AIM:To study the therapeutic effects of self-drafted Guzhang prescription in treatment of patients of liver cirrhosis(LC) and ascites. METHODS: 98 LC patients with ascits were randomly divided into two groups.The control group(48 cases)was treated with chemical medicine,including vitamins,hepatoprotective agent,diuretic and albumin(if necessary).The treatment group(50 cases) was treated with traditional Chinese medicine of Guzhang prescription.The therapeutic course was one year in two groups.The ascites-associated symptoms and signs,liver function,and HBV markers were observed before and after treatment, and biopsy in the liver was performed in part of the patients. RESULTS: After treatment,the clinical symptom and signs were improved in both groups,but the improvement in the treatment group was superior to that of the control group(P

Objective To discuss the effects of remifentanfl for delthemte hypotension in intracranial aneurysm clamp operation,evaluating the feasibility and safety.Methods Twenty intracranial aneurysm patients undergoing occlusion surgery were prospectively randomized in to two groups:Group Ⅰ and Group Ⅱ.Group Ⅰ adopted remifentanil for deliberate hypotension and Group Ⅱ adopted sodium nitroprusside.The data were analyzed with SPSS 11.5 for Windows.Results Deliberate hypotension was achieved at the target mean arterial pressure(MAP)for remifentanil and nitroprusside respectively.During deliberate hypotension,HR in Group Ⅰ were lower than that in Group Ⅱ(P<0.01).RPP in Group Ⅰwere lower than that in Group Ⅱ(P<0.01).Blood loss in Group Ⅰ were lower than that in Group Ⅱ(P<0.05).Conclusion For general anesthesia in intracranial aneurysm clamp operation,using remifentanil for deliberate hypotemion is a good choice.

Objective To investigate the effects of surgical trauma on Toll?like receptor 4 ( TLR4) expression in the hippocampus of aged mice. Methods Ninety male Kunming mice, aged 16-18 months, weighing 30-40 g, were randomly divided into 3 groups ( n=30 each) using a random number table:control group ( group C), anesthesia group ( group A), and partial hepatectomy group ( group PH). Normal saline 0.1 ml∕10 g was injected intraperitoneally in group C. In group A, fentanyl 0.2 mg∕kg and droperidol 5 mg∕kg were injected intraperitoneally. In group PH, fentanyl 0. 2 mg∕kg and droperidol 5 mg∕kg were injected intraperitoneally, and the mice underwent partial hepatectomy. Cognitive function was assessed using Morris water maze test at 1, 3, and 7 days after anesthesia or surgery. After the end of the test, the hippocampus was immediately harvested for determination of the TLR4, tumor necrosis factor?alpha ( TNF?α) and interleukin?1 beta ( IL?1β) protein and mRNA expression by Western blot and real?time reverse transcriptase?polymerase chain reaction, respectively. Results Compared with group C, no significant changes were found in group PH in the escape latency, percentage of swimming distance in the target quadrant, and TLR4, TNF?α and IL?1β protein and mRNA expression at each time point after anesthesia in group A (P>0.05), and the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF?α and IL?1βprotein and mRNA was up?regulated at 1 and 3 days after surgery in group PH ( P<0. 05 or 0. 01 ) . Compared with group A, the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF?αand IL?1βprotein and mRNA was up?regulated at 1 and 3 days after surgery in group PH (P<0.05 or 0.01). Conclusion Surgical trauma can up?regulate the expression of TLR4 in the hippocampus of aged mice, which may be involved in the mechanism of surgical trauma?induced postoperative cognitive dysfunction.

AIM: To compare the effects of Yangxueqingnao Granules (Radix Angelicae Sinensis, Rhizoma Chuanxiong, Herba Asari, etc.) and Zhennaoning Capsule on hypertension headache. METHODS: Ninety-six cases with hypertension headache were grouped randomly according to clinical order. The single/parallel contrast study was adopted. The two groups were treated separately for twenty days with two kinds of drugs and observed. RESULTS: The clinical total effective rate of Yangxuequingnao Granules Group was 88%, superior to that of Zhennaoning Capsule Group, 65%(P

BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.

Objective To evaluate the effect of curcumin pretreatment on c-Jun N-terminal kinase (JNK) signaling pathway during one-lung ventilation (OLV)-induced acute lung injury in mice.Methods Ninety SPF male C57BL/6J mice,aged 6-9 weeks,weighing 18-24 g,were randomly divided into 6 groups (n=15 each) using a random number table:two-lung ventilation (TLV) group;OLV group;curcumin 100,150,200 and 250 mg/kg groups (C100,C150,C200 and C250 groups).The corresponding doses of curcumin were administered intraperitoneally at 2 h before one-lung ventilation in C100,C150,C200 and C250 groups.The animals were tracheally intubated and mechanically ventilated in volume-controlled mode.The ventilator settings were adjusted to maintain the end-tidal pressure of carbon dioxide at 35-45 mmHg.In OLV,C100,C150,C200 and C250 groups,unilateral lung was ventilated for 1.5 h followed by 0.5 h of TLV.Bilateral lungs were ventilated for 2.0 h in group TLV.Peak airway pressure and airway pressure were recorded at 1.5 h of OLV and 0.5 h of TLV.At the end of mechanical ventilation,left lungs were removed for microscopic examination of the pathologic changes,and the index of quantitative assessment for alveolar damage (IQA) was recorded.Wet/dry lung weight ratio (W/D ratio) was determined,and the cell apoptosis in lung tissues was detected using TUNEL.The apoptosis index (AI) was calculated.The expression of JNK mRNA was determined using real-time polymerase chain reaction.The expression of JNK and phosphorylated JNK was determined by Western blot.The phosphorylation of JNK was calculated.Results Compared with group TLV,the IQA,W/D ratio,AI,expression of JNK mRNA and phosphorylation of JNK were significantly increased in group OLV (P＜0.05).Compared with group OLV,the IQA,W/D ratio,AI,expression ofJNK mRNA and phosphorylation of JNK were significantly decreased in C150,C200 and C250 groups,the parameters mentioned above were significantly decreased in sequence in C100,C150,C200 and C250 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group C100 (P＞ 0.05).Compared with group OLV,the pathological changes were significantly attenuated in sequence in C150,C200 and C250 groups.Conclusion The mechanism by which curcumin pretreatment reduces cell apoptosis during OLV-induced acute lung injury is related to inhibition of JNK signaling pathway activation in mice.

Objective To investigate the effect of postoperative analgesia with difference methods on immunity in patients after thoracic tumour surgery. Methods Forty ASA Ⅰ-Ⅱ patients aged 35-65 years old undergoing thoracic tumour surgery were randomized to receive either postoperative patient- controlled intravenous analgesia (PCIA) (group Ⅰ, 20 cases) or patient-controlled epidural analgesia (PCEA) (group E, 20 cases) for 48 h. Medicine compatibility in group Ⅰ: sulfentanyl 1μg/ml, tropisetron 0.05 mg/ml, the PCIA pump was set up to deliver a 5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h. Epidual catheter was placed at T4-5interspace before induction of anesthesia in group E. The PCEA solution contained 2 mg/ml ropivacaine. The PCEA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h after a loading dose of 0.33% ropivacame 6 ml. The VAS score, Ramsay sedation score and complications were reeorded. Blood samples were taken before induction (baseline) and at 2 h and 1st, 3rd and 7th day after surgery for determination of plasma concentrations of cortisol, interleukin 2 (IL-2) and the level of natural killer (NK) cells and eytokine-induced killer (CIK) cells. Results There was no significant difference in VAS score at 2 h after operation between two groups [(1.8±0.3) scores in group Ⅰ and (1.8±0.5)scores in group E].Ramsay sedation score at Ist, 3rd and 7th day after operation in group E were significantly lower than those in group Ⅰ (P<0.05), The plasma concentration of cortisol at 2 h and Ist, 3rd, 7th day after operation in group Ewere significantly lower than those in group Ⅰ (P<0.05), the levels of IL-2, NK cells and CIK cells in group E were significantly higher than those in group Ⅰ (P<0.05). Conclusions The efficacy of postoperative PCEA in improving immunity after thoracic tumour surgery is better than that of postoperative PCIA.

Objective To evaluate the blood-saving effect of tranexamic acid in pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass (CPB).Methods A total of 56 children of both sexes,aged 11 months-14 yr,with body mass index of 9.8-21.4 kg/m2,of ASA physical status Ⅱ or Ⅲ,with left ventricular ejection fraction ＞50％,scheduled for elective radical correction of tetralogy of Fallot with CPB,were randomly divided into 2 groups using a random number table:tranexamic acid group (TA group,n =30) and normal saline group (NS group,n =26).Anesthesia was induced with iv midazolam,sufentanil,vecuronium and propofol.The children were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of 1％-2％ sevoflurane and infusion of propofol,sufentanil and vecuronium.After induction of anesthesia,a loading dose of tranexamic acid l0 mg/kg was intravenously infused over 20 min before skin incision,followed by infusion at a rate of 10 mg · kg-1 · h 1 until the end of surgery in TA group,while the equal volume of normal saline was given instead in NS group.The volume of chest tube drainage at 24 h after surgery and volume of allogeneic red blood cells,fresh frozen plasma,platelet and cryoprecipitate transfused were recorded.The requirement for re-thoracotomy for bleeding,and the incidence of hepatic artery and portal vein thrombosis were also recorded.Results Compared to NS group,the volume of chest tube drainage at 24 h after surgery and volume of allogeneic red blood cells,fresh frozen plasma,platelet and cryoprecipitate transfused were significantly reduced in TA group.No re-thoracotomy was required in TA group,and the rate of re-thoracotomy was 15％ in NS group.No hepatic artery and portal vein thrombosis were detected in group TA.Conclusion Tranexamic acid (loading dose 10 mg/kg,maintenance dose 10 mg· kg-1 · h-1) can provide blood-saving effect and has high security in pediatric patients undergoing radical correction of tetralogy of Fallot with CPB.

Objective To evaluate the effects of dexmedetomidine on the expression of spinal matrix metalloproteinase-9 (MMP-9) in a rat model of neuropathic pain (NP).Methods Eighty-one adult male SpragueDawley rats,weighing 190-230 g,were randomly divided into 3 groups (n =27 each) using a random number table:sham operation group (group S); group NP; dexmedetomidine group (group Dex).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.Paw withdrawal threshold to von Frey filament stimulation (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured at 1 day before operation (To,baseline) and 5,9 and 16 days after operation (T1-3).Nine animals were sacrificed after measurement of pain threshold at T1-3 and their lumbar segments (L4,5) of the spinal cord were removed for detection of MMP-9 expression (by immuno-histochemistry) and tumor necrosis factor-alpha (TNF-α) content (by ELISA).Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the levels of MMP-9 and TNF-α were increased at T1-3 in NP and Dex groups.Compared with NP group,MWT was significantly increased,TWL was prolonged,and the levels of MMP-9 and TNF-α were decreased at T1-3 in Dex group.Conclusion Dexmedetomidine can inhibit up-regulation of MMP-9 expression,and decrease inflammatory responses,thus attenuating NP in rats.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.