This article discussed the ancient and modern meaning of security of intense drugs for pregnant woman. And emphatically studied the meaning of the ‘gu’, pointing out that ‘gu’had three connotations, one referred to disease, second mean the original disease, with the ‘new’disease relative, the third referred to reasons. In addition, the article expounded how can be safe for the pregnant woman to use drugs with extremely intense action. In this paper, its purpose was to examine how to achieve security under circumstance of sick and fi nally achieve balance and harmony.

Cerebral Infarction ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Neurology ; Parkinson Disease ; drug therapy ; Peripheral Nervous System Diseases ; drug therapy ; Phytotherapy

Objective To investigate the potential sedative effects of epidural anesthesia and its mechanism. Methods Fifty ASA Ⅰ -Ⅱ patients aged 20-55yr, scheduled for gynecological surgery were studied. Patients whose body weight exceeded 95 kg or was less than 45kg were excluded. Alcoholics and those addicted to sedative or opiates were also excluded. The patients were unpremedicated. Before anesthesia the patients' radial artery was cannulated for continuous BP monitoring and blood sampling. ECG, BIS and HRV were continuously monitored. Epidural puncture was performed at L1-2 . A catheter was inserted in epidural space for 3-4cm in a cephalad direction. The patients were randomly divided into 3 groups: epidural lidocaine group (group E, n = 15); intravenous lidocaine group (group Ⅰ , n = 15) and control group (group C, n =20). In group E the patients received an iv bolus of lidocaine 1.5mg?kg-1 followed by a lidocaine infusion at a rate of 30mg?kg-1?min-1 and an epidural bolus of normal saline 15 ml; in group C the patients received an epidural bolus of NS 15 ml only. The intravenous lidocaine infusion in group I was designed to mimic systemic absorption of lidocaine from epidural space. 20 min after epidural lidocaine or saline administration, a propofol infusion was started at a rate of 150ml/h until the patients lost consciousness, The amount of propofol infused was recorded. Blood samples were taken before propofol infusion for determination of plasma level of lidocaine. Results The amount of propofol infused when the patients lost consciousness was (1.22 ?0.25) mg?kg-1 in group E, (1.62 ?0.22) mg?kg-1 in group I and (1.85?0.41) mg?kg-1 in control group. The amount of propofol infused in group E was significantly less than that n group I and C ( P

Objective To know normal reference value of heart-type fatty acid-binding protein (H-FABP) in serum. Methods Serum H-FABP levels of 126 healthy individuals were measured by ELISA. Levels of MYO, cTnI and CK-MB were assayed in the same time as control. The normal threshold value was calculated as mean value?2s. Results The normal concentration of H-FABP in serum was 3 79?3 52?g/L and the difference in age and gender wasn’t significant. Conclusions The normal reference value of serum H-FABP is 0～10 83?g/L.

Objective To evaluate the role of extracellular signal-regulated kinase-cyclic AMP response element binding protein(ERK-CREB) signal pathway in glucocorticoid receptors-mediated chronic morphine tolerance in rats.Methods Male SD rats aged 2 months weighing 280-320 g were used in this study.A catheter was placed in subarachnoid space via foramen magnum according to Yaksh.Thirty-six rats in which intrathecal (IT) catheters were successfully implanted were randomly divided into 6 groups ( n =6 each):control group ( group C),chronic morphine tolerance group (group M),morphine + dexamethasone group (group MD),morphine + RU38486 group (group MR),dexamethasone group (group D),RU38486 group (group R).Normal saline 10 μl,morphine 10 μg,morphine 10 μg + dexamethasone 4 μg,morphine 10 μg + RU38486 2 μg,dexamethasone 4μg,RU38486 2 μg was administered IT twice a day(8:00 and 20:00)for 6 consecutive days in groups C,M,MD,MR,D,R respectively.Tail flick latency (TFL) was measured at 1 d before IT drug administration(baseline)and at 30 min after first IT drug administration during 1,3,5 d and at 1 d after last IT drug administration (T1～4).Maximum analgesic effect (MPE) was calculated.The animals were sacrificed after last TEL measurement.The L3～5 segment of the spinal cord was isolated for determination of the expression of phosphorylated ERK(pERK)and phosphorylated CREB(pCREB) by immunofluorescence staining.Results MPE was significantly T1 lower at T3,4 than at T1 in groups M and MD.Compared with group C,MPE was significantly increased,the expression of pERK and pCREB up-regulated in group M,but no significant change was found in the parameters mentioned above in groups R and D.Compared with group M,MPE was significantly increased,the expression of pERK and pCREB up-regulated in group MR,and MPE was significantly increased,the expression of pERK and pCREB down-regulated in group MD.Conclusion The mechanism by which glucocorticoid receptors-mediated chronic morphine tolerance may be associated with the inhibition of ERK-CREB pathway.

Objective:To investigate the chemical constituents from Avicennia marina.Methods:The isolation and purification of the CH2Cl2 and n-BuOH fractions of this plant were performed,and the chemical structures were elucidated by spectral analysis as well as comparison of their spectral data with literature values.Results:Three novel compounds were obtained and identified as erythro-guaiacylglycerol-?-ferulic acid ether(1),marinnone A(16) and marinnone B(17),along with eighteen known compounds as threo-guaiacylglycerol-?-ferulic acid ether(2),eleutheroside E2(3),(+)-lirioresinol A(4),dihydroxymethyl-bis(3,5-dimethoxy-4-hydroxyphenyl) tetrahydrofuran-9-O-?-glucopyranoside(5),(+)-lyoniresinol 3a-O-?-D-glucopyranoside(6),(-)-lyoniresinol 3a-O-?-D-glucopyranoside(7),epi-pinoresinol(8),leucoseceptoside A(9),jionoside C(10),salsaside A(11),ilicifolioside A(12),acteoside(13),isoacteoside(14),ethyl ferulate(15),avicennone D(18),avicenone E(19),avicennol C(20),and stenocarpoquinone B(21).Conclusion:Three new compounds(1,16 and 17) were obtained and thirteen known compounds,2-12,14 and 15 were isolated from Avicennia genus for the first time.

Objective To observe the ultrastructural changes of end-plate and gastrocnemius muscle of rats with spastic palsy after injected with botulinum toxin type A in order to provide scientific base of histomorphology for clinical use of botulinum toxin type A.Methods Wistar rats′ pyramidal tracts in experiment group were injured by electric current 2.5 mA for 30 s,twice,but 36 normal control rats were only drilled hole in skull(control group).Seventy-two rats were successful in building spastic palsy model.Botulinum toxin type A (6 U/kg) were injected into right gastrocnemius muscles of 36 spastic palsy rats (group B),and physiological saline were injected into the same muscles in 36 spastic palsy rats as control(group A).Control group were not injected.The rats of group A,group B were sacrificed on 3,7,15,30,60 and 90 days after botulinum toxin therapy,and right gastrocnemius muscles was separated for histological analysis.Results Under the electron microscope,the structure of muscle fiber in group B had changed(Z line rupture,disorder and abolition,myofilament lysis,triad tract diso-rder,vacuolar degeneration) and these changes in group B occurred earlier and were severer than those in group A.There was compensatory hypertrophy of muscle fiber at later stages in group B.During the first 15 days after botulinum toxin type A injection,there were many synaptic vesicle without pre-synaptic membranes near terminal portion of nonmedullated nerve fibers.Following this,between 15 to 30 days,there were many folds similar to postsynaptic membranes in the cellular membranes and there were many grains in it.But there was no synaptic vesicle and pre-synaptic membranes near them.Compensatory hypertrophy and atrophy of muscle fiber coexist at 90 days after injection in group B.Conclusions Injection of botulinum toxin type A maybe induce the sprout of nerve and degeneration of the partial postsynaptic where there are many grains.It also accelerates muscle atrophy,but it induces compensatory hypertrophy of muscle fiber at later stage.It implies that injection of botulinum toxin type A can improve spasm symptom of the gastrocnemius muscles and this is good for muscle fiber repairing.

AIM: To study the curative effect for patients with age related cataract and shallow anterior chamber after phacoemulsification.METHODS: Totally 38 patients (38 eyes) with age related cataract and shallow anterior chamber were selected and divided into two groups according to the depth of the anterior chamber, as mild shallow anterior chamber group (2-2.5mm) 23 eyes, high risk shallow anterior chamber group (<2.0mm) 15 eyes.Thirty-eight patients (38 eyes) with age related cataract with normal anterior chamber were as control group at the same period.All the patients received the operations by the same doctor and were followed up for 3mo.The observed items included visual acuity before and after operations, intraocular pressure, anterior chamber depth, corneal endothelial cell density and complications.RESULTS: There were no significant difference on visual acuity, intraocular pressure and corneal endothelial cell density between the two groups before operations (P>0.05).The visual acuity improved significantly after operation in both groups (P<0.05).Intraocular pressure after operation decreased significantly in both groups (P<0.05).Anterior chamber depth increased significantly after operation in both groups (P<0.05).Corneal endothelial cell density decreased significantly in both groups (P<0.05).There were no significant difference on anterior chamber depth, intraocular pressure and corneal endothelial cell density between the two groups at different time point after operations (P>0.05).Posterior capsular rupture occurred in shallow anterior chamber group in 1 eye, suspensory ligament rupture in 1 eye.Posterior capsular rupture and suspensory ligament rupture occurred none in normal anterior chamber group.Postoperative corneal edema occurred in 10 eyes (26%) in shallow anterior chamber group, which occurred in 3 eyes (8%) in normal anterior chamber group.The difference on the incidence was significant (P <0.05).CONCLUSION: Phacoemulsification should be taken timely for patients with age related cataract and shallow anterior chamber.The postoperative visual acuity can be improved and the anterior chamber depth can increase.The operation is safe and effective for those patients.

Andrology and gynecology have a similar or the same theoretical basis in Traditional Chinese Medicine (TCM). Andrology has a history of less than 3 decades in China, while TCM gynecology has developed for over a thousand years. The development of andrology could be greatly promoted with the guidance of the theories and prescriptions of gynecology.
Andrology ; China ; Gynecology ; Humans ; Medicine, Chinese Traditional

Objective To investigate the effect of dexmedetomidine on minimal induced dose of propofol and cardiovascular responses to tracheal intubation.Methods A double-blind randomized controlled trial was conducted.Sixty patients who underwent elective laparoscopic surgery were randomly divided into the dexmedetomidine group (treatment group) and control group.Patients in treatment group were given dexmedetomidine at dose of 0.1 μg/kg · min for 10 min before anesthesia induction,and then infused with 0.4 μg/kg · h until the end.Sodium chloride injection was infused at the same rate in control group.After 10 minutes from the start of dexmedetomidine or sodium chloride injection,propofol was infused by 0.4 mg/kg · min.The dosage of propofol used was recorded when eyelash reflex disappearing,and BIS value in 40 to 60.Propofol was infusion at the same rate,and laryngoscope was incubated at 2 minutes after fentanyl and rocuronium were given.The alertness/sedation (OAA/S scores),mean arterial pressure (MAP),heart rate,pluse oxygen saturation (SpO2) and BIS values were recorded at baseline (before dexmedetomidine or sodium chloride injection infusion),5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion,at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 min after intubation.Results OAA/S scores and BIS values in the treatment group were significantly lower than that of control group at 5 minutes and 10 minutes after the dexmedetomidine or sodium chloride injection infusion(P ＜0.05).MAP in treatment group was higher than that of control group at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 minutes after intubation (P ＜0.05).Heart rate in treatment group was lower than that of control group at 5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion and before the endotracheal intubation(P ＜ 0.05).There was no significant difference in terms of SpO2 between two groups (P ＞ 0.05).When patients consciousness disappeared and BIS values were in 40-60,the minimum induced dose of propofol was (88.00 ± 25.91) mg in treatment group and (117.33 ± 25.45) mg in control group.The dosage of propofol treatment group was obviously less than control group (t =4.423,P ＜ 0.05).Conclusion Dexmedetomidine reduces the minimum induced dose of propofol while maintaining more stable hemodynamic changes during anesthesia induction.However,there has no obvious inhibition effect on cardiovascular response to tracheal intubation.