BACKGROUND:Lung injury can be induced after injection of lipopolysaccharide(LPS) into the vein of aging rats,and with the development of lung injury,the kidney function can be influenced.Ginkgo biloba extract(GBE) has some effects such as clearing the free radicals,improving hemorrheology,protecting the vascular endothelial cells and so on. OBJECTIVE:To investigate whether renal function damage is induced by acute lung injury(ALI) in aging rats so as to support the hypothesis that lung is the start-up organ in multiple organ dysfunction syndrome in the elderly and the protective effect of GBE on it. DESIGN:Randomized controlled experimental trial based on the experimental animals. SETTING:Laboratory of Department of Pathophysiology,Institute of Basic Medical Science,Peking Union Medical College. MATERIALS:The study has been completed from May 2001 to January 2003 in the Laboratory of Department of Pathophysiology,Institute of Basic Medical Science,Peking Union Medical College.Thirty-six Wistar male rats were involved. INTERVENTIONS:For reproducing the mimic aging rats models,the rats were injected intraperitoneally,D-gal 50 mg/kg,once a day,for 6weeks totally,and randomly divided into 3 groups, namely: ①control group(saline ,intravenous injection);② LPS group( LPS,5 mg/kg intravenous injection) ③ GBE+LPS group (GBE was used 7 days prior to LPS,31 mg/kg ,once a day).Samples(blood,lung and kidney tissue) were collected at 2 or 6 hours after LPS or saline administration. MAIN OUTCOME MEASURES:Contents of creatinine(Cr),blood urea nitrogen (BUN),lactic acid (LA),NO (its metabolite is NO2-/NO3-) and methane dicarboxylic aldehyde(MDA);and activities of glutathione peroxi-dase(GSH-Px) and Na+-K+-ATPase were measured. RESULTS:Compared with control group,there was obviously ALI at 2or 6 hours after LPS administration.Cr [(94.7±10.3) μmol/L]and BUN [(l1.4 1.9)mmol/L]contents in blood were increased significantly until 6 hours after LPS administration.In LPS group,MDA[(22.5 2.6) nmol/L]and NO2-/NO3-[(25.8 2.9) μmol/g] contents in blood and in lung tissue were all increased significantly at 2 hours.But GSH-PX [(355.145.0)μkat/g],Na+-K+-ATPase [(886.3 97.2) nkat/g] activities in lung tissue were decreased significantly at 2 hours after LPS administration.The above changes lasted for 6 hours.However,significant change did not occur until 6 hours after LPS administration in renal tissue.All the above changes were markedly attenuated by pretreatment of GBE. CONCLUSION:ALI was caused by LPS intravenous injection in aging rats.Renal function damage could be induced by ALI in aging rats.GBE showed a protective effect on ALI and renal function damage in this animal model.

Objective To investigate whether gingko biloba extract (GBE) have protective effect on acute lung injury(ALI)induced by Lipopolysaccharide ( LPS) in aging rats and renal function damage induced by ALI. Methods Male aging Wistar rats(36) were used in the study. LPS group (LPS, iv route, 5mg/kg body weight) and GBE+LPS group (GBE was given starting from 7 days before experiment, once a day oral administration). The blood, lung and kidney samples were collected at 2 or 6 hours after LPS or saline administration. Results Compared with the aging control, ALI was obviously observed in LPS group, blood creatinine and urea nitrogen were increased significantly from (68.7? 6.9) mol/L and (5.9?0.6) mmol/L to (94.7?10.3) mol/L and (11.4?1.9) mmol/L, respectively (P

[Objective] To explore the effects of rifampicin on cell morphology,intracellular reactive oxygen species (ROS),reduced glutathione (GSH),and cell apoptosis in rotenone-induced differentiated pheochromocytoma (PC12) cells.[Methods] Rotenone was added in rat PC12 cells to develop a model of Parkinson's disease in vitro.Cell morphology was observed by microscope.Intracellular GSH was determined by a microplate reader.The intracellular ROS and the apoptosis rate were measured by flow cytometry.[Results] Compared with control group and rifampicin control group,GSH significantly decreased but ROS and apoptosis rate significantly increased in rotenone group.Compared with rotenone group,GSH significantly increased but ROS and apoptosis rate significantly decreased in a dose-dependent manner in rifampicin control group (100,200,and 300 μmol/L).[Conclusion] Rifampicin may reduce the damage of rotenone-induced differentiated PC12 cells through inhibiting oxidative injury in a dose-dependent manner.

Objective To explore morphine usage in emergency department (ED) and its effect on outcome in elderly patients with acute decompensated heart failure (ADHF) in a single Chinese center. Methods A prospective observational analysis was performed in elderly patients aged 65-99years with newly diagnosed ADHF, who were treated and admitted from ED of our hospital. The data including patients' demographic characters, past medical history, initial presentations and medication taking were collected and analyzed. According to using morphine or not, the patients were divided into two groups. The effects of morphine on mechanical ventilation, hospitalization stay and in-hospital mortality were also evaluated. Results The 82 patients were enrolled in this study, 52 males and 30females. In the 41 (50. 0%) patients using morphine (morphine usage group), the foregone incidence rates of coronary heart disease, type 2 diabetes mellitus and stroke were less, the levels of troponin T and random blood sugar were increased in morphine usage group than in non-morphine usage group.No other differences were found in initial presentations between the two groups. The patients often theophylline before morphine administration. And they had a higher prevalence of mechanical ventilation (95%CI: 1.22-7.41), but no differences were found in hospitalization stay and in-hospital mortality between the two groups. Conclusions Morphine is still as a common medicine in treatment of ADHF in ED. Morphine usage can increase prevalence of mechanical ventilation without influencing hospitalization stay and in-hospital mortality even in elderly ADHF patients. Morphine may be a safe medication in the rational treatment of early-stage ADHF in elderly patients with mechanical ventilation support.

Objective To explore the current occurrence of upper gastrointestinal bleeding (UGIB)in elderly patients and its possible risk factors and treatment program. Methods The clinical data of 758 elderly coronary heart disease patients with aspirin and clopidogrel co-therapy were collected, including past medical history,common condition,clinical medication,biochemical indicator and clinical turnover. The follow-up ended on the dates of a first occurrence of UGIB and death or after stopping co-therapy above 10 days. The follow-up time was 6 months. Results UGIB occurred in 48 patients,the occurrence rate was 6.3% (48/758). The occurrence rate of UGIB in proton pump inhibitor (PPI), H2-receptor antagonist (H2RA), gastric mucosa protective agents plus PPI, gastric mucosa protective agents plus H2RA and control was 3.7% (4/108),5.0% (12/240),1.4% (1/70),2.9% (3/102),11.8% (28/238). There were statistic differences in different methods (x2 = 18.63,P = 0.001). Conclusions The occurrence rate of UGIB combined with aspirin and clopidogrel co-therapy in elderly is high. Co-prescription with PPI and gastric mucosa protective agents is associated with a lower risk.

Objective:To investigate the feasibility,surgical technique and effect of osteosynthesis for proximal humerus fractures through the minimal incision anterolateral acromion.Methods: In this study,32 patients of proximal humeral fractures were selected and treated through the minimal incision antero-lateral acromion between January 2012 and October 2014.Of these patients,there were 19 males and 13 females,with mean age 46 years old (range: 22-78 years).The mechanism of injury was a trauma of simple fall for 21 patients and motor vehicle accident for 11 patients.According to Neer classification,18 cases had two-part fractures,12 had three-part fractures,and 2 had four-part fractures.All patients were sustained operation of open reduction and internal fixation.The average delay between trauma and surgery was 4 d (0.5-10.0 d).The operations were performed in invariable operating room with general anesthesia.The fractures were reduced and immobilized with anatomical locking plate through the minimal incision anterolateral acromion during operation.Patients were received passive motion after operation.Results: All the 32 cases were followed up ranging from 3 to 34 months with an average of 11 months.All the fractures were healed.There was neither failure of internal fixation nor incision infection case.The functional results of the shoulder,according to Constant-Murley score was on an average 86 (range: 69-100).Conclusion: The treatment for proximal humeral fractures through the minimal incision anterola-teral acromion approach is a feasible and effective method,which shows good results for treating proximal humerus fractures with correct indication.There are several advantages compared with conventional deltopectoral approach.They are minimal soft tissue disruption,minimal blood loss and easily to manipulate technique.But it required selection of indication strictly and surgeon's experience.

Objective To explore the role of MAPK and NF-?B in the increase of Toll-like receptor 4(TLR4) expression induced by lipopolysaccharide(LPS) in pulmonary micro-vascular endothelial cells(PMVECs) of mouse.Methods PMVECs were isolated,cultured and exposed to the different concentration LPS at(2 h),and(100 ?g/L) LPS in different time.The concentration of TNF-? in culture supernatant was detected using ELISA.(Using) PD98059 inhibitor for ERK,SB203580 inhibitor for P38 MAPK and PDTC inhibitor for NF-?B pretreated(PMVECs).RT-PCR was used to detect the levels of TLR4 and TNF-? mRNA.Western-blot was used to detect the protein expression of nuclear factor-kappa B(NF-?B) P65 subunit and ERK / P38 MAPK in nuclear extract after LPS exposure for 6 h respectively.Results With the treatment of 50～(500 ng /mL) LPS for(2 h) or(100 ?g /L)(LPS exposure) in different time,the concentration of TNF-?in culture supernatant of PMVECs was increased by a time and dosage dependent style(P

ObjectiveTo study effects of treating acute progressive cerebral infarction by the brain-located mild hypothermia therapy.Methods60 patients were randomly divided into the treatment group (30 cases) and the control group (30 cases). Drugs were used in both groups, and the located mild hypothermia therapy was only applied in the treatment group. After 72 hours and 7 days, the volume of cerebral infarction and the nerve function deficiency (NFD) scores of hemiplegic limbs were compared.ResultsThe volume of cerebral infarction of the treatment group was significantly smaller than that of the control group (P<0.01).There were significant differences on the neurological impairment scores between two groups (P<0.01).Conclusions The brain-located mild hypothermia therapy can reduce hydrocephalus of patients with acute progressive cerebral infarction, and have brain protection. These results provide an important theoretical foundation for the treatment of cerebral infraction with low-temperature therapy.

ObjectiveTo explore the effect of celecoxib on the tendon adhesion and healing after anastomosis.Methods54 New Zealand white rabbits were randomly assigned to one of 3 ( celecoxib,ibuprofen,and saline) groups.The deep flexor tendon was transected,followed by a primary repair.The care was begun the day after surgery and was continually provided for 14 days.Celecoxib was given[20 mg/( kg · d) ],ibuprofen was given [75 mg/( kg · d) ],or the same volume of saline solution was given respectively.At the 4th and 8th week the animals were killed and assessed by general observation,histologically observation,and biomechanical testing.ResultsGeneral observation,celecoxib group and ibuprofen group showed good shape of tendons,smooth surface,and covered with a film - like tissue,and it was easy to be separated.Saline group showed that tendon and surrounding tissue medium had dense adhesions,and it was difficult to be separated.Histologically observation showed between tendon and paratenon had clear gap in celecoxib and ibuprofen group.The mature fiber cells gradually arranged rules and in the same direction.Saline between the tendon and paratenon gradually emerged a gap,but more fibroblasts and arranged in irregular.Biomechanical testing showed that tendon sliding resistance appeared in celecoxib and ibuprofen group.Compared with saline group,the differences were statistically significant (0.354 ± 0.078/0.382 ±0.121 vs 0.521 ±0.126,P ＜0.05;0.075 ±0.035/0.097 ±0.043 vs 0.414 ±0.110,P ＜0.01).UTS (ultimate tensile strength had statistical significance among celecoxib,saline groups and ibuprofen group.(36.812 ±6.388 vs 24.899 ±4.667,P ＜0.05;34.297 ±8.132 vs 24.899 ±4.667,P ＜0.01 ;54.515 ±4.688/59.037 ± 6.606 vs 42.418 ± 5.594,P ＜ 0.01 ).ConclusionsCelecoxib can effectively prevent tendon adhesion,and does not affect the tendon healing.

Objective To define the functional mechanisms of two NSAIDs , paracetamol and ibuprofen , in specif-ic brain regions in headache control by observing the distribution of Fos -immunoreactive neurons in trigeminal ganglia and trigeminal nucleus caudalis in conscious rat models of vasculogenic headache .Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: control group ( saline group ) , acetaminophen group and ibuprofen group .Each rat was given electrical stimulation ( frequency 20 Hz, current 3-5 mA, pulse width 0.25 ms) at 50 minutes after injec-tion .The rats were killed and perfusion fixed after electrical stimulation .Trigeminal ganglia and trigeminal nucleus caudalis of the brains were taken out for paraffin sections and immunohistochemical staining , and Fos-immunoreactive neurons were counted under the Image J system .Results After electrical stimulation , there were significant differences of Fos protein expression in bilateral trigeminal ganglia and spinal trigeminal nucleus caudalis between the saline group and groups of non -steroidal anti-inflammatory drugs , but no significant difference of Fos protein expression in bilateral trigeminal ganglia and spinal trigeminal nucleus caudalis between the acetaminophen group and ibuprofen group .Conclusions The changes of Fos expression in bilateral trigeminal ganglia and spinal trigeminal nucleus caudalis after treatment with NSAIDs suggest that such structures participate in the pain transmission and expression and the pharmacology course of analgesic drugs .