Objective To observe the effect of intravenous pre-injection of neostigmine on cardiovascular response(CVR) caused by neuromuscular electrical stimulation(NMES) in selective posterior rhizotomy(SPR) for patients with cerebral palsy.Methods 56 patients with cerebral palsy undergoing SPR at lumbarsacral segments under general anesthesia were randomly assigned to 2 groups: intravenous neostigmine 0.04 mg/kg(no more than 1 mg in total) and intravenous atropine 0.02 mg/kg(no more than 0.5 mg in total) 5 min before NMES in group N,and intravenous normal saline 0.12 ml/kg instead in group C.The systolic blood pressure(SBP) and heart rate(HR) at following time points: before skin incision(T1),before intravenous neostigmine/atropine or normal saline injection(T2),1 min after NMES(T3),and 10 min after NMES(T4).Results SBP and HR at T3 in group N were significantly lower than those in group C(P<0.01).No significant difference was found at T1,T2 and T4 between two groups(P>0.05).Cases who needed extra dose of fentanyl during NMES in group N were significantly lower than those in group C(P<0.01).Conclusion Intravenous pre-injection of neostigmine before NMES can effectively decrease the CVR caused by NMES.

Aurantii Fructus is the dried and immature fruit of Citrus aurantium and its cultivars. To investigate the chemical constituents of Aurantii Fructus, the separation and purification of constituents were performed by column chromatography on silica gel LH-20, HW-40, ODS, PHPLC and PTLC. Fourteen flavonoids, including four flavone glycosides and ten polymethoxyflavones (PMFs) were isolated from the EtOAc fraction and Petroleum ether fraction of Aurantii Fructus and their structures were identified by physicochemical properties and spectral data (NMR and MS) as (2R) -and (2S)-6"-O-acetylprunin (1,2), naringenin-7-O-β-D-glucopyranside (3), 5,7,4'-trihydroxy-8,3'-dimethoxyflavone-3-O-6"-(3-hydroxyl-3-methylglutaroyl)-β-D-glucopyranoside(4), 4'-hydroxy-5,6, 7-trimethoxyflavone (5), natsudaidain (6), nobiletin (7), sinensetin (8), 5,6,7,4'-tetramethoxyflavone (9), 5,7,8,4'-tetramethoxyflavone (10), 3,5,6,7,8,3',4'-heptamethoxyflavone (11), tangeretin (12), 5-demethyl nobiletin (13), and 5-hydroxy-6,7,3', 4'-tetramethoxyflavone (14). Compound 3-5 s were isolated from this plant for the first time and compound 1 was a new one.
Citrus ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Fruit ; chemistry ; Mass Spectrometry ; Molecular Structure

Objective To determine if pregnancy affects the toxicity of bupivacaine and to investigate the effect of Shenfu injectio,a preparation of Chinese herbal medicine,on central nervous system and cardiac toxicity of bupivacaine in pregnant rats.Methods Twenty-four SD rats weighing 320-360 g were assigned to 3 groups(n =8 each):Ⅰ non-pregnant control group,Ⅱ pregnant control group and Ⅲ Shenfu injectio pretreatment group. The animals were anesthetized with isoflorane(2%-4%)-O_2 inhalation which was stopped before bupivacaine infusion was started.Femoral artery was canunlated for MAP monitoring and blood sampling and femoral vein was cannulated for bupivacaine infusion.MAP,HR and ECG were continuously monitored.All animals in the 3 groups received continuous infusion of 5% bupivacaine at 2 mg?kg~(-1).min~(-1).In group Ⅲ Shenfu injectio 10 ml?kg~(-1) was injected intraperitoneally(IP)30 min before bupivacaine infusion whereas in the two control groups(group Ⅰ and Ⅱ)equal volume of normal saline was injected IP instead of Shenfu injectio.The duration between the beginning of bupivacaine infusion and onset of convulsion/arrhythmia(QRS≥90 ms)/asystol was recorded and the amount of bupivacaine infused was calculated.Results There was no significant difference in the amount of bupivacaine causing convulsion and asystol between group Ⅰ and Ⅱ but the amount of bupivacaine causing arrhythmia was significantly larger in group Ⅰ(non-pregnant) than in group Ⅱ(pregnant control group)(P＜0.05).The amount of bupivacaine causing convulsion,arrhythmia and asystole was significantly larger in Shenfu injectio pretreatment group(group Ⅲ)than in pregnant control group(group Ⅱ)(P＜0.05 or 0.01).Conclusion Bupivacaine- induced cardiotoxicity is increased in pregnant rats and Shenfu injectio pretreatment can reduce the systemic toxicity of bupivacaine in pregnant rats.

Objective To observe the therapeutic effect of glycosaminoglycans(GAGs)on diabetes mellitus with early nephropathy in order to find a new therapeutic approach to diabetic nephropathy. Methods 60 cases of type 2 diabetic nephropathy(albuminuria:30 to 300mg/24h,male/female:38/22,ages:43-70 years old, course of disease:1-30 years)without hypertension were selected. Some indexes were analyzed before and after administration of regular therapy in routine group or glycosaminoglycans group. The elderly group and non elderly group of diabetes nephropathy were compared. When the metabolism is stable, the levels of endothelin (ET), Netricoxide (NO)and urinary albumin excretion rate(UAER)were measured. Results After three months treatment, the levels of UAER were decreased significantly in both GAGs group and routine group(P＜0.01).After three months, UAER was decreased step by step, and there was no difference between the two groups. The levels of UAER had no change in regular group and there was significant difference between this group and the other two groups. In GAGs group, the levels of whole blood viscosity of medium shear rate 1,whole blood viscosity of medium sheer rate 2,whole blood viscosity of low shear rate were declined and serum NO increased significantly; that of plasma viscosity, whole blood reduced viscosity, ET were all decreased to some degree. Conclusion GAGs has the therapeutic effect on type 2 diabetic nephropathy patients with microalbuminuria because of decreasing UAER and reversing the development of DN. The benefit was positively correlated with the time of taking glycosaminoglycans.

Objective To evaluate the roles of PI3K/Akt and JAK/STAT signal transduction pathways in reduction of myocardial ischemia/reperfusion (I/R) injury by postconditioning with α subunit-containing nicotinic acetylcholine receptor (α7nAChR) agonist in rats.Methods Sixty Sprague-Dawley rats,weighing 290-320 g,were randomly divided into 4 groups (n =15 each):I/R group,ischemic preconditioning group (IPC group),ischemic postconditioning group (IPOC group) and postconditioning with specific α7nAChR agonist PNU282987 group ( PNU group ).Myocardial I/R was produced by 30 min occlusion of left anterior descending coronary artery followed by 180 min reperfusion in the 4 groups.The animals were subjected to 3 cycles of 5 min myocardial ischemia and 5 min reperfusion before 30 min myocardial ischemia in IPC group.The animals underwent 3 cycles of 10 s myocardial ischemia at 5 s intervals before 180 min reperfusion in group IPOC.PNU282987 2.4 mg/kg was injected intraperitoneally immediately before the reperfusion.At 60 min of reperfusion,5 rats in each group were sacrificed and the hearts were removed to determine the expression of Akt and STAT3 mRNA,phosphorylated Akt (p-Akt) and phosphorylated STAT3 (p-STAT3) in myocardial tissues.The left 10 rats in each group were sacrificed at 180 min of reperfusion and the hearts were removed to measure the infarct size.Results Compared with I/R group,the expression of STAT3 mRNA and p-Akt was significantly up-regulated in IPC group,and the expression of p-Akt and p-STAT3 was significantly up-regulated in IPOC group ( P ＜ 0.05).The infarct size was significantly reduced in IPC,IPOC and PNU groups compared with I/R group ( P ＜ 0.05 ).Conclusion The mechanism by which α7nAChR agonist postconditioning reduces myocardial I/R injury is not related to PI3K/Akt and JAK/STAT signal transduction pathways in rats.

ObjectiveTo evaluate the effects of combined vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning on myocardial ischemia-reperfusion (I/R) injury in rats.Methods One hundred male SD rats aged 8 weeks weighing 250-350 g were randomly allocated into 5 groups ( n =20 each):sham operation group (group S); I/R group; vagus nerve electric stimulation postconditioning group (group POES) ; limb remote ischemic postconditioning group (group RP) and vagus nerve electric stimulation postconditioning + limb remote ischemic postconditioning group (group POES-RP).Myocardial I/R was induced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in groups I/R,POES,RP and POES-RP.In groups POES and POES-RP,right cervical vagus nerve trank was stimulated for 30 min with continuous electric rectangular pulses (2 ms,10 Hz) starting from 15 min of myocardial ischemia.The voltage of the pulses was adjusted to decrease HR by 10％ of the baseline HR before stimulation.In groups RP and POES-RP the animals underwent 10 min ischemia of bilateral hind limbs starting from 20 min of myocardial ischemia.Arterial blood samples were collected from 10 rats in each group at 120 min of reperfusion for determination of serum concentrations of cTnI,CK-MB,TNF-α,high mobility group box 1 protein (HMGB1),intercellular adhesion molecule-1(ICAM-1),IL-1,IL-6 and IL-10 (by ELISA).The animals were then sacrificed and myocardial infarct size was measured by Evans blue and TTC staining.Another 10 rats were sacrificed at 120 min of reperfusion for determination of myocardial contents of TNF-α,HMGB-1,ICAM-1,IL-1,ID6 and IL-10 (by ELISA).ResultsI/R induced myocardial infarct and significantly increased serum concentrations of cTnI,CK-MB,TNF-α,HMGBi,ICAM-1,IL-1 and IL-6 and increased myocardial contents ofTNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 in both ischemic and non-ischemic regions in group I/R as compared with group S.Vagus nerve electric stimulation postconditioning,limb remote ischemic postconditioning and vagus nerve electric stimulation postconditioning + limb remote ischemic postconditioning significantly decreased myocardial infarct size and serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 and decreased myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 in groups POES,RP and POES-RP as compared with group I/R.Compared with group I/R,myocardial IL-10 content in both ischemic and non-ischemic regions was significantly increased in groups POES and POES-RP.Compmared with group POES,myocardial infarct size,serum concentrations of cTnI,CK-MB,TNF-α,ICAM-1 and myocardial contents of ICAM-1 and IL-6 in ischemic region were significantly decreased,while myocardial content of IL-10 in non-ischemic region was increased in group POES-RP.Compared with group RP,myocardial infarct size,serum concenuations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and myocardial contents of TNF-α,ICAM-1,IL-1 and IL-6 in ischemic region were significantly decreased,myocardial content of IL-10 in ischemic region was increased and HMGB1,ICAM-1,IL-1 and IL-6 contents were decreased,IL-10 content was increased in myocardial of ischemic region in group POES-RP.ConclusionMyocardial I/R injury is attenuated and myocardial protection is enhanced by combination of vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning in rats by inhibiting inflammatory response in rats.

This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with the dose-dense ABVD regimen (ABVD-21) in terms of efficacy and toxicity. Patients who had early-stage unfavorable or advanced Hodgkin's lymphoma (HL) according to German Hodgkin Study Group criteria from March 1999 to February 2011 were analyzed for treatment response, long-term survival and hematological toxicity. There were 85 patients in the ABVD-21 group and 118 patients in the ABVD group respectively. The complete remission rates after completion of treatment were 92.9% and 90.7% for ABVD-21 and ABVD, respectively. During a median follow-up period of 62 months, no significant difference was found in projected 10-year progression-free survival (PFS) and overall survival (OS) rates (84.7% and 94.1% respectively for ABVD-21; 81.4% and 91.5% for ABVD). Subgroup analyses showed that ABVD-21 was significantly better than ABVD for patients with IPS≥3 in terms of PFS and OS rates. Grade 3 to 4 leukopenia (51.8% vs. 28.8%, P=0.001) and neutropenia (57.6% vs. 39.0%, P=0.009) were more common with ABVD-21. We were led to conclude that dose-dense ABVD did not result in better tumor control and overall survival than did ABVD for early-stage unfavorable HL. However, patients at high risk, for example, with IPS≥3, may benefit from dose-dense ABVD.

6.24 mmol/L) and sixty healthy persons in the health center of our hospital were investigated as hyperhpidemia group (Hyperlipidemias) and control group (Controls) respectively.Hyperlipidemias were given simvastatin 20 mg?d~(-1) for twelve weeks (Statins).Blood samples of ulnar vein were extracted from Statins at the end of twelve weeks as well as Controls and Hyperhpidemias at the beginning of the experiment. Blood serum,plasma and mononuclearcell were extracted and stored at a refrigerator of-80℃.The level of plasma angiotensinⅡwas detected by the method of radioimmunity.While the expression of RANTES mRNA and protein on mononuclearcell were assessed by real time reverse transcription polymerse chain reaction and Western blot respectively.Results①The plasma angiotensinⅡof Hyperlipidemias was higher than that of Controls [(92.13?22.03) vs (50.85?12.12),P

Objective The localization of pulmonary nodules in surgery remains a clinical challenge .In this study we dis-cussed the diagnostic and treatment value of CT-guided coil localization followed by real-time digital subtraction angiography ( DSA)-guided accurate resection of solitary pulmonary nodules (SPN) with video-assisted thracoscopic surgery (VATS). Methods This study involved 82 cases of SPN treated in the Department of Cardiothoracic Surgery of Jinling Hospital from September 2011 to May 2014 .The SPNs were preoperatively positioned by placing a metal coil close to the lesion under CT guidance on the same day of surger -y.Then VATS wedge resection of the SPNs was performed under the guidance of real -time DSA and further procedures followed in ac-cordance with the results of intraoperative pathology . Results The success rate of coil localization was 100%, the mean time of po-sitioning was (15.3 ±3.2) min, and the mean time of VATS wedge resection was (24.2 ±12.1) min.Pathological results revealed 45 cases of malignancy and 37 cases of benign lesions . Conclusion Preoperative CT-guided coil localization of SPNs showed a high accuracy and no serious complications , and by real-time DSA-guided VATS that immediately followed , the nodules could be precisely removed with the cutting edge 2 cm above the lesion , which achieved both the purposes of diagnosis and treatment of SPNs .

Objective To explore the relationship between post-traumatic stress disorder (PTSD) and perceived social support (PSS)ability among middle school students in earthquake-stricken areas after the Wenchuan earthquake accident. Methods A total of 1966 students from three secondary schools of Wenchuan earthquake-stricken areas were evaluated by PTSD Checklist-Civilian Version (PCL-C) and Perceived Social Support Scale (PSSS). Results The overall incidence rate of PTSD was 78.3%, with severe PTSD as 24.38%. Significant differences on the incidence rates of PTSD were found among the students who were in different PSS levels (P<0.05) and significant negative correlation existed between the levels of severity on PTSD and PSS (γ=-0.226, P<0.05). Significant differences on PTSD incidence rates were found among those students who were from different families or out-family PSS levels (P=0.009, P<0.05). Significant negative correlation existed between the severity of PTSD and family or out-family PSS level (γ=-0.176, P<0.05, γ=-0.214, P<0.05). Conclusion Relationships between the incidence rate, severity of PTSD and PSS levels existed among the middle school students in Wenchuan earthquake-stricken areas, with higher PSS, lower incidence rate and lighter severity of PTSD. Psychological intervention for earthquake-stricken students should be carried out.