Objective To investigate the application of anesthesia methods and clinical experience in treatment of severe traumat-ic shock .Methods 48 severe traumatic shock patients were randomly divided into two groups by different anesthesia treatment ,in-cluding delayed resuscitation group (A group) and routine group (B group) ,24 cases in each group .Results Patients completed operation as expected with stable vital signs in the operation .Patients completely awaked and recovered the spontaneous respiration after 3~4 hours .4 cases in group A (16 .6% ) and 12 cases in group B (50% ) were died .The mortality of group A was significant-ly lower than that of group B (P<0 .05) .Conclusion The appropriate anesthetic managements for the severe traumatic shock pa-tients could maintain the function of each organ ,create favorable conditions for operation ,and improve the survival rate of critical patients .

The clinical medical work is accompanied with high risk .The medical treatment risk exists everywhere at anytime, but the graduate students of the Medical colleges lack the understanding of the hygiene laws. Therefore it is necessary for them to accept the education of hygiene law.

Though lack of definite evidences,closed suction drainage after arthroplasty is routinely employed by the majority of orthopaedic surgeons with the aim of preventing the formation of wound haematoma,reducing delayed wound healing and the risk of deep infection.But the optimal time to remove drains is controversial.The usual time to remove drains is 48~72 h after operation when the volume of drains is less than 50ml within 24 h.But some scholars find that the time of draining more than 24 h increases the risk of wound infection.This paper reviews the literature of draining time,and concludes that the optimal time to remove drains is 24 h after the primary arthroplasty.

Aim To investigate the effects of bradykinin preconditioning on the damage produced by focal cerebral ischemia-reperfusion in rats.Methods Rats were scheduled to undergo middle cerebral artery ischemia-reperfusion by intraluminal suture.Prior to ischemia,bradykinin was pumped into the brain via extra carotid artery and control group was given the same amount of normal saline.The infarct volume、brain water content、permeability of blood brain barrier and histological neuronal changes were evaluated after 2 h ischemia and 24 h reperfusion.Results Compared with other groups, bradykinin preconditioning 15min before ischemia reduced infarct volume、brain edema、permeability of blood brain barrier and histological neuronal damage.Conclusion Bradykinin preconditioning may provide protective effects against cerebral ischemic injury.This protection may be due to the protection of cerebral vasculature and the decrease of infarct volume.

Objective To study effect of etoricoxib on IL-1βand TNF-αin patients with gouty arthritis.Methods 86 patients with gouty arthritis from July 2014 to July 2016 in our hospital were selected, all patients were divided into study group and control group according to the treatment method with 43 cases in each group.The patients in the control group were treated with diclofenac sodium, the patients in the study group were treated with etoricoxib.The clinical symptoms, clinical treatment effects, VAS score, serum IL-1β, TNF-αlevels and adverse reactions were observed and compared between the two groups.Results The VAS score, the joint swelling score and the mobility limitation score of the study group were decreased than before treatment and significantly lower than those of the control group, the difference was statistically significant (P<0.05).The effective rate of the study group (95.35%) was significantly higher than that of the control group (79.07%), the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups were significantly lower than before treatment and the levels of IL-1βand TNF-αin the study groups were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of etoricoxib in treating patients with gouty arthritis is significant, which can effectively relieve the clinical symptoms, inhibit the expression of IL-1βand TNF-α, and the adverse reactions less.

Aim Toexplorewhether1-methylhydan-toin(MH)could inhibit the basal secretion of growth hormone (GH ) and suppress the promoting effect of growth hormone-releasing hormone (GHRH ) in rab-bits.Methods Thirty-sixrabbitswererandomlydi-vided into six experimental groups according to the kind of dosing drugs,namely normal saline group(A), MH group (B ),octreotide group (C ),GHRH group (D),GHRH +MH group(E),GHRH +octreotide group(F),with 6 rabbits in each group.Blood was sampled (1. 0 mL each time)from each rabbit before injecting drugs and 5,15,30,45,60 min after drug administration.Clotting spontaneously,rabbits blood samples were centrifugated for 20 minutes at approxi-mately 1000 ×g and the supernatant was collected. Serum GH concentrations were determined by enzyme linked immunosorbent assay kit(ELISA Kit).Mean-while,the behavior of rabbits in each group after injec-tingdrugswascloselyobserved.Results TheGH level of rabbits in group A at each time point had no significant differences(P>0. 05 ).Group B and group C rabbit GH levels were significantly lower than those of group A (P<0. 05 ),while GH levels in group D were obviously higher than those of group A (P <0. 05 ).Compared with group D,rabbit GH levels in group E and group F decreased markedly(P<0. 05 ). No obvious toxic and side effects had been observed within one week after the experimental rabbits were ad-ministered corresponding drugs by intravenous injec-tion.Conclusions 1-methylhydantoincouldinhibit the basal secretion of GH in rabbits.1-methylhydan-toin could suppress the promoting effect of GHRH in rabbits.

Objective To investigate the effects of apolipoproteinA1 (apoA1) on levels of cholesterol, cholesteryl ester (CE), and expression of ATP-bindiag cassette transporter A1 (ABCA1) in human acute monocytie leukemia cell line (THP-1) macrophage-derived foam cells.Methods The cultured THP-1 cells were induced into foam cells by exposing first to phorbol myristate acetate (PMA, 50 ng/ml) for 48 h, and then to oxidized-low density lipoprotein (ox-LDL, 50μg/ml) for 48 h.Under treatment of apoA1 in different doses (5, 10, 15 and 20 μg/ml) and one simple dose (10 μg/ml) for different time (6, 12 and 24 h), THP-1 macrophage-derived foam cells were incubated to observe the expression of cholesterol and ABCA1.The concentrations of cellular total cholesterol (TC), free cholesterol (FC) and CE were determined by oxidization enzymatic methods.Oil red O dyeing experiment was used to show the cellular lipid droplets in the cells.The expression of ABCA1 was tested by immunofluorescence method.Reverse transcription-polymerase chain reaction was applied to investigate mRNA expression of ABCA1.Results The THP-1 cells turned into typical foam cells after treated with PMA (50 ng/ml) for 48 h, and ox-LDL (50 μg/ml) for 48 h.apoA1 could lower the levels of TC, FC and CE in THP-1 macrophage-derived foam cells in a dose-dependent and a time-dependant manner, apoA1 could increase the expression of ABCA1 protein in THP-1maerophage-derived foam cells without up-regulation of mRNA.Antibody of ABCA1 could up- regulate the expression of ABCA1.Conclusions apoA1 may decrease the levels of cholesterols in THP-1 macrophage-derived foam cells, by promoting the expression of ABCA1 and the reverse cholesterol transport of high density lipoprotein.

Objective To study and compare the clinical efficacy between intravitreal conbercept injection and (or) macular grid pattern photocoagulation in treating macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO).Methods Ninety eyes of 90 patients diagnosed as macular edema secondary to non-ischemic BRVO were enrolled in this study.Forty-eight patients (48 eyes) were male and 42 patients (42 eyes) were female.The average age was (51.25 ± 12.24) years and the course was 5-17 days.All patients were given best corrected visual acuity (BCVA),intraocular pressure,slit lamp with preset lens,fluorescence fundus angiography (FFA) and optic coherent tomography (OCT) examination.The patients were divided into conbercept and laser group (group Ⅰ),laser group (group Ⅱ) and conbercept group (group Ⅲ),with 30 eyes in each group.The BCVA and central macular thickness (CMT) in the three groups at baseline were statistically no difference (F=0.072,0.286;P=0.930,0.752).Patients in group Ⅰ received intravitreal injection of 0.05 ml of 10.00 mg/ml conbercept solution (conbercept 0.5 mg),and macular grid pattern photocoagulation 3 days later.Group Ⅱ patients were given macular grid pattern photocoagulation.Times of injection between group Ⅰ and Ⅲ,laser energy between group Ⅰ and Ⅱ,changes of BCVA and CMT among 3 groups at 1 week,1 month,3 months and 6 months after treatment were compared.Results Patients in group Ⅰ and Ⅲ had received conbercept injections (1.20 ± 0.41) and (2.23 ± 1.04) times respectively,and 6 eyes (group Ⅰ) and 22 eyes (group Ⅲ) received 2-4 times re-injections.The difference of injection times between two groups was significant (P＜0.001).Patients in group Ⅱ had received photocoagulation (1.43 ±0.63) times,9 eyes had received twice photocoagulation and 2 eyes had received 3 times of photocoagulation.The average laser energy was (96.05 ±2.34) μV in group Ⅰ and (117.41 ±6.85) μV in group Ⅱ,the difference was statistical significant (P=0.003).BCVA improved in all three groups at last follow-up.However,the final visual acuity in group Ⅰ and group Ⅲ were better than in group Ⅱ (t=4.607,-4.603;P＜0.001) and there is no statistical significant difference between group Ⅲ and group Ⅰ (t=-0.802,P=0.429).The mean CMT reduced in all three groups after treating for 1 week and 1 month,comparing that before treatment (t=-11.855,-10.620,-10.254;P＜0.001).There was no statistical difference of CMT between group Ⅰ and Ⅲ at each follow up (t=0.404,1.723,-1.819,-1.755;P=0.689,0.096,0.079,0.900).CMT reduction in group Ⅰ was more than that in group Ⅱ at 1 week and 1 month after treatments (t=-4.621,-3.230;P＜0.001,0.003).The CMT in group Ⅲ at 3 month after treatment had increased slightly comparing that at 1 month,but the difference was not statistically significant (t=1.995,P=0.056).All patients had no treatment-related complications,such as endophthalmitis,rubeosis iridis and retinal detachment.Conclusions Intravitreal conbercept injection combined with macular grid pattern photocoagulation is better than macular grid pattern photocoagulation alone in treating macular edema secondary to non-ischemic BRVO.Combined therapy also reduced injection times comparing to treatment using conbercept injection without laser photocoagulation.

Objective To explore the role of Foxp3+ T cells (Tregs) in liver injury induced by chronic intermittent hypoxia. Methods Thirty-two male Wister rats were divided into four groups:control group (A), high-fat diet group (B), intermittent hypoxia group (C), and high-fat diet and intermittent hypoxia group (D). After 4 weeks, blood samples were collected and livers were surgically removed. Using the standard automatic clinical analyzer to test serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL- C), alanina aminotransferase (ALT) and aspartato aminotransferase (AST). The MDA content of liver tissue was measured by colorimetrc method. The levels of TNF-αand IL-1βwere measured by radiommunoassay, and the expression of Foxp3 protein was measured by Western blotting technique. Results Serum levels of TC and LDL-C were significantly higher in B group than those of A, C and D groups, and which were higher in D group than those of A and C groups (P<0.05). There were no significant differences in serum levels of TC and LDL-C between A group and C group. Serum levels of ALT, AST, MDA, TNF-αand IL-1βwere significantly higher in C group than those of A group, and which were significantly higher in D group than those of A, B and C groups (P<0.05). There were no significant differences in these indicators between A group and B group, and between B group and C group. Foxp3 protein expression in liver was significantly lower in D group than that of other groups (P<0.05). Conclusion Foxp3+T regulatory cells involve in the regulation of hepatic injury induced by chronic intermittent hypoxia on the basis of a high-fat diet, and which may play an important role in this process of protective immune response.

Objective To explore the histological properties of isolated chondrons and chondrocytes from rabbit knee cartilage,and to determine if these properties vary with age.Methods Three groups of rabbit knees were evaluated according to different age:(1) young (2 months,n=10);(2) adult (8 months,n=10);and (3) old (31 months,n=10).The cartilage structure,proteoglycan,collagen-2,and collagen-6 content were determined by light microscopic using hematoxylin-eosin (HE),Toluidine Blue,and col-2,6 staining.The chondrons were enzymatically isolated using 0.3 g/L dispase and 0.2 g/L collagenase-2 by shaking for 3 hours.The morphology and composition of isolated chondrons were observed by HE and collagen-6 immunostaining staining after overnight coverslip monolayer culture under a microscopy.Results The chondrocytes became sparser and the total content of proteoglycans and collagen-2 were decreased in the articular cartilage with age.Compared to the chondrocytes,the surrounding rim or capsule was more obvious in the isolated chondrons,and they exhibited obvious differences in shape.The cells within one cluster from different age groups were similar to the morphology observed in cartilage in situ.The adult and old chondrons generally possessed a thicker pericellular matrix with more enclosed cells,and the chondrons contained more cells can reach 47％.Conclusion These findings further suggest that the properties of the chondrons and pericellular matrix have an important influence on the biomechanical microenvironment of the knee joint cartilage degeneration that occurs with age.