0.940) for RSBI. Conclusions This study shows that in a cohort of COPD patients, the assessment of DTF using diaphragm ultrasound may be useful to predict success weaning or failure during spontaneous breathing trial.

AIM To explore whether plasma vasoactive substances and neutrophil infiltration make different contribution in cerebral ischemia-reperfusion injury and protective effect of triacetylshikimic acid(TSA). METHODSThe rat models of ischemia 90 min and reperfusion 3-48 h were prepared with middle cerebral artery occlusion. TSA 50-200 mg·kg-1 were given (ig) immediately and 60 min again after the onset of ische- mia. Serotonin and thromboxane B2 (TXB2) concentrations in plasma were detected by fluorescence spectrophotometry and radioimmunoassay respectively. Myeloperoxidase(MPO) activity in brain tissue was quantified by chemical analysis. RESULTS At 3-24 h after reperfusion, the concentrations of plasmic serotonin, TXB2, and brain MPO activity increased obviously in a time-dependent manner. At 48 h after reperfusion, the concentrations of serotonin and TXB2 decreased to the same level of sham. Nevertheless, brain MPO activity remained more elevated than the contralateral cortex. At 24 h after reperfusion, TSA (100 and 200 mg·kg-1) was shown to possess the ability to inhibit the increased plasmic serotonin, TXB2 concentrations, and brain MPO activity induced by focal cerebral ischemia-reperfusion. CONCLUSION Vasoactive substances in plasma and MPO activity in brain tissue show different time courses during focal cerebral ischemia-reperfusion and make different contribution to brain damage. TSA is effective to protect the ischemic brain tissue from ischemia-reperfusion injury.

BACKGROUND:At present, many researches have shown that tacrolimus has protecting effect on peripheral nerves,however,whether tacrolimus has a similar effect on central neural system has not been known yet.OBJECTIVE:To investigate the effect of tacrolimus on neural behaviors and memory by observing the neural behaviors and detecting the expression of synaptophysin in cortex,hippocampus and basipodite.DESIGN:Parallel and before and post contrast study.SETTING:Department of neurosurgery, affiliated hospital of the two medical universities.MATERIALS:The experiment was carried out in the Laboratory of Department Neurosurgery,Shanghai Changzheng Hospital in November 2002.Twenty-four qualified Sprague-Dawley rats supplied by Shanghai Experimental Animal Center of medical institution of Fudan University,with body mass of 180-220 g,were randomly divided into three groups:control, injury and treatment,with 8 rats in each group.INTERVENTIONS:Anesthesia was induced by administration of sodium pentobarbital(with the concentration of 20 g/L,40 mg/kg) twenty-four hours before the operation.The coup energy was 151.95-172.21 kPa that was equal to medium injury. The control rats did not receive the coup. Tacrolimus was given to the treatment group in the dosage of 1 mg/kg body weight by intraperitoneal injection at 5 minutes post trauma. The drug was given once physiological saline. Before and post trauma (on the third and seventh day)all rats Accepted Beam Walking Test,Beam Balance Test and Memory Test,respectively. One week after trauma,all rats' heads was removed and the brain was taken out within seconds.The hippocampus,cortex and basipodite of the traumatic hemisphere were kept in methanal with the concentration of 4 percent. Immunohistochemistry and image analysis system were used to study the expression of synaptophysin in cortex,hippocampus and basipodite of the traumatic hemisphere.MAIN OUTCOME MEASURES: ①The performance records of neural behaviors and memory of the three groups. ②Results of the expression of synaptophysin in cortex, hippocampus and basipodite of the three groups.③Apoptotic cellscalculation of synaptophysin in cortex,hippocampus and basipodite.RESULTS:Totally 24 rats entered the final analysis. ①On the third day and the seventh day,the scores recorded in Walking Test and Balance Test of the treatment group were less than those in the injury group[Walking Test: (7.5±2.5) s,(5.5±2.1) s,(10.5±2.5) s,(8.2±2.5) s. Balance Test:(3.4±0.5)score,(2.5±0.2) score,(5.7±0.2) score,(5.0±0.5) score,P ＜ 0.05-0.01].But the scores recorded in memory test of the treatment group were still more than those in the control group,memory test[(4.9±1.7) s,(6.2±2.3) s,(4.0±1.5) s,(4.4±2.6) s,P ＜ 0.05-0.01]. ②The expression of synaptophysin in cortex,hippocampus and basipodite in the treatment group was still more than that in the injury group(140.36±3.87, 45.52±2.16,31.67±2.35,96.25±2.85,24.35±2.47,20.49±2.08,P ＜ 0.01);The expression of synaptophysin control group was especially more than that in treatment group (162.24±3.52,50.58±2.31,42.69±2.53, P ＜ 0.01).Apoptotic cells calculation of cortex,hippoeampus and basipodite in treatment group was far less than those in injury group,(10.37±2.12)%,(18.39±2.87)%, (12.78±2.45)%,(21.14±4.85)%,(38.57±3.78)%, (21.18±4.59)%,P ＜ 0.01].And apoptotic cells calculation in injury group was more than those in control group [(3.85±2.56)%,(4.96±2.15)%, (3.52±2.17)%,P ＜ 0.01].CONCLUSION:Tacrolimus can facilitate the expression of synaptophysin,refrain from calcineurin involving in the process of transcription-dependent and nontranscription-dependent apoptosis,and can also contribute to the recovery of memory and neural behaviors post trauma.

Taking global minimum essential requirements(GMER)as standard,school of basic medical science in Wuhan University paid more attention to the cultivation of students' professional skills, innovation ability and communication ability. ‘Response to injury’integrated course was carried out. Based on the immunology,this course involves pathology and pathophysiology and explores the mecha-nism of the diseases' diagnosis and treatment. It took small classes,bilingual education,literature read-ing ,experiments and discussions in various forms . This reform aimed to improve the immunology , pathology and pathophysiology teaching and make our medical education meet the process of globalization.