Objective To investigate the effects of recombinant human erythropoietin βinjection on levels of superoxide dismutase ( SOD ) , glutathione peroxidase ( GSH-PX ) , malondialdehyde ( MDA ) and homocysteine ( Hcy ) in patients with diabetic peritoneal dialysis.Methods 92 patients of parallel peritoneal dialysis in diabetic nephropathy who received therapy from September 2014 to September 2016 in our hospital were selected and randomly divided into the observation group and the control group with 46 cases in each group.The control group was treated with peritoneal dialysis routine treatment, while the observation group was treated with recombinant human erythropoietin βinjection on this basis.The levels of hemoglobin (Hb), hematocrit (Hct), renal function, SOD, GSH-PX, MDA and Hcy were compared.Results After treatment, the levels of Hb and Hct in the observation group were higher than the control group, the difference was statistically significant (P<0.05), the urinary albumin excretion rate (UAER) and serum creatinine (SCr) in the observation group were lower than the control group, the difference was statistically significant (P<0.05), the levels of SOD and GSH-PX in the observation group were higher than the control group, the levels of MDA and Hcy were lower the control group, the difference was statistically significant (P<0.05).Conclusion The effect of recombinant human erythropoietin βinjection on diabetic nephropathy patients with peritoneal dialysis was significant, which could improve the levels of SOD, GSH-PX, MDA and Hcy.

Objective To determine the median effective concentration (EC50) of epidural lidocaine inhibiting herpetic neuralgia.Methods The patients with thoracic or lumbar herpetic neuralgia,aged 20-60 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,were included in the study.Epidural catheter was placed under the guidance of the digital subtraction angiography (DSA).An injection of iohexol mixed with lidocaine was given under the guidance of DSA to make sure that drug solution covered all the injured nerve roots.The initial concentration of lidocaine was 0.37％.The concentration was determined by up-and-down sequential allocation.Each time the concentration of lidocaine increased/decreased in the next patient depending on whether or not the analgesia was effective.The ratio between the two successive concentrations was 1.06.Effective analgesia was defined as VAS score ≤ 1 within 30 min after administration.The EC50 and 95 ％ confidence interval of lidocaine inhibiting herpetic neuralgia were calculated using Dixon formula.Results The EC50 of lidocaine inhibiting herpetic neuralgia was 0.199 ％ and the 95 ％ confidence interval was 0.168 ％-0.216 ％.Conclusion The EC50 of epidural lidocaine required to inhibit herpetic neuralgia is 0.199％.

Objective To evaluate the role of phosphatase and tensin homolog deleted on ehromo-some ten (PTEN) protein in sevoflurane postconditioning-induced mitigation of focal cerebral ischemia-reperfusion (I/R) injury via activating PI3K/Akt pathway in rats.Methods One hundred and eight Sprague-Dawley rats,aged 2-3 months,weighing 250-280 g,were randomly assigned into 6 groups (n =18 each) using a random number table:sham operation group (group S),group I/R,I/R + sevoflurane postconditioning group (group I/R + S),I/R + normal saline group (group I/R + NS),I/R + selective PTEN inhibitor pic group (group I/R + P),and I/R + pic + sevofluraue postconditioning group (group I/R + P+ S).Focal cerebral I/R was induced by right middle cerebral artery occlusion (MCAO).The animals were anesthetized with intraperitoneal chloral hydrate.In I/R + P and I/R + P + S group,pic 20 μg/100 g (0.4 ml/100 g) was injected intraperitoneally every 3 h for 4 times before MCAO,and the equal volume of normal saline was given instead of pic in I/R + NS group.The rats in all sevoflurane postconditioning groups inhaled 2.5 ％ sevoflurane for 30 min starting from the onset of reperfusion,and the rats in the other groups inhaled oxygen for 30 min instead.At 24 h of reperfusion,neurological deficit scores (NDSs) were measured and the rats were then sacrificed.Their brains were removed for determination of infarct size (by TTC),cell apoptosis (by TUNEL),and expression of phosphorylated PTEN (p-PTEN) protein and phosphorylated Akt (p-Akt) (by Western blot).Apoptosis index was calculated.Results Compared with S group,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly increased,and the expression of p-Akt and p-PTEN protein was up-regulated in the other 5 groups.Compared with I/R and I/R + NS groups,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly decreased,and the expression of p-Akt and p-PTEN protein was up-regulated in I/R + S,I/R + P and I/R + P + S groups.There were no significant changes in the parameters mentioned above between I/R + S,I/R + P and I/R + P + S groups,and between I/R and I/R + NS groups.Conclusion Sevoflurane postconditioning can activate PI3K/Akt pathway via inhibiting PTEN protein,thus mitigating focal cerebral I/R injury in rats.

BACKGROUND:Neural stem cel s have multi-directional differentiation potential, self-sustaining and self-renewal capacity as wel as have strong migration ability. Bushen Huoxue Recipe can reduce neuronal damage and promote nerve cel regeneration, to achieve neural function reconstruction. Underlying mechanisms of Bushen Huoxue Recipe combined with neural stem cel transplantation in rats with tinnitus induced by sodium salicylate are yet unclear. OBJECTIVE:To investigate the effects of Bushen Huoxue Recipe combined with neural stem cel transplantation in rats with tinnitus induced by sodium salicylate. METHODS:Sixty Sprague-Dawley rats were randomized into five groups (n=12):normal control group, tinnitus model group, Bushen Huoxue Recipe group, stem cel group and combined treatment group (Bushen Huoxue Recipe combined with neural stem cel transplantation). Animal models of tinnitus induced by sodium salicylate were made in al the groups except for the normal control group. Fifteen days after modeling, rats were given intragastric administration of Bushen Huoxue Recipe water decoction (3 mL, 2.592 g/mL) for consecutive 7 days in the Bushen Huoxue Recipe group, intravenous injection of neural stem cel s (1 mL, 1.0×109/L) in the stem cel group, or their combined treatment in the combined treatment group. RESULTS AND CONCLUSION:Bushen Huoxue Recipe, neural stem cel transplantation and their combination al could effectively promote the recovery of drinking water inhibitory rate that was ranked as fol ows:combined treatment group

Objective To summarize the clinical experience of harvesting and using the lungs of cardiac death donor.Methods The lungs from donation after cardiac death (DCD) were harvested and used for lung transplantation.The donors suffered from severe craniocerebral trauma or brain neoplasms and were identified after cardiac death post declaration of brain death.Written consent about DCD was obtained from the consanguinities.The donor lungs were harvested after clinical evaluation of donors with considerable function and after the determination of DCD.The preoperative lymphocytotoxic cross match test was negative,ABO blood type was compatible,and the donors were all suitable for the transplant procedure.Results Two bilateral lung transplantations and one single lung transplantation were performed,with the warm ischemic time being 23,27,and 32 min,respectively.The operative course was uneventful The ICU stay was 31,18,and 26 days respectively,with dramatic improvement of pulmonary function postoperatively.Acute rejection occurred in two cases,which was treated with bolus of corticoids.There were no infection in our 3 patients,and the life quality was satisfactory during the follow-up period.Conclusion The lung from DCD may be one of the available resources used for lung transplantation on the basis of efficient management of the potential donors and clear evaluation of the donors.

OBJECTIVETo investigate the prospective association of fibroblast growth factor 21 (FGF-21) with NAFLD development in a 5-year prospective study involving a population-based cohort comprising 352 Chinese subjects.

METHODSThe clinical data of subjects were recorded, serum FGF-21 levels at baseline and follow-up were measured using an enzyme-linked immunosorbent assay,whether FGF-21 was independent predictor of NAFLD development were identified using logistic regressions. Chi-square test, non-parametric test and logistic regression analysis were used in statistical analyses.

RESULTS(1) Serum FGF-21 levels of NAFLD group was significantly higher than that of non-NAFLD group (318.34(169.64,520.77)pg/ml vs 197.22 (121.57, 318.76) pg/ml, Probability value less than 0.05). (2)At follow-up,significant increase of FGF-21 level was observed in those subjects who developed NAFLD (399.4 (253.9,754.2) pg/ml vs 318.34(169.64, 520.77)pg/ml, Probability value less than 0.05), but in non-NAFLD group, there was no significant difference of FGF-21 level between baseline and follow-up. (3) BMI, TC, HOMA-IR and FGF-21 were independent predictors of NAFLD through logistic regressions.

CONCLUSIONHigh FGF-21 levels was independent predictor of NAFLD, it may be useful for early diagnosis and intervention of NAFLD.

Objective:To conjugate IVIG and MTX to produce a specific cytotoxicity upon phagocytes.Methods :MTX was conjugated with IVIG by indirect conjugating methods. HSA was used as an intermedi-ary to conjugate MTX with IVIG. The indirect immunofluorescence was adopted to test the binding abilityof Fc fragment. MTT assay was used to measure the cytotoxicity of conjugation on phagocytes. Results:Conjugation showed stronger cytotoxicity upon target cells than free MTX,and it showed only less cyto-toxic effect on Fc receptor negative cells compared with the positive ones. The specific cytotoxicity of IVIG-HSA-MTX was significantly stronger than that of MTX. Conclusion: In vitro the conjugation showed ahighly specific cytotoxicity upon phagocytes.

Objective To investigate the curative effect of damage control theory in treating severe polytrauma patients combined with bone and joint injury. Methods A retrospective study was done on data including complication, death rate, fracture healing and joint function recovery of 63 patients with severe polytrauma combined with bone and joint injury( average ISS ≥27 points) admitted to our hospital from January 2006 to June 2009. Results Of all the patients, 57 shock patients were cured,three died of hemorrhagic shock within two hours after admission and one patient died of severe traumatic brain injury 11 hours after admission. One patient died of ARDS at 24 hours postoperatively and one died of multiple organ failure at day 6 after injury. Fracture healing was achieved in 52 patients, with satisfactory recovery of the limb function. Amputation was performed in two patients and three patients had mild claudication and pain walking. Conclusion Damage control strategy has great clinical significance in guidance of treatment of severe polytrauma combined with bone and joint injury.

BACKGROUND:Elderly patients with degenerative lumbar degeneration often appear insufficient holding power of pedicle screw in spine surgery, which is prone to occur de-pinning and leads to insecure fixation. How to increase the holding power of screws has become a hot research. OBJECTIVE:To observe the early clinical effect of pedicle screws with cement augmentation for treating lumbar degenerative diseases in elderly patients. METHODS:A total of 65 old patients with lumbar degenerative diseases received a treatment between August 2012 and April 2014, and were divided into two groups according to the treatment strategy:treatment group (n=24;internal fixation of pedicle screws with cement augmentation) and control group (n=41;routine internal fixation of pedicle screws). General conditions of patients in two groups were observed and compared. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) score system were used for evaluating the lumbar and back pain, and restoration of neurological function in lower limbs respectively. RESULTS AND CONCLUSION:Al of the patients successful y received the surgery and then were fol owed up from 3 to 20 months. The anterioposterior and lateral X-ray film revealed no loosening, loss, fracture of the screws, and no loss of intervetebral space height was found. There was no significant difference in the blood loss and hospital stay between two groups (P>0.05). JOA at postoperative 3 and 6 months, and VAS score at postoperative 3 months were significantly improved after the treatment of pedicle screws with cement augmentation, when compared to control group (P<0.05). VAS scores showed no difference at 6 months postoperatively in two groups (P>0.05). Pedicle screws with cement augmentation for treating lumbar degenerative diseases have the advantages of improving the screws holding strength, reconstructing the stability of lumbar vertebra and obtaining clinical efficacy on degenerative spine.

Objective To evaluate the effects of ambroxol on prevention of bronchopulmonary complications after thoracotomy in patients with chronic obstructive pulmonary disease(COPD).MethodsTotal 161 elderly patients aged ≥70 years with COPD undergoing thoracotomy were randomly allocated to two groups:ambroxol group (300 mg/d,6 d) and placebo group as control.Pulmonary complications were evaluated by clinical symptoms,radiographic changes,and blood gas analysis. Results The incidence rates of atelectasis were 8.6％ in ambroxol group and 28.8％ in placebo group,respectively.The PaO2 values after surgery in ambroxol group decreased more than in placebo group (P＜0.05) compared with the preoperative values.Side effects were not found in all patients.Conclusions Ambroxol should be considered as an alternative pharmacologic approach for the prevention of post-thoracotomy pulmonary complications in the elderly patients with COPD.