Objective To investigate the protective effect of N-acetylcysteine(NAC) on the development of myocardial hypertrophy in diabetic rats induced by streptozotocin. Methods Male SD rats were randomly divided into normal control (NC), control treatment (NCT), diabetic (DM) and diabetes treatment (DMT) groups. NAC was administered at dose of 1.4～1.5g·kg~(-1)·d~(-1) to NCT and DMT groups in the drinking water for 8 weeks. At termination the rats were surgically prepared for hemodynamic measurement, such as systolic blood pressure, heart rate, the rate of left ventricle relaxation (-dp/dt) and the time to maximum relaxation (T). Subsequently, the hearts were removed to assay relative ratio of left ventricle weight versus body weight (LVW/BW) and cardiomyocyte cross sectional areas.Plasma glucose, insulin, 15-F_(2t)-isoprostane(15-F_(2t)-Isop) concentration and superoxide dismutase (SOD) activity were analyzed. Results The LVW/BW ratio and cardiomyocyte areas were significantly attenuated by NAC treatment as compared to DM group (P＜ 0.05). Increases in -dp/dt and SOD activity and the decreases in glucose, 15-F_(2t)-Isop T (P＜ 0.05) were found at the same time. Conclusions NAC can effectively prevent the development of myocardial hypertrophy and improve diastolic function in diabetic rats, which may be related to its antioxidant capacity.

Objective To compare the characteristics of digital subtraction angiography ( DSA) and compu-ted tomography angiography ( CTA) of moyamoya disease .Methods To analyze the characteristic of DSA and CTA in 29 cases with moyamoya disease ,including arterial occlusion ,arteriarctia,abnormal proliferation of vascular ,collat-eral circulation.Results There were no statistically significant differences between DSA and CTA in detecting arteri-al occlusion,arteriarctia(CTA 53 hemicerebrum,DSA 57 hemicerebrum)(χ2 =2.167,P>0.05),abnormal prolifera-tion of vascular (abnormal:CTA 41 hemicerebrum,DSA 45 hemicerebrum;normal:CTA 16 hemicerebrum,DSA 12 hemicerebrum)(χ2 =0.757,P>0.05).But there was statistically significant difference between DSA and CTA in detecting collateral circulation .Conclusion CTA is a good method to find out moyamoya disease .But DSA is better in discovery collateral circulation of moyamoya disease .

The medication characteristics of doctor ZHENG Chong-guang in Qing Dynasty was studied from prescription metrology range index,including properties,tastes,channel tropism and function index.It was found that his clinic prescription practice was different from other doctors in Jiangzhe province which originated from his territory character,the territory character of Xin'an school was disclosed,it was suggested that prescription metrology range index was an valuable impersonal index for doctor's territory character.

Objective To study the levels of serum C -reactive protein (CRP),plasma fibrinogen (Fib),D-dimmer(DD)in the first onset young patients with acute progressive cerebral infarction.Methods 42 first onset young patients with acute progressive cerebral infarction(PIS group),50 cases of non -acute progressive cerebral infarction(N -PIS group)and 90 healthy people(health control group)were enrolled.The levels of serum CRP, plasma Fib and DD were detected and compared.Results PIS group:CRP (3.764 ±0.832)mg /L,Fib (3.994 ± 0.851)g/L,DD (1.560 ±0.225)μg/mL;N -PIS group:CRP (2.573 ±0.657)mg/L,Fib (2.468 ±0.739)g/L, DD (0.740 ±0.162)μg/mL;health control group:CRP (1.725 ±0.326)mg/L,Fib (2.103 ±0.584)g/L,DD (0.450 ±0.131)μg/mL.The levels of serum CRP,plasma Fib and DD of PIS group were higher than the other two groups(CRP:PIS group vs.N -PIS group t =8.89,PIS group vs.health control group t =13.99,N -PIS vs.health control group t =8.55,all P <0.01;D -D:PIS group vs.N -PIS group t =23.82,PIS group vs.health control group t =29.46,N -PIS group vs.health control group t =12.59,all P <0.01;FIB:N -PIS group vs.health control group t =2.85,P <0.05,PIS group vs.N -PIS group t =10.06,PIS group vs.health control group t =13.48,all P <0.01).Conclusion The levels of serum CRP,plasma Fib and DD are related to acute progressive cerebral infarction.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

Objective To explore the therapeutic effect of choledochojejunostomy with a subcutaneous blind loop of interposed jejunum for treating postoperative residual biliary stones.Methods The clinical data of 72 cases of choledochojejunostomy with subcutataneous blind loop of interposed jejunum were retrospectively analysed.Results After exploration of distal common bole duct,and when a No.8-10 bougie could pass through the sphincter of Oddi,a 10-15 cm segment of jejunum with its vascular pedicle was mobilized,and an end to-side choledochojejunal anastomosis was performed at the proximal side of the jejunal segment and its distal end was converted to a blind loop and fixed subcutaneously to relevant abdominal wall.A T-tube for external drainage was inserted across the choledochojejunal anastomosis and exited through the blind jejunal loop.Seventy-two patients were cured without any complication or mortality.Conclusions The procedure is simple and minimally invasive,so that it could be carried out very easily and quickly by general surgeons with basic choledochojejunostomy skill.

Objectives To evaluate the valproate plasma l ev els,the clinical efficacy and adverse effects in patients with epilepsy treated with the conventional preparations and the sustained-release preparations of sodium valproate (VPA-Na?SR).Methods 33 patients received oral conventional formul ation of sodium valproate for over six months and a similar dosage of VPA-Na?SR for 4 weeks.After 12 or 24 hours,the valproate plasma concentr ations of the two formulations were measured respectively before taking drugs in the early mor ning.The valproate plasma concentrations and the clinical efficacy of the VPA-N a?SR were assessed by comparing with that of conventional valproate.The adverse effects were recorded.Results The average valproate plasma trough concentration was s ignificantly higher in patients receiving VPA-Na?SR than that of those receiving conventional valproate.Seizure free in patients was achi eved by 76%(n=25) with VPA-Na?SR and by 45%(n=15) with conventional valproate resp ectively.There was statistical difference between the two formulations.The seizu re frequency was significantly reduced in 5 patients treated with VPA-Na?SR.A dverse ef fects were observed in 2 patients with conventional valproate,5 patients with V PA-Na?SR whose valproate plasma levels were higher than that of conventional p reparations.Adverse effects were related to increased valproate plasm a levels and individual drugtolerance. Conclusions The advantage of VPA-Na?SR is that serum valproa te con centrations may increase smoothly and minimize fluctuation in serum dr ug concentrations during a dosing interval. It is a more effective and more convenient antiepileptic agent.

BACKGROUND: Reperfusion injury and inadequate perfusion exist,causing the injury of intestinal mucosa during shock / resuscitation.OBJECTIVE: To investigate protective effect of shenfu injection (SFI) in equal dosage for human effect on intestinal mucosal pH (PHi) of sigmoid colon, the contents of nitric oxide (NO), malonialdehyde(MDA) and Ca2+ of intestinal mucosa, activity of serum diamine oxidase(DAO of rabbits during shock/resuscitation.DESIGN:A randomized controlled trial with experimental animals as the subjects.SETTING: DepartmentofAnesthesiology, Renmin Hospital of Wuhan University MATERIALS: The experiment was performed in the Research Institute of Anesthesiology, Renmin Hospital of Wuhan University from August to October in 2003. Twenty-four adult healthy white rabbits were randomly divided into 3 groups with 8 animals for each: Shenfu injection group (SFI group), shock/resuscitation group and control group .INTERVENTIONS: Hemorrhagic shock was induced by blood withdrawal from femoral artery at a rate of 2 mL/kg per minute until MAP dropped to 40 mmHg. MAP was maintained at this level for 60 minutes,then the collected auto-blood and the same volume of balanced salt solution was transfused to the animal for preparing shock/resuscitation model. In SFI group: the animals were given 2.1 mL/kg SFI together with the auto-blood transfusion and followed by a continuous infusion of 5mL/kg SFI per hour.MAIN OUTCOME MEASURES: Intestinal mucosal pH (PHi) of sigmoid colon, NO, MDA and Ca2+ contents of intestinal mucosa, activity of serum DAO were detected before shock (So), 1 hour after shock (S1), 1 hour (R1) and 3 hour (R3) following resuscitation.the R1 reperfusion (7.171±0.102) , and R3 reperfusion (7.194±0.106) of the SFI group were higher than those of the shock/ resuscitation group (6.920±0.155,6.971±0.165,P ＜ 0.05,P ＜ 0.01) and those of the contents of the reperfusion R1 (35.090±1.184) μkat/L and R3 (32.440±2.884) μkat/L of the SFI groups were significantly higher than those of the shock/resuscitation group [(50.994±2.684),(52.377±1.217) μkat/L,P＜ 0.01] and of the control group [(15.970±1.734), (16.620±0.767)μkat/L,Pgroup were significantly lower than those in the shock/resuscitation group [ (61.8±5.3,72.2±5.8 ) μmol/g , (68.2±4.9,96.9±8.5) μmol/L ,P＜ 0.05]. Ca2+ content of intestinal mucosa at reperfusion 3 hours in the SFI group [(2.43±0.27)μmol/L] was lower than that in the shock/resuscitation group [(2.93±0.34)μmol/L,P ＜ 0.05] and higher than that in the control group [(2.26±0.31 )μmol/L, (P ＜ 0.05)].CONCLUSION: SFI in equal dosage for human effect could protect intestinal mucosa from shock/resuscitation injury through improving perfusion and oxygenation, inhibit the activity of NO, reduce oxygen free radical and calcium overload, with a good protective effect on intestinal mucosa during shock/resuscitation.

Objective To evaluate the value of HbA2 level determined by capillary electrophoresis (Hb-CE)in screening and diagnosis of thalassemia.Methods HbA2 level of 249 thalassaemia carriers and 142 healthy controls confirmed by molecular biological detection were determined by Hb-CE method.The thalassaemia carrier subjects were divided into different groups and subgroups according to their results of gene detection.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value for the diagnosis ofα-thalassemia,β-thalassaemia,α,β-thalassaemia were calculated under different HbA2 cut-off value.Results Mean value of HbA2 in healthy controls was (3.03±0.27)%.Mean values of HbA2 inα-thalassemia group and its subgroups of silentα-thalassemia,standardα-thalassemia and hemoglobin H disease were (2.38± 0.55)%,(2.61±0.46)%,(2.47 ± 0.32)% and (1.07 ± 0.17)%,respectively.Mean values of HbA2 inβ-thalassaemia group and itsβ0 subgroup,β+ subgroup were (5.65±0.47)%,(5.71±0.48)% and (5.56±0.43)%.Mean value of HbA2 in compoundαandβ-thalassaemia group was (5.7±0.82)%.Compared with healthy controls,HbA2 level inα-thalassemia group,silentα-thalassemia subgroup,standardα-thalassemia subgroup and hemoglobin H disease group decreased signifi-cantly (t values of 11.73,5.02,12.91 and 33.46,respectively,P<0.01).HbA2 level in hemaglobin H disease was signifi-cantly lower than silent and standardα-thalassemia subgroups (t values of 15.62 and 21.31,respectively,P<0.01),but there were no differences in HbA2 level between silent and standardα-thalassemia subgroups (t=1.50,P>0.05).HbA2 level inβ-thalassaemia group,β0 subgroup,β+ subgroup and compoundαandβ-thalassaemia group increased significantly (t values of 55.12,44.33,38.94 and 9.10,respectively,P<0.01),but there were no differences in HbA2 level betweenβ0 andβ+ subgroups (t=1.79,P>0.05).Of 249 thalassemia carriers,all 124β-thalassaemia carriers were distinguished with ele-vated HbA2 level (>3.5%)determined by Hb-CE and only 57 were distinguished from 117α-thalassemia carriers by Hb-CE.Under the cut-off value of 2.5%,the sensitivity,specificity,positive predictive value,negative predictive value and accu-racy for the diagnosis ofα-thalassemia were 48.72%,97.18%,93.44%,69.70%,75.29%,respectively.Under the cut-off value of 3.5%,they were 100.00%,98.59%,98.41%,100%,and 99.25% for the diagnosis ofβ-thalassaemia,respectively. The analysis of ROC curve showed that the optimal HbA2 cut-off values for diagnosis ofα,β-thalassaemia by capillary elec-trophoresis were 2.8% and 3.7%,respectively.Conclusion When no abnormal bands,the elevated HbA2 (>3.7% in this study)determined by Hb-CE could be used as a marker forβ-thalassaemia diagnosis,but theβ-thalassaemia co-existingα-thalassemia could not be differentiated fromβ-thalassaemia diagnosis.Decreased HbA2 level (<1.5% in this study)and HbH band could be used for the diagnosis of hemoglobin H disease.Only HbA2 determination by Hb-CE has no clinical sig-nificance for the screen and diagnosis ofα-thalassemia.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.