OBJECTIVETo observe the efficacy of Xingnaojing Injection (XI) in treatment of sepsis-associated encephalopathy (SAE).

METHODSTotally 65 SAE patients were retrospectively analyzed at EICU from September 2010 to September 2013. They were assigned to the control group (32 cases) and the treatment group (33 cases) according to whether they received XI. Patients in the control group received anti-infection and symptomatic support, while those in the treatment group were intravenously injected with XI at 20 mL per day for additional 7-10 days. The fever clearance time, Glasgow coma scale (GCS), C-reactive protein (CRP), neuron-specific enolase (NSE), and improvement of electroen-cephalogram (EEG) were observed in the two groups.

RESULTSCompared with the control group, the fever clearance time was shortened, CRP levels decreased, GCS score and efficacy of EEG was alleviated in the treatment group after treatment with statistical difference (P < 0.05). No adverse reaction occurred during medication.

CONCLUSIONX1 was safe and effective in treatment of SAE.

C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Injections ; Phosphopyruvate Hydratase ; metabolism ; Sepsis-Associated Encephalopathy ; drug therapy ; Treatment Outcome

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

Objective To investigate the teaching effect of applying idea of ‘ integrating world with specialty' in teaching ward - round.Methods Totally 112 undergraduates from department of anesthesiology in Chongqing medical university were randomly divided into 2 groups:group C and group T.The students in group C and group T were received traditional method and teaching ward-round applying idea of ‘integrating world with specialty' respectively.The teching effects were compared.Results Constituent ratio of performance of written test and defence of case analysis in group C and group T were respectively as follow,excellent ( 12％,19％) vs.(31％,37％),good (25％,19％ ) vs.(50％,44％ ),middle (54％,50％ ) vs.( 19％,13％ ),bad (9％,12％ ) vs.(0,6％ ),and there were statistically differences between the two groups.Conclusion Teaching ward-round applying idea of ‘ integrating world with specialty' integrates medical knowledge with social skills and common sense of life,making it easier for medical students to understand and master professional knowledge,as a result of improving the students' ability of problem analysing and solving.

Objective To evaluate the changes in the expression of CXCR3 in regulatory T cells (Tregs) in the renal tissues of mice with renal ischemia-reperfusion (I/R) injury .Methods Forty-eight SPF male C57BL/6J mice ,aged 8-12 yr ,weighing 20-25 g ,were randomly divided into 3 groups ( n=16 each ) using a random number table:sham operation group (group S) ,group I/R and CD25 monoclonal antibody PC61 group (group P) . Bilateral kidneys were exposed and their pedicles were occluded for 45 min with atraumatic mini-clamp followed by 72 h reperfusion .PC61 250 μg was injected intraperitoneally at 24 h before the model was established .Blood samples were collected from the inferior vena cava at 24 and 72 h of reperfusion (T1 ,2 ) for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations .Bilateral kidneys were obtained for determination of CD4+ CD25+ Foxp3+ Treg count and CXCR3+ CD4+ CD25+ Foxp3+ Treg count in renal tissues and the pathological changes of the kidney were scored .Results Compared with group S , the serum BUN and Cr concentrations and pathological scores were significantly increased at T1 ,2 in I/R and P groups ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was increased at T2 in I/R group ( P<0.05) .Compared with group I/R ,the serum BUN and Cr concentrations and pathological scores were significantly increased at T2 ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was decreased at T2 in P group ( P<0.05 ) .Conclusion Up-regulation of CXCR3 is helpful in migration of Tregs into the renal tissues of mice with renal I/R injury .

Objective To observe the behavior changes and synaptic reconstruction of brain and the impact of gastrodin in rats with epilepysy induced by pentylenetetrazole.Methods Fifty Wistar rats in growth(50-70 g) were randomly divided into 5 groups:control group,Pentylenetetrazole (PTZ) group,gastrodin high dose group,gastrodin low dose group and sodium valproate group,each group had 10 rats.According to Racine classification,the behavior changes of rats and the frequency were recorded.Conventional method was adopt to perfuse cordis, fix and extract the brain,and the immunohistochemistry was used to detect synaptophysin(P38) expression in the temporal lobe and hippocampus of the brain after 4 weeks.Results 1.Four weeks after pentylenetetrazole ignited the growth period rats,the attack-level of each experimental group through comparison with each other,there was statistically significant difference(?2=35.83 P0.05).Conclusions There are mossy fiber sprouting and the formation of synaptic reconstruction in temporal lobe and hippocampus of the growth period rats repea-tedly ignited by pentylenetetrazole.Gastrodin may play a role in the formation of antiepileptic obviously,and through decreasing the expression of P38,which can inhibit the formation of synaptic reconstruction,as control seizures indirectly.

Objective To investigate the role of autophagy and synaptophysin (SYP) in cognitive impairment in de?pressed rats receiving electroconvulsive shock (ECS). Methods Clean and healthy adult male Sprague-Dawley rats were acclimatized to a standard laboratory environment for 7 days. The chronic unpredictable mild stress (CUMS) was used to establish the rat model of depression. Behavior tests were conducted before and after CUMS to evaluate the depression and cognition level of rats. After establishment of the model, 24 rats were randomly divided into ESC group (group E) and depression group (group D) with 12 rats in each group. The rats in group E were administered 80 mg/kg of propofol (10 mg/mL) by intraperitoneal injection, followed by ECS treatment. The rats in group D were administered propofol by intra?peritoneal injection, followed by sham-ECS treatments. The above interventions were conducted daily for 7 consecutive days. After the interventions, rats underwent behavior tests as before. Subsequently, rats were killed and specimens were collected for measurements. Immunohistochemistry was performed to examine autophagy markers such as Beclin 1 and LC3Ⅱand ELISA was used to detect SYP in the hippocampus. Results Group E after ECS significantly increased the percentage of sucrose preference (68.2%±8.7%), rearing times (7.0±1.9), total horizontal distance [(569.5±70.0) cm], es? cape latency [(21.9±5.3)s] and space exploration time [(20.5±3.9)s] compared with group D or group E before ECS. There was no significant difference in these index between groups before ECS or in group E between before and after ECS(P>0.05). Compared with group D, group E had upregulated protein expression levels of Beclin 1 and LC3Ⅱin CA1, CA3, DG as well as the area near the hippocampus and increased SYP contents (P<0.05). Conclusions Cognitive impairment in depression rats following ECS correlates with activated autophagy and increased SYP by ECS.

Objective To explore the effect of MECT on learning memory in depressed rats and its synaptic plasticity mechanism. Methods Fifty SD rats were randomly divided into 5 groups( n =10): MECT (received ECT with intraperitoneal propofol), ECT (received ECT only), propofol (received intraperitoneal propofol), depression, and control. The treatments were given daily for 7 consecutive days. All rats underwent open field and Morris water maze test. The SYP protein and mRNA expressions in rat hippocampus were detected using immunochemistry and RT-PCR, respectively. Results After treatment, the open field scores were much higher in MECT and ECT groups than in propofol and depression groups ( P <0.05); the learning memory was worse in ECT group than in MECT, propofol and depression groups ( P <0.05); the expressions of SYP protein and mRNA was higher in MECT and ECT groups than in propofol and depression groups ( P <0.05), the expressions of SYP protein and mRNA were lower in MECT group than ECT group ( P <0.05). Conclusions Propofol can improve learning memory in ECT-treated depressed rats through attenuation of ECT-induced expression of SYP in rat hippocampus.

Objective To investigate the effects of different doses of propofol on expression of synaptophysin (SYP) mRNA and protein in the hippocampus of mentally depressed rats after electroconvulsive therapy (ECT) .Methods Fifty adult male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 10 each): group Ⅰ control (group C); group D mental depression (group D) ; group Ⅲ , Ⅳ , Ⅴ propofol 90, 110, 130 mg/kg + ECT (group M_1, M_2, M_3). Mental depression was induced by isolation and chronic unpredictable mild stress (CUMS) in group Ⅱ-Ⅴ . Group M_1 , M_2 and M_3 received intraperitoneal (IP) propofol 90, 110 and 130 mg/kg respectively + ECT once a day ×7 consecutive days while group C and D received IP normal saline instead of propofol. The rats underwent open field test and sucrose liquid consumption test the day before and after mental depression was established and one day after treatment. The rats were killed after the last test for determination of expression of SYP mRNA (by RT-PCR) and protein (by immuno-histochemistry) in the hippocampus. Results The ambulation scores, rearing scores, grooming time and sucrose consumption percentage were significantly decreased while the center,grid detention time (CDT) was significantly increased in group Ⅱ-Ⅴ as compared with control group indicating mental depression was successfully induced. The ambulation scores, rearing scores, grooming time, sucrose consumption percentage, SYP mRNA and protein expression were significantly increased while CDT was significantly decreased after treatment in group M_1 and M_2 as compared with group D indicating that propofol 90 or 110 mg/kg combined with ECT was effective for the treatment of mental depression.Conclusion Propofol 90 or 110 mg/kg combined with ECT is effective in treating mental depression while proprofol 130 mg/kg combined with ECT is not. Excessive inhibition of SYP expression in hippocampus by large dose of propofol may explain the mechanism.`

OBJECTIVETo establish the quantitative analysis method of triterpene delta-amyrone in Sedum sarmentosum by HPLC-ELSD.

METHODThe Zorbax Sil Column was used and the mobile phase was dichloromethane-methanol (99:1). The flow rate was set at 0.5 mL x min(-1), the temperature of drift tube was set at 100 degrees C and the nebulizer nitrogen flow rate was 3.0 L x min(-1).

RESULTThe linear range of sigma-amyrone was 2.12-10.6 microg. The average recovery was 100.5%.

CONCLUSIONThe results showed that the method was reliable, simple and precise. It would be beneficial for the study of the quality control of S. sarmentosum.

Chromatography, High Pressure Liquid ; methods ; Plants, Medicinal ; chemistry ; Quality Control ; Sedum ; chemistry ; Triterpenes ; analysis

OBJECTIVETo evaluate the cost-effectiveness of different screening strategies for nasopharyngeal carcinoma (NPC) and recommend a preferable NPC screening strategy.

METHODSA Markov simulation model was constructed based on the natural history of NPC. Seven strategies (A. Annual screening; B. Annual screening for (Epstein-Barr virus, EBV) EBV-seropositive subjects, triennial screening for seronegative subjects; C. Biennial screening; D. Triennial screening; E. 4-year screening; F. 5-year screening; G. 6-year screening) were evaluated. The NPC-pickup rate, cost, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER) were calculated.

RESULTSThe ICERs of the 7 strategies were 83 111.6, 47 768.9, 50 164.7, 40 016.2, 34 272.8, 32 215.6, and 32 248.0 Yuan/QALY, respectively. The discounted QALYs of the strategies were 23 079.9, 22 955.6, 22 810.4, 22 636.5, 22 522.7, 22 445.0, and 22 361.9 years, respectively. The ICERs of the strategies were less than three times of the average per capita gross domestic product (89 976 Yuan) in China in 2010. The strategy A achieved a highest NPC pick-up rate (81.7%), a highest discounted QALY and a smallest number of NPC death (681), but a highest discounted cost and a greatest ICER. Compared with the strategy A, the strategy B achieved a little smaller NPC pick-up rate (73.1%), a little smaller number of NPC death (707), however, the ICER of the strategy B decreased by 38.2%.

CONCLUSIONThe strategy B (annual screening for EB virus seropositive subjects and triennial screening for seronegative subjects) is a preferable option for NPC screening.

Adult ; Carcinoma ; China ; epidemiology ; Cost-Benefit Analysis ; Early Detection of Cancer ; economics ; methods ; Epstein-Barr Virus Infections ; diagnosis ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Male ; Markov Chains ; Mass Screening ; economics ; methods ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; mortality ; Quality-Adjusted Life Years ; Survival Rate