Objective To investigate the effect of ramipril on urinary protein in elderly type 2 diabetic patients with nephropathy in different periods.Methods 120 type 2 diabetic patients with nephropathy (64 males, 56 females) with mean aged (68±3) years were randomized into treatment group and control group (n =60, each).According to test results of 24 h proteinuria and renal function, they were divided into 3 subgroups: the normal urine albumin (normal control) group, the early diabetic nephropathy group, and the clinical diabetic nephropathy group.The control group received conventional treatment, while the treatment group used conventional treatment combined with ramipril 2.5 mg/d.Both groups had treatment course of 3 months.The changes in 24 h urinary total protein and urinary albumin before and 1 and 3 months after treatment, and the changes in blood urea nitrogen and serum creatinine levels in patients with renal dysfunction before and 3 months after treatment were observed and compared.Results 24 h urinary total protein and urinary albumin were significantly decreased along with the extended treatment time (P＜0.05 or 0.01).The blood urea nitrogen and serum creatinine levels were significantly declined at 3 months after treatment versus pre-treatment (P＜0.05 for both).There were no significant differences in 24h urinary total protein and urinary albumin in control group before versus after treatment (P＞0.05 for both).At 1 and 3 months after treatment, there were significant differences both in the decrement of 24h urinary total protein and urinary albumin, and in the blood urea nitrogen and serum creatinine levels between the clinical diabetic nephropathy treatment group and the control group (P＜0.05 or 0.01).Conclusions Ramipril combined with conventional treatment can effectively reduce proteinuria and promote the recovery of renal function for type 2 diabetic patients with nephropathy.

Three ASA Ⅱ patients, aged 24-32 yr, weighing 56-74 kg, undergoing caesarean section with nitroglycerine for uterine smooth muscle relaxation, from May 2005 to April 2007 in our hospital, were studied. Among the 3 cases, 2 cases (39 or 40 weeks of gestation) were singleton pregnancy and 1 case (34 weeks of gestation) was twin pregnancy.Combined spinal-epidural block with an injection was used in the 3 patients and the block level was at T4-6-S3-5. The excess contraction of uterine occurred in the patient at 40 week gestation about 140 s after uterus incision and it was difficult in delivery of the fetus, trananasal administration was then performed with nitroglycerine 0.5 nag, but it was inefficient after 60 s observation. Nitroglycerine 0.2 nag was injected intravenously, 32 s later the uterine smooth muscle relaxation was good and the fetus was delivered smoothly. In the patients at 39 and 34 week gestation, nitroglycerine 0.2 mg was injected intravenously when the excess contraction of uterine occurred about 140 s after uterus incision and the 2rid fetus started to be. delivered respectively. The uterine smooth muscle relaxation was good 45 or 35 s after injection and the fetuses were delivered smoothly. Apgar score was 6-8 and 10 at 1 and 5 min after delivery in the 3 patients. The duration from hysterotomy to delivery was 195-240 s. Intravenous drip of oxytocin 20 U was given immediately after delivery, and then uterus contracted. No obvious adverse reactions were found.

Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

One hind leg(7 %TBSA)of the rat was scalded and the changes of the reduction-oxidation state and protein degradation in the soleus muscle were observed 72 hours postinjury both in vitro and in vivo.It was found that the lactate/pyruvate (L/P) and malate/pyruvate(M/P)ratios of the soleus muscle were significantly lower and the protein degradation rate much higher in the scalded leg than in the unscalded legs and the control.After the addition of insulin to the medium significant elevation of L/P and M/P ratios and reduction of the protein degradation rate in the soleus muscle could be observed.There findings suggest that there is a good correlation between the changes of the reduction-oxidation state and the protein degradation rate in the cytosol of the soleus muscle after scalding in the rat.

ve To investigate the effect of intravenous cAMP on the myocardial infarct size, the ultrastructure of myocardium and myocardial cell apoptosis and the possible mechanism of myocardial protection affected by cAMP against ischemia /reperfusion (I/R) injury. Methods Forty SD rats of either sex weighing 250-280g were anesthetized with abdominal sodium pentobarbital 4.5mg/100g, tracheotomized and mechanically ventilated (VT = 2ml/100g, RR = 60bpm) . Myocardial I/R was produced by tying and untying of left anterior descending coronary artery. Ischemia lasted 30 min and reperfusion 2h. Rats were randomly divided into 3 groups: control group (n = 8) in which left anterior descending coronary artery was exposed and a piece of silk thread was placed around the artery but not tied; I/R group (n = 16) in which normal saline 1ml was injected into sublingual vein before I/R; cAMP group (n = 16) received intravenous cAMP 1mg/kg 5min before I/R. The animals were then sacrificed and heart was harvested for determination of myocardial infarct size (by TTC) and ultrastructure examination (electron microscope) . Apoptosis was identified by TUNEL and apoptosis index (AI) was obtained. The expression of Fas, Bcl-2 protein was measured by immunohistochemical technique. Results The infarct size was smaller in cAMP group than that in I/R group . Myocardial apoptosis and necrosis were quite obvious in I/R group whereas in cAMP group the ultrastructure of myocardium was fairly normal. The AI in I/R group was significantly higher than that in cAMP group (P 0.05 ) . Conclusions cAMP can protect myocardium from I/R injury by modulating the expression of Fas and Bcl-2 protein and inhibit apoptosis following myocardial I/R.

Objective To investigate the effects of stellate ganglion block(SGB) on the pulmonary artery endothelial nitric oxide synthase (eNOS) and mean pulmonary artery pressure ( MPAP) in rabbits with hypoxic pulmonary hypertension ( HPH) .Methods Twenty-four rabbits of both sexes weighing 2.5-3.0 kg were anesthetized with 1.5% sodium pentobarbital 30 mg? kg-1 . Spontaneous breathing was maintained. Left stellate ganglion was exposed aseptically. An epidural catheter was fixed with one end placed close to stellate ganglion and the other end outside the neck through a hole in the skin for administration of drugs. One week later the rabbits were randomly divided into 4 groups with 6 animals in each group: Ⅰ control group; Ⅱ SGB group; Ⅲ hypoxia group and Ⅳ SGB + hypoxia. In group Ⅲ and Ⅳ the animals were placed in a closed box filled with hypoxic air (O2 % = 10 ? 2% ) 8 h a day for 2 weeks. In group Ⅱ and Ⅳ 0.25% bupivacaine 0.5 ml was injected through the catheter 3 times a day for 3 days. In group Ⅰ and Ⅲ normal saline 0.5 ml was injected instead of bupivacaine. The effect of SGB was confirmed by ptosis and miosis. The content of eNOS in pulmonary artery was detected using immunohistocheistry technique. Pulmonary artery was cannulated after thoracotomy for determination of MPAP. Results There was no significant difference in MPAP between control and SGB groups. MPAP was significantly increased in hypoxia and hypoxia + SGB groups compared with control group(P

Objective To investigate the protective effects of different concentrations of propofol on thelungs apainst acute injury induced by lipopolysaccharide (us) in rats.Methods Twenty-four male Wistar ratsweighing 150-250g were randomly divided into 4 groups with 6 animals in each group : (1) control group receivedonly normal saline; (2) LPS group received LPS 5 mg?kg~(-1)i. v.; (3) propofol group 1 received a bolus 5 mg?kg~(-1) after LPS followed by propofol infusion at 5 mg?kg~(-1) ; (4) propofol group Ⅱ received a bolus of propofol 10mg.kg~(-1) after LPS followed by propofol infusion 10 mg?kg~(-1). Blood samples were obtained from femoralartery for determintiion of serum concentrations of TNF-?, IL-? and IL-10 at 1, 2, 3, 4 h after LPS injection. Theanimals were then killed by exsanguination. The lungs were removed. Left lung was lavaged and the broncho-alveolar lavage fluid (BALF) was collected for determination of its neutrophil count, and protein, TNF-?, IL-I?and IL-10 levels. Right lung was used for measurement of wet / dry lung weight ratio. Results In LPS group thewet/dry lung weight ratio, BALF neutrophil counts and protein contents and BALF and serum TNF-?, Ib-I? andIL-10 levels were significantly increased compared with control group (P

Objective To investigate the protective effects of Shenfu injection on myocardium against ischemia and reperfusion injury in rats. Methods Twenty-four healthy male SD rats weighing 230-280 g were randomly divided into three groups (n = 8,each): sham-operation group(Sham), ischemia and reperfusion group (I/R), Shenfu injection group(SF) . In Sham group, the anterior descending branch of left coronary artery was exposed and a piece of silk thread was placed around the artery but untied. The ischemia and reperfusion injury models in I/R and SF groups were made by temporary ligation of the anterior descending branch of left coronary artery,ischemia lasted for 30 min and reperfusion for 60 min. In SF group, the Shenfu injection(10 ml/kg) was intraperitoneally injected 30 min before ischemia. In Sham and I/R groups, normal saline (10 ml/kg) was intraperitoneally injected. After 60 min reperfusion, the blood samples of all rats in each group were collected from the left carotid arterial catheter for determination of the concentrations of plasma TNF-?, IL-6 ( ELISA) . The myocardium samples were obtained for ultrastructure observation (Electron-microscope) .Results Compared with that in Sham group, the plasma concentrations of TNF-? and IL-6 in I/R group significantly increased( P

Objective To investigate the effect of angiotensin Ⅱ type Ⅰ receptor antagonist losartan on the infarct size and ultrastructure of myocardium and activation of NF-?B induced by myocardial ischemia and reperfusion (I/R) and the possible underlying mechanism. Methods Forty-two healthy male SD rats weighing 215-285 g were randomly divided into 4 groups: in control group ( n = 6) the anterior descending branch of left coronary artery (LCA) was exposed but not occluded; in I/R group (n = 12) the anterior descending branch of LCA was occluded for 30 min followed by 60 min reperfusion; in group LOS1 ( n = 12) and group LOS2 ( n = 12) losartan 5 mg (LOS1) or 10 mg (LOS2) was injected i.v. 15 min before myocardial ischemia. At the end of 60 min reperfusion the animals were killed and the hearts were harvested for determination of (1) myocardial infarct size (by TTC) , (2) ultrastructure of myocardium (electron microscope) and (3) activation of NF-?B.Results The infarct size in group LOS1 (34.6%?2.2%) and LOS2 (21.8%?4.0%) was significantly smaller than that in I/R group (45.4%?2.4%). Myocardial ultrastructure was well preserved in group LOS1 and LOS2 as compared to I/R group. NF-?B activity was significantly increased in I/R group and losartan pretreatment significantly reduced the increase in NF-?B induced by I/R. Conclusion Angiotensin Ⅱ type Ⅰ receptor antagonist losartan has cardioprotective effect on myocardium against I/R in a dose-dependent manner. Modulation of NF-?B activated by I/R may be involved in the mechanism.

Objective To investigate the effects of thiopental on expression of nuclear factor kappa B (NF-?B) and content of TNF-? and IL-1? in the lungs induced by lipopolysaccharide (LPS) .Methods Twenty-four male Kunming mice weighing 15-25 g were randomly divided into 4 groups (n = 6 each) : I control group received intraperitoneal (i.p.) normal saline (NS) 1 ml?kg-1 ; Ⅱ LPS group received i.p. LPS 5 mg?kg-1 ; Ⅲ LPS + thiopental (TH) received intrapentoneal TH 60 mg?kg-1 20 min after i.p. LPS 5 mg?kg-1 and Ⅳ TH group received i.p. TH 60 mg?kg-1 alone. The animals were bled to death at 3 h after LPS administration. The lungs were immediately removed for determination of expression of NF-?B p65 (Western blot) and TNF-? and IL-1? content (ELISA) in the lung. Results The expression of NF-?B p65 was significantly increased and the level of TNF-? and IL-1? in the lungs were significantly increased after LPS stimulation as compared with control group ( P