Objective To investigate the effects of controlled hypotension induced with sodium nitroprusside (SNP) or nicardipine on hemodynamics during hip operation and postoperative hepatic and renal function.Methods Twenty ASA Ⅰ or Ⅱ patients aged 20-70 yrs weighing 50-80 kg scheduled for total hip replacement or open reduction and internal fixation of fracture of acetabulum were randomized to receive either SNP (group Ⅰ ) or nicardipine (group Ⅱ ) for induced hypotension during operation. Each group included 10 patients. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. The probe of Hemo-Sonic ?100 esophageal supersonic hemodynamic monitor (Arrow U.S.A) was placed in the esophagus and fixed when best signal was obtained. ECG, hemodynamics including MAP, HR, CVP, CO and other parameters, SpO2 and PetCO2 were continuously monitored. Anesthesia was induced with propofol 2 mg?kg-1 , fentanyl 2-3 ?g? kg-1 and vecuronium 0.1 mg?kg-1 and maintained with 1.5% isoflurane and continuous infusion of propofol ( at 4-6 mg?kg-1 ?h-1 ) and intermittent i.v. boluses of vecuronium after tracheal intubation. MAP was reduced to 55-65 mm Hg with SNP (at a rate of 0.5-8.0 ?g?kg-1?min-1 ) or nicardipine (at 1.0-8.0 ?g?kg-1 ?min-1 ) . Intraoperative blood loss and blood transfusion and postoperative drainage from the wound were measured and recorded.Hemodynamic parameters were recorded before hypotension and 15, 30 and 60 min after start of induced hypotension and 15 and 30 min after recovery from hypotension. Hepatic and renal functions were measured before and after operation using total bilirubin, AST, ALT, BUN and creatinine. Results The two groups were comparable with respect to sex ratio (M/F) , age, height, body weight, duration of induced hypotension and operation. MAP and systemic vascular resistance (SVR) were significantly reduced and tachycardia developed during hypotension in both groups. The left ventricular ejection time was significantly prolonged and aortic blood flow (ABF) and cardiac output (CO) were significantly increased and CVP was lowered during hypotension as compared to the baseline values in SNP group. BUN was significantly reduced after operation ( P

Objective: To observe the clinical effects of moxibustion at abdominal acupoints for slow transit constipation (STC) due to yang deficiency of the spleen and kidney. Methods: A total of 52 cases with slow transit constipation in conformity with the inclusion criteria were selected and divided into a control group and an observation group according to their visit order and random digital table, 26 cases in each group. Patients in the control group received routine nursing guide. Besides the same routine nursing guide, patients in the observation group received moxibustion at the abdominal acupoints, once every day. The course of the treatment was 4 weeks in the two groups, and the 3-month follow-up was given after the course was finished, for comparing the clinical symptoms, results of colon transit tests, scores of depression/anxiety scale and nursing satisfaction. Results: The total effective rate was 92.3% in the observation group and 69.2% in the control group, with a significant difference between the two groups. After the treatment and during the follow-up checks, the scores of Chinese medical symptoms in the two groups were remarkably decreased than those before the treatment (all P<0.01); the scores of the observation group were obviously lower than those in the control group (all P<0.01). The discharge rates of the markers in the two groups were remarkably increased than those at the same time period before the treatment; moreover, the discharge rates of the markers at various time periods were remarkably better in the observation group than those in the control group (P<0.01). SDS and SAS scores were remarkably decreased after the treatment in the two groups (P<0.01). In comparison of SDS score between the two groups after the treatment, the difference was statistically significant (P<0.01). In comparison of SAS score between the two groups after the treatment, the difference was statistically significant (P<0.05). The nursing satisfaction was 96.2% in the observation group after the treatment, obviously better than that in the control group (73.1%). The recurrence rate was 8.3% in the observation group, remarkably lower than that in the control group (33.3%). Conclusion: Moxibustion at the abdominal acupoints plus routine nursing can remarkably improve the colon transit functions and anxious and depressive emotion in patients with STC, and the therapeutic effects are remarkable. Not only the clinical satisfaction is higher, but the recurrence rate is obviously lower than that of routine nursing.

Berberine is an isoquinoline alkaloid isolated from Rhizoma Coptidis and Cortex Phellodendri,which has a long medical history in China.Recent studies have indicated that berberine has multiple pharmacological activities including anti-inflammatory,anti-microorganisms,anti-cancer,cardiac protection,glucose lowering,regulating lipid metabolism and immune suppression.Berberine has been used for the treatment of intestinal infectious diseases for many years.With the continuous progress of the research,it is reported that berberine has many new clinical applications,including treatment of the cardiovascular disease,metabolic syndrome and its complications,cancers,abdominal adhesions and chlamydia trachomatis infection.This review is intended to introduce the role of berberine in various aspects of pharmacological effects,molecular mechanisms and clinical applications.

Objective To analyse the long-term result and prognosis of 18 FDG PET/CT positioning three - dimensional conformal radiotherapy ( 3 DCRT ) for stage Ⅲ non - small cell lung cancer. Methods Sixty-four cases with stage Ⅲ non-small cell lung cancer (clinical stage Ⅲa- Ⅲb ) were randomly divided into two groups: PET/CT positioning three-dimensional conformal radiotherapy group (PET/CT group) and the conventional CT positioning three-dimensional conformal radiotherapy group (conventional CT group). In the PET/CT group, the target volume and critical organs were sketched according to PET/CT after fusion of the PET and the CT images; the treatment plan was worked out, then conventional fractionated 3DCRT ( total dosage around 40 Gy) followed by field-shrinked radiotherapy to a total dose of 65 Gy or sowas performed ;in the conventional CT group, the target volume and critical organs were sketched according to CT and 3DCRT were performed to the same total dose; All cases were treated with the TP scheme (paclitaxel 175 mg/m2,d1 ,cisplatin 40 mg,d2-4) adjuvant chemotherapy for 6 cycles after the radiotherapy. Results The followup rate was 100%. The number of patients who completed the 1-,2-and 5-year follow-up were 40,20 and 11 respectively ;The number of patients of the PET/CT group and conventional CT group were 23 and 17,11 and 9,7 and 4 respectively. Target volumes of 13 cases in the PET/CT group were changed. The complete remission and partial remission rates of the two groups were 13% 、66% and 19% 、53% (x2 = 0. 33, P =0. 564), respectively. The 1-,2-and 3-year local control rates of the PET/CT group and conventional CT group were84 % 、66% 、53 % an d72% 、59% 、44% ( x2 = 2.36, P = 0. 124 ) respectively. The1 -, 2-and 3-year survival rates were 72% 、34% 、22% and 53% 、28% 、13% (x2 =2. 46,P =0. 117) respectively. The level-1 and level-2 lungs' and trachea's late radiation injury of the PET/CT group and the conventional CT group were 28% and 53% ( x2 = 4. 14, P = 0. 042 ), respectively. The hilar and mediastinal lymph node recurrence rates of the PET/CT group were lower than those of the conventional CT group, were 3% ,25%(P = 0. 026) and 6%, 28% ( P = 0. 042 ), respectively. The main reason for treatment failure was distant metastasis both in the PET/CT group and conventional CT group,56% and 47% (x2 = 0. 56,P = 0. 453 ),respectively. Conclusions PET/CT, as a method of sketching the target of stage Ⅲ non-small cell lung cancer, can improve the radiation treatment plan, reduce the recurrence rate of hilar and mediastinal lymph nodes, meanwhile it can not improve the long-term survival rate; Distant metastasis was the main reason of failure.

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI).Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016.The patients were divided into two groups according to the prolongation of R time at admission,and the basic data and the outcomes were analyzed.Results In basic data,Glasgow coma scale (GCS) [(9.7 ± 4.4) scores vs (12.1 ± 2.2) scores] was lower,and injury severity score (ISS) [(32.4 ± 8.9) scores vs (21.7 ± 10.4) scores],head abbreviated injury scale (AIS) [(5.0 ±0.0) scores vs (4.1 ± 1.5) scores],hemorrhage volume [(6.2 ± 5.5) ml vs (1.1 ± 1.8) ml] and mean arterial pressure[(127.2 ± 28.1) mmHg vs (103.3 ± 17.0) mmHg] were higher in the prolonged R time group.In outcomes,the in-hospital mortality (42.9％ vs 17.2％) and the rate of neurosurgical intervention (71.4％ vs 37.7％) were higher,and the duration of mechanically ventilated [(9.3 ±3.2) d vs (4.1 ± 1.7) d],ICU stay [(10.2 ± 4.4) d vs (5.6 ± 2.1) d] and hospital stay [(22.4 ± 8.1) d vs (8.3 ± 4.7) d] were longer in prolonged R time group.The Logistic regression analysis results showed that GCS ≤8 scores,ISS ＞ 25 scores and R time ＞ 10 min were the possible risk factors of hospital mortality.Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality,and the prediction efficiency of R time need to be explored and validated by more research.

AIM:To select an optiomal formulation of liposome entrapped alkanin prepared with ethanol injection in the combination of orthogonal design and central composite design/Response surface method.METHODS:Five influencing factors,including ratio of alkanin to liposome and soyabean lecithin to cholesterol,volume ratio of ethanol phase to water phase,soybean concentration and mannitol concentration were chosen as indices by orthogonal design.Then the method utilized the central composite design,which fitted multivariate linear and second/third order nonlinear regression equation,to find out the optimal formulation.RESULTS:Third order regression equation gained made the good prediction about entrapment(85.4%)and alkanin load(5.16%),and exhibited no significant difference between theoretic value and measured value.CONCLUSION:The combination of orthogonal design with central composite design is a feasible and convenient method to optimize the prescription of alkanin-liposome.

Objective To observe the clinical effects of ambroxol on acute stroke-associated pneumonia (SAP).Methods From July 2011 to December 2012,a total of 82 patients with strokeassociated pneumonia (SAP) admitted to our hospital were selected and randomly divided into ambroxol group (n=43,treated with ambroxol in combination with antibiotic therapy) and control group (n =39,treated with antibiotic therapy).The defervescence time,hospitalization time,antibiotic use time,C-reactive protein level,blood oxygen partial pressure,bacterial clearance rate and the total effective rate were compared between the two groups.Results The defervescence time,hospitalization time,antibiotic use time were shorter in ambroxol group than in control group [(3.1 ± 0.8)d vs.(3.8±1.1)d,(11.7±3.7)d vs.(13.6±4.9)d,(5.4±1.7)dvs.(6.6±2.1)d,t=18.60,22.80,23.50,P=0.014,0.008,0.011,repectively].Bacterial clearance rate and the total effective rate were higher in ambroxol group than in control group [90.7％ vs.74.4％,93.0％ vs.74.4％,x2 =3.86,5.34,P=0.05,0.02].There were no significant differences in changes of C-reactive protein level and blood oxygen partial pressure between two groups before and after treatment (all P＞0.05).Conclusions Ambroxol is an effective treatment for acute stroke associated pneumonia,which can shorten antibiotic use time and duration of symptoms and remove bacteria effectively.

AIM:To select an optiomal formulation of liposome entrapped alkanin prepared with ethanol injection in the combination of orthogonal design and central composite design/Response surface method.METHODS:Five influencing factors,including ratio of alkanin to liposome and soyabean lecithin to cholesterol,volume ratio of ethanol phase to water phase,soybean concentration and mannitol concentration were chosen as indices by orthogonal design.Then the method utilized the central composite design,which fitted multivariate linear and second/third order nonlinear regression equation,to find out the optimal formulation.RESULTS:Third order regression equation gained made the good prediction about entrapment(85.4%) and alkanin load(5.16%),and exhibited no significant difference between theoretic value and measured value.CONCLUSION:The combination of orthogonal design with central composite design is a feasible and convenient method to optimize the prescription of alkanin-lipo-some.

Cell viability of Pichia pastoris was detected by flow cytometry (FCM) with two reagents fluorescein diacetate (FDA) and propidium iodide (PI). Compared with FDA/PI double-stained dot plots and PI single-stained dot plots,the latter could divide dead and living cells into two separate zones,and get the correct proportion. Then PI single-stained method was used to detect the change of cell viability in Pichia patoris fermentation. At glycerol batch and fed-batch phase,little dead cells were detected. At methanol fed-batch phase,cell viability decreased when cell weight increased,and was only 73.8% at 88 h.

Proteolytic degradation has been a severe problem when Pichia pastoris is employed to express recombinant proteins.One alternative method to circumvent this problem is to construct protease gene disruptant.However,the main study of gene disruption is focused on nonrecombinant Pichia pastoris rather than recombinant strain.In our study,we established two different methods to directly disrupt PRC1 and KEX1 gene in recombinant Pichia pastoris.On the basis of this,we further discussed and compared the application and advantages of both methods.