Objective To investigate the effects of ketamine preconditioning on the expression of induced nitric oxide synthase(iNOS)mRNA after myocardial ischemia-reperfusion injury induced by cardiopulmonary bypass(CPB)in patients with congenital heart disease(CHD).Methods Thirty-six patients with atrial or ventrieular septal defect were randomly allocated to 3 groups(n=12):control group and ketamine preconditioning group(K1 group,K2 group).Ketamine 0.5 mg/kg and 1.0 mg/kg,were injected at the time of sternum splitted,aorta intubated and before 5 minutes of aorta clamped off intravenously.Collected the myocardium at the time of superior vena cava intubated(T1),30 minutes after aorta clamped on(T2)and 30 minutes after aorta clamped off(T3).Detected the value of iNOS mRNA in myocardium by one-step real time fluorescence quantitative RT-PCR.Results The levels of iNOS mRNA were significantly increased at T2 and T3 as compared with T1 in the three groups,and were significantly lower both in K1 group(2.33±0.31,3.76±0.61)and K2 group(1.92±0.12,3.12±0.39)than those in control group(2.85±0.48,4.49±0.86)(P＜0.01 or ＜0.05).Furthermore,they were lower in K2 group than those in K1 group(P＜0.05).Conclusion Ketamine can significantly decrease iNOS mRNA in myocardium,and decrease the plasma marker of cardiac muscle injury,it shows dose dependent.

Objective To investignte the effects of ambroxol on lung injury in children undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Thirty-six ASA Ⅱ or Ⅲ children of both sexes aged≤8 yr,weighing≤25 kg undergoing repair of ventricular septal defect (VSD) under CPB were randomly divided into 3 groups (n=12 each):I control group (C);II low dose ambroxol group (2.25 mg/kg) (A,) and III moderate dose ambroxol group (4.50 mg/kg) (A2).Ambrexol was diluted with normal saline 10 ml and infused slowly after skin incision in group A1 and A2.In group C equal volume of normal saline(10 ml) was infused instead of ambroxol.Blood samples were taken from radial artery before skin incision,at 20 rain of CPB,20 rain after aortic unclamping,2 h and 6 h after temtination of CPB and 12 h after operation for determination of plasma MDA concentration and SOD activity and blood gas analysis.Respiratory index (RI) and pulmonary compliance (CL)were calculated.Results The plasma MDA concentration and RI were significantly lower while plasma SOD activity was significantly higher in group A2 than in group C and A1·CL was significantly higher in group A2 than in group C.Conclusion Ambroxol 4.50 mg/kg can attenuate lung injury in children undergoing cardiac surgery with CPB by decreasing lipid peroxidation.

Objective:To investigate whether ghrelin, a novel endogenous ligand of growth hormone secretagogue receptor ( GHS-R) , was expressed in the thyroid tissues of different thyroid diseases, and its implication. Methods:The paraffin-embedded specimens of thyroid tissues from 2000 to 2004 were obtained from 57 patients with different thyroid diseases, including 5 subacute thyroiditis, 8 Hashimoto' s thyroiditis, 7 hyperthyroidism (Graves disease) , 8 nodular goiter, 5 thyroid adenoma, 3 thyroid lympho-ma, 8 papillary carcinoma, 3 follicular carcinoma, 5 medullary carcinoma and 5 undifferentiated carcinoma cases. The specimens of normal peri-adenoma thyroid tissues served as controls. Immunohistochemi-cal staining was used to detect ghrelin expression. Results:(1) ghrelin expression was undetectable in the thyroid tissues of normal control, subacute thyroiditis, Hashimoto' s thyroiditis and Graves disease. (2) ghrelin expression was also undetected in the tissues of nodular goiter, thyroid adenoma and thyroid lymphoma. (3 ) ghrelin-positive staining was found in the tumor cells of different types of thyroid carcin-moma. Five cases were positive within 8 cases in papillary carcinoma, 2 cases were positive within 3 cases in follicular carcinoma, 3 cases were positive within 5 cases in medullary carcinoma, 3 cases were positive within 5 cases in undifferentiated carcinoma. Conclusion:Ghrelin is expressed in malignant epithelial thyroid neoplasmas, but not in autoimmune or inflammatory thyroid diseases and benign nodular thyroid diseases. The results indicate that ghrelin expression may play an important role in the occurrence and development of thyroid carcinoma.

Objective To observe the therapeutic efficacy of needling QIN's eight head acupoints in treating insomnia.Method Sixty patients were randomized into QIN's eight head acupoints group (30 cases) and a conventional acupuncture group (30 cases). The modified Spiegel sleep questionnaire was evaluated respectively after 4-week and 8-week treatment.Result After 4-week treatment, there was a significant difference in comparing the modified Spiegel sleep questionnaire between the two groups (P<0.05), and QIN's eight head acupoints group was superior to the conventional acupuncture group; after 8-week treatment, there was no significant difference between the two groups in comparing the modified Spiegel sleep questionnaire (P>0.05).Conclusion QIN's eight head acupoints group had a more significant therapeutic efficacy compared to conventional acupuncture group after 4-week treatment.

Objective To observe the effect of topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection. Methods 100 patients with fractured bones suffered from phlebitis caused by mannitol injection were randomized into the observation group and the control group with 50 cases in each group. The observation group adopted topical application with warm and wet carthamus tinctorius alcohol and anisodaminum while the control received external application of 50% magnesium sulfate. The dosage was 3 hours per time,2 times a day, one time in the morning and afternoon respectively. The treatment continued till the phlebitis disappeared and the effect at the 24th,48th and 72th post treatment was compared between the two groups. Results The effect at the above mentioned time points in the obsevation group was superior to that of the control group(P＜0.05).Conclusion Topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection proved to be safe and had no adverse effect.

Objective: To investigate the clinical efficacy of combined acupuncture and herbal medicine based on Prof. QIN Liang-fu's experience in treating chronic gastritis. Methods: Ninety chronic gastritis patients were randomly divided into acupuncture, herbal medicine and acupuncture plus herbal medicine groups. The clinical effects were evaluated after 6 months. Results: After 6months, the clinical effect was better in the acupuncture plus herbal medicine group than in the acupuncture group and in the herbal medicine group(P＜ 0.05). Conclusion:The curative effect on chronic gastritis was better in the acupuncture plus herbal medicine group than in the acupuncture group and in the herbal medicine group.

Objective To evaluate the effects of dexmedetomidine on lung ischemia-reperfusion (I/R) injury in rats.Methods Ninety-six healthy SPF male Wistar rats,weighing 250-350 g,aged 8-12 weeks,were randomly divided into 4 groups (n =24 each):sham operation group (S group),I/R group,low dose dexmedetomidine group (DL group) and high dose dexmedetomidine group (DH group).In DL and DH groups,dexmedetomidine 100 and 500 μg· kg-1 · d-1 were injected intraperitoneally once a day for 2 consecutive days,while the equal volume of normal saline was given in S and I/R groups.Lung·I/R was induced by clamping the left hilum of lung for 45 min followed by reperfusion at 30 min after administration on 2nd day.At 45 min of ischemia,and 60 and 120 min of reperfusion,6 rats were sacrificed,and lungswere removed for determination of TNF-α (tumor necrosis factor-a) content and myeloperoxidase (MPO) activity in lung tissues.The percentage of damaged alveolar in lung tissues was detected at 120 min of reperfusion.Another 6 rats were lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of the total protein concentrations.Results Compared with S group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly increased in I/R,DL and DH groups.Compared with I/R group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly decreased in DL and DH groups.Conclusion Dexmedetomidine can alleviate the lung I/R injury in rats,and the mechanism is related to inhibiton of the inflammatory responses.

AIM:To examine the role and dynamic changes of mast cell(MC) and its subpopulations in simple and irradiated-wound of rats.METHODS:MC and its subpopulations were estimated using alcian blue-safranin (ABS)double staining RESULTS:(1)The total number of MC in two groups decreased coincidently on day 2 after wounding, and the total MC increased rapidly and reached maximal gradually on day 5 and 7 after wounding, the increment of MC remained consistently 28 day after wounding (2)Both mucosal MC( MMC) and Mix MC decreased obviously on day 2 after wounding, hereafter,they remained the low level all the time However, the CTMC kept in the high level after wounding (3)The Mix MC on day 5 and the total MC during day 5-15 after wounding were lower in irradiated group than in simple wound group CONCLUSION: MC and its subpopulations could delay the healing process of simple and irradiated wound

Objective To evaluate the value of transvaginal color Doppler sonography(TVCD)in the conservative treatment of early tubal pregnancy(TP).Methods Fifty cases of early TP were examined by TVCD before medical treatment,including the size of TP mass,blood flows graded according to Alder,hemodynamics parameters.All data were ananlized and compared with therapeutic results.Results Fortyfive cases were treated successfully(45/50),and 5 failed.According to TVCD,TP masses flow were graded from O to Ⅲ.In the successful group,4 cases were graded 0,21 Ⅰ,16 Ⅱ and 4Ⅲ,blood flow signals were measured in 41 cases,the mean velocity was(5.452±4.327)cm/s,PI(1.597±0.696),RI 0.680±0.107.In the failure group,all TP masses flow were graded Ⅲ,the mean velocity was(16.774±9.855)cm/s,PI 0.95 1±0.193,RI 0.567±0.034.Conclusions In the medical treatment of early TP,TVCD findings associated with the treatment outcome closely,it plays an important role in assessing conservative treatment of early TP.

Objective To study the changes and management of systemic and pulmonary hemodynamics during anhepatic period in patients undergoing orthotopic liver transplantation without veno-venous bypass.Methods Sixty-eight patients with end-stage liver disease undergoing orthotopic liver transplantation were enrolled in this research. Monitoring and recoding CVP, MAP, CI, HR, MPAP, PAWP PVR, SVR at different time points: preincision, before anhepatic, 5, 30 min of anhepatic, 5, 30, 60 min of neohepatic,ending of operation, 12 h and 24 h after operation. All the patients were divided into three groups according CVP during anhepatic period: group A(CVP <4 mmHg) ,group B(4 mm Hg≤CVP≤6 mmHg) ,group C (CVP>6 mmHg). Besides, calculating the concentration of dopamine, norepinephrine ,epinephrine and the volume of urine during of operation. Results There were different changes during different operation periods. During anhepatic period, HR, PVR and SVR increased, while CVP, CI, MAP, PAP, PAWP decreased(P<0.05). At early neohepatic period, HR decreased and CVP,PAWP, MPAP,CI,PVR SVR increased ,At the beginning of neohepatic period, MAP dacreased or increased quickly, and became steadily after 5 min. Among the three groups, the changes of hemodynamics in group B was slightest,and the concentration of dopamine, norepinephrine and epinephrine was smallest (P< 0.05 ). Conclusions The systemic and pulmonary emodynamics fluctuated sharply during anhepatic and early neohepatic period. It is important and useful to manage CVP 4 -6 mmHg, MABP ≥ 60 mmHg by infusing liquid and vasoconstrictors,such as dopamine, norepinephrine or epinephrine during anhepatic period.